Implementation of the Duties and Powers of the National Preventive Mechanism in 2012 At the time of the visit to Lucija Centre, 163 residents were accommodated there. The capacity of the high level supervision ward is 39 places, and during the visit all beds were occupied. After an interview with the Centre’s management and after the inspection, it was established by the NPM that the high level supervision ward corresponds to the secure ward as stipulated by Article 2, item 17 of the Mental Health Act. Specifically, there are persons (residents) accommodated in the unit who, on the grounds of their needs, must be given constant protection and safe care and cannot leave the facility of their own will. When commencing its operation, the Centre informed the court of the first referrals and accommodations to the current high level supervision ward (then called “secure ward”) and the court then conducted the proceedings regarding the admission to the secure ward and allowed the detention (for one year) of such residents to the secure ward by means of a court order. Since the court ordered the Centre to pay the costs of proceedings (the payment of an advocate of the opposing party and the costs of the court expert), and the Centre did not appeal against the court order on the calculation of costs, it was decided by Lucija Centre to transform the secure ward into the high level supervision ward and then it stopped informing the court on subsequent admissions. The question by the NPM, as to in what manner the transformation changed the treatment of persons in this unit and their protection, was explained in that the method of protection and treatment remained the same. It is emphasized by the NPM that the freedom of movement and liberty is limited to those residents who cannot leave Lucija Centre of their free will since their departure is prevented at the exit of the Centre. As a result, it was proposed that in such cases Lucija Centre should proceed in accordance with the provisions of the Mental Health Act, and if the court again imposes the payment of the costs of the proceedings, it should file an appeal against the decision(s), and separately inform the NPM about it. In its response report, when referring to procedures for the admission of patients in the secure ward, the Centre made a reference to the Guidelines for Work with Persons Suffering from Dementia in the Field of Institutional Care of the Elderly of 6 June 2011, issued by the Ministry of Labour, Family and Social Affairs. The said Guidelines state that “if an operator decides to choose the high level supervision ward, the same staffing, technical and spatial conditions must be provided as for the secure ward, but a verification is not needed and the procedure involving the admission is not conducted according to the procedure involving involuntary admission in accordance with the ZDZdr. Neither are there any differences between the secure ward and the high level supervision ward as regards the methods and techniques of work with residents suffering from dementia.” Lucija Centre also communicated that in case of any statutory modification such modification would be fully taken into account. The Ombudsman assessed that the part of the Guidelines referring to the high level supervision wards are contrary to the ZDZdr, and requested from the responsible Ministry that it adopt the necessary measures. The conduct of the social care institutions that follow the Guidelines in this part is, therefore, contrary to the applicable arrangement, in the NPM’s opinion. By means of a letter no. 070-18/2011/6 of 12 July 2012, the Ministry assured the NPM that the guidelines would be modified so that high level supervision wards would remain no longer in the guidelines. At the same time, a more detailed concept of treatment of dementia sufferers outside secure wards would be given, where no limitations of freedom should be used, neither by means of technical restraints or any other restraints (more on this topic in the Annual Report of the Human Rights Ombudsman for 2012, in the chapter Limitation of Personal Liberty – Guidelines for Work with Persons Suffering from Dementia in the Field of Institutional Care for the Elderly). National Preventive Mechanism in the Republic of Slovenia under the Optional Protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 83