ANNUAL REPORT OF NPM 2019 _______________________________________________________________________________________ Patients' food is another aspect of their living conditions that is of particular importance to the CPT. Food should not only be adequate in terms of quantity and quality but also given in satisfactory conditions 100. The NPM has observed that staff prepared the food at each CBH. NPM has not received any complaints regarding the quality and quantity of food. Physical ill-treatment and incidents between residents The NPM has not observed any indication that physical ill-treatment is exercised by the staff in the homes visited. On the contrary, in all the homes that were visited, the NPM noted the staff’s commitment to treat residents humanely. Furthermore, good communication between residents and staff was noted. By analysing the medical and administrative documentation at the CBHs in Ferizaj and Vushtrri, the NPM has observed that there were cases of incidents between residents and cases of self-inflicted injuries. The NPM considers that the authorities' obligation to care for thee residents also includes the responsibility of protecting them against other residents who may physically assault them.101 Treatment and activities With regard to activities in general, in most of the homes visited, the NPM was informed that residents usually listen to music, watch TV, make drawings, and go out in the city, while in some CBHs they carry out excursions to distant places, either in nature or to other cities, twice a year. The NPM encourages the leaders of these institutions to attach importance to the development of educational and training work therapy, psychosocial and recreational activities and to have an individualized treatment plan according to the needs and abilities of residents. Health care The NPM was informed that in the CBHs, health services are provided by Family Medicine Centres. In the CBH in Ferizaj, one resident has severe disorders. Based on his medical record, the resident has been using the same psychiatric therapy for years, has not been visited by a psychiatrist for several years, and his mental state has not been reassessed. Psychiatric services in this institution have not been available for almost 5 years and this makes it difficult for nurses to work. According to the staff, regular psychiatric services cannot be obtained at the Mental Health Centre in Ferizaj. In relation to this situation, the NPM talked to the Director of the CBH in Ferizaj, who stated that they were awaiting engagement of a psychiatrist. There were also problems with the supply of medicines to this House. The NPM notes that Article 18, paragraph 1 of the Law No. 05/L-025 on Mental Health states: “Persons who are in residential social care institutions are offered counselling, treatment, rehabilitation and mental health care equally and according to health standards, approved by the Ministry of Health". Whereas paragraph 2 of this Article reads: “The way of organization and provision of services, as provided in paragraph 1. of this Article shall be determined by special sub-legal act proposed by the Ministry of Health 100 Ibid, paragraph 35. For more information, see the CPT Report on Visit to Bulgaria, published on 6 October 2017, page 75, paragraph 153, at: https://rm.coe.int/16807c4b74 101 44