78 health care The units visited by the NPM were: – Old Vaasa Hospital (155 beds) – The psychiatric ward of Vaasa Central Hospital (68 beds) – Psychiatric unit for the Southern Ostrobothnia Hospital District (88 beds) – Psychiatric wards of Päijät-Häme Joint Authority for Health and Wellbeing (72 beds) – The Vantaa clinic of the VTH – Emergency care unit at Vaasa Central Hospital – Emergency care unit at Seinäjoki Central Hospital – City of Espoo sobering-up station Presented in the following are some of the observations made during visits, and statements and recommendations based on them. Some of the observations and recommendations were pending response from the visited institution: Atmosphere/treatment • The general impression given by the visit was that the wards at the hospital had a calm and professional atmosphere, with “patients first” as the general principle. • There were no signs of tension in the relationship between the staff and the patients. The patients did not mention any demeaning or undignified treatment, and they felt they were receiving appropriate care. • There were no signs that the patients were mistreated in any way or that the patients felt unsafe. However, the hospital had no specific whistle-blowing policy in place should mistreatment be detected or suspected. In the Ombudsman’s opinion, the staff must have instructions to follow on how to proceed in a situation in which they observe mistreatment, and how to intervene. This also requires that mistreatment is correctly identified and defined, and that a clear position is taken by the management that mistreatment is unacceptable and will always lead to consequences. The patients and their families should also have instructions on how to report mistreatment. Seclusion facilities • The seclusion room was furnished only with a thin, yellow plastic mattress, and there was no drain in the room. In addition, the room was hot and stuffy. The Ombudsman noted in general that having appropriate equipment in the seclusion room is of major importance when assessing whether a patient’s seclusion has, as a whole, been implemented in a manner that qualifies as dignified treatment and high-quality health and medical care, as referred to in the Act on the Status and Rights of Patients. The Ombudsman found the conditions in the seclusion room to be unacceptable.