1.4 Obiski v domovih za starejše 1.4 Visits to retirement homes Pritožbene poti: podobnosti in razlike med domovi Complaint procedures: similarities and differences between retirement homes Ob obiskih domov v letu 2014 smo ugotovili, da so pritožbene poti dobro urejene. Način podajanja pritožb je utečen v vseh obiskanih domovih. Stanovalci in svojci oseb z demenco imajo tako na voljo skrinjice/ nabiralnike za pritožbe tako na oddelkih kot na recepciji doma ali v bližini le-te, prav tako imajo tam navadno knjige vtisov, ustne ali pisne pritožbe pa lahko podajo tudi neposredno zaposlenim. Če smo v katerem od domov opazili, da na VO ni skrinjice za pritožbe, smo predlagali, da jo namestijo (Center starejših Pristan, Center starejših Zimzelen, Dom starejših Kranjska Gora). Ne glede na morebiten dvom, da bi bile osebe na VO sposobne podati pisno pritožbo, je prav, da se jim ta način, ki lahko zagotavlja anonimnost, omogoči. Pritožbene poti so opisane v domskih zloženkah, v dogovoru, ki ga prejmejo ob sprejemu, pogosto pa so opisane tudi v posebnih pravilnikih, ki jih izobesijo na oglasnih deskah, skupaj s hišnim redom. V vseh domovih na VO preverjamo, ali so pritožbene poti na vidnem mestu in dom opozorimo, če temu ni tako. During our visits in 2014, we established that complaint procedures were arranged accordingly. A method of submitting complaints was established in all visited homes. The residents and relatives of persons with dementia may submit complaints in collection boxes situated on wards and at the home’s reception desk or nearby, where they may also find books of impressions. Oral or written complaints may also be forwarded directly to the staff. If we noticed that the collection box was not in a secure ward, we suggested its installation (Pristan Retirement Home, Zimzelen Retirement Home and Viharnik Retirement Home in Kranjska Gora). Irrespective of the possible doubt that residents in secure wards would be able to submit a written complaint, this method which provides anonymity should be available to them. Complaint procedures are described in brochures which the residents receive upon admission and are also frequently described in the special rules displayed on notice boards together with the house rules. We verified in secure wards of all homes whether complaint procedures were visible and informed the homes if they were not. Dom starejših Kranjska Gora nam je tako npr. v odzivnem poročilu navedel, da so v času od našega obiska že namestili skrinjice za pritožbe na obeh gospodinjskih skupinah. Prav tako so na informativne table na vsaki skupini izobesili obvestila o zastopnikih in seznam pravic oseb na VO. Domovi se najpogosteje razlikujejo v tem, kdo obravnava pritožbe in kako se vodi evidenca o prejetih in rešenih pritožbah. Ugotavljamo, da domovi beležijo razmeroma malo pritožb, še posebno pa so maloštevilne pisne pritožbe. Teh je na leto manj kot deset in jih navadno vodstvo doma in socialna služba shranjujeta ločeno. Glede na naravo pritožbe obravnavajo na strokovnih timih ali komisiji za reševanje pritožb. Domovi nam največkrat pojasnijo, da so pritožbe/mnenja/želje stanovalcev in svojcev ustni in da se rešujejo sproti. Navadno se beležijo v raportnih knjigah ali osebnih spisih in se ne vodijo enotno. Potek reševanja pritožb zabeležijo le, če gre za obsežnejšo pritožbo. Domovom, ki tega še nimajo, smo predlagali, naj vodijo enotno evidenco pisnih pritožb (tudi če jih prejmejo po elektronski pošti), saj je tako transparentnost obravnavanja pisnih pritožb veliko boljša. Poleg tega menimo, da je pomembno, da se skupaj s prejetimi pritožbami vodi dokumentacija, ki dokazuje postopek reševanja posamezne pritožbe in končni odgovor osebi, ki se je pritožila. The retirement home in Kranjska Gora replied in its response report that collection boxes for complaints had already been installed at both household units after out visit. Notifications about representatives and a list of rights of persons in secure wards were also put on notice boards in both units. Who discusses the complaints and how the record on the received and resolved complaints is kept are issues which are addressed differently in each retirement home. We established that the homes record a relatively low number of complaints, particularly written complaints. There are fewer than ten per year, and the management of the home and the social service store them separately. Relating to the nature of the complaint, the complaints are discussed by expert teams or committees for resolving complaints. The retirement homes explained that the complaints/ opinions/wishes of the residents and relatives were usually oral and resolved promptly. They are kept in report books or personal files and are not kept uniformly. The resolution procedure is recorded only when discussing more extensive complaints. Dom starejših Kranjska Gora nam je v odzivnem poročilu tako sporočil, da na podlagi našega predloga vodijo enotno evidenco pritožb. We proposed to the homes, which had not implemented this method already, that they keep a uniform record of written complaints (even if received by e-mail) since this improves the transparency of reviewing written complaints. We further believe that it is important to keep a record of all documentation together with the complaints received, which proves the process of resolving individual complaints and final reply to the complainant. Razgovori s stanovalci, verska oskrba In its response report, the retirement home in Kranjska Gora stated that they had started to keep a uniform record of complaints on the basis of our proposal. Ob obiskih domov DPM opravi tudi razgovore z naključno izbranimi stanovalci z demenco ali njihovimi svojci, če pokažejo interes za pogovor. V teh pogovorih največkrat izpostavijo pozitivne vtise (zadovoljstvo glede zaposlenih, hrane, svojega doživljanja bivanja na VO), le redko izražajo pritožbe. Ob obisku Doma starejših Kranjska Gora pa je v pogovoru z izvedencem ena od stanovalk izrazila obtožbe o vdoru druge stanovalke v njeno sobo. Izvedenec je zadevo raziskal in ugotovil, da je glede na omejeno gibljivost obtožene stanovalke malo verjetno, da bi le-ta dejansko vstopala v sobo stanovalke, ki je problem izpostavila, še manj pa je verjetno, da bi obtožena stanovalka te vdore organizirala. Ocenil je, da je navedene pripombe mogoče pripisati psihičnemu stanju stanovalke, ki je problem izpostavila ali pa v njeno sobo dejansko vstopajo drugi stanovalci – tisti, ki zaradi upada spoznavnih sposobnosti ne najdejo svoje sobe in bi zato lahko po pomoti vstopali v sobo stanovalke, ki je problem izpostavila. Izvedenec DPM je ob obisku domov ugotovil, da iz razgovora s stanovalci, razpoložljive zdravstvene dokumentacije in razgovora z osebjem ni mogoče potrditi, da bi bili stanovalci izpostavljeni neprimernemu in poniževalnemu ravnanju. Interviews with residents and religious care When visiting retirement homes, the NPM also conducts interviews with randomly selected residents with dementia or their relatives if they are interested in being interviewed. In the interviews, residents highlight their positive impressions (satisfaction relating to the staff, food, their experience of living in secure wards) and only seldom complain. During her interview with the expert, one of the residents of the retirement home in Kranjska Gora mentioned that another resident had broken into her room. The expert looked into the matter and established that, given the limited mobility of the accused resident, it was not very likely that this person had entered the room of the resident, and it was even less likely that the accused resident had organised these entries. The expert assessed that these complaints could be attributed to the resident’s mental condition, or her room really was being entered by other residents who due to their poor cognitive abilities were unable to find their rooms and thus entered the room of the resident, who raised the issue, by mistake. From the interviews held with residents, the available medical documentation and interviews with the staff of the visited retirement homes, the NPM expert did not establish that the residents had been subjected to inappropriate or degrading treatment. 110 poročilo o izvajanju nalog DPM v letu 2014 DržavnI preventivnI mehanizEm po Opcijskem protokolu h Konvenciji OZN proti mučenju in drugim krutim, nečloveškim ali poniževalnim kaznim ali ravnanju IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2014 National Preventive Mechanism under the Optional Protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 111