unstable remission. An inspection visit was also carried out to Taheva Sanatorium which
provides a special care service as well as a general care home service.
There is an increasing wish to offer people with mental health disorders more of a home-like
living environment, and many special care homes have moved to smaller family-house types
of buildings. For example, Vääna-Viti Home operates in this kind of building. New family
homes were also built for 43 residents of the South-Estonian Special Care Services Centre.
These houses built in Võru town have home-like living conditions, and people with challenged
mobility can move around more easily in these houses.
One of the main problems in special care homes in recent years is shortage of staff. It is not
rare that even though a care home has the statutorily required number of activity supervisors
this is not sufficient to take care of people with an increased need for care and assistance and
people with complicated mental disorders or to offer an individual approach and ensure a
safe living environment. Activity supervisors who spend most time dealing with residents
must also cook and clean the rooms in addition to caring for people. In several care homes, in
the evenings and at night the staff member on duty must move between different units of the
care home, so that some residents are temporarily left without supervision.
In line with the requirements entering into force at the beginning of 2020, to work as an
activity supervisor providing special care it is no longer merely sufficient that the person has
registered for training. The necessary training must in any case be completed. Unfortunately,
several activity supervisors in the institutions inspected had not completed the training
required by law. Untrained staff might not know how to guide and support the development
of people in their care or how to cope with agitated people. The Chancellor recommended
that the necessary training be quickly arranged.
The freedom of movement of a person receiving the 24-hour special care service under a
court ruling may only be restricted in a situation of danger (see the Social Welfare Act). That
person may be placed in a proper seclusion room for up to three hours until arrival of the
ambulance or the police. However, not all care homes comply with this requirement, and the
freedom of movement of residents is restricted inadmissibly. Due to absence of a proper
seclusion room, agitated people have been taken to calm down in their own room or another
room not adjusted for seclusion. This is not safe. When documenting a person’s placement in
a seclusion room, some care homes have failed to record the required data based on which it
is later possible to verify whether placement in the seclusion room was justified. The