On
February 12, on the instructions of the Human Rights Defender, employees and
experts of the National Prevention Mechanism of the Human Rights Defender's Office
conducted an unannounced visit to the "Vardenis Neuropsychological Social
Care Home" SNCO of the Ministry of Labor and Social Affairs of RA.
During
the visit, many issues were raised, which were also recorded before and remain
unresolved. In particular:
• the
social care home continues to be overcrowded, the necessary living space for
the personal space of the wards is not preserved։ the beds in the rooms are
placed too close to each other, violating the right to privacy of the patients;
•
there is a significant lack of psychiatrists (more than 450 patients are served
by two psychiatrists);
• a
differentiated approach that does not meet the standards of human rights is
shown towards patients;
•
realization of the patients' right to a walk is not ensured (most of the year
they are not taken out for a walk);
•
Violations of the procedure for using restraints continue to be recorded, the
logs are not kept properly, there are many deletions, and the days and hours of
using restraints and conducting periodic medical examinations have mostly been
changed;
• by
examining the medical documents, it became clear that the injuries sustained by
the dependents or the person exercising restraint, as well as the information
about the effectiveness of the restraint, are not properly recorded;
•
physical restraints are traumatic and ineffective. Physical restraint is often
carried out in rooms in the presence of other wards;
• in
almost all cases of the use of medicinal sedatives, a proper medical
examination was not carried out and their results were not properly recorded,
in particular, in the logs there were only data on the patient's blood pressure
and body temperature, and in some cases also on blood pressure;
•
improper conditions of medicines were recorded in the departments;
•
according to the wards, there are rodents in some departments for a long time;
•
problems related to personalization of clothing were recorded. Caregivers who
are unable to personalize their own clothing are provided with clothing at
random after washing;
• the
departments need to be repaired, the conditions of the rooms are insufficient
(mattresses do not match the beds, there is a lack or absence of wardrobes,
etc.);
• In
some departments bathrooms of the social care home are in dire need of repair.
• The
kitchen and laundry facilities are in dire need of repair. There is an urgent
need to repair both the laundry and kitchen facilities;
• the
social care home lacks an adapted and accessible environment, for example, the
entrances to the departments are not equipped with ramps, as a result of which
the wards with mobility issues have difficulties using the bathroom and
walking;
•
There is a need for repair in the dining halls of the departments. Due to the
lack of space and property, the patients used the meal in shifts, in addition,
during private conversations, the patients voiced their dissatisfaction with
the quality of the provided food and the repetitions of the dish. Uniform,
repetitive food is constantly provided (boiled fish, pasta, boiled potatoes,
etc.), which is unacceptable. Coffee is provided at best once a week instead of
every day.
•
problems related to informed consent were recorded: dependents do not give
informed consent and are not properly informed about their rights,
• the
institution of guardianship does not function properly, there is no proper
control over the actions of guardians for the benefit of the wards;
•
there is a need to provide employment to patients. Despite the presence of an
employment center in the social care home residents' occupations in the wards
are still limited to the TV set in the lounge, which has been out of order in
some wards for a long time.
•
Patients who do not have a personal mobile phone cannot call relatives or
establish counseling contact with relevant bodies, including the Human Rights
Defender, in the absence of payphones.
That
circumstance is very worrying both from the viewpoint of the need to maintain
the social relations of the latter and to ensure the possibility to establish
contact with the responsible state bodies.
The
patients contact their relatives only once a month through the personal mobile
phones of the social workers, and the possibility of additional calls is
provided to the latter on the birthdays of the dependents or their relatives.
The patients are directly dependent on the employees of the social care home to
use the actual telephone connection. Such practices are problematic and can
lead to abuse.
•
application and complaint boxes are not opened on time (in the box opened
during the monitoring visit, there was an application-complaint written 4
months ago);
• the
issue of the availability of accessible public transport to the social care
home has not yet been resolved, in the conditions where about 450 patients are
kept there;
• the
need for training of medical and non-medical staff of the social care home
remains relevant;
• the
issues related to prosthetics of patients have not been resolved;
• the
working conditions of the psychiatric organization's employees are
unacceptable, etc.;
The
protection of human rights is a comprehensive process, which implies
guaranteeing the rights of all participants in the process, ensuring dignified
treatment of each of them, and establishing relationships guaranteeing mutual
respect.
One
of the components of this principled approach is the state of the rights of the
employees of those bodies, which are called to protect the rights of other
people. Decent working conditions and social guarantees for employees of
psychiatric organizations, including wages, should be continuously improved.
The
document on the results of the visit, which also includes proposals aimed at
solving the recorded problems, will be sent to the Ministry of Labor and Social
Affairs of RA. The Human Rights Defender emphasizes the organization of
constructive discussions with all interested parties on the issues raised.
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