Latvian ombudsman Juris Jansons has made the protection of the rights of people with special needs in long-term social care and social rehabilitation institutions one of the priorities of his work. In connection with this, representatives of the Office of the Ombudsman visit social care institutions. Such a visit was also in “Ziedugravas” in Skriveris.
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Suggestions for improvement
The visit took place on December 13, 2022 and was not previously booked. Representatives of the office met with representatives of the administration of the social care center, as well as interviewed individual residents to find out their opinion about the services, provided opportunities and living conditions. After the visit, the representatives of the office gave oral recommendations to the administration of the institution, which should be changed. On the other hand, on February 12 and 13, 2023, specialists of the Ministry of Welfare conducted an inspection in “Ziedugrava”, after which the institution was also given recommendations for improving social services.
“Ziedugravas” is a social care institution of the municipality of Aizkraukle region, where residents can receive both long-term social care and rehabilitation due to age or functional disorders, and short-term, if a person is still of working age and is in a crisis situation. A total of 130 people can be accommodated there, and most of the time about that many stay there on a daily basis. The center has several buildings and an adjacent area where residents have the opportunity to spend their free time.
One year after the visit, at the end of last year, the Ombudsman Juris Jansons sent a letter to the management of “Ziedugravu”, the Minister of Welfare and the municipality of Aizkraukle region, which outlines what needs to be improved in the institution. The objections are mainly related to the condition of the premises, the procedure for providing certain services and other issues. The letter states that the residents’ rooms, common use and also the sanitary facilities were visually unattractive and inadequate, as they were significantly worn out, as well as not furnished taking into account the individual needs and safety of seniors and persons with functional disabilities. Individual rooms of the residents are cozy, individualized and close to the family environment, but most of the rooms looked impersonal and more like hospital wards, especially those where people who are sleeping and people with mobility impairments live. It is also recommended to make the work with the residents closer to a family environment, to provide services more appropriate to the needs of the residents, which also affects the design of rooms and rest areas, providing people with individualized clothing, the right to keep personal belongings, which clearly increases the sense of security and autonomy of the residents.
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More activities
According to representatives of the Office of the Ombudsman, privacy of people is not ensured in all rooms, especially in those where several people live. In rooms where people with functional disabilities and sleeping are placed, delimiting screens should be placed so that they can be used during the daily hygiene care of the residents, which should happen more often. It is also recommended for the residents to provide classes and leisure activities that meet their individual needs, as the representatives of the Ombudsman’s Office observed during the visit that some of the center’s residents spend most of their time aimlessly in their rooms, and a small number also go out for walks. The center has a plan of events, but everyone should be given a meaningful day to prevent the decline and loss of their life skills.
It is also stated that the number of residents who receive or should receive assistive devices is not collected and documented. A specific employee should be responsible for this, who would also monitor which aids need to be replaced or need repair.
Repair and paint the walls
The institution had to make improvements, and in February of this year, the “Ziedugravas” social care center sent information to the ombudsman, explaining how the recommendations were implemented.
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As stated in the institution’s response, regarding the repair of premises in which the living conditions were assessed as unsatisfactory, buildings 6 and 7 have been demolished, and a new building is being built in their place in accordance with the necessary and mandatory requirements, but the clients have been moved to other buildings. Repairs have already been carried out in the stairwell and common areas of the dementia patient unit of the 2nd building. Cosmetic improvements have been made in the rooms of the 8th and 9th buildings, while the common and sanitary facilities have been completely renovated. Regarding the recommendation on the individualization of the premises, a large part of the living rooms are adapted to the individual wishes and needs of the clients, the work on creating coziness is still ongoing. Completed wall painting in dementia client common areas and common dining room.
“At the beginning of this year, a documented record of technical aids was introduced in the institution, and the responsible employee – a physiotherapist – uses specific forms, recording the safety checks of the aids, as well as a form on the client’s assessment regarding the need for technical aids. In order to ensure the privacy of the residents, we inform you that screens are used in daily work. In addition, the 2024 budget provides for the purchase of additional screens. This year, it is planned to create a separate private communication room,” said the answer.
With regard to personal hygiene measures, the current vacancies of nursing staff will be filled at the end of 2023, and bathing of customers will be provided daily in accordance with the requirements set forth in legal acts. In addition, podiatrist service is regularly available. Changes have also been made in the organizational structure and the social worker has been designated as the responsible employee in the supervision of the day-to-day work of the nursing staff. Currently, all vacancies in the institution are filled, and this year’s budget provides for two additional vacancies for caregivers, which are currently advertised. Supervisions are also provided for social work specialists, courses and trainings for nursing staff.
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The range of daily regular classes has also been expanded, there are individual classes, excursions, attendance at social events, walks in the territory.
From the beginning of 2023, several forms have been introduced in the institution and certain internal procedures for the circulation of information have been established in order to be able to fully reflect the state of health of clients in accordance with the principles of protection of sensitive personal data. Improved protection of sensitive data, ensuring that diagnoses and prescribed medications are displayed in an encrypted form on medication dispensing boxes. In addition, the institution has issued and familiarized each employee with the rules for the use of restricted information.
The center is developing
Diāna Bebre-Kondrāte, the director of the social care center “Ziedugravas”, admitted to the newspaper “Staburags” that many cases have already been resolved and would have been completed even without the recommendations of the ombudsman, because the center’s operations are not standing still.
— There are no objections to the tests, because they are necessary and only help at work. However, without seeing what has been done in a certain period of time, and without delving into the work of a social care institution, in my opinion, it cannot be judged from one visit. We regularly plan improvements in buildings, premises and services, and a lot has been done in the past years. Of course, it all depends on finances, so you have to evaluate what is more urgent, for example, roof repair or wallpaper in the rooms. However, we also do a lot on our own and even in our spare time. We also diversify the offer and events, but if a person does not have the desire or interest to participate in them, we cannot force anyone. Neither the ombudsman’s office nor the ministry can advise how to ensure this. Therefore, thanks to our employees, whose work is not easy, but the pay is often minimal, – said Diāna Bebre-Kondrāte.
Tags: Social care center Ziedugravas agree accusations understand operation institution Staburags .lv
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