Ombudsman Takes Stand on Operation of Care Home for Persons with Disabilities of Heves County “Harmónia” United Social Care Institution

The conditions of care provided to children living with autism spectrum disorder (ASD) at the Care Home for Persons with Disabilities of the Heves County “Harmónia” United Social Care Institution are worrisome, the Commissioner for Fundamental Rights concluded in his report. Dr. Ákos Kozma asked the competent Ministry to intervene in order to remedy the specific problems as well as the systemic deficiencies revealed.

The Ombudsman was contacted by a civil society organization which complained about the treatment of the residents and the general operation of the Care Home for Persons with Disabilities of the Heves County “Harmónia” United Social Care Institution. The petitioner objected, among others, to the fact that the Institution did not have enough specialized staff prepared to look after persons with autism spectrum disorder. The petitioner also reported two fatalities that had taken place in unclear circumstances, and expressed concern regarding the practice related to the medication of persons with ASD. Based on the petition, the Commissioner for Fundamental Rights ordered an inquiry, and on 29 July 2020, the Commissioner’s staff carried out an unannounced on-site inspection at the Institution, interviewing the members of the management, as well as the Institution’s specialist personnel and residents. The on-site inspection focused mainly on the problems indicated in the complaint. 

In his report on Case No. AJB-816/2021, Dr. Ákos Kozma established that the co-location of minor- and adult-aged residents, as well as the disregard for their health condition and the severity of their disability constituted an impropriety. The lack of expert staff and the permanent deficiencies in physical amenities together violated the residents’ right to human dignity; furthermore, the lack of external supervision with respect to all members of the specialist personnel also gave reason for concern.

In addition, documentation on contacts was not rigorously kept. Regarding the denial of consent to an adult resident placed under guardianship to changes in their medication, the Ombudsman exposed the omission of the guardianship authority.

Moreover, the report found serious fundamental rights-related improprieties in connection with the lack of documentation, as well as the duration and manner of repeatedly ordered, more than a month-long isolation in the case of a 15-year-old boy living with autism spectrum disorder. 

Furthermore, it turned out from the documents reviewed that the Institution’s regulations on restrictive measures were contrary to the legal provisions of guarantee: thus, in particular, with respect to the scope of persons entitled to order restrictive measures, the ex post review and documentation disregarding time limits set by legislation, and the ordering of restrictive measures in advance, based on probability. In the Ombudsman’s view, the Institution’s practice based on these provisions also constitutes an impropriety. The accurate assessment of the reason for the fatalities identified in the petition is a medical professional matter, and as such, it fell outside the investigative competence of the Commissioner for Fundamental Rights. At the same time, based on the documents made available and the answers received during the inquiry, there was no obvious and legally identifiable omission discovered that would have allowed the Commissioner to draw conclusions in this matter. Nevertheless, the Ombudsman called attention to the fact that there is still no solution to the problematic of conducting independent inquiries after fatalities having occurred in residential institutions.

The Commissioner’s inquiry also extended to the circumstances of care provided to children with autism spectrum disorder. Based on the information gathered, currently, there is no competent residential institution in Hungary that could look after children with good or outstanding intellectual capacities who, nevertheless, need special care due to their autism spectrum disorder, or those who, in addition to their ASD, live with serious behavioural problems, and are often in a crisis situation.

The Ombudsman submitted recommendations to the Minister of Human Capacities, the Heves County Director of the General Directorate of Social Affairs and Child Protection (SZGYF), as well as to the Head of the Institution and the Head of the Guardianship Authority.

The Commissioner for Fundamental Rights proposed to the Minister that the legal regulation be supplemented so that the reason for the death of persons with disabilities living in institutional care would be investigated in each case by an independent organ in the framework of a public inquiry, and also that a protocol be issued to set the relevant professional standards. Furthermore, the Commissioner suggested examining what additional pay-related measures would be necessary in order to mitigate the systemic lack of professionals observed in residential institutions. At the same time, he asked the Minister to initiate the setting-up of a special expert group, with the involvement of the relevant professional organizations, with a view to the creation of residential institutions for children in need of special care due to their autism spectrum disorder.

For the report, please click on the following link: AJB-816/2021.