Serious shortcomings in elderly care homes – wellbeing services counties’ self-monitoring failed after reduction in staffing level

Deputy-Ombudsman Maija Sakslin: inspections in 2025 revealed several situations where residents’ good care and treatment was not realised or was clearly compromised.

On the order of Deputy-Ombudsman Maija Sakslin, several inspection visits were carried out in the 24-hour housing service units for the elderly in 2025. The inspections involved assessing the quality and content of the services received by social welfare clients. The aim was to examine how the legislative amendment concerning the minimum staffing level had impacted the work of unit staff members and the quality of service received by clients. A particular point of investigation was whether the clients’ fundamental rights had been restricted and what kind of restrictive measures had been used.

Based on the findings, several units had reduced their staffing level without a separate assessment of clients’ service needs or functional capacity, which is unlawful. The carers’ working time had not been enough to cover all their tasks, and a reduction of the staffing level had had a deteriorating impact the quality of care. Tasks related to basic care had been left undone, the carers had not had time to spend time with the clients, organise meaningful activities or spend time outdoors, and staffing had not been increased during terminal care. Numerous shortcomings were observed in the use and recording of restrictive measures.

Deputy-Ombudsman Maija Sakslin emphasises that reducing the staffing level to the extent that staff members have to resort to restrictive measures because of an insufficient number of staff members is unlawful and violates the fundamental and human rights of vulnerable clients. Wellbeing services counties’ self-monitoring with regard to the amendment of the legislation on staffing levels has failed.

Deputy-Ombudsman Sakslin: It is a serious shortcoming that there is still no legislation on the requirements and procedures for using restrictive measures and on related monitoring. In the absence of legislation, in my oversight of legality, I have required that each unit has instructions on how to reduce and discontinue the use of restrictive measures and that staff members are familiar with the requirements concerning the restriction of fundamental rights. I have tried to expedite the preparation and implementation of legislation and national guidelines.

The Deputy-Ombudsman has steered the use of restrictive measures in several of her decisions and visit reports, such as 2838/2025, 2803/2025, 6255/2024, 2474/2024, 1497/2023, 3014/2022, 7866/2020, 4180/2020 and 3187/2020 (all in Finnish). The decisions are available at www.oikeusasiamies.fi. A restrictive measure is a measure that interferes with a person’s fundamental rights, such as the right to self-determination or freedom of movement. Restrictive measures include using a crotch belt and anti-strip jumpsuit and raising the bedrails.

Further information is available from Principal Legal Adviser Lotta Hämeen-Anttila, tel. +358 9 432 3353.