The CPT’s 5th periodic visit to the Republic of San Marino aimed to evaluate, based on the recommendations from the Committee’s 2013 visit, the treatment of persons held in police custody at San Marino Prison, persons subject to “compulsory medical treatment” (trattamento sanitario obbligatorio - TSO) and residents of the “La Fiorina” nursing home.
The report states that no allegations of ill-treatment were received, or any indication of such acts witnessed, in any of the facilities visited.
Regarding detention by law enforcement agencies, the Committee welcomes the progress made to strengthen safeguards against ill-treatment. Persons in police custody had rapid and effective access to a lawyer (including a court-appointed lawyer), were able to notify a chosen person of their situation and, unlike in 2013, were systematically informed of these rights. Nevertheless, some custody registers require improvement, except that of the Civil Police, which was detailed and well kept. In their response, the authorities of San Marino confirm that the registers of the Gendarmerie and the Guard of the Rock have since been revised, as per the Committee’s recommendations.
The delegation finds that material conditions at San Marino Prison are satisfactory. Incarcerated persons had access to two exercise yards for up to seven hours daily, a well-stocked library and a common room with a TV, radio and board games.
The Committee welcomes the fact that San Marino Prison now has a dedicated healthcare team. In emergencies, an ambulance is called and, if necessary, specialist consultations can be arranged. However, the Committee urges the authorities to operationalise the electronic medical record system and maintain comprehensive records, including documents relating to the medical examination on admission.
As was the case during the CPT’s previous visits, all prison surveillance staff were provided by the Gendarmerie. The Committee reiterates its recommendation that gendarmes assigned to prison duties should never participate in criminal investigations. Further, the CPT calls upon the San Marino authorities to provide specific and regular training for all staff performing custodial duties, including volunteers. In their response, the Sanmarinese authorities have confirmed their implementation of these recommendations.
The CPT also calls upon the San Marino authorities to take legislative measures to ensure that remand and sentenced prisoners be allowed, as a matter of principle, to receive visits, make telephone calls and send and receive letters. In their response, the Sanmarinese authorities indicate that this recommendation has been implemented by newly adopted prison legislation, which also establishes the procedure for the imposition of disciplinary sanctions.
On the subject of involuntary psychiatric hospitalisation, the report reiterates that the two rooms at the emergency department of San Marino Civil Hospital are unfit for patients in acute mental crisis. The Committee requests to be kept informed of the progress of the project to create secure rooms for such patients. Furthermore, the CPT recommends the presence of at least one psychiatric nurse when a person is involuntarily hospitalised, and psychiatric training for nurses, including on the application of means of restraint. It also reiterates its long-standing recommendation that the judge authorising the compulsory medical treatment systematically see the person concerned before any decision is taken. San Marino’s authorities assert that psychiatric training for nurses has been organised and that a trained nurse will be on call 24/7 to provide assistance as required.
The delegation gained a positive impression overall of La Fiorina nursing home, notably in terms of material conditions, staffing levels, and both the treatment and activities available to residents. The CPT recommends enhancing residents’ access to the garden. In their response, the San Marino authorities informed the Committee that renovation works have recently been completed to facilitate access to the outdoor area. Although the report finds no indication of abuse in the application of mechanical restraint, the Committee makes specific recommendations to ensure that they are accompanied by appropriate guarantees, such as general guidelines and appropriate medical supervision.
A number of residents had been brought to La Fiorina by their family and placed in the institution without assessing their decision-making capacity and willingness to stay there. The CPT recommends an assessment of the consent capabilities of all residents, in particular when placement was authorised by family members. More generally, a comprehensive and clear legal framework is needed for involuntary placements in nursing homes, especially in cases where restrictions on movement amount to de facto deprivation of liberty.
The visit report and Government’s response are made public at the request of the San Marino authorities.