The institution of the trusted person was incorporated into the Social Services Act as of 1 July 2021. In social service providers, however, it aroused mixed or rather negative reactions of the type: “Yet another idea from the table (similar to the key worker)... It is unnecessary... Even so, recipients will not want a trusted person...” As a result, there was often terse informing and the creation of a form stating that “the social service recipient is not interested in a trusted person.” Since November 2022, the institution of the trusted person was also strengthened through quality standards of social services, since it became one of the criteria of the procedural standards of quality of provided social services, specifically found in criterion 1.15. In this article, we will try to answer several questions regarding the trusted person in social services with the aim that this institution be accepted as meaningful support for recipients of social services provided in a residential form.

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  1. Slovak legislation recognizes a trusted person in criminal proceedings, specifically in the Criminal Procedure Code (§ 48a, para. 2 of Act No. 301/2005 Coll.). This is the right of the injured person to be accompanied in criminal procedural acts by a trusted person. The trusted person may be a natural person capable of legal acts, whom the injured person chooses, but it cannot be a person who has the position of judge, prosecutor, accused, defense counsel, witness, expert or interpreter in criminal proceedings (that is, a person “outside criminal proceedings”). The purpose of choosing a trusted person in criminal proceedings is providing assistance, especially psychological support. The trusted person can also be the injured person’s attorney-in-fact. The trusted person is obliged to keep confidential any facts learned during criminal proceedings.
  2. In an international perspective, the Convention on the Rights of Persons with Disabilities (UN, 2006) refers to appropriate and effective measures to ensure that persons with disabilities have equal rights to own or inherit property, manage their financial affairs and have equal access to bank loans, mortgages and other forms of financial credit and ensure that persons with disabilities are not arbitrarily deprived of their property (see Art. 12). In addition, it is important to ensure that persons with disabilities enjoy the same right as others to liberty and personal security (see Art. 14). World Health Organization document

## WHO

The QualityRights Tool Kit (WHO, 2012) states standard 3.3, according to which users of services can exercise legal capacity and are provided with the support they may need regarding legal capacity. It also includes the following criteria: 3.3.4. Service users may nominate a support person or a network (of support people) based on their own free choice and consult with them on their decisions about care, treatment, personal, legal, financial and other matters. Chosen persons will be recognized by staff (the facility). 3.3.5. Staff (facilities) respect the authority of the nominated support person or network (of support people) so that service users are supported in communicating their own decisions. 3.3.7. If a service user has no support person or network (of support people) and wishes to set one, the facility helps them obtain appropriate support. 3. As of 1 July 2021, the rights of a recipient of social services also include the right to designate a trusted person (Act No. 218/2021 Coll.). The trusted person provisions in social services are in the following statutory wording of the Social Services Act: § 6 para. 3 lit. a), d), para. 6; § 10 para. 6 lit. b); § 74 para. 15 lit. b), para. 16 lit. b; § 94c para. 1 lit. i), para. 2 lit. l).

From the perspective of the Social Services Act, there are three conditions for the trusted person (§ 6 para. 3 lit. d): - it must be a natural person (that is, not a legal entity), - written consent of the natural person, - legal capacity of the natural person.

It is explicitly stated in the Act that “the guardian’s consent is not required for the designation of a trusted person” (under § 27 para. 2 of the Civil Code). That means that if the recipient has been deprived of legal capacity or has restricted legal capacity by a court and has an appointed guardian, the guardian cannot interfere in the recipient’s decision-making regarding the designation of a trusted person. This means that guardian consent, which is intended to protect the interests of the recipient, is not required for the designation of a trusted person, unlike other decisions and activities concerning the recipient.

For the recipient of social services regarding the designation of a trusted person, the following duties arise with respect to the provider of social services (§ 6 para. 6 of the Social Services Act): - immediately notify the provider of personal data of the trusted person, specifically:

  1. name, surname and title,
  2. address of permanent or temporary residence,
  3. personal identity number, if assigned, and date of birth,
  4. phone number and email address.
  • after the designation of a trusted person, provide a copy of the written consent of the natural person to being designated as trusted person,
  • notify changes to the data and circumstances listed above.

For the provider of social services there are the following legal duties regarding the trusted person: - immediately report the use of restrictive means and every entry of restriction of a recipient of social services, including the data in the restriction register, within eight days of using restrictive means against the recipient’s trusted person (§ 10 para. 6 lit. b of the Social Services Act); - when terminating the contract unilaterally under § 74 para. 14, deliver a copy of the termination (including the reason for termination) into own hands to the trusted person (§ 74 para. 15 lit. b of the Social Services Act), which is one of the conditions for unilateral termination of the contract for provision of social services (§ 74 para. 16 lit. b of the Social Services Act); - process personal data on the trusted person (§ 94c para. 2 lit. l; para. 1 lit. i).

What is the difference between the “Slovak trusted person” and the support person according to WHO?

The starting point for current quality standards were exactly the standards of the WHO QualityRights Tool Kit. In relation to criterion 1.15, we draw attention to the terminological differences between the original English text and the Slovak translation adopted into the Social Services Act. Because of social and health service facilities, and in respect of the principles of subsidiarity (substitute support) and participation, users of such services should have the possibility: 1. to select one SUPPORT PERSON or NETWORK OF PEOPLE. The support person chosen by the recipient of social services is called TRUSTED PERSON in the Social Services Act (not very adequate in view of the translation) and in quality standards as TRUSTED PERSON. The law uses only the singular form, which does not exclude that a given client may have more than one support person. 2. regarding the service user, the WHO QualityRights Tool Kit emphasizes: - free and own choice of support person or network of people; - supported decision-making; - support in cases where the person does not have such a person but wishes to appoint a support person. 3. regarding the provider of (social and health) services, the emphasis of WHO QualityRights Tool Kit is on: - recognition of the client’s freely chosen support person or network of people, - respect for their authority, - support in communication of the user’s own decisions, - enabling consultation of the user’s own decisions with the support person or network of people, - identifying the client’s wish regarding a support person if they do not have one, - providing help in obtaining support in appointing a support person if they do not have one themselves. The quality standard adopts the text while omitting cases where the recipient of social services has no support person of their own (this does not mean that the social service provider does not have to help them find such a suitable person if they wish). In addition, the Slovak text of the standard states, “so that the recipient of social services’ decisions are effectively communicated and implemented.” 4. regarding the content of support, WHO QualityRights Tool Kit states consultation within support for decision-making, i.e. supported decision-making, especially regarding: - care, - treatment, - personal matters, - legal matters, - financial matters, - others...

The quality standard omits the treatment area (which does not mean that this area cannot be a subject of consultation with the trusted person) and specifies free decisions about the provision of social services.

The substantive difference between understanding a “support person” according to WHO QualityRights Tool Kit and “trusted person” in the Social Services Act was influenced historically by the initial circumstances that led to legislative change in 2021, as presented by the drafters of the amendment to the act: 1

  • initiatives and shortcomings from recipients of residential social services or their relatives pointing to inappropriate treatment of recipients by employees of social service facilities (from which arose the need for “independent external” support of the person in relation to residential social services),
  • findings, submissions, shortcomings (102 findings in 2020) of the Commissioner for Persons with Disabilities’ Office addressed through instruction on proper procedure, counseling, or forwarding submissions to the police or prosecution (40 of them),
  • abuse of the guardian’s function, conflicts of interest, facilities signing life insurance contracts in the name of recipients of social services (which was to be paid out after their death either to them or on behalf of them, while those signing were the recipients themselves); the court-appointed guardian was often not a person freely chosen by the recipient of social services, see § 6 para. 3 lit. d of the Social Services Act),
  • a rising number of people dependent on residential social services creates “market pressure” to free places, followed by termination of the contract with the social service recipient for “gross breach of good morals” in order to “get rid of the recipient of social services, freeing the place for others” (see § 74 para. 15 lit. b, para. 16 lit. b of the Social Services Act),
  • unjustified use of restrictive means (see § 10 para. 6 lit. b of the Social Services Act),
  • preventing the recipient’s contacts with family.

To which types and forms of social service does the trusted person institution apply? The right to designate a trusted person under § 6 para. 3 of the Social Services Act applies only to a recipient of social services in a social service facility, so it does not apply to outreach social services. Criterion 1.15 of the quality standards does not apply to social services provided in ambulatory form and to the following types of social services:

  • low-threshold social service for children and families (§ 28),
  • caregiver service (§ 41),
  • transport service (§ 42),
  • escorting service and reader service (§ 43),
  • interpreting service (§ 44),
  • mediation of interpreting service (§ 45),
  • mediation of personal assistance (§ 46),
  • lending assistive devices (§ 47),
  • monitoring and signaling need for help (§ 52),
  • crisis help provided through communication technologies (§ 53),
  • respite care (§ 54),
  • assistance in the exercise of guardianship rights and duties (§ 55),
  • day centre (§ 56),
  • support for independent living (§ 57),
  • canteen (§ 58),
  • laundry (§ 59),
  • personal hygiene centre (§ 60).

How to communicate with recipients of social services regarding the right to designate a trusted person? Already when communicating with an applicant for social services, it is appropriate in social counseling to briefly inform them of the right to designate a trusted person. This communication can be more specific and detailed in social counseling provided to the recipient during their adaptation process. The person responsible for communicating the right to a trusted person should be a social worker or social work assistant who provides social counseling. In the advisory conversation, it is appropriate to focus on specific topics in this communication with the recipient, as well as on the person who may be a potential trusted person for the client:

  • Explanation of the term “trusted person”: It is a “trusted person” freely chosen by the client, i.e. a close relational person who supports them, whom they trust and with whom they can, as needed, consult personal, financial, legal matters, as well as matters related to the provision of social services.
  • Who can be a trusted person?
    • It can be a parent (father, mother), child (son, daughter), spouse, and other relatives (grandson, granddaughter, uncle, aunt, nephew, niece, etc.). In social services practice, such a person is often called a “contact person”, which may also connect to the recipient’s right to establish conditions for ensuring personal contact, telephone contact, written contact or electronic contact with a person they themselves identify, especially for the purpose of protecting their rights and legally protected interests, building and maintaining social ties with family and community, and maintaining partnership relationships (§ 6 para. 3 lit. a of the Social Services Act);
    • It can be a partner or partner of the recipient of social services;
    • It can be a person who is also a court-appointed guardian of persons with restricted legal capacity. Here it should be emphasized that the trusted person does not have to be the guardian, and the right to designate a trusted person does not require expression of will in the form of a legal act;
    • It can be a friend, an acquaintance of the recipient, or another person they trust, who supports them and will agree to this role.
  • Can any person be a trusted person? The Social Services Act requires that it be a person capable of legal acts and that they give free consent to being designated as a trusted person. The law explicitly does not prohibit other persons. Potential conflicts of interest may arise if a recipient of social services asks an employee of the social service provider to be their trusted person (especially in cases of long-term residence in social services). An employee’s conflict of interest may be especially due to loyalty to the employer versus the interests of the recipient—these are not always aligned, especially in cases of unilateral termination of the contract by the provider, and further with the use of restrictive means, where the employee may end up in the role of the person applying restrictions and at the same time the person who should be informed about the use of restriction; also in conflicts between multiple recipients there is a danger of biased treatment of one person, and the like. In cases where the recipient would like to ask an employee to become their trusted person, we recommend rather using the role of key worker and communicating to the recipient that this employee can continue to support them in the role of key worker.
  • Can a recipient of social services have more than one trusted person? A recipient can have more support persons by their own choice and judgment, but from the perspective of the Social Services Act, a “trusted person” is one person to whom the provider of social services has specific obligations. Therefore, it would be appropriate for the recipient to ask one person among their support persons (“contact persons”) to act in the role of trusted person.
  • What is required from and expected of a trusted person? Besides providing free consent and selected personal data, the law does not fundamentally define specific duties for the trusted person. What is expected is primarily:
    • general support for the person of whom they are the trusted person;
    • support for the person of whom they are the trusted person in exercising legal capacity;
    • support for the person of whom they are the trusted person in decision-making (e.g., in personal, legal, financial, health and other matters) and implementation of their decisions;
    • cooperation with the provider of social services in exceptional cases (e.g., when restrictive means are used, in unilateral termination of contract, and so on).
  • Is there an obligation for the recipient to choose a trusted person? Under the Social Services Act, it is a right, not an obligation.
    • Can a recipient change the trusted person? In principle, yes, but they are obliged to promptly inform the provider of social services of this fact.
    • Can the trusted person withdraw consent to being designated as trusted person? Yes, they can do so at any time. Since the consent was given in writing, we recommend using written form in this case as well.

The recipient of social services should not be pressured in time to choose a trusted person, but if they do not respond to this right, appropriate repeated communication about appointing a trusted person is advisable. Since the Convention emphasizes, within the right to equality before the law, enabling persons with disabilities access to support, the provider of social services should have a duty to implement this right. It is important that every communication about the right to appoint a trusted person be efficient, understandable and supportive for the recipient. In some cases this may even mean supporting communication with the person the recipient wants to choose as a trusted person, including support in areas that the Social Services Act places as duties of the recipient, especially regarding notification of the trusted person’s personal data (see below regarding the “consent of trusted person”). In terms of recipients of social services who, during long-term use of social services, were not accustomed to the role of a trusted person, it is also important to explain the difference and/or relation between:

  • key worker (chosen freely among facility employees) and trusted person (“from outside” the provided social service, freely chosen from people who support them and in whom they trust);
  • guardian and trusted person (it can be, but does not have to be, the same person; important is that in the guardian case there is a court decision, while in the trusted person case a free decision of the recipient);
  • “contact person” and trusted person (it can be, but does not have to be, the same person, e.g., the contact person is a daughter, but the trusted person is a partner).

What documentation should be kept for the trusted person?

The right to appoint a trusted person or trusted person can be part of an internal document in which the social service provider states respect for the human rights and freedoms of service recipients (e.g., internal directive, process, house rules, etc.). Informing a recipient about the right to appoint a trusted person can be an integral part of the social counseling process within the provision of social services (see criterion 1.4 of quality standards). An alternative is a brief internal regulation or process focused on the trusted person institution.

Although under the Social Services Act it is the obligation of the recipient to notify the provider of the personal services data of the chosen trusted person, a simple written form may be helpful, e.g., a “consent of trusted person” or “consent of natural person to be designated as trusted person,” which will include the personal data required by law. 2This consent can be part of the client file.

What mistakes to avoid in relation to the trusted person?

  • Ignoring the right to designate a trusted person (not communicating about this right);
  • understanding the trusted person as an unacceptable “critic of the social service provider”,
  • formalized informing about the trusted person institution (e.g., only in the form of large “community meetings”);
  • not supporting recipients to determine a trusted person;
  • not distinguishing between legal representation by a court-appointed guardian and the role of trusted person in terms of supporting the recipient in areas touching on support for their decision-making in personal, legal, financial, health and other matters;
  • not distinguishing between trusted person and key worker;
  • forcing the selection of a trusted person (it is a right, not an obligation; selection of trusted person must be by free choice);
  • missing consent of a natural person to being designated as trusted person.

Ten benefits of a trusted person for a recipient of social services

A trusted person as the recipient’s freely chosen person can have several benefits in support or prevention:

  1. It provides help and emotional support.
  2. It supports them in effectively communicating and implementing their own decisions, thus facilitating supported decision-making.
  3. It supports them in exercising the right to legal capacity.
  4. They can consult with them about their decisions on care, treatment, personal, legal, financial and other matters.
  5. They can consult their own decisions about the provision of social services with them.
  6. As a person outside the social service facility, they help prevent maltreatment.
  7. They help prevent unjustified use of restrictive means in social service provision.
  8. As a freely chosen person, they can help prevent abuse of the role of the court-appointed guardian.
  9. They help prevent abuse of unilateral termination of contracts by the provider of social services.
  10. They help them find appropriate social services or support after lawful termination of a contract by the provider of social services.

Author: prof. PhDr. Andrej Mátel, PhD.

List of references

MPSVaR SR. 2021. Explanatory report to Act No. 218/2021.

United Nations. 2006. Convention on the Rights of Persons with Disabilities. A/RES/61/106. New York: UN.

World Health Organization. 2011. WHO QualityRights Tool Kit. Geneva: WHO.

Act No. 301/2005 Coll. Criminal Procedure Code.

Act No. 448/2008 Coll. on Social Services and on the amendment and supplementing of Act No. 455/1991 Coll. on Trade in Crafts (Trade Licensing Act), as amended.

1See Explanatory Report to Act No. 218/2021. Comments have been added in italics. 2See e.g. https://zssipel.sk/wp-content/uploads/2023/02/Institut-dovernika-suhlas.pdf