Institutions for persons with disabilities 2.4.4 No saving at the expenses of human rights Besides positive developments such as the National Council resolution on increasing budget resources for the occupational integration of persons with disabilities as well as the promotion of independence and budget increase of the Monitoring Committee in October 2017, the NPM also continued to observe backward steps. Commission 2 thus reported about cost-cutting measures in a facility for persons with mental illnesses which meant that the intensity of care had to be reduced considerably. The staffing ratio was reduced from 1:2 to 1:4 due to cuts and on the initiative of the Land. This resulted in additional autonomy for some of the residents. Others, in turn, had serious problems with the change of shifts and reduction in the presence of qualified staff. Some residents reacted to the altered conditions with defecation and bedwetting. Persons with increased care needs had to leave the facility. Joint activities were reduced due to staff shortages. Relocation of persons with metnal illnesses due to cust-cutting measures The reasons for the relocations were explained as having to do with changes in support needs and a necessary distinction in the types of housing. However, the Land conceded at the same time that the staffing ratio also had to be reduced for cost-cutting reasons. The Land argued that, in line with the principle of normality, a change in facility is reasonable for persons with impairments if this change is prepared accordingly. The NPM cannot understand this argument. First of all, it is incompatible with the UN CRPD that persons with disabilities are taken from their care environment and moved to other facilities for financial reasons. Persons who are suffering complex long-term, mental illnesses rely on types of housing with as little stress as possible in which they are familiar with the routines to stabilise their situation. For the persons with chronic mental illnesses in particular, it is important to ensure together with those affected that a satisfying quality of life is achieved. Financial reasons are no justification for relocation But there has to be a balance between the conscious promotion of abilities and the safeguarding of resources in order to avoid overload. This can only be achieved through a specific continuity of care and constant monitoring of individually defined and pursued goals. Overload must be avoided When planning a change in the type of housing and care, multi-professional teams have to evaluate in how far help to helping oneself and the promotion of self-responsibility can be sufficiently guaranteed. Changes brought about by cost-cutting measures of the Land that act contrary to the wellbeing, the health or the maintaining of an already achieved functional level of those affected must be avoided. Deterioration in the quality of care and forced relocations have to be avoided. 93

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