Retirement and nursing homes Residents and their relatives need to be certain that the nursing home deals with critical observations and is seriously interested in making improvements. No organisation is safe from “blindness of the system” and negative routines. The way in which individual facilities deal with complaints differs greatly, as ascertained by the commissions on their visits to retirement and nursing homes. The commissions were told in one facility in Tyrol and in Burgenland that the establishment of a low-threshold complaint management had not been dealt with, as it was possible to contact the head nurses or facility manager, which was a rare occurrence anyway. In a nursing home in Upper Austria, Commission 2 observed that written criticism could be submitted but that staff were unable to explain how the complaints are processed and how the outcome is communicated. It was also not possible to voice complaints anonymously. The home operator assured the NPM that a comprehensive new concept would be developed and implemented in 2018. Few complaints do not necessarily indicate customer satisfaction In a facility in Styria, residents testified to Commission 3 that there were several cases of verbal abuse on the part of two employees. They also spoke of “assault” when being assisted with personal hygiene. In concrete terms, they described situations in which those in need of care were shouted at or even “pushed” in front of others. As a penalty for undesired behaviour, these persons’ mobile phones were taken away temporarily or they were forced to stay in their room or not allowed to go to the dining room. Residents claimed that they have stopped complaining about these caregivers, as there has been no reaction to date. They also rarely tell their relatives anything negative “so that they won’t worry”. The management of the facility and the staff on the other hand were convinced that there is an open complaint culture in their organisation, as there is the opportunity to voice complaints in a forum once a month. An internal anonymous complaint channel was however not planned. Besides, there were no notices on contacting the Styrian Patient and Care Ombudsman Board (Steirische PatientInnen- und Pflegeombudsschaft) and the representatives of the residents. There was also a complete lack of information on the rights of residents. When the problematic behaviour of the caregivers was brought up, the manager admitted to the commission that she was aware of the allegations and had organised that the two caregivers in question are no longer permitted to work alone and “were under observation”. Commission 3 had the impression that trying to improve the atmosphere or openly discuss the problem with those affected had no priority. A care facility in Lower Austria installed a residents’ council in order to give the residents the possibility to have their say. The residents elect one representative for each floor who is invited to regular meetings with the home management. Ideas, feedback, wishes and filed complaints are discussed and decided on together, as are the form in which residents are informed about solutions and what is rejected or in the process of being implemented. Residents‘ council 31