1 – INTRODUCTION In the year under review, the National Agency chose to focus on the topic of residential care and nursing homes. Nevertheless, the National Agency is in fact obliged to include residential care and nursing homes in its visits. This mandate follows from Article 2 (1) of the State Treaty on the establishment of a national mechanism of all Länder in accordance with Article 3 of the OPCAT, which obliges the National Agency to conduct visits to “places of detention” within the meaning of Article 4 of the OPCAT. This concerns all places where persons are or may be deprived of their liberty, either by virtue of an order given by a public authority or at its instigation or with its explicit consent or acquiescence. This includes long-term care facilities, as persons may be deprived of their liberty in being accommodated there, or may be subject to measures involving deprivation of 38 liberty. These facilities may be either public institutes or privately owned. Since commencing its visits to residential care and nursing homes in 2015, the National Agency has visited such facilities in every Land. In the reporting period, it carried out 28 visits to residential care and nursing homes, three of which were follow-up visits. The latter were arranged in order to assess the extent to which the facilities had implemented recommendations from previous visits. To ensure humane conditions in care facilities, it is vitally important that patients are able to lead as self-determined a life as possible, regardless of the severity of their care needs. Where it is not possible to avoid certain limitations, these must be kept to a minimum level of what is strictly necessary. The visits addressed in particular the issues of: measures for deprivation of liberty; ensuring maximum freedom of choice for patients in all matters; protection against violence; respectful treatment of residents; as well as general conditions in the facilities, for example in terms of accessibility. The Medical Service of the Health Insurance Funds [Medizinischer Dienst der Krankenkassen] and residential home authorities are also tasked with inspecting residential care and nursing homes. There is therefore potential for overlaps in individual assessment criteria. Yet what differentiates the inspections is their particular focus. In its visiting activities, the National Agency is concerned with humane conditions. Consequently, any overlaps with other inspection mechanisms will only arise where the focus is on ensuring the human dignity of residents. Given this focus, it is often necessary for the National Agency to express criticism over circumstances that are not addressed, or not addressed sufficiently, in other inspections. The present report draws on findings from all visits conducted to date to residential care and nursing homes. 1.1 – THE NATIONAL AGENCY AS A PREVENTIVE MECHANISM IN RESIDENTIAL CARE AND NURSING HOMES The National Agency conducts visits to residential care and nursing homes with the aim of preventing potential violations of human dignity in places where people are deprived of their liberty. The Agency works together with the facilities and the highest supervisory authorities in order to bring about sustainable improvements in living conditions. 1.2 – COOPERATION WITH THE RESPONSIBLE MINISTRIES The responsible ministries must enable the National Agency to fulfil its mandate. This implies a number of obligations for those ministries. However, in isolated cases, the ministries responsible for residential care and However, in a small number of cases, the facilities visited stressed that residential care and nursing homes are already inspected by various control mechanisms, and it was therefore not clear why further inspection was necessary. 38 Nowak / McArthur, The United Nations Convention against Torture – A Commentary, 2008, p. 926, margin no. 2 34