residents should be aware of the option of having a late evening meal. one facility, it was reported that consent was requested orally every day before the measure was applied, although this was not documented. 2.2.9 – Further training courses One facility used a form for obtaining consent that included the notice that a witness’s signature was required for residents who were capable of giving consent but incapable of providing a signature – and that the witness should be a permanent employee. Such a requirement gives the impression that the person concerned is not free to choose who acts as their trusted person in such matters. This entails the risk that the person concerned may feel under pressure, and that their right of selfdetermination could be violated. On several occasions, certificates relating to further training for employees showed that a time slot of only 20 minutes was provided for topics such as “deprivation of liberty”, “emergency call training” or “fall management – best practice”. Further training should be designed to promote professional standards of care and support. A reasonable amount of time should therefore be available for training. In several facilities, the opinion was expressed that lowerable beds offer a viable alternative to other measures involving deprivation of liberty. However, if persons are unable to stand up independently from a lowerable bed once it has been lowered, this may constitute a measure involving deprivation of liberty. This would therefore require the consent of the person concerned, or a court permit. 2.2.10 – Deprivation of liberty Consent In the case of several residents, measures involving deprivation of liberty (such as bed rails) were taken at the resident’s own request. However, various shortcomings were identified in connection with the consent required for such measures: The installation of bed rails or the lowering of a lowerable bed may constitute a measure involving deprivation of liberty within the meaning of section 1906 (4) of the German Civil Code [Bürgerliches Gesetzbuch, BGB]. In principle, it is possible for the persons concerned to consent to such measures. However, this requires that the persons concerned are capable of giving consent in a specific decision-making situation, that their consent was recent, and that they have been informed about alternatives as well as the possibility of revoking their consent. This should be documented in a transparent manner. Furthermore, persons who have given such consent should be asked at regular intervals (e.g. every three months) whether their declaration still applies. The response should be documented, dated and signed by the resident to confirm the validity of the declaration. In some cases, the consent had been given in writing several years previously, yet the facilities had not subsequently acquired renewed consent at regular intervals. In other cases, the facility could not find evidence of acquired consent at the time of the visit. In numerous cases, documentation on consent was incomplete. For example, facilities had not always informed residents of the possibility to revoke consent at any time, or what alternative measures were available – or at least any such steps had not been documented. In one case, details such as the resident’s living area and room number were not recorded, which could lead to the incorrect application of a measure involving deprivation of liberty if two residents within the same facility had the same name. Consent was also found to measures involving deprivation of liberty that were no longer being applied. No dated and signed notice of cancellation was available. In Absence of judicial authorisation In one facility, it was found that the placement order for one resident had already expired a week prior to the visit. However, the person remained in a living area where the exit door was locked and could only be opened by employees. In another facility, it was found that bed rails Services] (ed.): “Expertenstandard Ernährungsmanagement zur Sicherung und Förderung der oralen Ernährung in der Pflege”, 1st update 2017; Deutsche Gesellschaft für Ernährung e.V. [German Nutrition Society]: “DGE-Qualitätsstandard für die Verpflegung in stationären Senioreneinrichtungen,” 3rd edition, 2015 41