sole TV set in the communal room required permission from staff. Residents were not allowed to lock their rooms, and after they returned from visits home they were only allowed to unpack their bags with the help of a care worker. They were instructed to always ask when they wanted something or wished to do something. During the interviews conducted by the commission, they were not able to explain why these rules existed, and through non-verbal communication expressed the view that they did not understand the rules. Encouragingly, with the help of external support this facility has since reviewed all its principles for action (operations plan, sexual education plan and concept of “fully assisted living”), drawn up new house rules with the residents’ assistance, and developed a selfrepresentation model. Furthermore, the regional government of Styria has announced that in the near future it will assess the implementation of these measures. A further indicator of lack of self-determination is the approach to sexuality at institutions and facilities. At numerous residential homes, the commissions found there were deficits in this regard. Many institutions and facilities lack pedagogical concepts regarding sexual education. It cannot be taken for granted that support will be provided regarding exploration/experience of sexuality and issues surrounding masturbation, relationships, contraception and parenthood. In an institutional context it is vital that persons with disabilities not be viewed as asexual or treated as such. Failure to acknowledge sexuality prevents development of positive feelings about the body. It is much more difficult to categorise sexual excitement or the need for closeness or distance if during bath time or when getting dressed/undressed one has to rely on others or is accustomed to other people having control over one’s body. It is important to be able to discuss issues such as what should be considered normal care, how sexual desire should be handled, how satisfaction can be achieved, respect for other peoples’ boundaries, and awareness of what behaviour constitutes sexual encroachment, without these subjects being taboo. A failure to handle issues surrounding sexual self-determination makes individuals susceptible to violence and abuse. Sexuality must not be a taboo subject The commissions often observed the detrimental effects of a lack of structural accessibility in institutions and facilities. The NPM considers it an infringement of human rights when state-authorised institutions and facilities, at which in many cases the cost of care is borne by the state, restrict mobility and autonomy of persons with disabilities by failing to provide adequate accessibility in a manner that could be avoided. In numerous cases, the NPM has persuaded the institution in question to eliminate these shortcomings. Moreover, at older institutions and facilities the Laender as the operator organisations for providing assistance for persons with disabilities tolerate enormous deficits. It is true that long transition periods for ensuring full barrier- Restrictions of mobility due to inadequate structural accessibility infringe human rights 76