National Preventive Mechanism Lack of staff during night shift As already found in the 2013 reporting year (NPM Report, p. 29), the commissions repeatedly found inadequate staff resources. During the reporting year, the observations were concentrated increasingly on the night shift. Commission 5, for example, found that in a home in Lower Austria, there were five living areas where only four employees were present during the night shift. This means that one living area was inevitably intermittently not manned. This is highly problematic for the care and safety of the affected persons. The residents who were questioned stated that there were noticeable negative consequences for them in the form of lengthy wait times, wearing incontinence pads only at night and impatient staff. The operator of the facility stated that considering the current funding arrangements, more staff at night could only be realised at the expense of less staff during the day. This would limit care and activities during the day and represent a disadvantage for the residents. Inadequate staff resources, especially during night shifts In another case, there were only two caregivers at night for 78 residents who were distributed across three floors. As a result, some stations inevitably remained unmanned at night and calls by residents who could not use the call system remained unheard. At the time of the commission’s visit, there were a total of 23 persons at the care and nursing allowance level 5 and eleven persons at the care and nursing allowance level 6 (care measures that cannot be coordinated as to time and permanent presence of a caregiver, including at night) who needed nursing care. Two caregivers for three floors While the supervisory authorities of the Laender verify if the operators of the facilities comply with the predefined minimum staff figures, they do not verify whether the staffing at night is sufficient, considering the care necessities and difficulties that can result from structural and spatial components. The NPM is of the opinion that there must be adequate personnel present at night to guarantee the safety of the residents. Care personnel must be able to undertake unforeseen care in a timely manner, recognise emergencies early on and hear calls for help. Furthermore, there should be – something that the commissions were pleased to find in some facilities – programmes in the evening for residents with dementia who are restless and not sleeping. ¾¾ Insufficient staff resources during the night shift. ¾¾ Safety of the residents is not always guaranteed. ¾¾ Evening programmes are necessary. 85