Annual Report 2015 - Spain’s National Preventive Mechanism In the San Juan de Dios Centre there is a mechanical restraint protocol which recommends the use of alternative immobilisation measures (verbal control, medication, solitary confinement, etc.). However, despite the existence of a policy of dignified and respectful treatment which attempts to minimise the use of mechanical restraints, it was deduced from the interviews conducted with the residents that all of them had been restrained on at least one occasion. Some stated having suffered what they consider to be abusive practices: ‘Being tied to a chair in a hallway’; ‘I was tied on top of the bed for two days’; ‘Sometimes they restrain you because you fight with someone, they tie you up and lock the door and you spend 3 or 4 days sleeping’. In the case of the Ciempozuelos facility, the NPM also highlighted that although the procedure for mechanical restraint must always be managed and, where possible, applied by medical personnel, the occasional assistance of auxiliary security personnel where there is a need for applying restraints should be assessed. Mechanical restraints in the San Juan de Dios Centre in Ciempozuelos (Madrid) 74 Locking of rooms 96.  In the Pumarín Mixed Residence it was established that bedrooms are often locked as a preventive measure to avoid escapes or, in some cases, violent outbreaks by some residents. This could be dangerous given that there is no video surveillance in the bedrooms, meaning that a person in care could find themselves in an emergency situation which goes undetected. Neither is there a solitary confinement room, despite the personnel interviewed confirming that, on occasion, it was decided to lock very distressed residents in their bedrooms, which are not adapted for such situations. Support systems §339 AR 2014 97.  From the interviews conducted with the residents of Ciempozuelos it was established that they usually view admission to the solitary confinement area of Unit 10A (the ‘observation area’, also known as the ‘fish bowl’ by the patients) as a punishment, without distinguishing between whether it was ordered for therapeutic reasons or due to a breach of the rules. An assessment should be made of mechanisms for engaging and providing