From an organisational perspective, important decisions were made at the level of the Upper Austrian regional government by determining the pedagogical overall responsibility for all three regional facilities and seamless leadership and responsibility chains. For the first time, pedagogical guidelines as guidance will be developed and implemented for these three facilities. In the facility itself, a new leadership and staffing culture must be developed among other measures. It is essential that the measures to be implemented do not peter out once the project has been completed. That is why ongoing implementation monitoring is planned, as well as an evaluation of the entire implementation process after about three years. The project results offer the opportunity to tackle comprehensive improvements. Whether and how the implementation will be successful will be observed during continued visits by the commissions.  2.4 Opportunity for comprehensive improvements Project offers an opportunity for fundamental changes in Upper Austria. Institutions and facilities for persons with disabilities 2.4.1 Introduction In 2014, the commissions carried out 78 monitoring and control visits in institutions and facilities created especially for persons with disabilities. As was the case in the previous year, public and private operators were monitored and controlled, whereby the range of institutions included homes, shared accommodations, day care centres, sheltered workshops and nursing wards. These types of institutions and facilities are encompassed both by the OPCAT mandate and by the mandate set out in Section 16 (3) of the UN Convention on the Rights of Persons with Disabilities (CRPD). The monitoring activities turned out to be very complex due to differing levels of need, the broad range of offerings and the diversity of the institutions and organisational forms. At the same time, the commissions also found qualitative and quantitative deficits with regard to care, especially for people with double and multiple diagnoses (learning disability and mental disorder or psychiatric impairment). Persons with intellectual impairment, who additionally are experiencing a psychosocial crisis or a mental illness, sometimes show extremely aggressive behaviour toward themselves or others; this creates a great deal of stress for themselves, the care staff and their families. Mentally disabled persons exhibit mental health issues and classic psychiatric disorders three to four times more frequently than the average population. This statement by the World Health Organisation (WHO), is based on the higher degree of vulnerability of 68 Broad range of offerings, but nevertheless there are still deficits in care