Retirement and nursing homes In spring 2020 the NPM emphasised in written and personal exchanges with the Federal Ministry of Social Affairs, Health, Care and Consumer Protection that nursing home operators need evidence-based instructions on the one hand and legal security on the other in the greatest health crisis in recent history. The dialogue with the Ministry was preceded by meetings with operator organisations, umbrella associations and the representatives of the residents. In this context, there was consensus that during the pandemic supplementary and normatively binding standards are required for effective infection prevention. Nursing homes and the employees who work there should not have the impression that in practice they can only choose between being accused of the criminal deprivation of liberty or the gross negligence of human life. The head of a nursing home expressed the dilemma to Commission 5 in the following words: “It is an intolerable situation. When there is a COVID-19 outbreak everything is inspected even though there are no infection prevention standards. But then it is easy for everyone to blame supervisors for having done things wrong.” Dilemma of contradictory requirements From 1 November 2020 the Minister of Health issued nationally binding directives through several short-notice amendments (COVID-19 Preventive Measures Regulation – COVID-19 Schutzmaßnahmenverordnung as well as COVID-19 Emergency Measures Regulation – COVID-19 Notmaßnahmenverordnung). These stipulate amongst others the number and frequency of regular tests for employees of nursing homes, the FFP2 mask obligation, the required content of hygiene concepts (especially for a possible outbreak of SARS-CoV-2 infection), but also regulations for managing visits by relatives and the admission and re-admission of residents. Progress through standards For the NPM it is an improvement that the operators of retirement and nursing homes and homes for persons with disabilities are compelled to observe specific precautionary measures to minimise the risk of infection. Unlike in the spring, health and social collateral damage as a consequence of social isolation and the complete shielding of residents can thus no longer be accepted. The way in which the NPM observed and legally assessed the restriction of personal freedom in retirement and nursing homes is explained in detail in this chapter (see chapter 2.1.4). The regulations of the Federal Ministry of Social Affairs, Health, Care and Consumer Protection for infection prevention (COVID-19 Preventive Measures Regulation and COVID-19 Emergency Measures Regulation) increased the workload in the facilities enormously. However, the existing staffing ratios do not even come close to covering this additional work, for example the demanding hygiene concepts, visiting management, the regular testing of residents as well as the staff or the organisation and implementation of the COVID-19 vaccinations. There are increasing levels of exhaustion among those who repeatedly pushed themselves beyond their own limits in recent months to protect the residents or to nurse them in the best way possible Infection prevention binds human resources 32