Retirement and nursing homes – the autonomous determination of care needs as well as the assessment of dependence on care, diagnostics, planning, organisation, execution, monitoring and evaluation of all care-related processes (see Section 14 of the Federal Act on Healthcare and Nursing Professions). Active involvement of those in need of care in care planning As explained in detail in the NPM Report 2018 (p. 42 et seq.), the way in which the relationship with those in need of care as well as the cooperation with their relatives is handled has effects that can prevent or foster violence. The NPM is thus of the opinion that those in need of care and their relatives should be actively involved in decision-making processes, in particular in care planning and care work. This can be implemented within the framework of care visits, for example. These visits will show the residents that there is interest in their well-being and enable the staff to receive regular feedback on their work and the effectiveness of intervention as well as recognise weaknesses. Care visits are an important instrument for quality assurance when they contribute to detect which individual resources of those in need of care could be activated. This can then increase the person’s, the relatives’ and the staff’s ability to perceive changes that can be further influenced positively. The specialised examination that is part of care visits documents care measures taken and processes implemented to date. By sharing this information, other aspects can be uncovered, which require the extension or revision of the care plan. Especially in difficult situations, the expert advice and exchange of experience can help strengthen the personal responsibility and job satisfaction of the caregiving staff. Commissions observed in several homes that care visits attended by the ward manager are organised in a way that they facilitate a professional transfer of sound information. Care visits and review meetings can reveal further training needs because they enable managers too draw conclusions on the staff’s capability to act in certain situations. All of these effects help in developing a jointly supported human-rights-based understanding of care. This is the prerequisite for implementing care concepts with a rehabilitative approach that counter the inappropriate use of measures that restrict freedom and polypharmacy. In some nursing homes, general practitioners also take part in care visits with the consent of those in need of care. This requires coordination and making appointments, but the result is considerably more informative and saves resources. Care visits do not appear to be common practice. For example, Commission 2 observed on a visit to a home in Upper Austria in 2019 that no care visits are made by the care service management even though the technical supervision of the regional government of Upper Austria had already criticised this in 2018. 27

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