Retirement and nursing homes XX  Those in need of care and their relatives shall be actively included in all decisionmaking processes, in particular in care planning and care work. XX  Management responsibility also consists of practicing and supporting a positive culture of error. XX  The NPM recommends using care visits for quality assurance in such a manner that they contribute to a jointly supported understanding of care and to resolving difficult situations. The necessity for any further education measures that become evident through this experience shall be met. XX  Care that honours the right to the best possible health shall be organised with a rehabilitative approach. Attempts shall be made to minimise the use of medicationbased restrictions of freedom on care visits. 2.1.3 Violence prevention and de-escalation management Broaching the issue of aggression and violence in care facilities is a fundamental condition for finding the causes thereof and being able to initiate change. For the NPM, it is important to examine the issue “from both sides”, that is, to take not only violence against residents but also violence against caregivers seriously. Caregivers have a right to a healthy and safe working place. What is of critical importance from the NPM’s point of view is therefore that there is awareness on all hierarchical levels that dealing with violence is a preventive matter for the entire organisation – and not a personal problem or the failure of individual employees. Those in need of care and staff are equally affected by structural violence, that is, conditions under which they live and work without being able to influence them. Violence prevention is the responsibility of organistations Those who are unable to look after their own needs will sooner or later be unable to look after the needs of entrusted persons in need of care. The NPM has heard complaints from all of the Laender about increasing demands, stress and strain, fewer breaks, difficulties in filling vacant positions and overtime that cannot be reduced due to a sense of responsibility to the elderly and colleagues. Commission 2 observed an extremely high number of remaining leave that had not been taken in two homes in Upper Austria. Nursing staff alone had a total of 5,325 hours of remaining leave at the end of 2019, which is equivalent to 26 fulltime annual holidays. The Commission considered it an urgent requirement to increase staffing levels and to involve the caregivers in shift planning. In this context, an evaluation of mental stress at the workplace and employee satisfaction would be essential. If the daily routine in care facilities is tightly scheduled and primarily based on the concept of “warm, full, clean”-care as opposed to equally important responsibilities such as considering relationships and quality of life, constant pressure is exerted on all those involved. Persons who are cognitively impaired Relationship work is integral part of good care 28