Hospitals and psychiatric institutions The non-medical staff in the casualty department worked between three and 15 additional hours per month. On average, 160 hours of remaining leave were open, but there were also employees with 253 and 307 hours of remaining leave. Regarding this matter, the office of the regional government of Lower Austria informed the NPM that a reduction in the number of additional and overtime hours could be achieved by filling the vacant medical and nursing care positions. Changes in the team cause additional workload for staff On a monitoring visit of Vienna General Hospital, University Department of Psychiatry and Psychotherapy, Psychiatric Intermediate Care (IMC) ward 4C, Commission 4 ascertained that the hitherto very stable care team made up of predominantly older and experienced officially qualified caregivers was recently confronted with numerous changes and had been reduced in size for several months as a result of sick leaves and departures. This resulted in considerable additional workload for the team. The care staff found training new employees challenging, as the work in the ward is complicated and requires competences in the field of psychiatry and intensive care, which the new colleagues naturally do not yet have. In response to this criticism by the NPM, three officially qualified caregivers were hired who were trained by experienced colleagues. XX  Sufficient medical and nursing care staff shall be made available to guarantee an adequate medical care of the patients. XX  When changing teams and filling positions that have become vacant, attention shall be given to training the new employees in time. This is a imperative to provide continuous adequate care of the patients. 2.2.4 Execution of measures that restrict freedom Structural deficits in the Department of Geriatric Psychiatry at Graz Regional Hospital In its Annual Report 2018 (see p. 57 et seq.), the NPM most recently highlighted structural deficits in the Department of Geriatric Psychiatry and Geriatric Psychotherapy at Graz II Standort Süd Regional Hospital. The criticism was of the cramped conditions in the department and the shocking lack of space amongst others. Commission 3 had observed that patients were accommodated in five-bed or six-bed rooms. Measures to protect their privacy in the event of a necessary restraint (e.g. the use of screens) were not adequately implemented or not at all. Land Styria promised improvements As a consequence of the criticism, a “commission of experts in geriatric psychiatry” was deployed to bring about qualitative improvements. In 51