74 persons with disabilities Isolation facilities and their furnishings • The residential unit had no separate secure or seclusion room Challenging and physically violent situations are resolved through other methods. • The NPM drew attention to the furnishings of the secure room in the group home and the mattress on the floor, which was protected by a rescue sheet that had been attached with duct tape. The secure room had no direct access to the toilet or shower facilities. The Ombudsman stated that dignified treatment and a good standard of care require that a person held in isolation must always have access to a toilet, and they should be proactively offered the possibility to use the toilet without having to ask. For this reason alone, a person should be able to contact a member of staff without delay. In addition, the seclusion room should have a clock so that the person in seclusion can keep track of time. Follow-up: Following the Ombudsman’s visit, the unit reported that the secure room had been fitted with a mattress that meets the safety requirements. Decision-making • The NPM visited the unit run by a private service provider and noted that no appealable decisions had been documented, as required by the Act on Special Care for Persons with Intellectual Disabilities, although there had been situations in which it had been necessary to restrict the residents’ right to self-determination. Based on the report provided by the unit, no expert assessments on the necessity and application of restrictive measures had been made, as required by the law, although the unit had applied restrictive measures since early 2016. The Ombudsman observed that there were substantial shortcomings and deficiencies in the decision-making procedures of the unit and the prompt provision of expert assessments, which required immediate remedy. The Ombudsman drew specific attention to the documented cases of negligence and decided to conduct, on his own initiative, an investigation into the decision-making process for the use of restrictive measures in the unit.