health care • Patient in a rehabilitation and acute ward were allocated to double-occupancy rooms as a rule. The Ombudsman referred to the Valvira statement, according to which it had been shown that allocating psychiatric patients to single-occupancy rooms reduced the occurrence of altercations and the use of restrictive measures, and speeded up recovery. The Ombudsman recommended that the general objective of the Valvira statement to allocate patients to single-occupancy rooms be observed in the design of the new premises. • It was considered a positive development that there was a separate room for visits by family and friends. However, on the negative side, the patients were forced to share their rooms with one or several other patients, and the hospital could not provide a fenced outdoor area for patients who require special observation. Follow-up: The hospital responded after the visit that the new hospital will have single rooms for all patients. However, the modern and patient-driven care concept does not support the use of fenced-off outdoor spaces. Adequate outdoor time will be enabled for all patients by means of adequate staffing and designated carers. Outdoor time • A hospital had no separate outdoor area or fenced-off yard in which patients under special observation could spend time outdoors. The wards seemed to abide by varying practices in regard to outdoor time, and it did not become clear during the visit how outdoor time was organised in practice for patients of different status, or whether patients in voluntary care were able to go out as and when they wished to do so. On several wards, outdoor time was not routinely included in the weekly programme. The outdoor area for psychiatric patients at Päijät-Häme Joint Authority for Health and Wellbeing. The Ombudsman stated that outdoor time is part of good care, and the staff should encourage patients to spend time outdoors. The Ombudsman stressed the importance of monitoring actual outdoor time and including outdoor time in the patients’ care plans. The Ombudsman stressed that access to outdoors may not be restricted simply because the outdoor areas are not suitable for patients under restriction of movement or because there are not enough staff to supervise 81