cases the lack of a possibility to reach agreement with patients and the resultant endangerment to themselves and to others led to fixation, fixation in gerontological psychiatry was more frequently indicated by the danger of falling, in order to ensure infusion therapies, etc. What is more, the progress of the diseases was more difficult and laborious as a rule in the field of gerontological psychiatry, also particularly because it was necessary to proceed much more carefully with regard to the necessary medicine therapy. In order to prevent patients falling out of their beds, patients in the gerontological psychiatric wing were generally protected using 3-point fixation and bed bars. Floor beds can considerably reduce injuries caused by falling. Hence, they are a more suitable means than the type of fixation described above, and should be acquired in a greater number. Reaction: The floor beds which the Commission had requested had been ordered via the procurement department of the clinic and would be delivered soon. The separate acute area with a maximum of eleven useable beds in the emergency room has a small, spartanically-equipped, windowless hose-shaped common room, which was hence unsuited as a recreation room. The time spent by the patients in 050B wing – acute psychiatry is approx. six weeks to four months. In light of this relatively long stay, the yard area available was too small. The wing itself also appeared to be very cramped. It has only one group room. Individual therapy took place in a room that was also put to other purposes. The largest room in the wing was the dining room, which also offered a possibility to make tea, but no kitchenette which was open at all times was available for the patients. The Commission recommended improving the spatial situation. This should particularly include the establishment of separate therapy rooms with the appropriate equipment, as well as enlarging and re-designing the yard area. Reaction: The clinic had provided an assurance that the spatial circumstances that had been mentioned and in some cases complained of would be examined, and in particular that changes would be made on 050B wing. It was not possible to enlarge the garden area on 050B wing for constructional reasons. Moreover, participation in the “Werdenfelser Weg“ project would take place aiming to reduce measures entailing deprivation of liberty and fixation at court level. The Commission welcomed participation in this project. 5.4 Child and youth welfare facilities The Joint Commission carried out inspection visits at three facilities for child and youth welfare in 2012. 72