5.1.7 Follow-up visit to Berlin youth prison The Joint Commission carried out a follow-up visit to Berlin youth prison on 29 August 2012. It had already visited the facility in the previous year on 7 April 2011, when it became aware of large numbers of problems. The repeat visit was now intended particularly to help determine the degree to which the shortcomings that were discovered had been remedied. The Commission visited the places which it had complained about on its first visit: the penal detention wing, the admissions area, the visiting area of the specialist drugs area, the social therapeutic department, the specially-secured cells containing no dangerous objects, the cellular confinement cells, the sanitary facilities of the remand detention area and the medical department with its waiting area. The Commission spoke with the prison governor and with other officers. It also spoke with the inmates who were in cellular confinement at the time of the visit. The Joint Commission found that the majority of the recommendations from their previous inspection visit had not yet been implemented. Recommendations by the Joint Commission and the reaction by Berlin Senate Administration for Justice and Consumer Protection The specially-secured cells containing no dangerous objects were now clean on the occasion of visit and had been fitted with new mattresses. The sanitary facilities were also in good condition. However, fixation is still being carried out using metal handcuffs and footcuffs. The Commission had emphasised in its report of 16 June 2011 that metal handcuffs and footcuffs are not suitable for fixation as a matter of principle because of the inherent risk of injury, and had hence recommended a belt or bandage system to be used in future. The prison governor stated that he would see to it that they were purchased. Reaction: Where binding is necessary within the narrow statutory preconditions, the existing metal cuffs were preferable. They were much wider than the cuffs that were otherwise used. The proposed belt and bandage system hence appeared to be suited to prolonged fixation in the medical context, and was used as a rule if patients were fixed in bed. This was not the means of choice for the normally short fixation of a highly-excited person, especially since there was no bedframe in the specially-secured cells. The health risks were minimised by the use of direct supervision by an officer during the entire duration of the fixation and the medical supervision that was prescribed by law (section 74 subsection (1) of the Berlin Youth Prison Act [Jugendstrafvollzugsgesetz]). 57