 Detainees in segregation should have a means of rest at their disposal, ready access to toilet facilities, and regular access to a shower, as well as at least one hour of outdoor exercise every day and access to reading matter.56  Applying handcuffs as a matter of routine to immigration detainees whenever they leave their detention facility, such as on hospital transfers, is disproportionate; the use of means of restraint should be considered on individual grounds and based on the principle of proportionality.57 8. Monitoring and complaints mechanisms  Independent monitoring of detention facilities for irregular migrants is an important element in the prevention of ill-treatment and, more generally, of ensuring satisfactory conditions of detention. To be fully effective, monitoring visits should be both frequent and unannounced. Further, monitoring bodies should be empowered to interview irregular migrants in private and should examine all issues related to their treatment (material conditions of detention, custody records and other documentation, the exercise of detained persons’ rights, health care, etc.).58  Effective complaints procedures are basic safeguards against ill-treatment in immigration detention. As regards complaints procedures, immigration detainees should have avenues open to them, both internally and externally, and be entitled to confidential access to an appropriate complaints authority.59 9. Adequate health care  Medical screening of all newly-arrived detainees is in the interests of both detainees and staff, in particular for identifying those at risk of self-harm, screening for transmissible diseases and the timely recording of any injuries.60  All newly-arrived detainees should benefit from comprehensive medical screening (including screening for transmissible diseases) by a doctor or a fully-qualified nurse reporting to a doctor as soon as possible after their admission.61  The record drawn up after a medical examination of a detainee, whether newly-arrived or not, should contain: (i) a full account of objective medical findings based on a thorough examination; (ii) an account of statements made by the person concerned which are relevant to the medical examination, including any allegations of ill-treatment made by him/her; (iii) the doctor's observations in the light of (i) and (ii), indicating the consistency between any allegations made and the objective medical findings. In addition, the results of every examination, including the above-mentioned statements and the doctor’s observations, should be made available to the detainee and his/her lawyer.62 Ukraine: 2009 visit, paragraph 71; Bulgaria: 2008 visit, paragraph 44. Netherlands: 2011 visit, paragraph 56; Malta: 2004 visit, paragraph 67. 58 19th General Report on the CPT’s activities, paragraph 89. 59 United Kingdom: 2012 visit, paragraph 136; Spain: 2011 visit, paragraph 97. 60 Sweden: 2015 visit, paragraph 37. 61 Sweden: 2015 visit, paragraph 37. 62 Austria: 2014 visit, paragraph 46. 56 57 7