Annual Report 2012: Spain’s National Preventive Mechanism small villages of the Toledo province hinterland expressed with great sorrow the feeling of being uprooted as a result of their placement in the residence. These are persons who were well integrated with their neighbors, who lose their social network and their contacts, and live far from their family surroundings and their village. Small residences located in these villages would be a better solution for these persons, who could thus conserve a greater degree of autonomy, main­ tain their social support network and avoid the impairment caused by institu­ tionalization. The visits of persons that belong to guardianship foundations, which represent the sole contact with the exterior for some residents, are a positive note worthy of mention. A Record of official visits is required Disciplinary measures imposed must be discussed or explained to the affected residents Appropriate health care 144 194. The center does not have a Record of official inspection visits in which to record those made by the Ombudsman Institution, the Public Prosecutor’s Of­ fice, the Government of Castile-La Mancha or the Provincial Council itself, which must be corrected. 195. Even though the center does not have any regulations or system of rules per se, some «punishments», which vary from one building to another, are imposed on residents. Some of the punishments mentioned during the inspection were having to watch television in the room with persons with severe mental disabili­ ties, having the resident wear a pajama or nightgown (which means he/she can­ not leave the unit), or restricting visits. For example, notes made by nurses in a patient’s file stated the following: «She was dressed with a pajama because last night she did not want to get in bed, and she was finally found with a lighter. She’ll have to wear pajamas until the 12th, but she won’t be told.» (2010). «Alter­ cation with another resident. She is dressed in pajamas and will not leave the unit until the 3rd of November (one week)» (2011). These punishments are generally applied for minor infringements (altercations with other residents, showing lack of respect for staff, not respecting timetables) and constitute alternatives to the use of physical restraints. In this sense, the external experts considered them positive, because an incident that is of minor importance in terms of aggressive­ ness towards the resident («wearing pajamas») is in itself a deterrent, as noted during the inspection visit, thus avoiding more aggressive actions. However, it seems that in most cases these measures are not discussed or explained to the residents, which should be corrected. 196. From a healthcare point of view, residents were well taken care of, with magnificent results in respect to the pathologies common to severely dependent persons. Likewise, the treatments seemed to correspond to the pathologies, and note was made of the effort to develop written protocols for the most common health care procedures. THE OMBUDSMAN OF SPAIN