National Preventive Mechanism 5.1.6 Regular raising of awareness in relation to measures that restrict freedom Under the Federal Constitutional Law on the Protection of Personal Freedom and the Nursing and Residential Homes Residence Act (Heimaufenthaltsgesetz), measures that restrict freedom are only permitted if they are implemented in order to uphold human dignity and comply with all conditions prescribed by law. This includes in particular compliance with all formal requirements laid down by law, which is established in the specific individual case after the judicial review of measures that restrict freedom. Therefore, the notifications to the representative(s) of the residents must clearly state not only the person who orders the measure, but the order must also be issued by a person with authority to do so. The measure ordered must be authorised and signed off by this person. Thus, mechanical restrictions of freedom in long-term care facilities may be ordered by qualified nursing staff, whilst medication-based measures must be ordered by a doctor. The notifications must also state the diagnosis, the specific type of danger to the individual or to other persons and the milder measures previously applied without success. If there are any formal errors, this will render the restriction of freedom unlawful and will constitute a breach of the right to protection of personal freedom guaranteed by constitutional law. Incorrect reports The NPM has found a lack of awareness and sensitivity in this area. The list of ascertained shortcomings includes the absence of specific diagnoses and documentation of situations of danger, a lack of internal clarity regarding the persons authorised to impose such measures, the failure to record measures that restrict freedom in the nursing care documentation system, the absence of instructions from a doctor, deficient evaluation and thereafter the failure to update reports about measures that restrict freedom, confusing documentation which even the facility staff can no longer follow, a lack of documentation concerning proportionality and unreported measures that restrict freedom. For example, in one facility in Lower Austria, there were reports on measures that restrict freedom which were no longer being applied, whilst current measures were not being reported. Following a request by the NPM, the documentation system was standardised and reports on measures that restrict freedom were updated. On various occasions the NPM recommended that staff be advised of the need to comply with the formal requirements of the Nursing and Residential Homes Residence Act when implementing measures that restrict freedom. This is not an insignificant requirement, but rather a basic prerequisite for the admissibility of restrictions of human rights. Staff do not always recognise measures that restrict freedom 114 In some retirement and nursing homes numerous alternative measures to measures that restrict freedom were apparent in the nursing documentation, coupled with a more sensitive approach and good cooperation with the