3.2.5 Human resources.................................................................................89 3.2.6 Report of the commissions..................................................................90 3.2.7 International collaboration and cooperation.....................................91 3.2.8 Report of the Human Rights Advisory Council...................................93 4 Monitoring framework, methodology and further action by the NPM.....................95 4.1 Preamble............................................................................................................95 4.2 Goals and basic principles.................................................................................95 4.3 Monitoring methodology..................................................................................97 4.4 Further action....................................................................................................98 5 NPM findings and recommendations.........................................................................99 5.1 Retirement and nursing homes.........................................................................99 5.1.1 Introduction.........................................................................................99 5.1.2 Geriatric care requires attentiveness and competent leadership......104 5.1.3 Violence in nursing care....................................................................107 5.1.4 Introduction of care standards in relation to pain...........................110 5.1.5 State‘s duty to protect also relates to non-approved facilities..........111 5.1.6 Regular raising of awareness in relation to measures that < restrict freedom..................................................................................114 5.2 Hospitals and psychiatric institutions and facilities.......................................119 5.2.1 Introduction.......................................................................................119 5.2.2 Inadequate child and adolescent psychiatric care...........................123 5.2.3 Questionable use of security companies...........................................126 5.2.4 Immediate reporting of measures that restrict freedom and violation of personal rights...............................................................128 5.2.5 Application of measures that restrict freedom..................................129 5.2.6 Unacceptable transfer of patients requiring placement in a psychiatric clinic................................................................................131 5.2.7 Involuntary placement without doctor‘s certificate as the norm?...133 5.2.8 The unknown Istanbul Protocol........................................................134 5.2.9 Struggling with the care of a juvenile patient..................................135 5.2.10 Spatial redesign of the psychiatric wards in Mauer Regional Hospital..............................................................................................136 5.3 Child and youth welfare facilities...................................................................138 5.3.1 Introduction.......................................................................................138 5.3.2 Monitoring priority: prevention of sexual and all other forms of violence..............................................................................................142