VISITS TO RETIREMENT HOMES In 2019, the NPM visited 19 retirement homes and tried to improve the conditions for residents who require institutional care by means of its visits and recommendations. We carried out one regular visit during which 17 recommendations were provided. It is encouraging that the visited home has already realised 13 recommendations, while four are still pending. In 2019, we particularly wanted to examine the observance of the recommendations given by the NPM during its visits in the past, so we conducted twelve control visits. In addition to verifying the realisation of recommendations provided in the past, we issued 53 new recommendations, of which 26 have already been realised and 22 are to be complied with. During the drafting of this report, we have been waiting for the response from one of the homes regarding five recommendations. Six thematic visits to homes were carried out in August and October 2019. We are also waiting for the homes’ responses to the recommendations at the time of drafting this report (end of January 2020). During the visits, it was determined in particular that there were problems with acquiring legal bases for detention in the homes in which residents’ protection is not implemented by means of locking the ward. Unlike other forms of secure accommodation, restriction of personal liberty in retirement homes is not of such a type that would require a legal basis (it is a matter of a resident’s consent or a court’s decision). It was also established that procedures at the MDDSZ for the verification of secure wards take place but are still too slow. Due to the insufficient number of (verified) secure wards, residents are accommodated on the basis of court decisions in spite of negative opinions of retirement homes and consequently the dementia wards are overcrowded. We even discovered a case where a resident was accommodated in a bathroom because the ward was full, which is certainly unacceptable. Unfortunately, a shortage of staff was also noticed during this year’s visits. It is particularly evident in the low number of staff working at night when, frequently, no one is present on a secure ward continuously and, in one home, we also observed that residents are (still) bathed at unreasonably long intervals due to the lack of staff. The shortage of staff is undoubtedly also the reason for residents’ early retirement to their beds in the evening, which is why they wake up more frequently during the night, thus increasing the use of sleeping pills. We also highlight the NPM warnings regarding lowering the number of multi-bed rooms (in which four or more residents are accommodated in one room), and the issue of the functioning of the emergency call system that was noticed several times. On the other hand, we were also pleased to notice examples of good work and good practices by the staff that certainly contribute to better living conditions for residents. In several homes, progress when establishing and keeping records (e.g. about complaints and residents who are scheduled to visit their doctor) was noticed. Progress was also evident with regard to decorating wards and rooms. 29 2.1 VISITS TO RETIREMENT HOMES 2.1