2.1.5 Hygiene On a final note, the CGLPL outlined recommendations on patients' access to washing facilities, which primarily depends on architectural conditions. It acknowledges that, as highlighted by the Minister, the new infrastructure and renovations now provide for washing facilities that meet its recommendations. Plans for the publication of a guide on the architecture of full-time hospitalisation units in psychiatry will surely only improve the situation in the future. 2.2 Special recommendations During the latter half of 2014, the CGLPL inspected two mental health institutions: the public mental health institution (EPSM) of La Roche-sur-Foron (Haute-Savoie) in August and the speciallyequipped hospitalisation unit (UHSA) in Rennes (Ille-et-Vilaine) in December. The recommendations made in the wake of these inspections, the responses given and their monitoring by the Ministry of Health in 2017 can all be found in Appendix 4. 2.2.1 The public mental health institution (EPSM) of La Roche-sur-Foron (HauteSavoie) During the CGLPL's inspection, the institution was grappling with considerable instability in terms of its nursing staff and a lack of procedural organisation, which resulted in an unreliable admissions procedure, insufficient information for patients, scant activities available to patients, inadequate somatic monitoring and a distribution of medicines that violated physician-patient confidentiality. Since January 2016, a new management has been in place, and the certification audit by the National Authority of Health has taken place. New staff members have been recruited and staff turnover is improving. An institutional strategic plan is currently being drafted, such that the points concerning reception of patients and information for their attention - on which the HAS's observations were consistent with the CGLPL's - are gradually improving. Changes have been made regarding the distribution of medicines, but recruitment of somatic physicians remains difficult despite a new position having been created. Furthermore, the institution used to make excessive use of solitary confinement and restraint, including systematically placing detained patients in solitary confinement throughout their stay. The solitary confinement and restraint practices were assessed in 2015, and the implementing provisions of the Act of 23 January 2016, which call for traceability of such measures and a policy to reduce their use, were put into practice. The CGLPL notes these efforts to improve the situation, but finds it regrettable that the Minister did not respond to the recommendation about the systematic placement of detained patients in solitary confinement. 2.2.2 The specially-equipped hospitalisation unit (UHSA) in Rennes (Ille-et-Vilaine) Good practices The report highlighted the merits of such organisational rules as fitting out individual bedrooms rounded off with nicely laid out common areas, the joint reception of patients in the two treatment units, regular assessment of professional practices, secure running of the canteen and significant freedom of access afforded to chaplains. 47

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