The Joint Commission inspected the following three wings, and spoke with each assistant medical officer and with the head of the wing:    clinic for gerontological psychiatry, Building 6, wing 06C: a total of 24 beds, of which 23 occupied clinic for acute psychiatry and psychoses, Building 5, – wing 050A – emergency room: a total of 27 beds occupied clinic for acute psychiatry and psychoses, Building 5 wing 050B – acute psychiatry: a total of 25 beds occupied Positive findings In the three wings which it visited, the Joint Commission welcomed the compliance with the standards and principles for the staff requirement in accordance with the Psychiatry and Staff Ordinance (Psychiatrie- und Personalverordnung), as well as the friendly furnishing of the patients’ rooms, each of which had a modern sanitary room with a shower connected to it. The considerable, various efforts of the head medic and the head nurse in the emergency wing to keep the measure of the fixation of patients as infrequent and as gentle as possible made a highly positive impression on the Commission. The range of further training within the clinic for staff on measures for the deescalation of patients’ sensitivities making them aggressive towards others and themselves deserves particular mention. This training programme is intended to contribute towards fixation being dealt with in an extremely sensitive manner. In this curriculum, those attending further training amongst other things are bandaged up in a self-experience module in order to be able to appreciate the fixation situation. Thanks to this measure, the number of occasions on which fixation had been used had considerably fallen on the emergency room. The head nurse is of the opinion that fixation should be restricted to the shortest possible period and that it may only take place with suitable medication accompanying the measure since it is otherwise not ethically justifiable. Direct supervision by an officer was a matter of course. The refining of fixation that was as gentle as possible was the goal of the head nurse. Efforts had been made to develop a system guaranteeing optimum protection against injuries. By closing a door and separating from the remaining wing area, it is possible to accommodate highly-acute, acute and sub-acute patients in the emergency room separately. The sub-acute area has 20 beds. The acute area contains seven beds for acute patients, as well as a supervision area with four fixation beds for highlyacute patients, which can be constantly visually monitored from the adjoining duty room through the large window pane. This spatial separation ensures considerable minimisation of the conflict potential between the various groups of 69