fundamental and human rights �.� national preventive mechanism against torture had to be restrained to the chair with a belt for the duration of the meal to keep them still. The Deputy-Ombudsman noted that tying a resident down is always a restrictive measure. In addition, such restraints can cause anxiety and aggression. The Deputy-Ombudsman requested the city to report on what basis the resident was tied to the chair for the duration of the meal. The Deputy-Ombudsman also wanted to know why the resident was not allowed to leave the table and later directed back to continue the meal – several times if necessary. Furthermore, the Deputy-Ombudsman asked the city to determine who made the decision to tie the resident to the chair and whether, as part of the decision-making process, the matter had been discussed with the resident’s next of kin or family members (2217/2018). According to the report provided by the city, the decision to restrict the right of self-determination, such as using restraints, is always made by the physician in charge of the patient. The decision on the restrictive measure and its start and end times are recorded in the patient data system. Restrictions are discussed with the residents’ next of kin and family members, but their wishes must sometimes be ignored to permit the resident more freedom of movement instead of, e.g., being tied to a wheelchair for the whole day. In the report, it was stated that people with memory loss disease do not always recognise the feeling of hunger, so they must be provided with relaxed and frequent opportunities to eat. The mobility of the residents must sometimes be restricted during meals to secure their nourishment and safeguard the other residents’ right to a peaceful meal. Only those residents who compulsively and repeatedly rise from the table and wander around the dining area and ward hallways are restrained. Such behaviour has a corresponding effect on others who are having their meal, preventing anyone from eating in peace and repeatedly interrupting the meal. The eating and condition of residents tied to their chairs is monitored continuously, and residents who appear anxious are released. An evening follow-up visit was made to the unit. The NPM noted that at least two residents were wearing back-zip overalls – also at night. Back-zip overalls are a restrictive measure on which there are no regulations. The Deputy-Ombudsman noted that the use of a back-zip overall infringes on the patient’s right to self-determination. The use of an overall must always be based on physician’s decision and the use must be stopped immediately when it is no longer necessary (3082/2018). The safety of residents at night On the basis of observations made during a visit to a unit offering round-the-clock assisted living, the Deputy-Ombudsman noted that conditions in the unit were not safe for the residents at night. The Ombudsman had already drawn attention to the matter on an inspection in 2007. The situation had deteriorated since then, as the number of residents in the unit had grown and the night nurse was also responsible for the residents of the serviced flats. The nurses hoped that two nurses could work the night shift or that the city’s mobile night-time service team could take care of the night-time alarms of the serviced housing residents. The nurses did not know the people living in the serviced flats or their illnesses, so the night shifts felt unreasonably stressful to them. The Deputy-Ombudsman requested the city to report on the sufficiency of night-time care and the safety of the residents at night (657/2018). The city reported that two practical nurses would be hired for the nursing home with fixed-term employment contracts beginning on 1 May 2018. That will enable assigning two nurses to the night shift. In addition, the home care night nurses will answer the night-time alerts made by the residents of the serviced flats around the nursing home from 1 March 2018. The nursing home’s nurse will no longer be required to care for the residents of the service flats. Only one nurse worked the night shift of a nursing home close to the one described above and assisted the night nurse of that care home every night in addition to her own work. For this reason, the doors of the residents had been equipped with alarms so the night nurse would know to return to her post in the nursing home if the residents 105