- 88 279. Staff resources were very weak in the hospitals visited (with the possible exception of the Attica State Mental Hospital for children); further, most of the nursing staff in post had received either insufficient training or none at all. As a result, it was not uncommon to find two unqualified nursing staff members attempting to care for 40 or more patients, many of them bedridden or severely handicapped. This creates a situation of high risk for patients, despite the good intentions and genuine efforts of the staff. The CPT has consequently made recommendations with a view to both reinforcing staff resources and improving training. 280. With a few exceptions, the living conditions of patients ranged from mediocre to poor, and on occasion were appalling. In this respect, it should be stressed that even though, quite rightly, efforts are being concentrated on dehospitalisation of chronic patients, it is essential, from a humanitarian standpoint, for those currently held in large psychiatric institutions to be afforded decent living conditions suited to their state of health. It should be borne in mind in this connection that, by reason of their mental illness, many chronic patients will have to remain for some time in a psychiatric hospital. The CPT has made a series of recommendations in relation to living conditions and concerning, more specifically, patient accommodation, clothing and bedding, equipment, hygiene and food. 281. In the establishments visited, the treatment of patients consisted essentially of medication to control their behaviour; patients normally had no activities or stimulation capable of vitalising their potential. The CPT has recommended that the Greek authorities develop varied programmes of therapeutic activities using the full range of treatments (psycho-, socio- and occupational therapy) and that an individualised therapeutic programme be drawn up for each psychiatric patient. As regards, more particularly, medication, the on-site observations made by its delegation have led the CPT to recommend that measures be taken to ensure that the administration of drugs is performed solely on the basis of a doctor's written prescription and strictly in accordance therewith, and that evaluations of drug treatments administered are carried out at sufficiently frequent intervals. 282. Another area of concern for the CPT relates to the use of isolation and instruments of physical restraint. The delegation did not find any evidence of instructions or guidance issued to staff concerning recourse to such measures and, more specifically, their therapeutic purpose. The use of these measures was left to the discretion of a nursing staff which was for the most part untrained and numerically inadequate having regard to the number of patients in its care. Under such circumstances, there is a serious risk of resort being had to isolation and instruments of physical restraint in excess of requirements. The CPT has made a series of proposals on this subject, and, in particular, has recommended that a detailed medical policy on isolation and instruments of physical restraint be laid down and that resort to such measures be either expressly ordered or approved by a medical doctor. 283. Further recommendations and comments have been made in relation to the failure fully to apply in practice the provisions of the 1992 Law on the modernisation and organisation of the health system concerning management and consultation structures and involuntary hospitalisation, and in relation to complaints procedures and outside intervention.