A new guidance has been developed in collaboration by members of the Mental Health and Learning Disability Nurse Directors Forum, Experts by Experience and the Care Quality Commission (CQC) aimed at reducing harm from ligatures in mental health wards and wards for people with a learning disability. The guidance has been written for staff who have responsibilities for caring for patients, as well as those who assess and manage risk in the inpatient environment, and those responsible for buying, installing and maintaining fixtures and fittings.
The built environment is one of five key factors that the guidance says should be considered in working to reduce harm from ligatures, the others being therapeutic engagement, staffing and skills, technology and procurement.
The detailed section on the built environment focuses on minimising harm associated with the use of ligatures, including ligature material and ligature anchor points. The guidance gives examples of safety interventions, and a critical difference with previous advice is that low-lying ligature points should not be deemed low risk, and should be removed wherever possible.
The guidance also covers ward layout and design, and the importance of striking that delicate balance where staff are able to observe patients, support a home-like environment, provide private spaces to support patient dignity and create a therapeutic environment.
The Mental Health and Learning Disability Nurse Directors Forum has developed a ligature point assessment template designed to support staff in identifying and recording ligature risk points, controls and actions required to mitigate risks associated with the built environment.
