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-19 Apr. 2023

How refurbishment is reducing ligature risks

The construction and refurbishment of mental health environments presents unique challenges for public and private healthcare.

Keeping vulnerable people safe from harm requires specialist knowledge and an acute understanding of the ligature risks posed in each estate.

Nabeel Javed, Construction Manager at Willmott Dixon Interiors, has dedicated the last few years of his career to supporting capital projects teams in the NHS.

Nabeel Javed, Construction Manager at Willmott Dixon Interiors

Fit for purpose mental health facilities

Rosewood Terrace is an inpatient mental health rehabilitation unit at St. Michael’s Hospital in Warwick.

The building was recently revamped by Willmott Dixon Interiors and its supply chain partners on behalf of Coventry and Warwickshire Partnership NHS Trust.

It’s one of several ‘anti-ligature’ projects we have been contracted to deliver at St. Michael’s, which are designed to prevent vulnerable people from accidentally or intentionally self-harming.

“We are delivering anti-ligature works to the very best standard,” says Nabeel Javed, who is leading the refurbishment programme. “It’s specialist work and very different from a traditional refurbishment. There is a large amount of detail behind each project and a huge focus on patient risk.”

Image above: Recent anti-ligature work completed at St Michael’s Hospital in Warwick.

Additional support for NHS Trusts

Budgetary constraints in public healthcare have led to gaps in construction expertise.

In practical terms, that means when a door or window is upgraded to meet anti-ligature requirements, other alterations such as removing vinyls or making good around the frame may not necessarily be included in the scope of works.

Nabeel believes that huge value can be added through “the finer details” by influencing guidance and assisting NHS Trusts in taking a schedule of works to a finished project.

He explains: “We might typically expect to see an architect or a clerk of works involved in refurbishment projects of this scale but generally that kind of knowledge doesn’t exist within the NHS. “We’ve developed an understanding of mental health estates that has enabled us to make our customers aware of any problems as well as offering them practical solutions. It means we can work with customers from preconstruction to project delivery.”

Image above: Recent anti-ligature work completed at St Michael’s Hospital in Warwick.

Applying anti-ligature expertise

Nabeel and his team have developed an in-depth understanding of approved ligatures and ligature points.

It covers everything from the installation of toilet facilities to wardrobe designs.

“Most contractors are used to working with a certain type of fire door but anti-ligature works require bespoke doors with topple arms that sense an increased weight,” explains Nabeel. “They need to be wired in a certain way so they can send out an alarm in an emergency. Similarly the toilets we install are very different from a standard model and require a connection to power supply units. Understanding these specialist items is crucial.”

So too are the relationships we’ve developed with the specialist manufacturers of such products, which significantly increases the speed and efficiency of installation.

Image above: Recent anti-ligature work completed at St Michael’s Hospital in Warwick.

Communication leads to good customer relations

Pre-planning, communication and good customer relations are essential to the success of projects delivered in a live hospital environment.

It’s especially important given the make-up of our teams, which feature small, well drilled groups of as little as 10-15 operatives on-site – including subcontractors.

The approach has also proved effective in the delivery of similar anti-ligature projects, such as Forest House, a psychiatric unit for young people, and Albany Lodge, a 24-bed mental health care unit in St. Albans.

Nabeel says: “We oversee the work and orchestrate it but we’ve developed a supply chain that has an enhanced understanding of anti-ligature. We have points of contact for every facet of the refurbishment.”


A specialist in any location

The success of our partnership with Coventry and Warwickshire Partnership NHS Trust has led to our appointment on several additional projects across St. Michael’s Hospital and beyond.

As anti-ligature becomes a more pressing concern for our resource poor NHS Trusts, in-house maintenance and capital project teams are often being left to carry the burden of delivering vital upgrades to estates.

It’s clear that they can only benefit from external expertise.

Nabeel says: “NHS Trusts face continual challenges in managing budgets and resources and generally don’t have the means to deliver projects of this type from start to finish. “We want hospitals to be aware that there is a service out there that can help them.”

Find out more about our anti-ligature work at St Michael’s Hospital in Warwick here.

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