IHEEM HISTORY AND HERITAGE All designed ‘in house’


Four such appliances were requested for inclusion in the unit – a stainless steel sink, a cooker top, an oven, and an ironing table. Amos Millington explained that all these units were designed ‘in house’, which ‘provided a novel diversion from the normal drawing board activity’. He explained: “Which method to employ to raise and lower, safely and easily, the sink and cooker units, was solved by observing the equipment used by any gent’s hairdresser – a hydraulic plinth, one each for the sink, cooker top, and oven. The electric cooker top was a Tricity model with controls on a flexible conduit for remote mounting, but a commercial pattern of electric oven was chosen, since domestic models, being rather tall, were not considered suitable for adaptation.”


He added: “The three pieces of equipment were mounted on purpose- designed timber frames with suitable heatshields where necessary, the whole assemblies being bolted to purpose- made steel plates attached to the top of the pedestals on each hydraulic plinth. To ensure stability, each assembly was located in, and ran in, sliding door track runners, attached vertically to the rear wall in the line of travel. The hydraulic plinths were of standard design, as supplied to hairdressing salons. Final connections for piped services such as water and waste to the sink were effected using flexible pipes. Height adjustment of the ironing board was achieved merely by securing a ladder- type assembly to the wall and employing timber brackets on the ironing board itself, which would locate in the rungs of the ladder at any desired height.”


Making a useful contribution Modestly describing he and his fellow engineers’ efforts in the design and creation of the bespoke equipment described in the article, Amos Millington said: “These designs for the disabled and infirm may seem but a drop in the ocean when compared with what has been, and is being, developed by specialist departments and manufacturers, but hopefully it illustrates that a Works Department can make a useful and practical contribution to designing that ‘one-off’ item which may be needed in the care of the disabled person.” Another interesting paper that Amos Millington provided to me was co- written by he, Tom Carnwath, and Ted McGuinness, of the Trafford Healthcare NHS Trust (respectively, at the time, Estates director, Clinical director, and General Manager, Mental Health, at the Trust), and centred on a new psychiatric unit commissioned in 1992 on a greenfield site within the grounds of the Trafford General Hospital. This article,


42 Health Estate Journal August 2018


entitled ‘Making Hospitals Safer For Patients’, was published in issue 22 of Psychiatric Bulletin in 1998, and focused on one of the perennial concerns for healthcare estates departments – fire safety. It considered the importance of fire doors being fit for purpose in helping to limit the spread of smoke and toxic gases in the event of fire, while emphasising the need to minimise the chances of parts of self-closing doors being used as a ligature point.


Official guidance of the time ‘During the design stage’, the authors note that ‘reference was made to the appropriate Government documents’ – namely HTM 81 (1987), HBN 35 (1988), and to the local authority and local fire authority for Building Regulations approval. The unit in question was designed to offer a ‘more domestic’ environment than the ‘old’ hospital it replaced, with particular emphasis on landscaping of outdoor areas and internal décor and furnishings, with all patients accommodated in single bedrooms. In line with official guidance at the time, the doors fitted to each bedroom had a 30-minute fire delay rating, and a one- way observation facility. The authors add: “As these were fire-rated doors, the fire authority advised fitting automatic door closures. The devices comprised a spring mechanism attached to the top of the door, connected to the door frame by upper and lower short projecting arms, joined at the end to form a moving


‘‘


The Millennium Window at Trafford General Hospital Chapel is backlit by an X-ray film viewing system, with the patterns representing veins and intestines, and the staff and serpent, medicine. The colours are liturgical colours of the church’s seasons.


‘V’ shape. Each room also contained an automatic smoke detector linked to the main fire panel.”


‘Two problems’, however, emerged – many patients found the observation facilities ‘intrusive’, and rendered them ineffective by hanging clothes and other items inside their doors, which meant staff had to open the doors regularly for observation, disturbing sleep at night. There was also a risk that the door closure mechanism could be used – via ligature – as a potential means of suicide. On the observation front, to avoid disturbing the patients’ sleep, night nursing staff began laying a towel between the door and its jamb, but this negated its effectiveness as a fire door.


Fatal incident


The article went on to explain that, ‘although not considered at risk of suicide’, a patient hanged himself using the top projecting arm of the automatic door closure in a first floor bedroom. Under the weight of his body the arm ‘bent down’ over the door closure mechanism, and effectively jammed the door closed. External access to the room from outside via a window was impossible, since it incorporated a restricted opening mechanism, and it took 45 minutes for staff to get the door open, by which time any hope of resuscitation had passed.


The subsequent hospital review heard evidence that the self-closure of doors was required for fire safety. Potential


External access to the room from outside via a window was impossible, since it incorporated a restricted opening mechanism, and it took 45 minutes for staff to get the door open, by which time any hope of resuscitation had passed


©Amos Millington


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