For example, it’s quite well-known that with a door-top alarm system it’s still possible to attach something to the door latch and successfully create a ligature. To alert clinical staff of suicide attempts or ligature learning, the alarm needs to be able to detect any abnormal load on any part of the door – not just the top.

At the time The Junipers was being designed and built, we were in the final stages of trialling our full-door ligature alarm. Turning the entire door into a weighing scale, it sends an alert to the control panel in the nearest nurses’ station when a ligature has been attempted anywhere on the door.

DPT was extremely heartened, like us, to recognise the impact this would have on both patients and clinical staff at The Junipers. As the alarm was still in its final trial phase, I felt very grateful to be working with such a forward-thinking Trust that embraced this new technology as openly as it did, and I feel this is attributable to the shared passion that I referred to earlier.

Reducing restrictive practices We’re all familiar with mechanical locks; they’re what the vast majority of us in the UK still have on our external doors at home; we use metal keys to lock and unlock them. They also still exist in many mental healthcare facilities across the UK. However, mechanical locking systems can only be controlled by clinical staff, due to the metal keys creating a potential risk of self-harm or weaponisation. This means that patients/service-users are often left without the ability to lock and unlock the only private space they have – which can cause increased anxiety, and leave patients feeling belittled in a place that is intended for recovery.

As a progressive Trust, I was confident that DPT would also be interested in exploring alternatives to traditional mechanical locking for The Junipers; particularly after the Care Quality

The Junipers purpose-built facility in Exeter.

Commission (CQC) issued guidance on reducing these kinds of restrictive practices.2

Listening to experts by lived experience From listening to experts by lived experience, we understand that trust, free movement, and privacy, all contribute to patient recovery, and break away from the stereotypical institutional environments. Our electronic locks are accessed using anti-ligature wristbands that we designed specifically for patients – empowering them with the independence to lock and unlock their only private space. Patients have a greater sense of privacy and freedom as a result, since they don’t have to ask permission for their door to be locked and unlocked whenever they leave their bedroom, while valuable time for clinical staff is freed up by obviating the need to attend to doors on request.

SHP’s full-door ligature alarm is built into the door – making it almost invisible and non-institutional.

These en-suite doors may look unconventional at first, but they keep patients safe while adding to the recovery-led aesthetic. THE NETWORK | APRIL 2020 25

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