---
title: "Ligatures: The Risks You Should Be Aware Of"
description: Even the smallest risk must be identified, and measures put in place to minimise. Explore all the ligature risks you should be aware of.
---

[LST Radiator And Radiator Cover News ](https://www.contourheating.co.uk/blog)

# [Ligatures: The Risks You Should Be Aware Of](https://www.contourheating.co.uk/blog/ligatures-the-risks-you-should-be-aware-of)

 Written by [Robin Mansell](https://www.contourheating.co.uk/blog/author/robin-mansell) | 19 August 2019 09:00:00 Z

Suicide statistics in mental health settings demonstrate that three-quarters of patients who kill themselves on a psychiatric ward do so by hanging or strangulation, prompting regulators to focus heavily on [ligature risks.](https://www.contourheating.co.uk/blog/5-ligature-statistics-that-may-surprise-you)

Architects, specifiers and ward managers should closely observe any ligature risk- no matter how big or small-when redesigning or upgrading their facility.

## Ligature Risks: Key Examples

Even the smallest risk must be identified, and measures put in place to minimise. Some examples of risks are as follows:

- Power cords on medical equipment
- Call bell cords
- Handrails
- Doors
- Doorknobs
- Door hinges and hardware
- Showerheads and curtains
- Exposed plumbing or piping
- Paper towel and soap dispensers on walls
- Electrical switches
- Lighting fixtures
- Projections from ceilings

## Managing Identified Risks

It’s extremely difficult, and in some cases impossible, to completely remove ligature risks. Doing so may serve as a hindrance for employees carrying out necessary tasks, and for service users by taking away their rights of independence.  

In managing risks, it is recommended that you take a ‘remove, replace, protect, or manage’ approach, as highlighted by [The Nottinghamshire Healthcare NHS Ligature Risk Reduction Policy (2019)](https://www.nottinghamshirehealthcare.nhs.uk/download.cfm?doc=docm93jijm4n5826.pdf&ver=9367)

 

### Remove, Replace, Protect, Manage

| **Action** | **Description/Definition** |
| --- | --- |
| Remove | If the risk would leave the patients at risk, the ligature should be removed and there is no suitable alternative. |
| Replace | The ligature Is removed and replaced with a purposely designed similar [anti-ligature piece of equipment.](https://www.contourheating.co.uk/products) |
| Protect | Provide materials that [hide the potential ligature](https://www.contourheating.co.uk/products/anti-ligature-radiator-covers). |
| Manage | There is a need to keep the risk because of the potential injury is greater than the potential of an attempted suicide, for example, grab rails within an elderly in-patient/dementia unit. |

[Source](https://www.nottinghamshirehealthcare.nhs.uk/download.cfm?doc=docm93jijm4n5826.pdf&ver=9367)

## Examples Of Ligatures and Ligature Point Risks To Consider

Before we head into the examples, it’s important to understand the distinction between ligatures and [ligature points](https://www.contourheating.co.uk/blog/managing-ligatures-the-official-guidance-you-should-know).

**Ligature:** Anything that binds or ties. Examples include: chains, linen, clothing, cords, tubing, etc

**Ligature point:** Anything that could be used to attach or secure a ligature. Examples include: shower rails, coat hooks, water pipes, door frames, etc.

| **Potential Ligatures and Ligature Points** | **Potential Risk Control** |
| --- | --- |
| Bedsteads | Should be appropriate to the environment |
| Brackets, picture rails, [ventilation grilles](https://www.contourheating.co.uk/blog/anti-ligature-ventilation-grilles-for-prisons-part-1), ducts | Brackets: remove, box in or chase into wall Grilles: perforations should be a maximum of 3mm in diameter |
| Coat hooks | Remove all hooks behind doors, in wardrobes, etc |
| Curtain rails | Collapsible rails and safety track |
| Curtain tracking | Avoid gaps in fixed tracking |
| Curtain wires | Avoid use of curtain wires |
| Doors (closers, handles, frames) | Careful consideration of design |
| Electrical wiring | Should be ‘chased’ into wall or fitted flush to wall |
| Exposed pipework | Consider height and accessibility |
| Hinges | Consider types of hinges and gaps between doors and frames |
| Light switch cords | Should not be nylon. Consider solid pull cords or infra-red automatic switches Consider anti-ligature light switch covers |
| Patient’s lockers/wardrobes | Remove hanging rails |
| Radiators | Consider boxing in with [appropriate covers](https://www.contourheating.co.uk/products/anti-ligature-radiator-covers) |
| Wardrobes | Consider design (handles, internal hooks, door closing etc) |
| Window and window openings | Consider handles, trickle vents, hinges |
| Window and door weatherproof seals | Consider ligature points |
| Sink taps, plugs | Consider ligature points |
| Smoke detectors | Consider ligature points or appropriate covering |

[Source](https://www.nottinghamshirehealthcare.nhs.uk/download.cfm?doc=docm93jijm4n5826.pdf&ver=9367)

When assessing ligature risks, consider the use of the outdoor environment too. Anchor points in the garden may include windows, drainpipes, fencing, and trees.

 

## Conclusion

We hope that this blog will enable you to identify and list all potential [ligature points](https://www.contourheating.co.uk/blog/managing-ligatures-the-official-guidance-you-should-know) within your working environment that are accessible to Service Users.

Contour’s range of [anti-ligature products](https://www.contourheating.co.uk/blog/your-essential-guide-to-anti-ligature) are designed to help minimise the risk of self-harm and suicide in mental health settings, providing Service Users with a safe and secure environment.

If you’d like to learn more about how we work with mental health settings to reduce ligature risks, fill out the form below.

 

 

## About Us

*Contour produces a range of innovative, safe surface temperature systems for healthcare, education, mental health, commercial and secure sectors, working in close partnership and collaborating with architects, M&E engineers, NHS Trusts, local authorities, design consultants and contractors to deliver outstanding safe heating solutions.*

*Contour is the exclusive partner of [BioCote®](http://www.biocote.co.uk/) anti-microbial technology for LST and anti-ligature radiators.  BioCote® additives reduce bacteria by up to 99.9%. Contour combines an extensive range of colour-paints is with BioCote® for a durable, high-quality finish.*

*Contour’s heating solutions offer secure, single-person quick access to radiator guard interiors for regular deep cleaning and maintenance.  Each year, Contour save the NHS millions of pounds in cleaning costs, therefore delivering.*

[View full post](https://www.contourheating.co.uk/blog/ligatures-the-risks-you-should-be-aware-of)

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