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Adult high secure services

These services provide treatment for those who are assessed as representing serious danger to others and therefore require treatment in a high security hospital.

Research in this area has indicated that the physical safety of patients and staff is not just dependent on the successful execution of procedures for security alone, but is closely linked to the impact of the physical surroundings including interior design, fixtures and fittings.

Key principles

  • Create a secure environment for staff, patients and visitors, which also protects the wider community
  • Create an environment which supports the therapeutic care of the patients and promotes improvement in their conditions
  • Create an environment which respects the dignity and supports the needs of the patient

 

Guide to design

Research is being carried out continually to identify best practice in design, but there are some key principles on which key stakeholders and designers agree.  This is intended as brief overview of the subject and does not constitute definitive guidelines. The product recommendations below do not constitute an exhaustive list and we would always recommend that you consult your Altro Consultant on specific project requirements.

Top tips for design in all areas

  • Enable observation, maintain security and prevent self-harm and harm to others
  • Maintain calm, to allow for the fact that patients are frequently distressed or angry and may be restrained
  • Facilitate the development of relational security, both to motivate the staff and enable the implementation of therapeutic care
  • Allow for the provision of a low stimulus environment
  • Promote security for all, avoiding blind/ dark  areas and providing visibility
  • Specify using Light Reflectance Values to help reduce glare which can disturb
  • Design areas to minimise the risk of hostage taking and barricades
  • Prevent and control the spread of infection and contamination
  • Specify finishes which enable easy cleaning, maintenance and hygiene. A well maintained environment delivers a caring message to the patients, their families and the staff, promoting patient recovery and enhancing staff morale
  • Promote calm through colour, light and texture
  • Owing to the high demands placed on installed products in situ, which may be subjected to frequent attacks, care must be taken to select tried and tested, robust, durable products, which offer the minimal opportunity for self-harm or use as a weapon.
  • All fixtures and fittings must be anti-ligature

Bedrooms/ wards

  • Fixtures and fittings should not make it possible for patients to harm themselves or others
  • The room design should not allow for any concealed areas from which patients may attack staff
  • Bedrooms should include an ensuite bathroom
  • Design should preserve the patient's privacy and dignity, while allowing staff observation

Product recommendations: Altro Suprema II safety flooring combined with Altro Whiterock wall cladding, Altro resins

Ensuite bathrooms/ shower rooms

  • Eliminate any self-harm or ligature points
  • Flooring should be impervious and fully bonded to the substrate
  • Ensure that the flooring is slip-resistant from edge to edge and seamless to prevent picking and minimise damage

Product recommendations: Altro resins on floors and walls

Wheelchair accessible bathrooms/ shower rooms

  • Eliminate any self-harm or ligature points
  • Flooring should be impervious and fully bonded to the substrate
  • Ensure that the flooring is slip-resistant from edge to edge, effectively sealed around walls and splashbacks, affording protection for both the patients and staff, who may or may not be wearing footwear, when moving about in areas that could be simultaneously wet and dry in patches
  • Ensure the safety flooring offers the latest in PUR cleaning technologies to maintain cleanliness and hygiene, promoting effective infection control

Product recommendations: Altro Aquarius safety flooring combined with Altro Whiterock wall cladding, Altro resins on floors and walls

Dining rooms

  • Use slip-resistant flooring in eating areas where there is the risk of spillages
  • Specify an acoustic underlay or acoustic flooring to reduce noise in areas where the clatter of food trolleys can significantly contribute to ambient noise levels and patient distress

Product recommendations: Altro Suprema II, Altro Wood Safety, Altro Whiterock wall cladding

Kitchens/ ward serveries

  • Design should allow patient participation in appropriate kitchen tasks, while permitting staff observation
  • Flooring and walling should be impervious and fully bonded to the substrate to maintain hygiene
  • Welded joints will aid hygiene and the maintenance of cleanliness

Product recommendations : Altro Stronghold 30, Altro resins, Altro Whiterock wall cladding

Lounges/ education/ leisure areas

  • Flooring and walling should be impervious and fully bonded to the substrate
  • Design flooring and walling to aid relaxation and reduce anxiety
  • Use slip-resistant flooring in areas where there is the risk of spillages
  • Specify flooring which affords sufficient flexibility of function to enable the space to be subdivided for activities

Product recommendations: Altro Suprema II, Altro Walkway Plus, Altro Wood Safety, Altro Whiterock wall cladding

De-escalation areas

  • Create a calming, low-stimulus space for patients with muted and restful colours
  • Install durable, hard-wearing, slip-resistant, seamless flooring which can withstand picking and other forms of attack

Product recommendations: Altro resins on floors and walls, eg Altro TB Screed, Altro Multiscreed Naturals, Altro Mosaic and AltroScreed Quartz, bespoke solutions available (conditions apply, please ask your Altro Consultant)

Seclusion suite

  • Create a calming, low-stimulus space with ensuite facilities to manage highly disturbed patients
  • All fixtures and fittings must significantly reduce the risk of patient self-harm by being anti-pick and seamless

Product recommendations: Altro resins on floors and walls, eg Altro TB Screed, Altro Multiscreed Naturals, Altro Mosaic and AltroScreed Quartz, bespoke solutions available (conditions apply, please ask your Altro Consultant)

Treatment rooms/ pharmacies

  • These areas may be used for emergency treatments or for the administration of medicine and therefore may be prone to liquid / powder spillages. Ensure the flooring is slip resistant for staff and patient safety
  • Create a relaxed ambience through design to promote calm behaviour

Product recommendations: Altro Suprema II, Altro Whiterock wall cladding

Corridors/ circulation areas

  • Incorporate way finding into the overall design to facilitate access and manage flow to key patient areas
  • Flooring should be impervious and fully bonded to the substrate
  • If spillages are a concern, from patients / staff carrying liquids etc, or from patients who may suffer from incontinence, install slip-resistant safety flooring offering the latest in PUR cleaning technologies to maintain cleanliness and hygiene

Product recommendations: Altro Suprema II, Altro Wood Safety, Altro Walkway Plus, Altro Whiterock wall cladding

Reception areas

  • Create a welcoming, good first impression to reduce anxiety and make people feel at home
  • Design in ease of orientation to other key areas in the building

Product recommendations: Altro Suprema II, Altro Walkway Plus, Altro Wood Safety, Altro Whiterock wall cladding

Visiting suites

  • Create a welcoming environment with a comfortable, bright atmosphere
  • Allow for staff observations
  • Promote staff, patient and visitor safety

Product recommendations: Altro Suprema II, Altro Wood Safety, Altro Whiterock wall cladding

Skirting boards

  • In patient areas under intermittent observation coved flooring provides optimum safety
  • In patient areas under constant observation hardwood skirting boards or equivalent may be installed

Product recommendations: coved Altro safety flooring or walls/floors seamless Altro resins

Doorsets

  • Allow staff observation as required
  • Allow for integrated blinds
  • Construction should prevent dismantling / removal of individual parts / breaking to be used for harm or as barriers
  • Design and installation should prevent ligature, finger-trapping, escape, hiding
  • Allow a two-way swing to prevent patients blocking entry 
  • Colour co-ordinate with the design scheme for a calming effect

Product recommendations: Altro Whiterock Doorsets