CH152-Preventing Suicide by Hanging and Strangulation Policy

Registration Number: {{org_field_registration_no}}

Preventing Suicide by Hanging and Strangulation Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} adopts a proactive, preventative, and safeguarding-focused approach to identifying, managing, and reducing the risk of suicide by hanging and strangulation among the people we support. Hanging is one of the most common methods of suicide and often involves the use of everyday objects. As a home care provider, we have a responsibility to assess environmental and individual risks, provide safe care, and take all reasonable steps to prevent avoidable harm. This policy aligns with Regulation 12 (Safe Care and Treatment), Regulation 13 (Safeguarding from Abuse and Improper Treatment), and the principles of the Mental Capacity Act 2005.

2. Scope

This policy applies to all employees, including care workers, support staff, managers, and agency personnel involved in the delivery or coordination of care for individuals supported by {{org_field_name}}. It covers adults and young people living in their own homes or supported accommodation who may be at risk of self-harm or suicide by ligature. The policy supports the development of risk-informed care plans, staff training, and multi-agency responses, and sets out clear protocols for identifying risk and acting quickly to protect life.

3. Related Policies

CH07 – Person-Centred Care Policy
CH13 – Safeguarding Adults from Abuse and Improper Treatment Policy
CH18 – Risk Management and Assessment Policy
CH19 – Emergency and Business Continuity Plan
CH27 – Staff Supervision, Training, and Development Policy
CH39 – Mental Capacity and Deprivation of Liberty Safeguards Policy
CH40 – Assisting with Personal Care Policy

4. Identifying Risk Factors

Staff must be trained to recognise risk factors associated with suicide by hanging or strangulation. These include a history of self-harm, previous suicide attempts, mental illness (such as depression, psychosis, personality disorder), substance misuse, bereavement, isolation, or trauma. Environmental risks may include access to belts, cords, curtain ties, dressing gown ropes, shower hoses, or stair railings. Emotional or behavioural signs such as withdrawal, hopelessness, mood changes, giving away possessions, or verbal expressions of suicidal ideation must be taken seriously. A person-centred risk assessment must be completed at the outset of support and reviewed regularly or following any trigger event.

5. Risk Assessment and Individual Safety Planning

All individuals assessed as having mental health needs or past suicidal ideation must have a documented ligature risk assessment. This includes identifying environmental risks in the person’s home and working with the individual (and family where appropriate) to remove or reduce access to potential ligatures. A personalised safety plan must be created, detailing triggers, coping strategies, emergency contacts, professional support contacts, and any restrictive measures (e.g., removing hazardous items). The risk assessment and plan must be reviewed monthly or sooner if the person’s mental health deteriorates, following a hospital admission, or after a safeguarding concern is raised.

6. Home Environment Safety Measures

Staff must assess the home environment for ligature points and potential ligature items. Risks include:

Shower cords or hoses
Window or curtain cords
Belts, dressing gown cords, scarves
Grab rails or handles in toilets or hallways
Suspended hooks or fixtures
Where risks are identified, the staff must work with the person and their family to implement appropriate measures such as replacing cords with non-loop alternatives, removing hazardous items, installing quick-release fixtures, or placing potentially harmful items under staff or family supervision. Staff are not permitted to forcibly remove property unless there is an immediate risk and the person lacks capacity, in which case a best interests decision must be made and documented.

7. Staff Training and Awareness

All staff must receive mandatory safeguarding training that includes suicide awareness and response to self-harm. In addition, specific training will be provided on:

Ligature risk awareness
Environmental risk assessment
Mental health first aid
Crisis intervention and de-escalation
Training is updated annually, and competency is assessed through supervision and reflective practice. Staff must know how to recognise signs of distress, respond appropriately, and escalate concerns without delay.

8. Monitoring Mental Health and Wellbeing

Staff must monitor the emotional wellbeing of people we support and respond sensitively to changes in mood, behaviour, or mental state. All observations and concerns must be recorded clearly in care notes and reported to the Registered Manager or Safeguarding Lead immediately. Staff should initiate wellbeing conversations routinely and encourage individuals to share their feelings. We also promote access to mental health professionals, counselling services, and crisis helplines. Where appropriate, staff assist with appointments, medication adherence, or referrals to local services. Documentation must include all efforts made to support emotional and psychological wellbeing.

9. Multi-Agency Working and Safeguarding

Preventing suicide is a shared responsibility across health and social care. Where risk of self-harm or suicide is identified, {{org_field_name}} works closely with:

GPs and Community Mental Health Teams
Local authority adult safeguarding services {{org_field_local_authority_authority_name}}
Approved Mental Health Professionals (AMHPs)
Emergency services
All concerns must be referred promptly to the Safeguarding Lead {{org_field_safeguarding_lead_name}} who will coordinate with external agencies. If a person lacks capacity or is at immediate risk, a Mental Health Act assessment or urgent hospital admission may be required. All safeguarding concerns are recorded and actioned in line with CH13 – Safeguarding Adults from Abuse and Improper Treatment Policy.

10. Incident Response and Emergency Action

If a staff member finds a person attempting or having attempted to hang or strangle themselves, they must:

Immediately call 999
Remove the ligature if it is safe to do so without causing harm
Provide first aid until emergency services arrive
Stay with the individual, offering reassurance and preventing further harm
Inform the Registered Manager and Safeguarding Lead immediately
Record a factual incident report
Inform next of kin or advocate unless this would place the person at greater risk
Following an incident, a full review of care plans, risk assessments, and home environment must be conducted, and learning shared across the team. Where required, a notification will be submitted to the CQC under Regulation 18 – Notification of Other Incidents.

11. Family and Carer Involvement

Where consent is given, or where it is deemed in the person’s best interest under the Mental Capacity Act, families and carers should be involved in safety planning. They must be informed of signs to watch for, how to access emergency help, and what support is available to them as carers. Education and emotional support for carers help prevent crisis and improve outcomes. All interactions must be documented with consent status noted.

12. Duty of Candour and Learning from Incidents

In the event of a serious incident or near-miss, {{org_field_name}} will apply Regulation 20 – Duty of Candour. The person, or their representative, will be informed of what happened, an apology will be given, and they will be updated on any investigations or actions taken. Learning from the incident will be shared in team meetings and used to improve systems and staff responses.

13. Efficient Risk Management at {{org_field_name}}

{{org_field_name}} prevents suicide risks through:

Thorough individual and environmental risk assessments
Robust multidisciplinary communication and safeguarding escalation
Routine supervision and staff mental health briefings
Partnership with mental health services and crisis teams
Real-time monitoring and follow-up after hospital discharges or critical events
Assigning a named mental health liaison within the service
Our approach ensures we are always aware, always alert, and always responsive to emerging risks.

14. Policy Review

This policy will be reviewed annually or sooner if required following a serious incident, safeguarding alert, new legislation, or updated CQC guidance.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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