DCW152-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 provide clear guidance on preventing suicide by hanging or strangulation within our domiciliary care service. This policy ensures that our organisation takes proactive measures to identify, assess, and reduce risks associated with suicide while supporting service users’ mental health and wellbeing.

Our home care service is committed to:

Identifying individuals at risk and implementing appropriate support strategies.
Training staff to recognise warning signs and respond effectively.
Reducing environmental risks that may contribute to suicide by hanging or strangulation.
Providing crisis intervention and emergency response procedures.
Ensuring multi-agency collaboration, safeguarding service users, and following Care Inspectorate Wales (CIW) regulations.

This policy aligns with the Regulation and Inspection of Social Care (Wales) Act 2016, the Social Services and Well-being (Wales) Act 2014, the Suicide and Self-Harm Prevention Strategy for Wales, and NICE guidelines on suicide prevention in community settings.

2. Scope

This policy applies to:

All staff, including care workers, supervisors, and managers, who support service users.
Service users who may be at risk of suicide or self-harm.
Families and external professionals, including mental health teams, social workers, and emergency services.

It covers:

Recognising suicide risk factors and warning signs.
Risk assessment and safety planning.
Environmental risk reduction.
Emergency response and crisis intervention.
Staff training and multi-agency working.

3. Identifying Suicide Risk Factors and Warning Signs

3.1 Understanding Risk Factors

Suicide risk is complex and may be influenced by multiple factors, including:

Mental health conditions such as depression, anxiety, PTSD, schizophrenia, or bipolar disorder.
Previous suicide attempts or a history of self-harm.
Substance misuse (alcohol, drugs, or prescription medication abuse).
Significant life events, including bereavement, abuse, trauma, or relationship breakdowns.
Social isolation or lack of support networks.
Chronic illness, disability, or pain that affects quality of life.

3.2 Recognising Warning Signs

Staff must be trained to identify early warning signs of suicidal thoughts, including:

Expressing feelings of hopelessness, worthlessness, or being a burden.
Talking about death or suicide (e.g., “I can’t go on,” “There’s no point”).
Sudden changes in behaviour, such as withdrawal, agitation, or recklessness.
Giving away personal belongings or preparing a will.
Unusual preoccupation with methods of suicide, including talking about hanging or ligatures.

If a service user exhibits any of these warning signs, staff must take immediate action.

4. Risk Assessment and Safety Planning

4.1 Suicide Risk Assessment

All service users at risk of self-harm or suicide must undergo a suicide risk assessment as part of their care plan. The assessment should:

Identify current risk factors and past history of self-harm or suicide attempts.
Evaluate protective factors, such as family support or coping mechanisms.
Determine the level of immediate risk (low, moderate, or high).

If a service user is at immediate risk, staff must escalate concerns to:

The Registered Manager ({{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}).
The Local Mental Health Crisis Team.
Emergency services (999) if urgent intervention is required.

4.2 Individual Safety Plans

For service users identified as at risk, a Safety Plan must be developed, which includes:

A list of coping strategies for managing distress.
Emergency contact details of crisis services, support networks, and family members.
Agreed environmental safety measures, including reducing access to ligature points.
Regular welfare checks by staff or family members.

Safety plans must be reviewed regularly and updated as needed.

5. Environmental Risk Reduction

5.1 Identifying and Reducing Ligature Risks

Our organisation ensures environmental risk reduction by:

Assessing service users’ homes for potential ligature points (e.g., door handles, exposed pipes, curtain rails).
Minimising risks where possible by:
- Removing or securing excess cords, ropes, belts, and ties.
- Using breakaway curtain rails and alternative fittings.
- Ensuring care environments are free of unnecessary hazards.

If a service user purchases or seeks ligature items, staff must report concerns immediately.

5.2 Supporting Independent Living While Ensuring Safety

We balance safety with personal choice and dignity by:

Encouraging open conversations about mental health and self-harm prevention.
Involving service users in decision-making about their environment.
Supporting service users to maintain personal autonomy while keeping them safe.

6. Emergency Response and Crisis Intervention

6.1 Responding to Immediate Suicide Risk

If a service user is found in distress or has attempted self-harm, staff must:

Call 999 immediately and request emergency medical assistance.
Ensure the service user is safe, removing any ligatures if necessary.
Stay with the individual and provide reassurance until help arrives.
Notify the Registered Manager and Safeguarding Lead ({{org_field_safeguarding_lead_name}}).
Complete a detailed incident report, documenting actions taken.

6.2 Post-Crisis Support

After an emergency, our organisation will:

Work with mental health professionals to ensure a structured aftercare plan.
Provide emotional and psychological support for the service user.
Review care plans and safety measures to prevent future incidents.

7. Multi-Agency Collaboration in Suicide Prevention

Effective suicide prevention requires collaborative working with:

GPs and mental health teams for psychiatric assessments and ongoing therapy.
Crisis intervention services for immediate support.
Social workers and safeguarding teams to ensure protective interventions.
Charities and support groups (e.g., Samaritans, Mind Cymru) to provide additional emotional support.

All safeguarding concerns must be reported to the Local Authority Safeguarding Team ({{org_field_local_authority_authority_name}}).

8. Staff Training and Responsibilities

All staff must complete mandatory training on:

Suicide awareness and prevention strategies.
Identifying and responding to self-harm.
Risk assessment and safety planning.
Managing ligature risks in domiciliary care settings.
Confidentiality, data protection, and reporting responsibilities.

Failure to adhere to this policy may result in disciplinary action, as outlined in the Disciplinary and Grievance Policy (DCW31).

9. Related Policies

This policy should be read alongside:

Safeguarding Adults from Abuse and Improper Treatment Policy (DCW13).
Mental Capacity and Deprivation of Liberty Safeguards Policy (DCW39).
Risk Management and Assessment Policy (DCW18).
Confidentiality and Data Protection (GDPR) Policy (DCW34).

10. Policy Review

This policy will be reviewed annually or sooner if required due to updates in suicide prevention guidance, CIW regulations, or safeguarding protocols. The Registered Manager is responsible for ensuring full compliance.

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}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.