safewards

Safewards is a model and set of interventions designed to reduce conflict and containment (restrictive practices) in psychiatric in-patient settings. It was developed by Professor Len Bowers and his team at the Institute of Psychiatry, Psychology & Neuroscience at King's College London. The Safewards model is based on the idea that conflicts (such as aggression, self-harm, or medication refusal) and containment (such as seclusion, restraint, or enforced medication) arise from the interaction between staff and patients, and can be reduced by improving the quality of these interactions. 

Building upon her lived experience as a mental health nurse, our resident expert Lisa Spong has spent over 10 years helping institutions across Australia adopt Safewards through in-person training and consultancy. Lisa has also been a prolific advocate for Safewards, speaking at various conferences around Australia and was co-chair of the Safewards Victoria Community of Practice for 7 years.​

Our clients include:

The Safewards model highlights six main areas or “originating domains” where changes can be made to enhance the ward environment and lower the chances of conflict. These areas include:

  • This originating domain discusses how staff manage their emotions and support each other in following rules. It highlights their consistency in addressing patients' needs and how daily routines focus on caring for patients. This also includes ensuring the ward is clean and organized.

  • Better quality furniture, equipment, and decoration in a ward make patients feel more comfortable and reduce conflicts. Wards with clear sightlines and fewer hidden spots are usually safer. Staff also need to find a good balance between supervising patients and allowing them privacy.

  • Wards are connected to the outside world. Events and people outside impact patients. Financial issues, family arguments, and personal worries continue during hospital stays. Drugs and alcohol can be accessed during leaves or if a patient escapes. Patients know they will eventually leave the ward and return to the real world.

  • Wards can be stressful, and patients can feel tension from each other. Emotions can be intense as everyone is trying to cope.

  • Patient characteristics that can lead to conflict are grouped into three categories:

    1. Symptoms like paranoia or hallucinations.

    2. Patients struggling with social interactions.

    3. Differences in age, gender, diagnosis, and living situations.

    Certain conflicts are more common in specific groups; for instance, younger men are more likely to leave care without permission than others.

  • Both staff and patients must follow legal and management policies. The Mental Health Act is a law that must be adhered to. Many hospital policies are designed to ensure all wards follow the same procedures and often align with national guidelines. This area gives staff significant authority over patients, as well as important responsibilities.

Our SAFEWARDS SERVICES

TRAINING

We offer comprehensive in-person training through an engaging one-day introductory course, as well as a more extensive two-day deep-dive workshop. Additionally, we provide convenient train-the-trainer options that allow you to empower others within your organisation with the knowledge and skills they need to succeed.

POLICY REVIEW

We provide expert consultation services that focus on aligning your existing policies and procedures to the innovative Safewards framework. Our experienced team is here to ensure that your organisation seamlessly integrates the best practices for safety and care, enhancing the overall effectiveness of your approach.

MENTORING

For more acute and challenging situations, we provide tailored 1:1 mentoring at both the leadership and frontline levels. This personalised approach helps us to effectively guide our clients through a successful and sustainable deployment of the innovative Safewards program.

Get in touch.

If you are interested in exploring the deployment of the innovative Safewards model or if you are simply seeking a comprehensive refresher on its key concepts, please do not hesitate to reach out to us for more information.