Dementia-Safe & Anti-Ligature Fit-Out SWMS

Dementia-safe and anti-ligature fit-out is the work that installs anti-ligature and dementia-safe fixtures, fittings, door hardware and electrical accessories in a dementia-care or mental-health area, to the project's anti-ligature specification, including the refit of in-use units. The dominant hazards are falls fixing fixtures, ceilings and door hardware at height, electric shock fitting anti-ligature electrical accessories and isolating circuits, a failure to achieve anti-ligature integrity at handover that compromises the protective function of the fixtures, and working safely in an occupied care setting. This SWMS covers the installation and proof-testing of the fixtures, fittings, door hardware and electrical accessories; it does not cover the anti-ligature design specification, the clinical model of care, or the building services beyond the connection, which are documented separately.

Under the model Work Health and Safety Act 2011 and the harmonised Work Health and Safety Regulations adopted in each state and territory, this is high risk construction work because it is carried out where a person can fall more than two metres and on or near energised electrical services; Victoria operates the equivalent provisions under the Occupational Health and Safety Act 2004 and Occupational Health and Safety Regulations 2017. The anti-ligature electrical accessories follow AS/NZS 3000, the fixtures, fittings and door hardware are installed to the project's anti-ligature design specification and the relevant health-facility design guidance, and staged work is coordinated with clinical staff where the area remains in use.

Failure to meet the primary duty of care is prosecuted under the Category 1 to 3 offences in the Work Health and Safety Act (and the equivalent provisions in Victoria's Occupational Health and Safety Act 2004), with maximum penalties indexed in most jurisdictions, imprisonment available for individuals, and a separate industrial manslaughter offence; current figures follow the prevailing penalty schedule of the responsible state regulator. This document is structured to satisfy the safe work method statement content requirements of the harmonised regulations and documents a controlled fit-out and proof test.

Hazards identified

9 hazards covered, sorted by priority.

Control measures

Hierarchy-of-controls order: elimination → substitution → isolation → engineering → administrative → PPE.

1. 1Engineering: Use a platform or elevating work platform with edge protection for fixtures, ceilings and door hardware at height, with a fall-arrest harness where a residual fall risk remains.
2. 2Elimination: Isolate and lock out before fitting electrical accessories and isolating circuits, test before touch, and use a licensed electrician under permit; use insulated tools.
3. 3Engineering: Install strictly to the anti-ligature specification, and proof-test fixtures and door hardware to that specification before handover.
4. 4Engineering: Use mechanical aids for fixtures, doors and joinery, with two-person handling; wear gloves and footwear.
5. 5Engineering: Clean and disinfect a used unit before works, treating residue as infectious; wear gloves, eye protection and a respirator.
6. 6Engineering: Deburr fixtures and trims and handle safely; wear cut-resistant gloves.
7. 7Engineering: Use on-tool extraction for cutting and fixing, with housekeeping; wear a P2 respirator.
8. 8Engineering: Use debris containment, with exclusion below and tool lanyards; persons below wear a hard hat.
9. 9Administrative: Use screening and barriers, staged work, exclusion and coordination with clinical staff where the area is occupied.

Applicable Codes of Practice

High-Risk Construction Work triggered

Worked example

A fit-out contractor is fitting out a dementia-care wing with anti-ligature and dementia-safe fixtures, fittings, door hardware and electrical accessories to the project's anti-ligature specification, with part of the wing remaining in use. The work is high risk construction work because it is carried out at a height where a person can fall more than two metres fixing fixtures, ceilings and door hardware, and on or near energised electrical services fitting the anti-ligature accessories and isolating circuits, so the contractor builds the safe work method statement around anti-ligature integrity, work at height, the electrical connection and working in an occupied setting. The anti-ligature accessories and circuits are worked only after isolation and lock-out by a licensed electrician who tests before touch, and fixtures, ceilings and door hardware at height are fixed from a platform or elevating work platform with edge protection, debris containment and tool lanyards, with the heavy fixtures, doors and joinery handled by mechanical aids and two-person handling. The defining control protects the people the area is built for: every fixture and door hardware item is installed strictly to the anti-ligature specification and proof-tested to that specification before handover, because a fixture that does not achieve anti-ligature integrity would compromise the protective function the design exists to provide. Where an in-use unit is refitted, it is cleaned and disinfected before works with clinical residue treated as infectious, dust from cutting and fixing is controlled with on-tool extraction and a P2 respirator, and the work is screened and barriered, staged, and coordinated with clinical staff so it can proceed safely while people are present. Cuts from fixtures and trims are controlled with deburring and cut-resistant gloves. Workers sign on to the statement before starting, the anti-ligature proof-test and electrical records are kept, and the signed statement is held on site for the responsible state regulator.

Related legislation

• Work Health and Safety Act 2011 (harmonised; enacted in all states and territories except Victoria, which applies the Occupational Health and Safety Act 2004), s.19 — Primary duty of care to workers and to other persons at or near the workplace
• Harmonised Work Health and Safety Regulations, section 291 — Defines high risk construction work (Victoria: Occupational Health and Safety Regulations 2017, Part 5.1)
• Harmonised Work Health and Safety Regulations, section 299 — Content and review requirements for a safe work method statement for high risk construction work (Victoria: regulation 327; Tasmania: regulation 312)
• Harmonised Work Health and Safety Regulations, Part 4.4 — Managing the risk of falls (work above two metres; Victoria applies the equivalent provisions of the Occupational Health and Safety Regulations 2017)
• Harmonised Work Health and Safety Regulations, Part 4.7 — Electrical safety: the prohibition on energised electrical work except where de-energising is not reasonably practicable and the prescribed conditions are met (Victoria applies the Occupational Health and Safety Regulations 2017 and state electrical-safety legislation)
• The project's anti-ligature design specification and health-facility design guidance — The protective fixtures, fittings and door hardware must be installed and proof-tested to the specification at handover

Frequently asked questions