As active partners in the For Me Provider Collaborative, the Thornford Park team, part of Elysium, are proud to share their recent BMJ Open Quality publication.
The team’s approach, which was grounded in co-design, empowerment, and a deep understanding of the humane aspects of care, led to meaningful reductions in incidents of self-harm and aggression amongst female patients, improving safety and wellbeing for both patients and staff.
This publication not only celebrates the achievements of the Oakley Ward team but highlights the collaborative spirit and ongoing commitment to raising the quality of care across secure settings through shared learning.
Reducing incidents of violence and aggression and self-harm on a secure mental health inpatient ward for women with learning disabilities
The key highlights of the report are:
- Co-designed interventions fostered empowerment and therapeutic relationships: The team introduced safety huddles and a co-designed activity programme, actively involving patients in shaping their care. This strengthened communication, built trust, and empowered patients through meaningful engagement.
- Importance of frontline leadership: This project demonstrated the importance of front-line insight and the value of empowering healthcare assistants as leaders in quality improvement. By harnessing their insight and initiative, Oakley Ward not only improved safety outcomes but also fostered a more inclusive, person-centred culture on the ward.
- Significant reductions in incidents: Over 12 months, the ward saw a 29% reduction in violence and aggression and a 25% reduction in self-harm per 1000 bed days. Seclusion hours also dropped by 55%, reflecting a safer, more supportive environment.
- A replicable model for humane, inclusive care: The success of this initiative—driven by multidisciplinary collaboration, strong leadership, and proactive staff—demonstrates how humane, co-produced approaches can transform inpatient care. The model is adaptable for other mental health and learning disability settings.
Farayi Zichawo, Lead Nurse on Oakley Ward, shared, “What made this project particularly unique and commendable was that it was led by Health Care Assistants (HCAs) — the staff group most frequently exposed to the risks associated with challenging behaviours. By working collaboratively and giving them the lead, we were able to develop practical, patient-focused solutions that made a genuine impact.
“Writing up the project was both a rewarding and reflective experience. It gave us an opportunity to step back and truly appreciate the journey — from identifying the problem on the ground, to developing solutions, testing change ideas and seeing real world impact. Collaborating with colleagues (Megan Georgiou and Margaret Paradza in particular) to gather data and write clearly whilst following the journal expectations, was a learning curve but also a great development opportunity.”
Please join us in congratulating the team for this outstanding achievement.
Sept 2025
