Wiltshire review

The wording of its Strategic Agreement to Share Information to include that signatory organisations know the 7 golden rules for information sharing and in particular understand that information can be shared to prevent harm to an individual and third parties including front line staff.

Work together to agree a protocol whereby information is shared with and from GPs about issues which relate to patients being a risk to themselves or others. This would include, sharing information relating to domestic abuse, drink driving, firearm applications/reviews, drug or alcohol abuse, and use of violence or weapons. Once this protocol has been piloted it should be sent to the Home Office and Dept of Health as a model of good practice.

To further develop care pathways for individuals with personality disorders, with explicit entry/exit criteria in Wiltshire

To sign up to the Wiltshire Strategic Agreement to share information.

Ensure a risk assessment is completed in all cases on victims of Anti-Social Behaviour so that risk can be identified and the appropriate support put in place.

NHS Wiltshire considered, how agencies involved should share information, for example if a person is charged with driving over the limit should a GP be informed? There could be a possible list of events in which a GP would be notified; this could include violent incidents, incidents with weapons or drug and alcohol.

The new Wiltshire Substance Misuse Service will build links and participate, when appropriate in the MARAC, MAPPA and ASBRAC boards.

Staff will receive annual domestic abuse training - the importance of communication and cross-referencing cases will form part of this training and monitored by regular one to ones and team meetings.

Housing Benefit Staff to attend MARAC meetings and share any concerns with their team.

Persistent offenders identified in the MARAC or MAPPA process, the chair ensures that a case Officer is appointed. Following this appointment a thorough investigation should be instigated into the reported offences, and an effective witness strategy implemented to secure evidence.

Provide training to all staff on basic mental health within their first year in post to enable staff to recognise and refer service users to appropriate agencies to both address the mental health need and manage the level of risk presented. Additionally, existing staff will have access to this training.

Additional reinforcement to be introduced in Victim Support training delivered to other agencies on the importance of identifying other people at risk from a perpetrator, through use of a case study.

Training on the DASH Risk Assessment Tool, incorporating MARAC and MAPPA awareness and referrals.

To have a formal perpetrator risk assessment that takes into account previous behaviour, current issues and any threats for identifying the level of risk that is posed to the victims and others. This should be initiated by the referring agency and then shared through the ASBRAC network for other agencies to contribute.

All organisations have a responsibility to ensure their staff understand Wiltshire and Swindon’s Safeguarding Adults Policies and Procedures and know how to recognise a vulnerable adult and refer to the most suitable agency.

The findings of the DHR to be formally put to the MAPPA Strategic Management Board with a view to increasing the awareness and use of MAPPA by agencies in appropriate high risk of serious harm cases.

Develop list of events in which a GP would be notified

The organisations who are invited to be signatories to the Agreement are reviewed to include organisations both statutory and voluntary that have contact with the public in Wiltshire. The Review is aware that this has already been actioned.

All organisations to ensure staff understand Wiltshire and Swindon’s Safeguarding Adults Policies and Procedures and know how to recognise a vulnerable adult and refer to the most suitable agency, through appropriate training about safeguarding vulnerable adults

To improve the awareness of practitioners of the evidence base in relation to working effectively with people with personality disorders in Wiltshire

An appropriate member of the Community4 team in the North and West to attend partnership agency meetings (ASBRAC, MARAC, SWITCH) as a method of joined up working and for sharing information relating to the risk to Community 4 workers and partnership agencies alike.

Robust monitoring of the progression of cases at “1:1” meetings to avoid lengthy delays and duplications.

NHS Wiltshire believes that on-going moderate mental health concerns should be managed by primary mental health liaison services. This service is just being established in Wiltshire.

A need for a common risk assessment to include on the referral any history of violence and/or alcohol fuelled behaviour. This would enable staff to refine the scope of interventions/support a client requires whilst improving staff safety.

Safeguarding is a static item on the Team meeting’s agenda and case studies will be discussed to ensure staff understand the importance and take the responsibility for recording, communicating and escalating issues through day to day advice and through their link officer roles.

Training provided to remove misconceptions and misunderstandings surrounding the data protection act so as not to paralyse staff from sharing information across services and with key stakeholders in these types of cases.

Police should ensure that Niche is flagged, when persons are MAPPA or MARAC nominal’s, to enable information to be shared with relevant agencies.

Utilise the recently implemented Personality Disorder Service for all service users assessed as High Risk of harm and having the profile for Personality Disorder (as per the guidance) to enable improved Offender Management of these particular cases.

Refresh and adhere to the RAAG Policy.

Awareness training to be developed to raise the importance of recording the decision for an action or inaction in relation to log sheets sent in..

Organisations need to ensure staff who come into contact with the public receive appropriate level training about safeguarding vulnerable adults.

The Quality Assurance and Serious Case Review Sub-Group of MAPPA to consider together with the relevant agencies how processes for MAPPA referral are imbedded in agency practice.

Monitor referral activity

Triangulate with reduction in other agencies involvement.

A training programme to ensure that senior and middle managers receive appropriate training and that all staff have the opportunity to complete information sharing e-learning training

In order to share information about vulnerable adults and assess risks at the earliest stage partners should consider building on the MASH model currently being implemented in Children’s Services to include ‘adults at risk’. Wiltshire Safeguarding Adults Board oversees the development of a pilot “MASH “programme in Wiltshire.

All appropriate staff and new starters to attend DASH / MARAC, training within the next twelve months 2013/14

Introduce a pre-tenancy process, to provide more information about prospective tenants.

NHS Wiltshire will explore how to develop a violent patient programme which would support patients who are known to have abusive behaviour.

Ensure records are updated in a consistent way regarding any threatening or violent behaviour of claimants/customers/known associates.

Police Officers, and most importantly Supervisors should receive refresher training in the DASH Risk Assessment model and the MARAC and MAPPA referral process. The training should include raising Officers awareness in identifying Domestic Abuse Incidents.

Address the issues that impact on behaviour and offending.

The Migration Meeting needs to be robustly managed, new evidence and risks highlighted and the appropriate status applied and targeting of AMBER ALERT and RED. Management should form part of this process.

Explore improving links with drug and alcohol service providers. This action should be shared with the drug and alcohol commissioning team, Wiltshire Council.

In order to share information about vulnerable adults and assess risks at the earliest stage partners should consider building on the MASH model currently being implemented in Children’s Services to include adults at risk.

The Training Sub-Group of MAPPA to consider how awareness of the potential for MAPPA involvement in high risk of harm cases can be promoted with management and practitioners via Multi-agency Training and e-learning.

That Victim Support should explore with the Homicide Support Service what can be done to provide support to the families of perpetrators, who are innocent of any crime and are traumatised by the homicide.

All staff to be aware of the safe guarding children and vulnerable adults policies and procedures for Wiltshire and to attend appropriate training.

NHS Wiltshire will work with other key Wiltshire agencies to extend the Multi-Agency Safeguarding Hub (MASH) to adults. The MASH is staffed with professionals from a range of agencies including police, probation, fire, ambulance, health, education and social care. These professionals share information to ensure early identification of potential significant harm, and trigger interventions to prevent further harm.

Concerns about the vulnerability of customers are shared with other departments and services, particularly Adult Social Services and the homelessness teams.

Staffing levels within the Intelligence Department are reviewed to enable stop and search forms to be inputted.

Staff to continue to develop skills in assessing and analysing the totality of an offender’s behaviour and working effectively with other agencies in order to achieve positive outcomes.

SWITCH Staff needs to be adequately trained to identify and deal with RISK and the strategic lead in force needs to ensure that staff has the requisite skills. Consideration should be given by the police to adopt a tenure policy for SWITCH police staff in line with the Wiltshire Probation policy.

The SWITCH Manager, MAPPA Co-ordinator and the MARAC Chair to review protocols and practice arrangements on referrals and potential re-routing of referrals to the most appropriate arrangements.

To review its “Lone Working” procedure on an annual bases and ensure all new staff are aware of the procedure at induction

Policy and Procedures for dealing with Domestic Abuse to be updated, and policies that are no longer relevant should be removed from the intranet site.

To be addressed with CID Officers and other specialist units to prevent Domestic Abuse incidents from being incorrectly identified, to be reinforced with staff and appropriate training delivered. Wiltshire Police need to address and remind staff of the escalation process to CPS in particular in cases of DA or by Perpetrators of serious or potential serious violence.

DAIT should have a holistic approach to the history of DA Perpetrators and the risks they represent. The MARAC and MAPPA Processes need to be firmly embedded with staff to recognise the risks.

Commission a Root Cause Analysis review under the AWP Incident Management policy, alongside any future Domestic Homicide Reviews and implement any actions that arise.

Wiltshire Police to address what is intelligence and what is crime recording? A system needs to be developed whereby intelligence is assessed and reviewed within the Intelligence Unit and highlighted to management in appropriate cases, which should then be investigated. Capacity to deal with and review the intelligence should be explored. Consideration for a mechanism to ensure this is done to highlight intelligence involving weapons and risks of serious harm need to be developed.

Wiltshire Police need to instil ownership of information and investigations. Has everything been done to reduce the risks; a list of tactical options for risk management needs to be made available for all officers to consider?