About this page. This page summarises a Domestic Homicide Review published in the Home Office DHR Library. The full report is available at the source link below. Victim and perpetrator names are not included in extracted summaries on this page.

Source · Domestic Homicide Review

Bath and North East Somerset review

CSP: Bath and North East Somerset Published: April 2023 Year of death: 2015 Extracted: 21 recs

Statutory domestic homicide review under section 9 of the Domestic Violence, Crime and Victims Act 2004. Source: Home Office DHR Library.

View full report (PDF) ↗ Source: Home Office DHR Library

Summary

The review identified concerns regarding inter-agency information sharing, delays in safeguarding referrals, and inconsistent risk assessments for individuals experiencing domestic abuse and mental health problems, particularly concerning child welfare.

Extracted recommendations

21 recommendations pulled from the report

#	Recommendation	Addressed to
1	Avon and Somerset Constabulary to ensure that all operational staff-members are reminded of the importance of intelligence submissions for any relevant incident they attend.	Avon and Somerset Constabulary
10	Referrals to Children's Social Care to ensure clarity on what is constitutes a referral to Social Care into CSC C.2 is The form used for all agencies to request a service from CSC. This was not progressed by any agency and CSC saw no need to undertake an assessment. If an agency is not happy with the response from CSC they should refer to the LSCB escalation policy	Bath & NES Council Children’s Social Care
11	Reminders to be given to Duty Team to ensure clarity and consistency in record keeping	Bath & NES Council Children’s Social Care
12	That the Local Safeguarding Adults Board reviews the quality of referrals being made into safeguarding, particularly those made by statutory partners. Working across agencies, particularly statutory partners to agree a minimum set of data that should be provided by organisations when making safeguarding referrals. Consideration also to be given to how referrals for alternative forms of support such as social care assessments should be identified separately from safeguarding concerns, or where information only is being shared that there is an agreed process for how these should be actioned by the receiving agencies.	BANES Safeguarding Adults Board
13	DHI risk assessment for clients entering casework services to be reviewed and re-issued to all staff and regional (all DHI services)	DHI
14	Relevant DHI policies and procedures to be reviewed to consider appropriateness of current thresholds for action under (all DHI services)	DHI
15	Lettings procedures to be clear about specifically asking about DV and what support is or could be in place.	Knightstone Housing
16	Audit of thyroid function test management as proxy for management of blood results	GP Practice
17	Baseline assessment of documentation of consideration of child and adult safeguarding issues for all patients on mental register	GP Practice
18	All patients on mental health register to have documentation of consideration of safeguarding issues	GP Practice
19	Staff are up to date with mandatory child and adult safeguarding training	GP Practice
2	All operational staff to be reminded of the importance of recognising the risk to children living within a parent declining mental health. To be measured by an increase in referrals from the Safeguarding Coordination Units to Children’s social care.	Avon and Somerset Constabulary
20	IRIS training and advocacy package completed	GP Practice
21	Specific DVA policy developed	GP Practice
3	AWP to organise training to increase awareness of how vulnerability to domestic abuse can be linked to history of trauma and agencies available to support	AWP
4	The Operating Protocol in relation to Safeguarding decisions between AWP and Bath and North East Somerset Council needs to be reviewed particularly in relation to alerts having to be made by Team Managers or Senior Practitioners	AWP \| Bath and North East Somerset Council Safeguarding Team
5	Awareness raising to be undertaken amongst AWP on CAADA DASH/Safe Lives tool and MARAC referrals, particularly the availability of option to refer to MARAC on professional judgement basis.	AWP \| Avon and Somerset Constabulary
6	Explore IT solutions to reduce potential admin delays in reporting Safeguarding concerns	BANES Local Authority \| AWP
7	During the Review it was identified that B&NES does not appear to have a clear multi-agency policy / procedure on Domestic Abuse and Violence or a multi-agency training programme.	B&NES Responsible Authorities Group(Community Safety Partnership)
8	Review procedure on passing messages to advisers	Citizens advice B&NES
9	Continue to implement the“ASK RE” Citizens Advice B&NES information policy which highlights the need not just to signpost to services but t where appropriate to directly refer.	Citizens advice B&NES
Recommendations extracted from the published report. Source: Home Office DHR Library. View full report ↗