Kirklees review

Consideration should be given to the development of an overarching training plan to ensure that staff are clear about how to recognise the basic signs and symptoms of domestic violence and abuse which agencies can then tailor or access according to service specific needs.

The training should ensure all staff know how to routinely ask questions and record the answers about the potential for domestic violence and abuse when someone presents as a potential victim of it.

The Kirklees Community Safety Partnership and Kirklees Safeguarding Adult Board's current and ongoing work on self-neglect should consider the feasibility of developing a coordinated case management/information sharing approach to the care of people who for whatever reason engage in risky behaviours that are not captured by other safeguarding processes. The Community Safety Partnership and the Kirklees Adults safeguarding Board are best placed to collaborate and facilitate discussion around this, with a view to agreeing and implementing a multi-agency protocol.

Because of the significant problems within Kirklees of street sex-workers, who through their lifestyles and who they engage with make themselves vulnerable to exploitation and violence, the Safeguarding Adult’s Board in Kirklees should consider whether sex-workers should be identified as ‘Adults at Risk’ and therefore whether a multi-agency safeguarding response would be appropriate.

That HSS ensure staff receive training in options available for people experiencing domestic abuse and refresher training is provided as appropriate, underpinning the existing guidance to support staff in identifying the most appropriate option, where domestic violence or abuse is disclosed or becomes evident.

That HSS puts in place a quality assurance system to ensure that accurate case notes and records are maintained so that actions and interactions with customers are fully recorded.

That KNH review and update their anti-social behavior policy and procedures which include reference to clear policies and procedures for KNH staff to follow around domestic abuse.

That KNH look into enabling a system prompt to ensure that failed initial tenancy visits are followed up with further communication with the tenant, to ensure appropriate welfare checks are made as appropriate.

To ensure that all keyworkers in Lifeline should have attended training refreshed every 3 years in domestic abuse, MARAC procedures and the use of the DASH risk assessment.

To ensure that Locala clinicians and Lifeline staff have access to an up to date list of walk-in centres in Kirklees so they can identify when patients access NHS services as opposed to the services of their regular General Practitioner.

That Lifeline’s child safeguarding policies should make specific reference to MARAC procedures, where the procedures can be located and information about the role of the in-house nominated lead manager.

To strengthen the interface between SWEET and Safeguarding Adults so as to ensure that when a vulnerable adult is linked to a sex-worker, SWEET is informed.

To review the MARAC briefing training pack and make sure it includes the impact of domestic abuse on sex-workers and the relevance of referring cases to MARAC.

To make sure that the MARAC briefing is delivered to Single Point of Access staff, Kirklees Community Mental Health Team, and the Supporting Peoples Team.

To ensure that specific family related questions are asked at SPA and point of referral, such as: Who lives with you? Does anyone support you? What is important in your life? Do you care for anyone? Do you have child(ren) / extended family? Do you need support if you are in a parenting role?

To ensure that managers and staff increase their knowledge and awareness around a ‘Think Family’ approach to develop strong working relationships across departments and agencies.

To develop strategies for the management of referrals where the situation is complex or there is a risk of poor outcomes for children and parents.

To develop new or adapt existing management information tools to ensure the quality and information gathered by SPA is fit for purpose.

Update ‘Think Family’ training to raise awareness of the different groups who face domestic violence and abuse and how services can respond effectively.

To review guidance as to when staff should discuss a case with a manager to obtain support and guidance with decision making.

To ensure that all patients are routinely asked about domestic violence and abuse when triaged in accident and emergency departments and that appropriate and proportionate action is taken immediately. Where there is a history of patients leaving the department before being seen, an appropriate triage risk assessment should take place and that patients are seen promptly

There should be an improvement in the recognition of adults at risk of abuse or neglect when they attend accident and emergency

Where the patient has been the victim of an assault or sexual abuse, to ensure that safety risks and social support needs are assessed and that safety and support arrangements are in place prior to discharge from both accident and emergency and inpatient hospital wards

To consider how CHFT can be more involved in multi-agency working with patients who have complex health and social care needs and who are difficult to engage with

To raise awareness about male victims of domestic violence and abuse with accident and emergency service users and members of staff

To ensure that mental capacity is assessed and the outcome recorded for all decisions where capacity is questioned in accident and emergency departments.