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
Reigate and Banstead review
CSP: Reigate and BansteadPublished: June 2023Year of death: 2017Extracted: 13 recs
Statutory domestic homicide review under section 9 of the Domestic Violence, Crime and Victims Act 2004. Source: Home Office DHR Library.
The report identifies systemic failures in understanding coercive control and its impact on the victim, leading to missed safeguarding opportunities and inadequate support. Challenges in inter-agency information sharing and assessment processes further exacerbated the victim's vulnerability, particularly after the removal of her children.
Home Office classifications
37 tags
Source-supplied classifications used by the Home Office to catalogue this review.
Victim - died by suicide
Victim - alcohol misuse
Victim - substance misuse
Victim - housing issues
Victim - pregnancy
Victim - mental ill health
Victim - anxiety
Victim - depression
Victim - suicide attempts
Victim - had been a victim of an abuser before
Victim - referred to marac at any time
Victim - case heard at marac before homicide
Children - subject to child protection or domestic abuse prior to homicide
Children - removed into care
Perpetrator - substance misuse
Perpetrator - known to agencies as a domestic abuse perpetrator
Perpetrator - known to police as a domestic abuse perpetrator
Perpetrator - known to social services as a domestic abuse perpetrator
Perpetrator - known to idva or other domestic abuse support service as a domestic abuse perpetrator
Perpetrator - known to school as a domestic abuse perpetrator
Aggravating factors - separation
Aggravating factors - coercive or controlling behaviour
Aggravating factors - stalking
Aggravating factors - physical stalking
Aggravating factors - sexual abuse
Aggravating factors - physical abuse
DHR process - police recommendations
DHR process - social services recommendations
DHR process - health services recommendations
DHR process - idva or other domestic abuse support service recommendations
DHR process - housing services recommendations
DHR process - identification of risk recommendation themes
DHR process - training recommendation themes
DHR process - policy recommendation themes
DHR process - multi agency working recommendation themes
DHR process - awareness raising recommendation themes
DHR process - other recommendation themes
Extracted recommendations
13 recommendations pulled from the report · 7 matched to organisations in the index
It is recommended that all police officers and police staff involved in the response to / investigation of incidents of domestic abuse ensure that accounts are obtained from the children involved/witnessing incidents with the appropriate expert advice and assistance.
It is recommended that once incidents of DA have been referred to the Safeguarding Investigation Unit, an experienced investigator reviews the historical as well as current Police involvement with the individuals. This will help inform investigative and risk management strategies.
It is recommended that where possible, incidents that are linked (same individuals, same domestic situation) are allocated to one investigating OIC. This will ensure single oversight of all reported incidents and help inform risk management strategies.
SSAB and SSCP to produce safeguarding referral guidance (adult and children) for organisations whose sole purpose is not safeguarding e.g. housing associations, drug and alcohol services, and to raise awareness of its availability.
ASC professionals to ensure (through Safeguarding Training and supervision) that the importance of timeliness in decision making is emphasised following receipt of a safeguarding enquiry referral.
RBBC CSP to highlight the need for the Home Office to consider updating the Multi Agency Statutory Guidance for the Conduct of Domestic Homicide Reviews (2016 to include specific guidance where a person may have taken their own life.
Professionals must understand the increased risk when children are removed, especially when a parent is experiencing domestic abuse, has other risks and has increased vulnerability. Support for the parent should be provided both before the children are removed and afterwards. Individual agencies to ensure their staff are trained understand and support the parent, including the management of risk. This will be scrutinised by the SSAB and SSCP, giving assurance to the SAB / SCP that the agencies have implemented this training.
Addressed to
Surrey Domestic Abuse Management Board (DAMB)
The MARAC process to be reviewed to ensure that information regarding relevant risks for a service user is passed safely and promptly to any involved service, including Primary Care e.g. GPs. Thia was also a recommendation in the Coroner’s report from the Inquest October 20.
RBBC CSP to request that the Home Office promotes the Domestic Abuse Housing Association Accreditation principles as best practice for housing associations70.
The Children Service Academy (SCSA), SSCP and SSAB will ensure that staff working with vulnerable adults, children and families have an in depth understanding through DA training including coercive controlling behaviour, the trauma impact of CCB, the increased risks including stalking, grooming of family members and professionals, retaliatory violence / resistance and an understanding of the links between substance abuse, mental health issues and domestic abuse. Through training, those professionals working in adult social care must have the tools to understand the needs of a victim suffering from domestic abuse, substance abuse and mental health issues.
The Surrey Children Services Academy (SCSA), SSCP and SSAB will develop a training programme and guidance information on Professional Curiosity which will be available to all agencies including the charity, community and faith sectors. Agencies to review improved understanding of professional curiosity in supervision.