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
Tendring review
CSP: Tendring
Published: June 2023
Extracted: 31 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 systemic failures in multi-agency risk assessment, information sharing, and professional curiosity, particularly regarding the perpetrator's history of violence and the dynamic nature of risk. It highlighted inadequate training, victim-focused tools, and a lack of focus on the impact of domestic abuse on children.
Extracted recommendations
| # | Recommendation | Addressed to |
|---|---|---|
| 4.10 | All perpetrators of domestic abuse should be assessed in terms of the level of threat and risk they may pose; this should be recorded, referred to, updated in light of subsequent incidents, and a chronology of incidents recorded which is easily visible on file. | Family Operations |
| 4.11 | Social Workers to use Section 17 (with consent) more often to undertake checks with partner agencies such as Probation and Community Mental Health Teams. | Family Operations |
| 4.12 | Where officers are executing search warrants and children are part of the household, consideration should be given to reporting their presence and outcome of enquiries to Children’s Social Care proportionate to the seriousness of their findings. | Police |
| 4.13 | When alerted to a breach of bail conditions in cases assessed as high risk, and children are in the household, the Police should consider that a notification is sent to Children's Social Care on each occasion. | Police |
| 4.14 | Where a victim contacts the perpetrator of domestic abuse in contravention of bail conditions she/he should be given warning advice as to the consequences, and safeguarding of children emphasised where relevant. | Police |
| 4.15 | JDATT to provide perpetrator’s history of violence against other partners and record this on contacts/referrals. | JDATT |
| 4.16 | Offender Managers must Review SARA when OASys is reviewed. This is a dynamic tool, not static. | Essex Community Rehabilitation Company |
| 4.17 | Offender Managers must contact Police for regular updates where domestic abuse has been identified either past or present. | Essex Community Rehabilitation Company |
| 4.18 | Offender Managers must include contact with Police as an activity within the Risk Management Plan where domestic abuse past or present is identified. | Essex Community Rehabilitation Company |
| 4.19 | Details of children with whom service users have regular contact must be obtained, not just those for whom they have Parental Responsibility, and added to the relevant sections in OASys. | Essex Community Rehabilitation Company |
| 4.2 | Using the commissioning and contract management process, Commissioners should ensure that any contracted provision is competent and capable of effectively identifying and addressing domestic abuse issues in both adults and children. | Multi-Agency |
| 4.20 | Practitioners and their supervisors should ensure that Risk Management Plans are updated when OASys is reviewed. | Essex Community Rehabilitation Company |
| 4.21 | Ensure all Offender Managers are familiar with treatment providers and the referral pathway, in particularly on which agency provides which service i.e. in relation to drug, alcohol and mental health provision | Essex Community Rehabilitation Company |
| 4.22 | Offender Managers must record all attendances within 24 hours of contact and schedule next appointments. | Essex Community Rehabilitation Company |
| 4.23 | Information sharing protocols amongst agencies should be reviewed and updated to ensure agencies are empowered to share information of victims and perpetrators. This information to include the agencies involvement with the victim and/or perpetrator, and their details of the risk to the victim. The purpose being to ensure that all involved agencies can make in depth investigations to provide services which will safeguard victims and risk assess perpetrators. | Housing Options Life Opportunities, Tendring District Council |
| 4.24 | WDP recommends that a review of the assessment and risk assessment be conducted by substance misuse services in Essex in order to ensure that family support networks are discussed and explored. | All Substance Misuse Services |
| 4.25 | Under the ‘Vulnerability’ section of risk assessment tools used by services there should be questions explicitly asking about domestic abuse by a partner, former partner, or family member and that this include asking about physical, emotional, sexual, and financial abuse and exploitation, and coercive and controlling behaviour. Note: It is understood that this action on this has already begun in some services. | All Substance Misuse Services |
| 4.26 | In partnership with the health visitor service managers and leads the Safeguarding Children Team will review and amend existing policy/practice guidance/Standard Operating Procedures (SOP) to ensure they clearly state that those practitioners with caseload responsibilities utilise historic information held within the health record to inform risk assessments. | Anglian Community Enterprises |
| 4.27 | To reduce the likelihood of ‘professional dangerousness’ impacting on the ability of health practitioners to make effective assessments and professional judgements about risk when working with families. | Anglian Community Enterprises |
| 4.28 | To support health visitors to identify when parental non-engagement could indicate increased risk of harm to a child. | Anglian Community Enterprises |
| 4.29 | To ensure ACE community children’s health practitioners accurately record key details about males in households where there are children, and consider men and their contribution to parenting and what risk or protective factors they may represent. | Anglian Community Enterprises |
| 4.3 | All agencies must ensure that in assessing risk either to or from a service user where domestic abuse is present or suspected, that they source and include the background history of the alleged perpetrator and take account of high risk predictors and the threat they pose. Assessment templates should be amended to flag this requirement if possible and incorporated in staff training. | Multi-Agency |
| 4.30 | To ensure ACE has an effective plan in place that defines the organisational response to domestic violence. | Anglian Community Enterprises |
| 4.31 | ACE to ensure that the Health Visiting Service has MARAC representation and fully contributes to the MARAC process. | Anglian Community Enterprises |
| 4.32 | The independent chair to raise the awareness of the Local Safeguarding Children's Board to the issues raised in this Review concerning the need for greater multi-agency awareness of the impact on children and young people of living with domestic abuse, the added difficulties of substance misuse, and the importance of effective holistic interventions to support children and their non-abusing parent/carer. | Local Safeguarding Children's Board |
| 4.4 | A multi-agency information sharing guidance document should be provided which gives frontline practitioners straightforward, practical instructions about how and when they are able to share information. | Multi-Agency |
| 4.5 | Practitioners and their managers should ensure that their domestic abuse training is sufficiently in-depth to perform their role, particularly around risk assessment of victims, children and perpetrators of domestic abuse. Training on coercive control should also be undertaken in light of new statutory guidance which came into force on 29 December 20159. | Multi-Agency |
| 4.6 | MARAC information and safety plans must always include consideration of the perpetrator’s full background history, any criminal record, past relationships where abuse has taken place, and the additional threat and risk such background poses to a victim and any children in the family. | MARAC |
| 4.7 | Youth Offending Services should be included in the MARAC partnership of agencies with whom information is shared and where the Services have information they should provide this to MARAC and attend if required. | Youth Offending Services |
| 4.8 | That a review of social work training in domestic abuse is completed and training (preferably mandatory) is introduced which addresses cycles of violence, power and coercive and controlling behaviour, as well as assessment of risk and protective capacity. | Family Operations |
| 4.9 | It is recommended that ‘Domestic Abuse Champions’ be identified in each quadrant to provide specialist knowledge, supervision and direction to practitioners and linking with Police and local services. | Family Operations |
| Recommendations extracted from the published report. Source: Home Office DHR Library. View full report ↗ | ||