Home / Sources / Domestic Homicide Reviews / Kent · Jul 2023
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

Kent review

CSP: Kent Published: July 2023 Year of death: 2011 Extracted: 11 recs

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

Original review (PDF) ↗ Source: Home Office DHR Library

Summary AI-generated

Verify against the full report at the source link
The review identified inconsistent domestic abuse risk assessments, inadequate information sharing between agencies, and a lack of multi-agency coordination, particularly in cases involving alcohol misuse and transient lifestyles. There were also concerns about staff training and understanding of domestic abuse indicators and MARAC processes.

Home Office classifications

31 tags

Source-supplied classifications used by the Home Office to catalogue this review.

  • Victim - alcohol misuse
  • Victim - housing issues
  • Victim - psychosis
  • Victim - had been a victim of an abuser before
  • Children - subject to child protection or domestic abuse prior to homicide
  • Perpetrator - case heard in court
  • Perpetrator - alcohol misuse
  • Perpetrator - housing issues
  • Perpetrator - mental ill health
  • Perpetrator - depression
  • Perpetrator - self harm
  • Perpetrator - suicide attempts
  • Perpetrator - known to agencies as a domestic abuse perpetrator
  • Perpetrator - known to police as a domestic abuse perpetrator
  • Perpetrator - known to probation services as a domestic abuse perpetrator
  • Perpetrator - known to others as a domestic abuse perpetrator
  • Perpetrator - known to family as a domestic abuse perpetrator
  • Perpetrator - attended drug and alcohol services
  • Aggravating factors - psychological or emotional abuse
  • Aggravating factors - physical abuse
  • DHR process - police recommendations
  • DHR process - health services recommendations
  • DHR process - probation services recommendations
  • DHR process - community safety partnership 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 - record keeping recommendation themes
  • DHR process - awareness raising recommendation themes
  • DHR process - other recommendation themes

Extracted recommendations

11 recommendations pulled from the report · 6 matched to organisations in the index

Recommendation 6.1

Addressed to NHS Kent and Medway | Clinical Commissioning Groups

NHS Kent and Medway/Clinical Commissioning Groups to ensure that all health providers and GPs understand and respond to statutory guidelines, best practice and local policy and procedures for domestic abuse.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.2

Addressed to NHS Kent and Medway | Clinical Commissioning Groups

NHS Kent and Medway/ Clinical Commissioning Groups, to ensure that all health organisations, including providers and GPs, understand and meet their statutory responsibilities towards domestic homicide reviews.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.3

Addressed to NHS Kent and Medway | Clinical Commissioning Groups

NHS Kent and Medway/Clinical Commissioning Groups to request NHS providers to identify leads in domestic abuse within each organisation and develop a domestic abuse strategy to include responsibilities and accountabilities from Board level to individual staff.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.4

Addressed to NHS Kent and Medway | Clinical Commissioning Groups

NHS Kent and Medway/Clinical Commissioning Groups to request NHS providers to develop and initiate a domestic abuse training strategy, and to request GP practices to undertake basic domestic abuse awareness training.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.5

Addressed to Kent and Medway Community Safety Partnership

Kent and Medway Community Safety Partnership to ask all member agencies to ensure that their frontline staff understand the MARAC referral process, including issues of consent.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.6

Addressed to Kent Police

When six DASH assessments have been graded ‘medium’ or ‘standard’ in a rolling 12 months period, Kent police should review the case and consider referral to the Public Protection Unit as High Risk case.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.7

Addressed to Kent Police

When conducting risk assessments, in addition to the DASH process, Kent police should take into account past information and intelligence data.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.8

Addressed to Kent Probation | London Probation

Kent and London Probation to ensure that in cases of domestic abuse Spousal Assault Risk Assessments (SARAs) are completed to a consistently high standard, that risk assessments are kept under review, and orders are enforced rigorously.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.9

Addressed to Kent Probation

Kent Probation to ensure that other relevant agencies are fully involved in risk assessment and risk management of domestic abuse cases.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.10

Addressed to Kent Probation | substance misuse services

Kent Probation and substance misuse services to ensure that there is closer liaison and more rigorous application of compliance with alcohol treatment orders.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 6.11

Addressed to Kent and Medway DAATs

Kent and Medway DAATs to ensure that agencies that support and treat individuals with substance misuse issues are aware of domestic abuse toolkits, eg STELLA project toolkit, and use them appropriately.

Verified wording from the published review · Original review (PDF) ↗