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

Ealing review

CSP: Ealing Published: July 2023 Year of death: 2013 Extracted: 12 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 identifies an escalation of domestic abuse, the victim's fear of statutory intervention hindering disclosure, and a lack of coordinated multi-agency information sharing and response. Professionals missed opportunities to identify and support the victim due to insufficient understanding of domestic abuse dynamics and care pathways.

Home Office classifications

29 tags

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

  • Victim - had been a victim of an abuser before
  • Victim - immigration involvement
  • Children - under 18 shared parental responsibility (victim and perpetrator)
  • Children - under 18 shared parental responsibility (between victims)
  • Children - under 18 shared parental responsibility (between perpetrators)
  • Children - living with victim (including adult children)
  • Children - living with perpetrator (including adult children)
  • Children - present at homicide (including adult children)
  • Children - subject to child protection or domestic abuse prior to homicide
  • Child - primary address same as victim
  • Perpetrator - case heard in court
  • Perpetrator - known to others as a domestic abuse perpetrator
  • Perpetrator - known to family as a domestic abuse perpetrator
  • Perpetrator - immigration involvement
  • Aggravating factors - coercive or controlling behaviour
  • Aggravating factors - psychological or emotional abuse
  • Aggravating factors - physical abuse
  • DHR process - family contributed to dhr
  • DHR process - family received draft report
  • DHR process - social services recommendations
  • DHR process - health services recommendations
  • DHR process - community safety partnership recommendations
  • DHR process - technology systems recommendation themes
  • DHR process - identification of risk recommendation themes
  • DHR process - training recommendation themes
  • DHR process - policy recommendation themes
  • DHR process - record keeping recommendation themes
  • DHR process - awareness raising recommendation themes
  • DHR process - other recommendation themes

Extracted recommendations

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

Recommendation 1

Addressed to Community Safety Partnership

The Community Safety Partnership via the VAWG Strategic Group launch publicity and awareness-raising for family, friends and victims or make use of national campaigns and efforts to raise awareness in the community.
• Providing information about where victims, family and friends can go for advice and to talk about their options and
• Address the role of Children’s Social Care to support non-abusing parents.

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

Recommendation 2

Addressed to Community Safety Partnership

The Community Safety Partnership via the VAWG Strategic Group provide guidance and support for employers and unions to develop employment policies that address domestic abuse, ensuring that employees are asked about domestic abuse and supported to address this before instigating disciplinary actions.

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

Recommendation 3

Addressed to London North West Healthcare NHS Trust

LNWHT should be assured professionals are undertaking a new birth visit and asking routine and follow-up questions around domestic abuse with evidence of risk assessment and any required support details.

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

Recommendation 4

Addressed to London North West Healthcare NHS Trust

All staff at LNWHT are trained to use the new assessment tool for domestic abuse.

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

Recommendation 5

Addressed to London North West Healthcare NHS Trust

LNWHT should ensure their DV policy is in line with NICE guidance and refers to creating an environment for disclosing DV and abuse. Consider IDVA for acute settings.

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

Recommendation 6

Addressed to London North West Healthcare NHS Trust

LNWHT should be assured around school nurses and health visiting record keeping skills.

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

Recommendation 7

Addressed to London North West Healthcare NHS Trust

LNWHT should ensure safeguarding children level 3 training is inclusive of domestic abuse and recommendations from this DHR.

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

Recommendation 8

Addressed to London North West Healthcare NHS Trust

LNWHT should review internal processes for creating alerts on electronic records in relation to domestic abuse.

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

Recommendation 9

Addressed to Community Safety Partnership

The Community Safety Partnership via the VAWG Strategic Group to provide support for safeguarding leads within Ealing schools on the Department for Education and Pan-London child protection referral procedures and best practice related to domestic abuse.

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

Recommendation 10

Addressed to LSCB

The LSCB to ensure that training be delivered for school safeguarding leads and includes equipping schools with the knowledge/skills to understand the risks associated with domestic abuse contained in the CAADA Dash and Barnardo’s DV Tools. This may be part of the LSCB training programme but it should be documented that all school Safeguarding leads have undertaken the LSCB module on domestic abuse.

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

Recommendation 11

Addressed to Community Safety Partnership

The Community Safety Partnership undertake audits and quality assurance measures to ascertain if recommendations from this DHR have been embedded in practice.

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

Recommendation 12

Addressed to Ealing Council Children’s Social Care

Ealing Council Children’s Social Care produce good practice in domestic abuse guidance for social care staff. Development of training for social work managers on risk management and decision making in domestic abuse cases.

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