South Cambridgeshire review

Following a pilot in Cambridgeshire, commenced in August 2001, the standard DASH risk indicator checklist has been amended to take into account the risks faced by older victims. It is recommended that the outcomes of that amendment are reviewed and, if they are positive, then consideration be given to it being embraced on a permanent basis by all relevant agencies. The pilot has been extended to July 2022.

Guidance is required relating to the potential requirement for a Carer’s Assessment be undertaken when a person registers with their GP as a Carer. This guidance could be provided via the Home Office ‘Safe At Home’ project which is considering the issues relating to both paid and family carers who are abusive to the person they care for.

Greater procedural clarity is required with regard to what can be done in the circumstances in which a victim of domestic abuse, who meets the Adult at Risk threshold, chooses to decline support that is offered to them.

Greater procedural clarity and training is required, for the police and their partner agencies, with regard to relationships that involve situations of bidirectional abuse. Options that embrace support, education and, if necessary and appropriate, sanction should be included within that training and procedure.

Cambridge University Hospital (CUH) to review the process used to monitor referrals to ensure that, when the safeguarding team advise staff to make a referral, that advice is followed up, if a referral is not received. (Completed by 31st January 2020).

The GP practice to consider how they could, more effectively, manage and retain oversight of complex cases where safeguarding concerns exist. (Completed by 31st January 2020).

The GP Practice should ensure that an effective policy is in place to address any concerns that a patient may be self-medicating beyond prescribed dosages. Any such policy should include the detail of how and when such concerns may be shared and addressed with other agencies as a means of ensuring the wellbeing of the patient(s) concerned.

The GP practice to define the circumstances under which they would cross reference, or link, the records of two or more patients, registered with the same practice, in circumstances where safeguarding concerns relate to all parties. (Completed by 31st January 2020).

GP Practice staff to receive training on the recognition of indicators of domestic abuse, together with the local support agencies and services that are available. The training should also include effective recording and onward referral processes. (Completed by 10th September 2020).

GP Practice staff to be able to record, and review, Systm One data relating to domestic abuse being experienced by patients. (Completed by 31st January 2020).

Relevant training to be provided to Cambridgeshire Police duty managers, to ensure that, when officers attend apparent suicide incidents, initial enquiries take into account any indication of domestic abuse or violence and, if they do, to refer such cases to the Duty Senior Investigating Officer for further evaluation. (Completed 31st March 2020)

Cambridgeshire County Council and Peterborough City Council Adult Social Care to review the current Carers Guidance, by 31st January 2020, with specific regard to Section 42 of the Care Act, 2014, and ensure that it is clear as to the point at which risks to Carers would need to be investigated under a Section 42 Safeguarding Enquiry, and the expectations from the multi-agency working within such an enquiry. (Completed by 12th March 2020)

Cambridgeshire County Council and Peterborough City Council Principal Social Worker to hold a Practice Event, by 31st March 2020, to share the learning from this Domestic Homicide Review, embracing the Good Practice identified and the importance of effective multi agency working. (Completed 9th March 2020)

Cambridgeshire County Council and Peterborough City Council Adult Social Care Services to strengthen the support to carers, as part of mainstream practice, to consolidate the fact that all front-line practitioners have received one off workshop training since this incident. (Completed by 31st January 2021).

Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) staff to seek consent or refusal of services directly from the patient rather than from relatives. (This guidance is to be included in the Q3 “Learning the Lessons’ bulletin of 2019. The Head of Adult Safeguarding and the Head of Learning and Development are to be the lead managers).

The Discharge Planning policy of Cambridgeshire and Peterborough NHS Foundation Trust staff is to be reviewed to ensure that it reflects the fact that it considers the effect of social stresses in care planning and in discharge planning. (The Director of Nursing and Quality will be the lead manager and the review will be undertaken during the next revision of policy).

During the discharge planning process, absolute clarity should be achieved with regard to the arrangements for the provision and administration of medication. (This guidance is to be included in the Q3 “Learning the Lessons’ bulletin of 2019. The Head of Safeguarding and Chief Pharmacist will be the lead managers).