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: February 2026 Year of death: 2019 Extracted: 10 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 significant challenges in engaging with the victim and perpetrators due to their homelessness and alcohol dependence, alongside gaps in inter-agency communication, information sharing, and adherence to safeguarding policies. The MARAC process was found to be ineffective in reducing risk.

Extracted recommendations

10 recommendations pulled from the report

#	Recommendation	Addressed to
1	Records maintained by GP Surgeries need to be current and reflect information that they are privy to from other NHS Organisations. Where a patient is homeless, the record should be flagged as such and contribute to a Surgery based risk register of vulnerable patients.	Kent and Medway CCG Now the Integrated Care Board (ICB)
10	Disseminate the learning from this review with local Community Safety Partnerships (CSPs) and highlight the risks associated with allowing rough sleepers to congregate in makeshift camps for a prolonged period.	Kent Community Safety Partnership (KCSP)
2	A process to be developed that assists Primary Care practices with quality monitoring including the monitoring of compliance with existing safeguarding policy and procedures beyond national contract measures.	Kent and Medway CCG Now the Integrated Care Board (ICB)
3	There are clear benefits to having a dedicated IDVA available in Accident and Emergency, along with a dedicated Homeless Practitioner role and bespoke processes in place to deal with homelessness. This good practice should be disseminated to other Acute Hospital Trusts.	East Kent Hospital University Foundation Trust
4	The police should review current procedures to ensure all MARAC victims, where appropriate, have operational information on STORM. This information needs to be current and relevant to assist call handlers undertaking real time risk assessments.	Kent Police
5	Current protocols and procedures should be reviewed to ensure client files and supervision client files are completed and adhere to policy guidelines in terms of content and timeliness.	KCC Adult Social Care and Health Directorate
6	Identify documents that have not migrated to MOSAIC.	KCC Adult Social Care and Health Directorate
7	A training needs analysis should be carried out to identify what training should be provided to Liaison and Diversion Practitioners (not professionally qualified) deployed in custody suites. This should cover existing staff and new staff recruited to these roles as part of their induction training. Training should specifically cover what circumstances must be referred to a qualified mental health specialist. The role and function of CJLDS practitioners should be widely disseminated to other KMPT departments. Vulnerability assessments are not mental health assessments.	CJLDS (KMPT)
8	Deliver workshop training to staff and volunteers that details what good record keeping looks like. Support managers to deliver a clear footprint across records and caseloads to ensure robust auditing and safe case progression.	Porchlight
9	It is recommended that a programme of review and evaluation of MARACs in Kent and Medway takes place. The findings of this review are to be taken to the Kent and Medway Domestic Abuse Executive Board and the Domestic Homicide Review Steering Group with recommendations for discussion. Kent and Medway Safeguarding Adults Board to be given sight of findings. (DA Leads for KCC, Medway Council and Kent Police).	MARAC Steering Group and DHR Steering Group
Recommendations extracted from the published report. Source: Home Office DHR Library. View full report ↗