Domestic Violence & Abuse

Summary of key contacts and links

There are useful national and specialist support organisations for all people  affected by domestic abuse within the annexes.  Contacts for example, Support for specific communities, contacts for Galop:  lesbian, gay, bisexual, transsexual people who experience hate crime, sexual or domestic abuse. National LGBT Domestic Abuse Helpline: 0800 999 5428; help@galop.org.uk or, www.galop.org.uk

Multi-agency procedures

Multi-agency risk assessments Conference (MARAC)

The aim of multi-agency working within MARAC is to protect the highest risk victims and their children – those at risk of murder or serious harm and to respond to perpetrators of domestic abuse.

For updated information about referrals and forms around conducting a risk assessment, see Domestic Abuse and Drawing a line in Solihull.

Definitions and roles and responsibilities

Domestic violence and abuse is:

‘Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members[1] regardless of gender or sexuality. This can encompass, but is not limited to, the following types of abuse:

  • Psychological
  • Physical
  • Sexual
  • Financial
  • Emotional

‘Controlling behaviour is: a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their every day behaviour.

Coercive behaviour is: an act or pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.

The government definition contained within Information for Local Areas on the change to the Definition of Domestic Violence and Abuse, Home Office, March 2013, is not a legal definition, but includes so called ‘honour’ based violence', female genital mutilation (FGM) and forced marriage, and is clear that victims are not confined to one gender or ethnic group’.

Domestic violence and abuse is not:

  • a minor tiff
  • a private quarrel
  • an occasional heated argument
  • loss of temper or self control
  • caused by alcohol and/or substance misuse

Victim / Survivor of domestic abuse

The term ‘victim’ is often perceived as negative. Some organisation and policies refer to those experiencing domestic abuse and violence as ‘survivors’ as they are often surviving the abuse on a daily basis. However, in Solihull CCG the term ‘survivor’ is used when the person has completed a ‘pattern-changing course’. The CCG domestic abuse policy uses the term ‘a person subject to domestic violence and abuse’.

A survivor of domestic violence and abuse is therefore ‘anyone who has been injured or has been emotionally or sexually abused by a person with whom she/he has had or is having a relationship.

Women are particularly vulnerable as one in four women will experience domestic abuse at some point in their lifetime. Research also shows that women are more likely to suffer more serious injury and on-going assaults than men. However it must be acknowledged that men can experience domestic abuse from their female partners and that domestic abuse also occurs in same-sex relationships.

Responsibilities

Responsibilities for Managers

All managers / GP Partners should:

  • Know that workers may require further support when they are working with families who are involved in/ have experienced domestic violence and abuse.
  • Know the indicators, which may lead to domestic violence and abuse.
  • Be aware that workers own values and judgments, prejudices and feelings about domestic violence and abuse may influence their own decisions and ensure appropriate supervisions is in place to support all workers.
  • Ensure that workers have the adequate and appropriate learning and development opportunities as part of their Professional Development and Appraisals. This will generally follow the guidance issued by the NHS, NICE and other regulatory and professional bodies.      
  • Identify a domestic violence and abuse representative for each practice/ department/ area.
  • Work in a collaborative manner with partner agencies and Solihull Community Safety Partnership (and as applicable, Birmingham Safeguarding Boards and/or Community Safety Partnership).
  • Ensure workers have the systems in place to maintain confidentiality of records.
  • Know that domestic violence and abuse is considered in child protection and adult’s at risk cases.
  • Acknowledge that asking for help, whether it is a worker or a patient, may leave a person feeling vulnerable and powerless and act, where it is possible and safe to do so, in a way that empowers the individual, maintaining their autonomy, self-esteem, dignity and respect.
  • Work together with partner agencies to ensure local statistical data is collated.

Responsibilities of workers within the CCG and Member Practices

All workers should:

  • Be aware of the extent and impact of domestic violence and abuse and know the indicators that may lead to domestic violence and abuse.
  • Know that there is a significant overlap between domestic violence and abuse with both child and adult protection cases.
  • Ensure that they attend learning and development sessions that prepares them to recognise domestic violence and abuse and enables them to respond accordingly.
  • Recognise that they have a responsibility to acknowledge domestic violence and abuse and take action to respond accordingly to the individuals’ needs and acknowledge their wishes.
  • Know who the designated person/ safeguarding lead is for their practice
  • Know the process for arranging the patient’s initial assessments with the designated person.
  • Respect the need for confidentiality and know when it is necessary to disclose information, with or without consent, and in line with the legal & policy framework related to safeguarding children and adults at risk information sharing guidelines and protocols. Note, in exceptional circumstances information may be shared without the patient’s consent. Some cases considered at MARAC meetings are likely to constitute exceptional circumstances because MARACs discuss the most serious of cases of alleged or suspected domestic abuse[5].  
  • Ensure that documentation guidelines relating to domestic violence and abuse are followed.
  • Document domestic abuse within the patient records safely and keep records for evidence purposes.
  • Undertake a personal safety assessment and never place themselves at risk of personal injury or substantial intimidation (see Lone Worker policy). Where a potential risk of violence is identified for staff an urgent risk assessment should be completed.
  • Be aware of the support services that are available locally.

The designated person’s role

When undertaking an initial assessment of the patient, the designated person will:

  • Conduct a risk assessment
  • Advise the patient about services available according to the risk level. This may result in:
    • The patient becoming part of the designated person’s own case load, if they are specialist domestic abuse practitioner themselves.
    • Referral to an appropriate local specialist domestic abuse service, if the patient consents.
    • Signposting to domestic abuse resources and provision of a basic safety plan if the patient is unwilling to engage in services at this time.
  • Ensure that the child protection and adult safeguarding procedures are initiated where required, especially where there is immediate risk of harm to patients and their children[6].

Supporting staff

Involvement in the protection of those experiencing domestic violence and abuse may be stressful to workers who need to demonstrate a non-judgmental attitude to both persons subject to domestic abuse and their carers/ significant others and establish support and protection. It is important that the impact on workers is recognised and that they are offered the relevant support.

Solihull CCG/ Practice Members will support staff in their commitment in the implementation of the Domestic violence and abuse policy and procedure.

Where there is likely to be a risk to the personal safety of workers, managers must ensure that appropriate arrangements are made and recorded in line with a ‘Zero’ tolerance guiding principle as outlined in the management of violence and aggression.

Contacts

In an emergency ring 999 for Police, or 101 for non-emergencies.


Reference

  1. Family members are: mother, father, son, daughter, brother, sister & grandparents; directly –related, in-laws or step-family.
  2. In this study (Barter et al, 2009), ‘emotional abuse’ covers a wide a range of experiences, including ‘being made fun of’.
  3. http://www.caada.org.uk/policy/CAADA-Insights-Factsheet-Teenage-Domestic-Abuse-Final.pdf
  4. http://www.caada.org.uk/policy/A_Palce_of_greater_safety.pdf
  5. See Responding to domestic abuse: Guidance for general practices, RCGP, IRIS, CAADA, 2012
  6. See fn 5, per page 3, the designated person’s role, RCGP guidance.