Domestic Violence, Adult Safeguarding & MARACs
News and updates from todays conference chaired by Nicole Jacobs CEO Standing Together against Domestic Violence.
Nicole opened the conference with a look at Supporting victims of domestic and made the following comments.
"Why does it take such a long time to enbed change in these organisations, there's a reason for that"
"If you haven't heard of DAHA and you work with housing colleagues please do point this out to them" (http://www.standingtogether.org.uk/consultancy/daha)
"The evidence is there that the work you are doing is really paying off"
"Maybe there are logistical reasons why people haven't moved out yet? So we have to remember "separating" when looking at risk factors"
Safeguarding and Domestic Abuse
Lindsey Pike, Senior Research and Development Officer, Research in Practice for Adults. In her presentation Lindsey said:
"The perpetrator will know what kind of language will chip away at that persons confidence"
"It's much more challenging to leave that situation once you create that dependence"
"People with poor mental health are more likely to experience domestic violence and people who have experienced domestic violence are much more likely to develop mental health issues"
This session will begin by looking at the policy context around safeguarding adults and domestic abuse, outlining how the Care Act 2014, which brought domestic abuse under the umbrella of safeguarding, includes a duty to promote wellbeing. The approach to safeguarding adults under the Care Act is Making Safeguarding Personal; ensuring a person-centred and outcomes focussed approach which is led by the individual. This aligns well to the models of support used in the domestic violence sector, including for example Women’s Aid’s Change that Lasts approach.
We will discuss the importance of a good understanding of coercive control when working with situations of domestic abuse, and examine the evidence about the experience of domestic abuse where people have care and support needs. The evidence suggests that domestic abuse within people with social care needs is under-recognised and underreported, highlighting the importance of improving the knowledge and skills of health, social care and police professionals working with adults.
The session will finish with an exploration of what ‘good’ outcomes look like, again emphasising that these should be led by the person, supported with appropriate signposting and skills.
Further information is available on a new resource for adult social workers, commissioned by the Chief Social Worker at the Department of Health and delivered by Research in Practice for Adults and Women’s Aid – http://coercivecontrol.ripfa.org.uk/
Working with perpetrators of domestic violence
Marianna Tortell, Chief Executive, Domestic Violence Intervention Project
Marianna made the following comments in her presentation;
"We should be working to make ourselves unemployed it would be great if our roles weren't needed....... unfortunately they are still needed"
"The Domestic Violence Prevention Programme is not anger management, often these perpetrators are very good at managing their anger, it's about behaviour change and attitude change"
"If you only address the drug and/or alcohol issues you are then left with a sober perpetrator"
"We are not going in saying you need to have a relationship with your children we are saying you need to stop this abusive behaviour to have a better relationship with your children"
DVIP has been developing and providing domestic violence prevention programmes (DVPP) for male perpetrators and integrated support services (ISS) for female (ex) partners of men engaged with a DVPP for 25 years. During that time, our services have expanded and we now provide:
- Group and one-to-one DVPPs with adult male perpetrators of domestic violence and abuse
- Group and one-to-one support services for female (ex) partners of men attending a DVPP
- London’s only language and culture-specific DVPP and ISS for Arabic-speaking communities
- A specialist service for young people using violent and abusive behaviours against a parent/carer, and integrated support for the parent/carer
- Expert risk assessments for public and private law cases
- Specialist therapeutic interventions for children and young people affected by domestic violence
- A combined domestic violence and problematic substance use treatment programme and integrated partner support
- Co-location of DVIP specialist practitioners in local authority Children’s Services teams
The aim of any intervention with perpetrators of domestic violence must be to increase the safety and wellbeing of survivors (both adults and children) by ending the physical, sexual and emotional abuse and increasing survivors’ space for action. In order for this change to be long-term, both behaviours and underlying attitudes need to be addressed and challenged within a programme of work in which perpetrators are supported to make these substantial changes and their (ex) partners are empowered to make safe choices and regain control over their lives.
Recent research carried out by CWASU and Durham University (Kelly and Westmarland, 2015. Domestic Violence Perpetrator Programmes: Steps Towards Change. Project Mirabal Final Report). has shown that long-term, in-depth interventions such as those provided by DVIP have a tangible, positive impact on the levels of violence and abuse. The researchers found that at the start of the DVPP, nearly three out of four women whose (ex) partners attended a group said they did not feel safe; 12 months later, eight out of ten women reported feeling safe. Comparing baselines measures from the men starting on the DVPP to 12 months later, the report found that:
30% of women had experienced sexual violence in the baseline measure; 12 months later 0% had experienced sexual violence
59% of women reported that their (ex) partner had threatened to kill them or someone close to them in the baseline measure; 12 months later 10% reported threats to kill
50% of women reported that their (ex) partner had tried to strange, choke, drown or suffocate them in the baseline measure; reduced to 3% 12 months later
87% of women reported that their (ex) partner had slapped, pushed or thrown something at them in the baseline measure; reduced to 7% after 12 months
Long-term, in-depth DVPPs have a tangible, positive impact on the lives of women and children and are an effective tool in holding perpetrators to account, reducing the harm they do to others and addressing the attitudes, beliefs and choices that they use to justify their abuse.
How can we support nursing staff to identify victims of domestic abuse
Carmel Bagness, Professional lead for domestic abuse, RCN
Pre-Event Abstract: Domestic Abuse – the role of the nurse in identifying abuse
Today we are constantly confronted with media narratives about violence and abuse, whether against individuals or nations or people who are associated with religious, cultural or military organisations or just going about their daily business. Many of us look to our home to feel safe and protected from the world, however we know that for many the last place they feel safe is at home. Domestic abuse is a complex issue, often hidden and underestimated, as well as being under reported or recognised by nurses and midwives. This can be related to preconceived ideas around who it affects and how it manifests itself in healthcare.
It is also important to acknowledge that nurses and midwives can be victims and may be unable to deal with the signs presenting in those they are caring for. We know that there is a need for further education and training, as they often report uncertainty about what to do or what can be done to best support a victim or suspected victim, especially when discovered out of context of the care being offered. The focus for this session is on how nurses can identify those who may be affected and using intuition plays a part, but evidence to confirm suspicions can be difficult to gather, especially as some victims may not relate their reality to being a victim of abuse. A key point is recognising that not all abuse is visible or obvious.
Asking a patient or client if they feel safe at home? can be a good starting place, however it needs to be carried out in a sensitive and safe environment, this may often require removing the person from a ‘carer’ or relative who may appear overly protective. It also needs to consider how the victim can be supported to be removed from the situation safely, and the possible consequences of not being able to immediately achieve this.
Simply beginning questioning can be difficult for some healthcare workers, as it feels intrusive, and the reaction is often uncertain. It must also be remembered that for some this may be because they themselves do not feel safe, or they may be perpetrators of abuse.
Recognising that this abuse crosses social and economic boundaries, as well as having ethnic and cultural nuances, including language barriers, a lack of friends or relatives they can call on for support. They may also have refugee or immigrant issues and so access to service may not be available or misunderstood.
Anyone can be a victim of domestic abuse; it is not gender, race, sexual orientation or age specific and can begin at any stage in a relationship. Nurses and midwives need to know how to identify this abuse, how to gain the confidence and trust of the individual, and have assurance that there are systems in place to support victims both in the short term and long term.
Future events of interest:
The New Care Models for Integrating Health and Social Care through EHCH, PACS & MCPs
Safeguarding Adults Level 3 Training Day
Safeguarding Vulnerable Adults in Mental Health Services
Safeguarding Children: Level 3 Mandatory Safeguarding Training in Accordance with the Intercollegiate Guidelines
Masterclass: Individual Management Reviews for Domestic Homicide Reviews & the use of Root Cause Analysis
Adult Safeguarding Summit 2017: Improving Adult Safeguarding Practice Decision Making, User Involvement & Outcomes
3 March 2017