Domestic abuse policy

Contents

1 Introduction

Domestic abuse can affect anyone irrespective of sex, ethnicity, class, religion, sexuality and disability. However, it is widely recognised that domestic abuse is a gendered crime involving a disproportionate number of female victims or survivors and can happen in all types of relationships involving a personal connection. Although RDASH recognises that most victims and survivors of abuse are female, this policy includes a gender-neutral definition of domestic abuse to ensure that all victims and survivors are included.

RDASH recognise that patients, staff, volunteers and contractors could be affected by domestic abuse for example, victim and survivor, living in a domestic abusive relationship, or a perpetrator of domestic abuse. The overall aim of this policy is to promote the health, safety and wellbeing of any individual in contact with the organisation.

Working in a multiagency partnership is the most effective way to approach the issue at both an operational and strategic level. RDaSH forms part of the strategic partnerships across localities, committed to responding effectively to domestic violence and abuse.

Domestic abuse against anyone is unacceptable and it is a breach of their human rights. Research evidence demonstrates that domestic abuse has a major impact on individual’s mental and physical health. This policy provides a resource for staff where domestic abuse has been disclosed and identifies the available support is available.

1.1 Domestic Abuse Act 2021

The Domestic Abuse Bill gained Royal Assent on 29th April 2021. The Act:

• creates a statutory definition of domestic abuse
• establishes the office of domestic abuse commissioner
• prohibits offenders from cross-examining their victims in person in the family courts
• creates a domestic abuse protection notice (DAPN) and domestic abuse protection order (DAPO)
• provides a statutory basis for the domestic violence disclosure scheme (Clare’s law) guidance
• creates a new domestic abuse offence in Northern Ireland to criminalise controlling or coercive behaviour
• creates a statutory presumption that victims of domestic abuse are eligible for special measures in the criminal courts
• enables domestic abuse offenders to be subject to polygraph testing as a licence condition following release from custody
• places a duty on local authorities to give support to victims of domestic abuse and their children in refuges and safe accommodation
• requires local authorities to grant new secure tenancies to social tenants leaving existing secure tenancies for reasons connected with domestic abuse
• extends the extra-territorial jurisdiction of the criminal courts of England and Wales, Scotland and Northern Ireland to further violent and sexual offences

1.2 Definition

Domestic abuse can happen between two people who are both aged 16 years or over, are personally connected to each other and the behaviour is abusive.

Personally connected includes:

• you are, or have been, married to each other
• you are, or have been, civil partners of each other
• you have agreed to marry one another (whether the agreement has been terminated)
• you have entered into a civil partnership agreement (whether the agreement has been terminated)
• you are, or have been, in an intimate personal relationship with each other
• each have, or there has been a time when they each have had, a parental relationship in relation to the same child
• you are a relative

Abusive behaviour consists of the following:

• physical or sexual abuse
• violent or threatening behaviour
• controlling or coercive behaviour
• economic abuse: this includes behaviour that has a substantial adverse effect on your ability to obtain, use, or maintain money or other property, or obtain goods or services
• psychological, emotional, or other abuse
• and it does not matter whether the behaviour consists of a single incident or a course of conduct

1.3 Children as victims of domestic abuse

Applies where behaviour of a person towards another person is domestic abuse and a child:

• sees or hears or experiences the effect of domestic abuse and is related to the person(s)

‘Related to’ in this context:

• the person is a parent of, or has parental responsibility(as in the Children Act 1989) for, the child, or the child and the person are relatives.

1.4 Controlling or coercive behaviour (controlling or coercive behaviour in an intimate or family relationship statutory guidance framework)

The Serious Crime Act 2015 received royal assent on 3 March 2015. The act created a new offence of controlling or coercive behaviour in intimate or familial relationships, closing a gap in the law around patterns of controlling or coercive behaviour in an ongoing relationship between intimate partners or family members. The offence carries a maximum sentence of 5 years’ imprisonment, a fine or both.

• Controlling behaviour is a range of acts designed to make a person subordinate 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 everyday behaviour.
• Coercive behaviour is a continuing act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.

1.5 Risk factors in domestic abuse

The following is a list of high risk factors that you need to consider:

• victims perception of risk of harm: tend to underestimate the harm to them, children and others
• separation including child contact: leaving an abusive relationship increases the likelihood of intimate homicide. Many incidents are related to child custody disputes
• pregnancy or new birth (child under 18 months): abuse can start or escalate during pregnancy and following birth
• escalation or repeated violence: domestic abuse victims are more likely to become repeat victims which increase in violence
• community issues and isolation: needs differ amongst ethnic minority victims, newly arrived communities, asylum seekers, older people, people with disabilities, traveller and gay, lesbian, bisexual or transgender people. This may be because of perceived racism, language, culture, insecure immigration status or accessing relevant support services. Be aware of potential forced marriages and honour based violence in those communities that try to restore their mistaken honour and respect. They may feel isolated and vulnerable
• stalking, this includes persistent and consistent calling, texting, sending letters and following the person. Stalking and physical assault, are significantly associated with murder and attempted murder. This is not just about physical violence but also coercive control and jealous surveillance. It is fixation and obsession
• coercively control and excessive jealous behaviour: complete control of the victim’s activities and extreme jealousy are associated with serious violence and homicide. Consider honour based violence. perpetrators may try and control professionals
• strangulation, choking, suffocation and drowning
• mental health, drug abuse and alcohol misuse: these are not the instigators of abuse, but could be contributing factors
• child abuse, this could be actual or witnessed (it is important that this is reported to the appropriate services at the time of disclosure)
• history of animal abuse, there is a link between animal abuse and domestic abuse
• suicide and homicide, threats of suicide by the perpetrator have a direct link to homicide in domestic abusive relationships

1.6 Prevalence of domestic abuse taken from the Office of National Statistic (ONS), November 2021 (the ONS do not provide gender neutral information)

1.6.1 Main points

• The number of police recorded domestic abuse related crimes in England and Wales rose 6% in the year ending March 2021 to 845,734; this follows increases seen in previous years and may reflect improved recording by the police alongside increased reporting by victims.
• The police made 33 arrests per 100 domestic abuse-related crimes in the year ending March 2021; the same as in the previous year (in the 38 police forces that supplied complete data in both years).
• Referrals of suspects of domestic abuse flagged cases from the police to the Crown Prosecution Service (CPS) for a charging decision decreased by 3%, from 79,965 in the year ending March 2020 to
  77,812 in the year ending March 2021.
• For the third successive year, the CPS charging rate for domestic abuse related crimes in England and Wales decreased to 70% in the year ending March 2021, down from 76% in the year ending March 2018.
• Demand on domestic abuse helplines increased in the year ending March 2021 with a 22% increase in people supported by the National Domestic Abuse Helpline in England; this is not necessarily indicative of an increase in the number of victims, but perhaps an increase in the severity of abuse being experienced, and a lack of available coping mechanisms.
• The number of cases discussed per 10,000 adult females at multiagency risk assessment conferences (MARACs) rose to 46 compared with 43 in the previous year.

1.6.2 Controlling or coercive behaviour

There were 33,954 offences of coercive control recorded by the police in England and Wales in the year ending March 2021. This is compared with 24,856 in the year ending March 2020 and 17,616 in the year ending March 2019. The rise of coercive control offences over recent years may be attributed to improvements made by the police in recognising incidents of coercive control and using the new law accordingly.

1.6.3 Domestic homicide

There were 362 domestic homicides recorded by the police in the three-year period between year ending March 2018 and year ending March 2020. This represents 19% of all homicides where the victim was aged 16 years and over during this period.

• Of the 362 homicides, 214 (59%) were female victims who were killed by a partner or ex-partner. In contrast 33 (9%) were male victims who were killed by a partner or ex-partner.
• The remaining 115 (32%) were victims killed by a suspect in a family category.

1.7 Domestic homicide review (DHR)

Domestic homicide reviews (DHRs) were established on a statutory basis under the Domestic Violence, Crime and Victims Act 2004.

A DHR is a multi-agency review of the circumstances in which the death of a person aged 16 or over has, or appears to have, resulted from violence, abuse or neglect by a person to whom they were related or with whom they were, or had been, in an intimate personal relationship, or a member of the same household as themselves.

2 Purpose

This policy aims to provide a framework to support staff to identify and respond to domestic abuse. It addresses adults and young people who are experiencing (or have experienced) domestic abuse, includes perpetrators of domestic abuse and how to support staff who are experiencing domestic abuse. It also covers children and young people who are affected by domestic abuse. This policy will draw on United Kingdom legislation and policy to give practitioners confidence that they are following best practice. This includes the Human Rights Act 1998, Children Act 2004, Care Act 2014 and the Domestic Abuse Act 2021.

3 Scope

This policy applies to those members of staff that are directly employed by RDaSH and for whom RDaSH has legal responsibility. For those staff covered by a letter of authority or honorary contract or work experience this policy is also applicable whilst undertaking duties on behalf of RDaSH or working on RDaSH premises and forms part of their arrangements with NHS Commissioners within Doncaster, Rotherham and NE Lincolnshire.

As part of good employment practice, agency workers are also required to abide by RDaSH policies and procedures, as appropriate, to ensure their health, safety and welfare whilst undertaking work for RDASH.

4 Responsibilities, accountabilities and duties

4.1 Chief executive

The chief executive retains overall responsibility for the development and implementation of Trust policies.

4.2 Director of nursing and allied health professionals

Is the executive lead for safeguarding

4.3 Deputy director of nursing and allied health professionals

The deputy director of nursing is responsible for the development, review and monitoring of this policy.

4.4 Nurse consultant

• The nurse consultant fulfils the role of corporate lead for adult and children safeguarding.
• Responsible for promoting compliance with regulatory and commissioning standards and ensuring that safeguarding policies, procedures are up-to-date and embedded within all clinical areas.
• Takes the lead on specialist areas of safeguarding practice within the trust including the PREVENT agenda, domestic abuse, female genital mutilation and perplexing presentations and fabricated or induced illness.

4.5 Safeguarding team

• Will provide expert advice, guidance and leadership regarding DA in the context of children, young people and adults at risk.
• Deliver training around identifying domestic abuse including the impact on children as part of the safeguarding learning and development programme.

4.6 Multi agency risk assessment conference (MARAC) representatives

Those with appropriate training will be responsible for attending the scheduled MARAC, soliciting and disseminating information in support of the process and offering appropriate advice to Staff regarding disclosures of domestic abuse that may form the basis of a MARAC referral.

4.7 Line managers

• Ensure all staff under their supervision have access basic awareness training on domestic abuse.
• Ensure all staff completing clinical risk assessments routinely ask about domestic abuse and will access relevant domestic abuse training in accordance with Responding to domestic abuse, A resource for health professionals (DOH, 2017).
• Ensure that staff are trained to undertake domestic abuse stalking and ‘honour’ based abuse (violence)(DASH) risk assessments.
• To be aware of the local MARAC referral process.
• Ensure they are able to offer the initial and appropriate advice to staff members experiencing domestic abuse, see appendix A.
• Provide the appropriate support to staff who have domestic abuse disclosed to them.

4.8 Modern matrons, ward managers and deputies and team managers

• Ensure that safeguarding adults board’s and local safeguarding children board policies and procedures in relation to domestic violence and abuse are implemented.
• Ensure all staff attend mandatory training.

4.9 Safeguarding children and adult supervisors

• Inform staff through the supervision process of the relevance and impact of domestic violence in relation to safeguarding children and adults.
• Advise on the need for referral and action to protect the child or children and adults.

4.10 Human resources

Offer informed advice and confidential support, to those staff members experiencing domestic abuse and to facilitate appropriate support mechanisms to diminish the risk of further abuse, while they are at work.

4.11 Clinical staff

• Attend training as per trust requirement.
• All clinical staff will receive domestic abuse information as part of their induction (basic awareness) and complete any additional domestic abuse training as prescribed by their training matrix within 6 months (see training implications below).
• As part of the assessment process clinical staff are responsible for making enquiries and asking about domestic abuse.
• They will have attended domestic abuse training up to level 3 dependent on role.

5 Procedure or implementation

5.1 Key principles

The key principles are underpinned by ‘Responding to domestic abuse, A resource for health professionals (DOH, 2017):

• ensure the safety of those abused and that of dependent children
• enable the healthcare professional to supply those abused with the appropriate information concerning other agencies providing support services
• create a healthcare environment where the abused can talk about their experience in a safe and confidential environment
• ensure that staff have the ability to receive disclosures of abuse and respond to such disclosures in a supportive, reassuring and appropriate manner
• ensure staff respond effectively to guarantee compliance with wider multi agency response to domestic abuse
• ensure that there is appropriate support for staff experiencing domestic abuse

5.2 Asking the question

Some people who present to health practitioners have indicators of possible domestic violence or abuse. In some healthcare settings (for example, mental health and drug or alcohol services, and sexual health services), more people will have indicators of possible domestic violence or abuse than in other settings.

The question about domestic abuse should be asked routinely, as part of the clinical assessment, if safe to do so. Victims of domestic abuse are often too afraid or uncomfortable to raise the issue of abuse themselves. Practitioners should be prepared to ask questions sensitively, but directly. The outcome of this question must be documented as part of the electronic patient record.

For example:

• do you feel safe at home?
• have you been physically hurt?
• do you feel isolated or controlled?

5.3 Responding to the risk

If a disclosure of domestic abuse is made the staff member must complete a domestic abuse, stalking, harassment and honour based violence (DASH) risk checklist (staff access only) (opens in new window).

Any action taken by staff in respect of domestic abuse will only be done with the consent of the individual unless the DASH (staff access only) (opens in new window) identifies a significant risk to the individual or a child’s health and wellbeing or the individual lacks capacity to consent.

Follow the guidance in the domestic abuse disclosure flowchart (appendix B) and always use the DASH risk identification tool when assessing an individuals’ level of risk. The DASH (staff access only) (opens in new window) risk identification tool is a checklist for practitioners to help them identify those individuals who are at high risk of harm and whose cases should be referred to a multi agency risk assessment conference (MARAC) in order to manage their risk. Revealing to an individual that they are at high risk of serious harm or homicide can be frightening and overwhelming, equally, explaining that someone is not currently high risk needs to be managed carefully to ensure that they do not feel that their situation is being minimised. Importantly, the checklist is just a tool and guide and not a substitute for professional judgement.

5.4 Standard risk 1 to 6 ticks in the yes box

Signpost to local and national domestic abuse support services by giving leaflets, phone numbers and assist in making contact if required. Details of domestic abuse support services available on the safeguarding page of the intranet. Consider making a referral to early help services for any children in the family home and follow local safeguarding children and adults procedures.

5.5 Medium Risk 7 to 13 ticks in the yes box

Signpost to local and national domestic abuse support services by giving leaflets, phone numbers and assist in making contact if required. Details of domestic abuse support services available on the safeguarding page of the intranet consent must be sought from the individual to enable sharing of information with support services. If there are children or adults at risk involved the practitioner must follow (available by area local safeguarding children and adults procedures here (staff access only) (opens in new window)).

5.6 High risk 14 or more ticks in the yes box or professional judgement

If the practitioner has serious concerns for safety or there is an increase in severity or frequency. If the individual is at immediate risk, then phone 999. If the individual is assessed as being high risk refer to MARAC as per local procedures. Local MARAC referral forms can be found on the safeguarding adults template (appendix D) and in the safeguarding templates on system one.

Consent to refer to MARAC must always be sought from the individual, however, it is not essential. If they refuse to give consent it is essential to give the reasons why the information is being shared without consent on the referral form. If there are children or adults at risk involved the practitioner must follow local safeguarding children and adults procedures and make a referral to children’s social care and, or adult safeguarding. An IR1 incident report should be completed.

5.7 Multi agency risk assessment conference (MARAC)

Domestic abuse incidents that are assessed as being ‘high risk’ using the DASH (staff access only) (opens in new window) will be addressed through the MARAC. MARAC’s are meetings where agencies share information about high risk domestic abuse victims. A risk focussed, safety plan is drawn up to help support the victim and try to reduce the risk to them and any children. MARAC works on the assumption that no single agency or individual can see the complete picture of the life of a victim, but all may have insights that are crucial to their safety. The victim does not attend the meeting but is represented by an independent domestic violence advocate who speaks on their behalf.

Aims of MARAC:

• to share information to increase the safety, health and wellbeing of victims and their children
• to jointly construct and implement a risk management plan that provides professional support to all those at risk and to reduce the risk of harm
• to reduce repeat victimisation
• to improve agency accountability
• to identify those situations that indicate a need for child protection procedures to be initiated
• improve support for victim’s involved in high risk domestic abuse cases

A number of agencies are represented on the MARAC and include: police, social care, 0 to 19 service, drug and alcohol service, domestic abuse service, education welfare, National Probation Service, Mental Health and Youth Offending team.

Under no circumstances should the perpetrator of domestic abuse be informed if a case involving them has been referred to MARAC. This includes subject access requests.

5.8 Information sharing with and without consent

Any information sharing must be under the Data Protection Act and GDPR.

Further information can be found in the associated policies found on the intranet. There are occasions where consent to share information is not needed:

• where there is a risk of serious harm to the victim, any children involved or someone else
• in the best interests for a person who lacks capacity to consent to disclosure
• when the courts request information about a specific case

If in doubt contact Caldicott guardian (medical director) or Information Governance team.

6 Domestic abuse and safeguarding children

Children may suffer both directly and indirectly in households where there is domestic abuse and violence

Hearing or seeing the ill treatment of another constitutes harm. A referral should be made to local authority children and young people’s services if a child lives in a household where domestic violence is believed to be a factor which may lead to them being in need of support or protection

7 Perpetrators of domestic abuse

The Respect phone line is a confidential and anonymous helpline for domestic abuse perpetrator’s looking for help to address their behaviour. The main focus of the respect phone line is to increase the safety of those experiencing domestic abuse by engaging with the abusers to reduce the risk. The phone line helps individuals who want to stop being violent and abusive.

• Phone: 0808 802 4040
• Website: Respect (opens in new window)

Open Monday to Friday, 9am to 5pm.

Perpetrator programmes are offered by some local authorities with details how to access them included on their websites.

8 Domestic violence disclosure scheme

The Domestic Violence Disclosure Scheme (DVDS), often referred to as “Clare’s Law” after the tragic case of Clare Wood, who was murdered by her former partner in Greater Manchester in 2009 was launched in 2014. DVDS was introduced to set out procedures that could be used by the Police in relation to disclosure of information about previous violent and abusive offending by a potentially violent individual to their partner where this may help protect them from further violent and abusive offending (HM Government, 2016c).

DVDS is a police led scheme which has two procedures for disclosing information:

• Right to ask, is triggered by a member of the public applying to the police for a disclosure.
• Right to know, is triggered by the police making a proactive decision to disclose information to protect a potential victim.

If you believe that someone you are working with, or someone you know, is at risk of harm and could be eligible under the scheme, you should refer them to the police on 101.

9 Safety advice

Victims of domestic abuse are at increased risk when they are planning to leave a relationship or have just left. Here is some safety advice that you could discuss with a victim.

• Dial 999 in an emergency and teach your children to call 999 in an emergency, and what they would need to say (for example, their full name, address and phone number).
• Ask them to plan in advance how they might respond in different situations, including crisis situations. Think about the different options that may be available.
• Do they have trusted neighbours, friends or family nearby where they could go in an emergency?
• If so, tell them what is going on, and ask them to call the police if they hear sounds of a violent attack.
• Rehearse an escape plan, so in an emergency you and the children can get away safely.
• Pack an emergency bag for yourself and your children, and hide it somewhere safe (for example, at a neighbour’s or friend’s house). Try to avoid mutual friends or family.
• Try to keep a small amount of money on you at all times -including change for the phone and for bus fares.
• Know where the nearest phone is, and if you have a mobile phone, try to keep it with you and charged up.

10 Staff who are experiencing domestic abuse

Guidance has been developed for managers (and colleagues) who may suspect staff are experiencing domestic abuse (appendix A)

11 Documentation

• Ensure that the electronic record is completed using the safeguarding templates on SystmOne, whilst adhering to the records management policy.
• Complete IR1 adhering to the incident management policy.

12 Training implications

People experiencing domestic abuse should expect staff to respond consistently and appropriately. Training staff to respond to disclosure (level 1) and how to ask about domestic violence and abuse (level 2) is essential for safe enquiry about experiences of domestic violence and abuse and a consistent and appropriate response. NICE (2016) recommend levels of domestic abuse training commensurate to job role as below:

• level 1 staff should be trained to respond to a disclosure of domestic abuse sensitively and be able to direct people to specialist services. This level of training is for allied health professionals, healthcare assistants and receptionists
• level 2 staff should be trained to undertake routine enquiry about domestic abuse in a way that makes it easier for people to disclose it. Staff should also be able to respond with empathy and understanding, assess someone’s immediate safety and offer referral to specialist services. This level of training is for nurses, doctors, prison staff and alcohol and drug misuse workers
• level 3 staff should be trained to identify and assess risk, safety plan and liaise with specialist services. This level of training is for safeguarding children health professionals, MARAC representatives and adult safeguarding representatives
• level 4 staff should be trained to give expert advice and support for people experiencing domestic abuse. This level of training is for domestic abuse navigators

12.1 All RDaSH employees

• How often should this be undertaken: At RDASH induction and 3 yearly.
• Level: Basic awareness.
• Delivery method: Leaflet.
• Training delivered by whom: Leaflet within induction booklet and sent out three yearly
  by Learning and Development team.
• Where are the records of attendance held: Staff record system (ESR).

12.2 All RDaSH employees who have service user contact

• How often should this be undertaken: 3 yearly.
• Level: 1.
• Delivery method: E-learning.
• Training delivered by whom: ESR.
• Where are the records of attendance held: ESR.

12.3 Clinicians required to complete a DASH risk assessment in response to disclosure of domestic abuse

• How often should this be undertaken: 3 yearly.
• Level: 2.
• Delivery method: face to face, virtual or e-learning.
• Training delivered by whom: External training providers.
• Where are the records of attendance held: ESR.

12.4 Clinicians who may make a referral and present a case at the MARAC

• How often should this be undertaken: 3 yearly.
• Level: 3.
• Delivery method: face to face, virtual or e-learning.
• Training delivered by whom: External training providers.
• Where are the records of attendance held: Staff are required to input training on the portal.

Staff can access training through a number of sources, see blended learning resource list on the safeguarding intranet page.

13 Monitoring arrangements

13.1 Raise the question re domestic abuse as part of assessments

• How: Domestic abuse audit.
• Who by: Safeguarding team.
• Reported to: Safeguarding assurance group.
• Frequency: Annually.

13.2 Meeting the agreed standard for training attendance for domestic abuse

• How: Training compliance reported through care group dashboards.
• Who by: Safeguarding team and care group directors.
• Reported to: Safeguarding assurance group.
• Frequency: Monthly.

14 Review and dissemination

The policy will be reviewed in accordance with the following on an as and when required basis:

1. legislative changes
2. good practice guidance
3. published domestic homicide reviews and serious case reviews
4. case law
5. significant incidents reported
6. new vulnerabilities
7. changes to organisational infrastructure

The domestic abuse policy is located on the RDASH intranet site, under clinical policies and procedures.

15 Equality impact assessment screening

To access the equality impact assessment for this policy, please email rdash.equalityanddiversity@nhs.net to request the document.

15.1 Privacy, dignity and respect

The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, ‘not just clinically but in terms of dignity and respect’.

Consequently, the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity, and respect, (when appropriate this should also include how same sex accommodation is provided).

15.1.1 Indicate how this will be met

No issues have been identified in relation to this policy.

15.2 Mental capacity act

Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individual’s capacity to participate in the decision-making process. Consequently, no intervention should be carried out without either the individual’s informed consent, or the powers included in a legal framework, or by order of the court.

Therefore, the trust is required to make sure that all colleagues working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason, all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005)to ensure that the rights of individual are protected, and they are supported to make their own decisions where possible and that any decisions made on their behalf when they lack capacity are made in their best interests and least restrictive of their rights and freedoms.

15.2.1 Indicate how this will be achieved

All individuals involved in the implementation of this policy should do so in accordance with the principles of the Mental Capacity Act 2005.

16 Links to any other associated documents

• Safeguarding adults manual
• Safeguarding children manual
• Health record keeping standards and health records management policy
• Clinical risk assessment and management policy
• Information governance policy
• Safeguarding principles and the approach for South Yorkshire(opens in new window)
• North Lincolnshire multi agency policy and procedures (opens in new window)
• Incident management policy

17 References

• Care Act (2014).
• Children Act (1989).
• Children Act (2004).
• Data Protection Act (2018).
• Equality Act (2010).
• Department for Health (2017) Responding to Domestic Abuse, A Resource for Health Professionals.
• Domestic abuse Act (2021).
• Domestic Violence, Crime and Victims Act (2004).
• Freedom of Information Act (2000).
• Health and Safety at Work Act (1974).
• Health and Safety (Consultation with Employees) Regulations (1996).
• HM Government (2018) Working Together to Safeguard Children.
• Home Office (2012) Domestic Violence Disclosure Scheme Guidance.
• Home Office (2015): Controlling or Coercive Behaviour in an Intimate or Family.
• Home Office (2022): Domestic Abuse Protection Notice or Orders Fact Sheet.
• Human Rights Act (1998).
• Management of Health and Safety at Work Regulations (1992).
• Mental Capacity Act (2005).
• Mental Health Act (1983).
• NICE (2016) Domestic Violence and Abuse.
• Office of National Statistics (2021) Prevalence of Domestic Abuse.
• Relationship Statutory Guidance Framework.
• Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (1995).
• Serious Crime Act (2015).

18 Appendices

18.1 Appendix A Guidance for supporting staff with domestic abuse

RDASH recognises that domestic abuse is a serious issue and that incidents of domestic abuse are common and critically affect many people’s lives. The impact on a member of staff experiencing domestic abuse is significant, but this may be an area that line managers are unclear about in terms of how to support the member of staff and the extent to which this is a personal or work, related area.

The effects of domestic abuse can influence the health and self-confidence of staff who may in turn feel unable to confide in others or seek help. Many of those that experience domestic abuse have difficulty attending work regularly and demonstrate longer term symptoms such as depression, anxiety, or stress that consequently affect work performance.

The trust recognises that it is important to increase awareness of domestic abuse and its impact in the workplace and are committed to providing guidance for both managers and employees and create safe opportunities and environments for disclosure.

The trust is committed to treating people with dignity and respect in accordance with the Equality Act 2010 and Human Rights Act 1998. Due regard has been given to the elimination of unlawful discrimination, harassment and victimisation (as cited in the Equality Act 2010).

The trust has a duty of care and health and safety laws ensure workers have the right to work in a safe environment where risks to health and well-being are considered and dealt with efficiently.

There are four main areas of health and safety law relevant to violence at work:

• Health and Safety at Work Act 1974
• Management of Health and Safety at Work Regulations 1992
• Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995
• Health and Safety (consultation with employees) Regulations 1996

18.1.1 Confidentiality and right to privacy

• The trust has provided safe areas (known as ‘wobble’ rooms) where staff can arrange to meet in private and away from their normal working area.
• Staff who disclose they are experiencing abuse can be assured that the information they provide is confidential and will not be shared with other members of staff without their permission.
• There are, however, some circumstances in which confidentiality cannot be assured. These occur when there are concerns about children or vulnerable adults or where the employer needs to act to protect the safety of employees.
• In circumstances where there needs to be a breach of confidentiality, specialist advice and support will be sought before doing so, keeping the member of staff informed and ideally gaining their consent. Information will only be shared on a strict need to know basis.
• All records concerning domestic abuse will be kept strictly confidential. No local records will be kept of absences related to domestic abuse and there will be no adverse impact on the employment records of victims and survivors of domestic abuse.

18.1.2 Recognising the indicators that point towards a problem with domestic abuse

Domestic Abuse is often associated with physical violence, but it can also be emotional or psychological. (Please see definitions in main body of domestic abuse policy). The below indicators may point towards a problem of domestic abuse, but they could also be the result of a different issue such as ill health. An aware and proactive manager and colleague should be looking out for these issues more generally as an indicator that something might be wrong, without assuming it will be related to domestic abuse.

The more supportive atmosphere we can create as an employer, the more likely our staff are going to feel comfortable disclosing a problem with domestic abuse.

18.1.2.1 Work productivity

• Change in work patters, for example, frequent absences.
• Change in quality and quantity of work for example, drop in usual performance.
• Changes in phone and email usage for example, avoiding calls or strong reactions to calls and emails.
• Increasing number of hours at work for no reason.
• Change in partners behaviour, for example, frequent visits to work, which may indicate coercive control.

18.1.2.2 Physical indicator

• Visible bruising or repeated injury with unlikely explanations.
• Change in pattern or amount of makeup used.
• Change in manner of dress, for example, clothes that do not suit the climate which may be used to hide injuries.
• Substance use and misuse.
• Fatigue and sleep disorders.

18.1.2.3 Changes in behaviour or demeanour

• Conduct out of character.
• Changes in behaviour for example, quiet, anxious tearful, aggressive.
• Isolating from colleagues.
• Obsessed with leaving on time.
• Secretive about home life.
• Worried about leaving children at home.

18.1.2.4 Other indicators

• Partner or ex-partner stalking employee in or around the workplace or on social media.
• Partner or ex-partner exerting unusual amount of control or demands.
• Isolation from family and friends.

18.1.3 Raising the issue

Members of staff experiencing domestic abuse may want to consider informing their employer. It is recognised that this is not always an easy step for those experiencing domestic abuse.

However, any disclosure will be respected and confidentiality will be maintained if at all possible.

Staff who are trade union members may also wish to contact their staff-side representative to access trade union support.

In the first instance staff are encouraged to inform their line manager if they are experiencing domestic abuse. In this regard, managers will take disclosure seriously, consider the information fully and sympathetically, recognise that admission can be a difficult experience and, where appropriate, seek advice from human resources.

In some cases, members of staff may prefer to raise their concerns with someone other than their line manager (either direct or indirect). If this is the case staff can contact HR directly in confidence.

18.1.4 If a manager sees signs of domestic abuse

If a manager sees signs that a member of staff is experiencing domestic abuse then a meeting should be facilitated as soon as possible to discuss their concerns and identify appropriate support:

• suggest that you go somewhere quiet and comfortable, away from their workplace
• support the member of staff
• have an open posture
• be prepared for them to be upset and tearful

18.1.5 Responding to a disclosure

Managers should respond promptly in providing a non-judgemental and supportive environment to ensure the member of staff feels safe when disclosing. This includes respecting their boundaries and privacy.

It is important to be clear that it is not the manager’s role to deal with incidents of domestic abuse or advise employees on dealing with domestic abuse but assist the employee to enable them to decide on a suitable course of action. The manager should:

• provide a sensitive and non-judgemental approach
• ensure that confidentiality is respected as far as possible
• recognise that the employee may need some time to decide what to do and may try many different options during this process
• discuss measures to prioritise safety in the workplace
• complete a DASH assessment with the individual to identify the level of risk
• be aware of what support is available and explore these options with the employee. The trust can offer support from the employee assistance programme (03303 800 658, available 24 hours and 7 days)
• provide information for specialist domestic abuse services
• consideration should be given of the impact on any children in the relationship and referral to children’s social care
• managers should keep a written note of discussions as they may be required as evidence. Any information should be stored confidentially within the staff member’s personal file

18.1.6 Risk Assessments

If domestic abuse is disclosed, undertaking a workplace risk assessment can ensure that the potential risk to employees and colleagues is lessened. It is important to note that each person’s needs are different and that any measures should only be used with the authorisation and consent of the individual concerned. Risk assessments may also assist the manager to offer suitable support.

This may include:

• paid and unpaid leave to attend relevant appointments, (with support agencies, solicitors, to rearrange housing or childcare, or at court)
• temporary or permanent changes to working times and patterns
• changes to specific duties, for example to avoid potential contact with an abuser
• temporary redeployment or relocation
• measures to ensure a safe working environment, for example changing a phone number to avoid harassing phone calls
• using other existing policies, including flexible working
• access to counselling or support services in paid time
• temporary onsite parking
• each case will be considered on its merits and managers and employees should agree on a combination of annual leave, flexible time arrangements and paid or unpaid absence, where agreement cannot be reached, managers have the right to treat this as sickness absence

18.1.7 What not to do

18.1.7 Safety planning

The trust will actively provide support to members of staff to minimise the risk to their safety while at work. A workplace risk assessment should be considered with the assistance of the trusts head of security and line manager:

• CCTV is available on most trust premises
• staff have access to personal alarms
• lighting has been improved in all public areas of the trust
• reminders not to divulge information about colleagues, especially personal details
• offering temporary changes to workplace, work times and patterns to reduce the risk at work and journeys to and from work
• blocking emails
• changing work phone numbers
• escorting staff off premises
• provision of ‘safe places’ within the trust’s service areas (‘wobble’ rooms)
• in extreme cases provide safe accommodation

18.1.8 Perpetrators of domestic abuse

Domestic abuse perpetrated by employees will not be condoned under any circumstances nor will it be treated as a purely private matter. The Trust recognises that it has a role in encouraging and supporting employees to address violent and abusive behaviour of all kinds.

Domestic abuse is a serious issue which may lead to criminal proceedings. In these circumstances, management reserves the right to conduct its own internal inquiry using the trust PiPoT policy.

Managers must escalate to the Safeguarding team and HR department when an incident occurs that may warrant investigation and disciplinary action and ensure that the matter is progressed through the stages of this procedure in a consistent and timely manner.

If the victim and the perpetrator are both members of staff, the HR department should be contacted so that appropriate action can be considered. Action will depend on individual circumstances but could include:

• temporary adjustments to duties or location of one or both members of staff
• potential action under the disciplinary policy
• advice from and or involvement of the police

In addition, adult and child safeguarding policies should be considered if a manager becomes aware that a member of staff is potentially or actually perpetrating domestic abuse and may seek advice from the Safeguarding team.

Domestic abuse is always the responsibility of the perpetrator, however, managers should aim to support staff undertaking action to address their behaviour associated with perpetrating domestic abuse, taking account always of the trust responsibility to protect children and adults at risk.

18.1.9 Local resources

All resources regarding domestic abuse can be found on the RDaSH intranet page (staff access only) (opens in new window).

18.2 Appendix B Domestic abuse flowchart

1. Disclosure of domestic abuse.
2. Discuss in a safe and confidential environment.
3. Complete DASH risk assessment forms available (staff access only) (opens in new window).
4. Are there any children who were witness to domestic?
   • If yes, refer to children’s social care.
5. Is the individual safe to go home?
   • If yes, provide information for specialist domestic abuse services, consider making referral following safeguarding procedures.
   • If no, speak to line manager and safeguarding. Consider 999 for immediate risk. Contact local specialist domestic abuse services and refer to MARAC if high risk.

Note, if circumstances suggest police intervention is urgent and necessary, call 999.

Remember don’t act as a domestic abuse care worker for the person once you have referred the individual. However, if involved with the individual you may form part of the risk management.

18.2.1 Risk levels

• High risk, refer to MARAC (consent not required).
• Medium risk, provide information for local and national domestic abuse services.
• Low risk, provide information for local and national domestic abuse services.

18.3 Appendix C Support services

18.3.1 Doncaster

1. • Women’s aid: Advice helpline 01302 326411. A confidential advice service is available by face to face appointments or over the phone.
   • Doncaster domestic abuse hub, at the safer Doncaster partnership: 01302 737080.
   • Multi agency domestic abuse services (opens in new window): single point of contact for male and female services: 01302 326411 (Doncaster Women’s Aid).

18.3.2 Rotherham

1. • Women’s refuge (by Rotherham rise), Rotherham: 0800 470 1505. Open Monday to Friday from 9am to 5pm.
   • Choices and options: 01709 838400
   • Apna Haq: 01709 519 211
   • IDVA service: 01709 823 981
   • Rotherham rise: 0330 2020571

18.3.3 North Lincolnshire

1. • IDVA service based at the It’s my right project 01724 841 947.
   • Women’s aid, Grimsby: 01472 575757
   • Blue door: 0800 1974787

18.3.4 National helplines

1. • Male victims of domestic violence: 01823 334224
   • National domestic abuse helpline: 0808 2000 247 (free phone run by Refuge (opens in new window))
   • The men’s advice line, for male domestic abuse survivors: 0808 801
     0327 (run by Respect)
   • The mix, free information and support for under 25s in the UK: 0808 808 4994
   • National LGBT+ domestic abuse helpline, 0800 999 5428 (run by Galop)
   • Live free from fear helpline: 0808 8010 800 (run by Welsh women’s aid this helpline supports men and women and provides support in English and Welsh)
   • Samaritans (24 hours and 7 days service): 116 123
   • Mankind: 01823 334244

RESPECT, lead on the development of safe, effective work with perpetrators, male victims, and young people using violence in their close relationships. Respect homepage (opens in new window).

Further information is available on the safeguarding intranet page

18.4 Appendix D SystmOne templates for safeguarding

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Document control

• Version: 7.
• Unique reference number: 152.
• Approved by: Clinical policies review and approval group.
• Date approved: 5 July 2022.
• Name of originator or author: Nurse consultant safeguarding.
• Name of responsible individual: Nurse consultant safeguarding.
• Date issued: 18 July 2022.
• Review date: July 2025.
• Target audience: All staff within the organisation.

Page last reviewed: November 19, 2024
Next review due: November 19, 2025

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