1. To Learn & Develop Christine Johnson Lead Nurse Safeguarding (named nurse) - STFT Health Visitors Roles and Responsibilities in Domestic Abuse

2. Changes in Health Visitor front line service delivery A Rapid Performance Improvement Workshop was held during 2010 which changed local responsibilities in the delivery of the H/V service across SOTW: Increased contacts / home visiting Earlier intervention during the ante-natal period when there are concerns New Child Health Records and Recording documentation to support a history of the Family Health Assessment, Significant Events Recording and ROPE documentation An Early Warning Assessment Tool to establish the level of concern to determine the need for universal or targeted support to families Electronic Birth Record to support standardised work, monitoring and data collection

3. Health Visitor Practice and Induction The Health Visitor at every contact asks about Domestic Abuse as per the care plans when safe to do so The Health Visitor students attend action learning sets on Domestic Abuse All Safeguarding training is seen as an essential skill The essential skills training is organised for the new qualified Health Visitor in the first 3 months of qualifying as part of their induction programme The newly appointed Health Visitors and School Nurse have an intensive 3 months programme of Supervision with the Safeguarding Nurse Advisors

4. Refuge Liaison Health Visitor Role There is a named Liaison Health Visitor who links with Places for People refuge and reports to the generic Health Visitor to improve communication and support to families Represents the Health Visitor service on the DV forum Is a member of the Domestic Abuse Training sub- group Delivers multi agency Domestic Abuse Awareness Sessions Supports Student Nurses, Health Visitors and Medical Students in understanding Domestic Abuse Supports ‘White Ribbon Day’

5. Domestic Abuse Policy (Crime and disorder Act 1988; amended by the Police reform Act 2002 & Police Justice Act 2006) A Domestic Abuse Policy was developed during 2010 to provide health staff, including Health Visitors with clear standards for practice. The Principles of the policy are: Organisational and front line roles and responsibilities Statutory framework Safeguarding – (close liaison and Safeguarding Supervision from the Safeguarding Nurse Advisors) Good Practice – endorsing a proactive approach to DA Routine Enquiry – Home Office and Department of Health Guidance recommending Routine Enquiry as Standard Practice for Health Professionals Information Sharing – appropriately, proportionately and safely

6. Learning outcomes for Health Visitors attending Safeguarding Children Domestic Abuse Training Focus on: Understand what Domestic Abuse (DA) is and its prevalence Recognise the impact of abuse on parenting capacity Understand the impact of DA on children’s well being and development and the links to safeguarding Identify the barriers that prevent women leaving abusive relationships Know how to respond to disclosure and/ or signs of domestic abuse and how to ask clients questions sensitively Application of using the ‘Assessment Framework’ to assessing the risk for children

7. Framework for the Assessment of Children in Need and their Families (2000)

8. Routine and Selective Enquiry Training Workshops were delivered to all Health Visitors and Midwives to inform them of their Role and Responsibilities for Domestic Abuse and Safeguarding Children and how to incorporate the process as normal part of Health Assessment. Routine Enquiry Policy: Guidelines are in place to ensure a standardised approach to Routine Enquiry Learning Outcomes - focus on how to ask clients questions and understand the next steps and to understand the principles to guide good practice They must consider ‘honour based violence’ issues (Honour based violence is a crime or incident, which has or may have been committed to protect or defend the honour of the family and/or community)

9. Health Visitor as Victims Advocate

10. Multi Agency Risk Assessment Conferences (MARAC) Health Visitors are trained in: Completion of the MARAC risk indicator checklist How to manage risk through the community safety plan Sign posting to appropriate services – refuge / Domestic Abuse agencies local and national Refer to MARAC if appropriate Refer to Child Protection agencies Follow up referrals Support the MARAC process by providing reports to the Safeguarding Team Nurse Advisor MARAC representative Complete actions identified on the MARAC risk management plan Monitoring using the Health Visitor ‘Early Warning Assessment Tool’

11. Health Visitor involvement in Child Concern Notification (CCN’s) The Safeguarding Team Nurse Advisor, supported by the Designated Nurse and Lead (Named) Nurse Safeguarding, is currently in liaison with other agency’s and Health Visitor Safe Care Leads to identify a mechanism to directly notify Health Visitors of Domestic Abuse incidents reported to the Police. The implementation of this process would support early intervention to prevent further harm to victims and children

12. Thank You To Learn & Develop