Safeguarding Domestic Abuse
Level 2
For all clinical staff.
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Aim and Objectives
DOMESTIC ABUSE – THERE’S NO EXCUSE
AIM
To help staff across SEPT to develop an understanding &
awareness of the key concepts of Domestic Abuse.
OBJECTIVES
•
•
•
•
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To recognise signs & symptoms of Domestic Abuse
To understand the wide ranging impact on individuals & families.
To know how to access support services.
To know how to get support within SEPT.
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What is Domestic Abuse?
The UK government (Home office 2013) defines Domestic Violence & Abuse as:
‘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 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 &/or dependant by isolating
them from sources of support, exploiting their resources & capacities for personal gain,
depriving them of the means needed for independence, resistance & escape &
regulating their everyday behaviour.
Coercive behaviour is:
An act or a pattern of acts of assaults, threats, humiliation & intimidation or other abuse
that is used to harm, punish or frighten their victim.
This includes issues of concern to black and minority ethnic (BME)
communities such as 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.
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Background
Domestic Abuse is:
• A major social issue
• A serious public health issue
• Completely unacceptable
There is still much stigma associated with
domestic abuse so it often remains a hidden
problem or a family secret.
Domestic Abuse:
Can cause lasting damage to
physical & mental health.
Is a major cause of family
distress & social exclusion.
Causes significant harm to
children.
It can start when a
relationship is just beginning,
during it or when it is over.
There is no typical abuser, it transcends all
boundaries regardless of race, gender, sexuality,
religion, age, disability or social background
Men can also be victims of domestic abuse.
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Early intervention is vital to
limit the negative
consequences of domestic
abuse.
DOMESTIC ABUSE – THERE’S NO EXCUSE
Facts and Figures
1:4 women and 1:6 men
have experienced
domestic abuse
(CADDA 2012)
750,000 children live
in households with
domestic abuse
(DoH 2002)
25% of teenage girls &
18% teenage boys have
experienced some form
of physical violence (NSPCC
2009)
1-2 women per week are murdered by
an intimate partner or family member.
Domestic abuse accounted for
18% of all violent incidents
reported to the police in 2011
(Smith et al 2012)
(CADDA 2012)
A woman may experience up to 35 episodes
of domestic abuse before seeking help. (DoH
2000)
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More than 30% of cases of
domestic violence start or
escalate during pregnancy.
This increases in teenagers to
70%
(Lewis and Drife, 2001, 2005)
DOMESTIC ABUSE – THERE’S NO EXCUSE
Types of Abuse
Domestic abuse rarely consists of a single incident but
typically involves escalating patterns of controlling
attitudes, behaviours & misuse of power. It can
include:
• Physical violence – punching , hitting, slapping &
kicking- Strangulation & choking – Pulling hair,
biting or burning – using weapons.
Violence can lead to unconsciousness, serious
physical injury or death of the victim.
• Emotional, psychological or mental abuse – being
verbally abused, constantly blamed or criticised –
being humiliated or put down in front of others –
isolation from family or friends.
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DOMESTIC ABUSE – THERE’S NO EXCUSE
... Types of Abuse
Domestic abuse can also include:
• Sexual Abuse – rape or sexual assault,
degrading sexual acts, forced to watch or act
out pornography
• Financial Abuse – left without money, wages,
benefits or pension taken away – having to
account for all spending- denied access to
work
• Other forms of Abuse & controlling behaviour
– Threats or violence to children – threats or
violence to pets – damage to or theft of
property – being watched, stalked or harassed.
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Power and Control
Power & control are central. The
abuser uses threatening,
controlling and/or violent
behaviour to establish &
maintain power & control over
another.
Power differences, can include
physical strength, financial control,
isolating from friends and family or
immigration status which all allow
the abuser to :
•Maintain control
•Isolate the victim
•Ensure compliance
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DOMESTIC ABUSE – THERE’S NO EXCUSE
MAINTAIN
CONTROL
ISOLATE
THE VICTIM
NO WAY
OUT
DOMESTIC ABUSE – THERE’S NO EXCUSE
Cycle of Abuse
Domestic abuse falls into a common pattern, or cycle of violence.
Crisis phase
The abuser lashes out with aggressive, belittling or violent behaviour.
Calm phase
The abuser often rationalises what they have done. The abuser may come up with a string of
excuses or blame the victim for the abusive behaviour – thereby avoiding taking responsibility for
their actions. The abuser may try to regain control & keep the victim in the relationship.
Honeymoon phase
•This phase may give the victim hope that the abuser has really changed.
•The abuser often asks for forgiveness & promises it will never happen again.
• The victim may be forgiving & hope for a happier future. They try to forget or minimise what
happened.
Tension building phase
•A lot of time is spent thinking about what the victim has done wrong .
•The abuser creates a situation where they can justify abusing again.
•Tensions begin to build again.
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
Almost one in four women has been physically
assaulted by a partner or ex-partner at some
point in their lives.
TRUE
FALSE
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
On average how many women are killed by
their partner or ex-partner?
1 woman a day
1-2 women a month
Continue
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1-2 women a week
Click on the arrows
Death
Depression & loss
of self confidence
Increased risk
of harm to
children
Homelessness
and housing
issues
Self harm , attempted
or actual suicide
Impact of
domestic Abuse
on victims
Everyone's responses are
different & there is a wide
range of possible negative
impacts
Increasing likelihood of
misusing drugs or
alcohol as a coping
strategy
Domestic
Abuse can lead to serious short &
long-term physical,
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emotional, social & economic consequences for the victims.
Fear, panic flashbacks,
anxiety, PTSD, anger and
sleep disturbances
Feelings of
shame, despair &
hopelessness
Unemployment
and poverty
Feelings of complete
isolation
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Barriers to Leaving
There are many reasons why a person
may remain in an abusive relationship.
These include:
 Fear of the abuser ( including the risk
of murder)
 Fear of, or experience of not being
believed.
 Dependency on or love of the abuser
 Belief that the abuser will change
 Financial dependency
 Reliance on the abuser for care due
to illness or disability
 Religious or cultural beliefs
 Mental health problems
 Lack of knowledge & access to
support
 Low self esteem
Abusers are very good at controlling &
manipulating their victims.
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DOMESTIC ABUSE – THERE’S NO EXCUSE
When the victim has children
additional reasons for not leaving the
abuser can include:
 Keeping the family together
thinking its best for the children
 Fear of losing the family home
 Stigma of becoming a single parent
 Wanting to stay in the local
community due to family, friends or
school.
The point of leaving the home & the
relationship is the most dangerous
time for both the victim & their
children.
Barriers to Leaving…
Vulnerable adults can have significant
problems in leaving the abuser even if they
want to.
Additional barriers for vulnerable adults,
including some older people & people with
learning difficulties can be:
• Inability to act independently to get help
• Older adults or adults with physical
disabilities may not be able to go to
refuge as no facilities to their needs
• Lack of knowledge of & access to services
• Isolation from others as a result of being
dependant on an abusive carer
• Fear of losing their primary carer & their
home
• In some cases fear of losing custody of
their children
• Fear of change to their lifestyle
Culture, faith & ethnicity can directly
affect a persons experience of
domestic abuse.
Additional barriers for victims from
Black & ethnic minority backgrounds
who are thinking of leaving their
abuser can include
• Family honour, shame & stigma
within the community
• Language barriers
• Immigration status & no recourse
to public funds
• Perceived or actual racism
• Cultural beliefs
• Forced marriage
• Fear of separation from children,
family & the community.
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DOMESTIC ABUSE – THERE’S NO EXCUSE
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Disclosure
When a victim discloses it is important that they receive an
immediate response that is sensitive to their needs.
It is important that we•Listen & believe
•Remain non-judgemental
•Assess immediate safety
•Provide support & information to help them to decide
what to do next
•Victims should be advised that domestic violence is a
criminal offence
•Signpost to other agencies – Safer Places or Women’s Aid
Never advise a victim to leave their partner- The risk of
serious injury & homicide escalates dramatically when a
victim leaves an abusive relationship.
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Confidentiality and Information Sharing
Confidentiality is essential in keeping
someone safe from their abuser.
Reassure the individual that you will keep
whatever they tell you confidential unless:
• They or someone else is at risk of serious
injury or murder
• A child is at risk of significant harm
Responsible information sharing plays a key
role in enabling organisations & professionals
to protect victims of domestic abuse & their
children.
Casework, advocacy, conducting risk
assessments & providing general support &
protection may all require information about
individuals to be shared with other agencies,
however practitioners should be open &
transparent about how & what information
needs to be shared.
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In families where domestic
abuse is occurring children will
be at much greater risk of
significant harm because of
their age & dependency on
their parents.
If you consider the child is at
risk:
• Consult your local
safeguarding child
procedures
• Contact your manger or
safeguarding team for
advice
Data protection should not be a
barrier against sharing
information
DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
Domestic Abuse can lead to serious short and
long term physical, emotional, social and
economic consequences for the victims.
TRUE
FALSE
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
The point of leaving the home and the
relationship is the most dangerous time for both
the victim and their children.
TRUE
FALSE
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
When a victim makes a disclosure it is
important that they receive an immediate
response. Which should you NOT do?
Encourage them to
have a safety plan
Listen and believe
Assess immediate
safety
Encourage the
victim to tell her
partner
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Health Issues
It is vital that staff understand the effects of domestic abuse on victims health. In the
UK Domestic Abuse is a serious health issue.
Health professionals are often the victims first or only contact & could provide a vital
lifeline to safety. Victims are more likely to access & be admitted to health & hospital
services than non-abused individuals & be issued with more prescriptions.
Health professionals need to be alert to presenting signs & be aware of their
responsibilities. Health professionals are well placed to identify & intervene on behalf
of victims. Routine enquiry is now common place in community services, maternity
services, mental health & Accident & Emergency.
Those who ask direct questions are more likely to have patients disclosing the abuse
& can therefore take appropriate steps in supporting the victim, signposting & safety
planning.
Certain factors are considered high risk & should prompt enquiries about domestic
abuse……
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Factors that may increase risk
The effects of Domestic abuse are often compounded by other factors
• Substance misuse
• Alcohol
• Mental ill health
High risk factors are identified as:
Pregnancy
Separation
Escalation of abuse
Isolation
Animal abuse
Sexual abuse
Child abuse
Strangulation
Use of weapons
Excessive control/ jealousy
Stalking & harassment
Threats to kill
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November 2012, two specific
criminal offences of ‘stalking’ and
‘stalking involving fear of violence or
serious alarm or distress’ came into
force in England and Wales,this
highlighted the serious impact
stalking can have and help bring
perpetrators to justice.
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
What percentage of known domestic abuse
starts or escalates in pregnancy?
15%
30%
Continue
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50%
DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
Victims are more likely to access and be
admitted to health and hospital services than
non-abused individuals
TRUE
FALSE
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
The most dangerous time for a victim and their
children is at the point of leaving the
relationship.
TRUE
FALSE
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
Whose responsibility is it to safeguard victims
and their children?
Health and social
care
All agencies
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Children
•In 50% of cases of violence between
adults there is also abuse against
children.
•In almost 90% of cases where domestic
abuse takes place in a family, children are
present in the same or the adjacent room
whilst the violence is happening.
•
•
•
•
•
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Children’s experiences can
include being:
Physically, emotionally &
sexually abused
Witness to the abuse
Threatened, to force
compliance
Interrogated about their
parents activities
Told their behaviour is the
reason for the abuse
A child’s perception and
reaction to living with
domestic abuse is
influenced by:
Age
Gender
Race/culture
Economic status
Disability
Individual resilience
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Children
Possible impacts include:
Inconsistent parenting which may impact on attachment
Distress & fear caused by noise & tension, which may include physical signs
Fear & instability preventing exploration & play, and learning
A parent may be unpredictable, inconsistent and ineffective with their parenting and
therefore unable to meet their child’s physical and emotional needs
Influence of parents negative attitudes & behaviours leading to aggression, bullying,
criminal behaviour
Children may intervene to protect the non abusing parent and therefore be at risk of
harm or become complicit with the abuse
Finding it hard to form relationships
Anger, withdrawn, secretive, afraid, insecure, sad, depressed
Increased risk taking behaviour and/or self harm
Feeling increased responsibility for siblings
Not feeling safe
Emotional & behavioural problems
Missing or exclusion from school
Long term mental health issues
Drug & alcohol misuse
Inappropriate sexual behaviour
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The child’s perspective
DOMESTIC ABUSE – THERE’S NO EXCUSE
‘My first memories are of waking to the dull thud of my mother being thrown
against the wall in the next room and to the sound of my father’s voice raging at
her..…I lay in my bed silent and terrified, curled into a ball with the covers pulled
high to try to block it all out’
Jenny Tomlin (2005) Behind Closed Doors, Hodder, London.
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Supporting children
DOMESTIC ABUSE – THERE’S NO EXCUSE
If a child discloses to you REMEMBER:
 Believe what the child tells you
 Be supportive
 Don’t judge
 Be honest
 Tell the child it is not their fault
 Thank the child for being strong and telling
you
 Seek advice from manager or safeguarding
lead
 Be alert to the possibility that the child
may also be abused
 Signpost and use resources that exist
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Safeguarding
In families where domestic abuse is occurring children will be at much
greater risk of significant harm. If you consider that a child is at risk:
• Consult local safeguarding child protection procedures
• Contact local Safeguarding Children Team for support and advice.
If a vulnerable adult is at risk then follow SEPT Safeguarding Adult
Procedures.
• Contact local Safeguarding Adult Team for support and advice.
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What to do if you are concerned for the
welfare of a child
All staff have a legal duty to report any concerns
they may have for the safety and welfare of a child.
If you are concerned about a child or young person
you must seek advice from the Safeguarding team
and your line manager with a view to making a
child protection referral.
However, You may need to ensure
the child or young person’s
immediate safety and access
emergency assistance if necessary.
Referrals to children’s social care must be
made within one day of identifying the
concern and telephone contact must be
followed up with a written referral within
48 hours.
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You MUST record
all information and
actions clearly with
your name,
designation,
signature and date.
You must inform your Line Manager
or the Trust Safeguarding
Team.
If you are unable to contact your
line manager or a member of the
safeguarding team you should seek
advice directly from children’s
social care
DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
In what percentage of cases where domestic
abuse takes place in a family are children
present in the same of adjacent room whilst the
violence is happening?
30%
50%
Continue
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90%
DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
Children who experience prolonged exposure
to domestic abuse are at greater risk of harm.
TRUE
FALSE
Continue
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Teenage Relationship Abuse
Teenagers experience as much
relationship abuse as adults. Several
independent studies have shown that
40% of teenagers are in abusive dating
relationships. This is exacerbated by
the fact that adolescents can be more
accepting of, and dismissive about, this
form of behaviour. Young people who
had been in care (Looked After Child)
are particularly vulnerable to
relationships with controlling and violent
partners.
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Some of the signs below could indicate
that a young person is experiencing
relationship abuse.
• Changes in mood and personality
• Isolation from family and friends
• Frequent texts and calls from
boyfriend / girlfriend
• Inappropriate sexual behaviour /
language / attitudes
• Depression
• Pregnancy
• Use of drugs / alcohol (where
there was no prior use)
• Self-harm
• Eating disorders or problems
sleeping
• Symptoms of post-traumatic stress
• Bullying / being bullied
DOMESTIC ABUSE – THERE’S NO EXCUSE
Vulnerable Adults
Some older adults, or people with a
disability, may be especially vulnerable to
domestic abuse.
• Due to their age, disability or illness they
may be less able to protect themselves.
• They may have difficulty in making their
wishes & feelings known.
• They may not have capacity to make
informed decision
The abuse, which may be by partner, family
member or someone with whom there may
be a relationship, may involve
• Physical or sexual abuse
• Taking money without permission
• Bullying or humiliation
• Not allowed contact with friends or family
• Withholding food or medication
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Multi Agency Working
DOMESTIC ABUSE – THERE’S NO EXCUSE
A Multi agency approach is essential as victims,
abusers & their families maybe in contact with some
of the following services:
• The police, courts & probation
• Local councils: Children schools & families, Adult
social care, Housing or Youth services
• Health services: GP’s, Midwives, health visitors,
school nurses, district nurses, Hospital services
including A&E, Mental Health services
• Non statutory agencies; including domestic abuse
organisations
• Local community groups & organisations
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DASH and MARAC
DOMESTIC ABUSE – THERE’S NO EXCUSE
DASH stands for Domestic Abuse Stalking & Harassment – it is a common
Risk assessment tool (2009) used by all agencies to assess risk to victims
from Domestic Abuse; including Police and Social Care
In Essex DASH is the assessment tool used to refer to MARAC – Multi Agency
Risk Assessment Conference, these are regular local meetings where
information about high risk domestic abuse victims is shared between local
agencies. A risk focused, co-ordinated safety plan can be drawn up to support
the victim.
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
Teenagers experience as much relationship
abuse as adults.
TRUE
FALSE
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
Young people who had left care and were living
alone were less vulnerable to relationship
violence.
TRUE
FALSE
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
A multi agency approach is essential to protect
victims and their families.
TRUE
FALSE
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Question
The purpose of MARAC is to risk assess and
form a co-ordinated risk focused safety plan
for…
Victim only
Victim and children
Children only
Perpetrators
Continue
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DOMESTIC ABUSE – THERE’S NO EXCUSE
Summary
Domestic Abuse is a serious social problem & a violation of human rights.
The needs of children & vulnerable adults can be overlooked due to the secrecy, fear
& shame often associated with Domestic abuse.
The legal definition of significant harm includes ‘impairment suffered from seeing &
hearing the ill-treatment of another’
This highlights the suffering & damage that can occur from living in a household with
domestic abuse, even where there is no direct harm to the child or vulnerable adult.
If you are worried about a child or adult in a household where there is abuse
REMEMBER - Record it & Report it
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Useful contacts and references
Women’s Aid Federation of England www.womensaid.org.uk
Safer Places (men and woman) 0845 0177 668 www.saferplaces.co.uk
Refuge – 24 hr helpline 0808 2000 247 www.refuge.org.uk
Respect www.respect.uk.net
National Centre for Domestic Violence www.ncdv.org.uk
The Hideout – Women’s Aid website for children www.thehideout.org.uk
Broken Rainbow – offers services to LGBT www.broken-rainbow.org.uk
Caada - www.caada.org
Forced Marriage Unit 0207 008 1501 www.fco.gov.uk
Karma Nirvana 0800 5999 247 www.karmanirvana.org.uk
Action on Elder Abuse 080 8808 8141 www.elderabuse.org.uk
Toolkit for addressing teenage relationship abuse for key stages 3, 4 & 5
http://www.homeoffice.gov.uk/publications/crime/teen-relationship-abuse/teenabuse-toolkit?view=Binary
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Publications and Further Reading
Improving Safety, Reducing Harm – A practical toolkit for front-line professionals (DoH
2009)
Responding to Domestic abuse – A handbook for health professionals (2005)
What to do if you’re worried a child is being abused. (HM Government 2015)
Striking the Balance - Practical Guidance on the application of Caldecott Guardian
Principles to Domestic Violence and MARACs (Multi Agency Risk Assessment
Conferences) – (Department of Health, 2012)
National service Framework for Children, young people and maternity services (2004)
Working together to safeguard children (2015)
Every Child Matters (2004) www.everychildmatters.gov.uk
UK Study of Abuse and Neglect of Older People: Qualitative Findings Comic relief &
DoH 2007
Information Sharing www.gov.uk/government/publications/safeguarding-practitionersinformation-sharing-advice
Ten pitfalls and how to avoid them – What research tells us (NSPCC 2010)
www.nspcc.org.uk/inform
Three steps to escaping violence against women & girls, Home Office 2011 – available
on www.homeoffice.gsi.gov.uk/crime/violence-against-women available to download
in different languages
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Access to Further Information
Staff should be aware of how to access
the Trust Safeguarding Children Policy,
Safeguarding Adults Policy, Information
sharing Guidance and Whistle blowing
policy, including managing allegations
made against staff who work with children
and vulnerable adults. Staff must make
sure they know how to access their local
safeguarding children team contact details
Information can be accessed
via the Safeguarding site on
the Trust Intranet which
includes: key document’s,
Local and Trust polices,
Safeguarding Team contact
details and referral forms.
Remember- Safeguarding children is everyone's responsibility, if something doesn’t
seem right- seek advice from your line manager or Trust safeguarding team.
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Remember, if you want to find more information / evidence
about this subject or anything else which is relevant to your
work or study, join your local healthcare library.
For staff in Essex contact Basildon Healthcare Library.
www.btuheks.nhs.uk
[email protected]
01268 524900 EX3594
It may be that you work in a different
area,
for example Luton.
Details of all the Health Libraries in
the East of England can be found at
this site…
www.eel.nhs.uk
You are welcome to join any of these.
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Review of Objective(s)
Before taking the end of course test, please ensure you have acquired the relevant
knowledge against the modules objective(s) below:
“At the end of this training, you should be able to identify:
What abuse is and how different types of abuse might be identified
Where abuse may take place
Who abuses
Why abuse might occur and to whom
What to do if you witness abuse
Where to find additional information
Safeguarding service structure in SEPT
And:
To recognise signs & symptoms of Domestic Abuse
To understand the wide ranging impact on individuals & families
To know how to access support services
To know how to get support within SEPT”
If not, please take this opportunity to revisit any of the content
within the three presentations.
Continue
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You now need to take the test!
Remember to
click the ‘home’
icon when you
have finished
the test to save
your results!
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