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Agenda item

Review of Kent's Domestic Abuse (DA) Framework

Presentation by Kent County Council Officers.

Minutes:

Members received a PowerPoint presentation from Emily Matthews, Commissioning Officer, Kent County Council entitled - ‘Kent Integrated Domestic Abuse Services.

 

The KCC Commissioning Officer advised Members that the change in social attitude towards Domestic Abuse (DA); in particular the reporting of incidents by victims and their expectation of action from authorities and positive outcomes for themselves; had necessitated a wholescale review of the DA Framework of services for victims in Kent by the County Council. She highlighted the fact that 3 cases of DA homicide had occurred in Kent during 2016-17. The essential review of each tragic case cost some £20K and it was essential that lessons were learnt and existing measures and procedures improved as appropriate. Her presentation covered the following principal areas:

 

Context

 

·         60,000 DA victims in Kent & Medway based on Home Office ‘ready reckoner’ tool;

·         Cost to Kent’s public services estimated at £170M per annum;

·         All DA services experiencing a large increase in demand;

·         Over 25,00 calls made to Police in 12 months to August 2014 regarding domestic abuse;

·         Over 3,000 children known to Social Services live in households where DA is a factor. 

 

Map of Previous Provision [up to April 2017]

 

·         Women’s refuge with resettlement support (KCC) situated nearby to Dartford, Sevenoaks, Swanley, Maidstone, Ashford, Shepway Canterbury, Thanet and Dover;

·         KCC ‘Floating Support’ throughout the County;

·         Independent Domestic Violence Advisor (IDVA) (multi-agency funded) throughout the County;

·         Freedom Programme (Grants/Charitable funding) situated nearby to Gravesham, Tonbridge and Malling, Maidstone, Tunbridge Wells, Swanley, Ashford, Canterbury and Thanet;

·         Advice and Recovery Services (Grants/Charitable funding) – situated near to Gravesham, Tonbridge and Malling, Tunbridge Wells, Ashford, Shepway, Canterbury and Thanet.

 

Kent suffered from a geographical inconsistency in services with a support gap in rural areas. An added complication was funding sustainability issues for voluntary and short-term support services in support of DA victims.

 

A Choice to Make ….

 

·         Number of key DA contracts - Kent Refuges, Floating Support and IDVA (multi-agency funded) – were due to end on 31 March 2017;

·         No increase in funding was anticipated under the continuing climate of downward pressure on existing budgets;

·         Choice of ‘same again’ services with potentially decreasing resources and increasing demand or a ‘managed decline’;

·         OR, do something different? – Make existing resources go further through ‘new ways of working’ within existing budgetary constraints.

 

Evidence Base

 

·         Joint Strategic Needs Assessment (JSNA) – Greater Integration; Improved Interventions; Integrated Pathways; Effective offer to ‘hard to reach groups’ e.g. substance abuse, mental health, perpetrators etc.; Commission services which increase numbers of victims who can stay in their own homes;

·         Chartered Institute of Housing Needs Analysis – Gaps for service users with complex needs; move on challenges; need for more collaborative commissioning;

·         Multi-Agency Risk Assessment Conference (MARAC) Needs Assessment – Commissioning of an integrated, holistic model of support;

·         NICE Guidance – Commission integrated care pathways;

·         Summary – All the evidence points in the same direction…’better if we do it together’.  

 

Integrated working was essential to address the varied and complex needs of victims.

 

The Proposal – By pooling budgets, commissioning collaboratively, integrating pathways and retaining local expertise it is possible to:-

 

·         Reshape the landscape of domestic abuse services;

·         Deliver better outcomes and efficiencies;

·         Establish a stable, sustainable platform from which innovation can flourish;

·         Increase the focus on the customer journey – prevention, seamless transition into different elements of service delivery;

·         Reduce geographical inconsistency;

·         Create seamless client journeys with better outcomes;

·         Provide a single point of access and triage;

·         Ensure charitable and grant funding is able to enhance strong core provision;

·         Enable more coherent strategic oversight.

 

Focus on the client was essential, addressing the victim’s feelings and wants and reducing the geographical inconsistency in service provision across the County. KCC had worked hard during the last 2-3 years to provide a County-wide integrated service with a cascading funding provision through KCC downwards to the District Councils.

 

Consultation Outcomes

 

·         Consultation period from 8 June – 15 August 2016;

·         Significant support for the proposal to integrate from wide range of stakeholders;

·         Two key areas of concern – countrywide model may prove unwieldy/inefficient, fear of a loss of local knowledge and expertise – feedback on both these areas of concern have been absorbed and fed into the model.

 

Triage, Assessment & Referral – Lever in existing PCC’s Victim Support service for standard and medium risk victims and enhance with funding from Police & Crime Commissioner (PCC) resources for high risk victims, through a County-wide Training, Awareness and Education programme in four (4) specified areas to provide DA victims with accommodation and community support. Provider requirements to include:-

 

·         Holistic delivery on an area basis;

·         To develop and maintain partnerships and networks across the area(s);

·         To have comprehensive oversight over the contract area, respond to changing demands and move to a more community based model of delivery;

·         To work with commissioners and partners to contribute to a coordinated, networked community response, articulated well with other provision.

 

The tender process was run on quality not price with the objective of obtaining for DA victims the most innovative support available in the market.

 

Strategic Development

 

·         Flexible dynamic network that develops, not just DA specific links but allied areas e.g. Live well, Early Help;

·         Securing and simplifying future governance – complex picture to secure Safeguarding objectives;

·         The key requirement to addressing the Toxic Trio of – Domestic Abuse, Substance Misuse and Mental Health, which can all occur in the same household, underlining the need for an holistic approach by service providers, rather than the traditional ‘silo’ approach to address individual victim needs;

·         5 year flexible outcome focussed contract [with 4 year renewal option], that will develop over time to achieve the goals of Devolution, a Violence Against Women and Girls (VAWG) Strategy, with Health and Social Care integration, rolled out over three stages; Stage 1 – Select Area Leads, fix current issues, establish basic networks and baseline measure; Stage 2 – Co-design outcomes framework and incentivisation scheme, opportunity for further integration; Stage 3 – Review progress and network, develop and broaden where necessary, consider redistribution of investment, prepare consider and co-produce for next model of commissioning.

 

A Strategy Group had been set up to address the complicated structure of service provision in Kent, and increase individual accountability amongst service providers.

 

The new service landscape – new service comprising 4 large areas under an integrated contract, based on services that had previously been provided in a ‘silo’ rather than an ‘holistic’ approach:-

 

·         Dartford, Gravesham, Swale and Maidstone;

·         Sevenoaks, Tonbridge and Malling and Tonbridge Wells;

·         Ashford, Canterbury and Shepway;

·         Dover and Thanet.

 

Medway was under separate contract and provision arrangements.

 

What is different?

 

·         Comprehensive network of support, no wrong door, no repeated referrals, no restrictions on help offered to victims;

·         Quicker , effective action, lower waiting times;

·         Clear pathways for victims in their own communities, using assets they know well;

·         Fall in number of high risk victims (fewer MARAC);

·         Medium risk outreach new and more effective to prevent escalation to high risk victims;

·         Focus on reducing harm earlier;

·         Overall reduction in harm to vulnerable adults and children;

·         Fewer domestic homicides, fewer reviews;

·         Clearer response for hard to reach groups e.g. men, BAME, older people;

·         Meaningful data to enable strategically driven evidenced change;

·         Better data-sharing;

·         The sector will be brought together under an interface agreement outlining the outcomes and behaviours upon which we agree.

 

Co-ordinating data collection to obtain maximum results and improve and develop the new services would be essential.

 

Dartford Service April – July 2017

 

·         Services delivered by Centra Support from within a larger Housing Group which has the infrastructure to get results ;

·         Working to build local links with key partners, stakeholders and support groups, attending DA Forums, delivering at One Stop Shops;

·         Widespread improvements to refuge accommodation including: upgraded CCTV and door intercoms, deep clean of all accommodation, introduction of door intercoms to improve safety, consultation currently underway for total redecoration;

·         Face to face IDVA service with ‘drop-in’ visits rather than remote ‘helphone’ support;

·         Improved Outreach provision for medium and standard risk victims.

 

Centra’s Dartford Links

 

·         Council Housing Department;

·         Social Services;

·         Health Visitors;

·         Witness Care Unit (for Court support) via Centra and Citizens’ Advice Bureau (CAB);

·         Paladin (stalking and harassment);

·         MARAC;

·         Family Matters;

·         Mind;

·         Iranian and Kurdish Women’s Rights;

·         Kent Police.

 

Centra are keen to expand links and welcome joint working and contributions as to how to develop services.

 

The Numbers

 

·         42 - IDVA (high risk);

·         32 - Outreach;

·         17 – Refuge;

·         Equating to 91 victims supported.

 

The above figures did not include walk-in victims attending One Stop Shops, Brief advice & guidance cases, Resettlement support or MARAC Support cases.

 

The Dartford Refuge was consistently full; with clients staying in the Refuge for between 3 and 18 months dependent on their individual circumstances.

 

Coming Soon…

 

·         Hospital IDVA service to be delivered in Darenth Valley Hospital with KCC and PCC support financed by a 3 year Home Office VAWG Transformation Funding programme to provide full-time on site support for DA victims admitted to DVH;

·         Through partnership and collaboration during the life of the contract (including residual services from the ‘Choices’ scheme), ongoing transformation, evolution and improvement to the service offer, to victims of domestic abuse and their families.

 

Feedback would be sought from individual service providers on a 12-18 month cycle of change and improvement.

 

In a subsequent Q&A session the following points were confirmed by the KCC Commissioning Officer and the Strategic Director (External Services) in response to specific questions from Members:

 

·         Ownership and Governance of Kent’s new Integrated Domestic Abuse Services [IDAS] would most likely sit within the Safeguarding and Social Care Directorates of the County Authority;

·         Domestic Homicide Reviews were best co-ordinated by unitary authorities. KCC led in Kent with District authorities contributing as appropriate. The KCC funding request for DA Homicide Reviews had been received after budgets had been set in Dartford. The SD(ES) advised that this had necessitated some budget flexibility;

·         The IDVA Service was traditionally advertised in public toilets and facilities in government buildings, via the KCC website and to a degree, through collaborative work with Kent Police. KCC perceived a need to update training and awareness and to improve message dissemination to advertise the new integrated services through more ‘media savvy’ partners;

·         Service transition issues and risks, including ‘hot spots’ for services had been addressed through the ‘evolving’ model of service provision by Contra, using the ‘whole family’ approach. Records showed that some 90% of DA victims wished to stay in the abusive relationship, consequently the new service provision had to concentrate its work in the area of keeping partners and families safe together. Financing the new service given the partnership aspect was a ‘risk’. Contingency plans were in place for a 10-20% reduction in service provision, should funding streams fail;

·         Capacity issues at the Dartford Refuge were addressed by KCC through a 3 monthly performance report cycle to identify any possible gaps in provision and to identify external help as required. Victims of DA were housed under a national network agreement; if a local Refuge was full, victims could be accommodated in the next nearest Refuge under the terms of the National Agreement. ‘Choices’ also continued to work in the Dartford area within the new Centra contract. 

 

The Chairman thanked the Commissioning Officer for her excellent and comprehensive presentation.