Page 24 - Adult C Overview Report - FINAL

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improvements in MARAC and associated processes with improvement plans in place.

8.4. This review has highlighted the complexity of assessing, managing interventions and
improving outcomes for people who are victims of domestic abuse and alcohol dependant
who are change resistant, especially where the perpetrator/s and friends are also problem
drinkers.

8.5. This review found no gaps in service delivery to Adult C. All the commissioned and statutory
services that should have been engaged were actively seeking to improve outcomes for her

using tried and tested models. Services signposted to other services as necessary and made
appropriate referrals. The disclosure from Adult 1 that nothing that professionals tried would
have kept them apart is testament to the difficulties faced by professionals.

8.6. Some agencies have recognised where they could make improvements and have made single
agency recommendations to improve their own practices e.g. the substance misuse service
have recommended increased MARAC training for staff and the Clinical Commissioning Group
have recognised the need for GPs to be more aware of MARAC from this and other reviews
(including MARAC minutes being shared to enable awareness of patients who are known
victims of domestic abuse and flagging on systems). The process by which this can happen is
subject to recommendation in this review.

8.7. Whilst there is a process identified such as the TATI that could be beneficial in future cases in
the locality, people with these needs and issues require more of an assertive outreach
approach.

8.8. Approaches of that nature are labour intensive and are often for one specific issue e.g.
domestic abuse, mental health. What is required is a more eclectic service that is able to
support people with multiple needs, whose lifestyles are likely to lead to tragic outcomes

unless intervention approaches can be person tailored rather than service specific.

8.9. In such cases, alcohol, domestic abuse and health services need to work more closely
together to align their approaches, each cognisant of the other’s plans and goals. Improving
outcomes for domestic abuse victims will not be possible without improving outcomes for
alcohol addiction.

8.10. The new integrated vulnerability service delivery model that is proposed for the area, if it is
introduced in the way proposed, will meet much of the needs of the population with issues

force against others. Evidence is used to drive improvements in the services provided and to highlight good practice. HMICFRS
report annually on their effectiveness, efficiency and legitimacy via our PEEL assessments.

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