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During the course of your practise as an Occupational Therapist with Northstaffs Combined Health Care NHS Trust, between November 2010 - May 2011 you:
1. Were unable to work unsupervised, in that you were required to undertake joint assessments and home visits.
2. Did not prioritise tasks effectively, in that you:
a. Did not adhere to the timetable set for you by your supervisors;
b. On 06 April 2011, you missed a Mileage training session;
c. On 07 April 2011, you missed a Stay at Home Review Meeting;
d. On 11 April 2011, you missed a scheduled follow-up visit to Service User 3
3. Did not perform comprehensive risk assessments,
4. not proved.
a. not proved.
b. not proved.
c. not proved.
d. not proved.
e. not proved.
6. Did not communicate effectively with service users and colleagues, in that:
a. not proved.
b. not proved.
c. not proved.
d. on 28 April 2011, you did not clearly communicate the OT recommendations to the Multidisciplinary Team (MDT), following your assessment of Service User 2 (FS)
e. not proved.
f. whilst at Meadowcroft Assessment at Bucknall Hospital:
i. not proved.
ii. not proved.
iii. not proved.
7. Did not write reports effectively in that you:
a. Had difficulty in structuring reports;
b. Included informal comments;
c. Did not to distinguish between problems and recommendations; and
d. Did not include appropriate strategies or suggestions.
8. Failed to undertake adequate home assessments in that:
a. on 23 March 2011, when assessing Service User:
i. not proved.
ii. not proved.
iv. Your assessment of Service User‟s mobility was inconsistent with your conclusion that Service User was independently mobile with a walking stick; and
v. You did not identify potential hazards and/or dangers.
b. On 28 April 2011, when assessing Service User 2, you did not allow the service user the opportunity to problem solve and thus, you were unable to fully assess the service user‟s abilities.
9. Compromised patient safety in that:
a. on an unknown date in March 2011, a suicidal client stated that he would „shoot himself if he had a gun‟ and soon afterwards he asked you for a pen and paper and you:
i. not proved.
ii. failed to inform members of the MDT about your assessment with client
10. on 05 April 2011, you incorrectly stated that a service user could return to her flat with five days of day care when the service user required 24 hour care;
11. Failed to keep accurate records in that:
a. Many client notes were incomplete;
b. Files were not updated following amendments; and
c. Reports were missing from client files.
12. Demonstrated a poor knowledge of the process of dementia in relation to level of function and performance in daily living skills;
13. Demonstrated an inability to retain information;
14. not proved.
15. The matters set out at 1-14 amount to misconduct and/or lack of competence.
16. By reason of that misconduct and/or lack of competence, your fitness to practise is impaired.
1. The Registrant, Angela Contucci who was a newly qualified Occupational Therapist, was employed by the North Staffordshire Combined Health Care Trust (the Trust) as Band 5 Occupational Therapist on a one year fixed term contract commencing on 15 November 2010. She was employed as part of the team providing Occupational Therapy for Older people with Mental Health needs. Her direct supervisor was Niamh Corkery, a Band 6 Occupational Therapist. The Trust was aware from the outset of her employment that Ms. Contucci had dyslexia.
2. Shortly after commencing employment, concerns were raised about Ms. Contucci’s performance. Initially these were dealt with on an informal basis and she was provided with extra support from Fiona Platt, the Occupational Therapy Team Leader and from her supervisor, Niamh Corkery.
3. Despite the additional support the concerns continued and on 18 January 2011 it was decided to invoke the Trust’s Performance Improvement Policy. Members of staff were advised to raise any concerns about Ms. Contucci with the Team Leader Investigation Officer, Sarah Watson.
4. On 08 February 2011, there was an informal meeting which Ms. Contucci attended at which an action plan was discussed and which was intended to identify the various concerns about her performance which needed to be addressed. Ms. Contucci indicated that her dyslexia made it difficult for her to do paperwork and she also reported she was having difficulty sleeping. This resulted in a referral to Occupational Health who reported, in due course, that there was no medical reason why Ms. Contucci should be unable to retain information.
5. In February 2011, it was decided that Ms. Contucci should continue to receive support through preceptorship. However, at a preceptorship meeting held on 10 March 2011, it was decided that preceptorship could not support every aspect of Ms. Contucci’s practice in which she needed help. This resulted in the preceptorship support focussing on her clinical reasoning, time management, communication and report writing.
6. On 15 March 2011, it was decided that Ms. Contucci required a higher level of supervision which included that she be accompanied by a senior Occupational Therapist for complex assessments and that she should meet with the senior Occupational Therapist before any home visits took place.
7. In April 2011, Ms. Contucci missed a mileage training centre course and a Stay at Home review meeting. On 11 April 2011 she also missed a follow-up visit with a service user. On 9 May 2011, it was decided to move Ms. Contucci to the Complex Care Needs Ward, where her supervisor was Rachel Johnson, an Occupational Therapy Clinical Specialist. The following day, Ms. Contucci took sick leave and indicated that she was considering resigning. A review of her caseload found that a number of Ms. Contucci’s case notes were unfinished or missing or had not been updated following suggested amendments by supervising colleagues. Ms. Contucci returned to work after three week’s sick leave and shadowed Band 3 staff at Meadowcroft, where further concerns were raised about her performance. This resulted in a capability meeting being scheduled for 12 July 2011. Ms. Contucci resigned the day before the meeting. At the capability meeting, and in view of Ms. Contucci’s resignation, it was decided that she would not be re-employed as an Occupational Therapist.
8. The previous reviewing panel noted;
“The matter was reported to the HCPC and at the substantive hearing, which was heard on dates in April and July 2013, a number of the Particulars of the Allegation were admitted by Ms. Contucci and/or found proved (as noted above) and the Panel found that her fitness to practise was impaired on grounds of lack of competence. It also found that a number of Standards of Proficiency had been breached: 1a6, 1a7, 1b1, 1b3, 2a1, 2a3, 2a4, 2b2, 2b5, 3a1, 3a2.
That Panel indicted in its determination that this Reviewing Panel might find it useful if Ms. Contucci were to compile a portfolio of continuing professional development which should be clearly structured and demonstrate effective report writing skills and might include some of the following :
• Successful completion by examination of training course for occupational assessment
• Successful completion of a relevant therapy module at university
• Detailed case studies including activity and environmental analyses demonstrating an understanding of the impact of disability/ageing on function
• Reflection on her own learning relating to significant events. These may have required risk assessment and/or may have involved complex communication issues.
The Panel also recommends that Ms. Contucci provide further references and testimonials from any employer for whom she works in the next 12 months.”
9. At this review hearing, the Panel heard submissions from Ms Owusu-Akyem on behalf of the HCPC. She referred to the background evidence of the case and made reference to the Substantive Panel’s decision and the review hearing Panel’s decision. She submitted that the Registrant has provided a reflective piece which shows a level of insight however, she has not worked as an Occupational Therapist since 2011. Ms Owusu-Akyem observed that there is no evidence of keeping up to date with continuing professional development. She also submitted that at this stage it is not appropriate to impose a Striking Off order and she invited the Panel to extend the Suspension Order for a further 12 month period.
10. The Registrant gave detailed evidence to the Panel. At the outset of the hearing she submitted additional documents consisting of two references and details of a university module that she had obtained and was looking for advice regarding its suitability in meeting the recommendations set by the 2014 Panel.
11. The Registrant explained that she has recently identified a mentor who is an Occupational Therapist. She explained that her current role at the Joy of Sound enables her to work with service users and alongside an Occupation Therapist assistant. She stated that her role with the Healthy Living Club was enabling her to get experience in note writing and working with people who have dementia. She stated clearly that her role in both areas was not that of an OT but she felt she could draw on her learnt skills. She explained that if she were permitted to return to practice she would avoid stressful situations and would only accept posts that would enable her to stay in London and work at her own pace.
12. In coming to its decision, the Panel took into account all the written and oral evidence before it. It had regard to the submissions of the parties and to the advice of the Legal Assessor.
13. The Panel considered whether the Registrant’s fitness to practise remains impaired. In undertaking this task the Panel considered whether the Registrant’s conduct which led to the allegation is easily remediable; second, that it has been remedied; and third, that it is highly unlikely to be repeated. In coming to its decision the Panel has exercised its own judgment in reaching its decision. It has taken into account the public interest which includes protection of patients, maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour.
14. The Registrant has yet to remedy the deficiencies that were identified in the substantive reasons following a hearing which concluded in July 2013 and then reiterated in the review hearing of July 2014. In particular the Registrant has not worked as an Occupational Therapist since June 2011 and she has failed to keep up to date with any Continuing Professional Development. Although the Registrant has identified a course that she might wish to undertake, she is yet to enrol upon that course. Given the period of time she has not worked as an Occupational Therapist and the lack of investigation and subsequent understanding about the course it is not clear to the Panel or the Registrant if this course is the most appropriate to address her shortcomings. She would be required to undertake a return to practice course. Further, the Registrant has not undertaken any personal study. The Registrant states that she was unable to undertake any courses due to financial constraints but the Registrant has not demonstrated any initiative to undertake any personal development which is cost free.
15. The Panel were concerned that the Registrant demonstrated little insight into her own shortcomings and she has failed to identify or undertake any significant steps to remedy the deficiencies that were identified in her practice notably her clinical deficiencies and that relates to particular 3, 8a(iv)(v), 8b 9a(i), 10 and 12. The Registrant gave detailed evidence as to the voluntary work she is undertaking at present. But when questioned by the Panel she was unable to explain how her current roles related to the skills required of an Occupational Therapist.
16. Notwithstanding that the Registrant has been suspended for a period of 2 years by the HCPC she has demonstrated very little insight into the regulatory process that she is subject to. Although she has recently taken some steps towards acquiring a mentor through her voluntary work she was unable to explain how that mentor could assist her in remedying her deficiencies and appeared to be in effect seeking advice from the Panel. However she provided no evidence of a plan regarding how that relationship would work. The Registrant throughout the hearing did not demonstrate that she either accepted or understood that even as a newly qualified Occupational Therapist she has a professional responsibility to be able to act autonomously.
17. The Panel considered that the Registrant’s fitness to practise remains impaired.
18. The Panel noted that a sanction is only to be imposed to the extent that it is required to protect service users and to maintain a proper degree of confidence in the registered profession and this regulatory process. To ensure that these principles are observed the Panel first considered whether any sanction is still required at all. Having decided that a sanction is required, the Panel then considered the available sanctions open to it in an ascending order of seriousness.
19. The Panel determined that to take no action would be insufficient given the extent of the lack of competence found proved and the Panel is not satisfied that the deficiencies identified have been remedied. The Panel considered that mediation is not relevant or appropriate in this case and a Caution order would not afford service users any degree of protection.
20. The Panel then went on to consider a Conditions of Practice Order. However, the Panel considered that the Registrant has been unable to acknowledge or accept and therefore remedy the deficiencies in her practice and in those circumstances it could not formulate workable or practicable conditions.
21. The Panel considered whether a further period of suspension would enable the Registrant to develop full insight into her deficiencies and in particular whether it could facilitate a deepening of the Registrant’s understanding of her role as an Occupational Therapist. It concluded that the Registrant has failed to make any significant or meaningful steps to address her deficiencies during the 2 years that she has already been suspended from practice.
22. Whilst the original Panel considering these matters concluded that the deficiencies were capable of being remedied this Panel having heard the evidence has concluded that the Registrant does not have the ability to remedy those deficiencies. In coming to this conclusion it noted that the Registrant fails to accept any personal responsibility for the deficiencies that were identified in her own practice. The Registrant also fails to understand or accept that even as a newly qualified Occupational Therapist she has a professional responsibility in carrying out her work. The Panel considered that there was no realistic prospect of the Registrant being able to undertake safe practice. In those circumstances the Panel concluded that the only appropriate and proportionate order is a Striking Off Order.
History of Hearings for Angela Contucci
|Date||Panel||Hearing type||Outcomes / Status|
|24/06/2015||Conduct and Competence Committee||Review Hearing||Struck off|