Mrs Kiran Garner

Profession: Practitioner psychologist

Registration Number: PYL15366

Interim Order: Imposed on 08 Apr 2013

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 24/11/2015 End: 12:30 24/11/2015

Location: Health and Care Professions Council, Park House, 184 Kennington Park Road, London, SE11 4BU

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

 

Allegation (as found proved)

 

During the course of your practice as a Clinical Psychologist with Huntercombe Group:

 

1.     You did not maintain professional boundaries in relation to Patient A in that:

 

a) On 26 June 2012, during a therapy session with Patient A at Beech House Hospital you:

 

i. You allowed Patient A to:
1) Touch your hands;
2) Touch your face;
3) Place his head on your arm(s);
4) Touch your hair
5) Touch your chest and/or/blouse and/or jewellery;
6) Touch your head;
7) Kiss your cheek;
8) 
9) Place his head in your lap.


ii. Did not take appropriate action to limit the physical contact between you and Patient A;

 

iii. Did not control the therapeutic space in that you allowed Patient A to:


1) Leave the therapeutic space;
2) Freely walk around the therapeutic space;
3) Kneel in front of you;
4) Sit in close proximity to you.


iv.


v. Excluded the chaperone from the therapy session on two occasions;


vi. Did not end the therapy session within the allotted time;


vii. Re-entered the therapy space with Patient A, without a chaperone, after the therapy session had concluded.

 

b) :


i.


ii.


iii.


c) Between November 2011-July 2012 you:


i. Did not seek clinical supervision in relation to maintaining boundaries with Patient A despite management instruction to do so;


ii. In April 2012 you met with Patient A despite specific instruction from Patient A's responsible clinician (RC) not to;


iii.  


2. The matters described in paragraphs 1a)-1c) amount to misconduct and/or lack of competence; and


3. By reason of that misconduct and/or lack of competence, your fitness to practise is impaired.

Finding

Decision 


1. The Panel has been convened to consider a mandatory review of a substantive Conditions of Practice Order (hereafter “CoPO”).  The CoPO was imposed for a period of 12 months on 25 November 2014.  Allowing for the fact that the Order did not commence until the appeal period expired, it is due to expire on 23 December 2015.


2. The CoPO was made by the Panel that conducted the final hearing.  That hearing took place over ten days between 22 September 2014 and 25 November 2014 when the CoPO was made.  The final hearing Panel concluded that the factual particulars (save for particulars 1(a)(i)(8); 1(a)(iv); 1(b); 1(c)(i) and 1(c)(iii)) were proven.  The Panel also found that those particulars demonstrated a lack of competence then impairing Mrs Garner’s fitness to practise.


3. The case against Mrs Garner arose out a referral made by the organisation responsible for the management of Beech House Hospital, a low secure psychiatric hospital, where Mrs Garner was working.  The matter that precipitated the complaint was that a patient at the hospital, Patient A, had assaulted three members of staff following a planned therapy session with Mrs Garner.  The respects in which Mrs Garner’s interactions with Patient A were open to criticism are set out in the factual particulars of the allegation that were found proven.  The final hearing Panel found that Mrs Garner’s judgement was clouded and that she failed to make objective assessments of Patient A and of her relationship with Patient A, and that she had adopted a passive approach in order to pacify the patient.  A number of mitigating factors were identified, including organisational shortcomings at the hospital, pressures of work and a lack of support from her employers.

4. The conditions imposed by the CoPO were the following:


1. You must prepare a full and develop a CPD plan, using the British Psychological Society CPD template, based on the learning identified in the reflective statement. Copies of your reflective statement and CPD plan must be provided to the review Panel.
2. When preparing your reflective statement and CPD plan you must seek the opinion of a Clinical Psychologist who has not previously worked with or supervised you, particularly in relation to the content of paragraphs 103 and 112 of the decision of the Panel.
3. You must continue to receive routine clinical supervision from your clinical supervisor and you must provide a report from your supervisor to the review Panel.
4. You must inform the HCPC if you take up any employment other than self-employment.
5. You must inform the following parties that your registration is subject to these conditions (save for the content of condition 2).
A. Any organisation or practitioner employing or contracting with you to undertake professional work (save for any patient or those with whom you are conducting therapy);
B. Any agency you are registered with (at the time of application) and;
C. Any prospective employer (at the time of your application).
6. You will be responsible for meeting any and all costs associated with complying with these conditions.

5. The Panel has accepted and applied the advice it received from the Legal Assessor as to the proper approach it should adopt in undertaking the review.  In particular:


• The decision on the allegation made by the final hearing Panel is now settled. 
• The matter to be decided by the Panel is whether the present circumstances require the imposition of another sanction upon the expiry of the present CoPO.
• In making this decision the Panel is required to apply the usual sanction considerations: namely a sanction is not to be applied to punish, but should only be imposed to the extent that it is required to protect the public and to maintain a proper degree of confidence in the registered profession and this regulatory process.
• To ensure that these principles are applied the first question to be answered is whether any further sanction is required.  If it is, then the available sanctions have to be considered in an ascending order of seriousness until one that sufficiently addresses the proper sanction goals is reached.
• As the finding against Mrs Garner was one of lack of competence, the sanction range ends with the making of a suspension order.  The sanction of a striking-off order is not available.


6. Having considered the matter by reference to the approach already described the Panel initially considered whether Mrs Garner’s fitness to practise is still impaired.  The conclusion of the Panel is that her fitness to practise is still impaired for the following reasons:


• Mrs Garner has not fully reflected on her interaction with Patient A, and in particular has not arrived at a full understanding as to how her clinical relationship with him went astray.  The Panel considered that, in her oral evidence Mrs Garner demonstrated an inability to conceptualise the therapeutic relationship from Patient A’s perspective.  It follows that she has not come to a full understanding of what happened with regard to that patient in 2012.
• The Reflective Statement prepared by Mrs Garner fails to demonstrate how the theoretical knowledge she has acquired applies to the shortcomings identified by the final hearing Panel.
• Further, the opinion of a Clinical Psychologist on her Reflective Statement has not been obtained by Mrs Garner.  In the judgement of the Panel there remains a risk of repetition unless and until that step is taken.
• Her self-reflection has not been complete, and in particular she has failed to grasp the relevance to her professional practice of therapeutic steps she has taken during 2015, evidence of which was given by Mrs Garner in a private session of the hearing today.
• It follows from these findings that although the breaches identified by the final hearing Panel are capable of remediation, and the Panel accepts that Mrs Garner has made some efforts towards achieving remediation, nevertheless at the present time they have not been fully remediated.


7. Having concluded that Mrs Garner’s fitness to practise remains impaired, the Panel considered whether a sanction remains necessary.  The conclusion of the Panel is that a sanction continues to be necessary because there is an on-going risk to service users and others as a result of the incomplete understanding of what went wrong.  In the judgement of the Panel neither the risk to service users and others nor the wider public interest considerations would be adequately addressed by the imposition of a caution order.


8. The Panel has concluded that the circumstances require the imposition of a further CoPO.  The full terms of the Order that will be made with immediate effect are set out below, but it is necessary for the Panel to give some narrative explanation of what the Order is designed to achieve:


• Mrs Garner has prepared a Reflective Statement but not obtained the opinion of a Clinical Psychologist on it and the conditions have been re-worked to reflect this position.  This reflects the Panel’s view that Mrs Garner has not fully applied her theoretical knowledge demonstrated by the existing Reflective Statement to the circumstances that existed with Patient A, new condition (1) is required.
• The risk to service users requires the Panel to prohibit Mrs Garner from working as a sole practitioner (condition 2).
• New conditions (3), (4) and (5) are substantially the same as conditions previously imposed with minor drafting changes. Condition (6) remains unchanged.


9. The Panel has determined that the appropriate length of this new CoPO is 6 months on the basis that the steps required to be taken by the terms of it should be achievable before any review of it takes place.  However, if Mrs Garner is of the view that she has achieved what is required of her significantly before the automatic review will take place, it is open to her to request an early review of the Order.

Order

Order:  The Registrar is directed to annotate the Register to show that for a period of 6 months from today’s date, namely 24 November 2015, you, Mrs Kiran Garner, must comply with the following conditions of practice:


(1) You must seek the opinion of a Clinical Psychologist on the Reflective Statement you have already prepared and submitted to the HCPC.  In conjunction with the Clinical Psychologist you should prepare an updated reflective statement demonstrating your ability to apply the theoretical knowledge you have to your experiences with Patient A.   The Clinical Psychologist must not be someone with whom you have previously worked or been supervised by.


(2) You must not undertake clinical work with clients as a sole practitioner.


(3) To the extent that you undertake clinical work with clients, you must receive clinical supervision from a Clinical or Counselling Psychologist, and you must provide a report from your supervisor to the HCPC Review Panel.


(4) You must promptly inform the HCPC if you take up any employment other than self-employment for which your HCPC registration is required.


(5) You must inform the following parties that your registration is subject to these conditions:


a. Any practitioner or organisation employing or contracting with you to undertake professional work for which your HCPC registration is required;
b. Any agency you are registered with (at the time of registration);
c. Any prospective employer (at the time of your application).


(6) You will be responsible for meeting any and all costs associated with complying with these conditions.

Notes

This Order will be reviewed before it expires.

Hearing History

History of Hearings for Mrs Kiran Garner

Date Panel Hearing type Outcomes / Status
24/11/2015 Conduct and Competence Committee Review Hearing Conditions of Practice