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(as proved at the final hearing on 25 October 2013)
During the course of your practice as an Occupational Therapist at Bristol City Council, between July 2010 and April 2012:
1. You did not display appropriate communication skills in that:
a) you did not demonstrate effective verbal and non – verbal communication skills appropriate to the situation
b) you did not demonstrate effective listening skills, including observing non-verbal cues from service users and their family members
c) you did not adequately explain to service users the reason for obtaining consent and the purpose of assessments, home visits and interventions.
2. You did not manage your case load in that:
a) you were unable to manage a full case load
b) you were unable to practise unsupervised.
3. You failed to demonstrate appropriate clinical reasoning and problem solving skills in that you:
a) did not clearly establish the nature of the problems that prompted the referrals
b) offered solutions to service users without fully establishing what the problem was
c) asked for service users' medical history but did not understand the implications of medical conditions
d) did not demonstrate appropriate knowledge and understanding of equipment.
4. You performed inappropriate assessments and/or clinical interventions, in particular:
a) on 24 August 2011 you:
i. not proved
ii. failed to ask Service User A about their skin integrity.
b) On 25 January 2012 you:
i. made limited records during the visit with service user B
ii. not proved
iii. not proved
iv. did not comment on or explain the potential hazards in relation to the missing footplates from Service User B's wheelchair.
c) On 30 March 2012 you:
i. did not demonstrate awareness of service user C’s pain levels and/ or exhaustion
ii. did not expand on questions and/ or did not ask questions in any clear order giving the impression of a lack of focus and clear purpose
iii. asked unnecessary questions where the information was already available on PARIS.
d) On 2 April 2012 you:
i. did not engage fully with service user D and did not notice that service user D seemed to be tiring
ii. not proved
iii. not proved
iv. measured service user D for a new chair inaccurately in that you measured the existing chair and not Service User D.
5. The matters set out in paragraphs 1 - 4 constitute misconduct and/or lack of competence.
6. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
1. Ms Dawn Ebanks on behalf of the Council referred the Panel to the previous Panel’s written determination of 25 October 2013 and drew the Panel’s attention to the findings of that Panel, the resulting finding of impairment and that Panel’s reasoning for the imposition of a Suspension order for 12 months. The proven lack of competence occurred between August 2011 and April 2012 whilst the Registrant was an Occupational Therapist (OT) at Bristol City Council. The Registrant, who had qualified in 2007, was found to have been in breach of applicable HCPC Standards of Conduct and –
• not to have appropriate communication skills;
• not to have managed her case load;
• to have failed to demonstrate appropriate clinical reasoning and problem solving skills; and
• to have performed inappropriate assessments and/or clinical assessments in respect of four service users.
2. The Order of Suspension was reviewed and extended on 19 November 2014 and again on 30 April 2015.
3. The Panel was satisfied on the documentation that the notice of hearing had been properly served by recorded delivery upon the Registrant in accordance with the HCPC Practice Note “Service of Documents” August 2012.
4. Ms Ebanks applied for the review hearing to proceed in the absence of the Registrant pursuant to rule 11 of the HCPC (Conduct and Competence) (Procedure Rules) 2003. She referred the Panel to the fact that, on 16 October 2015, the Registrant confirmed by email that she would not be attending this review hearing and that the Registrant had sent a bundle of documentation, including her written submissions to be considered by the review Panel. The Panel carefully considered the circumstances and the HCPC Practice Note “Proceeding in the Absence of the Registrant” August 2012. The Panel determined that the Registrant had voluntarily absented herself and there was no significant risk of injustice if the review hearing proceeded. The Panel further determined that the interests of justice required this review hearing to proceed in the Registrant’s absence.
5. Ms Ebanks submitted that it was a matter for the Panel to consider whether the evidence submitted by the Registrant, together with the Registrant’s written submissions, demonstrated that the Registrant’s knowledge and skills were now sufficient so that she could practise without further restriction.
6. The Panel took into account all the evidence before it and the oral and written submissions made, and accepted the Legal Assessor’s advice.
7. In this case, the Registrant’s proven lack of competence had been wide-ranging. The Panel was particularly concerned that the Registrant had been unable to handle her case load, which had manifested itself in a number of specific failings.
8. The Registrant had submitted a helpful bundle of sample OT assessments and intervention reports which goes some way to demonstrating some improvement in her clinical reasoning. However, the Panel was not satisfied that they provided clear evidence of working autonomously or of satisfactory competence in, for instance, managing a case load in a demanding working environment. There were no up to date references from managers or supervisors in her current employment. The Registrant had been unable to find an OT mentor to assist her to address her deficiencies. In these circumstances the Panel was not satisfied that the Registrant had remediated her competence in all the areas that had been found deficient. Therefore, the Registrant’s fitness to practise currently remains impaired.
9. The Panel next considered what, if any, sanction was appropriate and proportionate in this case.
10. No further action or the imposition of a Caution Order would fail to promote adequate protection of service users and would not address the wider public interest of maintaining public confidence in the profession. Both of these options were therefore rejected.
11. The Panel considered the imposition of a Conditions of Practice Order, but could not be satisfied that workable and measurable conditions could be drafted to sufficiently address the Registrant’s competency failings. The Panel therefore also rejected a Conditions of Practice Order as being sufficient and proportionate.
12. The Panel moved on to consider extending the present Suspension Order. The Panel determined that it would be sufficient and proportionate to extend the present Suspension Order for six months in order to protect service users and the wider public interest. This period was the minimum necessary to allow the Registrant to gather and present evidence to the next review Panel that she has adequately remediated the identified deficiencies in her competence as an OT.
13. The Panel noted that on this occasion it could not address a Striking-off Order because the Registrant had not yet been suspended for a continuous period of two years, but that the next review Panel would have the power to make that Order if it considered no lesser sanction was sufficient and proportionate.
14. The Panel reviewing this order may be assisted by the following:
a. the Registrant’s attendance at the hearing;
b. a report from a registered OT mentor in relation to a personal development plan aimed at enabling the Registrant to demonstrate her fitness to practise;
c. up to date references from current managers or supervisors from any paid or voluntary work undertaken by the Registrant. Such references should address, but not be restricted to, time-management, communication, ability to manage competing demands, and note-taking.
The Order will be reviewed by 22 May 2016.
This was a Conduct and Competence Review Hearing held at the HCPC on the 23 October 2015.
History of Hearings for Anne Allardice
|Date||Panel||Hearing type||Outcomes / Status|
|22/04/2016||Conduct and Competence Committee||Review Hearing||Struck off|
|23/10/2015||Conduct and Competence Committee||Review Hearing||Suspended|