Ms Annia Katarina Elsesser

Profession: Social worker

Registration Number: SW76490

Hearing Type: Final Hearing

Date and Time of hearing: 09:00 14/06/2016 End: 16:00 16/06/2016

Location: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

Please note that the decision can take up to 5 working days to be uploaded onto the HCPTS website. Please contact one of our Hearings Team Managers via tsteam@hcpts-uk.org or +44 (0)808 164 3084 if you require any further information.

 

Allegation

 

In the course of your employment as a Social Worker for the London Borough of Islington:

 

1. On or around 25 October 2012, you gave unauthorised access to confidential information to a third party in that you:

a. Allowed the third party to view the information of a service user on the local authority's computer system without seeking the appropriate consents; and/or

b. Allowed the third party to stay unsupervised in the office.

 

2. In relation to the relative of service user A, your actions fell below the required standard in that:

a. You did not respond to some of her telephone calls in a timely manner and/or

b. You did not provide her with the care plan and/or support plan within the required timescales.

 

3. On or around 12 October 2012 you made the following inappropriate comments to an employee at the Bremerton Estate Office:

a. 'British people are so lazy' or words to that effect;

b. 'No wonder England is at the bottom of the heap, as no one wants to work' or words to that effect and

c. 'Person B is a very lazy boy' or words to that effect.

 

4. You made inappropriate entries on service users' case files in that:

a. On 5 August 2012, you wrote: 'A great deal of time wasted this morning trying to complete work on a deceased service user. I completed the risk assessment but there is another risk

assessment on screen which has been aborted and which needs to be removed from IAS, IN ORDER FOR ME TO PROCEED TO THE NEXT STAGE , that is the Case Conference. I have alerted HASS SUPPORT, Colleague A' or words to that effect; and

b. On 8 August 2012, you wrote: 'Dear, I despair what a terrible system. I tried this morning with person C, to start a safeguarding alert but not possible. Yes if there is problem with draft support plan, cannot proceed with anything else. I want the support plan to be closed, whatever person D is doing, and I need to do my work. Why is the support plan in draft form when this was approved months ago? If you reassign it will have to be finalised once again by manager. I cannot waste more time. I need to amend support plan to include shopping Thanks' or words to that effect.

 

5. On or around 16 October 2012, you received a safeguarding alert regarding service user E and you did not escalate this alert with your manager within the required timescales.

 

6. The matters described in Paragraphs 1 to 5 constitute misconduct and/or lack of competence.

 

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

Finding

Preliminary matters:

Service

1.     The Panel was satisfied on the documentary evidence provided, that the Registrant, Ms Annia Katarina Elsesser, had been given proper notice of this hearing in accordance with the Rules. Notice of this hearing was sent by first class post to her address on the Register by letter dated 17 March 2016. The notice contained the relevant required particulars.

 

Proceeding in Absence

 

2.     The Panel heard the application from Ms Portas, on behalf of the HCPC, to proceed in the absence of the Registrant.

 

3.     The Panel heard and accepted the advice of the Legal Assessor, who advised that the discretion to proceed in the absence of the Registrant was one that must be exercised with the utmost care and caution.

 

4.     Having considered the circumstances the Panel determined to proceed in the absence of the Registrant. The reasons are as follows:

 

*   Service of the appropriate notice of this hearing has been properly effected.

 

*  The Registrant has not been in contact with the HCPC at any stage of these proceedings. ,It follows that the Registrant has not requested adjournment, nor would the Panel suppose that ,there would be any greater chance of the Registrant attending in the future were it to adjourn.

 

*  There is a public interest in proceeding. The allegation dates back to 2012. The Panel was aware that there were two witnesses who were in attendance to give evidence and was mindful of the impact on the witnesses if it did not proceed and that memories fade with the passage of time.

 

*   In all the circumstances the Panel was of the view that the Registrant knew or ought to have known of today’s hearing and has voluntarily chosen not to attend.

 

 

Application to amend charges

 

5.     At the outset of the hearing, Ms Partos made an application, on behalf of the HCPC, to formally amend the allegation, in the terms proposed. The proposed amendments were:

 

·          from the stem of particular 2, to delete the words ‘your actions fell below the required standard in that’ and,

 

·          in relation to particular 4, to set out the wording of the entries in the electronic records in schedules, rather than in the body of the particular itself.

 

6.     She submitted that the Registrant had been put on notice of the proposed amendments on 19 May 2015, which neither changed the mischief nor the substance of the particulars. She said that there had been no response to the proposal from the Registrant.

 

7.     The Panel heard and accepted the advice of the Legal Assessor.

 

8.     The Panel was of the view that the deletion from particular 2, of the phrase ‘your actions fell below the required standard in that’, was appropriate as this was the assessment which would fall to the Panel to make in due course, in light of the evidence. The deletion would not adversely affect the case against the Registrant. It was also of the view that the setting out of the wording of the entries in schedules A and B, rather than in particular 4 itself, did not affect the nature of the allegation.

 

9.     In light of the above, the Panel decided to allow the amendments, as to do so did not result in any unfairness to the Registrant.

 

Background

 

10.    The Registrant had qualified as a Social Worker in 1987 and had been employed by the London Borough of Islington (the Borough) for 26 years, lately in the Adult Social Care Service. At the relevant time, the Registrant was working in the On-going Support and Review Team for the Borough. In this role, she was responsible for adults with physical disabilities and older people.

 

11.   Concerns initially came to light regarding the Registrant’s practice in October 2012, and she was suspended on 1 November 2012 pending an investigation. In December 2012, witness 2, the Service Manager for the Multi-Disciplinary Locality Teams within the Housing and Social department for the Borough, was asked by SG, Service Director of Adult Social Care at the Borough to investigate those concerns. As part of her investigation she conducted a number of investigatory interviews with members of staff. She also conducted a number of investigatory interviews with the Registrant. She prepared a Disciplinary Investigation Report, completed 24 May 2013. It is this report which provides much of the evidence upon which the HCPC relies.

 

12.   The particulars relate to August and October 2012, and involve allegations of:

 

·     permitting unauthorised access to a service user’s electronic case file by a professional third party;

 

·     not responding to a Service User’s request for information in a timely manner;

 

·     making inappropriate comments to a caretaker when seeking assistance for delivery of furniture to a service user;

 

·     recording inappropriate entries, which complain about deficiencies in the electronic recording system, in service users’ electronic case files;

 

·     and not escalating a safeguarding alert to a manager within required timescales, which had been received from a Hospital in respect of a service user who had been admitted there.

 

13.   The matter was referred to the HCPC in July 2014, by witness 2.

 

Decision on facts

14.   On behalf of the HCPC, the Panel heard evidence from:

 

·          witness 1 – an HCPC registered Social Worker who, at the relevant time, was the Strategic Social Worker Lead for Integrated Community Services at the Borough, who was acting as the Principal Social Worker across Adult Social Care and Learning Disability services in Islington.

 

·          witness 2 – an HCPC registered Social Worker who, at the relevant time, was employed as the Service Manager for the Multi-Disciplinary Locality Teams within the Housing and Social Department for the Borough. She was in post from 26 November 2012, and from 13 December 2012 became the Investigating Officer for the internal investigation into the Registrant.

 

15.   The Panel heard and accepted the advice of the legal assessor. The Panel understood that the burden of proving each individual fact rests always on the HCPC and that the HCPC will only be able to prove a particular, if it satisfies the required standard of proof, namely the civil standard, whereby it is more likely than not that the alleged incident occurred.

 

16.   The Panel found the evidence of witness 1 to be credible, but it was limited, particularly in relation to the wider circumstances of the team. Witness 1 had recently returned from a period of 14 months’ maternity leave, when she joined the team in October 2012 and was given temporary responsibility for supporting the team until the newly appointed Service Manager came into post on 26 November 2012. Her evidence was directly relevant to the incident on 25 October 2012, the subject of particular 1.

 

17.   In relation to witness 2, the Panel found that she had conducted a thorough investigation, whereby she interviewed members of the staff, and complied a comprehensive report. However, the Panel found that it should treat her oral evidence with caution. This was because it took the view that she was somewhat defensive when giving her live evidence to the Panel. There were a number of occasions when, under questioning, she had a tendency to alter her position so as to defend her employer’s position. For example, in relation to Panel questions as to the period of time it took the Registrant to send out the care plan, Witness 2 initially said it was four days (which she considered unreasonable). She then said that the weekend should also be counted in the time frame, which would make it 5 days. She later went on to suggest that the care plan had never been sent out following the assessment in 2011, and so the delay was, in fact, a year and four days. This was a position which the HCPC had never sought to advance.

 

18.   The Registrant did not attend, but the Panel did not hold her non attendance against her and scrutinised all of the evidence objectively.

 

Particulars 1(a) and 1(b)

19.   The Panel found both 1(a) and 1(b) proved.

 

20.   The Panel had regard to the first hand evidence of witness 1. She described that on 25 October 2012, she was sitting in the main team room when she saw someone she did not recognise sitting at the Registrant’s desk, looking at the computer and accessing a service user’s records. This person identified herself as an Independent Mental Capacity Advocate (IMCA).

 

21.   The Panel had regard to the ‘Islington Staff Guidance (on the Application of the Mental Capacity Act 2005)’ (the Guidance) and in particular, where it covers access to information by an IMCA. It states:

 

·          Although an IMCA is entitled to access relevant social and health care records you still need to comply with the Data Protection Act and the council’s policies and procedures when you provide this information. For example you must ensure:

 

o    you never allow an IMCA access to our electronically held records eg IAS;

o    you ensure that IMCA’s are supervised at all times when in a council building and never allowed unsupervised access to client information;

 

 

22.   In relation to particular 1(a), the Panel was mindful that the wording of this particular included the words ‘…without seeking the appropriate consents’. The Panel noted that the Guidance was not explicitly framed in terms of ‘consent’, and the Panel had not received any specific oral or documentary evidence of what constituted ‘appropriate consents’.

 

23.   The Panel took into account that although the Guidance explicitly prohibited allowing an IMCA access to the Borough’s electronically held records, the evidence of witness 2 was that custom and practice did allow for such access in certain situations, notwithstanding the Guidance. Witness 2 gave the example of a large volume of information which would be impractical to print off. In such a situation she explained that arrangements might be made to allow for the IMCA to visit the offices to view specific information in a secure setting. In such a case, she said that the Social Worker should first obtain appropriate consent, which would involve, in the first instance, seeking authorisation from their line manager. The Panel noted that this process was not set out in any Borough policy document placed before it.

 

24.   However, the Panel also took account of the responses of the Registrant recorded in her investigation interview with witness 2. The Registrant stated: ‘I am afraid I did not think properly about the steps to be taken prior to showing any case records. I acted on impulse after I remembered the advice of the previous service manager (…). I should have had time for reflection. I should have been more prepared. I should have asked for permission from Housing, home carers, for permission to access their material on the IAS Data Base’. In light of this, the Panel was satisfied that the Registrant had not sought permission from her line manager to allow the IMCA access to the electronic files and therefore that she had not obtained the appropriate consents.

 

25.   The Panel then referred back to the stem of the particular, to consider whether this amounted to giving ‘unauthorised access’. The Panel accepted that the evidence showed that there had been a high level of management turnover in the previous year within the service, and different managers may have had different practices and procedures. Witness 1 had reported a conversation with the Registrant at the time, where the Registrant stated that previous managers had permitted the practice of allowing IMCAs to access the electronic files.

 

26.   The Registrant in her own interview acknowledged that although she had been advised by a previous manager to allow access to IMCA workers, ‘It would have to be discussed with the manager.’ Given that the Registrant accepted that she had not turned her mind to discussing access by the IMCA with the manager, and had not discussed it with her, the Panel was satisfied that the Registrant had given ‘unauthorised access’.                                                                                                                                                                                                                                                                                           

 

27.   In relation to particular 1(b), the Panel accepted the evidence of witness 1 that she had come across the IMCA alone at the Registrant’s desk. It also took account of the Registrant’s admission in the interview that, on reflection, she could not remember clearly whether she had left the IMCA on her own. She said ‘I may have pop out into the reception for a few minutes. I certainly leave the IMCA worker on her own when I was call into a meeting room to speak to MW and CR. It is possible that another service user, (…) pop into the office and I was asked by the receptionist to deal with it’. Although the IMCA herself was interviewed by witness 2, and her recollection had been that the Registrant had been present throughout, she did concede that the Registrant may have gone to get a drink or to the toilet. In the circumstances, the Panel was satisfied that the Registrant had allowed the IMCA to stay unsupervised in the office.

 

28.   Referring back to the stem, given the previous finding that the Registrant had not turned her mind to the steps to be taken prior to showing any case records, the Panel was satisfied that this amounted to giving ‘unauthorised access’ to confidential information.

 

Particulars 2(a) and 2(b)

29.   The Panel found both 2(a) and 2(b) not proved.

 

30.   The Panel noted that the terms of 2(a) related to unspecified, undated telephone calls, and there was little specific evidence of not responding to telephone calls. It took account of the complaint letter sent by the relative of servicer user A, which made only passing reference to the Registrant not responding to messages. The relative gave no details, and in the Panel’s view, the issue of unreturned phone calls was not the substance of the relative’s complaint.

 

31.   Witness 2, in her statement said ‘I cannot recall the dates of the further telephone calls from [the relative] to [the Registrant]. I am unsure whether [the Registrant] responded to these telephone calls’. In her oral evidence, witness 2 accepted that she could not recall whether there were, in fact, any telephone calls at all, let alone whether there were any telephone calls which were not responded to.

 

32.   The Panel therefore concluded that it could not be satisfied that the Registrant had not responded to some of the relative’s telephone calls in a timely manner.

 

33.   In relation to particular 2(b), the Panel was mindful that it was only during witness 2’s oral evidence, that the suggestion was made that service user A’s care plan had not been provided to the family at all, following the assessment on service user A, which had taken place in 2011. This was not how the HCPC had presented its case, nor was it how the matter had been investigated in the internal investigation. In light of this, the Panel interpreted the timescale for providing the care plan, as starting from 11 October 2012, which was the date on which the relative of service user A requested a copy of the care plan.

 

34.   The Panel noted that 11 October 2012 was a Thursday. The Panel saw a copy of the recorded delivery slip, which showed that a copy of the care plan was sent to the relative of service user A by recorded delivery on 16 October 2012, which, the Panel noted was a Tuesday. The Panel also took into account that the Registrant was off work, due to sickness, on Monday 15 October 2012.

 

35.   The Panel did not accept witness 2’s evidence that the days of a weekend should be treated as working days. Whilst it recognised that the service may be a 7 days’ a week service, it was not satisfied that this would mean that the Registrant would be working 7 days’ a week. The Panel noted that the Customer Service Document to which it had been referred, did not specify a required timescale in which to provide requested written documentation. It therefore applied it’s own objective assessment as to what would be a reasonable timescale. It considered that the timescale, which included the weekend and a day when the Registrant was off work, was both acceptable and reasonable.

 

Particulars 3(a), 3(b) and 3(c)

 

36.   The Panel found particulars 3(a) and 3(c) not proved and particular 3(b) proved.

 

37.   In relation to particular 3(a), the Panel noted that it had not seen a copy of the original complaint submitted by person B’s line manager, MH, The Panel had not heard direct evidence from either Person B or MH. The evidence came from the notes of the investigation interviews held by witness 2 with both MH and person B. The Panel noted that person B had refused to sign those notes or to make any amendments to them  as he did not want to continue engaging with the process, and so there was no confirmation from person B as to the accuracy of the notes of interview.

 

38.   Person B described the Registrant as ‘very upset, not aggressive, but unhappy’ when he refused to help with the furniture, as it was not part of his duties. The extent of what he alleged that she had said to him was: ‘people are so lazy’ and ‘I was a lazy boy’. He did not allege that the Registrant had said ‘British people are so lazy’, as set out in the particular. The support worker to whom person B spoke on the telephone at the time to ascertain his duties, described that she could hear the Registrant shouting, but not what was being shouted. It seemed to the Panel that the word ‘British’, had come from MH who was reporting what person B had told him.

 

39.   The Registrant, in her written response to the complaint, dated 18 October 2012, admitted that she thought she had said that ‘the problem was laziness’. The Panel was satisfied that the Registrant had used words to the effect of ‘the problem was laziness’ but was not satisfied that she had said to him ‘British people are so lazy’.

 

40.   The Panel went on to consider whether ‘the problem was laziness’ constituted words to the effect of ‘British people are so lazy’. The Panel was of the view that they did not, because the addition of the word ‘British’ had connotations of a racial element, which the Panel was not satisfied was present in a more general phrase about laziness.

 

41.   In relation to particular 3(b), the Panel noted that neither person B, nor MH, had alleged that the Registrant had said ‘No wonder England is at the bottom of the heap, as no one wants to work’. However, the Registrant in her interview said that she had felt intimidated by person B, had become exasperated and had said ‘no wonder England is at the bottom of the heap, as no one wanted to work’. She said that she had wanted him to know that he had been really unhelpful and she was ‘very sorry’ about it. Given the Registrant’s own admission as to her words, the Panel was satisfied that she had said words to the effect of ‘No wonder England is at the bottom of the heap, as no one wants to work’.

 

42.   The Panel next considered whether this comment was inappropriate, as alleged in the stem. The Panel was of the view that the comment was unprofessional, said in anger and could have caused offence, albeit person B said he was not offended. The Panel was satisfied that the Registrant had lost her temper, but as a professional, she would be expected to manage her emotions and de-escalate the situation. In all the circumstances, therefore, the Panel was satisfied that the comment was inappropriate.

 

43.   In relation to particular 3(c), and for the same reasons as for 3(a) above, the Panel was satisfied that the Registrant had used words to the effect of ‘the problem is laziness’. However, it was mindful that she had denied that she had used more personal language to describe person B’s laziness. In the absence of other evidence to assist with what words were used by the Registrant, the Panel could not be satisfied that the Registrant had said ‘person B is a very lazy boy’. It also concluded that the words the Registrant admitted using were not words to the effect of ‘person B is a very lazy boy’, because they were not personalised.

 

Particulars 4(a) and 4(b)

44.   The Panel found both 4(a) and 4(b) proved.

 

45.   In relation to particular 4(a), the Panel noted that the email document, in which the manager had cut and pasted the relevant entry by the Registrant from service user C’s electronic records, had the date as 5 August 2011. The particular itself, and all other references to the entry in the evidence, including witness 2’s statement, had the date 5 August 2012. The internal investigation had also proceeded on the basis that the date was 5 August 2012. However, in her oral evidence, when asked about the conflicting years in the date, witness 2 said that this was a computer generated date, rather than being typed in incorrectly by a member of staff, effectively suggesting that the entry was made in 2011. The Panel was not persuaded by this explanation. Although it did not have the original electronic records, the Panel was of the view that it was more likely than not, that the date had been added by the manager, to show the source and reference of the electronic entry to his line manager, and the incorrect year had been typed in, in error.

 

46.  In any event, the Panel considered, on the Legal Assessor’s advice, whether the precise year of the date was a material part of the particular. The Panel concluded that it was not. This was because the Panel was satisfied that there had been no confusion about the date by the Registrant when she had been questioned by witness 2, and her understanding of the substance of the allegation was clear. At no stage did the Registrant deny that she had made the entry. She said: ‘My intention was to portray the difficulties when I am trying to to input relevant information on IAS’. The Panel was satisfied that the Registrant had made the entry.

 

47.   Referring back to the stem, the Panel was satisfied that the entry was ‘inappropriate’. The Panel was of the view that a service user’s records should be focussed on the issues pertaining to the service user and not on organisational issues or problems. The Panel was also of the view that if the Registrant had any issues with the electronic recording system, then she should address, or continue to address them in a different and more appropriate way.

 

48.   In relation to particular 4(b), the Registrant did not deny that she had made the entry, she said: ‘The email (…) is not offensive, it gives an indication of the urgency of my situation, how the system is failing, why I am being prevented from doing my work. (…) It indicates the pressure I am under for work to be finished as soon as possible.’ The Panel was satisfied that she had made the entry.

 

49.   Referring back to the stem, the Panel was satisfied that the entry was ‘inappropriate’ for the same reasons given for 4(a) above.

 

Particular 5

50.   The Panel found this proved.

 

51.   It was the Panel’s view that the actions which the Registrant took were not necessarily inappropriate, but they were not in accordance with the requirements of the procedure. The evidence showed that a safeguarding alert had been scanned and faxed to the Registrant from the Duty Team about service user E on 15 October 2012. It had been received from the Hospital by the Duty Team, as the Registrant had not been at work on that day due to sickness. A file note entry, dated 16 October 2012, made by the Registrant on her return to work that day, makes reference to the alert and other matters relevant to service user E. The Panel was therefore satisfied that the Registrant was aware of the alert, but did not escalate it to her manager within the 24 hours as required by the policy.

 

Decision on Statutory Grounds

52.   The Panel next considered whether the facts found proved as set out above, amounted to misconduct and/or lack of competence, and if so, whether by reason thereof, the Registrant’s fitness to practise is currently impaired.

 

53.   Ms Partos submitted that each of the allegations effectively amounted to misconduct on the part of the Registrant. She submitted that there were a number of breaches of the relevant standards. She submitted that it was the HCPC’s position that all of the particulars fell short of the standards to be expected of a Social Worker.

 

54.   The Panel heard and accepted the advice of the legal assessor. The Panel was aware that any findings of misconduct and/or lack of competence were matters for the independent judgement of the Panel.

 

55.   The Panel was aware that consideration of impairment only arises in the event that the Panel judges that the facts found proved do amount to one or both of the statutory grounds and that what has to be determined is whether there is current impairment which is looking forward from today.

 

56.   In the Panel’s judgement, the facts found proved could not appropriately be categorised as amounting to a lack of competence. The Panel did not consider that they represented a fair sample of the Registrant’s work, during which she had persistently fallen below the standards expected of a Social Worker, occurring as they did during a limited period of two months within a career spanning 26 years.

 

57.   In relation to particular 1, the Panel noted that the IMCA was a fellow professional who had an entitlement to relevant information, and who would have had her own responsibilities as to the confidentiality of a service user’s information. The Panel also took account of the fact that witness 1 had completed a data security form at the time, which indicates the level of risk caused by the incident. She had rated the incident as ‘very low risk’ because the IMCA had not been in the office for a substantial amount of time, meaning that her ability to use the system to find information about other service users was limited. She also acknowledged the IMCA’s own responsibilities regarding confidential information. 

 

58.   However, the Panel considered the highly sensitive nature of the information recorded within the electronic records of service users, in this case, service user F. It also considered the fact that the Registrant admitted that she had not addressed her mind to the potential risks of allowing the IMCA unsupervised access, and without having sought her manager’s authority. In light of this, the Panel was of the view that particular 1 was sufficiently serious as to amount to misconduct.

 

59.   In relation to particular 3(b), the Panel was of the view that the Registrant should have remained professional and stayed in control of her emotions. She had accepted that she had spoken in anger, and she was clearly frustrated. However, her comment to person B was, in the Panel’s view, derogatory and judgemental. The Registrant had not met person B before and in her role as a Social Worker, she had the responsibility to try to de-escalate and manage the situation more professionally. In the Panel’s judgment, particular 3(b) was sufficiently serious as to amount to misconduct.

 

60.   In relation to particular 4, although the Panel recognised that the Registrant’s frustrations with the difficulties in the system may have been justified, it considered that this did not justify using service users’ electronic records as a forum to express those frustrations. Whilst the Registrant’s motivation may have been to remove blockages from the electronic system, which hindered efficient work practices, the Panel was of the view that there was an emerging theme of the Registrant using intemperate communications to express her frustration. In the Panel’s judgement, particular 4 was sufficiently serious as to amount to misconduct.

 

61.   In relation to particular 5, the Panel was of the view that the Registrant had made a professional judgement based on her knowledge of the service user. She had not ignored the alert when she had returned to work, but had assessed that this was not a safeguarding issue. On the evidence before it, the Panel was not satisfied that her professional judgement was wrong. She had applied her mind to the situation, the duty team was aware of the alert, as was the Social Work Team Manager at the Hospital which sent the alert. Her error was not to follow the ‘Protecting Adults at risk’ policy and escalate the alert to her manager, whose responsibility it was to confirm the action to be taken and whether or not the alert can be closed as an active safeguarding matter.  Whilst the Panel found that this was an incident of poor practice, it was not, in the Panel’s judgement so serious as to amount to misconduct.

 

62.   The Panel also found that the Registrant had breached the following Standards:

 

 

·  Standards of conduct performance and ethics –

2. you must respect the confidentiality of service users

7. you must communicate properly and effectively with service users and other practitioners

 

·  Standards of proficiency Social Workers in England –

                                          i.    7.1 be able to understand and explain limits of confidentiality

                                         ii.    7.2 be able to recognize and respond appropriately to situations where it is necessary to share information to safeguard service users and carers or others

                                        iii.    8.1 be able to use interpersonal skills and appropriate forms of verbal and non-verbal communication with service users, carers and others

                                        iv.    8.2 be able to demonstrate effective and appropriate skills in communicating advice, instruction, information and professional opinion to colleagues, service users and carers

                                         v.    9.1 understand the need to build and sustain professional relationships with service users, carers and colleagues as both an autonomous practitioner and collaboratively with others

                                        vi.    9.6 be able to work in partnership with others, including those working in other agencies and roles

                                       vii.    10.2 recognise the need to manage records and all other information in accordance with applicable legislation, protocols and guidelines

 

 

Decision on impairment     

63 .  Having determined that the Registrant’s actions in particulars 1, 3(b) and 4 amounted to misconduct, the Panel went on to consider whether her fitness to practise is currently impaired as a consequence of that misconduct.

 

64.   Ms Partos submitted that the Registrant’s fitness to practise is currently impaired. She identified the case of Grant and said that it was not the contention of the HCPC that principles (a) (risk of harm to the public) or (d) (dishonesty) were invoked. She submitted that principles (b) (bringing the profession into disrepute) and (c) (breaching a fundamental tenet of the profession) were invoked. She submitted that in the absence of any engagement by the Registrant, the Panel could not be satisfied that there had been adequate insight, remorse or remediation by the Registrant. She effectively submitted that a finding of impairment was required in order to uphold public confidence in the profession.

 

65 .  The Panel accepted the advice of the legal assessor. It had regard to the Practice Note on Impairment, and in particular the two elements of impairment, namely the ‘personal component’ and the ‘public component’

 

66 . The Panel first considered the ‘personal component’.

 

67. In the Panel’s judgement, the Registrant’s misconduct raised a number of issues, in particular in relation to her communication skills, both verbal and written, and also her understanding of the importance of handling sensitive, confidential information.

 

68.  In relation to her communication skills, the Panel was of the view that there was evidence of the Registrant being impulsive and venting her anger and frustration, without thinking of the potential consequences to either colleagues, service users or herself. The Panel considered that particulars 3(b), 4(a) and 4(b) were illustrative of a pattern of such impulsive behaviour, which gave the Panel cause for concern.

 

69 . In relation to her understanding of the importance of handling confidential information, the Panel was of the view that there had been some evidence of analysis and reflection by the Registrant during the course of the internal investigation. Although her initial reaction at the time of the incident and her initial interview had been that she could not see what the problem was, her later reflections sent to witness 2, demonstrated that she had started to understand the potential issues and concerns of allowing unauthorised access to information to a third party.

 

70. The Panel was of the view that communication skills are remediable. The Panel noted that the Registrant had been able to reflect and recognise the issues with unauthorised access to information, and was also of the view that she had the potential to remediate her communication skills. However, in the absence of any engagement with the HCPC during the course of these proceedings, the Panel had no evidence that she had in fact remediated. It also had little or no evidence of any insight the Registrant had into her communication skills, beyond her acceptance in the investigation, that she had behaved in that way. In the circumstances, the Panel was unable to conclude that there was no risk of repetition in the future, particularly if the Registrant were to become frustrated with her working environment.

 

71. The Panel had regard to the context in which the Registrant was working at the time. In relation to the working environment, the Panel took account of the significant amount of evidence to the effect that the service was then a difficult working environment. There had been a high turnover of locum social work and management staff, and at least three members of staff interviewed by witness 2 described very high case loads and low staff morale.

 

 

72. The Panel was of the view that these issues should and could have been picked up and resolved by consistent management, supervision and appraisal, but there were not appropriate systems and personnel  in place at the time for that to happen effectively.

 

73 . However, notwithstanding the working environment, the Panel concluded that this did not detract from the Registrant’s personal responsibility. She was an experienced Social Worker of some 26 years’ experience, who should have been capable of appropriate self control and communication. In the absence of evidence of remediation, in respect of the ‘personal component’, the Panel concluded that the Registrant’s fitness to practise is currently impaired.

 

74. The Panel went to consider the ‘public component’. The Panel agreed with the HCPC position, that this was not a case which involved a risk to public protection. The Panel acknowledged that the evidence supported the position that the Registrant was motivated by wanting to act in the best interests of service users.

 

75.  However, the Panel has already found that there was little evidence of the Registrant’s insight or remediation, meaning that it had been unable to conclude that there was little or no risk of repetition and that the Registrant may resort to intemperate verbal or written communications. In such circumstances, the Panel was of the view that public confidence in the reputation of the profession would be undermined if a finding of impairment were not made in this case. Accordingly, in respect of the ‘public component’ the Panel concluded that the Registrant’s fitness to practise is currently impaired.

 

Decision on sanction

76. Having concluded that the Registrant’s current fitness to practise is impaired, the Panel went on to consider what would be the appropriate, proportionate  and sufficient sanction or other outcome in this case.

 

77 . The Panel accepted the advice of the legal assessor. It had regard to the Indicative Sanctions Policy (ISP) and considered the sanctions in ascending order of severity. The Panel was aware that the purpose of a sanction is not to be punitive, but to protect members of the public and to safeguard the public interest, which includes upholding standards within the profession, together with maintaining public confidence in the profession and its regulatory process.

 

78 . The Panel considered that the following were mitigating factors in this case:

 

a.    The difficulties encountered in the work place, including:

                                 i.   The high case loads;

                                 ii.   The low staff morale;

                               iii.   The high turnover of locum social work and management staff; and

                               iv.   The difficult electronic recording IT system.

b.            The motivation of the Registrant throughout was to try to work in  the best interests of the service users;

c.            The Registrant had 26 years of previous experience of working for the same employer and the Panel had not been told of any other difficulties with the Registrant’s practice.

 

79. The Panel considered that the following were aggravating factors:

·       There had been repetition and what the Panel found to be a pattern of behaviour;

·       The Registrant had demonstrated only a limited degree of self awareness regarding her communication skills and a limited recognition of the issues.

 

80 . In relation to insight, for the reasons previously set out, the Panel had found that the Registrant had demonstrated only limited insight in relation to particulars 3(b) and 4, although the Panel had previously noted that there was some evidence of reflection and insight by the Registrant in respect of particular 1. However, in the absence of any engagement by the Registrant with the HCPC or in these proceedings, the Panel had no information as to her current level of insight in respect of her behaviour, which was the subject of particulars 3(b) and 4 and specifically what recognition she had of the potential impact of her behaviour on public confidence in the profession, and how she might avoid a re-occurrence of such behaviour in the future.

 

81 . The Panel does not consider the option of taking no further action to be appropriate or proportionate in the circumstances of this case. It would not address the identified risk of repetition.

 

82 . The Panel does not consider that a Caution Order would meet the criteria as set out in paragraph 22 of the ISP. This was not an isolated incident, albeit it occurred over a limited period of two months. There was a pattern of behaviour, coupled with a risk of recurrence. The Registrant had shown limited insight and there was no evidence of remediation.

 

83. The Panel next considered a Condition of Practice Order, and was of the view that paragraph 24 of the ISP was relevant. The Panel had identified that the behaviour was capable of remedy, there was no risk of harm to service users, and the Panel had previously found that the Registrant had the potential to develop insight. The Panel considered that a Conditions of Practice Order was the appropriate and proportionate response. It would be for a period of 12 months as this would provide the opportunity and framework within which the Registrant could develop good insight and fully remediate her behaviour.

 

84. The Panel therefore decided to impose a Conditions of Practice Order.

 

Order

 ORDER: The Registrar is directed to annotate the Register to show that for a period of 12 months from the date on which this Order comes into effect (‘the Operative Date’), Ms Annia Katarina Elsesser, must comply with the following conditions of practice:

 1.    You must work with a workplace supervisor, registered by the HCPC or other appropriate statutory regulator, to formulate a Personal Development Plan designed to address the following areas:

 A.     Management of self;

B.     Communication, both verbal and written;

C.     Protection of confidentiality;  

2.       Within 3 months of the Operative Date, or of obtaining employment as a Registered Social Worker, if not currently employed as such, you must forward a copy of your Personal Development Plan to the HCPC.

 

3.          You must meet with your workplace supervisor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan. This can be included within normal supervision meetings.

 4.          You must obtain a report from your workplace supervisor, regarding your progress towards achieving the aims set out in your Personal Development Plan and submit it to the HCPC before the Order is to be reviewed.

 5.            Before this Order is reviewed, you must submit to the HCPC a reflective piece, written by you, which demonstrates your understanding of your personal responsibility for, and the consequences of, the issues found proved in this case.

 6.            You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.

 7.            You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

 8.                     You must inform the following parties that your      registration is subject to these conditions:

 A.      Any organisation or person employing or contracting with you to undertake professional work;

B.      Any agency you are registered with or apply to be registered with (at the time of application); and

C.      Any prospective employer (at the time of your application).

Notes

The order imposed today will apply from 14 July 2016. This order will be reviewed again before its expiry on 14 of July 2017.

The Panel imposed an Interim Conditions of Practice Order to cover the appeal period.

Hearing History

History of Hearings for Ms Annia Katarina Elsesser

Date Panel Hearing type Outcomes / Status
01/06/2018 Conduct and Competence Committee Review Hearing Struck off
13/06/2017 Conduct and Competence Committee Review Hearing Suspended
14/06/2016 Conduct and Competence Committee Final Hearing Conditions of Practice