Ms Sarah Sikpa
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Between 20 March 2014 and 4 August 2014, while working as a
Practitioner Psychologist at Cambridgeshire and Peterborough NHS
Foundation Trust on behalf of the Cambrian Group, you:
1. Did not appropriately record any clinical contact and/or record case notes with the required timescales for:
a. Service User A
b. Service User B
c. Service User C
d. Service User D
e. Service User E
f. Service User F
g. Service User G
h. Service User H
i. Service User I.
2. The matters described in paragraph 1 constitute misconduct and / or a lack of competence.
3. By reason of your misconduct and/or lack of competence, your fitness to practise is impaired."
1. The Registrant was employed by the Cambian Group as a Senior Psychologist in the Child Exploitation Service from March 2014 to May 2014 as a locum for three days a week before moving to a permanent, full time contract with the company in May 2014, until her resignation in August 2014.
2. The service contains a number of residential homes which each look after up to five LAC female children who have experienced child exploitation or child trafficking. As the Senior Psychologist, the Registrant was responsible for overseeing the clinical care of service users in two of the homes. She was expected to work autonomously and provide consultation and training to care home staff. She undertook individual work with the service users, including assessments and intervention when required, and was responsible for liaising with all parties involved, such as the Local Authority, Health Care etc, in order to coordinate the clinical care of the service users. She was also the supervisor of a Psychology Assistant.
3. At the end of July 2014 a service user absconded and her whereabouts were unknown. The Registrant was the allocated psychologist for the missing child. Witness 1 called the Registrant on 31 July 2014, requesting her to meet at the Residential Home to urgently review the clinical input. Although the Registrant initially said that she was unavailable, when pressed she later agreed and met Witness 1 at the home. Witness 1 requested that she and the Registrant review the service user’s file whereupon it became apparent that the Registrant had not made any clinical notes or entries. That prompted Witness 1 to review all the clinical files pertaining to the Registrant’s clinical case load and it became clear that the Registrant had not recorded any clinical notes or entries for any of the Service Users in her care (A – I) since the start of her employment. At that stage the Registrant was suspended and subsequently resigned.
Decision on Facts
4. The Panel heard oral evidence from Witness 1, who until February 2016 was employed as the Clinical Lead at the Cambian Sexual Trauma Service. The Panel also heard oral evidence from the Registrant. The Panel was provided with a Final Hearing Bundle which included the witness statements of Witnesses 1 and 2 and an Exhibits bundle which included all of the exhibits referred to by the witnesses.
5. The Panel considered that Witness 1 gave careful, measured evidence and was credible. The Panel considered that the Registrant was at times evasive and inconsistent. She sought to make excuses for not making appropriate case notes, for example by suggesting that it was the lack of a lap-top, when she could easily have entered handwritten notes into the relevant case files as she claimed to have done in another context. The Registrant could not explain why she was still in email correspondence with her ex-Line Manager at Cambian in September 2014 regarding unfinished case notes, when she had also given evidence that these notes had been emailed to her Line Manager on 31 July 2014. Accordingly, the Panel found that the Registrant was not a reliable witness and preferred the evidence of Witness 1.
6. The Panel accepted Witness 1’s evidence that at her meeting with the Registrant on 31 July 2014 it became apparent that the Registrant had not made any notes in relation to Service User A. The Panel also accepted that Witness 1 reviewed further case notes and it became clear that the Registrant had not recorded any case notes on file for Service Users A to I.
7. The Panel had regard to the contents of the Registrant’s resignation email dated
4 August 2014 in which she wrote, “following a period of reflection, I remain in agreement that it is unacceptable for me to have failed to translate all my case notes into public documents and in a timely manner. This does not reflect my usual standard of practice and was in my view largely the result of not having a working laptop for a few months at the start of my employment and working part time. Nevertheless, in this instance I did not fulfil my duties. Therefore, I believe that it is appropriate for me to submit my resignation effective immediately”.
8. The Panel did not find the Registrant’s evidence that she kept case notes at home as credible. It considered that had that been the case the Registrant would have informed Witness 1 about that at their meeting and returned them to the Service. The Panel was presented with no evidence of note keeping at all and it also considered that whatever pieces of paper which the Registrant may have kept at home, they could not amount to appropriate notes. The overviews presented by the Registrant seriously lacked important information such as dates, places of meetings, conversations or risk assessments that would have indicated appropriate notes having been kept. These overviews were not deemed by the Panel to be an adequate or clinically appropriate record of work with service users over a prolonged period of time.
9. The Panel considered that her admitted failing to translate case notes into case files in a timely manner was not an appropriate standard of practice for a registered Practitioner Psychologist and that her partial admissions fell far short of the facts of her complete lack of making clinical notes on the files.
10. For all of the above reasons, the Panel was satisfied that all of Particular 1 had been proved to the required standard.
Decision on Grounds
11. The Panel considered that as the Senior Psychologist, the Registrant was responsible for overseeing the clinical care of extremely vulnerable young female service users at two different residential homes. The Panel considered that the Registrant’s failings were systematic and prolonged, affecting the records of at least nine extremely vulnerable service users who were at risk. The Panel was satisfied that by failing to record appropriately any clinical contact the Registrant failed to promote and protect the interests of these service users and had failed to keep accurate records which amounted to a serious falling short of Standards 1 and 10 of the HCPC Standards of conduct, performance and ethics and 1b, 2 and
2b.5 of the Standards of proficiency for Practitioner Psychologists.
12. The Panel was satisfied that the Registrant was aware of the required standards and knew that she had breached them. The Panel considered these to be serious breaches which amounted to misconduct and did not amount to lack of competence.
Decision on Impairment
13. The Panel was satisfied that the Registrant’s misconduct had put her service users at unwarranted risk of harm as demonstrated by the lack of appropriate information on file regarding Service User A who had absconded. The Panel was also satisfied that the Registrant had brought her profession into disrepute and had breached fundamental tenets by failing to protect and promote the interests of service users or to keep accurate records.
14. Whilst the Panel accepts that the Registrant has shown some insight, it was not presented with appropriate evidence of remediation such as further courses or supervision. Additionally, the Panel found that the Registrant has failed to demonstrate sufficient insight into the substantial risks to service users, the Public and the Service as a whole as a result of her failure to keep any notes on file. In relation to the Registrant’s employment since the incident, the Panel was only presented with a reference regarding agency work since March 2016 and a potential offer of employment. There was no evidence as to what the Registrant had been doing between August 2014 and March 2016. Accordingly, the Panel was not satisfied that the risk of repetition was low.
15. Taking all matters into consideration, the Panel was satisfied that reasonable members of the public would be alarmed if the Registrant was allowed to continue to practise as a Practitioner Psychologist unrestricted. The Panel concluded that public confidence in the profession and its Regulator would be undermined were a finding of impairment not made.
16. For all these reasons, the Panel found that the Registrant’s fitness to practise is
currently impaired by reason of her misconduct.
Decision on Sanction
17. The Panel considered the submissions made by Mr Foxsmith on behalf of the HCPC and Mr Dunlop on the Registrant’s behalf. The Panel received and accepted the advice of the Legal Assessor.
18. The Panel was mindful that the purpose of any sanction was not to punish the Registrant but to protect the public and maintain public confidence in the profession and the HCPC as its regulator, by the maintenance of proper standards of conduct and behaviour.
19. The Panel had regard to the Indicative Sanctions Policy. The Panel applied the principle of proportionality by weighing the Registrant’s interests with the public interest and by considering each available sanction in ascending order of seriousness.
20. In determining the appropriate and proportionate sanction, the Panel had regard to its findings of misconduct and current impairment. The Panel was satisfied that the extent of the Registrant’s misconduct was too serious for it to take no action, and that this was not an appropriate case for mediation. Whilst the Registrant has shown limited insight, this was not an isolated incident. The Panel has found that the risk of repetition is not low and therefore a Caution Order would not be appropriate.
21. The Panel next considered whether Conditions of Practice would be sufficient and would adequately protect the public. The Panel was of the view that workable conditions could be formulated. In coming to that view, the Panel considered whether a Suspension Order was appropriate and concluded that a suspension was not necessary in this case and would be disproportionate.
22. Accordingly, the Panel concluded that the following Conditions will be imposed for a period of 18 months:
1. You must maintain a written record of every case where you have undertaken any clinical intervention and you must:
a. provide a copy of these records to the HCPC on a monthly basis, the first report to be provided within 28 days of the Operative Date, or confirm that there have been no such cases during that period; and
b. Make those records available for inspection at all reasonable times by any person authorised to act on behalf of the HCPC.
2. You must place yourself and remain under the supervision of a clinical supervisor based in your workplace, registered by the HCPC or other appropriate statutory regulator, and supply details of your supervisor to the HCPC within 28 days of the commencement of this Order. You must attend upon that supervisor as required and follow their advice and recommendations.
3. You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.
4. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.
5. You must work with your workplace clinical supervisor to formulate a Personal Development Plan designed to address the deficiencies in the following areas of your practice:
a. Record keeping;
b. Professional and ethical standards
6. You must maintain a reflective practice profile detailing every occasion when you have had any clinical involvement with a client and must provide a copy of that profile to the HCPC on a quarterly basis or confirm that there have been no such occasions in that period, the first profile or confirmation to be provided within 28 days of the commencement of this Order.
7. You will be responsible for meeting any and all costs associated with complying with these conditions.
8. Any condition requiring you to provide any information to and obtain the approval of the HCPC is to be met by you sending the information to the offices of the HCPC, marked for the attention of the Director of Fitness to Practise or Head of Case Management.
9. 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).
10. Evidence that you have complied with the above conditions must be provided to the HCPC not later than 28 days prior to the Review Hearing.
Order: The Panel imposes a Conditions of Practice Order for a period of 18 months. This order will be reviewed before its expiry on 18 April 2018.
History of Hearings for Ms Sarah Sikpa
|Date||Panel||Hearing type||Outcomes / Status|
|08/07/2020||Conduct and Competence Committee||Interim Order Review||Interim Conditions of Practice|
|06/01/2020||Investigating Committee||Interim Order Application||Interim Conditions of Practice|
|21/03/2018||Conduct and Competence Committee||Review Hearing||Suspended|
|19/09/2016||Conduct and Competence Committee||Final Hearing||Conditions of Practice|