Mr Rudolph Antonio Coombs

Profession: Social worker

Registration Number: SW22741

Interim Order: Imposed on 30 Aug 2017

Hearing Type: Final Hearing

Date and Time of hearing: 09:00 29/08/2017 End: 16:00 01/09/2017

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

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

Allegation as amended

During the course of your employment as a Social Worker by the London Borough of Newham, you:

1. Between December 2010 and July 2013, you were the designated care co-ordinator for Service User A, and you:

(a) Acted outside your scope of practice, in that you:

(i) Allowed London Borough of Newham and/or East London Foundation Trust headed paper to be used for Service User A's personal correspondence;

(ii) Corresponded with external parties on Service User A's behalf;

(iii) Allowed correspondence concerning Service User A's court case to be sent directly to you at your work address;

2(a) Did not adequately analyse and/or demonstrate your analysis of the potential impact of legal proceedings on Service User A’s physical and/or mental well-being.

2(b) As a result of paragraph 2(a) above your mental health assessment of Service User A was inadequate. 

3. The matters described in paragraphs 1-2 constitute misconduct and/or lack of competence.

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

Finding

Preliminary matters

Application to amend the allegation

1. Mr Chalmers made an application to amend the factual particulars of the allegation. The HCPC had informed the Registrant by a letter dated 23 October 2015 that it intended to apply to amend the allegation on the day of the hearing and set out the proposed amendments. The Registrant had raised no objection to the proposed amendments at the time. Mr Chalmers stated that the proposed amendments were purely for clarification and ought to be permitted as they properly reflected the evidence and particularised the case against the Registrant more clearly.  He further submitted that no injustice to the Registrant would arise.  Mr Galvin did not oppose the application. The Panel accepted the advice of the Legal Assessor. The Panel was satisfied that the amendments did not substantially change the allegation and that there would be no resulting prejudice or unfairness to the Registrant. It therefore allowed the application.

Background

2. The Registrant qualified as a Social Worker in 2007. Between 2008 and 2010 he was employed as a locum social worker in Community Mental Health Teams in Hackney and Newham. Between 2010 and 2015 he was employed as a social worker in the Community Mental Health Team for adults aged 18 – 65 in the London Borough of Newham (LBN). During the period of his employment relevant to the matters alleged, he was seconded to the East London NHS Foundation Trust (ELFT).

3. In July 2013 the ELFT received a letter from solicitors asking for costs awarded in an action in the High Court in which Service User A had been unsuccessful. The letter was addressed to the Registrant and indicated that he had been involved with Service User A’s case. LBN were automatically informed about this letter and an investigation into the Registrant’s involvement was initiated.

4. The case centred on allegations that whilst the Registrant was the designated care coordinator for Service User A he acted beyond his scope of practice in regard to litigation in which she was involved. Further he did not record or undertake an assessment about the impact of legal proceedings on her physical or mental wellbeing.

5. The Registrant explained that he acted in what he thought was the best interests of Service User A and gave her what he considered at the time to be appropriate and necessary support.

Admissions

6. At the outset of the hearing Mr Galvin informed the Panel that Mr Coombs admitted paragraphs 1 - 2 of the allegation. He also admitted misconduct and impairment of his fitness to practise.

7. There was before the Panel a bundle of documents containing witness statements and exhibits prepared on behalf of the HCPC. There was also a bundle from the Registrant, comprising his statement together with supporting documents. This had been submitted to the HCPC Investigating Committee in July 2015. 

8. The following witnesses were called on behalf of the HCPC namely –

• KB – Employed by LBN as a Senior Advisor for Safeguarding Adults. She was the Investigating Officer who had been asked to investigate allegations that the Registrant had acted outside the boundaries of his role and code of practice, including acting in a manner that could be construed as performing the duties of a legal representative in Court. The Panel found KB to be a credible and balanced witness, open in her response to questioning, restricting her evidence to matters within her own knowledge.

• MO’B – at the relevant time MO’B was the Clinical Nurse Lead within the Community Mental Health Team for South West Newham. He was employed by ELFT and was the Registrant’s clinical supervisor from June 2012 – July 2013. The Panel found him to be a credible and concise witness albeit more limited in the scope of his evidence.

9. The Registrant gave evidence.

10. In reaching its decision on the facts the Panel considered all the evidence before it, both oral and documentary, together with the submissions made by Mr Chalmers and Mr Galvin. It accepted the advice of the Legal Assessor. It had well in mind that, although the Registrant had admitted the facts, the burden of proof was on the Council. Further that the Council must prove the facts on the balance of probabilities. 

Decision on facts

11. Particular 1(a) (i) was found proved on the basis of the Registrant’s admission and the evidence of KB together with the documents in the Exhibit Bundle including a letter dated 17 October 2012 on ELFT/LBN headed notepaper from Service User A to Bow County Court.

12. Particular 1a(ii) was found proved on the basis of the Registrant’s admission and the evidence of KB. Among the documents was a letter dated 30 August 2011 on EFLT/LBN headed notepaper to the Regional Director, Legal Services Commission, and a letter dated 9 January 2012 (also signed by Service User A) to a potential witness in Service User A’s High Court action. There was also a letter dated 20 September 2012 on EFLT/LBN headed notepaper to a Private Investigator in Jamaica, seeking his assistance in obtaining evidence relevant to the litigation. 

13. Particular 1(a)(iii) was found proved on the basis of the Registrant’s admission and the evidence of KB. The documents included a letter dated 15 November 2011 from the Land Registry Croydon Office, a letter dated 13 May 2013 from the Adjudicator to HM Land Registry and a letter dated 22 May 2013 from the Royal Courts of Justice Chancery Listing Office.  These letters were addressed to Service User A and expressed to be c/o (care of) Mr Rudolph Coombs at the CMHT address.

14. Particular 2(a) was found proved on the basis of the Registrant’s admission, the evidence of KB and the absence of any entry by the Registrant in Service User A‘s case records relating to commentary or analysis of the potential impact on her of the court proceedings. In his evidence the Registrant admitted that he had not considered it necessary to undertake such analysis.

15. Particular 2(b) was found proved on the basis of the Registrant’s admission, the absence of adequate detail in the case records and by reference to a number of letters. Two such letters are dated 21 June 2011 and 30 June 2011 and addressed “To Whom It May Concern”. The first is signed by the Registrant. The second, which has the same wording, differs only in that it appears to have been signed also by Service User A’s Consultant Psychiatrist. The letters purport to demonstrate Service User A’s “capacity in terms of her mental health in dealing with her possession order”. However, the letters provide no supporting evidence or reasoning for the determination of capacity asserted in respect of the five defining criteria. They also state that “there is no known admission to hospital” despite Service User A having been sectioned in December 2010.

16. A third letter, dated 29 September 2011, again addressed “To Whom It May Concern”, signed by the Registrant and also apparently by the Consultant Psychiatrist, repeats the wording of the earlier letters with an Addendum which appears to address a recent incident where Service User A had been arrested for brandishing an offensive weapon. This states that “the incident in my opinion was not related in any way to her mental health”, although the Addendum indicates that the incident was an irrational act related to “an ongoing court case”. Again there is no reason given to support the contention that Service User A has capacity nor is there any evidence of the Registrant having undertaken a thorough mental health assessment. Although two of the letters appeared to have been signed also by the Consultant Psychiatrist, the Panel was satisfied that it remained for the Registrant to ensure that the contents were comprehensive and fully reasoned.

Decision on Grounds

17. Although lack of competence, misconduct and impairment were admitted by the Registrant the Panel was aware that these are matters for its decision in the exercise of its professional judgment.

18. In reaching its decision the Panel considered the facts found proved together with the submissions of Mr Chalmers. It had in mind the admissions made by the Registrant. The Panel accepted the advice of the Legal Assessor.

19. In regard to lack of competence the Panel was not satisfied that this one case, albeit over an extended period, represented a fair sample of the Registrant’s work. He had been qualified and working as a Social Worker for 4 to 5 years at the time of the matters in question.  He had worked previously in the field of mental health care. Furthermore he had an extensive training record as a Social Worker which had included relevant topics such as Safeguarding Adult Awareness (July 2011) and Introduction to Client Affairs – Mental Capacity Act 2005 (January 2012). Taking these factors into account the Panel was not satisfied that the Registrant was lacking in competence.

20. In regard to misconduct the Panel found that the Registrant’s conduct, as set out in particular 1, fell short of the standards expected of a registered Social Worker. His proactive engagement in Service User A’s civil litigation, which included seeking supporting evidence from third parties, gave her false hope when he would have been aware that she had been advised  by solicitors and counsel on a number of occasions that her claim had  no realistic prospect of success. As a consequence the Registrant put Service User A at risk of financial loss as she was made subject to an order for costs.

21. Further, when Service User A had expressed concern that her post was being intercepted, the Registrant rather than ensuring this was investigated arranged for her post to be delivered to him at his work address.

22. The Registrant’s use of headed LBN/EFLT headed paper in corresponding on behalf of Service User A gave the clear impression that he was acting on behalf of Service User A in his capacity as a Social Worker employed by LBN/EFLT and, in that respect, made his employer susceptible to reputational damage. Furthermore, as a result of the litigation, an order for costs was made against his employers.

23. The Panel also found, in regard to particular 2, that by omitting to conduct a sufficiently analytical and comprehensive mental health assessment the Registrant fell short of the standards to be expected of a registered Social Worker. 

24. By his actions the Registrant was in breach of the HCPC standards of Proficiency for social workers applicable at the time:

Standards of proficiency
Registrant social workers must:
1. be able to practise safely and effectively within their scope of practice
1.1 know the limits of their practice and when to seek advice or refer to another professional
1.3 be able to undertake assessments of risk, need and capacity and respond appropriately
2. be able to practise within the legal and ethical boundaries of their profession
2.2 understand the need to promote the best interests of service users and carers at all times
2.3 understand the need to protect, safeguard and promote the wellbeing of children, young people and vulnerable adults
Standards of conduct, performance and ethics
1. You must act in the best interests of service users
6. You must act within the limits of your knowledge, skills and experience and, if necessary, refer the matter to another practitioner.
25. The Panel therefore finds that the Registrant’s behaviour fell well below the standard expected of a registered social worker and amounted to misconduct.

Decision on Impairment

26. The Panel then considered whether the Registrant’s fitness to practise is currently impaired by reason of his misconduct. In reaching its decision the Panel took into account the findings of fact, the submissions of Mr Chalmers and the submissions made by the Registrant. It accepted the advice of the Legal Assessor in regard to the relevant law to be applied.

27. The Registrant accepts that he was at fault in his handling of Service User A’s case, particularly in regard to his involvement with the civil litigation she was pursuing, but he does not appear to understand why. Whilst the Registrant may well have considered that he  was acting in what he felt was Service User A’s best interests in assisting her with the litigation, he appears still not to appreciate fully that, in doing so, he was acting outside the scope of his professional role.
He appears also to fail to recognise the potential impact of legal proceedings on Service User A’s physical and mental well-being.

28. Although misconduct of this nature could be remedied the Panel finds that the Registrant is lacking in insight and is unable to demonstrate effective remediation. Furthermore there is no evidence of reflective learning on his part. The training he has undertaken since July 2013, when this first came to the attention of his employer, and which is referenced in the Registrant’s submissions, does not appear specific to the issues concerned and no detail is provided of any relevant content. The Registrant has not worked as a Social Worker since January 2016. In the circumstances the Panel cannot be satisfied that such conduct would not be repeated. This finding means that in respect of the personal component, a finding of current impairment of fitness to practise is required.

29. The Panel is also satisfied that a finding of current impairment of fitness to practise is also required in the wider public interest. It is necessary to declare and uphold proper professional standards. The public would expect a registered social worker to follow accepted practices and to act only within the scope of his practice. Public confidence in the profession and the HCPC as a regulator would be undermined if a finding of impairment were not made.

Decision on Sanction

30. In reaching its decision on sanction the Panel has considered all the circumstances and all the evidence which contributed to its findings on the facts, the statutory ground and current impairment. It has considered also the submissions made by Mr Chalmers and by Mr Galvin. It has had in mind the HCPTS Indicative Sanctions Policy. It has accepted the advice of the Legal Assessor. It has exercised the principle of proportionality at all times. The Panel is aware that sanctions are not intended to be punitive although a sanction may have a punitive effect. A sanction should be no more than is necessary to meet the legitimate purposes of providing adequate protection to the public and otherwise meeting the wider public interest in protecting the reputation of the social work profession, maintaining confidence in the regulatory system, and declaring and upholding proper professional standards. The Panel has sought to balance the public interest against the rights of the Registrant to practise his chosen profession.

31. Mr Chalmers in his submission accepted that the Registrant was apparently intending to assist Service User A and there was no element of personal interest or gain. Mr Galvin in his submission, contended that a Caution Order would be the appropriate sanction. He observed that the Registrant was nearly 62 years of age, was no longer working as a social worker and had no intention of returning to social work. He submitted that in these circumstances a Conditions of Practice Order would be inappropriate. He further submitted that a Suspension or Striking Off Order would be disproportionate.

32. The Panel identified the following aggravating factors-

• The particular vulnerability of Service User A
• The Registrant’s failure to appreciate that his proactive engagement in Service User A’s litigation was giving her false hope when legal advice had previously been clear that her case had been weak
• The Registrant’s failure to be more assertive in seeking  appropriate managerial or professional advice in regard to Service User A’s pursuit of litigation

33. The Panel identified the following mitigating factors:

• This appears to have been a one off episode in a hitherto unblemished career
• The Registrant’s motivation appears to have been a genuine attempt to help Service User A
• The supervision/ management oversight of the Registrant’s practice did not show sufficient tenacity in establishing what he was, and was not, doing in regard to his involvement in Service User A’s case.

34. The Panel first considered taking No Further Action but decided that this would be wholly inappropriate as it would not provide protection to the public if no sanction was applied. Furthermore, misconduct of this nature requires a sanction.

35. The Panel then considered a Caution Order. This would be insufficient and inappropriate as a sanction. The Indicative Sanctions Policy states that a Caution Order may be appropriate in cases of a minor nature where there is a low risk of recurrence and the Registrant has shown insight and taken remedial action. None of these criteria apply to the Registrant.

36. The Panel then considered a Conditions of Practice Order. The Indicative Sanctions Policy states that Conditions of Practice are unlikely to be suitable in situations where there is lack of insight. The fact that the Registrant is no longer working as a Social Worker would also make it difficult to formulate conditions which may require the Registrant to be specifically supervised and/or mentored. 

37. The Panel therefore considered a Suspension Order. It decided that a Suspension Order for 12 months is sufficient and necessary to protect the public in view of the Registrant’s lack of insight and remediation. It makes this order on the basis that the Registrant’s failings are remediable through reflective insight and relevant training. Although the Registrant has indicated that he has no intention of returning to social work practice this cannot be guaranteed as his circumstances may change. A Suspension Order would allow the Registrant the opportunity, should he wish to take it, to demonstrate to a future review panel that he has reflected on his shortcomings and taken remedial steps through training and discussion with a senior practitioner to develop his understanding of why his conduct was at fault and how this could have, and did, impact adversely on Service User A.

38. The Panel did consider a Striking Off Order but concluded that this would be disproportionate given that the Registrant was well motivated, if misguided, in his actions. The Panel also had in mind that this was a single episode and that the Registrant had an otherwise unblemished record as a social worker. 

Order

The Registrar is directed to suspend the registration of Mr Rudolph Antonio Coombs for a period of 12 months from the date this order comes into effect.

Notes

This order will be reviewed again before its expiry on 28 September 2018.

An Interim Order of Practice Order was imposed to cover the appeal period.

Hearing History

History of Hearings for Mr Rudolph Antonio Coombs

Date Panel Hearing type Outcomes / Status
14/03/2019 Conduct and Competence Committee Review Hearing Struck off
18/02/2019 Conduct and Competence Committee Review Hearing Adjourned
24/08/2018 Conduct and Competence Committee Review Hearing Suspended
29/08/2017 Conduct and Competence Committee Final Hearing Suspended
02/05/2017 Conduct and Competence Committee Final Hearing Hearing has not yet been held