Miss Irene Spiers

Profession: Occupational therapist

Registration Number: OT25726

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 19/12/2017 End: 17:00 19/12/2017

Location: 405 Kennington Road, London

Panel: Conduct and Competence Committee
Outcome: Voluntary Removal agreed

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During the course of your employment as an Occupational Therapist at Durham County Council between January 2015 and March 2016:


1. You did not undertake an assessment and/or fully record an assessment in relation to the following Service Users:


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;

j) Service User J;

k) Service User K;

l) Service User L;

m) Service User N;

n) Service User P;

o) Service User Q;

p) Service User R;

q) Service User S;

r) Service User T;

s) Service User U;

t) Service User V.


2. You did not complete a Care Plan in relation to the following Service Users:


a) Service User B;

b) Service User C;

c) Service User D;

d) Service User E;

e) Service User F;

f) Service User G;

g) Service User H;

h) Service User I;

i) Service User J;

j) Service User K;

k) Service User L;

l) Service User N;

m) Service User P;

n) Service User Q;

o) Service User R;

p) Service User S;

q) Service User T;

r) Service User U;

s) Service User V;

t) Service User W.


3. You did not carry out the following home visits and/or did not make a case recording of the following home visits:


a) To Service User C on 30 September 2015;

b) To Service User D on:

i) 29 January 2015;

ii) 10 June 2015;

iii) 18 June 2015.

c) To Service Users E and F on:

i) 21 July 2015;

ii) 22 July 2015.

d) To Service User G on 13 October 2015;

e) To Service User H on 27 April 2015;

f) To Service User I on 15 June 2015;

g) To Service User J on 15 September 2015;

h) To Service User M on 01 October 2015;

i) To Service User N on 17 February 2016;

j) To Service User O on 27 October 2015;

k) To Service User P on 09 February 2016;

l) To Service User U on 23 November 2015;

m) To Service User W on 25 January 2016.


4. You did not carry out follow up work and/or did not record follow up work:


a) after an adaptation was identified and/or made in relation to the following Service Users:


i) Service User A;

ii) Service User C;

iii) Service User D;

iv) Service Users E and F;

v) Service User I;

vi) Service User J;

vii) Service User L;

viii) Service User O.


b) in respect of risk management including:


i) Addressing the technique used by Service User A to access his shower;

ii) Completing a moving and handling plan and/or risk plan in respect of Service User M;

iii) The concerns about Service User O’s grandchildren and/or condition of her property.

iv) Addressing the risk to Service User P and her daughter that was raised with you;

v) Addressing the risk identified to Service User W as a result of his epilepsy.


5. You did not record whether an intervention was recommended and/or ensure that any recommended intervention was delivered in relation to the following Service Users:


a) Service User C;

b) Service User G;

c) Service User H.


6. You did not complete adequate and/or any case recordings in respect of the following Service Users:


a) Service User C after 24 September 2015;

b) Service Users E and F after 9 July 2015;

c) Service User G for over 5 months;

d) Service User H after 27 April 2015;

e) Service User O for over 4 months;

f) Service User U after 18 November 2015.

g) Service User V after 27 October 2015;

h) Service User W.


7. The matters described at particulars 1 to 6 constitute misconduct and/or lack of competence.


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


Preliminary Matters

Service of notice

1.     The Panel was satisfied that the notice of hearing had been sent to the Registrant at her registered address on 21 September 2017 in accordance with the Conduct and Competence Procedure Rules 2003.


Proceeding in the absence of the Registrant

2.     Ms Ebanks made an application for the hearing to proceed in the absence of the Registrant.


3.     The Panel accepted the advice of the Legal Assessor and applied the guidance in the HCPTS Practice Note “Proceeding in the Absence of the Registrant”.


4.     The Panel noted that the Registrant sent an e-mail to the HCPC dated 27 September 2017. The Registrant stated that she would not be attending the hearing and that “I look forward to receiving the decision made by the panel on 19 December 2017”. In an e-mail, dated 15 December 2017 the Registrant confirmed that she would not attend the hearing and that no one would attend on her behalf.


5.     The Panel considered the circumstances of the Registrant’s absence. She has waived her right to attend the hearing and she has stated that she would not be represented. There was nothing to suggest that the Registrant might attend a hearing if this hearing was adjourned to a later date. The Registrant has set out in writing the matters she wishes the Panel to consider. The Panel decided that it was in the Registrant’s interests and the public interest for this hearing to consider the Registrant’s voluntary removal from the Register to be concluded today.



6.     The Registrant was employed as a locum and then on a temporary contract as an Occupational Therapist at Durham County Council (DCC) between January 2015 and March 2016.


7.     When the Registrant left her position there was a handover with her line manager. It was discovered that aspects of her work had not been completed and an investigation was carried out. It was identified that in a substantial number of cases there was a lack of professional recording. This included the absence of adequate records of visits and assessments, the absence of care plans, and care plans not updated. The Registrant had not carried out the required home visits or follow up work. The supervision records demonstrated that regular supervision took place and the Registrant was provided with support and advice. The Registrant was offered the use of a laptop to assist her to manage her appointments and keep records.


8.     DCC provided to the HCPC a case summary list which detailed the absence of sufficient recording. DCC provided the HCPC with twenty one case files which covered the most serious problems.


9.     On 25 September 2016 the Registrant sent an e-mail to an HCPC case manager. She stated that she had not practised as an Occupational Therapist since she left DCC. She said that she did not intend to practise again but recognised that an investigation had to be carried out “due to the seriousness of allegation”.


10.   On 13 June 2017, the Registrant wrote to the HCPC stating that she wished to be removed from the register. In the letter, she confirmed that she was aware of the Allegation, that she accepted that her fitness to practise was impaired, and that the consequences were serious for the service users, colleagues, the OT service and the local authority. The Registrant apologised and accepted full responsibility.


11.   On 15 December 2017 the Registrant sent a further letter to a case manager at the HCPC. She again stated that she accepted full responsibility for the allegation. She set out mitigating circumstances, which she said were “not an excuse”.



12.   Ms Ebanks submitted that the proposed Voluntary Removal Agreement (VRA) was appropriate. It secured the appropriate level of public protection and was not detrimental to the public interest.


13.   The Panel accepted the advice of the Legal Assessor and applied the guidance in the HCPTS Practice Note on “Disposal of Cases by Consent”.


14.   The Panel noted that the Registrant has signed the proposed VRA, which confirms her admission of the Allegation. The correspondence from the Registrant demonstrates that she fully understands the consequences of the VRA. She recognises and understands that she will not be able to practise as an Occupational Therapist.


15.   The Panel was satisfied that the proposed VRA provides a high degree of public protection. Under the terms of the agreement the Registrant has agreed that she will not seek re-admission to the Register. However, the Registrant also agreed that if she were to seek re-admission to the Register, she could only do so after a period of 5 years had elapsed in the same way as if she had been struck off the register. The Panel was satisfied that this provides sufficient protection for members of the public because it is the highest measure of protection available.


16.   The Panel next considered the wider public interest. The Panel carefully considered whether an informed member of the public would have any concerns about the proposed VRA.


17.   The Panel considered the nature and gravity of the Allegation. The whole of the Allegation concerns the inadequacy of the Registrant’s work as an Occupational Therapist, particularly the quality of her professional record keeping. It is alleged that the Registrant’s fitness to practise is impaired by reason of misconduct and/or lack of competence. The Panel’s view was that the Allegation was not so serious that a full public hearing is required. Members of the public would be reassured that the Regulator has carried out an appropriate investigation and that the VRA provides the same degree of public protection as a Striking Off Order.


18.   The Panel also considered that members of the public would be reassured that the Regulator has acted appropriately, taking into account the Registrant’s wish to be removed from the Register and the level of insight she has demonstrated. The Registrant has recognised the seriousness of the Allegation and she has accepted responsibility. This reinforces the Panel’s view that the HCPC has acted appropriately in agreeing to the Registrant’s request for a VRA.


19.   The Panel therefore agreed the proposed Voluntary Removal Agreement and the withdrawal of the HCPC Allegation.


ORDER:The Registrar is directed to remove the name of Miss Irene Spiers from the register with immediate effect.


If the Registrant seeks to return to the HCPC Register at any time the application would be treated as if the registrant had been struck off as a result of that allegation.


Hearing History

History of Hearings for Miss Irene Spiers

Date Panel Hearing type Outcomes / Status
19/12/2017 Conduct and Competence Committee Final Hearing Voluntary Removal agreed