Miss Deborah J Watson

Profession: Occupational therapist

Registration Number: OT20331

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 07/12/2018 End: 17:00 07/12/2018

Location: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

Whilst employed as an Occupational Therapist with Tees, Est and Wear Valleys NHS Trust, you:   

On 16 July 2015:

a) In relation to Service User A:

i) Left her in a therapy suite unaccompanied in breach of the employer’s regulations and guidelines; and/or

ii) Did not consider the observation and engagement care plan for Service User A; and/or 

iii) Made an incorrect assessment of the observation and engagement care plan.

b) In relation to Service User B:  

i) Allowed him to leave the therapy suite without escort; and/or 

ii) Did not check the observation and escort requirements of Service User B with ward staff; and/or  

iii) Did not follow the observation and escort requirements of Service User B. 

c) In relation to Service User C:  

i) Did not check following the observation and escort requirements of Service User C with ward staff; and/or  

ii) Did not follow the observation and escort requirements of Service User C. 

2. Between 26 August and 26 November 2014, in relation to Service User D did not ensure

a) Follow-up; and/or 

b) Review; and/or 

c) that interventions were provided.  

3. Between April 2014 and October 2014 did not seek clinical supervision. 

4. On 19 November 2014, in respect of a GP referral of Service User E did not: 

a) Follow up the referral; and/or 

b) Prepare a risk assessment; and/or 

c) Prepare a risk management plan.

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.

Finding

Background:

1.The Registrant is an Occupational Therapist registered with the HCPC. She was employed as a Band 6 Care Coordinator Occupational Therapist initially by Leeds and York Partnership NHS Foundation Trust and from 1 October 2016 by Tees, Esk and Wear Valleys NHS Foundation Trust (the Trust). The Registrant was employed in a community setting but, following concerns about her practice, a performance improvement plan was implemented and the Registrant was moved to a role in an acute mental health ward, where she was subject to supervision. A further concern arose when the Registrant left a service user unaccompanied in a therapy suite. An investigation was conducted which identified additional concerns in relation to the Registrant’s practice.

2. The Registrant made a self-referral to the HCPC on 20 October 2015, resulting in these proceedings.

3.The Trust carried out a Disciplinary Hearing in March 2016, resulting in her summary dismissal for gross misconduct on 4 March 2016.

4.At the substantive hearing on 11-13 December 2017 a Panel of the Conduct and Competence Committee found all the factual particulars of the allegation proved and determined that those facts constituted misconduct. The Panel found that the Registrant’s fitness to practise was impaired in relation to the “personal” and “public” components. By way of sanction, the Panel imposed a Suspension Order for 12 months.

5.The Panel advised the Registrant that the reviewing panel was likely to be assisted by:

•evidence that the Registrant had sought guidance or support from the Royal College of Occupational Therapists;

•evidence that the Registrant had made significant progress in implementing the plan which she had produced at the substantive hearing, including all aspects of Occupational Therapist practice and Information Technology skills;

•the Registrant’s reflections on how her continued professional development undertaken as part of the plan would impact on her future practice;

•the Registrant’s attendance at the review hearing.


Decision

6.The Panel was provided by the HCPC with a bundle of documents including the decision of the Panel at the substantive hearing.

7.The Panel was also provided by the Registrant with a bundle of documents including her reflections on the incidents and in relation to her practice generally as an Occupational Therapist, a current action plan, her current cv and details of various job vacancies.

8.The Panel heard oral evidence from the Registrant. In the course of her evidence, the Registrant acknowledged that there remained gaps in her skills and knowledge as an Occupational Therapist. She said that she considered that her fitness to practise remains impaired and she did not yet feel confident to take on a role as an Occupational Therapist.

9.The Panel took into account submissions of Ms Senior on behalf of the HCPC and Mr Oestreicher on behalf of the Registrant.

10.The Panel took into account the HCPC Practice Notes on Finding that Fitness to Practise is “Impaired” . The Panel also took into account the HCPC Indicative Sanctions Policy. The Panel accepted the advice of the Legal Assessor.

11.The Panel first considered whether the Registrant’s fitness to practise is currently impaired.

12.The Panel noted the findings of fact by the Panel at the substantive hearing on 7 December 2017 and that the Registrant’s fitness to practise was at that time impaired by reason of her misconduct.

13.The Panel was impressed by the Registrant’s reflective statements and the development of her insight into the effect and consequences of her failures in practice for the service users in her care.

14.However, the Panel was not persuaded that the Registrant had demonstrated that she had applied her knowledge of theory to the specific failings found in her practice at the substantive hearing. By her own admission, there remained gaps in her knowledge and skills, which gave rise to a risk of repetition which could potentially pose a risk of harm to service users and consequently undermine public confidence in the profession.

15.The Panel therefore considered that the Registrant’s fitness to practise remains impaired.

16.The Panel considered the available sanctions in ascending order of seriousness and applied the principle of proportionaity.

17.The Panel considered that it would not be appropriate to impose no order or a Caution Order because the public would not thereby be protected.

18.The Panel gave careful consideration to Mr Oestreicher’s submission that it should impose a Conditions of Practice Order at the expiry of the current Suspension Order. In particular it considered his proposal to impose a condition requiring direct supervision.  The Panel concluded that a condition in the terms he suggested or In any other terms sufficient to protect the public would be so restrictive as to amount to suspension in all but name. The Panel considered that a Conditions of Practice Order would be premature considering the continuing deficits in the Registrant’s skill and knowledge.

19.In the circumstances, the Panel decided that the appropriate and proportionate sanction was a further Suspension Order for a period of 12 months. This period of time could be used by the Registrant to demonstrate that she had made sufficient progress in her professional development to return to practice as an Occupational Therapist.

20.The Suspension Order will be reviewed by another panel before it expires. The next reviewing Panel is likely to be assisted by the following:

•the Registrant's attendance at the hearing;

•evidence  that the Registrant has specifically addressed the underlying causes of the incidents which resulted in the specific findings of misconduct at the substantive hearing and the practical steps that she has taken to improve her ability to assess risk in similar situations;

•evidence of the Registrant’s work since the date of this hearing, whether paid or unpaid, in a role related to that in which her knowledge and skills as an Occupational Therapist have been deployed, together with any references and/or testimonials in relation to such work; and especially in relation to her ability to assess and respond to risk.

•evidence of the Registrant’s continuing professional development and that she has kept her knowledge of Occupational Therapy practice up to date.

Order

The Panel decided to impose a Suspension Order for a period of 12 months.

Notes

No notes available

Hearing History

History of Hearings for Miss Deborah J Watson

Date Panel Hearing type Outcomes / Status
07/12/2018 Conduct and Competence Committee Review Hearing Suspended
11/12/2017 Conduct and Competence Committee Final Hearing Suspended