Ms Doreen Claire Ruta

Profession: Social worker

Registration Number: SW80293

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 20/12/2018 End: 17:00 20/12/2018

Location: ETC Venues, Avonmouth House, 6 Avonmouth Street, London, SE1 6NX

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

During the course of your employment as a Social Worker with Oxfordshire County Council, between October 2013 and October 2014, you: 

  1. Upon receipt of information on or around 23 October 2013 that Client A was at risk of financial exploitation by others; 

a) did not carry out a Mental Capacity Assessment on Client A, as requested by your supervisor, until April 2014.

b) [not proved]

 

  1. Upon receipt of a report on or around 4 November 2013 that Client A was in possession of a knife:

a) did not undertake and/or record a Risk Assessment in relation to Client A and his family;

b) did not carry out and/or record an investigation into the event;

c) did not raise an alert on Oxfordshire County Council's Safeguarding Adults alert system;

d) did not report the incident to Thames Valley Police.

 

  1. Upon receipt of a report from a General Practitioner on or around 21 October 2013 that Client A looked malnourished and had no food available: 

a)  [not proved]

b) did record a Risk Assessment in relation to Client A

 

  1. Upon receiving information on or around 25 November 2013, that Client A was missing, had caused damage to his television and fridge, and made threats to kill his cousin:

a) did not undertake and/or record a Risk Assessment;

b) did not adequately undertake and/or record an investigation into the event;

c) [not proved]

d) did not advise the Safeguarding Manager that Client A had made threats to kill his cousin

5. Did not fully complete a Mental Capacity Assessment in relation to Client A until July 2014

6. On or around 27 February 2014, on receiving a request from Client A's General Practitioner for a safeguarding meeting:

a) advised the General Practitioner that Client A was already under Safeguarding when this was not the case:

b) did not discuss the request with a Safeguarding Manager.

7. In May 2014, when facilitating Client A's change of address: 

a) [not proved]

b) Did not inform the following authorities of Client A's change of address as required:

i. Thames Valley Police.

ii. Client A's General Practitioner.

c) Did not carry out and/or record a Risk Assessment in relation to the impact that the change of address would have on Client A.

8. Between 27 May 2014 and 6 June 2014, upon receipt of information that Client A had not received their medication for nine days: 

a) Did not undertake and/or record an assessment into Client A's family's ability to provide Client A with the medication.

b) Did not record an appropriate Risk Assessment.  

9. Upon receipt of information on or around 9 October 2014 that a heroin addict had visited Client A's residence, you did not raise an alert on Oxfordshire County Council's Safeguarding Adults alert system until 17 October 2014.

Finding

Background

1. The Registrant had been employed as a Social Worker at Oxfordshire County Council (‘the Council’) between February 2009 and January 2015. At the relevant time she had been employed in the Adult Social Care Team and responsible for safeguarding individuals who were identified as being at potential or actual risk of harm.

2. Client A was a 65-year-old Service User who had been allocated to the Registrant’s caseload on 7 October 2013. There were safeguarding concerns that he was being abused by drug and alcohol misusers in his social circle who were allegedly taking his money and locking him out of his accommodation. Further concerns arose in terms of Client A’s memory, his living conditions and self-neglect. Client A was, himself, a heavy drinker.

3. In July 2013 concerns were raised at the Council in relation to the Registrant’s practice in respect of Client A. Consequently, the Registrant’s work was internally audited.

4. Between 18 July 2014 and 1 September 2014, the Registrant took a period of extended unpaid leave (special leave) for personal reasons.

5. Failings were identified during the internal audit and the matter was escalated. On 24 October 2014, the Registrant was suspended from work. An internal investigation was carried out in respect of the Registrant’s practice in connection with Client A, commencing in November 2014.

6. A disciplinary hearing took place at the Council on 19 January 2015, following which, the Registrant was dismissed from the Council.

7. A referral to the HCPC was made on 13 February 2015 in respect of the matters which form the basis of the Allegation.

8. That panel determined that the matters found proven amounted to misconduct. In this regard the following was noted by the Panel:                                                                                                                                                                                                                                                                                                                             
The Panel has found that each of the facts found proved at particulars 4(a), 4(b), 4(d), 5, 7(c) and 9 amounted to misconduct. The Panel noted that the Registrant acted with care and good intentions towards Client A and he suffered no actual harm. It was also mindful that the Registrant was inexperienced in dealing with service users with the complex care needs of Client A and that some of the failings identified were explained by the Registrant’s working environment, as detailed in paragraphs 49 to 52 above. However, this did not excuse the Registrant from her professional duty to practise in the best interests of Client A, to acceptable professional standards. Client A was a vulnerable, older service user with complex needs.

The Panel determined that the facts identified above amounted to serious failings in respect of the fundamental responsibilities of a Social Worker. The standards of the Registrant’s practice in the above instances fell far short of what would be expected and, by departing from those standards, the Registrant exposed Client A, and those who came into contact with him, to a risk of serious harm. The Registrant’s conduct amounted to a breach of a fundamental tenet of her profession, in that the public is entitled to expect that the needs of such vulnerable service users are prioritised and acted upon immediately, in their best interests, whatever the working environment.

The Registrant also failed to maintain accurate and contemporaneous records. In so doing, her conduct potentially inhibited the ability of others to make fully informed decisions about Client A in the absence of the Registrant.

In all of these circumstances, the Panel was satisfied that the Registrant’s conduct detailed at particulars 4(a), 4(b), 4(d), 5, 7(c) and 9, both individually and collectively, would attract a degree of strong public disapproval. Accordingly, it determined that the Registrant’s actions amounted to misconduct.

9. The Panel further found that the Registrant‘s fitness to practise was impaired on the personal and public components of its decision. In that Panel’s determination it recorded the following:
The Panel noted that the Registrant has not practised as a Social Worker since she was suspended from the Council in October 2014. She has undertaken work in a social care role for a care agency as bank staff, in a role which includes undertaking care assessments for clients, writing up care plans, following up safeguarding issues and carrying out risk assessments. The Panel noted that there was a positive reference in this respect and there was no suggestion there has been a repetition of the failings identified. The Panel also noted that the Registrant has undertaken relevant on-line training which included safeguarding of vulnerable adults, assessment of mental capacity, record keeping and risk assessment.

However, the Panel was mindful that, in her current position with the care agency, the Registrant has not had the responsibility of taking a statutory lead for service users, in a role which mirrors the duties of a Social Worker. Furthermore, despite the online training she has undertaken, she has not had the opportunity to demonstrate that she is able to put that learning into practice. She has had no practical experience in the past 3 years within which she has been able to demonstrate that the failings have been fully remedied. In particular, she has not yet demonstrated that her knowledge, learning and understanding of MCA’s has improved in any practical way.

Whilst the Panel was encouraged by the steps taken thus far and her commitment to working in a social care role, it considers that the Registrant’s remediation is ongoing and not yet complete.

The Panel also considered the Registrant’s reflective piece and associated oral evidence, and noted that she has reflected upon the relevant events and demonstrated a degree of insight, in that she recognises how things should have been done differently. However, the Panel considered that the Registrant’s evidence of reflection exposed the fact that she has not yet developed a full appreciation of the importance of MCA’s and the circumstances in which an early MCA is required. Furthermore, there was insufficient reflection upon the specific incidents identified by the Panel as high risk and a lack of recognition of the need to escalate such matters with expedition.

It was clear that the Registrant is committed to social care work. She expressed care and concern for her service users and her compassion is evident in the testimonials produced on her behalf. There were many examples of good practice on the part of the Registrant in her care of Client A, particularly when it is considered in the context of the environment within which she was working at the relevant time. The Panel also noted that the Registrant has fully engaged in the regulatory process as well as the internal disciplinary process and the Employment Tribunal over a period of three years.

Nevertheless, given that the Registrant’s remediation is ongoing and her insight not yet fully developed, there remains some risk of repetition of the failings identified. Accordingly, the Panel found that the Registrant’s fitness to practise is currently impaired on a personal level.

10. At the sanction stage the panel identified the following aggravating factors in this case:

• Client A was a high risk, vulnerable service user with complex needs;

• The misconduct created a serious potential risk to Client A and those who came into contact with him;

• The absence of good record keeping by the Registrant potentially compromised the care of Client A in the absence of the Registrant;

• The misconduct continued for a relatively long duration, during which the Registrant failed to complete some essential assessments;

• There was an over-reliance on Client A’s informal carer to meet his needs.

11. To balance against those issues, the panel identified the following mitigating factors;

• The Registrant has fully engaged in the regulatory process;

• The Registrant made admissions without prevarication to a number of particulars;

• There have been no previous regulatory issues;

• The events in question related to one service user.

• The Registrant has demonstrated some insight. She recognised that her work fell below the standard expected of her and that she would do things differently now;

• The Registrant has continued with her Continuous Professional Development, reflected upon what happened and recognised her personal responsibility for what occurred despite the lack of adequate supervisory support available to her at the time;

• No actual harm was caused to Client A or associated people;

• Of her own volition, the Registrant has taken remedial action by undertaking a number of on-line training courses. She has also undertaken some safeguarding and risk assessment work in her current role;

• There were a number of positive testimonials;

• The Panel considers that the risk of repetition is low.


12. The panel came to the decision that a Conditions of Practice Order was proportionate and appropriate. The terms of that Order, which will expire on 16 January 2019 are:

1. Within 28 Days of obtaining work which requires your registration with the HCPC, you must place yourself and remain under the supervision of a workplace supervisor, registered by the HCPC, and supply details of your supervisor to the HCPC. You must attend upon that supervisor as required and follow their advice and recommendations. You must promptly inform the HCPC of any change of supervisor.

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

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

4. 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).

5. You must work with your supervisor to formulate a Personal Development Plan designed to address the deficiencies in the following areas of your practice:

i. Record Keeping

ii. Knowledge, understanding and application of the Mental Capacity Act 2005

iii. Production of timely Risk Assessments, incorporating a multi- agency approach.

6. Within three months of obtaining work as a Social Worker you must forward a copy of your Personal Development Plan to the HCPC.

7. You must meet with your supervisor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan.

8. You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

9. You must keep a reflective log of issues relating to all Mental Capacity Assessments which you undertake during the period of the order.

13. That panel suggested that it would assist the Reviewing Panel for the Registrant to provide the following:

1. A report from the workplace supervisor evidencing the extent to which you have demonstrated your abilities in respect of the following areas:

i. Record Keeping

ii. Knowledge, understanding and application of the Mental Capacity Act 2005

iii. Production of timely Risk Assessments, incorporating a multi-agency approach.

2. A copy of the reflective log detailed at Condition 9 above.

Today’s Hearing

Evidence and Submissions

14. The Registrant placed before the Panel a written statement and supporting information relating to training she has undertaken, and evidence of the efforts she has made to obtain employment in a Social Worker capacity. The Registrant provided oral evidence of the difficulties she has met in the last year in obtaining a position whilst being under a Conditions of Practice Order: she stated that she had not appreciated what the effect of this sanction would be. Due to her failure to gain employment she has been unable to demonstrate her compliance with the Conditions of Practice Order. She told the Panel in private session of the personal challengers she has encountered in the last year and stated that she was hopeful that her personal situation would improve next year. The Registrant sought to have the present conditions varied to make seeking employment easier.

15. The HCPC drew the Panel’s attention to the concerns expressed by the substantive hearing panel in relation to the Registrant’s lack of full remediation at that time and the fact that the Registrant has been out of practice since October 2014. The HCPC acknowledged that the Registrant has fully engaged with the HCPC but emphasised that little had changed since the substantive hearing and there was therefore no evidence that the Registrant was able to return to practice without some form of restriction.

16. The HCPC drew attention to the fact that the Registrant had not produced any reference from her current place of work and had not produced a log. of training. The documentary evidence produced showed only the training up to September 2017.

Decision

17. In undertaking its task today, the Panel is conducting a comprehensive appraisal of the Registrant’s current abilities with a view to establishing whether she is now fit to return to unrestricted practice.  The Panel is not undertaking the task of rehearing the matters that had been brought against the Registrant nor going behind the previous findings. 

18. This Panel has taken into account all documentation placed before it and has heard and given appropriate weight to the fresh evidence supplied by the Registrant.  It has heard the parties’ submissions, taken and accepted the advice of the Legal Assessor, and it has reminded itself of the terms of the relevant HCPTS Practice Notes.

19. The Panel noted that the Registrant had not been able to demonstrate compliance and fulfilment of the Conditions of Practice. It also noted that the Registrant’s training evidence identified the last training undertaken was in September 2017, this is despite her records showing that she has paid for some online training modules but has failed to complete them. The Panel was concerned that the Registrant was vague about further training which she might pursue. The Panel also noted that the Registrant had not provided any tangible evidence of remediation by way of a reflective statement or log. In such a document she could have listed not only the training she has undertaken in the past, but how this training has influenced and improved her professional thinking and how she would change her practice as a result of this training. This reflective document would have given the Registrant the opportunity to note the situations she orally described to the Panel involving residents at the care home where she
worked. Including these case studies within her reflective document could have provided further evidence of how she was continuing to apply her social worker training in another environment.

20. The Panel concluded that this lack of evidence supported a finding that the Registrant’s fitness to practise remains impaired on the personal and the public components. At this stage the Panel accepted that the issues it has identified, remain ones which are capable of remedy.

21. Having come to this decision, the Panel moved on to consider what was the appropriate and proportionate restriction to place on the Registrant’s registration. The Panel considered that a lesser sanction of mediation or a Caution was inappropriate as it would not provide sufficient public protection.

22. When considering whether a Conditions of Practice Order remained the appropriate and proportionate sanction the Panel considered whether this was the least restrictive level of sanction it could impose and came to the conclusion that it was. This being the case, it did not give further consideration to imposing a period of suspension.

23. The Panel appreciated that the Registrant may have difficulty in finding work whilst under Conditions of Practice Order. However it did not accept that it was impossible within a social work environment to find means of demonstrating skills and knowledge and obtaining support, guidance and supervision.

24. The Panel has therefore taken the opportunity to review the terms of the Conditions of Practice Order to provide more flexibility. The Panel has provided guidance to the Registrant as to what information she could provide to a future reviewing panel even if not working as a Social Worker.

25. The variations the Panel has made to the terms of the Conditions of Practice Order are:

a. Deletion within condition 1 of reference to ‘workplace’.

b. Deletion of condition 6.

c. Revised what was condition 9, but is now condition 8.

26. Whilst the Panel appreciates that it cannot bind a future reviewing panel it has identified evidence which the Registrant may wish to produce at such a review, whether she has been able to find work in a social work capacity or not. This guidance is different from that suggested by the substantive hearing panel and includes ways in which the Registrant may be better able to prepare herself for a return to practice. This guidance is as follows:

1. A report from the supervisor evidencing the extent to which you have demonstrated your abilities in respect of the following areas:

i. Record Keeping

ii. Knowledge, understanding and application of the Mental Capacity Act 2005

iii. Production of timely Risk Assessments, incorporating a multi-agency approach.

2. A copy of the logs as detailed at Condition 8 irrespective of whether you have secured a role as a Social Worker.

3. Written evidence that you have taken steps to become conversant with the terms of the Care Act 2014 and its allied statutory guidance.

4. Recent references and testimonials from employers irrespective of the role in which you are working for that employer.

5. Consideration of engagement with and participation in professional bodies and networks with a view to accessing further appropriate training and personal development or to identify a possible mentor or informal supervision opportunity.

27. The Panel considers that on the current information provided by the Registrant she requires a further twelve month period in which to undertake appropriate remediation of her professional failings. This order will therefore take effect on 16 January 2019 and come to an end twelve months later.

Order

ORDER: The Registrar is directed to vary the Conditions of Practice Order against the registration of Ms Doreen Claire Ruta for a further period of 12 months on the expiry of the existing order. The Conditions are:

1. Within 28 Days of obtaining work which requires your registration with the HCPC, you must place yourself and remain under the supervision of a supervisor, registered by the HCPC, and supply details of your supervisor to the HCPC. You must attend upon that supervisor as required and follow their advice and recommendations. You must promptly inform the HCPC of any change of supervisor.

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

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

4. 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).

5. You must work with your supervisor to formulate a Personal Development Plan designed to address the deficiencies in the following areas of your practice:

i. Record Keeping

ii. Knowledge, understanding and application of the Mental Capacity Act 2005

iii. Production of timely Risk Assessments, incorporating a multi- agency approach.

6. You must meet with your supervisor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan.

7. You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

8. You must keep and produce to the HCPC in advance of your next review hearing:

a. A written log of issues relating to all Mental Capacity Assessments which you have observed or undertaken during the period of the order;

b. A written log of all your training and the potential impact of it on your social work practice from the date this order comes into effect.

Notes

The order imposed today will apply from 16 January 2019.

This order will be reviewed again before its expiry on 16 January 2020.

Hearing History

History of Hearings for Ms Doreen Claire Ruta

Date Panel Hearing type Outcomes / Status
15/11/2019 Conduct and Competence Committee Review Hearing Hearing has not yet been held
20/12/2018 Conduct and Competence Committee Review Hearing Conditions of Practice
18/12/2017 Conduct and Competence Committee Final Hearing Conditions of Practice
02/10/2017 Conduct and Competence Committee Final Hearing Adjourned part heard
23/01/2017 Conduct and Competence Committee Final Hearing Adjourned part heard