Mr Andrew S Woodall

Profession: Occupational therapist

Registration Number: OT33880

Hearing Type: Review Hearing

Date and Time of hearing: 12:30 17/01/2018 End: 17:00 17/01/2018

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

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

(The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing on 28 – 29 October 2014)
During your employment as an Occupational Therapist for Chesterfield Royal Hospital NHS Foundation Trust between September 2003 and May 2013, you:
1) Failed to maintain adequate records in that:
a) You did not make entries on the clinical case notes for significant periods of times in relation to:
i. Child 19, you did not make any entries after 20 June 2007;
ii. Child 16, you did not make any entries after 27 July 2007;
iii. Child 17, you did not make any entries between 12 September 2009 and 11 September 2012;
iv. Child 23, you did not make any entries;
(a) Between 20 February 2008 and 11 July 2010; and/or
(b) Between 13 July 2010 and 4 May 2011; and/or
(c) After 10 November 2011;
v. Child 15, you did not make any entries between;
(a) 24 April 2010 and 22 December 2010; and/or
(b) Between 24 December 2010 and 9 October 2012; and/or
vi. Child 14, you did not make any entries;
(a) Between 12 June 2010 and 26 January 2011; and/or
(b) Between 10 February 2011 and 30 November 2011; and/or
(c) After 23 December 2011;
vii. In relation to Child 13, you did not make any entries after 16 February 2009;
viii. Child 20, you did not make any entries after 3 December 2009;
ix. Child 3, you did not make any entries after 29 June 2006;
x. Child 4, you did not make any entries after 10 September 2007;
xi. Child 9, you did not make any entries after 18 February 2009;
b) You did not record visits that you had undertaken in relation to the following cases:
xii. Child 12;
xiii. Child 11;
xiv. Child 14;
xv. Child 13.
c) Your notes for the following cases contained incomplete entries:
i. Child 22;
ii. Child 10;
iii. Child 21.
2) Did not undertake and/or record visits in relation to the following cases:
a) Child 8;
b) Child 7;
c) Child 6;
d) Child 5.
3) Did not complete statement reports in relation to the following cases:
a) Child 18 due on or around 11 October 2012;
b) Child 15 due on or around 10 April 2012.
4) Failed to complete requested and/or required actions in that:
a) In relation to Child 1 :
i. Between on or around 24 March 2011 and September 2012, you did not arrange for an improved head support to be provided for her class chair;
ii. Between on or around November 2011 and September 2012 did not complete a sling assessment.
b) In relation to Child 2, you did not provide the school and/or Child 2’s parents with any exercise programmes following your assessment of the child in around June or July 2012.
5) Failed to discharge service users in the following cases:
a) Child 3
b) Child 4
c) Child 9
d) Child 19
6) Stored confidential information in an inappropriate manner in that you had approximately 56 patient case files at home.
7) The matters described in paragraphs 1 – 5 constitute misconduct and/or lack of competence.
8) The matters described in paragraph 6 constitute misconduct.
9) By reason of that misconduct and/or lack of competence your fitness to practise is impaired.
At the substantive hearing the Panel found particulars 1(a)(i); 1(a)(ii); 1(a)(iii); 1(a)(iv)(b) & (c); 1(a)(v)(a)&(b); 1(a)(vi)(c);1(a)(vii); 1(a)(ix); 1(a)(x); 1(a)(xi); 1(b)(i-iv); 1(c)(i-iii); 2(a-d); 3(a-b); 4(a-b); 5(a-d) & 6 (above) proved (these were also admitted by the Registrant). The Panel found particulars 1(a)(iv)(a), 1(a)(vi)(a)&(b) and 1(a)(viii) (which the HCPC offered no evidence on) were not found proved. The Panel went on to find that the proven particulars amounted to misconduct and the Registrant’s fitness to practise to be impaired. A Suspension Order was imposed as a sanction.

Finding

Preliminary Matters:
Application to hear part of the evidence in Private:
1. Ms Bragg told the Panel that some parts of the evidence may touch upon the Registrant’s health.  She applied that as and when such evidence was identified it should be heard in private to protect the privacy of the Registrant.
2. The Panel heard the advice of the Legal Assessor, which it accepted, and decided to hear those parts of the evidence or submission relating to the Registrant’s health in private to protect his privacy.
Background:
3. The Registrant was employed as an Occupational Therapist at Chesterfield Royal Hospital NHS Foundation Trust between 2003 and 2013. He was based in the Children’s Community Occupational Therapy Department where he was responsible for children with learning and physical impairment. Concerns arose in 2012 concerning his failure to maintain adequate records, to make visits and to complete required actions in relation to numerous children under his supervision between 2007 and 2012.
4. The Registrant did not appear and nor was he represented before the Conduct and Competence Committee of the HCPC at a final hearing on 28-29 October 2014. He had indicated in writing that he admitted the facts as set out in the amended allegation. He was also found to have kept approximately 56 files at home, some of which had been at his home for several years. The proven allegations included his failure to maintain adequate records for 14 service users and his failure to undertake or record visits to four service users. His conduct was found to have fallen “well short” of that which would be regarded as proper in the circumstances. The misconduct had persisted over an extended period of time with a large number of cases involving particularly vulnerable patients.
5. The Panel at the final hearing found that the Registrant’s fitness to practise was impaired by reason of his misconduct. The Panel considered the personal component in relation to the Registrant’s own practice and any evidence of insight, remorse or remediation and the public component in relation to protection of service users and the need to declare and uphold proper professional standards. The Registrant was found to pose a risk of harm to those in his care. There was no evidence of insight or remediation, so as a consequence there was a risk of repetition.
6. The Panel at the final hearing imposed a Suspension Order of 12 months. The case was too serious for any lesser order. The Panel at the final hearing considered that the misconduct was remediable and that a period of suspension would give the Registrant an opportunity to reengage with the process and demonstrate insight. The Registrant was advised that the following may assist his case on review:-
• The Registrant’s attendance at the review hearing
• Independent evidence of his current health
• Evidence of his adherence to HCPC CPD standards
• References from any paid or voluntary employment addressing issues of case management and record keeping
• Evidence of any training he has undertaken to address the misconduct identified, and
• Evidence of the coping strategies he has developed to deal with stressful situations.
The first review:
7. The Registrant attended the first review hearing on 23 October 2015 and gave evidence of his remorse at his failings and his intention to remediate his failings. He asked for his suspension to be extended so that he could undertake and complete a plan to take the appropriate courses on time management and record keeping. He was working full time as a support worker for young people with additional needs or disabilities and provided a reference from his manager. The Panel commended the Registrant’s positive response, but noted his admission that his fitness to practise remained impaired. On that basis, the Suspension Order was extended for a further 12 months.
The second review:
8. The Registrant attended the second review hearing on 29 October 2016 and gave evidence of his training and his continued work with children and young people with challenging behaviour. He produced evidence of his work and a good reference from his current employer. The Panel at the second review was satisfied that the Registrant had taken substantial steps to address the concerns about his failings. He was found to have shown good insight into his shortcomings and to have significantly reduced the risk of repetition. However, the Panel remained concerned that his progress was not yet tested in a clinical setting in which he would be required to treat patients and to maintain records. His conduct therefore remained impaired on personal grounds, but no finding of impairment was required on public interest grounds in view of his progress towards remedying his previous misconduct.
9. The Panel at the second review therefore imposed a Conditions of Practice Order in the terms set out below on the basis that such an order would enable a supervised return to practice whilst mitigating and controlling the risks.
1) When undertaking work as an Occupational Therapist, you must place yourself and remain under the supervision of a workplace supervisor registered by the HCPC for a period of 6 months starting from the date that you take up a clinical role.
2) You must supply details of your workplace supervisor to the HCPC within 14 days of taking up a clinical role. You must attend upon that workplace supervisor as required and follow their advice and recommendations.
3) You should submit records of your supervision notes agreed with your workplace supervisor to the HCPC on a monthly basis during the 6 month period of supervision.
4) You must promptly inform the HCPC in writing within 14 days if you take up any employment as an Occupational Therapist.
5) You must promptly inform the HCPC in writing of any disciplinary proceedings taken against you by your employer.
6) 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 as an Occupational Therapist;
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). This review hearing
The third review:
10. The Registrant did not attend the third Review hearing on 29 September 2017.  He telephoned the HCPC on the day before the hearing to say that he had only recently collected the Notice of Hearing from his local post office and could not then attend the hearing at, what was to him, short notice, because of work commitments.
11. The hearing proceeded in the Registrant’s absence.  The third review panel had regard to an email from the Registrant dated 29 September 2017 and a positive reference from his line manager in his employment as a support worker.
12. The Panel acknowledged that the Registrant had worked hard in his role but found that he had made insufficient progress to permit him to return to unrestricted practice.  The Panel found there was no evidence of the Registrant returning to clinical or therapeutic work as an Occupational Therapist. In considering the personal component in relation to impairment, the Panel accepted that the Registrant had improved his administrative and organisational skills in his current position, but he had not returned to professional practice under supervision, so there remained a risk to service users.
13. The 2017 Review Panel found that the Registrant’s fitness to practise remained impaired and extended the Conditions of Practice Order by a further 4 months.   It gave the Registrant the following guidance with regard to a subsequent review: “The Panel has extended the current order by only 4 months so that the Registrant can now concentrate his mind on what is achievable or workable and demonstrate what practical steps he is taking towards an eventual return to practice as an Occupational Therapist. He would greatly assist his case by attending the next review hearing.”
14. It also warned the Registrant in the following terms: “The Registrant should also be aware that there will come a stage when these review proceedings will inevitably conclude either with his successful return to unrestricted practice or with his removal from the register, whether voluntary or otherwise.”
At the Review Hearing today:
15. The Panel read the bundle of documents put before it by the HCPC and the Registrant. The additional documents pertained to the efforts of the Registrant to find an appropriate placement.
16. The Panel heard evidence from the Registrant that he had continued to work at Aspire Disability Support Services where he was team leader of a team providing care to a severely disabled young man who needed considerable assistance to cope with living in his own home.
17. The Registrant gave encouraging evidence of the way in which the skills he employed in that work were transferable to work as an Occupational Therapist.  These skills included having a client centred approach, task analysis, motivation, establishing a system of communication and supporting staff to meet the client’s needs.
18. He gave evidence, supported by copies of emails, that he had communicated with the Royal College of Occupational Therapists and received good advice on CPD and the correct approach to making progress.
19. The Registrant also took the Panel through his written statement in which he set out the history of this case, outlined the difficulties he had encountered and set out his plan for the future.  This included realistic strategies for identifying and securing a suitable Occupational Therapy post.
20. Nonetheless, he had not yet attempted to find employment as an Occupational Therapist and complete a period of supervised work.  He gave evidence that he would apply in the New Year, as set out in his written evidence, and remained optimistic.
21. Ms Bragg submitted that the Registrant’s fitness to practise remained impaired until the Registrant could demonstrate in a supervised clinical setting that he could practise safely as an Occupational Therapist.  She submitted that an extension of the current Conditions of Practice Order was necessary to enable this to take place.
22. The Registrant did not make any submissions in addition to the evidence he had given.
23. The Panel heard and accepted the advice of the Legal Assessor.
Legal advice
24. The Legal Assessor advised that the Panel’s first task was to determine if the Registrant’s fitness to practise was still impaired. Its role was not to conduct a rehearing of the allegations nor was it to go behind the previous findings. He advised that in carrying out this assessment, the Panel must exercise its own independent judgment.
25. He advised that “the focus of a review is upon the current fitness of the registrant to resume practice, judged in the light of what he has, or has not, achieved since the date of the suspension. The panel should note the particular concerns articulated by the original panel and seek to discern what steps, if any, the registrant has taken to allay them during the period of his suspension.”
26. He also advised the Panel of the decision of Blake J in DR. ABRAHAEM- and -GENERAL MEDICAL COUNCIL 2008 EWHC 183
“In practical terms there is a persuasive burden on the practitioner at a review to demonstrate that he or she has fully acknowledged why past professional performance was deficient and through insight, application, education, supervision or other achievement sufficiently addressed the past impairments”
27. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired then the Panel should go on to consider what sanction, if any, should be imposed and that all the options under Article 30 of the 2001 Order could be exercised by the Panel. He also advised the Panel that it should bear in mind the principle of fairness and proportionality and to have regard to the Indicative Sanctions Policy document issued by the HCPC
Decision:
28. The Panel bore in mind that its first task is to decide if the Registrant’s fitness to practise is currently impaired.  Only if this is established, should it go on to consider what, if any, sanction should be imposed upon his registration.
29. The Panel had firmly in mind that the purpose of this hearing was to conduct a thorough review of the Registrant’s current fitness to practise, including an assessment of future risk, in the light of what he has achieved since the last hearing to allay the concerns identified by the previous panel.
30. In reaching its decision, the Panel has considered all the relevant material and had regard to the HCPC Practice Notes on Impairment and the Indicative Sanctions Policy.  The Panel accepted the advice of the Legal Assessor.
Impairment:
31. Having taken into account all the matters set out above the Panel found that the Registrant had developed significant insight into the importance of his misconduct and how to prevent it reoccurring in the future.  In this regard, the Panel was encouraged that the Registrant recognised that he was not yet ready to return to unrestricted practice as an Occupational Therapist.
32. Nevertheless, the Panel found that the Registrant’s remediation was still incomplete.  The Panel accepted that he had made progress through his work as a team leader at Aspire.  However, he was still not able to demonstrate that he could practise safely as an Occupational Therapist within a supervised clinical setting.
33. In those circumstances, the Panel found that there was still a significant risk of repetition.  Accordingly, it found that the Registrant’s fitness to practise remained impaired by reason of the need to protect the public, and in particular service users, from harm in the future.
34. For the sake of completeness and in fairness to the Registrant, the Panel records that it found that the need to promote and maintain public confidence and proper standards of conduct, had been satisfied in so far as they arise from the original misconduct.  The focus of this Panel is on the need to protect the public.
Sanction:
35. Having found the Registrant’s fitness to practise is still impaired, the Panel went on to consider, what if any sanction to impose on the Registrant.
36. The Panel had regard to the submissions and the Indicative Sanctions Guidance.  It also bore in mind its duty to protect members of the public and the wider public interest of maintaining public confidence in the profession and upholding proper standards of conduct, in so far as this was still engaged.
37. The Panel considered whether it could take no action, invoke mediation or impose a caution order.  It decided that none of those sanctions would protect the public because they would not restrict the Registrant’s practice in the way that was necessary.
38. The Panel considered that an extension of the current Conditions of Practice Order was the proportionate and appropriate sanction at this stage. The terms of the order remained necessary to provide protection to service users, because the Registrant had not yet demonstrated that he could practise at the level of an Occupational Therapist.
39. The Panel found that the conditions had adequately protected the public since they were imposed and would continue to do so in the light of the work he had done at Aspire and his favourable testimonial from his line manager.
40. The Panel decided that the appropriate period of extension was 12 months in order to give the Registrant time to secure appropriate employment and demonstrate his remediation over a period of 6  months.
41. The Panel considered whether it was necessary to impose a Suspension Order.  The Panel decided it was not because the Conditions of Practice Order was sufficient to protect the public in the light of the progress the Registrant had made at work. Nevertheless, the Panel is of the view that the Registrant should bear in mind the observations of the previous panel that if he is to return to work then he must do so in a reasonable time.
42. The next reviewing panel is likely to be assisted by:
1) The Registrant’s attendance at the hearing
2) Written evidence of his Continuing Professional Development (CPD) over the previous 12 months
3) A report from his workplace supervisor with regard to his practice as an Occupational Therapist, if he has obtained appropriate employment.

Order

The Registrar is directed to extend the Conditions of Practice Order against the registration of Mr Andrew S Woodall for a further period of 12 months on the expiry of the existing order.
1. When undertaking work as an Occupational Therapist, you must place yourself and remain under the supervision of a workplace supervisor registered by the HCPC for a period of 6 months starting from the date that you take up a clinical role.
2. You must supply details of your workplace supervisor to the HCPC within 14 days of taking up a clinical role. You must attend upon that workplace supervisor as required and follow their advice and recommendations.
3. You should submit records of your supervision notes agreed with your workplace supervisor to the HCPC on a monthly basis during the 6 month period of supervision.
4. You must promptly inform the HCPC in writing within 14 days if you take up any employment as an Occupational Therapist.
5. You must promptly inform the HCPC in writing of any disciplinary proceedings taken against you by your employer.
6. 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 as an Occupational Therapist;
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).


The order imposed today will apply from the expiry of the current order, namely 25 February 2018 date.
This order will be reviewed again before its expiry.

 

Notes

No notes available

Hearing History

History of Hearings for Mr Andrew S Woodall

Date Panel Hearing type Outcomes / Status
17/01/2018 Conduct and Competence Committee Review Hearing Conditions of Practice
29/09/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
26/10/2016 Conduct and Competence Committee Review Hearing Conditions of Practice