Mr David Morris

Profession: Speech and language therapist

Registration Number: SL05774

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 12/01/2018 End: 17:00 12/01/2018

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

Panel: Conduct and Competence Committee
Outcome: Voluntary Removal agreed

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Allegation

The Panel confirmed the following allegation:

 

Between 22 August 2014 and 27 January 2015, during the course of your employment as a Speech and Language Therapist at Chatting Independently:

 

1. In relation to Service User A:

 

(a)   You did not tell staff to ensure that Service User A was receiving thickened fluids and/or a mashed diet, despite being informed of the eating requirements of this service user;

 

(b)   You did not demonstrate the required knowledge of dysphagia when asked about your reasons for not ensuring that Service User A received thickened fluids and/or mashed food;

 

(c)    You stated that "staff hadn't had time" to thicken fluids for Service User A and/or that you were "confident that Service User A would not aspirate", or words to that effect.

 

(d)   You made significant changes to Service User A's diet, which was contrary to the advice of another Speech and Language Therapist who had experience of working with the service user;

 

(e)   You did not work within the capacity assessment and/or best interests decision framework before making significant changes to Service User A's diet.

 

2. Your actions described in paragraph 1 put Service User A at risk.

 

3. On or around 22 August 2014, whilst managing Chatting Independently, you did not ensure that staff were available and therefore Service User B was unable to have his peg flushed and medication given via his peg.

 

4. The matters set out in paragraphs 1 - 3 constitute misconduct and/or lack of competence.

 

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

Finding

Preliminary matters:


Service


1. The Panel is satisfied on the basis the documentation which it has been shown, that the Registrant has been served with notice of today’s hearing in accordance with the Rules.   The Panel has seen (i) a letter dated 27 September 2017 which was sent by first class post to the Registrant at his registered address and also by e-mail on the same date;  this letter gave notice of today's hearing to consider a Voluntary Removal Agreement.  


Proceeding in the absence of the Registrant


2. The Panel considered whether or not to proceed in the Registrant’s absence.  It noted that in an email sent by the Registrant to the HCPC dated 10 January 2018 the Registrant indicated that he is aware of today’s hearing and that he does not intend to attend.  It is also clear that the Registrant is content for the hearing to go ahead in his absence and he does not ask for any adjournment.  


3. The Panel has decided to proceed in the absence of the Registrant.   In reaching this decision, the Panel was mindful that it should exercise utmost care before doing so.  It took into account the matters set out in the HCPTS Practice Note on Proceeding in the Absence of the Registrant, and also received and accepted legal advice. 


4. The Panel is satisfied, on the basis of the email of 10 January 2018, that Registrant has voluntarily waived his right to be present.   The Panel noted he has not sought an adjournment and is satisfied that an adjournment would not result in his future attendance.   The Panel also takes the view that there is a clear public interest in notified hearings being heard expeditiously and at the allotted time.  


Background:


5. The Registrant was employed as a Speech and Language Therapist  ("SLT") and Manager at Chatting Independently ("Chatting"), a  residential rehabilitation centre for clients with learning difficulties and  complex physical needs.   Service Users A and B were both clients at  Chatting with speech and language therapy needs.   The Registrant  was the only SLT at Chatting and, as such, was responsible for the  care of Service Users A and B.   In August 2014, following a whistle- blowing concern, a safeguarding investigation into Chatting started.    At this time, Service User B had already been resident at Chatting for a  number of years while Service User A was transferred to Chatting  from Treloar  College shortly after this investigation began. 


6. The safeguarding investigation was conducted by Witness 1, a Senior  Community Learning Disability Nurse and Safeguarding Practitioner  within the Fenland Learning Disability Team.   During the course of her  investigation Witness 1 had concerns as to the treatment of Service  User A at Chatting.   Service User A had complex needs, suffering from  physical disabilities and learning difficulties.   He had dysphagia, a  disorder which affects an individual's ability to chew and swallow which  results in difficulties eating and drinking.   The main risks associated  with this condition are choking and aspirating which can be life  threatening.  


7. At his previous placement at Treloar College, Service User A had been  prescribed a specific diet of thickened fluids and mashed food because  of his dysphagia.   This had been prescribed by Witness 3, a Highly  Specialist SLT.   Service User A was prone to silent aspiration and  therefore at risk of chest infections.   Silent aspiration is when food or  drink passed into Service User A's lungs, he does not cough but  instead will become teary, blink a lot and/or his face will redden.  


8. No transition meeting had occurred prior to Service User A transferring  to Chatting despite efforts to arrange one by Treloar College.  Service  User A transferred to Chatting on about 12 August 2014.  A transfer  meeting at which the Registrant was present, eventually took place on  30 September 2014.   At this meeting, Service User A's Eating and  Drinking Profile was handed to the Registrant. 


9. During the safeguarding investigation, Witness 3 had provided details  of this specific diet to the Registrant.   Witness 4, Acting Locality  Manager, Clinical Lead for West Hampshire Continuing Healthcare  Team was appointed to work with the safeguarding investigation.    During a visit to Chatting on 13 October 2014, she noted that staff were  not following Service User A's Eating and Drinking Profile which had  been handed to the Registrant on 30 September 2014.   She saw that  Service User A was being fed food that was not capable of being  mashed.  


10. During the same visit, Witness 4 discussed the Registrant's knowledge  of dysphagia with him.   The Registrant informed her that he was not  qualified in dysphagia management and that his most up to date  training was when he had qualified many years previously.   Witness 4  became aware that Service User A was being asked to make choices  about his diet.   When she asked the Registrant about this, it became  clear that no Mental Capacity Act assessment had been completed and  that neither the Registrant nor the staff at Chatting were trained in the  Mental Capacity Act.  


11. The concerns in relation to Service User B became apparent during a  safeguarding meeting held on 3 October 2014.   Chatting is split into  two sites which were approximately 500 yards apart.   Service User B  received medication through a PEG tube which requires flushing to  ensure that the tube does not block, and medication is delivered.   On  22 August 2014, most staff at Chatting were taking part in a First Aid  Training Course at one site, leaving only three agency staff to care for  six service users, including Service User B, at the other site.   The  agency staff reported that they were not confident to flush Service User  B's PEG which resulted in Service User B being brought to the other  site so the qualified staff could flush his PEG. 


12. The matter was referred to the HCPC.  

 
Decision:


13. In reaching its decision, the Panel has taken account of the HCPTS  Practice Note on “Disposal of Cases by Consent” (Voluntary Removal).    It has received and accepted legal advice.  It has reviewed the terms of  the proposed Voluntary Removal Agreement.  It has had regard to the  submissions of Mr Claughton for the HCPC and to the fact that the  Registrant has requested that his name be removed from the Register  and has signed the proposed Voluntary Removal Agreement.   


14. The Panel has taken into account all the information put before it,  including:
(i) the determination of the substantive hearing panel,
(ii) the Registrant’s stated wish for his name to be removed from the Register.


15. The Panel is mindful that it should only agree to revoke the existing  Suspension Order if it is satisfied that voluntary removal of the  Registrant’s name from the Register would secure an appropriate level  of protection for SLT service users and that it would not undermine  public confidence in the SLT profession or in its regulatory body.


16. The Panel has carefully considered all the material before it.  It is  satisfied that the Registrant has not worked as an SLT since 2014 and  has now obtained long term employment in an occupation which does  not require professional registration.  

   
17.The Panel accepts that the Registrant no longer intends to practise as  a SLT.   It also accepts that the Registrant is aware that if, after 5  years, he did apply for re-admittance to the Register, his application  would be considered by the HCPC on the basis that he had been  struck off the register as a result of the Allegation.  


18. The Panel has decided that it would be appropriate to permit the  Registrant to voluntarily remove his name from the Register.  The  Panel is satisfied that service users will be adequately protected as (i)  any application by the Registrant for re-admittance to the Register  cannot be made for 5 years from the date that his name is removed  from the Register and (ii) his application will be treated, as if he had  been struck off the Register on the basis of the Allegation, and will be  made in light of the findings at the substantive hearing.


19. The Panel is also satisfied that an informed member of the public  would not consider that public confidence in the SLT profession would  be undermined in any way by allowing the Registrant to remove his  name from the Register.   The fact that he has been subject to  proceedings brought by his regulator has already served to maintain  public confidence in the SLT profession, and sent out a message as to  the standards it expects of its practitioners.


20. In these circumstances, the Panel has decided to approve the  Voluntary Removal Agreement and to revoke the Suspension Order  with immediate effect.

Order

Order: The Registrar is ordered to revoke the Suspension Order imposed on the registration of Mr David W H Morris with immediate effect.

Notes

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 Mr David Morris

Date Panel Hearing type Outcomes / Status
12/01/2018 Conduct and Competence Committee Review Hearing Voluntary Removal agreed
27/02/2017 Conduct and Competence Committee Final Hearing Suspended