Ms Debra Julie Howe

Profession: Social worker

Registration Number: SW78775

Hearing Type: Final Hearing

Date and Time of hearing: 09:00 18/06/2018 End: 16:00 25/06/2018

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

(as amended at the substantive hearing)

Whilst registered as a Social Worker and employed with Somerset County Council, you:

1. In respect of Service User A:

a) Allowed Service User A’s transfer to a new residential care home on or about 29 April 2016 and did not:

i. complete and/or record an adequate funding application prior to Service User A’s transfer;

ii. submit a funding application prior to the Service User’s transfer;

iii. complete and/or record a negotiated fee for Service User A prior to her transfer;

iv. complete and/or record the financial agreement and purchase order in a timely manner in that they were completed after Service User A’s transfer on or about 29 April 2016.

b) Did not complete and/or record an adequate assessment of Service User A in that:

i. you used a pre-existing ‘Understanding You D: How you live (UY:D)’ as a basis for your assessment;

ii. the assessment documentation completed in or around May 2016 was not compliant with the Care Act;

iii. you did not complete and/or record your reasoning for making recommendation about Service User A’s residential care;

iv. you did not make an independent assessment of Service User A’s care needs;

v. you did not consider alternative care options for Service User A;

vi. you did not take sufficient account of Service User A’s capacity or wishes about her placement.

c) Submitted a funding application for Service User A on or about 13 May 2016 which was inadequate and/or incomplete;

d) did not obtain Service User A’s consent and/or personal views regarding her potential transfer to an alternative nursing home until you were instructed to do so on or about 11 July 2016;

e) Did not act upon information received on 13 May 2016 that Service User A’s panel application had not been accepted, in that you did not complete and/or record a comprehensive action plan regarding Service User A’s care arrangements before going on annual leave on or about 13 May 2016;

f) Did not communicate effectively with Service User A and/or her family in that you:

i. On or about 23 May 2016, asked a Financial Assessment and Benefit Officer (FAB) to communicate information to Service User A’s husband regarding finalising Service User A’s funding arrangements; HCPC OFFERED NO EVIDENCE

ii. did not correct Service User A’s husband’s inaccurate understanding about her funding arrangements that he would have to pay a “top up” contribution;

iii. Did not inform Service User A and/or her family of the next steps following the rejection of her funding application.

2. In respect of Service User B, you:

a) Did not complete and/or record an adequate and accurate UY: assessment documentation in relation to Service User B on or about 21 July 2016, in that you:

i. did not record your professional judgment about Service User B’s likelihood of suicide;

ii. did not record an analysis of Service User B’s vulnerability, risk of harm or likelihood of harm;

iii. did not record the assault on Service User B, his dogs and his property;

iv. recorded inaccurate information regarding Service User B’s self-referral to ASC and his high court injunction;

v. did not record information regarding an assault on Service User B, his dogs and property; HCPC OFFERED NO EVIDENCE

vi. did not record information in the section of the assessment form relating to eligibility, professional conclusions and support planning.

b) Did not notify or consult with the police regarding a suspected criminal offence against Service User B, in a timely manner;

c) Did not conduct an adequate assessment about the concerns about Service User B’s safety in his home and whether he felt at risk;

d) Did not take into account and/or seek professional advice regarding the impact of Service User B’s diagnosis in relation to his own assessment regarding risk;

3. In relation to Service User C, you:

a) Did not complete and/or record the UY: D assessment in a timely manner in that you were allocated the case on 14 April 2016 and did not complete the UY: D until 12 May 2016;

b) Did not complete and/or record an adequate UY: D dated 12 May 2016 in that it did not contain sufficient information relating to:

i. the care provided to Service User C at home;

ii. why Service User C’s home care failed;

iii. what rehab support was given to Service User C.

c) You did not record your review of Service User C’s placement conducted on or about 01 July 2016.

4. In relation to Service User D, you:

a) did not complete and/or record an adequate UY: D assessment for Service User D which was Care Act compliant;

b) did not complete and/or record an adequate UY: N1 assessment in that your assessment contained insubstantial evidence and minimal analysis;

c) did not complete a best interest assessment for Service User D.

5. In relation to Service User E, you did not complete and/or record an adequate and/or comprehensive UY: D assessment in that:

a) you indicated that you had requested advice from the Sensory Loss and Community Health teams but did not include any information received in your final assessment;

b) the UY:D assessment contained gaps in the information relating to Service User E’s need for specialist sensory loss input or guidance.

6. In relation to Service User F, you did not complete and/ or record a UY: D assessment, although you were instructed to do so.

7. Your actions described in paragraphs 1 – 6 constitute misconduct and/or lack of competence.

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

Finding

Preliminary Matters

Service

1. The Panel is satisfied that there has been good service of the Notice of Hearing.

Proceeding in absence

2. The Registrant did not attended the final hearing.

3. The Panel first considered whether it ought to exercise its discretion to continue with this hearing in the absence of the Registrant. The Panel concluded that it was in the public interest to do so, having considered the HCPTS Practice Note on “Proceeding in the Absence of the Registrant”, having taken the Legal Assessor’s advice, and considered the guidance in R v Jones [2002] UKHL 5 and GMC v Adeogba, R v Hayward [2001] EWCA Crim 168 and GMC v Visvardis [2016] EWCA Civ 162, for the following reasons:

• The Panel is satisfied that the Registrant had Notice of the hearing;

• The Panel has seen an email dated 15 June 2018 from the Registrant, in which she confirms she will not be attending the hearing, stating that she could “…see little purpose in attending what I assume will be a public shaming”;

• The Registrant has not sought an adjournment and has asked for her representations produced at the Investigating Committee stage, contained in a letter dated 28 April 2017, to be placed before the Panel;

• The Panel concluded that, even if these proceedings were adjourned, there was very little likelihood that the Registrant would attend on a subsequent occasion;

• The Panel concluded that the Registrant has deliberately chosen not to attend this hearing, amounting to a deliberate voluntary waiver of her right to appear;

• There are a number of witnesses who have attended to give oral evidence. It is in the public interest that a hearing should take place within a reasonable time of the events to which it relates.

The Panel therefore determined that it was reasonable and in the public interest to proceed today in the circumstances, given that the relevant events date back to 2016.

Application to amend the allegation

4. There was an initial application by the HCPC to amend the particulars of the allegation. There was a minor amendment to Particular 1(e) where there was a typographical error, and a re-wording of Particular 1(f)(ii) to ensure that the particulars better reflected the evidence. The amendments did not alter the substance of the allegation. There was no prejudice to the Registrant in allowing it, as she had been provided with Notice of the proposed amendments by letter dated the 10 August 2017 and has not raised any objections to the amendments.

5. The Panel further concluded that it was in the interests of justice to allow the amendments, noting that in two instances the effect of the amendments was that the HCPC is offering no evidence against the Registrant, namely particulars (1(f)(i) and 2(a)(v).

6. The allegation set out above is therefore the amended allegation. Documentation 7. The Panel has been provided with a substantive bundle of documents which runs to 577 pages, from the HCPC. The Panel has also seen the Registrant’s submissions dated 28 April 2017 and the email dated 15 June 2018.

Background

8. The Panel heard oral evidence on behalf of the HCPC from:

• MN: Advanced Practitioner in Learning & Development at Somerset County Council (“the Council”) and the Investigation Officer;

• JI: Locality Manager for South Somerset at the Council;

• TK: Former Team Manager at the Council (who gave evidence from abroad via telephone);

• JS: Community Psychiatric Nurse at Musgrove Park Hospital;

• AM: Locality Lead (Advanced Practitioner at the time of the allegation) in Taunton’s Adult Social Care Team and the Council.

9. The Panel found each of the witnesses called by the HCPC to be credible, balanced and reliable, each witness making concessions where appropriate and admitting openly where, due to the passage of time, they were unable to recall very specific details relating to the facts of the case.

10. The Registrant is a Social Worker. She was employed with the Council, working in the Adult Social Care Taunton Community Team. She had been in this role since 2012. The Panel heard evidence that the Registrant’s line manager, TK, had developed concerns about her practice shortly after assuming management responsibility for her, and had managed her over a three-year period. TK gave evidence that she was aware that there had been performance issues with the Registrant throughout her employment with the Council, and attempts had been made to address these issues by previous managers.

11. The Registrant also had an extensive sickness record, which included the period from 9 December 2015 to 9 February 2016. Both JI and TK suggested that there was a link between work-related stress and illness, in that after performance issues were raised with the Registrant, she would thereafter be absent with stress. This led to further difficulties in the Registrant catching up on her return. TK’s evidence was that, although the Registrant’s sickness absence played a part in some of the difficulties she had at work, it was certainly not the only reason.

12. The Panel also heard evidence that the Council received five complaints about the Registrant relating to Service Users on her caseload during her absence from December 2015 onwards.

13. An informal Performance Improvement Process (PIP) had been in place from April 2015. TK’s evidence was that although there had been some improvement under this plan, there were also outstanding issues which still needed to be addressed.

14. Those remaining issues were incorporated into a further formal PIP put in place from April 2016 and reviewed in July 2016. Following the formal implementation of the PIP, the Registrant alleged she had lost confidence in her manager and made allegations of bullying. The Registrant declined the opportunity to put in a formal grievance about this. TK stated that the Registrant found it difficult to accept the criticisms being made of her performance. In oral evidence, TK denied that she had bullied the Registrant, and noted that her role as a manager was to challenge deficiencies in the practice of any Social Worker that she had responsibility for.

15. On 18 May 2016, JI was instructed to conduct an audit of the Registrant’s cases, which highlighted a number of concerning issues in relation to Service User A. This resulted in MN being asked to conduct an investigation into the Registrant’s work.

16. Between 13 and 14 June 2016, MN completed a desk-top review of the Registrant’s caseload. At that stage, the Registrant had a reduced caseload of seven or eight cases. Two further cases were reviewed; one in which the Registrant was the lead assessor and a second which, by the time of the review, had been closed (Service User F).

17. The Panel heard evidence from JI that this caseload was very low for the Registrant’s level of experience. Other Social Workers at the Registrant’s level had around 20-25 cases. Prior to her sickness absence, the Registrant had 23 open cases. 18 cases were reallocated during the period of her absence and upon her return she initially had three cases, which increased to approximately eight by July 2016. MN’s oral evidence was that the cases allocated to the Registrant were “routine” ones, to allow her to focus on improving her performance.

18. In addition to a reduced caseload, other supportive measures included some one-to-one mentoring sessions with an Advanced Practitioner, AM.

19. AM was involved in compiling the PIP along with TK. The purpose was to enable the Registrant to improve her performance, focusing on her practice base and her ability to manage her caseload effectively. Other issues to be addressed were time management, record-keeping, managing stress in the workplace, assessments and reviews, impact on Service Users and carers, the effect on teams, partnership agencies, and sickness.

20. The Registrant, according to AM, initially saw the PIP as supportive, but as time progressed, AM questioned the Registrant’s motivation to learn and change her practice, citing, for example, meetings that were cancelled by the Registrant and her failure to bring a completed self-assessment form to the next meeting. Whilst the Registrant had accepted that there some issues with her practice, she had not expected a formal PIP.

21. Of the four one-to-one sessions planned with AM, only two actually took place. The Registrant cancelled three further sessions, citing the fact she was too busy or was working from home. During the sessions, AM told the Panel that the Registrant appeared more focused on how her manager, TK, should have acted differently, rather than concentrating on the improvements required to her own practice.

22. AM expressed the view that the issues which TK had raised with the Registrant were fair and evidenced clearly in her supervision notes, and these demonstrated that her manager had tried to support her to improve her performance.

23. The Registrant’s submissions made the following points:

• She acknowledged that there were, at times, failings in her recording, but blamed this on her high workload prior to her taking sick leave in December 2015. At that stage she had in excess of 30 cases;

• The Registrant said that morale was low and peer group support was limited by the increasing volume and complexity of referrals to the service;

• When she returned to work in February 2016, she was placed on “front line Duty all day every day.” The Registrant said that this explained why her caseload was lower, as Duty social work is one of the most stressful of all social work tasks. She described being “set up to fail” by the process.

24. The Panel rejected the assertion that the Registrant’s ability to do her job was affected by being allocated to a Duty role. JI’s evidence was that, when she returned to work, the Registrant was asked to support the Duty desk to ease her back into work. The Registrant was taken off Duty for two weeks in February 2016, as she was struggling. JI added that the Duty cover expected of the Registrant was no higher than that expected of other Social Workers.

25. TK rejected the assertion that the Registrant’s caseload was reduced to allow her to undertake full-time Duty work. Undertaking work on the Duty desk required little record-keeping and the Duty system provided close management and other support. The Registrant returned to work on a phased basis over quite a few weeks and was allocated five or six cases, as well as being on the Duty desk.

26. TK’s evidence was that the Registrant was not spending all of her time working on Duty, and that she had sufficient time to complete assessments on the reduced caseload which she was allocated.

27. The evidence from AM was that she worked in an open-plan office with the Registrant and was hence able to observe the fact that the Registrant, upon her return to work, did not undertake Duty work as often as her colleagues did. She knew this as the Social Workers on the Duty desk sat in a specific location.

28. None of the HCPC witnesses agreed with the Registrant that there were any specific morale issues in the team.

29. The Registrant was interviewed by MN as part of her fact-finding investigation on 30 June 2016 and 3 August 2016. MN’s evidence was that the Registrant willingly answered questions, but lacked insight into the seriousness of the allegations. The Registrant sought to explain the shortfalls in her recording and assessments by alluding to the pressures that she and her colleagues were facing. The Registrant also alleged that the investigation, following on from performance management actions, was oppressive.

30. The first draft of the internal investigation report was completed on 7 July 2016 and the final draft was presented in a meeting on 20 July 2016. Thereafter, additional concerns were raised and the terms of reference for the investigation were extended to include other Service Users. The second draft report was produced on 9 August 2016 and a final report submitted on 19 August 2016.

31. The Registrant was suspended from the Council on 25 July 2016.

Decision on Facts

32. The Panel heard and accepted the Legal Assessor’s advice and exercised the principle of proportionality at all times. In approaching the task of deciding the facts, the Panel kept at the forefront of its deliberations the importance of requiring the HCPC to prove matters against the Registrant. The standard of proof to which the HCPC is required to prove matters is the civil standard – on the balance of probabilities.

33. The Panel was very conscious that when a witness has not given oral evidence, this is hearsay evidence. When considering hearsay evidence, which is admissible, the Panel paid due regard to the weight which it can attach to it, bearing in mind that it has not been possible for that evidence to be challenged or probed. This was particularly the case for the Registrant’s evidence.

34. In reaching decisions on the facts, the Panel has taken account of:

• The oral evidence from the HCPC witnesses;

• The documentary evidence before it;

• The written submissions from the Registrant. The Panel’s attention was specifically drawn by the Registrant in her written submissions to her letters to the Council dated 22 June 2016 and 3 August 2016. However, these submissions did not address all of the particulars of the HCPC’s allegation.

Particular 1(a)(i)-(iv) – Proved

39. Particular 1 relates to Service User A (“SUA”), who was transferred to a new residential care home on 29 April 2016 from her previous nursing home. In March 2016, SUA’s husband requested a review of his wife’s circumstances, on the basis that there was a change in her financial situation and a belief that she no longer required nursing care, making the care home she was residing in no longer appropriate.

40. On 18 March 2016, the nursing home made a request for an assessment of SUA’s needs to be undertaken. On 11 April 2016, two further referrals were made; one from the nursing home and one from SUA’s husband, which said that SUA’s funds were approaching the capital threshold and she would become eligible for Council funding. A District Nurse assessed SUA on 12 April 2016 and verbally informed the Registrant that SUA’s needs could be met in residential care. The Registrant visited the care home on 15 April 2016, but did not complete the assessment documentation.

41. For a “capital drop” assessment (the point at which a Service User’s personal assets drop below £23,250 and the Council can assist with funding), the Registrant should have completed a Needs Assessment (an Understanding You:D form (“UY:D”)) and a request for funding. There is no evidence that either of these assessments took place prior to SUA moving to a new care home on 29 April 2016.

42. In her witness statement, JI stated that the Financial Assessment and Benefit (“FAB”) Team would also complete a financial assessment (detailing where a Service User’s needs can be met and whether the Service User’s capital has fallen below the required threshold for Council assistance). In this instance, the FAB Team confirmed to the Registrant on 22 April 2016 that SUA would reach the “capital drop” level by 7 May 2016 and would then be entitled to financial assistance from the Council. However, SUA’s husband transferred her to a new residential care home some days before this on 29 April 2016, without Council funding being secured. The transfer and placement was therefore, for the initial period, on a privately funded basis.

43. The Registrant did not complete or submit the appropriate funding application prior to the transfer. MN’s evidence was that when she examined the file, she could not locate a finalised funding application. There was a partially completed application dated 4 May 2016.

44. There was equally no recording and/or negotiation regarding the fee prior to SUA’s transfer. There was no evidence of this in the case notes. An email dated 3 May 2016, from the care home to the Council, simply portrayed SUA as “self-funding”.

45. The Panel noted that the Registrant, in her letter dated 30 June 2016, described being told about the proposed move by SUA’s husband, but made no mention of a funding application or advice relating to the Council funding process.

46. JI’s evidence, on the issue as to whether the Registrant had “allowed” SUA to transfer to the new home, was that the Registrant should have sought to negotiate an appropriate fee with the new care home, in line with the funding levels that the Council had authority for. JI said that this fee negotiation should take place in advance of the transfer so that the Council could be sure that SUA had been placed in a secure location. Instead, the Registrant allowed SUA’s husband to arrange the transfer himself.

47. The Registrant was aware that SUA may have required a change in care home and was close to the capital threshold. She failed to follow Council procedures in accordance with their “Care Arranging Placements” policy (“the policy”). The policy provided to the Panel was dated December 2016; it had been updated and the earlier policy is not available. MN’s evidence was, however, that the general placement process had not changed.

48. MN’s evidence was that the correct approach was to complete the assessment of need for SUA; then the formal funding application; and then negotiate a fee with the care home. This should be done before the Service User moves into the home. This is the minimum practice standard when arranging new placements, as set out in the policy.

49. When the Registrant was asked by the Council’s Finance team after the transfer why there was no financial agreement in place, she indicated that she was still in the process of completing the assessment.

50. When asked during her evidence by the Panel to further define what she meant by “allowing” SUA’s transfer to an alternate care home to take place, MN clarified that there was a process which had to be gone through and that it was the professional duty of a Social Worker to anticipate issues which may arise. Moving between care homes, in circumstances where Council funding was likely to be required and where the fees charged were in excess of this, was an issue which should have been raised with SUA’s husband. This would have allowed a pause to take place, allowing the options to be considered. MN was not confident that this conversation had taken place.

51. The Panel accepted that this was the correct interpretation of “allow” in the stem of Particular 1(a). There was no evidence that the Registrant alerted SUA or her husband to problems occasioned by the proposed move with regard to Council funding.

52. The Registrant did not complete the financial agreement and purchase order until after the transfer; this is the process which triggers payment, and is part of the pre-transfer process. This was evidenced by the email dated 3 May 2016 from the residential home’s administrator, which noted that SUA has completed the move but that as of yet there was no financial agreement.

53. An agreement needs to be in place prior to the transfer, and forms part of the contractual arrangements. Once the document has been signed, the agreement is passed onto the FAB Team, who authorise the payment. The Registrant’s actions meant that there was no scrutiny of the funding application by a Senior Manager or Resource Panel to ensure that alternative care options had been considered and that an evidence-based approach had been used to support professional reasoning before making a decision.

54. By failing to follow the correct approach, the Registrant placed the Council at financial risk. JI’s evidence was that this was because the amount of money which the Council was allowed to spend on SUA was £467.08 per week, but the cost of residential care at the home to which she transferred was £700 per week. As soon as SUA fell below the “capital drop” threshold, the Council would have been liable for the entirety of the fees. The cost of the placement was substantially in excess of that usually agreed by the Council.

55. JI’s evidence was that there could have been some attempt to renegotiate the fee, but in the event that agreement could not be reached, then the Council policy would have been to consider a further transfer to a home which could meet SUA’s needs, but at the Council’s rates—hence why it is important to ensure agreement is in place regarding a fee prior to any move.

56. The Registrant was interviewed by MN on 30 June 2016 and was unable to offer any explanation as to why she did not complete the funding application prior to 29 April 2016. This issue was not addressed in the Registrant’s letters to the Council, as referred to in her submissions.

Particular 1(b)(i)-(vi) – Proved

57. In addition to the funding assessment, the Registrant was required to carry out an assessment of SUA’s care needs. Assessment information and professional recommendations are summarised in the UY:D form, which the Panel had sight of. This was also not completed until after SUA’s transfer.

58. The Registrant had used a pre-existing UY:D form held on the Council’s AIS data base, originally completed on 21 November 2014. The Registrant then added some updates to this form. Many of SUA’s requirements listed on the form, including medication, preferences and current situation, dated from 2014, but this was not made clear. The document in the HCPC bundle was dated “Version 1 Jan 2012” and “Version 4 May 2013”. Having out-of-date information still present in the assessment led to inaccuracies; for example, under the heading “What Matters Most to You” it was stated “for my personal outcomes to be met whilst my husband has an operation”. SUA’s husband was not in hospital at this point.

59. This form predated the introduction of the Care Act 2014 and was hence not legally compliant. The document completed by the Registrant was based on “Fair Access to Care” criteria, which pre-dated the Care Act. As such, the assessment could not be relied upon to justify the move. The Registrant added additional information to the pre-Care Act form when she should have completed an updated, Care Act compliant UY:D form.

60. During her interview on 30 June 2016, the Registrant acknowledged that her preferred way of working was to rely on the pre-existing assessment, which she would then add to. The Registrant stated that she struggled with changes to her practice and the new documentation which was required by the Care Act. She was unable to offer any explanation as to why she had used the pre-Care Act format of the UY:D form.

61. MN’s evidence was that the assessment which was undertaken by the Registrant was inadequate because it did not record her reasoning for making a recommendation about the transfer of SUA to the new care home. The AIS client records note that the Registrant had been told verbally by a District Nurse that a health assessment had been completed on 12 April 2016, which indicated that nursing care was no longer required. There was no record that any written assessment was seen or received by the Council.

62. The Registrant appeared to have simply accepted the verbal recommendation from the District Nurse without seeing her reasons and without carrying out an independent assessment herself as to whether the new care home was appropriate.

63. Although the Registrant visited SUA on 15 April 2016 and obtained some information from her and her husband, the Registrant still failed to record any reasoning about the placement, nor was there any evidence of analysis of the information which was gathered.

64. There was limited information recorded about what SUA was able to do for herself. The assessment did not take proper account of SUA’s wishes and capabilities and was hence not complete. There was no evidence, for example, that the Registrant obtained any information from the nursing staff at the home about SUA’s care needs. It would not have been possible to consider alternative care options without first carrying out a proper assessment, instead of simply relying on the District Nurse’s verbal conclusion. In any event, the Panel could see little or no evidence that the Registrant had considered alternative care options.

65. The UY:D form did not record in any detail SUA’s wishes regarding the proposed transfer. It also did not analyse whether SUA had capacity to make a decision about the proposed transfer, despite the comment on the UY:D form from 21 January 2016 that SUA “can be confused and non-cooperative and is diagnosed with dementia.”

66. As a result of these failings, SUA had the upheaval of being moved again to a new care home. From 3 May 2016, there were indications that the new care home was struggling to manage SUA’s mobility needs. From 10 May 2016, it was indicated in telephone conversations with the care home and the District Nurse that the care home could no longer meet SUA’s needs. She was described as being “off her legs” and having congestive heart failure, atrial fibrillation and dementia. These points should have been picked up in a robust nursing and social care assessment.

Particular 1(c) – Proved

67. The Registrant sent a completed funding application to JI on 13 May 2016, relating to the second transfer for SUA, for an ‘Urgent Out of Panel’ decision. JI rejected the application drafted by the Registrant for two reasons. Firstly, there was no up-to-date nursing assessment to confirm that SUA required nursing care. The Registrant had sought to rely on an old health assessment dated 21 January 2016, which was now out-of-date and no longer accurate. Secondly, as noted above, the Registrant relied on an old UY:D form, which was not Care Act compliant.

68. Before any payments could be authorised, a new health assessment was required to assess SUA’s up-to-date needs and what additional resources or support were required. The Registrant also needed to update the UY:D form. MN had emailed the Registrant to this effect on 13 May 2016 at 1.28pm, along with a case note of the decision at 2.23pm.

Particular 1(d) – Proved

69. In July 2016, SUA’s husband sought a further transfer for SUA, as he was struggling to drive to visit his wife on a daily basis. There was no evidence that SUA’s needs were not being met at the care home.

70. SUA’s husband had been involved in discussions with the care home about moving to an alternative home, operated by the same provider, at the same level of funding. SUA’s husband did not understand that he was not in a position to enter into such arrangements as SUA was being funded by the Council. There was no record that the Registrant had explained the process to him.

71. The records suggested that the Registrant was prepared to justify a further move on the basis that this was in accordance with SUA’s husband’s wishes. It may well have been that SUA agreed with her husband’s views, but there was no record of this made by the Registrant. There was no evidence that the Registrant spoke to SUA on her own, or took any actions to support and encourage her in the decision-making process until 11 July 2016, once plans were already in motion to transfer SUA, and only once she had been explicitly instructed to do so by an email from JI on 7 July 2016.

72. JI discussed this with the Registrant, as she believed that SUA had capacity. This was supported by the records, which suggested that SUA was capable of making decisions about her care and support. However, there was no concrete evidence that SUA wanted a further move, and indeed the Registrant told JI that SUA was “fed up” of being “moved from pillar to post”.

Particular 1(e) – Proved

73. Following the rejection of the funding application on 13 May 2016, the Registrant went on annual leave. The Registrant had taken no steps to ensure that SUA’s case would be progressed in her absence. JI stated that the Registrant left work at 3.30pm, taking a late lunch. She made the assumption that the outstanding actions would be dealt with by a Duty Social Worker. The Registrant did not ask the Duty Team to liaise with the District Nurse, or adequately chase the District Nurse for an update, having been notified that the District Nurse had not met SUA and had not received a written assessment. The Registrant had not updated the UY:D form.

74. The Registrant should have agreed and documented an action plan with her manager setting out the next steps to be taken in her absence by a colleague. JI’s evidence was that, as the Registrant had left for annual leave without resolving these issues, this resulted in the Council having to authorise funding for a new care home at a cost of £900 per week, well above the Council’s allowance, as when the case was picked up by a Duty Social Worker on 19 May 2016 there were no other appropriate options available, and the situation was increasingly urgent.

75. Had the Registrant taken appropriate steps to ensure that the assessment documentation was in order on 13 May 2016, there would have been more time to find an appropriate care setting at a lower fee.

76. In interview on 30 June 2016, the Registrant stated that she had received verbal assurance from the current care home that they could manage SUA’s needs in the interim period. However, this was not recorded in the case notes.

Particular 1(f)(ii) – Not Proved

77. The Panel had no evidence from SUA’s husband or from anyone who had spoken to him directly. Therefore, the HCPC has not proved to the requisite standard that he had an “inaccurate understanding” of SUA’s funding arrangements.

Particular 1(f)(iii) – Proved

78. MN’s evidence was that she was concerned that the communication in this case was inadequate in relation to the rejection of the funding application on 13 May 2016. The Registrant telephoned the manager of the care home to explain that the funding application had been rejected. However, she did not directly contact SUA or her husband to explain what the next steps in the process would be. The Registrant relied on the care home manager to pass the message onto SUA and her husband. She did not document this decision in the case notes.

Particular 2(a)(i)-(iii) & (vi) – Proved

79. This particular relates to Service User B (“SUB”), who had taken legal action against the Council’s property department in relation to a trespass issue and had sought an injunction to stop the Council removing him from his property. SUB was residing in a mobile home in a remote location.

80. SUB had indicated that he would end his life if he was evicted and moved to an unsuitable location, as was recorded in the UY:D. The Panel also heard evidence that SUB’s previous Social Worker, MW, had indicated that SUB’s intention in this regard was likely to be serious. SUB had previously been evicted from other properties and was well known to the Council.

81. SUB had been diagnosed with Asperger’s Syndrome and also had other disabilities. He was described by his previous Social Worker as “high functioning”. He had refused to accept alternative accommodation offered by the District Council as he considered that they did not meet his needs. A request had been made by the Council’s Legal Services and Strategic Manager to assess his needs to identify any vulnerabilities. This request was initially declined as SUB had capacity and had not approved any such assessment. However, after a Court hearing, at which progress towards an eviction was made, SUB made a self-referral for support. It was agreed that a joint visit would take place with the Council and a Community Psychiatric Nurse (“CPN”), JS.

82. The Registrant visited SUB with JS on 14 July 2016.

83. JS’s evidence was that the Registrant had established a good rapport with SUB and let him talk. JS said the Registrant had acted extremely professionally in the context of a difficult visit.

84. JS’s evidence was that the conclusion of her assessment was that SUB was not at immediate risk of suicide. The risk of suicide was directly linked to the threat of eviction, and as her impression was that there was no immediate threat of eviction, she concluded that there was no immediate risk of suicide. JS’s oral evidence was that she knew that it was likely that SUB would be evicted at some point in the future, but not in the short term, due to an appeal, but conceded she was specifically unaware that he had lost a recent High Court injunction. She admitted being unaware of the specifics of the legal process involved. Whether this would have made any difference would have depended on how SUB presented, and his answers to any further questions she posed, but JS did accept that this was relevant information which might have changed her perception of risk. She would have carried on with a suicide risk assessment in light of that information.

85. JS stated that she had asked SUB about what he would do if he felt suicidal, and had been told that he knew where to access assistance, if required.

86. The Registrant spoke with TK and JI about the case on 14 and 15 July 2016, who both directed her to make contact with the Safeguarding Team. However, the Registrant went on annual leave on 15 July 2016 without actioning this or completing the assessment.

87. The assessment was not formally completed until 22 July 2016. The Registrant had been told by SUB that he and his dogs had been shot by his neighbours and that he did not want to leave his home for fear that it would be “torched”. This information was not included in the assessment by the Registrant and it was unclear from the assessment whether the concerns were current or historic.

88. The Registrant uploaded the partially completed UY:D form on 25 July 2016, but only after she had been prompted by JI. The Registrant did not formally complete the assessment as she was suspended on 25 July 2016. The document’s conclusion section was blank.

89. The Safeguarding Team was contacted by the Registrant on 22 July 2016; at that stage there was insufficient information in the records to allow them to identify SUB’s vulnerabilities and so they required a more detailed assessment.

90. The Registrant told TK that SUB had been clear that, if he were evicted from the property, he would kill himself. However, in the case note dated 21 July 2016, the Registrant recorded the conclusion that SUB was not suicidal at the time of her visit and noted SUB’s desire for support during his Court proceedings. The Registrant had not provided any analysis of the link between the potential eviction and the risk of suicide.

91. The Registrant had failed to record how she had reached her conclusions and simply appeared content that SUB was not suicidal at the time of her visit. This was important as the focus was not just on SUB’s mental capacity but his eligibility for care and support and his vulnerability as an “adult at risk”.

92. JS’s evidence was that the Registrant had requested a copy of her assessment. JS said that, in response, she sent the Registrant a copy of the letter which she had sent to SUB’s GP, dated 4 August 2016. JS understood that the Registrant then copied and pasted it into the UY:D form. JS was of the view that this was “normal practice and agreed by both professionals on case by case basis.” JS did not see the UY:D form completed by the Registrant.

93. JS expressed surprise when she was subsequently contacted by the Council expressing concern that SUB was vulnerable, as she had not seen any information to justify this categorisation. She did, however, subsequently undertake a second assessment of SUB with a different Social Worker on 18 August 2016. However, she did not change her overall view as a result of the subsequent assessment. She was still unaware at the time of this subsequent assessment that SUB had lost his High Court injunction proceedings and was also unaware of the timeline for the eviction.

94. The Panel concluded that, instead of recording her own analysis, the Registrant had relied on JS’s judgment about whether SUB was a suicide risk. In the circumstances, the assessment should have been as full as possible, with the Registrant expressing a professional judgement about the risk of suicide. In the partially completed UY:D form, the Registrant did not input her opinion about the likelihood of suicide. This was despite telling JI and noting in the assessment that SUB was clear he would commit suicide if evicted. The Registrant had told another Social Worker, AC, who had a background in mental health, that it was her “gut instinct” that he would take this action. However, there was no evidence of probing or analysis of the information provided by SUB. It was of significance that it was SUB’s expressed intention to kill himself if evicted which prompted the initial request for the assessment.

95. Even though the visit was undertaken jointly with the CPN, the Social Worker would still be responsible for assessing SUB’s vulnerabilities and some analysis and recording on the likelihood of suicide was required. The Registrant had failed to record in the form what she had told JI orally.

96. The Registrant’s assessment did not analyse SUB’s current vulnerabilities, risk of harm, or likelihood of harm. The Registrant was aware that SUB and his dog had been shot at with a pellet gun by his neighbours. This was potentially relevant information, but it was left out of the assessment and initial case note on 14 July 2016. There was no analysis as to whether this issue was currently impacting on SUB. The shooting was a potential crime; the Registrant should have discussed with SUB whether he wanted the police involved and she should have recorded his response. MN described the assessment as having “effectively minimised the risks to Service User B’s safety and wellbeing.” There was also reference to his property being “torched” if he left the premises overnight, but this was not included in any analysis by the Registrant of SUB’s vulnerability.

97. As part of an assessment, a Social Worker should identify a Service User’s eligible needs and how these could be met, so that a support plan can be implemented. There were specific sections for these considerations in the UY:D form. The Registrant had identified that SUB had difficulties with his mobility, but had not addressed whether this affected his independence. The Registrant had left blank the sections on the UY:D form relating to eligibility, professional conclusions, planning, actions, and next steps.

Particular 2(a)(iv) – Not Proved

98. The UY:D form partially completed by the Registrant recorded that SUB had “recently won” a Court case involving the Council. This was incorrect as Judicial Review High Court proceedings had gone against SUB. However, from reading the UY:D form (section b) it appeared that the author of this information was someone called AS from Somerset Direct, dating from April 2016, as opposed to the Registrant. The Panel could therefore not be satisfied that the HCPC had proved its case on Particular 2(a)(iv).

Particular 2(b) – Not Proved

99. The evidence in relation to this particular is set out above. On a literal reading of this Particular, the Registrant did not consult with or notify the police in relation to the alleged shooting incident by SUB’s neighbours, aimed at both himself and his dog.

100. The HCPC’s case is that it is standard safeguarding policy that, if there has been a suspected criminal offence, the police should be consulted. Even if the incidents reported by SUB were historic, when taken together with his current fear of an arson attack, this issue should have been investigated further with the police.

101. However, there was clear evidence that the Registrant consulted with a Solicitor in The Community Law Partnership. The Registrant recorded in the case notes on 22 July 2016 that the incident had been clarified as happening “about a year ago”.

102. In addition, JS’s evidence was that the assaults, including attacks on SUB’s dogs, were historic and that she herself did not identify a current risk or safeguarding issue. In oral evidence, JS confirmed that her understanding was that the incidents were in the “distant past.” In answers to the Panel’s questions, she stated that the previous assaults might have taken place at a different location, when SUB was living on a traveller’s site or there had been travellers living close by. There had been some more recent incidents with neighbours which had involved throwing rubbish into the field where his mobile home was placed.

103. JS did not think there was any need to involve the police, as there was no serious concern or threat at the time. She considered that SUB was capable of contacting the police to request assistance if he felt he was under threat, and had told her that he had done this in the past. He also had access to both a mobile telephone and a computer.

104. Whilst one option open to the Registrant might have been to contact the police, the Registrant instead consulted with SUB’s solicitor, who confirmed that the issues were historic. The Panel concluded that there was no substantive failure on the part of the Registrant in not contacting the police in the circumstances of this case.

Particular 2(c) – Proved

105. The evidence in relation to this particular is set out above in Particular 2(a). SUB had expressed concern that his home might be the subject of an arson attack, but this was not recorded in the assessment. The Registrant told MN that this was because he had not told her that his neighbours made him feel at risk. However, it was reasonable to expect that the Registrant would have explored with SUB whether he felt safe in his home in light of his comments and to have incorporated these into the assessment, so as to properly document and evaluate the risks to his safety and wellbeing.

Particular 2(d) – Proved

106. SUB had been diagnosed with Asperger’s Syndrome. JI informed the Registrant of this prior to her visit to SUB. However, the assessment did not include any analysis of the potential impact of this on SUB’s thoughts regarding risk to himself. The Registrant took what SUB said at face value and did not enquire below the surface. There was a lack of professional curiosity.

107. The Registrant told JI that she had not considered this issue in detail, as she was not an “Asperger’s expert”. However, the Registrant should have considered the potential impact of the diagnosis on SUB’s thought processes. The Registrant could have sought specialist advice to help her understand SUB’s condition, which might have helped her to assess his risks and vulnerabilities. There was evidence in the HCPC bundle of specialist professionals who had been involved with SUB, including workers from the Asperger’s Specialist Team and Mental Health Social Workers, as can be seen in the letter dated 20 April 2015 from MW, SUB’s previous Social Worker. This gave some indication of the complexities of how SUB’s Asperger’s impacted on him. There was no indication that the Registrant had used this information or attempted to gather further information to assist her in obtaining a view of SUB’s assessment regarding risk.

Particular 3(a) – Not Proved

108. This Particular concerned Service User C (“SUC”). SUC had been placed in a residential care home by her daughter who cared for her. The carer had requested funding from the Council on the basis of a 12 week ‘disregard’. During this period, the Council can disregard the value of the Service User’s property to allow Service Users and families to plan how care home fees are to be financed in the long-term.

109. SUC was allocated to the Registrant on 14 April 2016. The Registrant completed the UY:D form on 12 May 2016. There was a legal requirement for assessments to be completed within 28 days.

110. The HCPC case is that, given the Registrant’s reduced workload of seven to eight cases, it was reasonable to have expected that the Registrant would have been able to undertake the assessment in a much shorter timeframe. The assessment was completed within 28 days. It is asserted that best practice would have been to complete the assessment as promptly as possible to minimise delay and uncertainty.

111. However, the Panel saw no evidence that the Registrant was given specific instructions that she had to complete the assessment earlier than the required 28-day period. The Panel accepted that the Registrant could have completed the assessment sooner, but this is not the same as establishing on the balance of probabilities that the assessment was not completed and/or recorded in a timely manner.

Particular 3(b)(i)-(iii) – Proved

112. The UY:D form completed in respect of SUC on 12 May 2016 was inadequate in a number of ways. Firstly, the Registrant had not recorded sufficient information about the care provided to SUC at home, such as the frequency or lengths of visits from paid carers or the tasks they were carrying out. It did not include what support the daughter had provided and why the daughter was struggling. This information would have allowed a full assessment of whether SUC could continue to live at home with additional support.

113. Secondly, there was inadequate information as to what, if any, rehabilitation support was given to SUC when living at home. MN’s evidence was that the Registrant should have initiated and documented a discussion with an Occupational Therapist and the Re-Ablement Team to explore whether the provision of additional equipment or physiotherapy would assist in allowing SUC to remain in her own home.

114. As a result of deficiencies in the Registrant’s assessment, the Resource Panel rejected the funding application on 13 May 2016. There was insufficient information covering the topics set out above. The information was subsequently provided in a resubmission, but the UY:D form, which is supposed to be accurate and provide a full picture, was not updated, so that it did not represent SUC’s history, current care and support needs.

Particular 3(c) – Not Proved

115. After the Registrant had resubmitted the finance form to the Resource Panel, JI agreed to the required funding level to be provided to SUC on 8 June 2016, on the basis that no other placement could be obtained at the Council’s fee levels. The placement was charging £650, which was over and above the Council’s £467.08 funding level.

116. A case note was entered by the Registrant on 30 June 2016 documenting a telephone call to the manager of the care home, in which she stated that she would review the placement on 1 July 2016, writing, “Acknowledged apt to review [SUC] tomorrow”. On the same day, the Registrant recorded that she had left a voicemail with SUC’s daughter to confirm the new arrangements. There were no further notes. There was no review documentation on the case system.

117. It was therefore entirely unclear whether in fact a review took place on 1 July 2016 which the Registrant had failed to record. It was equally possible that the reason why there were no records was that the review did not take place. The Registrant cannot be criticised for not recording a review which may not have actually taken place.

Particular 4(a) – Not Proved

118. The Particular concerned Service User D (“SUD”). SUD was an older lady with a significant cognitive impairment. She was living in a care home partly funded by the Council. Her condition had deteriorated such that she needed a higher level of specialist care, which required a transfer to an alternate care home. Therefore an assessment was required. She was transferred from Special Residential Care to an Elderly Mentally Infirm Nursing Home.

119. The Registrant was the leading Social Worker conducting the assessment. The particular alleges that the Registrant did not complete and/or record an adequate UY:D form which was Care Act compliant.

120. However, in her witness statement MN confirmed—and this was clarified in her oral evidence—that a Care Act compliant UY:D form was used. In addition, the HCPC rightly made a concession in closing submissions that the form was Care Act compliant.

Particular 4(b) – Proved

121. During the fact-finding investigation undertaken by MN, it was identified that the Registrant had undertaken an Understanding You: N1 (“UY:N1”) assessment of SUD’s mental capacity. The UY:N1 form is used to record an assessment of mental capacity where a significant decision has to be made and where there is concern that the individual Service User might not be capable of making that decision themselves.

122. The decision needed was whether SUD should transfer to an alternative placement. The Registrant concluded that SUD lacked the mental capacity to make this decision. However, there was insufficient evidence or analysis recorded to justify this finding. The assessment repeated the same statement in three of the four stages of the functional test (to evaluate the person’s ability to understand, retain, weigh up, and communicate their understanding). This statement was the carer and family’s views, rather than evidence of the Registrant’s attempts to assess SUD in these four areas. There was minimal analysis of the information she obtained.

Particular 4(c) – Proved

123. Secondly, having determined there was a lack of mental capacity, the UY:N1 assessment was inadequate because it did not thereafter go on to assess SUD’s best interests, in accordance with the Mental Capacity Act. There was no evidence that the Registrant had considered SUD’s best interests, and/or that every possible consideration had been given to involving SUD in the decision-making process and alternative options considered.

124. The Panel heard evidence from MN that it was highly likely that the Registrant had received training in relation to the Mental Capacity Act 2005.

Particular 5(a) – Proved

125. This particular concerned Service User E (“SUE”). SUE was registered blind and was diagnosed with dementia in 2006. He had become increasingly frail and it was felt that his carer was unable to provide the level of support which he now required. The Registrant was allocated the case on 7 March 2016 with a view to a placement into specialist care.

126. The Registrant updated a pre-existing UY:D assessment form on 18 March 2016. The form noted that she had requested advice from her colleagues from the Community Mental Health Team (“CMHT”) (“CMHT input requested on 17.03.16”) and on sensory loss (“Sensory loss advice sought”). However, the assessment did not include any information received from these colleagues in her final assessment.

127. The case notes showed that the Registrant had discussed SUE’s case with a specialist Sensory Loss Worker on 23 March 2016 and completed a joint visit with the CPN on 4 April 2016, and new information was recorded there but not incorporated into the assessment. There was sufficient time for the Registrant to incorporate this information into the UY:D form before SUE’s placement on 12 May 2016.

Particular 5(b) – Proved

128. The assessment in relation SUE was inadequate and contradictory. MN’s evidence was that the Registrant noted that SUE required specialist sensory loss input, but then placed him in a generic residential care home with no further guidance provided on his loss of sight. The Registrant should have obtained the relevant guidance and included this within the assessment, allowing a proper analysis of SUE’s needs and allowing advice to be given to the care provider on how best to manage his future care needs.

129. There was nothing in the assessment to explain how SUE managed his sight loss, either historically or at the time the assessment was undertaken. There was, for example, no reference to strategies he was using or any specialist equipment that was being used. There was also no reference as to how SUE’s needs could be managed given the cumulative effect of both his sight loss and dementia.

Particular 6 – Proved

130. This particular concerned Service User F (“SUF”). SUF was an older lady who met her care needs herself, having arranged for 24-hour live-in care. However, she was finding that this was financially very difficult to sustain and had requested advice and guidance on care options from the Council.

131. The Panel heard evidence from MN that the Registrant was directed to complete an assessment of SUF during her supervision on the 16 March 2016.

132. There was a case note recording that on 9 March 2016, the Registrant had visited SUF and that “[UY:D form] to be completed using information from today’s visit and daughter’s shared information.” However, there was no UY:D form on the system incorporating the information obtained in the meeting. There was a note in the electronic records dated 29 March 2016 recording that the Registrant had sent a closure/support letter to SUF, explaining that she was ineligible for services, and that the Registrant closed the case on 29 March 2016. There was insufficient recorded information summarising the Registrant’s findings, or documenting why SUF was ineligible for services.

Decision on Grounds

133. The Panel next considered whether the Registrant’s actions amounted to misconduct and/or a lack of competence, and it concluded that there was a lack of competence as opposed to misconduct. The Panel concluded that the Registrant had demonstrated a lack of skills, knowledge and judgement over a period of time.

134. The Panel had regard to the guidance in Calhaem v GMC [2007] EWHC 2606 (Admin) that deficient professional performance is conceptually different from negligence and misconduct. It connotes a standard of performance which is unacceptably low, and which (save in exceptional circumstances) has been demonstrated by reference to a fair sample of the Registrant’s work.

135. The Panel considered whether the Registrant’s actions also amounted to misconduct, but concluded, having considered the evidence as a whole, that this was not a case where the Registrant knew the standards which were expected of her but chose not to comply with them. Rather, this was a case where she genuinely struggled to comply with the expectations which were being placed upon her by the Council and her line manager.

136. The Panel concluded that the allegations encompassed a fair sample of the Registrant’s work at the relevant time, noting that she had a caseload of six to eight cases between February and July 2016. The allegation relates to six of these cases over a number of months, and in the Panel’s view constituted an unacceptably low standard.

137. The Panel does not intend to set out all of the evidence, which is detailed above, in relation to its findings of a lack of competence, but a brief summary is as follows:

• The Registrant was properly supported in relation to her work-related stress and was provided with both an informal and formal PIP. MN expressed disappointment that the Registrant was unable to make the changes that were required in her practice following this period of support with a low caseload;

• JI’s evidence was that there had been a number of years of extensive sickness absence and practice concerns about the Registrant. The problems which were identified with the Registrant’s performance pre-dated her being managed by TK and had been raised by a number of previous line managers;

• TK’s evidence was that the Registrant’s sickness absence was “absolutely not the sole reason” why she was unable to perform to the required standard;

• The Panel accepted the evidence of the HCPC witnesses that the Registrant had a significantly reduced caseload;

• Giving the Registrant Duty work on her return from sickness absence was meant as both a supportive and protective measure. The amount of Duty which the Registrant undertook was reduced when she told TK that she was struggling with it. The Panel rejected the Registrant’s submission on this point that she had been given excessive Duty work;

• The Panel rejected the Registrant’s submissions that being managed by TK was the reason for her poor standard of work;

• Although there was some evidence of good practice on the part of the Registrant (for example, developing a good rapport and trust with SUB), this was not reflected in the quality of her written assessments and ability to analyse information gathered;

• The Registrant was not able to make good use of the mentoring offered by AM, a professional educator who was independent from the Registrant’s line manager.

138. The Panel also concluded that the Registrant was in breach of the following HCPC Standards of Proficiency for Social Workers in England, dated August 2012.

1 be able to practise safely and effectively within their scope of practice

2 be able to practise within the legal and ethical boundaries of their profession

4 be able to practise as an autonomous professional, exercising their own professional judgement

8 be able to communicate effectively

9 be able to work appropriately with others

10 be able to maintain records appropriately

11 be able to reflect on and review practice

12 be able to assure the quality of their practice

14 be able to draw on appropriate knowledge and skills to inform practice

Decision on Impairment

139. The Panel next considered whether the Registrant’s fitness to practise is currently impaired in light of her lack of competence, having regard to the HCPTS Practice Note “Finding that Fitness to Practise is ‘Impaired’” and accepting the advice of the Legal Assessor. The Panel has also exercised the principle of proportionality.

140. The Panel is mindful of the forward-looking test for impairment. The test is whether a registrant’s fitness practise is currently impaired (as opposed to at any point in the past), the aim being the current and future protection of the public.

141. The Panel heard submissions on the issue of impairment from the HCPC. Ms Partos submitted, on behalf of the HCPC, that the Registrant’s fitness to practise is impaired on both the public and personal components.

142. The Panel concluded that the Registrant’s current fitness to practice is impaired, having regard to both the public and personal components of impairment, for the following reasons:

• The Registrant’s conduct was both serious and placed a number of Service Users at risk, particularly: SUA, who had to move care home on four occasions; SUB, with a risk of suicide; and the failure to take SUE’s needs into account;

• The Registrant’s written submissions demonstrate very little insight into her failings or consideration of the impact her actions had on Service Users;

• The lack of competence was repeated and there is no evidence of remediation; there is therefore a high risk of repetition. The Panel took the view that the lack of competence was capable of being remedied, but that it had seen no evidence that the Registrant had taken any steps in this regard;

• The Registrant was provided with a good deal of support by the Council, including a mentor, additional supervision, and a reduced caseload;

• The Registrant has provided no evidence of how she has kept her skills up-to-date, or of any Continuing Professional Development (“CPD”) or training since she was suspended by the Council in July 2016;

• The Registrant has provided no evidence regarding her present employment;

• The Registrant has provided no documentary or character evidence demonstrating any modifications in her practice since she left the Council;

• The Registrant’s actions have brought the reputation of the Council, and the Social Work profession, into disrepute, damaging public confidence in the profession;

• The Registrant has breached a fundamental tenet of the profession by not placing Service Users at the forefront of her practice and failing to act in their best interests;

• The Panel also had regard to the need to uphold proper standards of behaviour in concluding that the public component of impairment is clearly established. The Panel concluded that confidence in the Social Work profession would be undermined if there was no finding of impairment, given the seriousness of the lack of competence which has been identified.

Decision on Sanction

143. The Panel heard submissions on sanction on behalf of the HCPC. It paid regard to the HCPC’s “Indicative Sanctions Policy” and accepted the advice of the Legal Assessor.

144. The Panel had regard to the aggravating and mitigating circumstances in this case.

145. The aggravating features are:

• The Registrant’s lack of competence was serious, involving a risk of harm to service users as identified above, and was repeated;

• The Registrant did not take full advantage of the support which was offered to her;

• The Registrant has not provided any significant evidence of remediation or insight into her failings. There is no evidence of her current or future employment plans or that she has kept her skills and knowledge up-to-date;

• The Panel is concerned that there is a high risk of repetition in the future if the Registrant remains free to practice on an unrestricted basis;

• The Registrant’s actions brought the profession into disrepute and she breached a fundamental tenet of the profession.

146. The mitigating features are:

• There is some evidence that the Registrant had a health condition and has had stress-related absences in the past;

• The Registrant has engaged in these proceedings to a limited extent, in sending in written submissions, and she has acknowledged, at least in part, her failings;

• The Registrant was capable of undertaking some aspects of her role effectively; there was evidence from JS, for example, of her establishing a good rapport with SUB;

• The Registrant has had no previous regulatory finding against her in 12 years as a qualified Social Worker.

147. The Panel was mindful that the purpose of imposing a sanction in regulatory proceedings is to protect the public, and not to punish an individual registrant. The Panel also bore in mind the wider public interest and deterrent effect on other registrants, the reputation of the profession, and public confidence in the regulatory process.

148. In light of the above factors, the Panel determined that, given the nature of the Registrant’s lack of competence and the findings set out above, that to take no action or to impose a Caution Order would not adequately protect the public, nor would it be in the public interest, and would not retain public confidence in the regulatory process or the profession.

149. The Panel next considered whether to make a Conditions of Practice Order, but concluded that this was not an appropriate sanction, as:

• It was difficult to see how any workable or verifiable conditions could be imposed on the Registrant. The Registrant has not provided any evidence regarding her current employment or whether she is working as a Social Worker;

• The Panel noted that a Conditions of Practice Order is unlikely to be suitable in cases where there are serious or persistent overall failings and the Registrant lacks insight or denies wrongdoing. Given the lack of both insight and remediation, the Panel considered that a Conditions of Practice Order would not be appropriate to protect the public and to retain confidence in the profession of Social Worker;

• The Panel also noted that the Council had already introduced a variety of supportive measures, such as additional supervision and mentoring, which had not successfully addressed the Registrant’s lack of competence. Therefore, it seems unlikely that further measures of this kind, in the form of Conditions of Practice, would be successful at this time.

150. The Panel next considered a Suspension Order for a period of 12 months and concluded that this was the most appropriate sanction, for the following reasons:

• The sanction is the minimum required to provide adequate public protection, to maintain confidence in the profession, and to have a suitable deterrent effect upon the profession at large;

• The sanction provides the Registrant with an opportunity to remediate her lack of competence, with the potential of a return to Social Work;

• The sanction strikes a fair balance between the Registrant’s interests and the public interest, having regard to the mitigating and aggravating features.

151. The Panel is of the view that 12 months is the appropriate length for the Suspension Order in order to mark the seriousness of the Registrant’s lack of competence. It will also give the Registrant time to remediate the widespread concerns regarding her competency.

152. Whilst in no way seeking to bind any future review panel, this Panel anticipates that the following matters are likely to be of assistance to any future reviewing panel:

• The Registrant’s attendance at the review hearing;

• A document written by the Registrant which includes evidence of her reflection upon her failings/lack of competence and how any actions she has taken since this substantive hearing may have remediated those failings;

• Evidence of any paid or unpaid work she has undertaken;

• Up-to-date references/testimonials;

• Evidence of an up-to-date CPD record

Order

That the Registrar is directed to suspend the registration of Ms Debra Julie Howe for a period of 12 months from the date this order comes into effect.

Notes

This Order will be reviewed again before its expiry.

Hearing History

History of Hearings for Ms Debra Julie Howe

Date Panel Hearing type Outcomes / Status