Mr Lofton Alexander McTavish Hull

Profession: Social worker

Registration Number: SW31899

Hearing Type: Review Hearing

Date and Time of hearing: 12:00 08/10/2018 End: 16:00 08/10/2018

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

Allegation (as found proved at final hearing)

During the course of your employment with Devon County Council as an agency Social Worker, you:

1. Found not proved.

2. Found not proved.

3. You spoke to Child A’s Consultant Oncologist, Dr D,

. in an aggressive and / or rude manner and/or by
ii. you interrupted what he was saying.

4. On 28 August 2015 you spoke to Doctor F, a junior doctor:

i. in a rude and / or aggressive manner and/ or

ii. you interrupted what she was saying.

5. During a telephone conversation with a Staff Nurse at Bristol Royal Hospital for Children, you spoke to her in an aggressive manner;

6. On or around 12 October 2015, you disregarded the opinion of Person A when he advised that Child A was too unwell to attend a meeting and insisted that Person A and therefore Child A attend the meeting.

7. Did not maintain an effective relationship with Person A in that you gave him insufficient notice of scheduled meetings and /or contact sessions as follows;

a) on or around 10 September 2015, you contacted Person A at approximately 12.16pm and insisted that he and Child A had to attend a meeting at 11.00am the next day;

b) on or around 28 August 2015, you contacted Person A and informed him that a contact meeting was due to take place on the same day at 7.30pm;

c) on 15 September 2015, you contacted Person A at approximately 9.51am and informed him that a contact meeting was to take place at 10.30am on the same day;

d) on 12 October 2015, you contacted Person A at approximately 7.30am and informed him that a PEPS meeting was to take place on the same day at around 1pm.

8. Between February 2015 and October 2015, did not maintain an effective relationship with School E, in that you:

a) did not respond to e-mails and / or phone calls promptly and / or at all;

b) on or around 27 March 2015, did not attend a scheduled meeting and / or did not inform other attendees that the meeting had been cancelled;

c) did not communicate that meetings had been arranged and/or that dates had been changed and / or cancelled;

d) were rude and dismissive towards school staff.

9. Your actions described in Particulars 2, 4, 5, 6 and 7 placed Child A at risk of harm and / or were not in the best interests of Child A.

10. The matters set out in Particulars 1 – 9 constitute misconduct and / or lack of competence.

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

Finding

Background

1. The Registrant was employed as an agency Social Worker by Devon County Council from January 2014 until October 2015.

2. Child A and Child B were being cared for by Person A, who had a Special Guardianship Order (SGO). Person A and the children’s mother (Mother A) did not live together. On 21 August 2015, the Registrant became the allocated social worker for Child A and Child B. One of his main duties was to arrange contact between Child A and B and Mother A.

3. The majority of the factual particulars of the Allegation were found proved and the Final Hearing that panel found that the Registrant’s conduct and behaviour amounted to misconduct and in particular demonstrated a failure to:

a. understand the need to promote the best interests of service users and carers at all times;

b. demonstrate effective and appropriate skills in communicating advice, instruction, information and professional opinion to colleagues, service users and carers;

c. work in partnership with others, including those working in other agencies and roles;

d. contribute effectively to work undertaken as part of a multi-disciplinary team.

4. The Final Hearing panel found the Registrant’s fitness to practise to be impaired on both the personal and public interest components. The panel stated:

84. The Panel has found that the Registrant's misconduct put a vulnerable service user at risk on several occasions, caused unnecessary distress to his main carer and/or was not in his best interests.

85. His serious misconduct was persistent over a number of months and involved a failure to communicate effectively both with Person A and a significant number of those concerned in Child A’s care.

86. There is no evidence before the Panel that the Registrant has engaged in any way remediated his faults or that he has developed any insight or recognised the seriousness of his misconduct.

87. In those circumstances the Panel is satisfied on the evidence before it that the Registrant remains a risk to future service users.

88. The Panel also considered the public component of fitness to practise, namely the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession and the regulatory process. The Panel find that fitness to practise is impaired with regard to the public component.’

5. The Final Hearing panel went on to determine that the Registrant should be made subject to a 12 month Suspension Order on the basis that his failings were capable of being remedied and it was appropriate to give him the opportunity to do so. The Final Hearing panel stated that it was likely that the reviewing panel would be assisted by the following:

a. The Registrant’s attendance at the Review Hearing;

b. A reflective piece demonstrating that the Registrant has understood the significance of his misconduct and its impact on others and demonstrating how he would handle similar situations differently in the future;

c.  Evidence of study and learning that demonstrates that the Registrant has learned how to communicate effectively with service users, carers and other professionals in a multi-disciplinary team;

d. Evidence of any paid or unpaid work since this hearing;

e. References or testimonials demonstrating the Registrant’s ability to work with others in a non-confrontational manner;

f. Evidence of the Registrant’s future plans as a Social Worker;

g. Evidence that the Registrant has maintained his Continuing Professional Development in anticipation of a return to work.

HCPC Submissions

8. Ms Senior, on behalf of the HCPC, outlined the background circumstances and the history of this case. She referred the Panel to the information that the previous panel had suggested the Registrant may wish to provide to assist this reviewing panel. Ms Senior acknowledged, following the Registrant’s evidence, that he had demonstrated some insight. However, she queried whether the scope and level of his insight was sufficient.  Ms Senior was neutral as to whether the Registrant’s fitness to practise is currently impaired but suggested that if the Panel determine that his fitness to practise is impaired a Conditions of practice Order may be sufficient to protect the public and the wider public interest.

The Registrant’s Evidence

9. The Registrant chose to give evidence. He informed the Panel that he was appointed as a Deputy Manager of a Priory children’s home in July 2018 but has not yet started work in this role for administrative reasons. He stated that he has not worked in a social work role since May 2017. In relation to the Final Hearing panel’s findings, he informed the Panel that he ‘has to accept the panel’s findings’ because he chose not to attend the hearing and therefore the panel did not have the benefit of his version of events or the context. He stated that he chose not to attend the Final Hearing because, at that time, he had decided to give up social work. However, he stated that he has undertaken a lot of ‘soul searching’ since then and has decided to take the Final Hearing panel’s decision ‘on the chin’. The Registrant informed the Panel that he has worked in social care for 40 years and, on reflection, decided that his non-engagement with the HCPC was an ‘unpleasant way to end things.’

10. The Registrant informed the Panel that he has learnt from his mistakes and has a lot to offer the profession in either a private or public sector position. He made reference to the counselling course he has undertaken and the Leadership and Management course that he is due to complete as part of his forthcoming role as Registered Manager. He also outlined the work he had undertaken in formulating policies on behalf of Foundations Children & Family Services Limited (‘Foundations’). He stated that he had kept his social work skills and knowledge up to date through his work with Foundations and his ‘reading.’

11. During cross examination, and in response to questions from the Panel, the Registrant outlined what he had learnt during the supervision sessions with his supervisor at Foundations. He was also invited by the Panel to explain the impact of the Final Hearing panel’s findings on (i) himself as a professional social worker and, (ii) the wider public interest.

12. The Registrant informed the Panel that he did not consider his fitness practise to be currently impaired.

Panel’s Approach

13. In undertaking this review, the Panel took into account the hearing bundle and the documentary evidence provided by the Registrant, which included:

(i)  A character reference from the Service Manager/Director of Foundations.

(ii) Clinical Supervision Records dated 26 October 2017, 30 November 2017, 28 December 2017, 24 January 2018 and 21 February 2018.

(iii) A Clinical Supervision Update Report from the Clinical Lead at Foundations for the period September 2017 – March 2018.

(iv)  A reflective piece

(v) An email dated 31 May 2018, confirming that the Registrant’s registration on an online course (the counselling course) was complete.

(vi) An email dated 11 July 2018, confirming the offer of the Registered Manager role within the Priory Group.

14. The Panel also took into account the Registrant’s oral evidence and the submissions from both parties.

15. The Panel accepted and applied the advice it received from the Legal Assessor as to the proper approach it should adopt. In particular that:

• The purpose of the review is to consider the issue of impairment based on the previous panel’s findings of fact, the extent to which the Registrant has engaged with the regulatory process, the scope and level of his insight and the risk of repetition.

• In accordance with the case of Yussef v GMC [2018] an admission of guilt in response to allegations of misconduct is not a pre-requisite for sufficient insight to be found by the Panel. A registrant may, for example, deny an allegation but set out how the conduct which is alleged could affect confidence in the Registrant as a professional, public confidence in the profession, or fail to adhere to proper standards of conduct and behaviour. The key issue is whether the registrant has been sufficiently clear to avoid appearing inconsistent and superficial.

• In terms of whether his previous misconduct has been sufficiently and appropriately remedied, relevant factors include whether the Registrant:

(i) fully appreciates the gravity of the previous panel’s finding of misconduct and impairment;

(ii) has maintained his skills and knowledge;

(iii) is likely to place service users at risk if he were to return to unrestricted practice.

• The Panel should have regard to the HCPTS Practice Note: Finding that Fitness to Practise is impaired and must take account of a range of issues which, in essence, comprise two components:

(i) the ‘personal’ component: the current competence, behaviour etc. of the individual registrant; and

(ii) the ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

• It is only if the Panel determine that the Registrant’s fitness to practise remains impaired, that the Panel should go on to consider sanction by applying the guidance as set out in the HCPTS Indicative Sanctions Policy (ISP), and the principle of proportionality which require the Registrant’s interests to be balanced against the interests of the public.

Decision on Impairment

19. The Panel was encouraged by the Registrant’s decision to re-engage with the regulatory process. The Panel noted that the Registrant had taken the opportunity to consider the findings that had been made by the Final Hearing panel. He had provided the Panel with a reflective piece, a reference from a former employer and documentary evidence of current study. During his oral evidence the Registrant outlined further learning that he had undertaken. The Panel took the view that the efforts the Registrant had made to demonstrate that he is fit to return to the Register unrestricted were worthy of significant credit.

20. The Panel noted that the Registrant attempted to make a distinction between his acceptance of the Final Hearing panel’s findings and his view that, some or all, of the decisions were reached in the absence of context or explanation that he could have provided. The Registrant acknowledged that that was a decision that he had chosen to make and that he would have to accept the consequences.

21. The Panel recognised that the Registrant’s qualified acceptance of the Final Hearing panel’s findings did not preclude him from demonstrating sufficient insight. However, the Panel concluded that the Registrant’s oral evidence demonstrated only partial insight. The Panel accepted that the Registrant had reflected on the Final Hearing panel’s findings, but the quality of these reflections, particularly in light of the Registrant’s considerable experience as a social worker, lacked depth or detailed understanding.  Whether the Registrant agreed with the Final Hearing panel’s findings or not, the Panel took the view that he ought to have been able to articulate in a meaningful way the impact of those findings on his standing as a social work professional and the impact on the wider public interest which includes trust and confidence in the profession as a whole.

22. The Panel took the view that the paucity of the Registrant’s written reflections was echoed in his oral evidence. When the Registrant was asked to elaborate on the case studies referred to within the clinical supervision records, his responses were broad and vague rather than detailed and specific. The Panel was left with the distinct impression that although the Registrant had developed some insight the scope and level of his insight was insufficient given the nature and seriousness of the Final Hearing panel’s findings. The Panel took the view that the Registrant demonstrated a degree of professional arrogance. Therefore, the Panel was not satisfied that he fully understands or appreciates the role of a multi-disciplinary team, his role and the role of other professionals within the team.  The Panel formed this view in light of the Registrant’s response in relation to questions relating to Child A. The Registrant maintained that Child A was exposed to a ‘potential’ risk of harm rather than the actual risk of harm as described by an experienced nurse. The Panel also noted that the Registrant sought to justify his insistence that, on or around 12 October 2015, Child A attend a meeting, when the child was too unwell to attend, having regard to the risk that he would acquire an infection.

23. Whilst the Panel accepted that the matters found proved were remediable, the Panel was not satisfied that the Registrant had provided sufficient evidence of remediation. The Registrant had not provided any documentary evidence of specific training or CPD undertaken relevant to social work and his oral account of the steps he had taken to keep his skills and knowledge up to date was superficial. In any event, the Panel recognised that although formal or informal CPD is important, it is the learning that has been achieved as a consequence which is of most significance. The Registrant provided the Panel with only limited evidence that he had learnt anything and which would enhance his practice as a social worker.

24. In the absence of sufficient evidence of insight and remediation, the Panel was not persuaded that the conduct and behaviour identified by the Final Hearing panel would not be repeated. Therefore, the Panel was led to the inevitable conclusion that the Registrant’s fitness to practise remains impaired on the basis of the personal component, by reason of his previous misconduct.   

25. The Panel went on to consider the wider public interest. The Panel concluded that the public would be concerned that the Registrant had not taken full advantage of the opportunity to demonstrate that the deficiencies in his practice as identified by the Final Hearing panel have been appropriately remedied. In these circumstances, the Panel concluded that public confidence in the profession would be undermined if there was no finding of impairment. As a consequence, the Panel determined that the Registrant’s fitness to practise is impairs impaired based on the public component.

Decision on Sanction

26. Having determined that the Registrant’s fitness to practise is impaired, the Panel went on to consider what sanction, if any, should be imposed. The Panel bore in mind that the purpose of a sanction was not to punish the Registrant but to protect the public.

27. The Panel first considered taking no action. The Panel concluded that, in view of the nature and seriousness of the Registrant’s previous misconduct which has not been remedied and in the absence of exceptional circumstances, it would be inappropriate to take no action. Furthermore, it would be insufficient to protect the public, maintain public confidence and uphold the reputation of the profession.

28. The Panel then considered a Caution Order.  The Panel noted paragraph 28 of the ISP which states:

29. “A caution order is an appropriate sanction for cases, where the lapse is isolated, limited or relatively minor in nature, there is a low risk of recurrence, the registrant has shown insight and taken appropriate action.” 

30. The Registrant’s conduct and behaviour was not minor in nature and had the potential to have wide-ranging adverse consequences. Furthermore, the Registrant has not demonstrated that the skills and knowledge, specifically relevant to the Final Hearing panel’s findings, have been adequately addressed. Therefore, the Panel concluded that a Caution Order would be inappropriate and insufficient to meet the public interest.

31. The Panel went on to consider a Conditions of Practice Order. The Panel noted the Registrant’s re-engagement which suggested that he would be willing to comply with a Conditions of Practice Order. However, the Panel noted that the failings identified by the Final Hearing panel were attitudinal by nature and concluded that, as a consequence, such failings would not be adequately addressed by conditions.  In these circumstances the Panel was unable to formulate conditions which would be appropriate, workable and measurable.

32. The Panel next considered extending the current Suspension Order for a further period of time. A Suspension Order would send a further signal to the Registrant, the profession and the public, re-affirming the standards expected of a registered social work practitioner. The Panel noted that a Suspension Order would prevent the Registrant from practising during the extended suspension period, which would therefore protect the public and the wider public interest. A Suspension Order would also provide the Registrant with the opportunity to consider his future and develop the skills and knowledge required to return to the register unrestricted.

33. The Panel took into account paragraph 41 of the ISP which states:

‘If the evidence suggests that the registrant will be unable to resolve or remedy his or her failings then striking off may be the more appropriate option. However, where there are no psychological or other difficulties preventing the registrant from understanding and seeking to remedy the failings then suspension may be appropriate.’

34. The Panel determined that the Registrant should be given a further opportunity to consider carefully the decision of the Final Hearing panel and this reviewing Panel to properly focus on the issues that have been identified.

35. The Panel determined that the Suspension Order should be extended for a period of 6 months. The Panel was satisfied that this period would be sufficient for the Registrant to demonstrate that he is committed to addressing the deficiencies in his practice and return to the Register unrestricted.

36. The Panel decided that the appropriate and proportionate order is a Suspension Order. A Striking Off Order, would be disproportionate as the shortcomings in the Registrant’s practice are capable of being remedied and there remains a possibility that the Registrant is willing and able to demonstrate an appropriate level of insight and remediation.

37. The extended Suspension Order will be reviewed shortly before expiry. A future reviewing panel would be assisted by the following:

a) The Registrant’s continued engagement and attendance at the review hearing.

b) A reflective piece demonstrating that the Registrant understands:

• the significance of his misconduct;

• the impact of his role and the role of others within a multi-disciplinary team;

• the impact of poor communication within a multi-disciplinary team;

• the actual risk of harm to Child A;

• the impact on his professional standing and the wider public interest.

c) Documentary evidence of formal or informal CPD activities, relevant to social work, which specifically address the Registrant’s misconduct;

d) Any references and testimonials from paid or unpaid work with regards to skills and/or knowledge relevant to social work;

e) Any other evidence or information which the Registrant considers would be of assistance.

Order

The Registrar is directed to suspend the registration of Mr Lofton Alexander McTavish Hull for a further period of 6 months on the expiry of the existing order.

Notes

This Order will be revewed again before its expiry on 16 May 2019.

  

Hearing History

History of Hearings for Mr Lofton Alexander McTavish Hull

Date Panel Hearing type Outcomes / Status
16/04/2019 Conduct and Competence Committee Review Hearing No further action
08/10/2018 Conduct and Competence Committee Review Hearing Suspended
16/10/2017 Conduct and Competence Committee Final Hearing Suspended