Mr Vijayakumaran Kuttampoil

Profession: Practitioner psychologist

Registration Number: PYL23901

Hearing Type: Review Hearing

Date and Time of hearing: 09:00 20/09/2018 End: 11:00 20/09/2018

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

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

The following allegation was found proved by a Panel of the Conduct and Competence Committee at the substantive hearing which took place on 07 – 11 December 2015 and 18 – 20 July 2016)

 

During the course of your employment as a Clinical Psychologist employed by Cambridgeshire and Peterborough Foundation Trust at HMP Whitemoor between March 2011 and March 2012, you:
1) Did not follow the security process (at HMP Whitemoor) in that you:
a) carried your prison keys in your hand on at least one occasion instead of attaching them to you as required;
b) took personal possessions in a session with a prisoner on at least one occasion;
c) fell asleep during a group session with prisoners on 24 May 2011;
d) not proved
2) Behaved in an unprofessional manner towards colleagues in that you:
a) not proved
b) not proved
c) invaded the personal space of Colleagues A; B; E and F in that you;
(i) not proved
(ii) not proved 
(iii) not proved 
(iv) stood too close to colleague F when she was locking doors;
d) not proved
e) not proved
f) not proved
g) not proved
h) were unable to control your anger and/or frustration in the office on a number of occasions.
3) not proved
4) not proved
5) The matters described in paragraphs 1-3 constitute misconduct.
6) By reason of that misconduct your fitness to practise is impaired.

Finding

Background

1. The Registrant is a registered Practitioner Psychologist. He commenced employment at the Fens Dangerous and Severe Personality Disorder Unit (the Unit), within Whitemoor Maximum Security Prison in March 2011, as a Specialist Clinical Psychologist at NHS Band 7.

2. The Registrant had never worked in a prison before. The Unit operated within the prison, delivering group and individual therapy for approximately 70 inmates. At the Final Hearing, which concluded in July 2016, the facts found proved related to the Registrant not following the appropriate security processes at the prison; behaving in an unprofessional manner in respect of a colleague by standing too close to her as she was locking doors, and being unable to control his anger and/or frustration in respect of two meetings with a colleague. These events occurred in 2011-2012.

3. The substantive Panel concluded that the facts found proved at the Final Hearing amounted to misconduct and that the Registrant’s fitness to practise was consequently impaired by reason of that misconduct. It found the Registrant impaired on personal grounds due to lack of insight, personal reflection, remediation, and the consequent risk of repetition. It also found that a finding of impairment was required in order to declare and uphold the HCPC standards of conduct and to maintain the reputation of the profession. It imposed a Conditions of Practice Order for 3 years.

4. On 23 August 2016, the Registrant wrote to the HCPC to bring to its attention that, following disciplinary proceedings, he had been dismissed from his employment by his then employer, Nouvita Limited, with effect from 7 July 2016. He had appealed the decision, which was heard on 5 August 2016 and the appeal was dismissed. He explained that he was bringing the information to the attention of the HCPC, as required by his Conditions of Practice Order.

5. On 28 September 2016, the HCPC received a referral from Nouvita, dated 26 September 2016, regarding an alleged incident on 18 April 2016, of speaking in an unprofessional manner to a colleague during a ward round. This alleged incident was the subject matter of the disciplinary proceedings which had resulted in the Registrant’s dismissal from Nouvita.

6. The HCPC sought an early review of the Conditions of Practice Order which was considered by a panel on 7 December 2016 (the first review panel). The first review panel was concerned at what it considered to be a lack of insight on the Registrant’s part, including in relation to the type of information appropriate to disclose to the substantive panel. He had not appeared to understand the need to disclose the fact of his dismissal which had occurred prior to the conclusion of the Final Hearing. The first review panel decided that the Registrant’s fitness to practise remained impaired and that the appropriate and proportionate sanction was an Interim Suspension Order for a period of twelve months.

7. The Interim Suspension Order was reviewed by a panel on 31 October 2017 (the second review panel). The Registrant submitted a number of documents and gave oral evidence to the second review panel. The second review panel considered that whilst the Registrant had developed some insight into his past conduct, it did not consider that insight to be complete. The Registrant did not fully address in his written reflection or his oral evidence the issues regarding personal space, language, or behaviour in the workplace. The panel was also not satisfied that the arrangements for the Registrant’s clinical supervision during his last employment were adequate or that he fully appreciated the need for formal supervision arrangements. This was particularly important in that the Registrant had not worked professionally since July 2016.

8. The panel decided that a Conditions of Practice Order could be formulated which would address the Registrant’s failings and provide sufficient protection for the public. The panel made a Conditions of Practice Order for a period of twelve months in the following terms:

1. You must confine your professional practice to environments which are not high security prisons or high security hospitals or high security wards.

2. You must place yourself under the supervision of a clinical psychologist registered by the HCPC. You must meet at least monthly with that supervisor and provide to the HCPC prior to the next review copies of the formal supervision notes following these sessions.

3. You must promptly inform the HCPC if you take up any employment for which you require your registration, including self-employment.

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

5. You must inform the following parties that your registration is subject to these conditions:

a. Any organisation or person employing or contracting with you to undertake professional work;

b. Any agency you are registered with or apply to be registered with (at the time of application); and

c. Any prospective employer (at the time of your application)

6. At least 28 days before the date of the next review you must send to the HCPC a written reflective statement setting out your understanding of the issues of personal space, conventions about appropriate language and behaviour and how you might manage any cultural differences which have the potential to be problematic in the workplace, together with examples of how you have modified your behaviour in the light of this understanding.

Decision

9. Ms Knight outlined the background and highlighted the concerns about the Registrant’s level of insight identified by the second review panel.

10. The Registrant gave evidence to the Panel.

11. Ms Knight submitted that in circumstances where the Registrant has not been employed, he has complied with the Conditions of Practice Order as far as he could. It was for the Panel to consider the level of insight that the Registrant has demonstrated and whether his fitness to practise remained impaired. The HCPC’s position was neutral.

12. Mr Guest submitted that the Registrant’s fitness to practise was not impaired. He referred to the length of time which has elapsed since the matters which are the subject of the Allegation. He submitted that the Registrant has complied with the Conditions of Practice Order and that the Registrant’s attitude was exemplary. He submitted that the Conditions of Practice Order continued to have an impact on the Registrant and was an impediment to the Registrant obtaining employment. The Registrant has only been able to secure an offer of work which requires him to be self-employed and it is insecure in respect of hours of work and tenure.

13. The Registrant’s current position is that he has secured an offer of an engagement to work as a Practitioner Psychologist at the Priory Woodlands Unit in Coventry starting on 24 September 2018. The Registrant will not be an employee. He will be engaged as a locum in a self-employed capacity, with as yet unspecified hours, for an initial period of three months.

14. The Panel found that parts of the Registrant’s evidence were confused and that some of his answers were evasive. For example, in answer to Panel questions about whether he had informed the Priory Woodlands Unit that he had been dismissed by Nouvita.

15. The Panel considered whether the Registrant had demonstrated insight particularly as set out within condition 6 with regard to the issues of personal space, conventions about appropriate language and behaviour, and how the Registrant might manage any cultural differences which have the potential to be problematic in the workplace. The Panel considered that in the Registrant’s written reflective piece and in his evidence to the Panel he showed developing, but not yet complete, insight. That insight was based on a theoretical understanding of the issues and was not evidence by any practical example of his new approach.

16. The Registrant told the Panel about the need to respect personal space and not allow his emotions to affect the way in which he behaved in the workplace. He could not give details regarding the use of language. He referred to the inappropriateness of gift giving and explained this with reference to the fact that it might be perceived as grooming behaviour. The Panel did not consider that this evidence fully addressed the subtle reasons why gift giving may be regarded as inappropriate in the workplace.

17. The Panel noted that the Registrant has taken steps to consider and address the underlying reasons for his past misconduct. In particular he has made efforts to address the potential for emotional outbursts through techniques derived from Cognitive Behaviour Therapy and Mindfulness.

18. The Registrant has not had the opportunity to provide examples to the Panel that he has put his reflection into practise within the workplace because he has been unemployed. There has therefore been no testing of whether his insight has changed his behaviour, such that there will be no repetition of the misconduct.

19. The Panel considered that the Registrant demonstrated insight into the inadequacy of his clinical supervision in his previous employment and the importance of clinical supervision in the future. He has taken steps to arrange supervision sessions with Prof HH, a Consultant Clinical Psychologist. The Panel was provided with a letter dated 19 September 2018 from Prof HH confirming his appointment. The Registrant was unable to provide the Panel with supervision notes from supervision sessions prior to this review because he has not been employed.

20. The Registrant told the Panel that he has kept himself up to date with developments in clinical practice by reading relevant journals, books, and materials on the internet. In circumstances where the Registrant has been unemployed and has no resources to pay for training courses, the Panel considered that the Registrant has done as much continuing professional development he could.

21. The Registrant also provided the Panel with positive testimonials from a range of qualified professionals.

22. The Panel noted that the Registrant is due to start work in a new role and that this is likely to involve stressful situations. The Registrant will be self-employed and he indicated that he will probably be working as the sole psychologist within the unit. The role involves the assessment and treatment of patients with complex mental health conditions within a locked rehabilitation unit

23. In the above circumstances the Panel was not sufficiently confident that there would be no repetition of the misconduct and that the Registrant was safe to practise without restriction. The concern was that the Registrant’s ability to manage his emotions when interacting with colleagues in stressful situations has not been tested. The implementation of the Registrant’s reflections through a change in his behaviour in the workplace would demonstrate remediation of his misconduct and this had not yet been evidenced.

24. The Panel therefore decided that the Registrant’s fitness to practise remains impaired.

25. The Panel next considered the order which was appropriate, proportionate, sufficient and necessary to protect the public and to safeguard the public interest.

26. The Panel took into account the principles of proportionality balancing the interests of the Registrant with the public interest. The Registrant told the Panel that the Priory Woodlands Unit is aware of the current Conditions of Practice Order and that the current conditions of practice are not incompatible with the engagement.

27. The Panel decided that the appropriate and proportionate Order is to vary the Conditions of Practice Order and extend it for six months. The Panel decided that a six month period is necessary and sufficient for the Registrant to demonstrate that he has modified his behaviour in the workplace. The Panel took into account the adverse effect of continuing the order on the Registrant’s finances and reputation, and that the incidents took place over six years ago, but noted that a further incident had occurred in 2016 when the Registrant had been in a stressful working environment.

28. The risk that the Panel has identified in its decision on current impairment is in relation to whether the Registrant’s reflection and developing insight will change his behaviour within a stressful working environment. The Panel considered that there was no longer a requirement for the Registrant to provide a written reflective statement. However, the Panel decided that it was necessary and proportionate to add a requirement for the Registrant to provide a brief reflective statement in relation to his learning from each supervision session to enable monitoring and verification of his progress in relation to the concerns the Panel has identified.

29. The Panel also decided to add requirements for the Registrant to provide a report or reference from his clinical supervisor and from a manager at The Priory Woodlands Unit prior to the next review of the Conditions of Practice Order. A report from the clinical supervisor is required to provide an independent view of the Registrant’s developing insight which would not necessarily be apparent from supervision notes. A report from a manager was necessary because the Registrant’s clinical supervisor may have no direct knowledge of the Registrant’s interaction with his colleagues. The Panel considered this would not impose an onerous or disproportionate burden on the Registrant because the report could be provided by any manager in a position to comment about the Registrant’s behaviour within the workplace.

30. The Panel therefore decided to vary the Conditions of Practice Order and extend it for a period of six months.

Order

Order: The Registrar is directed to vary the Conditions of Practice Order against the registration of Mr Vijayakumaran Kuttampoil for a further period of 6 months on the expiry of the existing order. The Conditions are:

1. You must confine your professional practice to environments which are not high security prisons or high security hospitals or high security wards.

2. You must place yourself under the supervision of a clinical psychologist registered by the HCPC. You must meet at least monthly with that supervisor and provide to the HCPC prior to the next review a report from your clinical supervisor commenting on your insight into your ability to control your emotions at work and your working relationships with colleagues.

3. You must provide to the HCPC prior to the next review a brief reflective piece setting out your learning from each supervision session  in relation to interactions within the workplace and any examples of how you have modified your behaviour in the workplace.

4. You must promptly inform the HCPC if you take up any further employment for which you require your registration, including self-employment.

5. You must provide the HCPC, prior to the next review, with a report or reference from a manager from any organisation employing or contracting with you to undertake professional work. The reference or report should be written by an individual who is able to comment in relation to your behaviour and interactions with colleagues in the workplace.

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

7. You must inform the following parties that your registration is subject to these conditions:

A. Any organisation or person employing or contracting with you to undertake professional work;

B. Any agency you are registered with or apply to be registered with (at the time of application); and

C. Any prospective employer (at the time of your application).

Notes

The order imposed today will apply from 31 October 2018.

This order will be reviewed again before its expiry on 30 April 2019.

 

Hearing History

History of Hearings for Mr Vijayakumaran Kuttampoil

Date Panel Hearing type Outcomes / Status
20/09/2018 Conduct and Competence Committee Review Hearing Conditions of Practice
31/10/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
07/12/2016 Conduct and Competence Committee Review Hearing Suspended