Mrs Josephine Veronica Tait

Profession: Social worker

Registration Number: SW68321

Hearing Type: Final Hearing

Date and Time of hearing: 09:00 03/09/2018 End: 16:00 06/09/2018

Location: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

During the course of your employment as a social worker with Leicestershire County Council, you:

1. Did not complete and / or upload case notes to IAS in a timely manner for:
 a. Service User D, between 25 February 2016 and 25 April   2016;
b.   Service User F, between 11 February 2016 and 26 April  2016;
c.   Service User G, between 30 March 2016 and 25 April  2016;
d.   Service User U, between 30 March 2016 and 25 April  2016;
e.  Service User V, between 9 February 2016 and 25 April  2016.  


2. Did not complete required Mental Capacity At Assessments for:-
a.  Service User F, between 4 February 2016 and 26 April  2016;
b.   Service User R, between 25 February 2016 and 26 April  2016.

 
3.  Did not complete and or records assessments and or  reassessments for:
  a.  Service User M, between 25 November 2015 and 26 April    2016;
  b.   Service User G, between 30 November 2015 and 26 April    2016;
  c.   Service User K, between 17 November 2015 and 26 April    2016;
   d.   Service User X, between 2 October 2015 and 18 April    2016;
  e.  Service User V, between 9 February 2016 and 18 April    2016;
  f.   Service User P, between 12 April 2016 and 25 April 2016;
  g.  Service User Q, between 30 March 2016 and 25 April      2016;

  
4. Did not record on the case of Service User R between 1 February 2016 and 8 April 2016 despite a Mental Capacity Assessment being required.


5. Provided delayed and or inaccurate information to service users and their family regarding funding of services and or care and or placements in respect of:  
a.  Service User W;
b.   Service User Q;
c.   Service User X;
d.   Service User N;
e.  Service User C.


6. Did not follow instructions and guidance provided by managers in relation to:
 a.    Service User L;
   b.   Service User X.


7. Did not raise concerns with managers in relation to:
  a.   Service User I;
   b.   Service User L;


8.    Did not visit Service User K between 26 October 2015 and 26   April 2016.


9.   Delayed in arranging:
  a.   Home Care Services for Service User G between 16      February 2016 and 8 April 2016;
  b.   A Support Plan for Service User O to attend a day centre    between 5 April 2016 and 26 April 2016;
  c.   Inclusion Support for Service User H between 17 March    2016 and 26 April 2016.

10.   Did not respond to a call in respect of Service User E from  Support for Carers requesting an urgent call back.

11.   Did not follow up with the care home in relation to Service User  D to check whether the conditions put in place were working.
12.   Did not record the exceptional circumstances that justified  Service User E’s caring arrangement between 28 September  2015 and 1 March 2016.

13.    On or around 7 January 2016 did not record the outcome of an  assessment relating to Service User G.

14.   On or around 6 October 2015 recorded the outcome of a  Decision Support Tool meeting incorrectly in that you labelled it  as Fast Track Review in relation to Service User X.

15.   On or around 27 April 2016 produced an inadequate support  plan for Service User O in that:
  a.   there was no consideration of transport costs;
  b.   The care exceeded the bracket of care which you were   permitted to authorise.

16.   In relation to Service User J:
  a.   labelled the service user as having a learning disability   when they did not;
  b.   did not follow up the service user’s need for assistive    technology.

17. The matters set out in paragraphs 1 - 16 constitute misconduct  and or lack of competence.

18.  By reason of your misconduct and or lack of competence your  fitness to practise is impaired.

Finding

Preliminary Matters:

Service of Documents

1. The Panel was satisfied that the Registrant was notified of the date and time of the hearing via a letter dated 6 June 2018 which was sent by first class post to her registered address and accordingly the HCPC had discharged its duty to serve documentation on the Registrant in accordance with the Health and Social Work Professions Order 2001 (the Order).
2. The substantive hearing had been convened to consider the allegation against the Registrant.
Proceeding in Absence of the Registrant

3. Included in the Notice of Hearing was confirmation that the hearing could proceed in the absence of the Registrant. She was therefore on notice that the hearing could proceed and that the Panel could consider striking her from the register without her being present. The Presenting Officer submitted that it was in the public interest for the hearing to proceed in the absence of the Registrant given the serious nature of the allegation. She provided to the Panel copies of correspondence sent to the Registrant by or on behalf of the HCPC on 2 May 2018, 15 May 2018 (email), 13 June 2018, 16 July 2018 and 29 August 2018. The Registrant had responded by email on 15 May 2018 and reiterated her previously declared intention (by an email dated 7 November 2016) not to attend the substantive hearing. There was no request for an adjournment and no indication that the Registrant would attend a hearing at a future date if the hearing was postponed. The Registrant also had not indicated that she wished to be represented at the hearing.  Further, two witnesses for the HCPC were in attendance and in a position to proceed with the hearing.
4. The Panel noted the provisions of the HCPTS practice note in respect of proceedings in absence and received advice from the Legal Assessor, which it applied. There had been no request for an adjournment received, nor any interest expressed by the Registrant in providing evidence via video or telephone link. However, the Registrant had on two separate occasions expressed her desire not to participate in the proceedings. The most recent communication referenced limited reasons for not engaging in the process.
5. The Panel was satisfied that it was appropriate for it to exercise its discretion to hear the matter in the absence of the Registrant.  Proceeding in absence may disadvantage the Registrant, given the serious nature of the matters to be determined. Nevertheless, the fact that she was aware of the hearing and had chosen to not be represented, as well as witnesses being in attendance, together with the public interest in proceeding outweighed any potential prejudice which may be suffered by the Registrant. It was satisfied that the Registrant had voluntarily absented herself from the proceedings without making representations.
Amendments to the Allegation
6. The Presenting Officer also applied, at the commencement of the hearing, to amend the wording of the particulars in respect of Allegation 3(e) by changing the second date to more accurately reflect the evidence contained within the bundle. The Presenting Officer submitted that the changes to the date of 3(e) did not materially change the nature of the particularised allegation.

7. The Panel was conscious that the Registrant had voluntarily absented herself from the proceedings and chosen not to be represented.  As a consequence, she was unaware of the precise detail of the proposed amendments and unable to make representations on the same. The HCPTS has provided guidance to Panels in a document entitled “Unrepresented Registrants” and the Panel were conscious of the need to ensure that an unrepresented registrant has every reasonable opportunity for their case to be carefully and fairly considered.

8. The Panel also had regard to guidance issued by the HCPC entitled “Standard of Acceptance for Allegations” and had the benefit of legal advice from the Legal Assessor, which it accepted. The guidance document sets out that allegations must be drafted in clear and unambiguous language which enables the Registrant and anyone else reading them to understand what is being alleged.  So far as possible, the elements of the allegation should be set out:

a) briefly, concisely and in ordinary language which avoids the unnecessary use of technical terms or jargon; 

b) in separate paragraphs, each dealing with a single element of the allegation;

c) with the facts in chronological order (unless there is good reason to do otherwise); 

d) in the logical decision-making sequence of facts, statutory ground and, impairment.

9. The Panel was satisfied that the amendment proposed by the Presenting Officer at the commencement of the hearing ensured that the particulars of the allegation promoted the above requirements and did not unduly prejudice the Registrant. Accordingly the application to amend the allegation was approved.

10. In addition, the Presenting Officer reminded the Panel that the HCPC did not intend to provide any evidence in respect of Allegation 9(c).

11. At the conclusion of the evidence, and prior to making closing submissions, the Presenting Officer made a further application requesting amendments to four of the particulars:

a) The Presenting Officer believed that the initial application she had made to amend the allegation particular in respect of 3(e) should in fact have been made in respect of 3(d). She therefore requested that the particular be amended to have a concluding date of 18 April 2016 as opposed to 25 April 2016, but did not ask that the original particular for 3(e) to be reinstated.

b) Particular 11 – a witness corrected her statement while giving evidence to replace “care home” with “home care provider” and this amendment should be reflected in the particular.

c) Particular 4 - it was apparent from the bundle of documents that there was a note on the records within the time period originally specified. It was appropriate to amend the relevant time period to be consistent with Particular 2(b) and this served to limit the period of time the allegation related to and would not therefore disadvantage the Registrant.

d) Particular 8 – the HCPC sought to change the start date of the period of concern from 26 October 2015 to 17 November 2015.

The Presenting Officer submitted that the amendments requested were all minor in nature, did not change the scope of the case and could therefore be permitted by the Panel.

12. The Panel granted the application to amend particular 3(d) as they were satisfied that there had been a genuine error in relation to the first application to amend and that the Registrant would not be unduly prejudiced by the granting of the application. However, the Panel determined that the same could not be said in respect of the request to amend the other 3 particulars.  Although it was correct to say that amending the dates would limit the period for which the Registrant was alleged to have not acted appropriately, she was unaware of the further application and therefore unable to make representation on it. Further, the Registrant was not represented and therefore the Panel had a duty to ensure that it acted fairly and justly in respect of the proceedings to assist her as far as possible. Finally, the Panel were aware that there would need to be careful scrutiny as to whether the HCPC had discharged its burden of proof in relation to the final three amendments sought. As the evidence had already been heard by this point, and the HCPC was on the point of closing its case, the amendments could not be tested further in evidence. It was also noteworthy that the issues in relation to evidence for the allegations as drafted were not raised solely in the oral evidence of the witnesses, but were evident in the bundle of documents. The application to amend could therefore have been made prior to the commencement of the case. The prejudice which would be suffered by the Registrant as a consequence of the amendments being proposed at the end of the hearing substantially outweighed the public interest in allowing the HCPC to amend the allegation at this late stage. The Panel considered that granting the application to amend at this stage of the proceedings would be unfair to the Registrant and therefore the application in respect of the remaining three particulars was refused.

Hearing matters in Private
13. The Presenting Officer informed the Panel that although she did not intend to make reference to the Registrant’s health or private life in detail, the bundle did include documents relating to the health and private life of the Registrant upon which witnesses may comment.  It would therefore be appropriate for the Panel to hear any evidence that related to her health or private life in private.

14. The Panel had regard to the HCPTS Practice Note in relation to “Proceeding in Private” and was conscious that, while there is a presumption that proceedings will be in public, it was obliged to ensure the interests of justice were served, and that the private life of the Registrant was protected. It would be inappropriate to refer to the health and private life of the Registrant in a public hearing. Accordingly, evidence in relation to the Registrant’s health and private life would be heard in private to protect her privacy but all other matters would be heard in public.

Background:
15. The Registrant was a Social Worker employed by Leicestershire County Council (the Council) within the Promoting Independence team. Throughout her employment in that role (September 2015 to June 2016), there were concerns about her competence, as a consequence of which her probationary period was extended and she was provided with additional support by the Council. The Council referred their concerns about her practise to the HCPC. Although the Registrant had qualified as a social worker in 2006, the role with the Council was the first she had undertaken as a social worker. The Registrant’s employment with the Council ceased in June 2016 with concerns as to her competence remaining outstanding.

16. The HCPC provided a bundle of documents in support of the allegation in relation to the Registrant, and called two witnesses to give evidence to the Panel.

17. The Registrant had, in her email communications with HCPC, provided limited comments on the circumstances of the allegation but as a consequence of voluntarily absenting herself from the hearing, had not given evidence to the Panel. Furthermore she had not been able to make representations to the Panel on the amended allegation, hear the evidence of the witnesses or be subject to questioning by HCPC or the Panel.

 

Assessment of witnesses
RN
18. RN was employed as a Service Manager by the Council for the period of the Registrant’s employment. She provided written and oral evidence to the Panel and answered questions from the Presenting Officer and the Panel. She was not a qualified social worker but had invested her time and energy in supporting the Registrant during her employment. This witness gave her evidence in a straightforward way, doing her best to recall the details but indicating clearly if she was uncertain. The answers she gave were within her knowledge. She recognised positive aspects of the Registrant’s practise. The Panel considered her to be an impressive, credible, reliable and professional witness.

 SS

19. This witness was responsible for line managing the Registrant during her time with the Promoting Independence Team but was not herself a qualified social worker. The witness provided written and oral evidence to the Panel and answered questions. The Panel found her to be fair, helpful, thoughtful and patient throughout. She was not evasive and if she didn’t know something she was not prepared to speculate. The Panel found it understandable that she struggled a bit more with her recollection of details given that the events in question took place more than two years previously and she had also changed jobs and been on maternity leave in that time. SS appeared to be a considerate manager who recognised positive aspects of the Registrant’s practise and was aware of the personal issues affecting the Registrant. It was apparent that she had invested considerable time and effort in supporting the Registrant throughout her employment. 

Decision on Facts:
20. The Panel proceeded to consider each particular in turn, taking account of the documentary and oral evidence available to them, the submissions of the Presenting Officer and the legal advice provided by the Legal Assessor. In determining whether an allegation is ‘well founded’ or ‘proved’, the Panel is required to decide firstly whether the HCPC, which has the burden of persuasion in relation to the facts alleged, has discharged that burden. 


Particular 1(a) – Proved

21. The five particulars set out within particular 1 all related to an alleged failure to complete and or upload case notes to IAS (the Council’s case management system) in a timely manner, with each sub-particular referring to a distinct service user and date range. The Panel did not therefore need to judge the quality of the recording for this group of particulars, rather whether there had been activity in relation to the service user which the Registrant should have recorded on the system and whether she did so.

22. Particular 1(a) related to Service User D and a date range of 25 February 2016 to 25 April 2016. The Panel were satisfied that the Registrant had entered notes onto the IAS system on 25 February 2016 and that the next note on the records for Service User D was dated 11 May 2016 and created by another member of staff. That being the case, the Panel considered whether there was activity in relation to Service User D that the Registrant should have recorded. They were satisfied that, during a probationary performance improvement meeting on 5 April 2016, the Registrant indicated that she had “looked at alternative options of meeting his needs” (page D56 of the bundle). The Panel would expect her to record what options she had considered on the system for Service User D so that another professional accessing the records would be able to see what was under consideration for D. The Panel was satisfied that there was activity in respect of Service User D that the Registrant had not recorded on the Service User case notes and accordingly they found this particular proved.

Particular 1(b) - Proved

23. This sub-particular related to Service User F between 11 February 2016 and 26 April 2016. It was evident from the notes of Service User F that the Registrant made no recordings after 11 February 2016 (D317) yet during a supervision meeting on 22 February 2016 Service User F was discussed. It was therefore clear that the matter was active as the supervision note recorded “JT to ring [BW] to clarify whether he is already a community client and MCA needs revisiting or if he needs to be made a community client from scratch”. (D224). The actions taken by the Registrant in relation to Service User F following this meeting should have been recorded on the system and they were not. This particular was therefore proved.

Particular 1(c) – Not Proved

24. Service User G was the focus of this sub-particular, with a date range between 30 March 2016 and 25 April 2016. The Panel were satisfied that the Registrant had made a number of entries on Service User G’s record on 11, 12 and 21 April 2016 and therefore this particular was not proved.

Particular 1(d) – Not Proved

25. In respect of Service User U, this particular alleged the Registrant had neither completed or uploaded notes to the system between 30 March 2016 and 25 April 2016. However the bundle reflected two notes from the Registrant on Service User U’s record dated 20 April 2016. This Particular was therefore not proved.

Particular 1(e) – Not Proved

26. The final sub-particular alleged that the Registrant had not completed or recorded notes for Service User V between 9 February 2016 and 25 April 2016. This is confirmed by the service user notes (page D455 of the bundle) however the Registrant confirmed in the Probation Support Plan Mid-Way meeting on 11 April 20116 (D67) and again on 26 April 2016 at the Probation Support Plan Final meeting on 26 April 2016 that she had taken no action in relation to this Service User. She therefore had nothing to record in respect of this Service User and would not be expected to record taking no action, therefore this particular was not proved.

Particular 2(a) – Proved

27. Particular 2 related to an alleged failure by the Registrant to complete Mental Capacity Act assessments. 2(a) concerned Service User F and related to the period 4 February 2016 to 26 April 2016. Page D317 of the bundle included an entry by the Registrant on Service User F’s case record dated 4 February 2016 confirming that the Registrant was “gathering information towards MCA assessment” and Service User F was also discussed in supervision with SS on 8 February 2016 with a note being made that “MCA required in relation to managing finances”. The Panel was therefore satisfied that the Registrant was aware that there needed to be such an assessment for Service User F. However, there was no further entry provided to the Panel in relation to the completion of the assessment, and witness SS confirmed in her statement and oral evidence that there was no evidence that the Registrant had completed a Mental Capacity Act assessment for this service user. The Panel was therefore satisfied that this particular was proved.

Particular 2(b) – Proved

28. This sub-particular related to Service User R for the date range 25 February 2016 to 26 April 2016. It was apparent from the service user records (page D448 of the bundle) that the Registrant was aware that a Mental Capacity Act assessment was needed for Service User R on 25 February 2016 as she recorded an attempt to speak to a colleague about the assessment and a possible Court of Protection application. The only other entry by the Registrant on the records in this time period related to a plumbing issue. There was no evidence that the assessment had been completed, though the need for an assessment in respect of Service User R had been discussed at both the Midway and Final Probation Support Plan meetings (11 April and 26 April 2016) as evidenced at pages D67 and D117 of the bundle. SS gave evidence that there was a form to complete for Mental Capacity Act assessments which was recorded in a different part of the system, and that there had been no Mental Capacity Act assessment recorded by the Registrant for this service user. The Panel was therefore satisfied that this particular was proved.

Particular 3(a) - Proved

29. The third group of particulars related to an alleged failure to complete and or record assessments and or reassessments for a number of service users across different date ranges. The Panel considered that they would need to establish firstly whether any assessment was required, and if so, whether the Registrant completed and or recorded the assessment or reassessment. It also noted that the nature of the assessment was not specified and could therefore be an assessment in relation to one of a number of matters, such as support needs, finance or carers. 

30. 3(a) related to Service User M between 25 November 2015 and 26 April 2016. Both witnesses stated that there was either no assessment completed for this service user by the Registrant in this time period, or that it was commenced but not completed and uploaded to the system. The Registrant appeared to acknowledge in the Final Probation Support Plan meeting on 26 April 2016 (D117) that there had been no activity by her in relation to this service user since 30 December 2015 but that there had been a telephone conversation with the daughter the day before, which was confirmed by the relevant service user records (D 393- 395).  Witness SS gave oral evidence that the matter had been allocated to the Registrant to conduct an assessment and that she believed an assessment was started but not completed, and then not revisited as the circumstances changed over time. The Panel was therefore satisfied that the registrant was aware of the need to undertake an assessment, and that she did not do so.  As a consequence, they found this sub-particular was proved.

Particular 3(b) – Not Proved

31. This sub-particular related to Service User G between 30 November 2015 and 26 April 2016. However, within the notes of the Mid-way Probation Support Plan meeting on 11 April 216 it is recorded that “JT’s assessment contradicts itself because at the beginning…” (D62). Furthermore, the Panel identified the documented assessment for Service User G in the bundle (D74). This particular therefore had to be found not proven.

Particular 3(c) – Proved

32. Service User K was the focus of this sub-particular with the relevant date range being 17 November 2015 to 26 April 2016. This matter was somewhat unusual as it was apparent that Service User K came to the attention of the Council initially as a carer for another service user, his wife (Service User L), but then developed needs in his own right. The Panel were satisfied that the Registrant had commenced the carer’s assessment for Service User K but that she could not be criticised for not completing it given Service User K had indicated he no longer wished to be assessed as a carer. However, once concerns were raised about Service User K in his own right by the Coal Industry Social worker, together with the Registrant’s knowledge of the change in his circumstances, it was apparent that an assessment of Service User K’s individual need for support needed to be undertaken. This need was recognised by the Registrant when she entered a note on his record on 8 March 2016 that “I aim to arrange an assessment with S/U K and will contact him…”. She did not however conduct that assessment and the Panel were therefore satisfied that this sub-particular had been proved.


Particular 3(d) – Not Proved

33. This particular related to Service User X and a date range of 2 October 2015 to 18 April 2016. It would appear that the expectation by managers was that an assessment of need and a financial assessment were required for this service user, however the particular allegation relates to completing and or recording assessments and or reassessments and is not specific. This was supported by the Mid-way Probation Support Plan meeting on 11 April 2016, however the service user records completed by the Registrant on 13 April 2016 reflect “Assessment carried out”, and this appears to have been accepted by management at the Final Probation Support Plan meeting on 26 April 2016 and was within the date range of the allegation particular. This particular had not therefore been proven.

Particular 3(e) – Proved

34. This particular related to Service User V between 9 February 2016 and 18 April 2016. The Mid-way Probation Support Meeting on 11 April 2016 recorded that this case had been “allocated 09/02/16 for a Community Care Assessment” and the Registrant admitted that she had not had time to look at it and didn’t know what the assessment was for.  She therefore appeared to accept that an assessment was required and had not been done, therefore this allegation was proved.

Particular 3(f) – Proved

35. Service User P was the focus of this particular between 12 April 2016 and 25 April 2016. It was clear from the service user records (D436) that there had been no action taken by the Registrant in relation to this case in the date range alleged and the Registrant does not appear to have disputed (during the Final Probation Support Plan meeting on 26 April 2016) that a financial assessment had been required for this service user. As a consequence, the Panel considered that this particular had been proved.

Particular 3(g) – Not Proved

36. This particular related to Service User Q between 30 March 2016 and 25 April 2016. However, it was clear from the case records (D441) that a finance assessment had been recorded as completed by the Registrant on 7 April 2016, and an assessment of needs had been discussed with witness RN on the same date, which discussion resulted in RN agreeing to a placement in principle. As a consequence, the particular alleged could only be found not proven.

Particular 4 – Not Proved

37. This particular asserted that the Registrant had not recorded anything in relation to Service User R between 1 February 2016 and 8 April 2016 when a Mental Capacity Act assessment was required.  However, it is clear from the Service User records for R (page D448) that the Registrant did make an entry on the record of Service User R on 25 February 2016. As a consequence, the particular alleged could only be found not proven.

Particular 5(a)  - Proved

38. The sub-particulars at particular 5 all related to the Registrant allegedly either delaying in providing information or providing inaccurate information to service users and their families in respect of the funding of services and or care and or placements. The Panel therefore considered that they needed to be able to identify in each sub-particular what the extent of any delay was, or what inaccurate information was provided by the Registrant to a service user or a family.

39. 5(a) related to Service User W and contained two elements. The criticisms levelled at the Registrant by witness SS related to firstly the issue of a top up being backdated to October 2015, and secondly to the Service User contribution to the cost of his care. The Panel were satisfied that witness RN had been consulted by the Registrant in respect of the backdating of the top up and had raised no concerns with her, and this aspect of the particular was therefore not proven despite witness SS stating that the position of RN in this regard was wrong. It was clear the managers were not in agreement and that there was confusion as to the correct position. The Panel therefore could not be satisfied that the information the Registrant had supplied was inaccurate.

40. However, in respect of the Service User contribution, the Service User records do not reflect what the Registrant told the service user’s son. Whilst discussing the top up contribution, a member of the finance team spoke with the son on 10 February 2016, and recorded the son being confused as “he stated he had been informed by the placing social worker at the time that he would need to contribute the £50 weekly top-up towards the placement, but that the remaining £445 p/w would be paid by LCC”.  (D463). The Registrant was the social worker recorded for Service User W. The son reiterated his belief that he had been given incorrect information initially when he met with witness SS in June 2016.  Regardless of the fact that the Registrant appeared to have recorded on Service User W’s record in April 2016 the correct advice in relation to the potential for a contribution being required, the Panel found it more likely than not that the Registrant had provided inaccurate information initially and they therefore found this particular to have been proved on the balance of probability.

Particular 5(b) – Not Proved

41. This particular related to Service User Q and the fact that the Registrant had raised the issue of a financial assessment before determining that the eligibility criteria had been met in respect of Service User Q’s needs. Witness SS was clear that this should not have happened however it can not be said that the Registrant provided incorrect or delayed information in respect of Service User Q.  The Panel were not prepared to criticise the Registrant for discussing a financial assessment prior to the conclusion of a needs assessment. The Panel were satisfied that the allegation before them had not been proved.

Particular 5(c) – Proved

42. Service User X was the focus of this particular with witness SS asserting that there had been inaccurate or delayed information provided to the service user and or their family between October 2015 and April 2016. However, the Panel noted that the Continuing Care Panel did not consider this case until 15 March 2016 and they therefore considered that any delay could not have pre-dated this date. However, once the Continuing Care Panel had reached a determination, there was a delay of some 4 weeks before the family were informed, and the notification only happened once the Registrant had been prompted to contact them. The Panel therefore considered that the particular had been proved.

 


Particular 5(d) – Not Proved

43. Service User N was the focus of this particular however it was apparent from the service user records that the Registrant had recorded the provision of accurate information to the family of Service User N on 13 January 2016. There was no evidence before the Panel that any information provided by the Registrant was inaccurate or delayed, with the statement of witness SS merely asserting “…it would appear that the daughter of service user N was not given clear information about invoice date time scales in relation to third party top up and contributions towards cost of care until 1 February 2016”.  On this basis, the Panel found that this particular had not been proved.

Particular 5(e) – Proved

44. This particular related to Service User C. The Panel were satisfied that there was a clear instruction to the Registrant on 18 January 2016 to contact the family, but the service user records confirm this was not done until 8 April 2016. The Panel noted that there were attempts to contact the family but the telephone number was not correct for the one family member the Registrant tried to contact. Other numbers of family members were apparently available and therefore there had been a delay in contacting the family. Accordingly, this particular was proved.

Particular 6(a) – Proved

45. The two sub-particulars of this allegation concerned a failure by the Registrant to follow instructions and guidance provided by managers.

46. Particular 6(a) related to Service User L. The management instruction that was not complied with was to keep in touch with the hospital in relation to Service User L being discharged from hospital. This instruction was given to the Registrant during supervision on 15 December 2015 by witness SS. The service user notes reflect no action by the Registrant to keep in touch with the hospital thereafter, and the Council was only made aware on 7 January 2016 that Service User L had been discharged from hospital on 24 December 2015 as a consequence of the daughter contacting the Council on 7 January 2016 to express concerns in relation to L. This particular was therefore proved.


Particular 6(b) – Proved

47. The second sub-particular related to Service User X, with a clear management instruction being given on 4 April 2016 to the Registrant by Witness SS to complete relevant paperwork by 13 April 2016 (D98 of the bundle). The witness followed up the instruction on 13 April 2016 and the action was not completed until after that date and was therefore late. The Panel were therefore satisfied that the allegation had been proved.

Particular 7(a) – Proved

48. The two sub-particulars of this allegation centre relate to the Registrant’s failure to raise concerns about individual service users with a manager.

49. In relation to Service User I, the Panel considered that on 9 and 12 December 2015 and 7 January 2016, concerns were raised by the nephew of the service user in relation to the care of his aunt. Witness SS stated that the registrant should have notified her immediately particularly when second and third allegations were raised in relation to issues that were potential indicators of poor care. This was of particular relevance given the Registrant was already aware of concerns about her lack of awareness in respect of safeguarding issues, yet she missed opportunities to make management aware of the situation. The Panel noted that the Registrant did appear to have discussed some concerns with witness RN on 21 December 2016, however they are only aware of this as a consequence of witness RN confirming the discussion she had with the Registrant in an email (D254), which makes it all the more surprising that having discussed it with witness RN, the Registrant did not inform management of the third concern being expressed on 7 January 2016. The Panel therefore considered that this allegation had been proved.

Particular 7(b) – Proved

50. This particular related to Service User L who had been discharged from hospital with care needs but her carer (Service User K) ha been admitted to hospital. This placed Service User L at risk of harm and the Registrant should have immediately shared those concerns with management when she was informed by the daughter on 7 January 2016 but she did not.  The Panel were therefore satisfied that this particular was proved.
Particular 8 – Not Proved

51. It was alleged by this particular that the Registrant had not visited Service User K between 26 October 2015 and 26 April 2016. However, page D384 (the service user records for K) contained a note from the Registrant that she had visited the home of Service User K and spoken with him on 17 November 2015. Accordingly, the particular could only be found to be not proved. 

Particular 9(a) – Proved

52. Particular 9 related to an assertion that the Registrant delayed in arranging home care services in respect of Service User G between 16 February 2016 and 8 April 2018. The Panel accepted that witness SS appears to have had access to documents which had not been provided to them, and that the records for service user G do not reflect the Registrant commissioning home care services; in the period alleged.  The support identified by the Registrant on 17 February 2016 as being required for Service User G related to meals, shopping, laundry and medication. However, the records only reflect a request for a lunch call and a shopping call on 8 April 2016, and that was instigated by witness SS. Therefore, the Panel were satisfied that the Registrant had delayed in arranging services for Service user G as alleged, and found this particular proved. 

Particular 9(b) – Not Proved.

53. The records for Service User O reflect that a request from the family of Service User O had been received by the Council to extend the support provided by increasing attendance at a day centre from one day to two each week. However, the particular alleged only that the Registrant delayed in arranging a Support Plan for the service user to attend the day centre. It did not reference the updating of support plan or an increase in provision from one day a week to 2 days a week. As there was a support plan in place, and the service user was attending the day centre, the Panel considered that this particular, as drafted, was not proved.

Particular 9(c) – Not Proved

54. As set out in the case summary, the Presenting Officer offered no evidence in relation to this particular and the Panel therefore found it to not be proved.
Particular 10 – Not Proved

55. The only information provided to the Panel in support of this particular came from witness SS at paragraph 38 of her statement. This paragraph is not detailed and does not reference evidence of a phone call being received, or that it was not returned by the Registrant. There was therefore insufficient evidence available to the Panel to find the allegation proved, so it was not proved. 

Particular 11 – Not Proved

56. This allegation centred around an alleged failure by the Registrant to check with the care home that the measures in place were working. However, it was clear from the service user records that Service User D was in fact not resident in a care home but was still living at home.  The HCPC application to amend this particular had been refused due to it being made at the end of the hearing when it was evident that the particular had not been made out as drafted and granting the application would have caused undue prejudice to the unrepresented Registrant.  The relevant information existed within the bundle before any evidence was heard and therefore it was open to HCPC to make the application at the commencement of the hearing. This particular was therefore not proved.

Particular 12 – Proved

57. This allegation related to a perceived failure on the part of the Registrant to record the exceptional circumstances that justified Service User E’s caring arrangement between 28 September 2015 and 1 March 2016 having been asked specifically by management to determine the basis for the exceptional payment.  The Registrant had inherited the case and the arrangement was already in place. Although the family of Service User E had been prepared by the Registrant for the fact that the payment was likely to cease, the exceptional circumstances required to justify the arrangement had not been established by March 2016 and therefore could not be considered by management. This particular was therefore proved.

Particular 13 – Proved

58. The essence of this allegation was that the Registrant had not recorded the outcome of an assessment for Service User G on or around 7 January 2016. She had recorded that she had undertaken an assessment visit on that date, and what issues she was to cover with Service User G in that meeting, however she had not recorded any observations for the visit, or her conclusions. In the opinion of the Panel, any visit by a professional would involve an element of assessment, however informal the visit may appear.  It was therefore incumbent on the Registrant to ensure that a record of any pertinent facts (e.g. his level of oral intake, and management of his personal hygiene) obtained during a visit were recorded on the records of Service User G for the benefit of any other professional accessing the file in respect of Service User G. This particular was therefore Proved.

Particular 14 – Proved

59. This particular alleged that the Registrant incorrectly recorded the outcome of a Decision Support Tool meeting by labelling it as Fast Track Review in relation to Service User X. The Panel were satisfied that the Registrant had indeed referred to Service User X as a fast track case, as set out on page D481 of the bundle. Accordingly, this particular was found by the Panel to be proved.

Particular 15(a) – Proved

60. The accusation within this particular was that an inadequate support plan had been produced by the Registrant for Service User O in that the transport costs had not been included in the package of care.  There was no evidence provided to the Panel other than the specific recollection of witness SS. The Panel expected to have been provided with a copy of the plan that was said to have been deficient, but nevertheless were satisfied that witness SS specifically remembered the detail of this case and they found that it was more likely than not that the plan was deficient as per her evidence.  They therefore found this particular to be proved.

Particular 15(b) – Proved

61. This particular covered the issue of the care package approved by the Registrant in respect of Service User O exceeding the bracket of care which the Registrant was entitled to authorise. The Panel expected to be provided with independent confirmation of the limits of the Registrant’s authority to authorise care packages and noted that there was no reference to such limits within the job description provided at page D 3. However, the Panel did consider witness SS to be reliable and credible, and therefore, in the absence of evidence to the contrary, accepted her evidence in relation to this particular and found the matter proved.

Particular 16(a) – Proved

62. The last pair of particulars related to Service User J. Particular 16(a) asserted that the Registrant labelled the service user as having a learning disability when she  did not, however the Panel had not had sight of the document in which this was said to have occurred. However, given that the Panel have found witness SS to be both credible and reliable, in the absence of any challenge to her evidence, the Panel were prepared to accept her evidence given that there is corroboration by way of documentary evidence of her raising the issue with the Registrant in supervision and in a probationary meeting. The Panel therefore found this particular proved.

Particular 16(b) – Proved

63. The final particular concerned the Registrant’s failure to follow up Service User J’s need for assistive technology (i.e. a vibrating smoke alarm). The Panel noted the email sent by witness SS to the Registrant on 29 December 2015 in relation to this issue, some two months after the visit took place.  They also observed that the service user notes provided in respect of J did not cover the period between the visit and the email. The Panel therefore considered the particular to have been proven.
  
Decision on Grounds:

64. The Presenting Officer invited the Panel to consider whether the statutory grounds of Misconduct and or Lack of Competence were applicable in the light of the facts found proven. Aside from misconduct and lack of competence, the statutory grounds of impairment set out within the Health and Social Work Professions Order 2001 at article 22(1) had not been alleged by the HCPC (i.e. criminal conviction or caution, physical or mental health, or a finding of impairment by a regulatory body) and have not therefore been considered by the Panel.

65. Having determined the facts and found some particulars proved, the Panel was required to judge whether the facts they had found proved amounted to the statutory ground on which they were advanced by the HCPC and then whether the Registrant’s fitness to practise is impaired. The Panel had regard to the Practice Note issued by the Health and Care Professions Tribunal Service (HCPTS) entitled “Finding that Fitness to Practise is Impaired”, and noted that, in determining whether fitness to practise is impaired, it must take account of a range of issues which, in essence, comprise two components:

• the ‘personal’ component: 

the current competence, behaviour etc. of the individual registrant; and

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

66. In view of the findings of fact set out above, the Panel considered the issue of grounds but only in relation to the particulars that were found proved. No further consideration was given to the particulars that were found not proved. The Panel was aware that determining the issue of misconduct and / or lack of competence was entirely a matter for their judgement.

67. The Panel took into account the oral submissions of the Presenting Officer on behalf of the HCPC, and the limited comments submitted by the Registrant. It accepted the Legal Assessor’s advice and had regard to guidance issued by both the HCPC and HCPTS, particularly in relation to the “Approach to Fitness to Practise Proceedings” and “Finding Impairment”. The Panel was aware that lack of competence can be distinguished from misconduct in that it indicates an inability to work at the required level and connotes a standard of professional performance which is unacceptably low, demonstrated by reference to a fair sample of a registrant’s work. The Panel was aware that breach of the standards alone does not necessarily constitute misconduct. The Panel also bore in mind the explanation of that term given by the Privy Council in the case of Roylance v GMC (No.2) [2000] 1 AC 311 where it was stated that:

“Misconduct is a word of general effect, involving some act or omission  which falls short of what would be proper in the circumstances. The  standard of propriety may often be found by reference to the rules and  standards ordinarily required to be followed by a … practitioner in the  particular circumstances. The misconduct is qualified in two respects.  First, it is qualified by the word ‘professional’ which links the  misconduct to the profession ... Secondly, the misconduct is qualified  by the word ‘serious’. It is not any professional misconduct which will  qualify. The professional misconduct must be serious.

68. In terms of assessing a lack of competence, the Panel were assisted by the case of Holton v General Medical Council [2006] EWHC 3187 (Admin), where the High Court held that in assessing lack of competence, the standard to be applied was that applicable to the post to which the registrant had been appointed and the work they were carrying out.

69. The HCPC has adopted standards of proficiency for Social Workers as well as standards in relation to conduct, performance and ethics that apply to registrants of all professions regulated by HCPC. The Panel considered that the following standards for Social Workers (2012 edition) had been breached by the Registrant:

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

• 2.3) understand the need to protect, safeguard and promote the  wellbeing of children, young people and vulnerable adults

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

• 8.3) understand the need to provide service users and carers with the information necessary to enable them to make informed  decisions or to understand the decisions made;

• 9.6) be able to work in partnership with others, including those  working in other agencies and roles;

• 10) be able to maintain records appropriately

• 13) understand the key concepts o the knowledge base relevant to their profession;

• 14.2) be able to select and use appropriate assessment tools;

• 14.3) be able to prepare, implement, review, evaluate, revise, and conclude plans to meet needs and circumstances in conjunction with service users and carers;

70. The Panel also considered that the following standards of general conduct, performance and ethics for health and care professionals set by the HCPC had been breached by the Registrant:

a) 2012 issue:

• 1) act in the best interests of service users;

• 5) keep your professional knowledge and skills up to date;

• 6) act within the limits of your knowledge, skills and experience and if necessary, refer the matter to another practitioner;

• 7) communicate properly and effectively with service users and other practitioners;

• 10) keep accurate records;

b) 2016 issue

• 1) Promote and protect the interests of service users and carers;

• 2) Communicate appropriately and effectively;

• 3) Work within the limits of your knowledge and skills;


• 6) Manage risk;

• 7) Report concerns about safety;

• 10) Keep records of your work;

71. The Panel noted that breach of the standards alone does not necessarily constitute misconduct. However, the Registrant’s conduct and behaviour fell far below the standards expected of a registered practitioner. The Registrant was a social worker and repeatedly failed to meet the standards expected of her in relation to the lives of the vulnerable adults that she was responsible for protecting. The actions the Registrant was required to undertake were fundamental to her area of practice and could not be described as limited in nature or a momentary failure. 

72. The Panel was satisfied that the Registrant demonstrated a serious lack of competence in relation to the following particulars of the allegation:-

• 1(a)  Service User D was at risk of physical harm as a consequence of being unable to manage his nutrition given his diabetes. Other professionals (namely a diabetic nurse) were involved in his care and it was therefore important that comprehensive, accurate and timely notes were kept.

• 1(b)  Service User F was engaged with other professionals who needed to be aware of what was going on. There were areas of risk for Service User F and therefore it was fundamental that accurate records were kept.

• 2(a) It was a fundamental requirement that a social worker complete assessments where they were required, particularly those  prescribed by statute such as the Mental Capacity Act. This had not been completed by the Registrant in respect of Service User F.

• 2(b)  Service User R was vulnerable and at risk from others in the community. Concerns had been referred to the Council by the Police. It was a fundamental expectation that the Council protect Service User R from exploitation. 

• 3(a)   completion of an assessment in respect of Service User M was of fundamental importance, given his carer’s increasing difficulties, particularly given that the completion of the assessment would enable other services to be accessed.

• 3(c) risks were identified in relation to K but without a formal assessment, the progress which could be made was limited.

• 3(e)  the failure to determine correctly where liability lay for financial contributions would have a real and immediate impact upon those paying for care when they did not need to, and on the Council if it was covering the costs of those who should properly be contributing to the cost of care. The fact that the service user died before this was followed up was immaterial.

• 5(a)  in order to be able to explain to service users and their families the complex funding rules relating to adult social care, it is necessary to have solid grasp of it.  Social Workers need to know the rules and be able to explain them competently and accurately. Providing incorrect or delayed information can cause anxiety, distress and financial pressures for service users and their families, as well as damage the relationship with the social worker. This lack of  competence was not inconsequential.

• 5(c)  the failure in this particular was again not inconsequential and it was evident that it caused the family of Service User X concern. 

• 6(a)  the failure to follow management instructions and guidance in relation to Service User L was a serious issue.  There was a material risk that a vulnerable service user had been left with no care on her discharge from hospital.

• 6(b)  the failure to comply with management instruction in relation to Service User X meant that discussions with the family about third party top up payments did not happen in a timely manner and paperwork was rushed at the last minute. This could have led to the needs of the service user not being met properly and unnecessary charges being incurred.

• 7(a)  the repeated failure to inform managers of safeguarding concerns regarding Service User I was a serious issue. The potential concerns related to the care provided by a residential care home and urgent action may have been needed.

• 7(b)  again, the failure to notify management of concerns regarding the care of a vulnerable adult (L) was a fundamental issue.

• 9(a)  although the Registrant had identified the needs of Service User  G, the failure to ensure that the measures proposed to address those needs were being implemented meant that Service User G was exposed to significant risk.

• 12  the delay in identifying the exceptional circumstances justifying a direct payment to a spouse meant that the scarce financial resources of the authority may have been paid out incorrectly.

• 13  the failure to record the outcome of an assessment on the service user records was potentially serious as other professionals dealing with service User G would have been unaware of the nature of those concerns and how they were to be or had been addressed.

• 16(b)  having identified that Service User J was deaf and unable to hear a smoke alarm, the delay in ordering assistive technology (vibrating smoke alarm) could have had serious consequences in the event of a fire. This task should have been prioritised given the risk to Service User J.

73. The Panel noted that both witnesses confirmed that there were some aspects of the Registrant’s practise that were acceptable, and that some improvements had been noted, however both witnesses remained concerned about the Registrant’s basic understanding and ability to apply fundamental principles of practise. They were satisfied that they had been presented with a fair sample of the Registrant’s work and therefore felt able to conclude that the Registrant lacked competence to practise as a social worker at the current time.

74. The Panel concluded that collectively, the Registrant’s acts and omissions demonstrated a failure to act in the best interests of service users and potentially put them at risk – it was not relevant to their considerations that the risks had not materialised. Her conduct also had the potential to adversely affect colleagues within her team. Confidence and trust amongst colleagues is vital; they should be able to expect that individuals within the team can be relied upon to work in accordance within expected professional standards and in accordance with management instructions.

75. Although there was no evidence before the Panel of direct harm being caused to service users as a consequence of the Registrant’s acts and omissions, the service users were exposed to the risk of harm as a result of the failure to undertake visits, conduct assessments and record in a comprehensive and timely manner. However, the Panel were conscious of the unusual context of the Registrants employment with the Council, namely:

• the fact that she was effectively in her first year of practise but more  than 8 years after she attained that social work qualification;

• she was not eligible for Assessed and Supported Year in Employment  (ASYE) funding, even though it was accepted by witness SS that she would have benefited from it;

• neither of the managers responsible for the Registrant were qualified social workers;

• there was only one other qualified social worker in the team and that social worker was not considered a suitable mentor for the Registrant;

• the personal issues relating to the Registrants history and health;

76. Witness RN said that when concerns were raised with the Registrant she understood them, wanted to make improvements and was trying hard to do so. She said that the Registrant was unable to provide plausible explanations as to why the work was not done correctly and that she could see that the Registrant was sorry about that. She said that the Registrant “wanted to do a good job”. Witness SS said that the Registrant did not act in a malicious way but rather did not understand the requirements. She said that the Registrant wanted to do a good job but that, for whatever reason, she just never grasped the processes.

77. For the reasons set out above, the Panel concluded that the Registrant’s acts and omissions over the short period of her employment with the Council did not amount to misconduct. However, she was employed as a qualified social worker and therefore had a professional obligation to safeguard and protect the well-being of vulnerable adults. Service users, their families and the public have the right to expect that the Registrant in performing her professional role would maintain appropriate records as important decisions are based on the assessments and records completed by social workers.

Decision on Impairment:

78. To assist with determining whether fitness to practice is impaired when there is a finding of lack of competence, the HCPTS has published a practice note for the guidance of Panels and to assist those appearing before them. This document confirms that Panels are required to consider for each allegation:

a) whether the facts set out in the allegation are proved;

b) whether these facts amount to the statutory ground set out in the allegation (e.g. misconduct or lack of competence);  and

c) in consequence, whether the registrant’s fitness to practise is impaired.

79. Further, the test of impairment is expressed in the present tense in relation to the need to protect the public against the acts and omissions of those who are not fit to practise, but this cannot be achieved without taking account of the way a person has acted or failed to act in the past. The Panel noted the Presenting Officer’s submissions on the issue of impairment and also took account of the limited comments provided by the Registrant in advance of the hearing. It also received and relied upon advice from the Legal Assessor.

80. Given the Panel found that a number of particulars had been proved and amounted to the statutory ground of lack of competence, the Panel went on to consider public policy issues in addition to the behaviour of the Registrant. The Panel was mindful that a finding of impairment does not automatically follow a finding of lack of competence – such as if the panel can properly conclude the act or omission was an isolated error and the chance of repetition in the future is remote. They also noted the guidance in the case of Cohen v GMC [2008] that it must be highly relevant when determining impairment that the conduct leading to the charge is easily remediable, has been remedied and is highly unlikely to be repeated.

81. When assessing the likelihood of recurrence of harm, Panels must take account of the degree of harm caused by the Registrant and the Registrant’s culpability for that harm, recognising that the harm could have been greater or less than the harm which was intended or reasonably foreseeable and should not be considered in isolation. Panels may also take account of character evidence.

82. The Registrant had provided no testimonials from colleagues and no evidence that she had taken steps to remediate the issues identified or provide any assurance to the Panel that the same issues could not recur in future.

83. The Panel considered the Registrant’s current fitness to practise firstly from the personal perspective and then from the wider public perspective.

84. As the Registrant did not attend the hearing and expressed neither regret nor remorse the Panel was unable to explore:

• the degree of insight shown by her;

• the steps she had taken to maintain her competence to practice;


• her current work situation;

• the state of the Registrant’s health;

• her current personal circumstances.

85. The Panel were of the opinion that the Registrant appeared unable or unwilling to accept full responsibility for her acts and omissions. There was insufficient evidence before the Panel that the Registrant fully appreciated the overall gravity and potential consequences of her lack of competence and as a consequence, the Panel was not assured that such serious issues would not be repeated. There was no evidence before the Panel that the Registrant has been able to work safely and effectively as a social worker since her employment with the Council ended in 2016. In the absence of a sufficient level of insight and adequate evidence of remediation, the Panel concluded that there is a risk of the behaviours being repeated.

86. In considering the public component, the Panel had regard to the important public policy issues which include the need to maintain confidence in the profession and declare and uphold proper standards of conduct and behaviour. Members of the public would be concerned to learn that a social worker had been found to lack competence. It concluded that the Registrant’s acts and omissions presented the following issues:

• risk of harm to service users;

• brought the profession into disrepute;

• breached a fundamental tenet of the profession by failing to act in the  best interests of service users at all times;

• risk that all of these features are likely to be repeated in the future.

87. In all the circumstances, the Panel determined that public trust and confidence in the profession and professional standards could be undermined if a finding of impairment was not made.

88. On balance, given that the Panel had found 17 instances of lack of competence, and the lack of meaningful engagement by the Registrant with the regulatory process, the Panel concluded that the Registrant’s current fitness to practise is impaired on the basis of both the personal component and the wider public interest.  Her role was to protect her service users and the standard of her practice was not of the standard that was expected of a registered professional.

89. For the reasons set out above, the Panel were satisfied that the Registrant’s fitness to practise was and is impaired.

Decision on Sanction:

90. Having delivered the above findings, the Panel invited the Presenting Officer to address it as to sanction.  An appropriate period of time was allowed for the formulation of submission on sanction.
91. The Presenting Officer submitted that the HCPC have adopted a policy on sanctions to guide the panel. In her opinion the Panel had already accurately identified the aggravating and mitigating features of this case. The purpose of imposing a sanction was not to punish the Registrant but to ensure that the public was protected, promote public confidence in the profession and provide a deterrent to other registrants. In the event the Panel chose to deviate from the Indicative Sanction Policy, it would need to give reasons.
92. When considering what, if any, sanction was appropriate in this case, the Panel was mindful that each case must be determined on its own merits. The HCPTS has adopted a policy in respect of indicative sanctions to aid panels to make fair, consistent and transparent decisions. It was also aware of the need  to give clear and cogent reasons for its decision, particularly if departing from the policy. It received and applied advice from the Legal Assessor in relation to the imposition of a sanction.
93. The purpose of fitness to practise proceedings is not to punish but to:
a) protect the public by ensuring that registered health care professionals practise to a minimum universal standard;
b) maintain public confidence in the regulatory process;
c) protect the reputation of the profession concerned;
d) act as a deterrent to other registrants.
94. Article 29 of the Health and Social Work Professions Order 2001 provides that the sanctions available to a panel to protect the public are:
a) Mediation;
b) Caution;
c) Conditions of practice;
d) Suspension;
e) Striking off is not however available in this matter as the statutory ground was lack of competence.
Alternatively, a panel may decide that no further action is required.
95. When determining the appropriate level of sanction, panels must be proportionate so that the sanction:
a) Is appropriate in the circumstances;
b) Secures the protection of the public;
c) Takes account of the wider public interest;
d) Is the least restrictive means of securing public protection;
e) Is proportionate and strikes a proper balance between the rights          of the Registrant and the protection of the public.
96. The Panel found that the matter had the following aggravating features:-
• the failings in the Registrant’s practise were fundamental elements of practise (recording, provision of timely and accurate information);
• the vulnerable adults in her care had been exposed to a risk of harm by her failings;
• there was a lack of insight by the Registrant as to the potential consequences of her failures of practice;
• there was no evidence that the Registrant had remediated her practise and she therefore posed a risk to the public.
97. There were however also mitigating factors in existence in relation to the matter:-
• no harm had been suffered by any vulnerable adult as a result of the failings, as far as the Panel was aware;
• the Registrant’s work environment appeared to be challenging;
• the Registrant had an unblemished regulatory record prior to this  allegation;
• the two witnesses identified positive elements in the Registrant’s practice and attitude;
• the Registrant was dealing with personal issues relating to her own health and personal circumstances.
98. The Panel did not believe that the Registrant had demonstrated either insight or remorse for her actions. They recalled that Witness RN gave evidence that the Registrant was sorry that she had been unable to improve her practice. However, the Panel remained concerned as to her future practice. As result, it was not appropriate for the Panel to take no action. It noted that there was no outstanding dispute as the Registrant had left the employ of the Council and therefore mediation was also an inappropriate sanction in this matter.
99. The Policy identifies that a caution order may be 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 remedial action;
The Panel considered that none of these factors is present in this case.
100. However, the policy is clear that a caution order is unlikely to be appropriate in cases where the registrant lacks insight and the Panel does not therefore consider that a Caution Order would be appropriate in this matter given the lack of any insight or remediation shown by the Registrant. Further, the Panel had no information as to the current employment of the Registrant, her continued competence or personal obligations.
101. The Panel therefore moved on to consider whether a conditions of practice order would be appropriate. The purpose of a conditions of practice order is to restrict a registrant’s practice, require the registrant to take remedial action or impose a combination of both. Imposition of a conditions of practice order means that the panel is satisfied that the registrant is capable of practising safely with appropriate training, guidance and support. However, conditions will rarely be effective unless the Registrant is genuinely committed to resolving the issues to be addressed and can be trusted to make an effort to do so. The Policy points out that conditions of practice are unlikely to be suitable where, as in this case, the Registrant has lacked insight or engagement with the regulator.
102. The Panel was mindful of the environment the Registrant was working in at the time. Had the Registrant been able to demonstrate some improvement in the areas of concern, the Panel may have been satisfied that she could continue to practise safely and effectively under a conditions of practice order. It was also mindful of the fact that the Registrant had already been supported by her managers via a support plan and through supervision and that any conditions that they may consider would be likely to mirror the support she had already received and not succeeded with. In any event, given the lack of engagement by the Registrant, Conditions of Practise would not be an appropriate sanction in this case.
103. Given that the Panel considered that neither a Caution nor a Conditions of Practice Order would provide sufficient public protection, and that there was not, so far as the Panel was aware, anything to prevent the Registrant from understanding and seeking to remedy the failings identified by the Panel, suspension from practice was considered to be the only appropriate and proportionate sanction which could be applied.
104. Striking off was not considered by the Panel given that a striking-off  order may not be made in respect of an allegation relating to lack of  competence or health unless the registrant has been continuously  suspended, or subject to a conditions of practice order, for a period of  two years at the date of the decision to strike off
105. Having determined that a Suspension Order was the appropriate  sanction, the Panel considered the period of suspension, mindful of the  HCPTS policy statement that suspensions should not exceed one year.  In this case, the Panel believed that it was appropriate to suspend the  Registrant from practice for a period of 12 months. The Panel  considered this to be appropriate and proportionate given the lack of  engagement by the  Registrant, the wide range of concerns about her  practise and the failure of previous support mechanisms to secure any  material and sustained improvement in her practise. There were  substantial concerns in relation to the potential for harm to the public  and a realistic risk of repetition.
106. A suspension cannot be made subject to conditions, however, it may assist a future panel, when this order is reviewed, if the Registrant could present evidence as to how she has developed and reflected on the areas of concern found in relation to this allegation – i.e. record keeping, identification of risk and safeguarding issues, and providing accurate information in a timely manner. This might be achieved by undertaking training and / or maintaining a reflective portfolio and / or receiving support from a mentor. However, the Panel recognised that it cannot be prescriptive and its recommendations do not bind or fetter the discretion of a future panel considering this matter.

Order

That the Registrar is directed to suspend the registration of Ms Josephine Veronica Tait for a period of 12 months from the date this order comes into effect.

Notes

Interim Suspension Order:
Application for an Interim Suspension Order:
1. Upon the Panel determining the appropriate sanction to be a Suspension Order, the Presenting Officer requested that the Panel exercise their discretionary power to impose an interim suspension for the time allowed for appealing against the final disposal order or, if such an appeal is made, whilst that appeal is in progress. The imposition of an interim order is not an automatic outcome following the imposition of a Suspension Order.  She believed that the Registrant had been made aware of the likelihood of such an application on behalf of HCPC in the event that a sanction of suspension was imposed and therefore applied for the consideration of the Interim Suspension Order Application to proceed forthwith in the absence of the Registrant.
2. The Panel received and accepted advice from the Legal Assessor and then adjourned to consider whether it was appropriate to proceed to hear the Interim Suspension Order Application in the absence of the Registrant.
Panel’s decision:
3. The Panel was satisfied that the Registrant had been notified of the likelihood of such an application when she received the notification of hearing dated 6 June 2018, which the Panel had already accepted had been properly served on the Registrant. Although registrants had a right to be in attendance when such applications were to be considered, the Panel was satisfied that the imperative to protect the public from the Registrant’s failings in practise outweighed the Registrant’s right to attend, particularly given the Registrant had not given any indication that she would attend or make representations in the event that the application was adjourned to enable her to attend. It found that it was appropriate for consideration of an interim suspension order to proceed in the absence of the Registrant.
4. The Presenting Officer submitted that an Interim Suspension Order was applied for on the grounds of public protection and in the public interest based on the risk of repetition of failings as identified by the Panel in their decision. She reminded the Panel that the substantive suspension order that they had imposed would not take effect until the time for lodging an appeal  had elapsed, or when any such appeal is determined, whichever is the later. Given that the Panel has specifically found that the Registrant poses a risk to  the public and imposed suspension in general public interest, it would be entirely appropriate for an Interim Suspension Order to also be imposed.
5. The Panel carefully considered the submissions of the Presenting Officer and the advice provided by the Legal Assessor, which they accepted. They also noted the provisions of the guidance note issued by the HCPTS in respect of Interim Orders.
6. The Panel reminded itself that an interim order may be appropriate where:
• There is a serious and ongoing risk to service users or the public from the registrant’s lack of professional knowledge or skills; conduct or unmanaged health problems; or
• The allegation is so serious that public confidence in the profession or the regulatory process would be seriously harmed if the registrant was allowed to remain in practice on an unrestricted basis.
7. The Panel were mindful that, in imposing a Suspension Order, it had found that there was an ongoing risk to service users from the actions of the  Registrant. The Registrant was aware of the possibility of an Interim Order application and had not made any representations on the same in her limited  written submissions to the Panel. The factors which led the Panel to impose the Suspension Order were still pertinent. The Panel had no information as to the current employment, if any, of the Registrant, her health or personal  circumstances.
8. Given that the Panel earlier today considered the Registrant’s competence  to be such that suspension was warranted for the protection of public, it believed that public confidence in the regulatory process would be seriously harmed if the Registrant was allowed to remain in practice on an unrestricted basis pending the substantive Suspension Order coming into effect. The Panel were unaware whether the Registrant was currently working and without an Interim Suspension Order, there would be no bar to her practicing. Therefore, the Panel determined that it was appropriate and proportionate to impose an Interim Order of Suspension pursuant to Article 31(2) of the Health and Social Work Profession Order 2001 for a period of 18 months to protect the public and otherwise promote the public interest.
Interim Suspension Order:
The Panel makes an Interim Suspension Order under Article 31(2) of the Health and Social Work Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest.  This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

Hearing History

History of Hearings for Mrs Josephine Veronica Tait

Date Panel Hearing type Outcomes / Status
03/09/2018 Conduct and Competence Committee Final Hearing Suspended