Ms Thelma Angela Pitter
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(As amended on day 1 of the hearing, 1 April 2019)
Whilst registered as a Social Worker, you:
1. On or around 8 October 2017, at Home 1, made inappropriate comments to and/or threatened Service User A, in that you said:
a) ‘I may be a member of staff here but when I leave here, I am not a member of staff. I am a normal person on their own’, or words to that effect.
b) You hit your hands together and/or said on two occasions ‘do not fuck with me’, or words to that effect.
c) You hit your hands together and/or said, ‘you think I wouldn’t go and get my family’ and/or ‘my family will come down here,’ or words to that effect.
d) ‘They don’t realise that the threats she makes, I go back and relay that to my family, you need to know what my family will do’, or words to that effect.
2. Your actions at paragraph 1 amount to misconduct.
3. By reason of your misconduct, your fitness to practise is impaired.
Service and Proceeding in Absence
1. The Panel was satisfied that notice of today’s hearing had been properly served on the Registrant in terms of the relevant rules of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”) on 25 January 2019. The Panel next considered Ms Sheridan’s application to proceed in the Registrant’s absence.
2. Ms Sheridan referred to the Rules, the HCPTS Practice Note on Proceeding in the Absence of the Registrant and the relevant case law. Ms Sheridan advised the Panel that the Registrant is aware of these proceedings and she told the Panel that as well as the notice of hearing, the hearing bundle had also been sent to the Registrant on 25 January 2019, but it was returned “not called for” by the Post Office on 8 February 2019. No response was received from the Registrant when an email was sent to her by the solicitors for the HCPC on 13 March 2019 seeking to send the bundle electronically and again when a letter was sent to her 14 March 2019. Ms Sheridan reminded the Panel the Registrant has not indicated that she will be attending and has not requested an adjournment. The Registrant has not contacted the HCPC since February 2018. Ms Sheridan also reminded the Panel that there was also a public interest in the expeditious progress of proceedings.
3. The Panel is aware that its discretion to proceed in absence is one which should be exercised with care. The Legal Assessor gave advice to the Panel and referred it to the HCPTS Practice Note on Proceeding in Absence and to the case of Adeogba v GMC  EWCA Civ 162. This makes clear that the first question the Panel should ask is whether all reasonable efforts have been taken to serve the Registrant with notice. Thereafter, if the Panel is satisfied on notice, the discretion whether or not to proceed must be exercised having regard to all the circumstances of which the Panel is aware with fairness to the Registrant being a prime consideration but balancing that with fairness to the HCPC and the interests of the public.
4. The Panel agreed to proceed in the Registrant’s absence as it is satisfied that it is fair and in the public interest to do so. In reaching this decision, the Panel noted that the HCPC has made reasonable efforts to give notice and has complied with its Rules on notice. The Registrant has not asked for an adjournment and the Panel consider that the Registrant has waived her right to attend. As such the Panel also took account of the fact that this is a final hearing and that an adjournment would serve no purpose. The Panel balanced fairness to the Registrant with fairness to the HCPC and the public interest. In these circumstances the Panel is satisfied that it is appropriate and fair to proceed in the Registrant’s absence. No adverse inference would be drawn from the absence of the Registrant.
Application to Amend
5. Ms Sheridan applied to amend the allegation. She submitted that these amendments better reflect the evidence of MF in regards to the date and the evidence in the audio recording. She told the Panel that the proposed amendment had been sent to the Registrant on 13 December 2018 and she had not responded. She submitted that these amendments did not widen the scope of the allegation and the Registrant has not objected.
6. The Panel and heard and accepted the advice of the Legal Assessor as to fairness, the interests of justice and the avoidance of prejudice. The Panel having considered the application granted the amendment sought. It had been sent to the Registrant on 13 December 2018. There was not a risk of under prosecution and the amendments did not alter the overall seriousness of the allegation nor alter the nature or gravity of the allegation. The Panel determined it was not unfair or prejudicial to the Registrant to allow the proposed amendment and it was in the interests of justice to allow it.
7. The Registrant was employed as Senior Residential Support Worker at Home 1 from 19 September 2017 to 18 October 2017. Within her role the Registrant was responsible for helping with care for young people between 13 and 16 years old with emotional and behavioural difficulties.
8. On 8 October 2017, the Registrant was involved in a verbal confrontation with Service User A, a young person at the Home. An audio recording of this verbal altercation was made by Service User A and subsequently presented to the Registrant’s Line Manager, MF on 16 October 2017. That recording was in the HCPC evidence.
9. On 16 October 2017 a referral was made by MF to the Lambeth Local Authority Designated Officer (LADO) and a referral was then made to the HCPC.
Opening Submissions for the HCPC
10. Ms Sheridan opened the HCPC case. The audio recording of the altercation between the Registrant and Service User A was played to the Panel and written excerpts from MF of the recording were also available in the evidence. Ms Sheridan explained that Service User A was a vulnerable child from a difficult family background and was in Local Authority care. She was a resident in Home 1 which had clear policies as to how children in the home were to be supported. Staff had been told to avoid conflict and confrontation with her. Ms Sheridan summarised the evidence of the sole HCPC witness, MF, who gave live evidence. He was the Residential Children’s Home Manager at the time of the Allegation who had listened to the recording which Service User A had made on her phone.
The HCPC Witness:
Witness 1 – MF
11. The Witness formally adopted his statement as his evidence and confirmed it was true to the best of his knowledge and belief.
12. MF explained his role and responsibilities as the Home Manager overseeing the running of the home and supporting the staff. He set out for the Panel the Statement of Purpose and Function for the Home and explained that children at the home had emotional and behavioural difficulties.
13. MF told the Panel about Service User A who was placed in Home 1 in July 2017 and her difficult circumstances.
14. MF told the Panel that staff members, including the Registrant, were fully advised about the three Service Users at the home and had access to their individual behavioural management plans. Each plan would detail the Service User’s likely triggers and behaviours and guide staff how to manage those. Service User A’s plan was developed with her and it was noted in the plan that when she was distressed a normal or soft tone of voice was best, not raised voices. MF said that avoiding arguments with Service User A had been written into the plan and discussed with the Registrant and other staff. A script was in place to avoid escalation. This script would entail a small number of words which Service User A would be able to understand when angry. Staff should try and persuade Service User A to go with them somewhere else and to sit down and have a discussion.
15. MF confirmed that he recognised the voices on the phone recording as that of the Registrant and Service User A and another staff member.
16. MF said that at no time should the Registrant have spoken to Service User A in such a threatening way, as it may have been making the Service User A relive the abuse suffered in her life. It was not productive, particularly to a very vulnerable child in a home set up for her needs. The Registrant should have stayed calm and applied the behavioural management plan.
17. MF told the Panel that the Registrant had not engaged with the employer’s subsequent investigation and had resigned with immediate effect. She did not attend for an interview about the incident and made no further contact with her employer. MF said that at the time the Registrant had not reported the incident to him, or discussed nor raised it in supervision three days later.
18. In response to Panel questions, he explained the Registrant’s time at the home and spoke about her positively up until the alleged incident. MF said that the Registrant was not employed as a Social Worker but as a Senior Residential Support Worker. No social worker was employed there, but the Registrant told him that as a Social Worker she was experienced with young people. He considered that as a Social Worker she was well equipped to work at the home. She appeared confident in the role. He had been “really shocked” when he heard the recording as he did not expect her to behave in that manner.
Closing Submissions for the HCPC
19. Ms Sheridan set out her closing submissions on the facts, grounds and impairment. She reminded the Panel the onus of proof, on the balance of probabilities, rested on the HCPC. She referred to the evidence of MF and the audio recording in which MF recognised the Registrant’s voice. That evidence is not challenged. She invited the Panel to find the facts in allegation 1 proved as both threatening and inappropriate, except for particular 1 a) which was inappropriate.
20. Ms Sheridan invited the Panel to find that the allegation amounts to misconduct and was serious, falling substantially below the conduct expected of a professional. Service User A was a vulnerable teenage child with a difficult family background about which the Registrant was fully aware. She submitted that the audio recording was evidence of threatening and inappropriate behaviour by the Registrant toward a vulnerable 13 year old Service User.
21. Ms Sheridan submitted that Standards 1, 2, and 9 of the HCPC Standards of conduct, performance and ethics (2016) was engaged. The HCPC Standards of proficiency for Social Workers standards 2, 3, 8 and 9 were also breached by the Registrant. She submitted that the Registrant’s behaviour fell seriously short of that expected of a professional and referred to Roylance v GMC (No. 2)  and Meadow v GMC  1 All ER 1.
22. On impairment, Ms Sheridan referred the Panel to the HCPTS Practice Note on Impairment and to the guidance of Dame Janet Smith as discussed in the case of CHRE v NMC and Grant  EWHC 927 (Admin). She reminded the Panel of the public and personal component of impairment and the complete lack of evidence from the Registrant on insight, remorse or remediation. She reminded the Panel of the wider public interest and the need to uphold proper standards and maintain public confidence in the profession. Ms Sheridan submitted that a finding of impairment was required on both the public and personal aspects of impairment of fitness to practise.
23. The Legal Assessor reminded the Panel that when considering the facts the onus was on the HCPC and the standard of proof was the balance of probabilities. The Panel needed to assess and weigh all the evidence carefully. He reminded it of the definition of misconduct in the cases of Roylance and Meadow. On the issue of impairment, he referred the Panel to the guidance in the HCPTS Practice Note on Finding that Fitness to Practise is Impaired and to the case of Grant. He stressed the central importance of the public interest.
Decision on the Facts:
24. The Panel carefully assessed all the evidence it heard and the documents before it. It accepted the advice of the Legal Assessor. The Panel was aware that on matters of fact, as distinct from issues of lack of misconduct and impairment, the burden of proof rested on the HCPC and that the standard of proof was the balance of probabilities.
25. The Panel considered the evidence of MF. It was satisfied that he did his best to recall events and sought to assist the Panel. The Panel found him open, credible, reliable and consistent. The Panel accepted his evidence in full.
Particulars 1a), 1b), 1c) and 1d)
26. The Panel carefully considered the audio tape and the evidence of MF who identified the Registrant’s voice. The Panel was satisfied that it heard the Registrant say the words alleged in 1a), 1b), 1c) and 1d). The Panel heard hands being hit together. MF confirmed in his evidence that the Registrant had hit her hands together as she spoke the words in the particulars b) and c). He explained that Service User A had demonstrated how the Registrant had hit the back of one hand on the palm of the other as she spoke. The Panel accepted his evidence in conjunction with the audio evidence.
27. The Panel heard the words alleged in all 4 sub-particulars a) to d) delivered in an angry tone which appeared to escalate the incident. In relation to b) and c) the Panel found the accompanying hand hitting was particularly threatening. The Panel concluded that all the comments were inappropriate and threatening to Service User A, except for particular 1 a), which the Panel decided, taken alone, was not threatening, but was inappropriate.
Decision on Grounds:
28. The Panel accepted the advice of the Legal Assessor. It was mindful of the advice in the Roylance case and exercised its own professional judgement in assessing misconduct. The Panel considered all the circumstances of the case and the facts found proved. The Panel also carefully considered the HCPC Standards of conduct, performance and ethics (2016) (“the Code”).
29. The Panel found the Registrant breached the HCPC Standards of conduct, performance and ethics (2016), Standards 1.1 and 1.7, 2.1, 9.1.
30. The Panel recognised that the Registrant was not employed as a social worker at the Home but it heard from MF that she was employed, in part, because of her experience working with children as a Social Worker. At the time of the allegation she was a registered Social Worker with the HCPC. The Panel is mindful that the HCPC Standards of conduct, performance and ethics apply to all registrants and set standards of behaviour, not just in a professional setting.
31. The Panel has found that the language used by the Registrant was inappropriate and threatening and was directed at Service User A, a vulnerable child. It decided that this behaviour fell seriously short of what would be proper or expected of the profession. Accordingly, the Panel determined that the facts found proved amount to misconduct.
Decision on Impairment:
32. The Panel next considered whether the Registrant’s fitness to practise is currently impaired. It kept in mind the central importance of the protection of the public, the wider public interest and the guidance provided in the Grant case.
33. The Panel first considered the personal component of impairment. The Panel was concerned to note from MF that at the supervision session with him several days after the incident, the Registrant did not address the event, or tell MF about her behaviour to Service User A. The Registrant knew the Service User’s behavioural management plan, her background and her vulnerabilities, including her tendency to lash out and persist in arguing. Despite this the Registrant behaved in the way found proved and did not disclose it to MF, the Home manager. This demonstrated to the Panel a lack of insight and an acknowledgement of the inappropriate nature of her behaviour.
34. The Panel has no evidence about the Registrant’s current circumstances and has no evidence of any developing insight, remorse or steps to remedy her practice. In the absence of such evidence, the Panel is unable to assess the risk of repetition. The Panel was mindful of the need to protect the public and the seriousness of the allegation and in these circumstances determined that in light of the behaviour found proved, the Registrant presents a risk of harm to the public and a risk of repetition. It finds the Registrant’s fitness to practice is currently impaired.
35. The Panel was mindful of the guidance Grant on the central importance of the wider public interest and the need to safeguard public confidence both in the profession and the HCPC. It considered what a member of the public might make of the Registrant’s conduct toward a highly vulnerable Service User of 13 years old, and the effect that may have on the reputation of the profession.
36. The Panel determined that the public would be shocked by the conduct of the Registrant toward Service User A. Whether employed as a social worker or not, the Registrant’s behaviour was entirely unacceptable and reprehensible. Accordingly, the Panel determined that in order to declare and uphold proper standards and to maintain confidence in the profession and the regulator, that a finding of impairment is required on wider public interest grounds.
HCPC Submissions on Sanction:
37. Ms Sheridan reminded the Panel of the terms of the HCPC Indicative Sanction Policy (ISP) and the need to bear in mind the public interest and act proportionately. The Panel should balance the interests of the interests of the Registrant with the overarching need to protect the public and the public interest.
38. Ms Sheridan submitted that the aggravating features were the Registrant’s threatening behaviour to Service User A and lack of insight and remediation. A mitigating feature was that the Registrant had no previous fitness to practise history and was previously of good character.
39. Ms Sheridan advised the Panel that an Interim Suspension Order had been imposed on the Registrant on 15 January 2018 and has remained in place since then. The Registrant did not attend any of the Interim Order Hearings and made no representations.
Decision on Sanction:
40. The Legal Assessor referred the Panel to the ISP and reminded it to act proportionately. He advised the Panel to consider sanction in ascending order and to apply the least restrictive sanction necessary to protect the public. It should also consider any aggravating and mitigating factors and bear in mind the public interest and that the primary purpose of sanction was protection of the public.
41. The Panel found that the mitigating factors were that the Registrant had no previous fitness to practise history and this was an isolated incident.
42. The Panel considered that the aggravating features were:
a. The direct contravention of the behaviour management plan designed to assist the Service User;
b. The abuse of power in dealing with the Service User
c. Risk of harm to a vulnerable Service User ;
d. The lack of acknowledgement and insight by the Registrant.
43. The Panel approached sanction, beginning with the least restrictive first, bearing in mind the need for proportionality. Taking no further action and the sanction of a Caution Order would not reflect the seriousness of the allegation found proved and the finding of impairment. There was a complete lack of evidence of insight, remorse or remediation from the Registrant. These sanctions would not be adequate to protect the public or satisfy the wider public interest in maintaining confidence in both the profession and the regulatory process. Neither order was appropriate or proportionate in the circumstances of this case.
44. The Panel next considered a Conditions of Practice Order. The allegation found proved is serious. The Panel has no information before it as to the Registrant’s current circumstances and she has not engaged with the HCPC. There is no evidence of the ability or willingness of the Registrant to comply with conditions and in these circumstances the Panel cannot formulate workable, realistic and proportionate conditions of practice. In addition, such an order would not protect the public interest in maintaining public confidence in the profession or the Regulator and upholding and declaring proper standards.
45. The Panel next considered a Suspension Order. The Panel has found that the Registrant behaved in an inappropriate and threatening manner towards a vulnerable Service User and has not remedied her misconduct. The Panel concluded that the behaviour could be remedied given it was an isolated incident with no evidence of persistent failings. In these circumstances, the Panel determined that a Suspension Order would be proportionate and would adequately protect the public and the wider public interest.
46. The Panel acknowledged that the Registrant had been under an Interim Suspension Order imposed in January 2018. Bearing in mind the need to protect the public interest, the importance of maintaining confidence in the profession and upholding proper standards, the Panel decided that a Suspension Order for a period of 12 months was appropriate. This would also act as a deterrent to other Registrants and mark the unacceptability of her behaviour. This would give the Registrant time to reflect on her misconduct and take steps to remedy her behaviour.
47. The Panel next considered the sanction of Striking Off. The allegation proved is serious but the misconduct was not persistent or repeated. Whilst there is no evidence of insight, remediation or of the Registrant’s current circumstances the Panel determined that in all the circumstances of this case Striking Off would be not be proportionate at this stage and that a Suspension Order would adequately protect the public.
48. The Panel consider that a Reviewing Panel may be assisted by:
a. Engagement by the Registrant;
b. Evidence of insight and remediation;
c. Details of current circumstances;
d. Any relevant testimonials and references.
Decision on Interim Order
49. The Panel heard from Ms Sheridan and took account of all the information before it. She sought an Interim Suspension Order given the Panel’s findings. She advised that the Registrant was given notice of the possibility of an Interim Order within the Notice of Hearing sent on 25 January 2019.
50. The Panel accepted the advice of the Legal Assessor. He referred it to the HCPTS Practice Notes on Proceeding in Absence and on Interim Orders. He reminded the Panel that the primary purpose of an Interim Order is protection of the public and that it is necessary to balance the interests of the Registrant with the need to protect the public.
51. There has been no change in circumstances since the Panel decided to proceed in the absence of the Registrant and it determined to do so in respect of the interim order application. The Panel noted that the Registrant had been given notice of the Interim Order.
52. The Panel decided that it would be wholly incompatible with its findings, and with the sanction imposed to conclude that an Interim Order is not necessary for protection of the public or in the public interest. The Panel accordingly find that an Interim Order is necessary on both public protection and public interest grounds. Given its findings the Panel determined that it is appropriate that a Suspension Order is imposed on an interim basis for a period of 18 months to cover any appeal period. When the appeal period expires this Interim Order will come to an end unless there has been an application to appeal. If there is no appeal the Suspension Order shall apply.
Order: That the Registrar is directed to suspend the registration of Thelma Angela Pitter for a period of 12 months from the date this order comes into effect.
This order will be reviewed again before its expiry on 30 April 2020.
History of Hearings for Ms Thelma Angela Pitter
|Date||Panel||Hearing type||Outcomes / Status|
|01/04/2019||Conduct and Competence Committee||Final Hearing||Suspended|
|11/01/2019||Conduct and Competence Committee||Interim Order Review||Interim Suspension|
|12/07/2018||Investigating committee||Interim Order Review||Interim Suspension|
|15/01/2018||Investigating committee||Interim Order Application||Interim Suspension|