Miss Sarah Neita

Profession: Occupational therapist

Registration Number: OT52913

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 21/02/2019 End: 17:00 21/02/2019

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

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

As found proven at the final hearing on 28 February 2017:

 

The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing on 20-28 February 2017:

Between 5 May 2010 and 28 March 2012, during the course of your employment as an Occupational Therapist at the Lewisham Healthcare NHS Trust:

1. You demonstrated poor record keeping and/or record keeping that was not undertaken within the required timescales, in that:

a. On or around 17 October 2011, you:

(i) Had not written a report for a child who had been allocated to you on or around 11 November 2010;

(ii) Not Proved;

b. Not Proved:

(i) Not Proved

(ii) Not Proved

(iii) Not Proved

c. In March 2012 you did not complete the relevant paperwork following assessments with 3 children for 4 weeks or more;

d. In relation to Case 1:

(i) Not Proved;

(ii) You did not send the Occupational Therapy report to the child’s school in time for the child’s annual review on or around 30 June 2010;

(iii) Not Proved; and

(iv) You did not write any progress notes regarding the school visit you made on or around 28 March 2011.

e. In relation to Case 2, allocated to you on or around 11 August 2011;

(i) You did not complete the required assessments until 5 October 2011; and

(ii) You did not send the child’s report until on or around 18 January 2012;

f. In relation to Case 3, you did not write any notes for the handwriting groups which were held on or around 13 June 2011 and 22 June 2011.

g. Not Proved.

h. Not Proved.

i. Not Proved;

2. You did not demonstrate satisfactory clinical practice in that in relation to Case 1, you failed to follow up on your recommendation for a weighted hand splint.

3. Did not respect the confidentiality of service users, during the course of your employment and after you had resigned from Lewisham Healthcare NHS Trust you:

a. Took with you a number of documents which contained confidential children/family information and kept them at your home;

4. Not Proved.

5. The matters described in paragraphs 1, 2 and 4 constitute misconduct and/or lack of competence.

6. The matters described in paragraph 3 constitutes misconduct.

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

Finding

Preliminary Matters

Proceeding in private

1. An unopposed application was made by Ms Iskander for those parts of the hearing which dealt with the Registrant’s health to be heard in  private. This application was granted.

Background

2. The Registrant was employed as an Occupational Therapist at the Lewisham Healthcare NHS Trust (the Trust) from November 2009. The Registrant was primarily responsible for working with children with co- ordination difficulties in mainstream schools and with children with severe learning and movement disorders within Special Schools. The Registrant’s role was to meet patients and their families on both a one-to- one and group basis, assess patients, and set goals and targets for the development of their coordination.

3. There were some concerns within the Trust about the Registrant’s performance which led to a Performance Management Plan being instituted, which was satisfactorily completed in May 2011. By then, in April 2011, the Registrant had been promoted to a Band 6 role which required, on her part, more complex clinical reasoning and assessment. It also needed her to work at an increased pace.

4. In November 2010, Child 6 had been allocated to the Registrant and she carried out an Initial Assessment in November 2010. By October 2011, the Registrant had still not written a report on this child.

5. The Registrant demonstrated further poor record-keeping by a failure to complete relevant paperwork following her assessment of three other children. There were other examples of poor record-keeping and failure to complete records within required timescales in June 2010, March 2011, October 2011 and January 2012. All these matters were found by the panel of the Substantive Hearing in February 2017 to amount to examples of lack of competence.

6. Particular 2 alleged that the Registrant had not demonstrated satisfactory clinical practice in that, in a particular case, she had failed to follow up on her recommendation for a weighted hand-splint. In the view of the substantive hearing panel, this allegation, which was found proved, was linked to the failures of record-keeping and amounted to another example of lack of competence. That panel determined that there had been a pattern of failure on the Registrant’s part to take required action on cases in a timely manner. Although, in that panel’s stated view, health reasons had contributed to the level of the Registrant’s ability to meet the required standards, she was unable sufficiently or consistently to improve the standard of her work.

7. In March 2012, the Registrant submitted her resignation to the Trust. She took with her, on leaving, a number of documents which contained confidential information about children who had been allocated to her and their families. These papers included supervision forms, case load forms, reports, and notes of action plans. The Substantive Hearing panel determined that there was no justification for removing these documents and that the decision of the Registrant to do so amounted to disrespect of the confidentiality of service users; as such, this amounted to misconduct.

Early Review Hearing

8. The Registrant made an application for an early review which was heard on 27 October 2017. She had completed a Data Protection training course on 24 October 2017 and submitted a Reflective Learning piece that she had written for the course, dated October 2017.

9. The Registrant was employed as a Functional Analyst, but was on long- term sick leave. She argued that she was at risk of losing her job. She therefore wanted her case reviewed as she argued that the conditions were “harsh” and that it was inappropriate for her practice to be subjected to any restrictions at all. In her oral evidence, the Registrant said that having a Conditions of Practice Order, combined with her health, would prevent her from obtaining employment as an Occupational Therapist. She argued that the Substantive Hearing in February 2017 related to events which had taken place between 2010 and 2012, and that no service user had ever complained about her conduct or competence. She did, nevertheless, accept that she had made errors, albeit she attributed some of these to her health and what she considered was a general lack of support from the Trust. She added that she had learnt from her errors and had taken steps to ensure that she had addressed the issues. The panel noted that since the subtantive hearing, the Registrant had not applied for a post as an Occupational Therapist but had continued to be employed as a Functional Analyst.
 
10. The panel found that the Registrant’s fitness to practise remained impaired. At the conclusion of the hearing the panel found that conditions 1 and 2 of the Order should no longer be applied because the Registrant had successfully completed the Data Analysis Course and shown insight.

11. However, in relation to the other issues the panel found that both statutory grounds applied, namely public protection and the public interest. The panel considered that the Registrant was remorseful and had developed some further insight, but that she had not fully remediated them and the panel considered that without evidence of remediation and full insight, there was a risk of repetition if restrictions were not placed upon her practice. The panel therefore extended the Conditions of Practice Order in relation to the other six conditions, adapting condition 4.

The Hearing

12. The Panel have read the bundle of documents submitted by the Registrant. They heard submissions from Ms Iskander on behalf of the HCPC and from the Registrant. Ms Iskander invited the Panel to extend the current Conditions of Practice Order.

Decision

13. The function of the Panel in a mandatory review under Article 30 of the Health and Social Work Professions Order 2001 is to review whether the Registrant’s fitness to practise remains impaired and, if so, what the appropriate and proportionate sanction or outcome should be, so as to protect the public and safeguard the public interest.

14. The Registrant made submissions and produced a number of documents, including evidence that she is still employed as a Functional Analyst. She stated that she has been on long-term sick leave and that she is currently negotiating a phased return to work through the Access to Work scheme. She stated that she will need to update her training, which is intense and thorough, before she can go back to this role, which requires her to conduct assessments and to write reports within specific timescales. The Registrant acknowledged and apologised for the failings in her record-keeping between 2010 and 2012, but pointed out that she had learnt from these and had been in employment since 2012, with no further complaints. She stated that she would like to return to work as an OT at some stage in the future. She told the Panel that she had applied for a job as a Band 5 OT in Housing but did not pursue this due to her health. She stated that she would ideally like to work in housing or in mental health. She stated that she is a motivated person, keen to learn new skills and to practise as an OT again one day. She has considered applying for Occupational Therapy Technical Instructor (OTTI) or Occupational Therapy Assistant (OTA) roles and working her way up.

15. Ms Iskander acknowledged the work that the Registrant had done and the improvement in her insight. However, she argued that the fitness to practise of the Registrant was still impaired and that a Conditions of Practice Order was necessary in the public interest.

16. The Panel found that the Registrant was open and honest and that she has recently begun to take active steps to return to work. She has clearly suffered from significant health issues and the Panel were impressed by her commitment, determination and insight.

17. The Panel have considered the HCPC Practice Note “Finding that Fitness to Practise is ‘Impaired’”, the documentary evidence and the submissions from both parties. The Panel finds that, despite the Registrant’s efforts, her fitness to practise remains impaired. Both statutory grounds continue to apply, namely public protection and the public interest. The Panel accepts that the Registrant is genuinely remorseful and that she has insight, but acknowledges that her opportunities to remediate her failings have been significantly limited due to her extended sick leave. The Panel welcomes the fact that the Registrant is determined to return to work but considers that, without evidence of her report-writing and note taking, there is a risk of repetition if restrictions are not placed upon her practice.

18. The Panel considered what, if any, sanction to impose and referred to the HCPC Indicative Sanction Policy.

19. The Panel first considered taking No Further Action, mediation or a Caution Order. It concluded that these were not appropriate due to the nature of the findings because such sanctions would not restrict the Registrant’s practice and therefore would not protect the public.

20. The Panel decided that a Conditions of Practice Order for a period of 12 months remained appropriate and proportionate, in that it would strike a balance between the interests of the Registrant and those of the public. The Panel determined that the existing Conditions of Practice remain the most practicable and workable conditions.
 
21. This Order will be reviewed in 12 months. The Panel notes that a future reviewing panel may be assisted by:

• Testimonials from any current or recent employers, either in Occupational Therapy or otherwise (e.g. OTTI/OTA or any paid or voluntary work).

• Evidence that the Registrant has kept up-to-date with the profession, for example, a Continuing Professional Development (CPD) portfolio of evidence.

Order

Order

The Registrar is directed to extend the Conditions of Practice Order against the registration of Miss Sarah Neita for a further period of 12 months on the expiry of the existing Order. The Registrar is directed to annotate the HCPC Register to show that for a period of 12 months, you must comply with the following conditions of practice:

1. If you engage in professional work as an Occupational Therapist you must place yourself and remain under the supervision of a supervisor and supply details of your supervisor to the HCPC within fourteen days of commencing such work.

2. If you engage in professional work as an Occupational Therapist you must:

(a) Work with your supervisor to formulate a Personal Development Plan designed to address the following areas of your practice:

(i) Completing written assessments within the required timeframe;

(ii) Completing clinical records within the required timeframe;

(iii) Progressing cases by following up on recommendations for intervention.

(b) Within three months of commencing work as an Occupational Therapist you must forward a copy of your Personal Development Plan to the HCPC.

(c) Following the submission of your Personal Development Plan in accordance with (b) above, you must then provide, every three months, an updated Progress Report on your Personal Development to the HCPC, to be endorsed by your supervisor.

3. You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.

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

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

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

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

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

6. You will be responsible for meeting any and all costs associated with complying with these conditions.

Notes

The order imposed today will apply from 28 March 2019.

This order will be reviewed again before its expiry on 28 March 2020.

Hearing History

History of Hearings for Miss Sarah Neita

Date Panel Hearing type Outcomes / Status
21/02/2019 Conduct and Competence Committee Review Hearing Conditions of Practice
27/10/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
20/02/2017 Conduct and Competence Committee Final Hearing Conditions of Practice