Mr Alexander D G Tennant

Profession: Social worker

Registration Number: SW35684

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 12/02/2019 End: 17:00 12/02/2019

Location: Health and Care Professions Tribunal Service

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

The following allegation was considered by a Panel of the Conduct and Competence Committee at a Substantive Hearing on 15 to 18 August 2016.

During the course of your employment as a Social Worker at Knowsley Council between January 2011 and 04 February 2014, you:

1. Created Review Forms, which contained duplicated, inaccurate and/or no information on a number of Service Users’ records, including:

a. Creating duplicate Review Forms on the record of Service User A, for reviews that had not taken place, in particular:

i. On 13 November 2012 you created a Form 7, the written report section of which was an exact copy of the review which had taken place on 24 October 2012.

ii. On 29 January 2013 you created a Form 8M, a form to be completed by a consultant psychiatrist only, which was an exact copy of the information entered by the consultant from the cancelled review of 22 November 2012.

iii. On 6 February 2013 you created a Form 7, which was an exact copy of the review which had taken place on 24 October 2012.

iv. On 26 June 2013 you created a Form 7, which was an exact copy of the review which had taken place on 24 October 2012.

v. On 26 July 2013 you created a Form 8M, a form to be completed by a consultant psychiatrist only, which was an exact copy of the information entered by the consultant from the cancelled review of 3 July 2013.

vi. On 26 July 2013 you created a Form 7, which was an exact copy of the review which had taken place on 24 October 2012.

b. On 9 July 2012 you created a Form 7 on the record of Service User B, which did not contain sufficient information about the review, thereby incorrectly indicating that a review had taken place.

c. On 23 July 2012 you completed a Form 7 on the record of Service User B, which was not an accurate reflection of what was discussed at that review, because it was almost an exact duplication of the Form 7 created on 9 July 2012 (as at 1.b.above).

d. On 28 March 2013 you created a Form 7 on the record of Service User B, which did not contain the date of the review.

e. Creating duplicate Review Forms on the record of Service User B, for reviews that had not taken place, in particular:

i. On 28 May 2013 you created a Form 8M, a form to be completed by a consultant psychiatrist only, which is an exact copy of the review which had taken place on 23 July 2012.

ii. On 20 June 2013 you created a Form 8M, a form to be completed by a consultant psychiatrist only, which is an exact copy of one previously completed by the consultant.

iii. On 20 June 2013 you created a Form 7, which is an exact copy of the Form 7 created on 28 March 2013 (as at 1.d. above).

f. On 25 October 2012 you completed a Form 7 on the record of Service User C, which was not an accurate reflection of what happened in respect of that review, in that it did not state the non-attendance of the Service User or the re- scheduled date.

g. You duplicated Review Forms on the record of Service User C, for reviews that had not taken place, in particular:

i. On 23 November 2012 you created a Form 8M, a form to be completed by a consultant psychiatrist only, which is an exact copy of the review form completed by the consultant for the review which did not take place on 25 October 2012.

ii. On 23 November 2012 you created a Form 7, which was an exact copy of the review which you had created on 25 October 2012 (as at 1.f. above).

iii. On 6 February 2013 you created a Form 7, which was an exact copy of the review which you had created on 25 October 2012 (as at 1.f. and 1.g.ii.).

iv. On 25 June 2013 you created a Form 7, which was not an accurate reflection of that review, because it was a duplication of the Form 7 created on 25 October 2012 (as at 1.f. above).

v. On 9 July 2013 you created a Form 7, which was an exact copy of the review which you had created on 25 October 2012 (as at 1.f., 1.g.ii. and 1.g.iii. above).

2. Your actions in 1 above created incorrect work records.

3. Your actions at 1 and 2 above were dishonest.

4. The matter described in paragraphs 1 and / or 2 and / or 3 constitute misconduct.

5. By reason of your misconduct your fitness to practise is impaired.

Finding

Preliminary Matters

1. The Registrant attended via telephone. There was no objection to this by the HCPC.


Background

2. At the relevant time the Registrant was a registered Social Worker. Between January 2011 and January 2014 he was employed as a Level 3 Adult Mental Health Social Worker by Knowsley Metropolitan Borough Council (the Council). He was initially based in the Community Mental Health Team and, following a reorganisation in December 2012, he was moved to the Recovery Team.

3. One of the Registrant’s duties was to arrange regular reviews of the mental health assessments of the service users to consider, amongst other things, whether any changes to medication or other services were required. Such reviews would typically take place every three months on average but could be set with a greater or lesser frequency. Reviews would be attended by any professionals involved in caring for the service user.

4. Following an internal investigation by the Council the Registrant was dismissed from his employment in February 2014 and reported to the HCPC.

5. All parts of the Allegation (except Particular 3 in relation to 1(b) and 1(d)) were proved against the Registrant at a hearing which took place between 15 to 18 August 2016. In summary, it was found that the Registrant had dishonestly created work records in respect of the reviews of three service users during the relevant period. Some records were duplicates, all were inaccurate and gave the impression that work had been done by the Registrant when it had not or that the service user had been seen, when they had not. The Registrant created these documents to give his managers the false impression that he was up to date with his record keeping.

6. The original panel found that the ground of misconduct was made out (it appeared that a mis-managed health condition had contributed to the failings identified) and determined that the Registrant’s fitness to practise was impaired at that time.

7. In making its determination, the Panel considered that the Registrant:

‘deliberately and systematically concealed his failures to perform to the required standard by falsifying documents. This conduct was in his own personal interest… Vulnerable service users were put at serious risk of harm and some were actually harmed by significant delays to the reviews of their circumstances and the handling of their cases…’

8. That panel recognised that the Registrant suffered from some underlying health problems and he had taken some steps to address them, although no up to date information was available to it at the time the sanction was imposed. It also noted that the Registrant had identified, if not yet undertaken, an action plan to remediate shortcomings in his practice, such as organisation, time management and use of supervision.

9. A Suspension Order for a period of 12 months was imposed on 18 August 2016. The Order was reviewed on the 16 August 2017 and was varied to a Conditions of Practice Order for a period or 18 months.

This Review Hearing

10. This is a review of a Conditions of Practice Order which was imposed on the last occasion when this matter was reviewed.

11. The Panel heard representations on behalf of the HCPC and from the Registrant. The Panel took into account both the oral and documentary evidence in this matter.

12. The Registrant gave evidence to the Panel. He stated that he felt that he was in a different position from where he was last year and that he was of the view that he could work as a Social Worker without restriction. He stated that he was fully aware of his need to time-manage his work, to put into practice stress management skills and the need to prioritise his workload. He accepted that it was his responsibility to ensure that such matters were dealt with by him and if he were to return to unrestricted practice that these were matters that he would discuss with his employer. He stated that he is registered with two social work agencies but that he has yet to obtain social work positions. He stated that he fully accepts responsibility for his actions “without reservation” and that the time out of social work has allowed him to reflect on the need to manage himself and be honest. Finally, he stated that in his current role as a healthcare support worker he is using his social work skills of record keeping, time management and prioritising tasks. He said that he has coping mechanisms in place to aid with stress. For example, he referred to speaking to colleagues where appropriate, and practising meditation and mindfulness.

13. Mr Stephens submitted that the Panel may wish to consider whether the Registrant has provided sufficient evidence to satisfy it that there is no longer a risk of repetition of the conduct identified.


Decision

14. In coming to its decision the Panel, accepted the advice of the Legal Assessor. The Panel was referred to the case of Khan v General Pharmaceutical Council [2017] 1 WLR 169(SC).

15. In undertaking its task today, the Panel is not undertaking a rehearing of the matters which were brought against the Registrant, nor going behind previous findings. The Panel reminded itself that the decision as to what is the appropriate and proportionate disposal at this review hearing is a matter for its judgment alone. The Panel recognised that, at a review, it has to consider whether the concerns raised in the finding of impairment through misconduct have been sufficiently addressed to its satisfaction. In practical terms this means that there is a persuasive burden on the practitioner at a review to demonstrate that he has acknowledged past failings, and has sufficiently addressed past impairment. The Panel will also consider whether the Conditions of Practice Order has been complied with.

16. In respect of impairment the previous panel stated:

“ …., the Panel did note that in his submissions, the Registrant, to his credit, recognised the fact that he is not yet ready to return to a social work position without supervision. The Panel considered that, notwithstanding the encouraging steps taken by the Registrant to address his failings, he nevertheless still lacks the resilience required to return to unrestricted practice. In particular, the Registrant submitted that when he returns to social work (which he hopes to do in a phased manner), he would require direct supervision and support regarding workload, record keeping and stress/time management, ‘so as to avoid errors in the future.
In all of these circumstances, whilst the Panel is satisfied that the Registrant has remedied the issues and developed his insight as far as he is able to, he has also been insightful enough to recognise that his failings are not yet fully remedied to the point that he could return to unrestricted practice. Accordingly, there remains a risk that he could be overwhelmed by his workload in the future which may lead to a repetition of the misconduct identified. Accordingly, the Panel finds that the Registrant’s current fitness to practise remains impaired.”

17. This Panel has had the opportunity of hearing from the Registrant. He told the Panel that he fully accepts his responsibility for his past behaviour. He accepted that he did not manage his stress levels and he accepted that he had opportunities when working as a Social Worker to raise his concerns regarding his inability to cope at work. He fully accepted that he had been dishonest, he did not in any way seek to go behind that finding. The Panel recognises that the Registrant has made progress in the last year in terms of stress management, health and his ability to time-manage. The Registrant was remorseful and has insight as to his misconduct. However, the Panel remains concerned by the lack of evidence presented to it to demonstrate that the Registrant would not become overwhelmed by his workload and repeat his past misconduct.

18. The Registrant has not provided the Panel with sufficient evidence, other than his own word, that he would be able to manage stress at work, record correctly and time-manage his work. The Panel accepts that the Registrant is not currently working as a Social Worker but he has not provided independent evidence of his performance as a support worker which would enable the Panel to come to the conclusion that there is no longer a risk of repetition of the conduct identified in this case. The Panel had regard to the reference from IW which is positive but generic. It is therefore of limited assistance to the Panel because it is not focussed to the needs of this case and does not address issues such as record keeping, time management and how the Registrant copes in a working environment. The Panel considered that if the Registrant were permitted to return to unrestricted practice service users may be at risk of harm.

19. The Panel therefore concluded that the Registrant remains impaired.

20. The Panel next went on to consider what the appropriate sanction would be in this case. It is aware that the purpose of any sanction is not to be punitive, though it may have a punitive effect. The Panel has borne in mind that its primary function at this stage is to protect the public, while reaching a proportionate sanction, taking into account the wider public interest and those of the Registrant. In so doing, the Panel has taken account of the HCPC “Indicative Sanctions Policy”, applying it to the Registrant’s case on its own facts and circumstances.

21. In determining the appropriate and proportionate sanction, the Panel had regard to the seriousness of the Registrant’s misconduct and also bore in mind the limited independent evidence he has provided of the steps taken to address the failings identified previously.

22. The Panel first considered taking no action and allowing the Order to expire, however it concluded that this would be inappropriate and would not be sufficient to protect service users. The Panel considered that this was not an appropriate case for mediation and that a Caution Order would be insufficient.

23. The Panel next considered a Conditions of Practice Order. It noted that the Registrant has been working in roles which require many of the skills of a social worker since the final hearing without eliciting any complaints. Given the shortcomings identified previously, the Panel was satisfied that a Conditions of Practice Order for a further period of four months is the appropriate and proportionate sanction in this case. This will allow the Registrant to return to practice and provide him with a route back into safe and unrestricted practice in due course. The Order will give the Registrant a framework of support within which he can demonstrate his resilience within a social work role if he secures one.

24. The Panel accepts, as the Registrant asserted, that the existing conditions may be making it difficult for him to obtain social work roles. However, the Panel wishes to make it clear to the Registrant that even if he cannot find work as a Social Worker, any future reviewing panel may be assisted by independent evidence from his existing or another employer which addresses the Registrant’s ability to time-manage, prioritise a workload, keep accurate records and manage stress. The Registrant may wish to develop his own Personal Development Plan (PDP) to specifically deal with stress management in the workplace, record-keeping, time management and prioritisation of workload. It may be helpful if this was then signed off by one or more registered professionals who have worked with him to confirm that he is capable of managing these four areas of work.

25. The Panel considers that a varied Conditions of Practice Order for a period of 4 months will enable the Registrant to develop this PDP and potentially to find a role as a Social Worker. The variations are minor and are set out in Conditions, 2, 6, 8 and 9.

26. The Panel considered whether to make a Suspension Order or to impose a Striking Off Order and considered these would be disproportionate and unnecessarily punitive orders given the steps taken by the Registrant. It was satisfied that a Conditions of Practice Order for 4 months would adequately protect the public.

Order

The Registrar is directed to vary and to extend the Conditions of Practice Order against the registration of Mr Alexander D G Tennant for a further period of 4 months on the expiry of the existing Order. The conditions are:

1. You must inform the HCPC within 28 days if you take up any employment or other engagement as a Social Worker.

2. When undertaking employment or any other engagement which requires your registration as a Social Worker, you must place yourself and remain under the supervision of a workplace supervisor, a registered professional, and supply details of your supervisor to the HCPC within 14 days of taking up that work. You must attend upon that supervisor as required and follow their advice and recommendations.

3. You must work with your supervisor to formulate a Personal Development Plan designed to support the following areas of your practice:

• Stress management

• Time management

• Record Keeping

• Prioritisation of workload

4. You must meet with your supervisor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan.

5. You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

6. At least 28 days before any review hearing you must forward to the HCPC:

• a copy of your Personal Development Plan;

• a report from your supervisor detailing your progress under your Personal Development Plan;

• Up to date references that attest to your skills and abilities in respect of record keeping, time management, stress management, and prioritization of workload.

7. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer or by any agency or other organisation or person, if employed or engaged as a Social Worker.

8. 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 social work;

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

C. any prospective employer for a social work role (at the time of your application).

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

10. Any condition requiring you to provide any information to the HCPC is to be met by you, sending the information to the offices of the HCPC, marked for the attention of the Director of Fitness to Practise or Head of Case Management.

Notes

The Order imposed today will apply from 15 March 2019.

This Order will be reviewed again before its expiry on 15 July 2019.

Hearing History

History of Hearings for Mr Alexander D G Tennant

Date Panel Hearing type Outcomes / Status
12/02/2019 Conduct and Competence Committee Review Hearing Conditions of Practice
16/08/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
15/08/2016 Conduct and Competence Committee Final Hearing Suspended