Mr Andrew S Woodall

Profession: Occupational therapist

Registration Number: OT33880

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 17/01/2019 End: 12:30 17/01/2019

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

Panel: Conduct and Competence Committee
Outcome: Other

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Allegation

The following Allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing on 28 to 29 October 2014.

During your employment as an Occupational Therapist for Chesterfield Royal Hospital NHS Foundation Trust between September 2003 and May 2013, you:

1) Failed to maintain adequate records in that:

a) You did not make entries on the clinical case notes for significant periods of times in relation to:

i. Child 19, you did not make any entries after 20 June 2007;

ii. Child 16, you did not make any entries after 27 July 2007;

iii. Child 17, you did not make any entries between 12 September 2009 and 11 September 2012;

iv. Child 23, you did not make any entries;

(a) [Found Not Proved / HCPC Offered No Evidence]

(b) Between 13 July 2010 and 4 May 2011; and/or

(c) After 10 November 2011;

v. Child 15, you did not make any entries between;

(a) 24 April 2010 and 22 December 2010; and/or

(b) Between 24 December 2010 and 9 October 2012; and/or

vi. Child 14, you did not make any entries;

(a) [Found Not Proved / HCPC Offered No Evidence]

(b) [Found Not Proved / HCPC Offered No Evidence]

(c) After 23 December 2011;

vii. In relation to Child 13, you did not make any entries after 16 February 2009;

viii. [Found Not Proved / HCPC Offered No Evidence]

ix. Child 3, you did not make any entries after 29 June 2006;

x. Child 4, you did not make any entries after 10 September 2007;

xi. Child 9, you did not make any entries after 18 February 2009;

b) You did not record visits that you had undertaken in relation to the following cases:

xii.  Child 12;

xiii.  Child 11;

xiv.  Child 14;

xv. Child 13.

c) Your notes for the following cases contained incomplete entries:

i. Child 22;

ii. Child 10;

iii. Child 21.

2) Did not undertake and/or record visits in relation to the following cases:

a) Child 8;

b) Child 7;

c) Child 6;

d) Child 5.

3) Did not complete statement reports in relation to the following cases:

a) Child 18 due on or around 11 October 2012;

b) Child 15 due on or around 10 April 2012.

4) Failed to complete requested and/or required actions in that:

a) In relation to Child 1 :

i. Between on or around 24 March 2011 and September 2012, you did not arrange for an improved head support to be provided for her class chair;

ii. Between on or around November 2011 and September 2012 did not complete a sling assessment.

b) In relation to Child 2, you did not provide the school and/or Child 2’s parents with any exercise programmes following your assessment of the child in around June or July 2012.

5) Failed to discharge service users in the following cases:

a) Child 3

b) Child 4

c) Child 9

d) Child 19

6) Stored confidential information in an inappropriate manner in that you had approximately 56 patient case files at home.

7) The matters described in paragraphs 1 – 5 constitute misconduct and/or lack of competence.

8) The matters described in paragraph 6 constitute misconduct.

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

Finding

Background

1. The Registrant was employed as an Occupational Therapist at Chesterfield Royal Hospital NHS Foundation Trust between 2003 and 2013. He was based in the Children’s Community Occupational Therapy Department where he was responsible for children with learning and physical impairments. Concerns arose in 2012 concerning his failure to maintain adequate records, to make visits and to complete required actions in relation to numerous children under his supervision between 2007 and 2012.

2. The Registrant did not appear and nor was he represented before the Conduct and Competence Committee of the HCPC at a final hearing on 28-29 October 2014. He had indicated in writing that he admitted the facts as set out in the amended allegation. He was also found to have kept approximately 56 files at home, some of which had been at his home for several years. The proven allegations included his failure to maintain adequate records for 14 service users and his failure to undertake or record visits to four service users. His conduct was found to have fallen “well short” of that which would be regarded as proper in the circumstances. The misconduct had persisted over an extended period of time with a large number of cases involving particularly vulnerable patients.

3. The panel at the final hearing found that the Registrant’s fitness to practise was impaired by reason of his misconduct. The panel considered the personal component in relation to the Registrant’s own practice and any evidence of insight, remorse or remediation and the public component in relation to protection of service users and the need to declare and uphold proper professional standards. The Registrant was found to pose a risk of harm to those in his care. There was no evidence of insight or remediation, so as a consequence there was a risk of repetition.

4. The panel at the final hearing imposed a Suspension Order of 12 months. The case was too serious for any lesser order. The panel at the final hearing considered that the misconduct was remediable and that a period of suspension would give the Registrant an opportunity to reengage with the process and demonstrate insight.

The First Review

5. The Registrant attended the first review hearing on 23 October 2015 and gave evidence of his remorse at his failings and his intention to remediate his failings. He asked for his suspension to be extended so that he could undertake and complete a plan to take the appropriate courses on time management and record keeping. He was working full time as a support worker for young people with additional needs or disabilities and provided a reference from his manager. The panel commended the Registrant’s positive response, but noted his admission that his fitness to practise remained impaired. On that basis, the Suspension Order was extended for a further 12 months.

The Second Review

6. The Registrant attended the second review hearing on 29 October 2016 and gave evidence of his training and his continued work with children and young people with challenging behaviour. He produced evidence of his work and a good reference from his current employer. The panel at the second review was satisfied that the Registrant had taken substantial steps to address the concerns about his failings. He was found to have shown good insight into his shortcomings and to have significantly reduced the risk of repetition. However, the panel remained concerned that his progress was not yet tested in a clinical setting in which he would be required to treat patients and to maintain records. His conduct therefore remained impaired on personal grounds. However, in view of his progress towards remedying his previous misconduct, there was no finding of impairment on public interest grounds.

7. The panel at the second review therefore imposed a Conditions of Practice Order in the terms set out below on the basis that such an order would enable a supervised return to practice whilst mitigating and controlling the risks.

1) When undertaking work as an Occupational Therapist, you must place yourself and remain under the supervision of a workplace supervisor registered by the HCPC for a period of 6 months starting from the date that you take up a clinical role.

2) You must supply details of your workplace supervisor to the HCPC within 14 days of taking up a clinical role. You must attend upon that workplace supervisor as required and follow their advice and recommendations.

3) You should submit records of your supervision notes agreed with your workplace supervisor to the HCPC on a monthly basis during the 6 month period of supervision.

4) You must promptly inform the HCPC in writing within 14 days if you take up any employment as an Occupational Therapist.

5) You must promptly inform the HCPC in writing of any disciplinary proceedings taken against you by your employer.

6) 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 as an Occupational Therapist;

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). This review hearing

The Third Review

8. The Registrant did not attend the third review hearing on 29 September 2017. He telephoned the HCPC on the day before the hearing to say that he had only recently collected the Notice of Hearing from his local post office and could not then attend the hearing at, what was to him, short notice, because of work commitments.

9. The hearing proceeded in the Registrant’s absence. The third review panel had regard to an email from the Registrant dated 29 September 2017, and a positive reference from his line manager in his employment as a support worker.

10. The panel acknowledged that the Registrant had worked hard in his role but found that he had made insufficient progress to permit him to return to unrestricted practice. The Panel found there was no evidence of the Registrant returning to clinical or therapeutic work as an Occupational Therapist. In considering the personal component in relation to impairment, the panel accepted that the Registrant had improved his administrative and organisational skills in his current position, but he had not returned to professional practice under supervision, so there remained a risk to service users.

11. The 2017 reviewing panel found that the Registrant’s fitness to practise remained impaired and extended the Conditions of Practice Order by a further 4 months. It gave the Registrant the following guidance with regard to a subsequent review: “The Panel has extended the current order by only 4 months so that the Registrant can now concentrate his mind on what is achievable or workable and demonstrate what practical steps he is taking towards an eventual return to practice as an Occupational Therapist. He would greatly assist his case by attending the next review hearing.”

12. It also warned the Registrant in the following terms: “The Registrant should also be aware that there will come a stage when these review proceedings will inevitably conclude either with his successful return to unrestricted practice or with his removal from the register, whether voluntary or otherwise.”

The Fourth Review

13. The Panel heard evidence from the Registrant that he had continued to work at Aspire Disability Support Services (“Aspire”) where he was team leader of a team providing care to a severely disabled young man who needed considerable assistance to cope with living in his own home.

14. The Registrant had not yet attempted to find employment as an Occupational Therapist and complete a period of supervised work. He gave evidence that he would apply in the New Year.

15. The reviewing panel found that the Registrant had developed significant insight into the importance of his misconduct and how to prevent it reoccurring in the future. Nevertheless, the panel found that the Registrant’s remediation was still incomplete. The panel accepted that he had made progress through his work as a team leader at Aspire. However, he was still not able to demonstrate that he could practise safely as an Occupational Therapist within a supervised clinical setting.

16. The reviewing panel found that there was still a significant risk of repetition. Accordingly, it found that the Registrant’s fitness to practise remained impaired by reason of the need to protect the public, and in particular service users, from harm in the future. The panel decided that the appropriate order was a 12 month Conditions of Practice Order.

This Review Hearing

Evidence

17. The Panel read the bundle of documents put before it by the HCPC and the Registrant. The additional documents since the last review related to the efforts of the Registrant to find employment as an Occupational Therapist and a positive reference from his current employer, Aspire.

18. The Registrant gave evidence to the Panel. He explained that he felt optimistic after the last review hearing and was grateful for the opportunity given to him by the previous panel. He explained that unfortunately, despite his efforts, he has been unable to obtain employment as an Occupational Therapist and unable to find a suitable placement to undertake a return to practise course. He did secure an interview for an Occupational Therapist Band 5 rotational position, but was unsuccessful, partly because of his lack of recent experience.

19. He told the Panel that he had kept up to date with developments in Occupational Therapy, but at the same time he believed that there were some gaps in his knowledge of current processes.

20. In answers to questions from Ms Simpson and the Panel, the Registrant gave further evidence about his employment at Aspire, his current health and his plans for the future.

Submissions

21. Ms Simpson submitted that the Registrant had provided evidence that through his work at Aspire, he had remedied those areas of deficiency in his practice that were found by the final hearing panel. The Panel could therefore conclude that the Registrant’s fitness to practise was no longer impaired.

22. The Registrant did not make any submissions in addition to the evidence he had given.

Legal Advice

23. The Legal Assessor advised that the Panel’s first task was to determine if the Registrant’s fitness to practise was still impaired. Its role was not to conduct a rehearing of the allegations nor was it to go behind the previous findings. She advised that in carrying out this assessment, the Panel must exercise its own independent judgment and was not bound by the decisions of previous panels.

24. She also advised the Panel of the decision of Blake J in Dr. Abrahaem -and- General Medical Council 2008 EWHC 183.

“In practical terms there is a persuasive burden on the practitioner at a review to demonstrate that he or she has fully acknowledged why past professional performance was deficient and through insight, application, education, supervision or other achievement sufficiently addressed the past impairments”

25. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired then the Panel should go on to consider what sanction, if any, should be imposed and that all the options under Article 30 of the 2001 Order could be exercised by the Panel. She also advised the Panel that it should bear in mind the principle of proportionality and to have regard to the “Indicative Sanctions Policy” document issued by the HCPC


Decision

26. The Panel bore in mind that its first task is to decide if the Registrant’s fitness to practise is currently impaired. Only if this is established, should it go on to consider what, if any, sanction should be imposed upon his registration.

27. In reaching its decision, the Panel has considered all the relevant material and had regard to the HCPTS Practice Note on Impairment. The Panel accepted the advice of the Legal Assessor.

28. The Panel noted the positive reference provided by Aspire for the Registrant’s current work as team leader. It described that the Registrant manages a heavy workload well and included positive comments about his capability and attitude. The reference also confirmed that the Registrant’s work includes the administrative tasks such as completing record sheets, incident forms and medication records.

29. The Panel explored with the Registrant the breadth of his role at Aspire. He works 60 hours per week and has responsibility for a team of approximately eight support workers. He works primarily with one client, but also undertakes work with 20 other clients. The Registrant confirmed that he is in good health and that there has been no reoccurrence of the health problems that arose at and around the time of the events in 2007 to 2012.

30. The Registrant demonstrated to previous panels that he had insight into his past misconduct and he continued to demonstrate his insight in his evidence to the Panel.

31. The deficiencies identified by the final hearing panel were record keeping, failure to complete requested or required actions and inappropriate storage of confidential information. The Registrant explained to the Panel that his current role includes record keeping for the service users within his management. The Registrant also gave evidence about his time management skills within his current role. The Registrant is responsible for the safe storage of confidential client records at Aspire. When he speaks to other agencies about service users he takes care not to disclose confidential information.

32. The Panel noted that there was no evidence of repetition of any failure to keep records, any failure to complete required actions, or a breach of confidentiality. The Registrant’s current manager described him as “he manages well… and [is] extremely capable…” The Panel was satisfied that the Registrant has demonstrated remediation within his current role. The Panel also noted that the Registrant has demonstrated good standards of administrative work over a lengthy period of time and considered that he has embedded satisfactory standards in relation to paperwork and administration in a health and social care environment within his day to day work.

33. The Panel concluded that the risk of repetition is low given the Registrant’s level of insight and the evidence of remediation.

34. The Panel considered that the Registrant lacks some confidence in relation to his ability to practise. However, the Panel judged that this lack of confidence was due to the Registrant’s difficult experiences in trying to obtain employment over the past 12 months. It did not indicate that he is not fit to practise safely once he has completed the HCPC requirements for returning to practise. In the Registrant’s case this will be a minimum requirement of 60 days updating. The HCPC must be satisfied that the Registrant has satisfied those requirements.

35. The Panel was satisfied that the Registrant has sufficiently addressed his past misconduct and that he is currently fit to practise.

36. The Panel noted that the public aspects of impairment had been considered by previous Review Panels who were satisfied that sufficient action had been taken to promote and maintain public confidence and proper standards of conduct. The Panel did not identify any wider public interest considerations which required a finding that the Registrant’s fitness to practise remains impaired.

37. The Panel considered that the appropriate and proportionate Order under Article 30(2) was to revoke the current Conditions of Practice Order.

Order

The Registrar is directed to revoke the Conditions of Practice Order against the registration of Mr Andrew S Woodall with immediate effect.

Notes

No notes available

Hearing History

History of Hearings for Mr Andrew S Woodall

Date Panel Hearing type Outcomes / Status
17/01/2019 Conduct and Competence Committee Review Hearing Other
17/01/2018 Conduct and Competence Committee Review Hearing Conditions of Practice
29/09/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
26/10/2016 Conduct and Competence Committee Review Hearing Conditions of Practice
23/10/2015 Conduct and Competence Committee Review Hearing Suspended
28/10/2014 Conduct and Competence Committee Final Hearing Suspended