Mrs Debbie Leadbitter

Profession: Social worker

Registration Number: SW58239

Interim Order: Imposed on 19 Mar 2018

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 01/07/2019 End: 17:00 05/07/2019

Location: Health and Care Professions Tribunal Service

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

Whilst registered with the HCPC as a Social Worker working for Doncaster Metropolitan Borough Council, you:

 

1) Kept payments in advance for assessments that:

 

    a) you did not complete; and/or

    b) You did not submit to your employer; and/or

    c) Were carried out by other assessors; and/or

    d) Were cancelled and/or no longer required and not carried out.

 

2) Indicated that you were available to undertake assessments when you knew you had not completed previous assessments and did not have the capacity to complete the work.

 

3) Your actions in 1 and 2 above were dishonest.

 

4) Your actions described at particular 3 constitute misconduct.

 

5) Your actions described at particulars 1 and 2 constitute misconduct.

 

6) By reason of your misconduct your fitness to practise is impaired.

Finding

Preliminary Matters

Service and Proceeding in Absence

1.Notice of the hearing was sent by post to the Registrant on 27 February 2019 to the address given by the Registrant for HCPC registration purposes. The Registrant responded to that notice by returning a response pro-forma in which she indicated a change of address. A further copy of the hearing notice and the hearing bundle were sent to that newly notified address.

2.The Panel was satisfied there had been good service of the hearing notice.

3.In her response pro-forma mentioned above, the Registrant wrote that she did not feel able to attend the hearing due to her ongoing health conditions. Mr Dite asked the Panel to proceed in the Registrant’s absence. The Panel took into account the HCPTS Practice Note: Proceeding in the Absence of the Registrant.   It was clear that there would be a disadvantage to the Registrant if the Panel proceeded in her absence, particularly given that the Allegation included an assertion of dishonesty. However, the Panel also took into account the public interest in proceeding with cases with reasonable expedition.  The Registrant had indicated she did not intend to attend, she did not request an adjournment, and there was nothing to show that the Registrant would attend on a future occasion if the hearing were to be adjourned. There were three witnesses present and ready to give evidence in support of the HCPC’s case. The Panel noted that the Registrant had submitted a response alongside the pro-forma document and also that the bundle exhibited by the HCPC included minutes of her employer’s interview with her during their investigation and the Panel took full account of this information.

4.The Panel concluded that the fair and appropriate step was to proceed in the absence of the Registrant.

Proceeding in private (in-part)

5.Mr Dite indicated there would be some references within the evidence to the Registrant’s health conditions and he asked that those parts of the hearing be dealt with in private session. The Panel appreciated there was a clear public interest in hearings of this kind being heard fully in public. However, the Panel was satisfied it was appropriate to make exceptions in certain cases to protect the publication of certain categories of private information relating to registrants or witnesses. The Panel was satisfied it was appropriate to hold parts of the hearing in private when dealing with information concerning the Registrant’s health conditions.

Application to Amend

6.Mr Dite applied for the Allegation to be amended.  Notice of the proposed amendments had been served on the Registrant on 11 February 2019.  The Panel was satisfied that the proposed amendments were simply changes of detail to the form of the Allegation that had originally been drafted.  The Registrant would not be disadvantaged by the proposed amendments and the Panel approved the application. The amended form of Allegation is shown above.

Background

7.The Registrant is registered with the HCPC as a Social Worker and at the relevant time was employed by Doncaster Metropolitan Borough Council (DMBC).

8.In addition to her main employment with DMBC, the Registrant also undertook assessments for the Deprivation of Liberty Safeguarding (‘DoLS’) team within DMBC as a “Best Interests Assessor” (BIA). The assessments were of service users in care homes or hospitals who were believed to lack capacity to consent to care and treatment. This is an independent role, and at the time of these events, those assessments were allocated to the BIAs by the administration unit of the DoLS team. Payment for assessments would be activated by a BIA submitting an invoice for the relevant work.

9.There were about 90 BIAs engaged by DMBC.  Some of the BIAs were employed by DMBC and others were independent contractors.  The persons already employed by DMBC held their BIA role outside of, and in addition to, their substantive posts within DMBC and, as such, were entitled to be paid a fee in respect of each assessment carried out, on top of their salary for their substantive post.

10.At the relevant times, DMBC had a high number of assessments outstanding.  The process was that each BIA would offer to take a certain number of assessments for a certain period, for example, the following month.

11.A concern arose within DMBC that the Registrant was (i) failing to submit assessments in a timely manner, and (ii) being paid for allocated assessments before submitting the necessary assessment report.  An investigation and disciplinary procedure was started against the Registrant and, at that time, DMBC believed that the Registrant had over 90 assessments outstanding awaiting completion, and had, over a course of time, claimed approximately £37,000 for assessments she had not personally submitted. A clear point made in the HCPC case was that the Registrant was the only BIA who would claim, and be paid, a fee before submitting the relevant assessment.

Decision on Facts

12.The Panel heard evidence from the following three witnesses who were employed by DMBC:

(i) Witness 1  - Deprivation of Liberty Safeguard Officer;

(ii) Witness 2  - Principal Internal Auditor;

(iii) Witness 3  - Team Leader, Safeguarding Hub

The Panel found all 3 Witnesses to be credible, honest and open as to when their recall of events was unclear.

13.In addition the Panel received a witness statement from Witness 4, a Senior HR Officer.

14.The HCPC has the burden of proving the factual particulars on the balance of probabilities.  The Panel’s findings of fact in respect of each of the factual particulars are set out below.

Particular 1 is proved in full

Kept payments in advance for assessments that:

a)You did not complete; and/or
b)You did not submit to your employer; and/or
c)Were carried out by other assessors; and/or
d)Were cancelled and/or no longer required and not carried out.

15.In respect of both particular 1a) and 1b), it is clear from the documentary evidence in Appendix 5 of DMBC’s Interim Investigatory Report, which is a spreadsheet constructed by Witness 2 after an audit of available records, together with the oral evidence of Witness 2, that the Registrant kept payments for assessments that she had not completed and/or had not submitted to her employer.  The Panel found Witness 2 to be very credible and she was clear about the limits of her knowledge and did not draw inferences she could not support on the basis of her audit.  She admitted that the processes used within the assessment claims system were, at best, poor and inconsistently followed. These matters were accepted throughout by the Registrant.

16.In respect of both particular 1c) and 1d), it is clear from Appendices 6 and 7, to Witness 2’s Interim Investigatory Report, which are spreadsheets auditing sums paid to the Registrant in respect of assessments not completed by her for the reasons set out in those sub particulars, that both of these parts of the particular are proved. These matters were accepted throughout by the Registrant.

Particular 2 is proved in full

Indicated that you were available to undertake assessments when you knew you had not completed previous assessments and/or did not have the capacity to complete the work in a timely manner.

17.BIAs were invited to indicate to the DoLS administrative staff the number of assessments they would be able to deal with in a particular period.   The evidence from Witness 2 shows, and this has been accepted by the Registrant, that the Registrant had an increasing backlog of assessments awaiting submission. In around August 2016, the Registrant admitted to Witness 3, her supervisor, that she had a backlog of about 40 assessments in various stages of completion which she still needed to finish. However, in September 2016 she requested a further 31 new cases. The Panel noted that in her email requesting further cases she stated that she had capacity to complete the outstanding assessments.

18.By the time DMBC initiated an audit to look into the background circumstances, the Registrant had over 90 assessments which had not been submitted. The Panel accepted evidence suggesting that a period between 4 and 10 hours would, on average, be required to complete a single assessment.  The Registrant’s evidence was that, as an experienced BIA, she would take an average of 4 hours per assessment. The evidence from Witness 2 was that the Registrant was, on average, taking 159 days to return a completed assessment.

19.No clear account has been given as to how long BIAs were expected to take to complete assessments.  The Panel has taken into account that the assessments were part of a process operated by DMBC to assess whether the liberty of a service user could or could not be reasonably deprived.  In those circumstances it is clear to the Panel that the assessments were expected to be carried out as soon as reasonably practicable. Taking into account the evidence referred to above relating to the number of outstanding assessments and the average period taken by the Registrant to return completed assessments, it is clear to the Panel that the Registrant was both taking on too many subsequent assessment commitments when she had not completed previous assessments and did not have capacity to complete the work in a timely manner.

Particular 3 is not proved

Your actions in 1 and/or 2 above were dishonest.

20.The Panel has taken into account the guidance on dishonesty as that is set out, particularly in paragraph 74, of the judgment of the Supreme Court in Ivey (Appellant) v Genting Casinos (UK) Ltd t/a Crockfords (Respondent) [2017] UKSC 67.

21.It is relevant also to take into account both the personal characteristics of the Registrant and the quality of the relevant accounting and management arrangements.

22.Witness 1 said that she had a good working relationship with the Registrant and gave the opinion that the Registrant “did a lot of good work and her DoLS assessments were used as examples of good practice for other BIAs”. Witness 1 said that she thought that the Registrant would have stuck to an agreed deadline to complete outstanding assessments if a manager had come up with one.

23.Witness 2 said that “the processes in place were quite poor. All monitoring of DoLS assessments issued, paid for and returned was done on a spreadsheet that was difficult to follow and was not always kept up to date. Data quality was an issue”. When, in her oral evidence, Witness 2 was asked to say what she meant about data quality being an issue she said “processes not being carried out – data quality of records quite poor – input information not accurate – duplications – things missing. Had to piece together information from elsewhere, for example emails”.

24.Witness 3 thought the Registrant was “very good at her work, committed, enthusiastic, and keen to succeed”. When asked about whether she thought the Registrant would have been tempted to “work the system” Witness 3 stated, “I don’t believe she did as it’s not in her nature”. She did not doubt the Registrant’s honesty and integrity at the time.

25.The letter issued by DMBC, which gave the outcome of the disciplinary hearing, stated “It is clear that the systems, processes, procedures, monitoring and management of the DoLS assessments were chaotic, unclear and not robust. It seems clear that there were a number of different views about what the correct processes and procedures were that should have been followed”.

26.The Panel is satisfied that the accounting system used in making decisions as to payment for assessments was chaotic and not fully understood by those responsible for applying the process.

27.The Panel accepts the evidence that apart from one particular exception, the Registrant was the only BIA who was paid before an assessment was submitted.  The Panel has taken into account example emails issued to BIAs when assessments were allocated and has noted that those emails stipulated that invoices for work by BIAs should not be submitted until the assessment had been completed. However, it is clear from the evidence that there was a practice of administrative staff not applying this requirement in full.  For example, staff in the DoLS administrative team would take steps which would lead to payment in respect of an assessment (even though that assessment had not yet been submitted) if they received a “mismatch” report which they wrongly interpreted as showing that an assessment had in fact been submitted.  The evidence of Witness 1 was that the processes in the administrative team at that time were “back to front”.

28.The evidence submitted shows the average length of time some BIAs waited for payment in respect of assessments.   Not including the Registrant, those waiting periods range from 49 to 63 days. Witness 1 explained that BIAs developed a practice of submitting forward dated invoices so that the payment system would begin, in the knowledge that they would subsequently submit the assessment before the system managed to pay their invoice.

29.The accounting system operated by DMBC did not have any clear checks which would bar a payment being made if the relevant assessment had not yet been submitted. The evidence from Witness 3 was that she would authorise the payments without personally making any checks. She stated that she “assumed” at the time, that the work had been completed. She saw her role as merely “dotting the ‘i’s”.

30.The allegation of dishonesty has been denied by the Registrant. Moreover, the Registrant has not sought to conceal her conduct at any time.  The Panel finds that the accounting system in respect of paying for assessments and the guidance, such as it was, given to BIAs and administrative staff was inadequate.  Against that background, it was not surprising that some BIAs had to find their own way through the complex accounting system which led to some of them using the forward dated invoice as a basis to obtain timely payment in respect of their work.

31.The Panel has to determine the actual state of the Registrant’s knowledge or belief as to the facts relating to the system concerning claims for assessments. The Panel has taken into account, and accepted, the evidence that the Registrant’s practice of accepting payment for assessments before submitting the relevant assessment was unique amongst the BIAs.  The Panel has also taken into account that in the workplace investigation interview and in her written submissions to this hearing, the Registrant said, in effect, that she thought the claim process she followed was also followed by other BIAs.  Given the lack of clarity and the confusion surrounding the claim process, the Panel accepts that the Registrant genuinely believed that her manner of submitting claims was followed by others and she genuinely believed that what she was doing was an acceptable course of action. It has also taken into account the fact that Witness 1 was aware of the Registrant’s practice of arranging for payment before submitting assessments and did not question it. In addition, Witness 3, who was the Registrant’s line manager, admitted both in oral evidence and Panel questioning, that she was also aware of this, but she took no action to address the Registrant’s conduct until the internal audit process revealed the extent of the Registrant’s backlog of incomplete assessments.

32.The Panel found that the Registrant was open and transparent with colleagues about her conduct in this regard.

33.At this time, the Registrant was working a 37 hour week compressed into 4 days, and according to Witness 3, it was likely that given her responsibilities, she would have to work additional hours to meet the demands of her role. She had recently become manager of a team which had issues she needed to sort out. Witness 3 stated that the Registrant’s committed thorough approach would have contributed to her workload. She was also dealing with a number of personal issues at the time.

34.The Panel accepted the written and oral evidence to the effect that the backlog of assessments was discussed by the Registrant and Witness 3 in supervision. The Registrant in her written submission noted that she had not been given access to supervision notes to confirm this. Witness 3 admitted during oral evidence that she did not always record supervision discussions. She said that whilst there had been some informal discussion about how the Registrant was to remedy the backlog, she did not put in place any plan to assist the Registrant to address the issue. She conceded that she should have done more as a manager.  The Panel accepts the Registrant’s account that before the audit report emerged she had already discussed the backlog with Witness 3. Later, the Registrant expressed a willingness to complete the assessments even after her suspension from work, but the DMBC did not allow her to do so.

35.The Panel has considered the factors that would be taken into account by ordinary, decent people passing a view on dishonesty in the circumstances described above. The Panel is satisfied that ordinary, decent people would give considerable weight to the following:

•the lack of clear policy and knowledge amongst administrative staff and BIAs as to how the system worked
•the absence of proper checks within the system
•the belief on the part of the Registrant that what she was doing was a practice followed by other BIAs
•the failure by those in authority to raise any concern as to the Registrant’s open and regular practice over a considerable period of time
•evidence suggesting that the Registrant intended all along to complete her assessments
•the size of the backlog
•the significant sum of public money concerned

36.The Panel, having found above that the Registrant kept payments, has nevertheless concluded that given the very poor standard of administration being operated by DMBC and the factors referred to in the previous paragraph, ordinary, decent people would find that her actions were not dishonest.

Decision on Statutory Grounds

Misconduct is proved

Your actions described at particulars 1-3 constitute misconduct.

37.Misconduct is a word of general effect, involving some act or omission of sufficient seriousness which falls short of what would be proper in the circumstances.

38.The Registrant allowed a substantial backlog of her work to accumulate.  That work was related to assessments as to whether it was appropriate that the liberty of a service users should be deprived. The average period of delay on the part of the Registrant in submitting assessments was substantial. The Registrant was suspended from duty when she had more than 90 assessments outstanding.

39.The Registrant was an experienced and respected professional. The Panel finds that there was a serious falling short of the standards expected of the Registrant’s conduct as a BIA.  The Registrant has accepted her culpability in this respect in that she has said in her written submissions to the Panel:  “I fully admit that I had taken on too much in terms of allocation and my capacity to take on additional work”.

40.The failings on the part of the Registrant amounted to breaches of the following HCPC Standards of Conduct, Performance and Ethics, 2012:

1 - You must act in the best interest of service users

HCPC Standards of Conduct, Performance and Ethics, 2016:

6.1 – You must take all reasonable steps to reduce the risk of harm to service users, career and colleagues as far as possible 

10.2 – You must complete all records promptly and as soon as possible after providing care, treatment or other services.

41.The Panel, has concluded that the Registrant’s failings in particulars 1 and 2 above amount to misconduct.

Decision on Impairment

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

Impairment is proved

43.The Panel has taken into account the HCPTS Practice Note: Finding that Fitness to Practise is Impaired.  There is a range of issues that have to be taken into account which may be broken down into the following two components:

(i)the ‘personal’ component: the current competence, behaviour etc. of the individual registrant; and
(ii)the ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

44.In respect of the personal component, the Registrant has accepted that her standard of work in respect of the assessments was not acceptable.  The Panel has found above that there was a serious failing on the part of the Registrant in respect of her work as a BIA.  The Registrant has not supplied any evidence of her reflection on the potential consequences for service users who had outstanding assessments.  The Registrant has demonstrated insight regarding the failure on her part to properly manage her work. However,  the Panel has concluded there is insufficient evidence to show that the Registrant has developed strategies which in future would enable her to recognise when problems in managing her workload were arising and then to take appropriate action.  The Panel is satisfied that there is a future risk that the Registrant would not properly manage demands placed upon her against her capacity at work.

45.In respect of the public component, it is clear to the Panel that members of the public would be concerned to hear of a Social Worker who allowed assessments in important cases to accumulate in the manner that occurred in this case.  Such a member of the public would, in those circumstances, lose confidence in the Social Worker profession if a finding of impairment were not made.

46.The Panel finds, on both the personal and the public components, that the fitness to practice of the Registrant is impaired.


Decision on Sanction

47.On behalf of the HCPC, Mr Dite submitted that the Indicative Sanctions Policy (ISP) should be taken into account by the Panel. That document made clear that the primary purpose of sanctions was to protect the public but there were wider public interest factors that should be considered. Those were the deterrent effect to other registrants, the reputation of the profession concerned and public confidence in the regulatory process.  Misconduct had been found which meant that the full range of sanctions was available. It was important that the Panel took into account proportionality and the aggravating and mitigating features of the case.

48.Mr Dite further submitted that the Panel may find that aggravating features included that the failings of the Registrant concerned vulnerable service users. The Registrant had a substantial backlog of assessments and she did not have capacity to deal with that work. Mitigating features may be the personal and family circumstances of the Registrant and the fact that she was positively regarded by colleagues. It would be relevant for the Panel to know that an interim suspension order had been imposed on the Registrant on 19 March 2018 in respect of these matters. Case Law showed that panels should have regard to that background when determining sanction although a mathematical approach was not required.

49.The Panel took the advice of the Legal Assessor who made reference to various paragraphs within the ISP and relevant case law.

50.The Panel considered the appropriate order and took into account the ISP. The purpose of a sanction is not to be punitive. It is to protect members of the public. Relevant other objectives are to:

•create a deterrent for other social workers,
•maintain the reputation of the Social Work profession, and
•maintain public confidence in this regulatory process.

51.In deciding what, if any, sanction to impose, panels should ensure that any sanction is proportionate and strikes a proper balance between the protection of the public and the rights of a registrant.

52.The aggravating features in this case are:

•the importance of assessments concerning deprivation of liberty decisions relating to vulnerable service users
•the  substantial backlog of incomplete assessments
•the significant amount of public money paid to the Registrant in respect of assessments she had not produced

53.The mitigating features are:

•the poor and chaotic accounting system used by DMBC
•the lack of effective line management
•the Registrant’s expression of remorse and acceptance of her failings
•positive evidence from witnesses about the Registrant’s professional competence as a Social Worker
•external pressure from personal circumstances

54.The Panel, following the ascending order sequential approach, took the view that in this case it is not appropriate to make no order because of the serious nature of the Allegation that is now proved. Mediation is not appropriate because the failings of the Registrant were neither minor nor isolated.

55.A Caution Order is not appropriate because the misconduct on the part of the Registrant was of a serious nature and the actions of the Registrant were not isolated.

56.The Panel considered a Conditions of Practice Order. Such an order will be appropriate where a Panel is confident a registrant will adhere to the conditions, is genuinely committed to resolving the issues they seek to address and can be trusted to make a determined effort to do so. The Panel is satisfied that:

•the failings on the part of the Registrant are capable of correction
•there is no persistent or general failure which would prevent the Registrant from correcting her past failures
•appropriate, realistic and verifiable conditions can be formulated
•a reviewing  panel  will be able to determine whether conditions  have been or are being met.

The Panel has also taken into account the period of suspension already imposed on the Registrant on an interim basis

57.Having regard to the above factors the Panel has concluded that a Conditions  of Practice Order is appropriate and proportionate in this case.  The Panel concluded that the proportionate term of such an Order would be two years. In making the assessment that a Conditions of Practice Order was appropriate, the Panel concluded that a Suspension Order or a Striking off Order would both be disproportionate.

Order

The Registrar is directed to annotate the Register to show that, for 12 months, from the date that this order comes into effect (“the Operative Date”), you, Mrs Debbie Leadbitter must comply with the following conditions of practice:

 
1.You must place yourself and remain under the supervision of a workplace supervisor registered by the HCPC or other appropriate statutory regulator and supply details of your supervisor to the HCPC within 14  days of starting any employment as a Social Worker.  You must attend upon that supervisor as required and follow their advice and recommendations.

2.You must promptly inform the HCPC if you cease to be employed as a Social Worker or if you take up any replacement employment as a Social Worker.

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

4.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 a Social Worker:

b)any agency you are  registered with or apply to be registered with (at the time of application) as a Social Worker. 


The following conditions are imposed to enable an assessment of your capability in meeting workload commitments and to ensure you do not take on excessive professional commitments which have an impact upon your ability to meet the professional standards of a Social Worker.

5.You must work with your supervisor to formulate a Personal Development Plan designed to address the deficiencies in the following areas of your practice:

i.proactively planning how to effectively manage your workload
ii.taking effective action if your workload cannot be effectively  and reasonably managed.

6.You must forward a copy of any Personal Development Plan created  to the HCPC  within 28 days of any such plan being created.

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

8.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.

9.You must maintain a reflective practice profile detailing how you take action to proactively plan to manage your case load and/or take action when your workload cannot be effectively and reasonably managed.   This may be in the form of a Practice Diary.

10.Not less than 28 days before any Review of this Conditions of Practice Order you must produce to the HCPC a copy of the reflective practice profile referred to in the previous condition.

You should be aware that it is open to you to apply for an early Review of the Conditions of Practice Order.  Factors that are likely to be considered at any future Review would be the extent to which you have:

i.reflected on and remedied your failings regarding effective workload management as identified in the above Decision
ii.complied with the above Conditions.

Notes

Interim Order


1.On behalf of the HCPC, Mr Dite applied for an Interim Conditions of Practice Order on the basis that such an order was necessary for the protection of members of the public or otherwise in the public interest. He explained that although there was an Interim Suspension Order currently in force that Order would automatically lapse upon today’s Decision being made.

2.The Panel took into account the guidance relating to Interim Orders as that is contained in the Indicative Sanctions Policy. The Panel was satisfied that in the notice of hearing, the Registrant had been informed of the possibility of such an application.

3.The Panel considered whether it was fair and appropriate to hear the application in the absence of the Registrant and again noted the Practice Note: Proceeding in the Absence of the Registrant. The Panel took into account that it was in the interests of the public for such an application to be dealt with today. The Registrant had been given specific notice of the prospect of such an application. She had chosen not to attend the hearing. There was no indication that if the application were to be adjourned, the Registrant would attend on any future occasion. The Panel decided that it was fair and appropriate to proceed in the absence of the Registrant.

4.The Panel is satisfied it is necessary for the protection of members of the public and in the public interest to make an Interim Conditions of Practice Order. There are serious concerns regarding the Registrant’s fitness to practice which are set out in the Decision. The existing Interim Order will lapse today. If no further interim order is made the Registrant will revert to unrestricted practice which, in the view of the Panel, will create a risk of harm to members of the public. On that basis the Panel makes an Interim Conditions of Practice Order to run for a maximum period of 18 months.

Hearing History

History of Hearings for Mrs Debbie Leadbitter

Date Panel Hearing type Outcomes / Status
01/07/2019 Conduct and Competence Committee Final Hearing Conditions of Practice
22/05/2019 Conduct and Competence Committee Interim Order Review Interim Suspension
28/02/2019 Conduct and Competence Committee Interim Order Review Interim Suspension
07/12/2018 Conduct and Competence Committee Interim Order Review Interim Suspension
19/03/2018 Investigating committee Interim Order Application Interim Suspension