Mrs Jannette May Ryan
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The allegation below was considered by a Panel of the Conduct and Competence Committee [CCC] at the substantive hearing on 9 November 2017.
At the substantive hearing, the Panel found the following facts proved: (d), 1(f), 2, 3(a), 3(b), 4(a), 4(b), 5(a), 5(b), 5(c), 5(d), 5(e), 5(f), 6, 7 and that these amounted to misconduct. The Panel therefore imposed a Suspension Order for a period of 8 months:
1. Received a referral on or around 19 June 2015, in relation to Service User A, which raised safeguarding concerns and you did not:
a) not proved
b) not proved
c) not proved
d) Initiate a MASH referral;
e) not proved
f) Conduct and/or record a Mental Capacity Assessment of Service User A.
2. Did not complete and/or record the Section 42 enquiry in respect of Service User A.
3. Received a referral from the police on 4 August 2015, namely a Person A had been arrested for making threats to kill Service User A, and you:
a) Did not conduct a capacity assessment of Service User A;
b) Closed the case with no further action on 13 August 2015 without having and/or recording a discussion with a manager.
4. Received a referral from the police on 11 August 2015, namely that Service User A had been the victim of an assault by Person A, and you closed the case on 13 August 2015 and did not:
a) Visit Service User A;
b) Discuss and/or record a discussion with a manager.
5. Did not adequately complete a Safeguarding Investigating Worker Report, in preparation for the Enquiry Meeting, in that it did not address:
a) The views and wishes of Service User A;
b) What action had been taken at that point to protect Service User A;
c) Consideration of advocacy for Service User A;
d) Consideration of capacity of Service User A;
e) Risk to Service User A;
f) Consultation with Service User A's GP in relation to medication.
6. You completed and generated an ACM3D and an Individual Placement Agreement, prior to obtaining agreement from Service User C's family in relation to the payment of the top up fee.
7. Following your meeting with the family of Service User C on 3 February 2015, you did not cancel the Individual Placement Agreement when you learnt that there was no agreement to pay the top up fee.
8. The matters set out in paragraphs in 1-7 constitute misconduct and/or lack of competence.
9. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
Proof of Service
1. The Panel was provided with a signed certificate as proof that the Notice of Hearing had been posted on 3 June 2019 by first class post, to the address shown for the Registrant on the HCPC register. The Panel was satisfied that Notice had been properly served in accordance with Rule 3 (Proof of Service) and Rule 6 (date, time and venue) of the Conduct and Competence Committee Rules 2003 (as amended).
Proceeding in Absence
2. The HCPC made an application for the hearing to proceed in the Registrant's absence. The Panel was advised by the Legal Assessor and followed that advice. The Panel also took into account the guidance as set out in the HCPTS Practice Note "Proceeding in the Absence of the Registrant".
3. The Panel determined that it was fair, reasonable and in the public interest to proceed in the Registrant's absence for the following reasons:
a) The Panel noted that the Registrant did not attend the substantive hearing in November 2017 and the first review on 5 July 2018. The Panel noted the very recent communication from the Registrant via two emails sent on 4 July 2019. In these she did not request an adjournment of the hearing. The Panel notes that this is a mandatory review. In these circumstances, the Panel was satisfied that it was reasonable to conclude that the Registrant's non-attendance was voluntary and therefore a deliberate waiver of her right to attend and her right to participate in these proceedings.
b) There has been no application to adjourn and no indication from the Registrant that she would attend on an alternative date and therefore re-listing this final hearing would serve no useful purpose.
c) In these circumstances, as this is a mandatory review the Registrant's interests are outweighed by the public interest in ensuring that the hearing proceeds expeditiously.
4. The Registrant is a Social Worker registered at the HCPC. At the relevant time, the Registrant was employed as a Social Worker at Stoke-on-Trent Council (the Council).
5. The Registrant started working as a Social Worker at the Council in January 2005. On 11 June 2015, she joined the 'Tunstall Team' as a Level 10 Social Worker. In that role she was involved in the assessment and management of complex cases, including cases which involved the safeguarding of adults aged 18 and over. Despite a reorganisation, there was considerable continuity between the Registrant's previous work and her work on the newly-created team.
6. The Council used an electronic case management system for storing records. This system was called Care First. The expectation was that Care First should be updated promptly and each time a worker had a discussion with anyone related to the case. There were a number of components to the Care First electronic system, which included forms to complete, as well as observation logs.
7. Service User A had a learning disability, was unable to manage her finances, needed support with taking her medication and required small amounts of prompting with managing her personal care. Service User A lived with her husband, Person A, who also had learning difficulties, as well as other issues. Both service users were well-known to the Council and to the police.
8. On 17 June 2015, a new referral in respect of Service User A came into the Council. It was made by HM, a member of staff at an independent service provider agency, which provided support to service users in a number of areas including housing, financial assistance and debt management. Her referral detailed issues that Service User A was said to be nervous whilst in her property and allegations of exploitation by a neighbour, Person C.
9. On 19 June 2015, the case was allocated to the Registrant, who had previous dealings with Service User A, according to Service User A's notes. She visited Service User A's property on that day with a support worker. She accessed the First Contact form within the Care First system on that day, and made entries within it.
10. On 4 August 2015, a second referral was received in respect of Service User A. This second referral was made to the Council by the police, following an allegation made by Service User A that her husband (Person A) had threatened to kill her.
11. On 11 August 2015, a third referral was received in respect of Service User A. This third referral was made to the Council by the police and was as a result of Person A being arrested and charged with assaulting Service User A.
12. On 20 August 2015, a safeguarding meeting was held in respect of Service User A.
13. Service User C was a lady in her 70s who lived in a residential nursing placement. She went into residential care after she left hospital. When the Registrant was allocated the case, Service User C was already in residential care and had been self-funding her residential care for a long time. A referral was made by Service User C's family to the Council, to state that her funds had dropped below the threshold set by Local Government. The Registrant was therefore allocated to the case to determine whether the Council would pick up the funding.
14. The Registrant did not attend the HCPC final hearing which took place on 6-9 November 2017 and that panel went on to find that most of the particulars found proved amounted to misconduct. The panel determined that with regard to impairment:
‘there were some indications within the papers that the Registrant had some insight into her failures within her practice. There were her admissions to her employers during the investigatory and disciplinary process, and she is recorded as saying that she wanted to learn form her mistakes. Although she was unable to explain herself and the particular failures in the disciplinary proceedings, she did say it was not the way she normally worked. In the documentation, the Registrant repeatedly refers to feeling “overwhelmed”, despite the Council saying that her caseload was light, at 18, with only 3 ‘ongoing’ cases, compared to 20-22 overall cases for most of her colleagues. She had apologised and demonstrated remorse during the disciplinary proceedings, and TG had told the Panel that it was clear to her that the Registrant was distressed by the process. The Panel notes that the Registrant had a 30-year unblemished record with the Council, the final 10 years of which had been as a Social Worker.’
15. The panel subsequently imposed a 8-month Suspension Order having identified the following mitigating factors:
- The managerial oversight of the Registrant was not particularly supportive;
- The Registrant had made admissions and demonstrated remorse during the Council's disciplinary process
- The Registrant had a previously unblemished career of 30 years at the Council, the last 10 years of which had been in the role of Social Worker.
16. The panel suggested that a reviewing panel may be assisted by the following:
- The participation of the Registrant, ideally in person or, alternatively, through other means such as via telephone, with representation, or written submissions;
- A reflective piece identifying her insight into the actions that gave rise to the allegations and their impact on others;
- Evidence of training relevant to the assessment and management of risk, mental capacity assessments, structured record keeping, and any other relevant training;
- Testimonials from colleagues and managers relevant at any recent workplace, including voluntary work.
17. The matter was most recently reviewed on 5 July 2018. That panel noted that there had been no engagement from the Registrant during the review process and in the absence of any evidence of any positive insight and remediation the Panel concluded that there had been no material change in circumstances with regard to the risk to service users and the impact on public trust and confidence.
18. That panel determined that her fitness to practise was impaired and imposed a Suspension Order for a further period of 12 months. It encouraged the Registrant to participate at a future review hearing; provide a reflective piece identifying her insight; provide evidence of training relevant to the issues raised in this case and lastly to provide references and other testimonial evidence.
19. Ms Senior, on behalf of the HCPC, outlined the background circumstances and the history of this case. She referred the Panel to the information that the previous panels had suggested the Registrant may wish to provide to assist this reviewing panel. Ms Senior submitted that the only communication received from the Registrant since October 2016 were emails received on 4 July 2019 in which the Registrant states “I still feel the client was not left at risk and I had liaised with all the relevant professionals to ensure this… I feel very remorseful for any actions taken which my employer deemed as gross misconduct.”
20. Ms Senior submitted that as the Registrant has not provided any credible information with regards to insight and remediation, her current fitness to practise remains impaired. She submitted that the Registrant’s latest emails did not address the concerns identified in this case. She reminded the Panel of their powers including to direct a Striking Off Order.
21. The Panel noted the contents of the emails received from the Registrant on 4 July 2019.
22. The Panel heard and accepted the advice of the Legal Assessor.
23. The Panel first considered whether the Registrant’s fitness to practise remains impaired. It concluded that the Registrant’s engagement with the HCPC process has been extremely limited and there has been no engagement between October 2016 and 4 July 2019. The Registrant has not addressed the recommendations made by the substantive panel, or by the panel that reviewed the matter in July 2018. Her most recent emails, whilst expressing her remorse, do not address the nature of the misconduct found and her impairment on both the personal and the public components.
24. In the circumstances, the Panel concluded that the Registrant’s fitness to practise is currently impaired both with regard to the risk to service users and that a finding of no impairment would undermine the need to uphold proper standards in the profession and to maintain public confidence in the HCPC as its regulator.
25. Therefore, the Panel concluded that the Registrant's fitness to practise remains impaired.
26. Having determined that the Registrant's fitness to practise remains impaired the Panel went on to consider what sanction, if any, to impose.
27. The Panel first considered taking no action. The Panel concluded that, in view of the nature and seriousness of the Registrant's misconduct, to take no action on her registration would be inappropriate. Furthermore, it would be insufficient to protect the public, maintain public confidence and uphold the reputation of the profession.
28. The Panel went on to consider a Caution Order. As the Registrant has demonstrated very little insight into her misconduct other than during the internal disciplinary process, the Panel concluded that the risk of repetition remains and that a Caution Order would be inappropriate and insufficient to protect the public and to meet the wider public interest.
29. The Panel was unable to formulate any workable or measurable conditions. In reaching this conclusion the Panel noted that the Registrant's current professional and personal circumstances are unknown, and she has not provided any of the information that was suggested by both the final hearing and the first reviewing panels. Her latest emails indicate an intention not to return to practice as a Social Worker in the near future. The Panel concluded that, whilst the Registrant's commitment to remediation remains unknown, a Conditions of Practice Order would not satisfy the public or the wider public interest.
30. The Panel next considered extending the current Suspension Order for a further period of time. A Suspension Order would send a further signal to the Registrant, the profession and the public re-affirming the standards expected of a registered social worker practitioner. The Panel noted that a Suspension Order would prevent the Registrant from practising during the extended suspension period, which would therefore protect the public and the wider public interest. A Suspension Order would also provide the Registrant with the opportunity to consider her future, develop the skills and knowledge required to return to practice and put specific plans in place.
31. The Panel took into account paragraph 41 of the Indicative Sanctions Policy (ISP) states: ‘If the evidence suggests that the registrant will be unable to resolve or remedy his or her failings then striking off may be the more appropriate option.’
32. The Panel took the view that the above paragraph may apply to the Registrant. However, the Panel determined that given the Registrant’s very recent engagement with the process, the Registrant should be given a further opportunity to consider carefully the decision of the final hearing panel, the first review and of this Panel and properly focus on the issues that have been identified. The Panel reminds the Registrant that there is a persuasive burden upon her to demonstrate that she has addressed her shortcomings in this case.
33. The Panel determined that a further Suspension Order should be imposed for a period of 6 months. The Panel was satisfied that this period would be sufficient for the Registrant to demonstrate that she is committed to addressing the failings identified and working towards a return to practice if that is what she chooses to do.
34. The Panel decided a Striking Off Order, would be disproportionate as the shortcomings in the Registrant's practise are capable of being remedied, there remains a possibility that the Registrant is able to demonstrate remediation and in light of the mitigation identified by the previous panel. However, although this Panel cannot bind a future reviewing panel, a Striking Off Order may be imposed if the Registrant's non-engagement continues.
35. The extended Suspension Order will be reviewed shortly before expiry. A future reviewing panel would expect the Registrant to participate in the review hearing and provide evidence that she has made significant steps towards a safe and effective return to practice. Therefore, the following may be of assistance:
- The participation of the Registrant, ideally in person or, alternatively, through other means such as via telephone, with representation, or written submissions;
- A reflective piece identifying her insight into the actions that gave rise to the allegations and their impact on others
- Evidence of formal or informal training relevant to the assessment and management of risk, mental capacity assessments, structured record keeping, and any other relevant training and any other training relevant to her continuing professional development;
- References and/or testimonials from colleagues and managers relevant at any recent workplace, including voluntary work.
Order: The Registrar is directed to suspend the registration of Mrs Janette May Ryan for a further period of 6 months upon the expiry of the existing order.
The order imposed today will apply from 7 August 2019. This order will be reviewed again before its expiry on 7 February 2020.