Mr David Skelton

Profession: Social worker

Registration Number: SW40086

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 03/06/2019 End: 17:00 05/06/2019

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

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

Between 2013 and 2016, whilst registered as a Social Worker and during the course of your secondment to Cambridgeshire and Peterborough NHS Foundation Trust:

1. You did not maintain accurate and/or up to date records in respect of the following service users:

a. Service User A

b. Service User B

c. Service User C

d. Service User D

e. Service User E

f. Service User F

g. Service User G

h. Service User H

i. Service User I

j. Service User J

k. Service User K

l. Service User L

m. Service User M

2. You made entries in the following Service Users’ records, in relation to prescribed medication, using out-of-date information that you copied from earlier entries in the records:

a. Service User M

b. Service User A

c. Service User N

d. Service User D

3. You updated Service User records without verifying that the information you entered was current and/or correct, in relation to the following service users:

a. Service User A

b. Service User B

c. Service User C

d. Service User E

e. Service User G

f. Service User H

g. Service User I

h. Service User J

i. Service User K

j. Service User L

k. Service User M

l. Service User N

4. You did not undertake regular home visits and/or record regular home visits in relation to the following Service Users:

a. Service User A

b. Service User B

c. Service User C

d. Service User E

e. Service User H

f. Service User J

g. Service User K

h. Service User N

5. Between January 2016 and October 2016, you submitted false claims for mileage amounting to over 1000 miles.

6. The matters described at particular 5 were dishonest.

7. The matters described in particulars 1-5 constitute misconduct and/or lack of competence.

8. The matter described in particular 6 constitutes misconduct.

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

 

Finding

Preliminary matters:

Service

1. The Panel was provided with a signed certificate as proof that the Notice of Hearing had been sent on 28 February 2019 by first class post to the address shown for the Registrant on the HCPC Register. The Notice was also sent to the Registrant by email on the same date. The Panel was satisfied that Notice had been properly served in accordance with the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”).

Proceeding in absence

2. Ms Hollos applied to proceed in the absence of the Registrant. She provided the Panel with a copy of a Pre-Hearing Form, dated 28 October 2018, in which the Registrant stated that he did not intend to appear in person at the hearing. She also provided the Panel with a File Note of a telephone conversation between a representative of the HCPC and the Registrant dated 25 February 2019 which read:

“AM called Reg on…re receipt of pre-hearing form in which he indicates that he will not be attending the final hearing. AM asked whether there was any specific reason why he did not want to attend. DS explained that he had now retired and had no intention of returning to the profession. DS explained that he would not be attending any of the hearings and that we should not proceed with the matter as it would be a waste of time.”

3. The Panel accepted the advice of the Legal Assessor, who took the Panel to the guidance given in the cases of Jones (2003) 1 AC 1,  Tait v The Royal College of Veterinary Surgeons [2003] UKPC 34 and GMC – v Adeogba [2016] EWCA Civ 162.
 
4. The Panel concluded that the Registrant had made it clear on two previous occasions, firstly in the Response Proforma dated 28 October 2018, and secondly in the telephone call recorded on 25 February 2019, that he had decided to absent himself from the hearing. He had not requested an adjournment and there was nothing to suggest that he would attend if the hearing were to be adjourned. In those circumstances the Panel concluded that there was an overriding interest to proceed in the absence of the Registrant.

Witnesses

5. The Panel heard live evidence from:

• KB – Head of Service

• JC – Investigating Officer

• PH – Team Manager


Background:

6. Between 14 October 2002 and April 2017 the Registrant was employed as a Social Worker with Peterborough City Council and was seconded to work with the Cambridgeshire and Peterborough Mental Health Partnership NHS Trust (“the Trust”). In his role as a Social Worker, the Registrant was the Care Co-ordinator for a number of service users who were receiving support and treatment within the Trust. He was responsible for assessing and commissioning packages of care support, assessing social care needs and reviewing those needs, liaising with colleagues internally, liaising with carers and external agencies and identifying safeguarding needs. He was also a qualified Advanced Mental Health- Practitioner (AMHP), responsible for completing assessments under the Mental Health Act, specifically assessing whether service users should or should not be detained under the Mental Health Act for assessment and/or treatment.

7. In November 2016, Service User C, a Service User allocated to the Registrant, died. In accordance with standard practice, an Initial Management Report was undertaken to provide an overview of the circumstances surrounding the death.

8. The Initial Management Report found that Service User C had died of natural causes; however, it revealed a worrying lack of visits recorded by the Registrant. It was further suggested that the Registrant had not been checking or updating progress reports; had cut and pasted old information from previous reports and care plans; had failed to fully complete risk assessments; and had not visited this Service User for two years.

9. As a consequence of this, a desktop review of the Registrant’s cases was undertaken by PH. The results of that investigation now form the basis of Particulars 1 - 4. In summary form, PH claimed that in relation to a number of service users, the Registrant had either not undertaken regular home visits, or, if he had undertaken them, he had not  recorded them; he had not maintained accurate and/or up to date records; he had updated Service User records without verifying that the information he entered was current and/or correct; and he had made entries in relation to prescribed medication using out-of-date information that he copied from earlier entries in the records.

10. On 14 December 2016, JC was appointed as the investigating officer. As part of her investigation, she obtained travel expense claim forms submitted by the Registrant between January 2016 and October 2016 to ascertain whether mileage had been claimed by the Registrant in travelling to the address of Service User C. Her research led her to assert that the Registrant had been submitting excessive mileage claims.

11. As part of the documentation in the case, the Panel was provided with details of an interview conducted by JC with the Registrant in January 2017 as part of the Disciplinary Investigation. In that interview the Registrant asserted that he had been overworked. He said that his contracted hours of work had been reduced from 37 hours per week to 32, at his request, but that there had been no corresponding reduction made to his caseload.

12. In giving evidence before the Panel, KB was questioned about the Registrant’s workload. She said that there had been a rota to ensure that no social worker was undertaking excessive work and that, in her view, the Registrant had not been overworked. PH was also questioned on this issue and stated that, in his opinion, the Registrant’s workload had not been excessively high, and he had not seen anything within the documentation to suggest otherwise. He accepted that the team had been hard pressed at the time, but said that other social workers who had been under the same pressure had maintained standards that had not fallen below the minimum required, in contrast to the Registrant.

13. In relation to the mileage claims, the Registrant asserted in interview that he was not aware of having made inappropriate claims and that he did not realise that “you had to be that precise.”

14. In the pre-hearing form, dated 28 October 2018, signed by the Registrant and submitted to the HCPC in response to the Allegation, the Registrant stated that he admitted the facts alleged against him.

Decision on Facts:

15. The Panel accepted the advice of the Legal Assessor, who advised on the burden and standard of proof to be applied in the proceedings, the consideration required to be given to the Registrant’s good character, and the definition of dishonesty as established in the case of Ivey v Genting Casinos (UK) Ltd t/a Crockfords [2017] UKSC 67.

16. In reaching its decision the Panel took into account the evidence of KB, JC, and PH, and the documentation provided by them. The Panel found the three witnesses called by the HCPC to be credible and reliable. Their oral evidence supported their written statements.

17. The Registrant had not provided any submissions or documentation for the consideration of the Panel other than the admission made by him in his Pre-Hearing Form. The Panel took this document into account but attached little weight to it in light of his lack of legal representation. The Panel also took into account the points raised by the Registrant in the course of his Investigation interview, and emails that he sent to JC in January 2017, and to the Assistant Director Adult Operations in May 2017, in response to his suspension and JC’s investigation report respectively.

18. Throughout its findings, the Panel relied upon the evidence and documentation provided by the witnesses called by the HCPC. They preferred this evidence to the evidence provided by the Registrant referred to earlier. The Panel did not accept the suggestion made by the Registrant that his work and record keeping had been disproportionately affected by reason of the additional workload that he had been carrying. It was clear to the Panel that this was an excuse that had been provided at the time of interview without any evidence to corroborate his claim to have raised the issue previously with his manager.

19. The Panel concluded that it would be convenient to deal with Particulars 1 and 3 together as there was some overlap in the material relating to them.

Particular 1: You did not maintain accurate and/or up to date records in respect of the following service users; and

Particular 3: You updated service user records without verifying that the information you entered was current and/or correct, in relation to the following Service Users:

20. The Panel was informed that the Registrant had been under an obligation to keep and maintain accurate records. KB explained that the Registrant was working with a Care Programme Approach (CPA); a package of care designed for people with mental health problems. This involved an initial assessment, a risk assessment and a care and support plan, which are all shared with the Service User, and regularly reviewed.

21. The Panel was shown the Clinical Record Keeping Policy which states that records should be entered onto the electronic system, RiO, within 24 hours, failing which they needed to be prefaced with the term Late Entry. The Panel was also provided with the Trust’s Care Planning Policy which states that: “Care and support provided to the Service User should be reviewed on an on-going basis as required, but as a minimum every 6 months unless clinically indicated otherwise.”

Service User A

22. PH informed the Panel that a “summary and initial plan document” is part of the core assessment. The “core assessment” is an overall assessment of a Service User’s needs. PH suggested that the core assessment should be updated and reviewed at least annually and when clinically relevant.

23. The Panel found two summary and initial plan documents contained within Service User A’s records; one completed by CS,  a nurse, on 3 October 2014 and one completed by the Registrant on 14 June 2016. The Panel noted a significant gap in time between the two documents. Furthermore, it appeared that the Registrant had largely copied and pasted CS’s assessment of 3 October 2014 into his document created on the 14 June 2016. The Panel accepted PH’s evidence that it was unlikely that nothing had changed in relation to Service User A’s circumstances in a time period of 2 years.

24. The Panel was informed that a Crisis, Relapse and Contingency Plan (crisis plan) is a document which provides information regarding actions that should occur if the Service User becomes unwell. The Panel found that there were two crisis plans for Service User A - one completed by CS on 3 October 2014 and one completed by the Registrant on 15 June 2016. Again it appeared that the Registrant’s crisis plan had been copied from the previous crisis plan completed by CS.

25. The Panel also found 4 CPA reviews provided for Service User A: a CPA Review completed by CS on 3 October 2014; two CPA reviews completed by the Registrant on 14 April 2015; and a CPA Review completed by the Registrant on 14 June 2016. The reviews completed by the Registrant were largely left blank.

Service User B

26. PH informed the Panel that Service User B suffered from schizophrenia, chronic long term severe mental illness and had significant impairments linked to that illness around cognitive and social functioning.

27. The Panel found two summary and initial plan documents contained within Service User B’s records which formed part of the core assessment. One of these had been completed by KM on 11 May 2015 and the other completed by the Registrant on 23 March 2016. On comparing the two documents, it was clear to the Panel that the bulk of information had been copied and pasted. Of particular significance was the ‘Summary, formulation, list of problems section’. In 2016, the document repeats a statement from the previous recording in 2015, namely, “…aggression towards his carers car earlier today.” The 2016  record stated ‘earlier today’ even though that statement was now almost a year old, suggesting that it had been copied and pasted with no thought as to whether it was still relevant.

28. The Panel also found two crisis plans contained within the records provided for Service User B; one completed by DN on 3 June 2015 and the other completed by the Registrant on 15 June 2016. It was clear that the crisis plan completed in 2015 had been written by a ward nurse when Service User B had been admitted to hospital. The crisis plan for 2015 concerned what should have happened whilst Service User B was in hospital. The crisis plan completed by the Registrant was identical to that of the 3 May 2015, notwithstanding that records showed that Service User B was discharged from hospital on 8 June 2015.

Service User C

29. PH informed the Panel that The Trust changed to using the electronic RiO system in 2013, and that when this occurred all records were transferred over to the RiO system and a warning stating, “This information has been migrated and should be reviewed before being acted upon” appeared on the record.

30. The Panel found two crisis plans completed by the Registrant in the records for Service User C - one on 13 June 2013 and one on 15 June 2016. The 2016 crisis plan still contained the warning that information had been migrated from the previous system. It was clear, therefore, that this plan had not been reviewed. The Panel heard that this warning should have been taken out and that updated information should have been entered.

31. In addition, the 2016 crisis plan was identical to the 2013 crisis plan. It appeared that the Registrant had simply re-dated the previous plan. There was no evidence that the plan had been updated. There was a gap of more than 3 years between the crisis plans.

32. The Panel found two risk assessments completed by the Registrant for Service User C - one on 13 June 2013 and one on 15 June 2016. In relation to the 2013 risk assessment, the Panel noted that there was again the warning from the previous computer system that the information had been migrated, and it therefore appeared that this information had not been reviewed. There were boxes containing exclamation marks denoting where information should have been filled in, which again suggested that the information had not been reviewed. In comparing the 2013 risk assessment with the 2016 risk assessment, the two documents were identical even though they were 3 years apart. Both assessments were also extremely brief.

Service User D

33. The Panel found four crisis plans produced within Service User D’s records: three crisis plans completed by the Registrant dated 31 October 2016, 14 June 2016, and 15 June 2016; and one crisis plan completed by KV on 15 April 2015. All of the crisis plans completed by the Registrant in the ‘Contingency Plan’ section stated: ‘Contact care coordinator [KV]’. The Panel heard that KV had retired by that time and the Registrant was the newly assigned Care Coordinator. This suggested that this information had not been updated, but copied and pasted from the previous version completed by KV.

Service User E

34. The Panel found  three crisis plans provided for Service User E in the records, all completed by the Registrant, on 13 June 2013, 8 April 2015 and 15 June 2016. The Panel concluded that the 2013 crisis plan was a version that had been migrated from the previous electronic system; it still contained the warning that the information should be reviewed before being acted upon and did not contain much information.

35. The 2015 and 2016 versions were also very minimal in nature, containing limited information. Furthermore, the 2015 and 2016 versions were identical even though they were more than a year apart, suggesting to the Panel that the 2016 version had been copied and pasted from the 2015 version without any regard as to whether the information had changed or needed to be updated.

Service User F

36. The Panel heard that Service User F had been involved with The Trust for many years. She had bipolar disorder and had frequent admissions to hospital under the Mental Health Act.

37. The Panel found three crisis plans provided for this Service User: one completed by SO on 30 November 2015 and two completed by the Registrant on 8 December 2016 and 15 June 2016. It appeared to the Panel that the majority of the information contained in the Registrant’s crisis plans had been copied across from the 2015 plan. In the June 2016 crisis plan, the Care Coordinator was referred to as KV which was obviously incorrect as the Registrant was the Care Coordinator at that time.

38. The Panel found two summary and initial care plans for this Service User. One plan had been completed by FA on 23 January 2016 and the other had been completed by the Registrant on 15 June 2016. Everything referenced in the Registrant’s plan related to information known about the Service User in 2015. There were no updates provided about the Service User for the first half of 2016 and the information therefore appeared to have been copied and pasted from FA’s summary and initial care plan. There was some information about a hospital admission but this was from January 2016 and so was no longer relevant in June 2016. For example, the opening statement reads: “[Service User F] has been admitted to Oak 1 ward for a period of assessment and treatment”, which appeared in the January 2016 plan and was no longer relevant in the June 2016 plan. It largely contained historical information which was no longer clinically relevant.

Service User G

39. The Panel found two summary and initial plans provided as part of Service User G’s records: one completed by MB on 10 June 2014 and one completed by the Registrant on 15 September 2016. On comparing these two documents, they appeared almost identical, even though the plans were two years apart. For example, the 2014 plan stated, “[Service User G] more recently has said she wants to buy a new sofa”. This same sentence appeared in the 2016 plan even though this information was now two years old and could no longer be relevant.

40. There were also two crisis plans provided within the records for Service User G: one completed by MB on 10 June 2014 and one completed by the Registrant on 15 September 2016. Again, it appeared that the Registrant had re-dated the information contained within MB’s assessment without reviewing it to see whether this was still correct. The two plans were two years apart and the Panel heard that it was unlikely that nothing would have required updating within that time period.

Service User H

41. The Panel found three crisis plans provided within Service User H’s records, all completed by the Registrant, on 15 June 2016, 7 August 2015 and 13 June 2013. The original 2013 crisis plan had not been altered in any way by June 2016, other than deletion of the warning that the information had been migrated from the previous system. Some boxes contained no information and the contingency plan was blank across all versions. The Panel heard that this was a very limited plan for a Service User who had significant risks and could become angry and aggressive.

Service User I

42. The Panel found two crisis plans contained within the records for Service User I: one completed by KS on 13 June 2013 and another completed by the Registrant on 15 September 2016. The 2016 plan completed by the Registrant was an exact copy of the previous crisis plan completed by KS, despite the time gap of 3 years. It appeared that this had again just been copied and pasted. Furthermore, the plan completed by the Registrant contained the warning message from the transfer over to the previous system in 2013.

Service User J

43. The Panel found two crisis plans provided within Service User J’s records: one completed by KB on 5 April 2015 and one by the Registrant on 15 June 2016. KB was a ward nurse and the crisis plan she had completed revolved around keeping Service User J safe in hospital and what to do in respect of her admission. The plan completed by the Registrant was a direct copy of KB’s plan from over a year ago. The Service User was no longer in hospital meaning that a lot of this information was now clinically irrelevant. Records showed that Service User J was discharged from hospital on 12 May 2015.

Service User K

44. The Panel found two crisis plans provided within Service User K’s records, both completed by the Registrant on 13 June 2013 and 7 July 2016. It appeared that the Registrant had copied the information from the 2013 plan onto the 2016 plan. The only difference between the two entries is that the information migration warning had been removed, despite the fact that the two records were three years apart.

Service User L

45. The Panel heard that Service User L had a diagnosis of schizophrenia and was vulnerable.

46. The Panel found three summary and initial case plans which formed part of the core assessment. One was one completed by KV on 24 August 2015, and two were completed by the Registrant, on 19 October 2016 and 28 November 2016. The Panel found that the information across all three was largely identical. For the November 2016 plan, the Registrant had largely copied and pasted what had come before, although there were some updated elements which suggested that he had reviewed it to see whether the information was still relevant. However, it had not been thoroughly reviewed as there was still mention of Service User L’s mother’s death. The 2015 plan completed by Kathy Vardy states, “[Service User L’s] mother recently died from cancer.” This same sentence appeared in both the Registrant’s plans, over a year later.

47. The Panel found four crisis plans contained with Service User L’s records. One was completed by SS on 27 August 2015, and three were completed by the Registrant, on 15 June 2016, 19 October 2016 and 28 November 2016. The crisis plan completed by the Registrant in June 2016 looked identical to the plan completed by SS in August 2015. In the ‘Crisis Plan’ section it stated that the Care Coordinator, VM, should be contacted. However this information was out of date as the Registrant was the Care Coordinator for this Service User. This has been removed from the October and November 2016 plans which appeared to have been updated.

Service User M

48. The Panel heard that Service User M had significant and enduring mental illness and was vulnerable.

49. The Panel found two summary and initial plans contained within the records for Service User M. One had been completed by EK, on 28 July 2015 and the other completed by the Registrant on 19 October 2016. These appeared to be largely identical, and it appeared that the Registrant had copied and pasted from EK’s version produced 15 months earlier with no updates or changes.

50. The Panel found three crisis plans contained within Service User M’s records. One had been completed by EK on 28 July 2015, and two had been completed by the Registrant, on 19 October 2016 and 15 June 2016. These were identical to the plan produced by EK. The Registrant’s plans were still stating the Care Coordinator that should be contacted was EK, even though the Registrant would now be the Care Coordinator for this Service User. It did not appear that any of the information had been reviewed or updated since the plan prepared by EK in July 2015.

51. The Panel heard that a Presenting Problem document is part of the core assessment completed by the Care Coordinator. The Panel found that the original document had been completed by JCL on 7 March 2014. The Registrant had then completed another core assessment on 19 October 2016. The information contained within both documents was identical even though they had been completed over two years apart.

Service User N

52. The Panel found two Presenting Problem documents completed as part of the core assessment for Service User N. One had been completed by the previous Care Coordinator on 21 September 2014 and a further one completed by the Registrant on 15 June 2016. The ‘Current Interventions/Medication’ section completed for the 2014 plan listed the medication that the Service User was then taking. A letter from Service User N’s doctor then confirmed changes to Service User N’s medication. Despite this, the ‘Current Interventions/Medication’ section completed by the Registrant on 15 June 2016 contained the same medication information that was written in the 2014 core assessment.

Conclusion in relation to Particulars 1 and 3

53. On the basis of the findings set out in Paragraphs 20 to 52 above, the Panel found Particulars 1 and 3 proved in their entirety. It was clear that in relation to Service Users A, B, C, D, E, F, G, H, I, J, K, L and M, the Registrant had not maintained accurate or up to date records, and that in relation to Service Users A, B, C, E, G, H, I, J, K, L, M and N, he had updated service user records without verifying that the information he had entered was current or correct.

Particular 2 You made entries in the following Service Users’ records, in relation to prescribed medication, using out of date information that you copied from earlier entries in the records:

54. The Panel heard that social workers are notified of any changes in a Service User’s medication. Normally, there would be a review by a consultant psychiatrist organised by the Care Coordinator. The consultant psychiatrist would then write a letter to the Service User copying this to the Care Coordinator outlining the outcome from that review which would include any change to medication for that Service User.

Service User M

55. The Panel saw that the original Presenting Problem document was completed by JCL on 7 March 2014. Following this, the Registrant completed a further core assessment on 19 October 2016. The information contained within both documents was identical even though they were over two years apart. The list of medication had been copied over from one document to the other.

56. The Panel noted that a consultant’s letter for Service User M had been sent on 23 June 2016 which confirmed changes in the medication to be taken by Service User M. This letter, which was uploaded to the RiO system, named the Registrant as the Care Coordinator. The changes to the medication notified on 23 June 2016 had not been incorporated into the core assessment completed by the Registrant on 19 October 2016.

Service User A

57. The Panel found two Presenting Problem documents contained within Service User A’s records: one completed by CS on 3 October 2014, and the second completed by the Registrant on 14 June 2016. The section asking about current medication had been completed by CS in 2014 and then appeared to have been copied and pasted and re-dated by the Registrant a year and half later in June 2016.

58. The Panel had sight of a letter sent from Service User A’s doctor on 22 March 2016 providing updated information concerning Service User A’s current medication. The Registrant was named as the Care Coordinator and yet the updated medical information contained within the letter was not inputted into the core assessment 3 months later in June 2016.

Service User N

59. The Panel found two Presenting Problem documents completed as part of the core assessment for Service User N. One had been completed by the previous Care Coordinator on 21 September 2014, and the other by the Registrant on 15 June 2016. The ‘Current Interventions/Medication’ section completed for the 2014 plan listed the medication that the Service User was taking. This was followed by a letter from Service User N’s doctor confirming the following changes to Service User N’s medication: “Clozapine issued following a green blood result on the 17th February, current dose is 100mg in the morning, 250mg at night, supplied in a blister pack with Epilim Chrono 1000mg at night, Aripiprazole 30mg in the morning, Miratazapine 30mg at night and Pirenzipine 50mg at night”. The Care Coordinator was the Registrant. The letter was uploaded to the RiO system so was fully accessible to him. Despite this, the “Current Interventions/Medication” section completed by the Registrant on 15 June 2016 contained the same information that was written in the 2014 core assessment.

Service User D

60. The Panel found two Presenting Problem documents for Service User D, one completed by KV on 17 April 2015, and one completed by the Registrant on 31 October 2016. There was a consultant letter dated 20 January 2016 noting Service User D’s medication as ‘Flupentixol Decanoate 80mg 2/52’. This is not referred to in the Presenting Problem  document completed by the Registrant on 31 October 2016 where he appears simply to have copied the information contained in KV’s assessment across to his entry on 31 October 2016.

Conclusion in relation to Particular 2

61. On the basis of the findings set out in Paragraphs 54 to 60 of this determination, the Panel found that in relation to Service Users M, A, N, and D the Registrant had made entries in the records in relation to prescribed medication using out-of-date information that he had copied from earlier entries in the records.

Particular 4 You did not undertake regular home visits and/or record regular home visits in relation to the following Service Users:

62. PH informed the Panel that any Service User with a Care Coordinator should be visited monthly.

Service User A

63. The Panel found that the progress notes provided for Service User A contained no record of contact by the Registrant since 2014.

Service User B

64. The records revealed that, from leaving hospital in June 2015 until his death in December 2016, Service User B was seen only three times by the Registrant.

Service User C

65. Service User C’s records indicated that he had not been seen by the Registrant for two years prior to his death.

Service User E

66. The records for this Service User showed that in 2015 and 2016 there were only 7 contacts made by the Registrant.

Service User H

67. The records for this Service User showed only one visit recorded by the Registrant in 2016. In 2015 there were no recorded visits.

Service User J

68. PH informed the Panel that at the very least there should have been visits to this Service User every six months. There were no documented entries of any contact with Service User J by the Registrant on the RiO records after her discharge from hospital in May 2015 despite the fact that the Registrant was recorded as her Care Coordinator until 2017.

Service User K

69. PH informed the Panel that he believed this Service User would have required 6 monthly visits. The Panel found only one record entered by the Registrant on RiO, dated 20 November 2014.

Service User N

70. PH informed the Panel that he believed this Service User would have required 6 monthly visits. The RiO records revealed only three recorded contacts with this Service User during 2015 and 2016, dated 20 November 2014, 28 January 2015 and 6 December 2016.

Conclusion in relation to Particular 4

71. For the reasons set out in Paragraphs 62 to 70 of this determination, the Panel found that the Registrant  had not undertaken regular home visits or recorded regular home visits in relation to Service Users A, B, C, E, H, J, K and N.

Particular 5. Between January 2016 and October 2016, you submitted false claims for mileage amounting to over 1000 miles

72. JC informed the Panel that she compared the Registrant’s diary with the travel expense claim forms submitted by the Registrant in 2016 to ascertain whether any mileage had been claimed by him in visiting the address of Service User C. She discovered that he had not claimed any mileage to the address of Service User C during this period. She discovered, further, that there appeared to be discrepancies around the amounts of mileage he had claimed in respect of other service users. For example, on 5 October 2016, the Registrant had claimed 21 miles from Pembroke House to Peterborough Magistrates Court, to Oak Ward and then back to Pembroke House. She had compared this with the AA/RAC Route Finder calculations which indicated that the maximum number of miles for this journey should have been 10 miles.

73. JC informed the Panel in evidence that, on looking at the totality of his mileage claims, there were significantly more mileage claims than visits recorded in the Registrant’s diary. She said that, in his interview, the Registrant had claimed that his record keeping was poor and that, if he had claimed mileage, he must have conducted a visit even though he may not have diarised it. However, JC said that it appeared that the Registrant had also claimed mileage for personal visits, which did not fit with his version of events. She informed the Panel that there was no Service User located at Yaxley and yet the Registrant had claimed mileage to Yaxley on the following dates: 5 January 2016, 6 January 2016, 25 January 2016, 4 March 2016, 10 March 2016, 15 March 2016, 17 March 2016, 22 March 2016, 18 April 2016, 19 April 2016, 21 April, 2016, 12 May 2016, 13 July 2016, 14 July 2016, 6 September 2016 and 21 September 2016.  She created a spreadsheet showing the mileage that she alleged had been over claimed, which concluded that he had over-claimed 1,111 miles valued at £366.35.

74. In reaching its decision the Panel concluded that the Registrant:

• recorded numbers or initials for some visits instead of location of places visited;

• claimed mileage in respect of journeys not undertaken;

• claimed mileage which exceeded the actual distance between destinations on his journeys;

• claimed mileage for journeys which were not Council related business.

75. In reaching its decision, the Panel concluded that the documentation showed the following:

January 2016

• Recorded diary activity: entries on 4 occasions on 2 dates in relation to 2 Service Users.

• Travel Expenses Claim Form: mileage claimed for 16 dates totalling 445 miles.

February 2016

• Recorded diary activity: entry on 1 occasion on 1 date in relation to 1 Service User.

• Travel Expenses Claim Form: mileage claimed for 16 dates totalling 487 miles.

March 2016 

• Recorded diary activity: entries on 6 occasions on 6 dates in relation to 4 Service Users.

• Travel Expenses Claim Form: mileage claimed for 19 dates totalling 732 miles.

April 2016

• Recorded diary activity: entries on 2 occasions on 1 date in relation to 2 Service Users.

• Travel Expenses Claim Form: mileage claimed for 13 dates totalling 370 miles.

May 2016

• Recorded diary activity: entries on 8 occasions on 3 dates in relation to 8 Service Users.

• Travel Expenses Claim Form: mileage claimed for 15 dates totalling 612 miles.

June 2016

• Recorded diary activity: entries on 11 occasions on 6 dates in relation to 10 Service Users.

• Travel Expenses Claim Form: mileage claimed for 13 dates totalling 457 miles.

July 2016

• Recorded diary activity: entries on 19 occasions on 10 dates in relation to 15 Service Users.

• Travel Expenses Claim Form: mileage claimed for 16 dates totalling 566 miles.

August 2016

• Recorded diary activity: entries on 17 occasions on 8 dates in relation to 16 Service Users.

• Travel Expenses Claim Form: mileage claimed for 12 dates totalling 335 miles.

September 2016

• Recorded diary activity: entries on 21 occasions on 9 dates in relation to 17 Service Users Travel Expenses Claim Form: mileage claimed for 15 dates totalling 516 miles.

October 2016

• Recorded diary activity: entries on 4 occasions on 3 dates in relation to 2 Service Users.

• Travel Expenses Claim Form: mileage claimed for 16 dates totalling 573 miles.

Conclusion in relation to Particular 5

76. On the basis of its findings in Paragraphs 72 to 76 of this determination the Panel concluded that, between January 2016 and October 2016, the Registrant had submitted claims for mileage amounting to over 1000 miles and that this information was false in that it related to journeys which were not in connection with his work. The Panel did not accept the Registrant’s explanation that he had mistakenly failed to diarise these journeys. The errors had not occurred on an occasional basis: they had occurred repeatedly over a 10 month period. Furthermore, they had included claims for personal usage.

The matters described at a particular 5 were dishonest
 
77. The Panel considered the issue of dishonesty in the light of the decision of the Supreme Court in Ivey v Genting Casinos (UK) Ltd t/a Crockfords [2017] UKSC 67. It noted the part of the judgment of Lord Hughes:
 
“When dishonesty is in question the fact-finding tribunal must first ascertain (subjectively) the actual state of the individual’s knowledge or belief as to the facts. The reasonableness or otherwise of his belief is a matter of evidence (often in practice determinative) going to whether he held the belief, but it is not an additional requirement that his belief must be reasonable; the question is whether it is genuinely held. When once his actual state of mind as to knowledge or belief as to facts is established, the question whether his conduct was honest or dishonest is to be determined by the fact-finder by applying the (objective) standards of ordinary decent people. There is no requirement that the defendant must appreciate that what he has done is, by those standards, dishonest.” 

78. In reaching its decision the Panel took into account the following responses provided by the Registrant in interview with JC;

a. He did not think that the allegation in relation to discrepancies in his mileage claims was justified and he was not aware of having claimed for anything that he ought not to have claimed for;

b. He had been claiming mileage for 20 years and said that “nothing has changed”;

c. He confirmed his signature on each of the mileage claim forms;

d. He understood that by signing each form he was declaring that the expenses claim was accurate;

e. When asked to comment on specific claims, the Registrant responded that “I did not know you had to be that precise” and explained the additional miles by suggesting that that represented the totality of his journeys for that day;

f. He was not able to provide an answer justifying his mileage claim in relation to some specific cases;

g. He accepted claiming mileage for a personal appointment on one occasion and demonstrated an awareness that he did not think he should be making such a claim;

h. He explained that he had submitted more claims for mileage than there were corresponding diary activities because he was behind on his RiO entries;

i. He denied over-claiming. He stated that he had not given enough detail as to where he had been.

79. The Panel took into account that:

a. The Registrant was an experienced social worker who, on his own account, had been submitting mileage claims for 20 years;

b. The Travel and Subsistence Policy at D724 made it clear that:

i. There is an obligation on the employee to record the actual miles undertaken per journey on each claim;

ii. The employee must provide a full explanation for each journey;

iii. Managers may check distances in order to verify claims (e.g. by using either the RAC or AA web based route planner).

c. That Policy would have been available and known to the Registrant.

d. There had been multiple false claims

e. The claims had included personal claims

80. In considering the issue of dishonesty the Panel took into account the Registrant’s good character. It accepted that this meant that it was less likely than might otherwise be the case that the Registrant had acted dishonestly.

81. In considering the issue of dishonesty, in line with the decision in Ivey v Genting Casinos (UK) Ltd t/a Crockfords [2017], the Panel concluded that not only were the claims false, but the Registrant had known them to be false at the time of submitting them. They could not be explained away by reason of an innocent or negligent mistake. There were numerous claims that did not involve service users but had been made for personal reasons. The Panel concluded that the Registrant must have known that the claims were false at the time of submitting them. The Panel concluded that this was dishonest by the standards of ordinary honest people.


Decision on Grounds:

82. The Panel gave careful consideration to all the evidence and to the submissions made by Ms Hollos. The Panel accepted the advice of the Legal Assessor who addressed the Panel on the meaning of lack of competence, misconduct and impairment. She referred to the cases of Roylance –v- General Medical Council No 2 [2001] 1 AC p311, Cohen v GMC [2008] EWHC 581 and Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Paula Grant [2011] EWHC 927.

83. The Panel first considered whether the facts found proved were so serious as to amount to lack of competence. The Panel concluded that the Registrant had over 20 years’ experience as a Social Worker and that it was inconceivable that his failings amounted to an inability on his part to attain the standards expected of him in relation to such basic areas of practice. The Panel found that the Registrant had the requisite knowledge and skill to carry out his work. Accordingly, his behaviour did not amount to a lack of competence on his part.

84. The Panel then considered whether the Registrant’s actions amounted to misconduct. It concluded that his actions in relation to each Particular amounted to a serious departure from the standard of conduct that could properly be expected of a social worker performing the role that the Registrant was employed to perform at the time.

85. In so concluding, the Panel found that the Registrant had breached the following:

HCPC Standards of Conduct, Performance and Ethics (July, 2008)

1. You must act in the best interests of service users

10.  You must keep accurate records

HCPC Standards of Conduct, Performance and Ethics (January 2016)

9.  Be honest and trustworthy

HCPC Standards of Proficiency for Social Workers (August 2012)

10.  Be able to maintain records appropriately

86. The Panel took into account the evidence provided by KB that the implication of not undertaking visits to service users was that there was a risk that the care plans were no longer relevant and appropriate. It would not be possible to know if service users were receiving the correct care packages or whether their health and social care needs were being met. Furthermore, if a visit was undertaken but not recorded on the system, the records would be outdated. Accurate information was required for continuous assessment of the Service User and their support network. Other staff could be required to undertake visits to service users in times of leave or sickness. Therefore, if the system records were not up to date, staff would be undertaking visits without the relevant information which could put them at risk and/or could result in them not being aware that the mental health of the Service User was deteriorating.

87. The practice of repeatedly cutting and pasting important information from one record to another showed a disregard for whether the information was accurate. This was clearly deplorable.

88. The Panel also took into account the Registrant’s dishonesty which was clearly serious and was compounded by its effect in the misappropriation of public funds.

89. Accordingly, the Panel determined that the facts found proved amounted to misconduct.

Decision on Impairment:

90. In considering whether the Registrant’s fitness to practise is currently impaired by reason of his misconduct, the Panel accepted the advice of the Legal Assessor and took note of the Practice Note, ‘Finding that Fitness to Practise is “Impaired”’, provided by the HCPTS.

91. In reaching its decision, the Panel was mindful of the case of Cohen v GMC and asked itself whether the conduct was easily remediable, whether it had been remedied and whether it was highly unlikely to be repeated. The Panel was also mindful of the test endorsed in the case of Grant –v- NMC and considered:

• whether the Registrant had presented and/or continues to present a risk to patients/service users;

• whether the Registrant had brought and/or is liable to bring the profession into disrepute;

• whether the Registrant had breached and/or is liable to breach one of the fundamental tenets of the profession;

• whether the Registrant had acted dishonestly and/or is liable to act dishonestly in the future.

92. In relation to the risk of repetition, the Panel found that there had been numerous failings and that, as the Registrant had demonstrated no remorse, insight or remediation, the likelihood that he would repeat his misconduct was high. The Panel concluded that a finding of impairment of fitness to practise was required on public protection grounds. 

93. In considering the public component, and whether the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment were not made in the particular circumstances, the Panel concluded that the Registrant’s fitness to practise is currently impaired on this component also. In so concluding, the Panel took into account:
 
• the number of vulnerable service users  involved;

• the potential risks to the service users, as identified in this determination;

• the length of time over which the behaviour was evidenced;

• the Registrant’s dishonesty.

94. The Panel therefore finds that the Registrant’s fitness to practise is currently impaired.

Decision on Sanction:

95. The Panel heard submissions from Ms Hollos and heard and accepted the advice provided by the Legal Assessor.

96. The Panel kept in mind that the purpose of sanction is not to be punitive but is designed to protect the public and the wider public interest. The Panel took into account the current Indicative Sanctions Policy published by the HCPTS. The Panel applied the principle of proportionality, weighing the Registrant’s interests against the need to protect the public and the wider public interest. The Panel was aware of the requirement to look at the least restrictive sanction first.

97. The Panel concluded that the Registrant’s misconduct was aggravated by the fact that:

• the misconduct relating to Particulars 1 – 4 involved numerous vulnerable service users over a prolonged period of time (some 3 years);

• the dishonesty relating to Particular 5 continued for over 10 months and was at the expense of the public purse;

• the Registrant was an experienced Social Worker in a position of trust.

98. The Panel concluded that the Registrant’s misconduct was mitigated by the fact that the Registrant:

• was a person of good character with an unblemished long career hitherto;

• had accepted in an email to JC that his record keeping had fallen to below an acceptable standard, and had submitted a Pre-Hearing Form to the HCPC  in which he indicated that he admitted the Allegation.

99. In view of the seriousness of the misconduct, to take no further action, to order mediation or to impose a caution order would not be sufficient to protect the public or maintain confidence in the profession and the regulatory process. It could not be said that the misconduct was minor. Furthermore, the Registrant had shown no evidence of remediation or insight, and it was the judgment of the Panel that there was a high risk of repetition.

100. The Panel considered a Conditions of Practice Order, but concluded that this would not be sufficient in light of the seriousness of the misconduct. Furthermore, such an order would not be workable in light of the Panel’s finding of dishonesty and disengagement from the proceedings, meaning that the Panel could not trust the Registrant to abide by any conditions that it might see fit to impose.

101. The Panel considered a Suspension Order but concluded that this would not be sufficient to protect the public or the wider public interest. The Registrant had been dishonest in the course of his employment. His misconduct had related to numerous vulnerable service users over the course of a considerable period of time and had involved cutting and pasting of records previously created by other professionals. There was no evidence of remediation or insight and the risk of repetition was high. There was no indication that the Registrant might use a period of suspension to reflect on his misconduct, develop insight or take remedial action.  Furthermore, the public interest could not be satisfied by such an order in light of the seriousness of the misconduct that had been found proved.

102. The Panel concluded that a striking off order was the only appropriate order in the serious circumstances of this case. The Registrant’s serious misconduct had involved numerous vulnerable service users over an extended period of time and dishonesty in making false mileage claims. The Registrant had not remediated his actions, and had shown no insight. It was the conclusion of the Panel that the risk that he would repeat his actions was high.

103. Further, the Panel concluded that any lesser sanction would undermine confidence in the profession. In light of the seriousness of the Registrant’s actions, a striking off order was necessary to reaffirm clear standards of professional conduct in order to maintain public confidence in the profession and the regulatory process.

Interim Order:

104. Following the announcement of the sanction and the Registrant’s right of appeal, the Presenting Officer applied for an Interim Suspension Order.

Proceeding in absence

105. The Panel was satisfied that it was appropriate to consider the HCPC’s application for an interim order in the absence of the Registrant because he had been informed by the Notice of Hearing sent to him that such an application might be made, and he had not responded with regard to that warning.

The application

106. The Panel has already found that there is a real risk of repetition and subsequent harm if an Order is not imposed, given the Panel’s findings in this matter. Accordingly, the Panel is satisfied that an Interim Order is required for protection of the public. The Panel is also satisfied that an Interim Order is otherwise in the public interest. The protection of the public and the public interest outweighs the Registrant’s interests in this instance. The Panel has concluded that the appropriate length of this Interim Suspension Order should be 18 months, as the Interim Order would continue to be required pending the resolution of an appeal in the event of the Registrant giving Notice of such an appeal within the 28-day period.

107. The Panel makes an Interim Suspension Order under Article 31(2) of the Health and Social Work Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest. This order will expire: (i) if no appeal is made against the Panel’s decision and Order, upon the expiry of the period during which such an appeal could be made; or (ii) if an appeal is made against the Panel’s decision and Order, the final determination of that appeal, subject to a maximum period of 18 months.

 

Order

Order: That the Registrar is directed to strike the name of Mr David Skelton from the register on the date this order comes into effect.

Notes

No notes available

Hearing History

History of Hearings for Mr David Skelton

Date Panel Hearing type Outcomes / Status
03/06/2019 Conduct and Competence Committee Final Hearing Struck off