Ms Rhoda Donkor

Profession: Social worker

Registration Number: SW105928

Interim Order: Imposed on 17 Mar 2017

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 13/06/2019 End: 13:00 13/06/2019

Location: Health and Care Professions Tribunal Service

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

 

 

 

Whilst registered as a Social Worker and employed by Hampshire County Council between 29 February 2016 and 20 January 2017:

 

1. Following receipt of an email from another team at the Council dated 4 August 2016, which raised concerns in relation to Service User A being denied access to visit his mother, you:

 

a) Did not respond to that email;

b) Did not put the case of Service User A's mother into the duty workflow system.

c) Did not discuss the matter with management staff and/or seek advice until 11 October 2016.

d) Did not ensure the email was put on Service User A's mother's file.

 

2. In relation to Service User B, you:

 

a) On or around 9 August 2016, following concerns reported by Service User B's granddaughter:

i. Did not record your case note relating to the call with Service User B's granddaughter as a safeguarding concern and/or did not record the information on the safeguarding module.

ii. Did not discuss the matter with management staff or a senior social worker.

b) Did not complete the provision request until 5 October 2016

 

3. In relation to Service User E, you:

 

a) Did not complete and/or record any contact with Service User E with regard to setting up a direct debit following queries raised by the finance team in August 2016.

b) Did not respond to an email from the finance department dated 30 August 2016.

c) Did not record your review meeting with Service User E on 27 September 2016 at all, or in a timely manner.

 

4. In relation to Service User F, you:

 

a) On 25 October 2016, incorrectly recorded that the service user had refused an assessment.

b) On 3 November 2016, did not promptly record on the system that the service user had been found safe.

 

5. In relation to Service User G, following a telephone call with Service User G's husband on 24 October 2016, during which he informed you of a safeguarding concern, you:

 

a) Did not record the information on the safeguarding module.

b) Did not index the original request from Service User G's husband on the system.

c) Did not put the case in the duty workflow system.

d) Did not promptly inform a team manager or senior social worker of the safeguarding concern.

e) Did not share and/or record sharing the safeguarding concern with Service User G's General Practitioner.

 

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

 

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

Finding

Preliminary matters

Service of notice of review hearing


1. The Panel was aware that written notice of these proceedings was posted by first class post to the Registrant at her registered address on 15 May 2019. Notice was also served by email. The Panel was shown documents which established both the fact of the service and the identity of the Registrant’s registered address and also of her email address. In these circumstances the Panel accepted that proper service of the notice had been effected in accordance with the rules

Proceeding in the Registrant’s absence

2. Ms Simpson on behalf of the HCPC submitted that the Panel should consider the case in the absence of the Registrant.

3. The Panel has seen an email from the Registrant dated 06 June 2019 in which she states that she will not be attending this review hearing. The Registrant attached to that email her written “reflection of the case, along with evidence of training completed”. In addition the Panel has seen an email dated 7 June 2019 from Ms Simpson to the Registrant informing the Registrant that she could participate by telephone. Ms Simpson informed that Panel that there was no response to that email and that a further attempt by her to contact the Registrant by telephone on 12 June 2019 went to ‘voicemail” and did not attract a response.

4. The Panel heard and accepted the advice of the Legal Assessor.

5. The Panel was aware that a decision to proceed in the absence of the Registrant was one to be taken with great care and caution. However the Panel has decided to proceed in the absence of the Registrant. The reasons are as follows:

• Service of the appropriate notice of this hearing has been properly effected.

• The Registrant did not attend and was not represented at the hearing in June 2018.

• The Registrant has not applied for an adjournment and has stated that she will not be attending this hearing.

• The Panel has had an opportunity to study the Registrant’s written “reflection of the case”.

• There is no reason to suppose that an adjournment would result in the future attendance of the Registrant.

• There is a public interest in proceeding.

• This review of the Order is mandatory.

• In all the circumstances the absence of the Registrant should be treated as voluntary.

Proceeding in Private

6. Ms Simpson submitted and the Panel directed, that any material that related to the health of the Registrant should be received in private, but otherwise the hearing should be conducted in public.

Background

7. The Registrant is a registered social worker. At the material time, the Registrant was employed as an Assessed and Supported Year in Employment (“AYSE”) Social Worker with Hampshire County Council (“the Council”) between February 2016 and January 2017.

8. On 14 November 2016, the Registrant’s Line Manager made a referral to the HCPC following an incident in which the Registrant allegedly failed to recognise a safeguarding concern in respect of Service User G. Service User G’s carer had called Adult Service and the Registrant had responded to this call. Service User G’s carer had stated that he was not coping and felt he might seriously harm Service User G. There was a concern that the Registrant did not recognise the urgency of this alert and instead chose to wait until the following day to raise this with her Manager.

9. Further concerns raised with the Registrant throughout her ASYE year were also referred in respect of her alleged failure to recognise and/ or act on safeguarding concerns received by the Council in respect of a number of service users. There were also concerns relating to poor record-keeping and failures to undertake case/ administrative tasks despite significant support, training and supervision being given to the Registrant.

Hearing on 20 -22 June 2018

10. At the hearing in June 2018 the Registrant was not present at the hearing and was not represented.

11. Having considered all the material before it, the Panel made the findings of facts that are set out above. In respect of the statutory grounds the Panel made the determinations that are also set out above. The Panel concluded that the Registrant’s fitness to practise was thereby impaired. In respect of impairment the Panel stated its reasons in the following terms;

The Panel heard the submissions of Ms Mond-Wedd that the Registrant’s current fitness to practise is impaired by reason of both the personal and public components and that public protection concerns are engaged, as well as the need to uphold the wider public interest. The Panel had regard to the Registrant’s written submissions dated 13 May 2018.

The Panel accepted the advice of the Legal Assessor who referred to CHRE v (1) NMC (2) Grant [2011] EWHC 927. The Panel took into account the HCPTS Practice Note entitled “Finding that Fitness to Practise is ‘Impaired’”. The Panel was aware that impairment is a matter for its own independent judgment and that public protection and the wider public interest should be considered.

The Panel was of the view that in her submissions the Registrant had demonstrated a degree of insight into the conduct in question. She stated as follows:

Although I was told that it was reasonable to not know everything, there was a sense of caution for me to disclose not knowing something due to a fear that this may be used against me in my assessment. Therefore I tried to solve issues myself which resulted in the cases taking longer to resolve and at times putting service users at risk.

Nonetheless I acknowledge that my manager not being approachable is not an excuse as I could and should have utilised my other colleagues’ skills and knowledge. I have come to understand that seeking help and support is not a sign of weakness and rather not doing so can evidently be detrimental to myself and others.

I acknowledge and accept the allegations put forth by [Ms 1] and agree that I should have contributed effectively to the team and upheld the values of Social Work to safeguard vulnerable individuals. I regretfully apologise for the mistakes I made and hope that you will see to give me a second chance to prove myself and improve my practice in the future.”

However, the Panel was of the view that a deeper reflection on the matters in question, why they put service users at risk, and more detail about what should have been done differently, would have been appropriate. In the Panels view, the Registrant’s insight is therefore still in the process of development.

The Panel took into account that the Registrant was a new social worker in her first year of practice, and that she had apologised for her actions.

However, the Panel has no information about what the Registrant has done with regard to furthering her professional development since the matters in issue, and has no evidence of any steps taken to remediate or undertake further training or learning.

The Panel considered the case of Grant which set out questions from the Fifth Shipman Report to be asked by it when considering impairment. In considering these questions the Panel concluded that the Registrant had in the past put service users at unwarranted risk of harm and had in the past, brought the profession into disrepute and breached fundamental tenets of the profession.

The matters which have been found to constitute lack of competence and misconduct, taken together, occurred over a significant period of time, despite considerable support in the form of an ASYE programme and monthly supervision. Ms 1, in the Panel’s view, wished the Registrant to develop, and had made different suggestions to the Registrant to help her develop working relationships with the other team members, as evidenced in the detailed notes of the monthly supervision meetings. Despite the significant training and supervision, the Registrant was unable to put her training into practice in significant respects.

In addition, the Registrant has herself recognised in her written submissions that she tried to solve problems herself without asking others for help, although she now realises that seeking help is important and can prevent service users being put at risk. This is a significant recognition on the Registrant’s part, but as stated above, the Panel is of the view that further reflection and deeper understanding of this issue as well as the risk created are needed. Further, there is no evidence before the Panel that there has been remediation of the matters of concern, such as evidence of re-training, learning or reflection, for example, in relation the importance of working as a team or the importance of dealing correctly with safeguarding matters. As a result, the Panel was of the view that there is a real risk of repetition of the lack of competence and misconduct in question, and that therefore the Registrant is liable to put service users at unwarranted risk of harm, to bring the profession into disrepute an
d to breach fundamental tenets in the future.

The Panel also considered the wide public interest. The Panel was of the view that the reputation of the Adult Services Team, as well as the profession was put at risk by the Registrant’s conduct in respect of Service User G. Ms 1’s evidence was that in respect of the Registrant’s inaction in respect of Service User G, she called the police who raised “significant concerns” that Adult Services had waited over 24 hours to share the safeguarding information with them and Ms 1 apologised to the police on behalf of Adult Services. It is relevant in the Panel’s view that when the police did a priority welfare call within an hour of being informed by Ms 1, they deemed that Service User G and her husband were unsafe to remain together. In addition, taking into account the Registrant’s lack of competence and misconduct and the risks created for service users as a result over a significant period of time despite a low caseload, formal training and regular supervision the Panel was of the view that the wider public int
erest is engaged. The need to maintain public confidence in the profession and uphold proper standards would be undermined if a finding of impairment were not made in the particular circumstances.

The Panel therefore found that the Registrant’s current fitness to practise is impaired”.

12. In determining the sanction that was appropriate, the Panel concluded that to take no action, to refer the matter for mediation or to impose a caution order were inappropriate. The Panel further concluded that that for the reasons it stated, and having regard to the need to protect service users, a Conditions of Practice Order was neither sufficient or appropriate

13. The Panel determined that the appropriate sanction was the imposition of a Suspension Order for a period of 12 months. It explained its reasons for the above conclusions in the following terms;

The Panel heard the submissions of Ms Mond-Wedd, read the HCPC’s Indicative Sanctions Policy (ISP), took into account the Registrant’s written submissions, and accepted the advice of the Legal Assessor. The Panel was aware that the aim of sanction is not to be punitive. Rather, the aim is to uphold the public interest, which includes protection of the public. Sanction is a matter for the independent judgment of the Panel. The Panel took into account the principle of proportionality in coming to its decision on sanction.

The Panel identified the following mitigating factors:

i. the Registrant’s admissions to the facts

ii. the Registrant was a newly qualified Social Worker

iii. no previous regulatory findings

iv the Registrant has apologised

v. health issues which led to time off work

vi the Registrant’s 1.5 hour commute to work

vii. the Registrant’s potential to be a good social worker (Ms 1’s evidence).

The Panel identified the following aggravating factors:

i. there was a series of inactions and actions over a period of time;

ii. the Registrant presented a significant risk of harm to a number of vulnerable service users.

The Panel was of the view that mediation is not appropriate because it is not satisfied that the only other appropriate option would be to take no further action.

No further action would not address the real risk of repetition and therefore the risks to service users, which the Panel has already found to exist. Nor would it satisfy the public interest in this case, namely the need to maintain confidence and uphold proper standards. The Panel considered and discounted a Caution Order for the same reasons.

The Panel next considered a Conditions of Practice Order In this regard the Panel took into account para. 30 of the ISP which states:

“Conditions will rarely be effective unless the registrant is genuinely committed to resolving the issues they seek to address and can be trusted to make a determined effort to do so. Therefore, conditions of practice are unlikely to be suitable in cases:

• where the registrant has failed to engage with the fitness to practise process, lacks insight or denies any wrongdoing;

• where there are serious or persistent overall failings”.

The Panel noted the Registrant’s expression of willingness to improve her practice in the future, as well as her partial insight and her acceptance of responsibility for her failings, which are, in the Panel’s view, in principle capable of being remedied. However, the Panel was concerned that the issues of concern were numerous and persistent despite an ASYE framework of support, training and supervision. In addition, the Registrant’s deficiencies and failings were in respect of the core requirements of a social worker.

The Panel’s view, as set out in its earlier determination, was that the Registrant was unable to apply the advice and training she received in practice to real life situations, as was clear, for example, in the case of Service User G and her husband. The Panel was also mindful of the Registrant’s lack of assertiveness in approaching colleagues for advice. The need to communicate as part of a team was a regular feature of her supervisions with Ms 1, but did not appear to materialise in practice. For example as late as October 2016 the Registrant did not promptly share with senior colleagues or share with Service User G’s GP the safeguarding concerns, as her training had instructed her.

Therefore, the Panel was not satisfied that it could formulate workable, verifiable and practicable conditions, because of the issues in her practice which occurred despite the Registrant being subject to a recognised ASYE programme, training and frequent supervision. Further, the Panel considered that it was it possible to draft conditions that would ensure the Registrant applied learning and approached colleagues for advice. This was compounded by the lack of evidence of remediation of those deficiencies and failings. As such, the Panel could not be satisfied that it could formulate conditions which would address the risks which it has already identified and therefore the Panel could not be satisfied that service users would be sufficiently protected against those risks.

The Panel next considered a Suspension Order. The Panel was of the view that this would be an appropriate and proportionate sanction, as the next sanction in the hierarchy of possible sanction. The Panel is was of the view that suspension would be proportionate to protect the public, and uphold the public interest. The Panel decided that 12 months was proportionate to reflect the continuing inability of the Registrant to put her training into practice despite continuing support and regular supervision.

While not the reason for imposing the suspension, or the length of it, the Panel was of the view that the Registrant should be afforded time to demonstrate further insight and remediation.

14. The Panel gave guidance as to what might assist a reviewing panel. It stated as follows;

The Panel was of the view that a future Panel reviewing the Suspension Order would be assisted by the following:

• evidence of the undertaking of training in communication skills and interpersonal skills, including assertiveness training;

• a written reflective statement from the Registrant showing an understanding of why her practice fell below the expected standards, and what she would do differently. The reflection should also include examples, not necessarily in the social work context, of the Registrant working as part of a team, her communication skills and organisational skills;

• any references of testimonials in respect of any employment, whether paid or unpaid.

• The Registrant’s personal attendance at the review

The decision of this Panel

15. Ms Simpson summarised the relevant facts and the conclusions of the previous Panel. In summary she submitted that the Panel should find that the Registrant’s fitness to practise remains impaired. She said that the Registrant had not adequately addressed the failings established at the substantive hearing; she had not complied with a number of the suggestions made by the substantive Panel as to what might assist a reviewing panel. She submitted that in all the circumstances a continuation of the suspension order for a further 12 months was the appropriate and proportionate order for the Panel to make.

16. The Panel has read the reflective statement from the Registrant attached to the email dated 7 June 2019. In that statement she has raised the possibility of suspension being lifted. She attributed her previous failings to her fear of being judged incompetent and to a fear of failing, which constituted a communication barrier, preventing her from seeking support and advice when required. Without giving details of the circumstances of her present employment, she says that she is developing her confidence and improving her organisational and interpersonal skills. She also says that she is currently awaiting counselling to address “my anxiety and confidence”.

17. The Panel noted that despite the suggestions made by the original panel as to what would assist a reviewing panel, the Registrant has not attended and has not produced any testimonials. Nor has she provided examples of how her learning, organisational and communications skills have improved. Moreover, the evidence that she has submitted as to training, namely a single and undated certificate, is limited in character. The certificate states that the Registrant has completed an online course in “communication skills in Health and Social care Level 2”

18. The Panel heard and accepted the advice of the Legal Assessor

19. The Panel is aware that it has all the powers that are set out in Article 30 [1] of the Health and Social Work Professions Order 2001 [The Order] and which are summarised in the letter dated 15 May 2019 sent to the Registrant and giving notice of this hearing.

20. This Panel is aware that the process under Article 30 [1] of the Order is one of review and not one of appeal and that its function is to determine whether the Registrant’s fitness to practise is still impaired and if so whether the suspension order under review remains the appropriate and proportionate means of public protection or should be varied or replaced by some other order.

Decision of this Panel on Impairment

21. Having taking account of the submissions made by Ms Simpson and the written submission of the Registrant, the Panel has concluded that the Registrant’s fitness to practise remains impaired. In coming to this conclusion the Panel noted that the Registrant has not complied with all of the suggestions made by the substantive panel as to what would assist a reviewing panel. There is very little evidence of remediation and no independent evidence that she has developed the communication, interpersonal and organisational skills which would be required. Moreover evidence that the Registrant has further developed her insight is limited. The Panel concluded that in all the circumstances a restriction on the Registrant’s ability to practise was still necessary in order to protect service users and also in order to sustain public confidence in the profession of Social worker and in the HCPC as its regulator.

Decision on Sanction:

22. In considering the appropriate sanction the Panel had regard to the HCPC’s Indicative Sanctions Policy and the advice of the Legal Assessor.

23. The Panel has applied the principle of proportionality. The Panel is aware that the purpose of sanction is not to be punitive and that it must consider the risk the Registrant may pose to services users in the future and determine what degree of public protection is required. The Panel has considered the sanctions available in ascending order of severity. The Panel considered that to take no action or to impose a Caution Order would not be appropriate as neither action In particular, would not afford the necessary public protection.

24. The Panel next considered whether a Conditions of Practice Order would adequately address the concerns identified. For all the reasons identified by the original panel, the Panel has determined that a Conditions of Practice Order would not be appropriate. Moreover, the Panel has no evidence of the nature of the Registrant’s present employment or as to her plans for the future. Evidence of insight is limited. There is a risk of repetition. Accordingly the Panel considers conditions of practice which would sufficiently protect service users cannot be formulated.

25. The Panel next considered a continuation of the Suspension Order. The Panel has concluded that suspension for a further period of 12 months would be appropriate. This would enable the Registrant to seek advice and then to address and remedy the failings which were established at the original hearing. It would also give the Registrant the opportunity to establish that she has acquired the skills necessary to enable her to return to safe and effective practice as a Social Worker. The Panel considers that a striking off order would at this time be disproportionate.

26. The Panel was of the view that a future panel reviewing the suspension order would be assisted by the following:

• The personal attendance of the Registrant at the review. In the opinion of this Panel, the Registrant’s personal attendance would be very important.

• Details of all the work both paid and unpaid that she has undertaken since the making of the suspension order.

• Testimonials and references from persons with or for whom the Registrant has worked since the making of the suspension order and in any employment whether paid or unpaid.

• A written statement from the Registrant setting out the steps that she has taken to seek advice as to how to address the failings that were established at the original hearing. Particulars of the advice sought and given should be included. It would help the reviewing panel if the statement also set out in detail what the Registrant has done to follow that advice and how she has sought to develop her communication, assertiveness and organisational and interpersonal skills. Details and proof of training undertaken would be helpful. In addition, it would be helpful if she set outs what she has done to develop her skills in identifying risk and responding to safe guarding concerns.

Order

ORDER: The Registrar is directed to suspend the registration of Rhoda Donkor for a further period of 12 months on the expiry of the existing order.

 

Notes

The order imposed today will apply from 20 July 2019. This Order will be reviewed again before its expiry on 20 July 2020.

Hearing History

History of Hearings for Ms Rhoda Donkor

Date Panel Hearing type Outcomes / Status
13/06/2019 Conduct and Competence Committee Review Hearing Suspended
20/06/2018 Conduct and Competence Committee Final Hearing Suspended
18/05/2018 Conduct and Competence Committee Interim Order Review Interim Suspension
21/02/2018 Conduct and Competence Committee Interim Order Review Interim Suspension
20/11/2017 Conduct and Competence Committee Interim Order Review Interim Suspension
01/09/2017 Investigating committee Interim Order Review Interim Suspension
17/03/2017 Investigating committee Interim Order Application Interim Suspension