Mrs Victoria V Asirvatham

Preliminary Matter

1. During the course of the Registrant’s submissions to the Panel she made reference to a number of personal matters that necessitated an application for them to be heard in private. There was no opposition to this course and the Panel granted leave for this part of the proceedings to be heard in private.

Background

1. The Registrant is a registered Occupational Therapist (OT). On 8 December 2008, she was employed as a Band 5 Occupational Therapist by 2Gether NHS Foundation Trust (the Trust), which provides mental health and learning disability services. She was responsible for adult patients with severe and enduring mental illness.

2. From 3 November 2014 to 2016, she was employed in the Wotton Lawn Inpatient Unit, which provides inpatient treatment for adults with mental illness who require hospital treatment due to an acute episode prior to returning to the community.

3. On 26 February 2018 to 2 March 2018 a Panel of the Conduct and Competence Committee considered an Allegation that the Registrant’s fitness to practise was impaired in relation to her responsibilities for eight separate service users over the period March 2015 to May 2016. The Registrant had failed in a wide range of areas of core occupational therapy skills including the adequacy of her assessments and observations, the adequacy of her clinical reasoning, failures to initiate or implement Care Plans, and failures in respect of her case notes. The difficulties persisted despite the support provided by the Registrant’s managers of a reduced caseload, a less complex case load and supervision.

4. The Final Hearing panel also considered that the Registrant had demonstrated an alarming lack of insight. There was no evidence that the Registrant recognised the effect that her shortcomings had on service users and colleagues.

5. The Final Hearing panel decided that the appropriate and proportionate Order was a Suspension Order for a period of twelve months.

6. At the first review hearing, that panel found that the Registrant’s fitness to practise remained impaired and extended the period of suspension for a further twelve months.

7. In providing its reasons for this determination, the panel complimented the Registrant on her attendance at the hearing and took the view that she was enthusiastic and motivated in relation to her role as a support worker and her desire to return to practice as an OT. However, the panel also expressed its concern that the Registrant had not understood the seriousness of her lack of competence and said that she, during the course of her evidence, had failed to focus on the most serious findings made by the panel at the final hearing. Her level of insight, the panel added, was limited and it found no evidence that the Registrant had remediated her deficiencies to the full.

8. At today’s hearing, the Registrant provided a large number of documents which confirmed that she had been working successfully over the last year in her position as support worker, and had attended and completed relevant training, for example Assessment, Motor and Process Skills (AMPS) course. These papers included a reflective essay in which, amongst other things, she stated that she recognised that she still needs to improve “her care planning, setting goals, treatment planning and interventions”. She added that she needed to be supervised by an Occupational Therapist regularly in order to maintain the quality of work expected of a professional.

9. Also provided to the Panel were testimonials, including one from the Registrant’s supervisor which spoke well of her employment as a support worker and one from a nurse who has worked with the Registrant since November 2016 which attested to her compassion, honesty and empathy.

Decision

10. The Panel took all of the above matters into account, listened with care to the submissions made and paid due regard to the relevant HCPTS Practice Note. It accepted the advice of the Legal Assessor.

11. It is plain to the Panel that the Registrant has cooperated fully with the regulatory process and has done her upmost to provide this Panel with as much information as possible in relation to what has been happening to her over the past 12 months. The Panel commends her for this and recognises that she has gained further insight into her deficiencies – encapsulated by her recognition that, if permitted to return to work, she needs the supervision of a senior OT.

12. This fact, amongst others, persuades the Panel that her fitness to practise remains impaired on both public protection and public interest grounds. The Panel did give consideration to imposing a Suspension Order but felt this would be disproportionate in the circumstances. Her improvement in insight and remediation is such that, in the Panel’s judgement, the appropriate and proportionate order to impose is that of a Conditions of Practice order for a period of 18 months – this to take effect when the current order of suspension expires on 30 March 2020. The conditions are as follows:

The Registrar is directed to annotate the HCPC Register to show that for 18 months from the date that this Order takes effect, you, Mrs Victoria V Asirvatham, must comply with the following conditions of practice:

1. Before undertaking work as an OT you must satisfactorily complete the HCPC return to practice requirements and forward confirmation of so doing to the HCPC.
2. You must place yourself and remain under the supervision of your workplace supervisor, registered by the HCPC or other appropriate statutory regulator and supply details of your supervisor to the HCPC within one month of the Operative Date. You must attend upon that supervisor as required and follow their advice and recommendations.
3. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.
4. You must inform the following parties that your registration is subject to these conditions:
A. any organisation or person employing or contracting with you to undertake professional work;
B. any agency you are registered with or apply to be registered with (at the time of application); and
C. any prospective employer (at the time of your application).
5. You must meet with your supervisor on a monthly basis to formulate a personal development plan designed to address the deficiencies in the following areas of your practice:
 
I. Assessment observation
II. Clinical reasoning
III. Treatment planning and evaluation
 
6. Within three months of the Operative Date you must forward a copy of your Personal Development Plan to the HCPC.

7. You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.
8. You must maintain a reflective practice profile detailing every occasion when you conduct assessment and observations, clinical reasoning, and treatment planning and must provide a copy of that profile to the HCPC on a monthly basis or confirm that there have been no such occasions in that period, the first profile or confirmation to be provided within one month of the Operative Date.

The Order imposed today will apply from 30 March 2020. This Order will be reviewed again before its expiry.

History of Hearings for Mrs Victoria V Asirvatham