Mr Terry J Hindmarch

Profession: Occupational therapist

Registration Number: OT32281

Hearing Type: Review Hearing

Date and Time of hearing: 13:00 17/01/2020 End: 17:00 17/01/2020

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

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

Whilst registered with the Health and Care Professions Council (HCPC) as an Occupational Therapist, you:

1. In regards to Service User 1, between 2014 – 2015:

a) delayed handing over vital equipment which had been delivered to the care home;

b) due to your lack of contact with Service User 1, did not recognise significant decline in and / or take action regarding Service User 1’s condition;

c) did not seek timely senior support to handover the equipment and / or  wait for the representative’s handover;

d) did not follow due process for a full manual handling assessment of slings / hoist as Service User 1 had not previously been hoisted;

e) did not provide an accurate verbal handover to support staff;

f) [HCPC offering no evidence]

g) did not provide management with an accurate reflection of Service User 1’s needs;

h) did not follow instructions, which included:

i. [HCPC offering no evidence]

ii. [HCPC offering no evidence]

iii. producing a written timeline.

2. In regards to Service User 2, between 2014 – 2015:

a) did not contact and / or record contact with Service User 2 in a timely manner to progress their case;

b) did not maintain adequate case recordings for Service User 2;

c) [HCPC offering no evidence]

d) did not complete an adequate Assessment report for Service User 2 in that it required substantial amendments before it was authorised - not proved;

e) [HCPC offering no evidence]

f) [HCPC offering no evidence]

3. In regards to Service User 3, in 2015:

a) did not maintain adequate contact with Service User 3’s family in regards to potential Disability Facilities Grant funding - not proved;

b) did not provide adequate information at a case conference meeting at a hospital on 13 March 2015;

c) did not establish and or maintain a therapeutic relationship and / or advocate on behalf of the family through the grant process - not proved

d) [HCPC offering no evidence]

4. In regards to Service User 4:

a) did not record any contact with Service User 4 between 19 May 2015 and 6 August 2015 and / or  maintain adequate records for this Service User.

5. In regards to Service User 5, in 2015:

a) did not contact a district nurse as instructed by your manager;

b) did not make a recommendation about widening the doorway and ramping until 22 June 2015 and / or progress the case in a timely manner;

c) [HCPC offering no evidence]

6. In regards to Service User 6:

a) did not progress Service User 6’s case in a timely manner;

b) did not follow a management instruction not to contact Service User 6 when the case had been transferred to a new worker - not proved

7. In regards to Service User 7, in 2015, you:

a) did not explain eligibility criteria to support your decision not to supply seating to Service User 7; and / or

b) did not provide advice about possible alternative solutions.

8. In regards to Service User 8, on 5 December 2014:

a) made no formal introduction and / or  provide a reason for visiting Service User 8 and / or  display your identification badge -not proved

b) did not explore and / or record exploring Service User 8’s feelings of low mood or suicidal thoughts and / or respond to his suicidal statements - not proved

c) did not ensure that appropriate mental health treatment was sought and / or  was provided to Service User 8.

9. In regards to Service User 9, in June 2015, did not acknowledge and / or record Service User 9’s low mood or suicidal thoughts during his angry outbursts.

10. In regards to Service User 10, in June 2015:

a) produced an Assessment Report for Service User 10 that:

i. contained insufficient and / or incorrect information; and / or

ii. could not be authorised.

11. In regards to Service User 11, in 2015:

a) did not progress Service User 11’s needs for shower equipment;

b) did not evidence the activities you had undertaken in the case recordings - not proved

c) did not undertake and / or  record a follow up visit to Service User 11;

d) left Service User 11 at significant risk when transferring on or off the stair lift and / or accessing the shower facilities.

12. In regards to Service User 12, in 2014:

a) unnecessarily questioned Service User 12 repeatedly - not proved; 

b) did not end and / or re-arrange the assessment when Service User 12 felt unwell - not proved;

c) did not seek advice from the nurse on duty - not proved.

13. In regards to Service User 13, in 2014:

a) asked Service User 13 to stand from his chair despite him having no lower garments on - not proved;

b) did not identify Service User 13 was spending the majority of his time in the bedroom - not proved.

14. In regards to Service User 14, in March 2016:

a) did not follow an instruction from your manager to contact the community nursing team the morning after your visit;

b) did not fully lead the assessment of Service User 14;

c) [HCPC offering no evidence]

d) did not assess and / or  explore Service User 14’s comments in relation to suicide.

15. In regards to Service User 15, in March 2016:

a) did not progress Service User 15’s case in a timely manner in that you did not complete Service User 15’s report following an instruction from your manager;

b) [HCPC offering no evidence]

c) did not communicate the outcomes of Service User 15’s assessment to her housing provider and / or to the Service User.

16. In regards to Service User 16, in 2016:

a) prescribed an unsuitable piece of equipment - not proved;

b) did not manage and / or  record the risks to Service User 16 following your allocation of equipment - not proved.

17. The matters as set out in paragraphs 1 – 16 constitutes misconduct and / or lack of competence.

18. By reason of your misconduct and / or lack of competence your fitness to practise as an OT is impaired.

Finding

Preliminary Matters
Proceeding in private
1. Ms Navarro, on behalf of the HCPC, submitted that parts of the hearing should be conducted in private, as this review hearing relates to matters concerning the Registrant’s health and the health of third parties connected with him. The Registrant has no objection to the application.

2. Having accepted the advice of the Legal Assessor, the Panel determined that parts of hearing that refer to the Registrant’s health and the health of any third party should be conducted in private so as to protect the right to a private life of the Registrant and any third party.

Submissions for the HCPC
3. Ms Navarro, on behalf of the HCPC, reminded the Panel of its powers on review under Article 30(1) of the Health and Social Work Professions Order 2001 to 
• Extend, or further extend the period for which an order has effect
• Make an order which could have been made when the order being reviewed was made; or
• Replace a suspension order with a Conditions of Practice Order.

4. Ms Navarro submitted that in reaching its decision, the Panel should address what, if anything, has changed since the last order was imposed. This included consideration of what if any, steps the Registrant has taken to address any specific failings; his current level of insight and how has this altered; and what he has done to maintain and update his professional skills and knowledge.

5. Ms Navarro referred the Panel to the case of Abrahaem v GMC [2008] EWHC 183 (Admin) which indicates that in practical terms there is a persuasive burden on the Registrant to demonstrate that he has fully acknowledged the deficiencies that led to the original finding and has addressed that impairment sufficiently “through insight, application, education, supervision or other achievement”.

Evidence and Submissions of the Registrant
6. The Registrant provided the Panel with some written submissions and gave evidence on oath. He told the Panel that, in view of the length in time since he last practised as an Occupational Therapist, he is required to undertake a mandatory 30 days of updating. The Registrant explained he was in the process of applying to local authorities to be accepted for a 30 day period of work as an Occupational Therapy Assistant (OTA). He considered that this would provide him with an opportunity to demonstrate that he is capable of working to the required professional standard and to keep case records and notes to the standard expected of an Occupational Therapist. He has not been in a financial position until now to progress this plan but is now actively pursuing a placement.

7. The Registrant informed the Panel that he rejoined the Royal College of Occupational Therapists in February 2019 and reads journals to keep up to date. He has purchased books about record keeping and has studied the Care Act 2014 to understand changes in legislation.   He has booked to attend a Manual Handling course on 24 February 2020 as he considered this an aspect of practice which he would benefit from updating.

8. The Registrant told the Panel that he fully accepted the deficiencies in his past practice. He recognised that he allowed other issues in the workplace to dominate and this contributed to his failings. He had felt under increasing pressure and accepted responsibility for failing to keep adequate case notes and progress cases properly.   He also accepted responsibility for the deficiencies identified in his communications with patients.

9. The Registrant told the panel he had attended courses on being assertive, mindfulness based stress reduction and understanding procrastination. He considered that he has learned to manage stressful situations step by step, and how to avoid procrastination through positive distraction. He would in future ask for help and support if he were to experience difficulty in his work which is a change to his past practice.

10. There had also been an incident of breach of confidentiality at work which had impacted him greatly.

11. The culmination of circumstances had led to the Registrant losing confidence and feeling unable to continue as an Occupational Therapist. He had sought employment in the fast food industry but now misses his professional practice and has a deep desire to return to it and to helping to resolve the difficulties and challenges faced by vulnerable patients. He considered that within three to four months he would have done sufficient work or activities to demonstrate his fitness to practise unrestricted by completing a placement as an Occupational Therapy Assistant and showing his clinical skills and his ability to keep records as required. His current workplace is supportive of his desire to undertake this placement but it is a question of finding an available position.  

12. The Registrant also intended to make contact with the Royal College of Occupational Therapists to enquire about the availability of a mentor to assist him in his return to practice and remediation of deficiencies.

Submissions on Sanction
13. Ms Navarro for the HCPC submitted that if the Panel considered that the Registrant’s fitness to practise remained impaired, a short further period of suspension would be appropriate and proportionate. She submitted that the HCPC is encouraged that the Registrant has shown better insight into his deficiencies than was previously the case. However, she submitted, the Registrant is in the early stages of the remediation process, and still to embark on retraining and CPD activities.   The proposed period of updating as an OTA does not require the Registrant to be actively on the register and so is not prevented by a Suspension Order being in place. Ms Navarro submitted that to impose a short period of further suspension would protect the public and uphold proper standards of conduct and public confidence in the profession and the HCPC as a regulator. Ms Navarro proposed an extension of the Suspension Order for a further five months bearing in mind the Registrant considered he would need at least three months to complete a placement as an OTA.

14. Ms Navarro submitted that if the Panel was minded to consider a Conditions of Practice order, then any conditions formulated must be workable and reasonable bearing in mind his practice setting and not be tantamount to suspension.  

15. Ms Navarro reminded the Panel that should the Registrant receive an extension of the Suspension Order at this hearing it would be open to him to apply for an early review should he consider this appropriate.

16. The Registrant submitted that he accepted the need to demonstrate remediation to show that he is fully fit to practise. He did not object to the proposed extension of the order for a further five months.

Decision
Impairment
17. The Panel heard and accepted the advice of the Legal Assessor.   It had regard to the Practice Note: Review of Article 30 Sanction Orders.

18. The Panel was encouraged by the Registrant’s development of substantial insight into his deficiencies and how background factors had contributed to a decline in the standards of his practice. The Panel considered he had made productive use of time to reflect and develop a better understanding and to undertake work to address aspects of his personal functioning.

19. However, whilst the Registrant had informed the Panel of his desire to return to practice and his plans for the immediate future, for the purpose of this hearing he has provided no information or evidence of actual remediation to address his misconduct and the deficiencies identified.   He has therefore not discharged the persuasive burden to demonstrate that his deficiencies have been fully addressed and that the risk of repetition has been reduced. 

20. The Panel determined that the Registrant’s fitness to practise remains currently impaired on grounds of public protection.

21. The Panel further considered that the public interest was engaged and that a finding of current impairment was necessary to uphold public confidence in the profession and proper standards of professional conduct. 

Sanction
22. The Panel considered taking no action, but decided that this exceptional outcome was not appropriate given the deficiencies found in the Registrant’s practice and his misconduct.

23. The Panel next considered a Caution Order would not be sufficient to protect the public or to address the wider public interest. 
 
24. The Panel next considered a Conditions of Practice Order. The Panel recognised the long period of time that the Registrant has not been practising and has been unable to maintain and demonstrate his clinical skills. The Panel was mindful that the deficiencies identified in the Registrant’s practice were significant and that no evidence of practical remediation is currently available. In those circumstances the Panel considered it could not be satisfied that a Conditions of Practice Order would be sufficient to protect patients and further that any conditions that could be formulated would be tantamount to suspension.   

25. The Panel recognised that the Registrant intends to undertake a placement as an Occupational Therapy Assistant as soon as possible, and that this would provide useful evidence of remediation for the consideration of a future reviewing panel.

26. The Panel considered whether a Suspension Order remained appropriate and proportionate. It determined that the public would remain adequately protected by a Suspension Order, and that it would be a proportionate response to the risks identified to both patients and the public interest.

27. The Panel considered the more restrictive sanction of a Striking Off order but in all the circumstances considered this would be disproportionate particularly in light of the Registrant’s developing insight and willingness to remediate.

28. The Panel therefore determined that it is appropriate and proportionate to extend the current Suspension Order for a period of six months.   This period was determined to be appropriate to give the Registrant an opportunity to put into effect his plans for remediation and for both the Registrant and the HCPC to be enabled to provide evidence for the purpose of the next review hearing.

Order

The Registrar is directed to suspend the registration of Mr Terry J Hindmarch for a further period of 6 months on the expiry of the existing order. 

Notes

No notes available

Hearing History

History of Hearings for Mr Terry J Hindmarch

Date Panel Hearing type Outcomes / Status
16/07/2020 Conduct and Competence Committee Review Hearing Suspended
17/01/2020 Conduct and Competence Committee Review Hearing Suspended
28/01/2019 Conduct and Competence Committee Final Hearing Suspended
29/10/2018 Conduct and Competence Committee Final Hearing Adjourned part heard