Mrs Louise Middleton
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Allegation
During the course of your employment as a Dietitian with NHS Fife, on dates in or between February and August 2011, you:
1. On dates between May and June 2011 in relation to Case 1, you did not maintain accurate patient records, in that you:
(a) altered an electronic version of a dietetic letter originally dated 25 May 2011;
(b) destroyed the paper copy of the dietetic letter dated 25 May 2011, previously filed In the dietetic notes, and replaced It with the amended version;
(c) did not file three emails dated 1-3 June 2011 in the dietetic records
2. On dates between February and June 2011 in relation to Case 1, you did not conduct an adequate assessment of a Service User, In that you:
(a) did not take into account and/or adequately consider the case history of the service user when conducting your own dietetic assessment and plan;
(b) did not use the correct growth chart and/or did not plot growth chart correctly;
(c) did not sufficiently consider and/or review the information provided by the Health Visitor.
3. On dates between February and June 2011 in relation to Case 2, you:
(a) did not undertake an adequate assessment in respect of the Service User, in that you:
i. [Not proven]
ii. did not complete and/or plot the preterm growth chart correctly and/or accurately.
(b) did not formulate an appropriate dietetic plan, in that:
i. there was no and/or inaccurate information on the feeding requirements; and/or
ii. [Not proven]
iii. you did not adequately consider and/or identify that the Service User was being given diuretics and/or
iv. Identified 4 feeds a day as being adequate
(c) did not follow a jointly agreed dietetic plan;
(d) [Not proven]
4. In relation to Case 4:
(a) [Not proven]
(b) You did not undertake an accurate anthropometric assessment of the Service User in that, you:
i. did not calculate the infant's gestational age correctly; and/ or
i. did not plot the growth chart correctly.
(c) You did not undertake an adequate initial assessment in that, you:
i. did not assess and/or calculate the infant's actual consumed intake; and/ or
ii. did not assess and/or calculate information relating to feeds such as;
a. timing of feeds, and/or
b. length of time to complete feeds, and/or
c. sucking ability, and/or
d. feed losses
(d) You did not take appropriate account of the child's diagnosis and the likely impact on feeding;
(e) You did not make appropriate plans for frequency of review;
(f) You did not seek advice from and/or contact the Consultant medical staff.
5. On or around 5 May 2011 in relation to Case 5, you:
(a) did not follow the medical management plan;
(b) did not discuss a change of plan with the doctor and/or document reasons for a different course of action;
(c) did not undertake an adequate assessment of the Service User in that, you:
i. did not review and/or consider information in the medical notes, including blood results; and/ or
ii. [Not proven]
(d) did not undertake an accurate anthropometric assessment in that, you:
i. did not measure the Service User's height accurately; and/or
ii. did not plot the Service User's age correctly on the growth chart; and/or
iii. did not review the anthropometric data in the medical notes; and/ or
iv. did not correctly plot and/or interpret data relating to the Service User's nutritional status.
(e) [Not proven]
(f) [Not proven]
(g) requested that a GP undertake blood tests, including some that were unnecessary;
(h) [Withdrawn by HCPC]
6. In respect of Case 6, you:
(a) did not plot accurately the Service User's weight and/or height measurements on a growth chart;
(b) [Not proven]
(c) [Not proven]
(d) documented the need to discuss pump feeding with the Service User's parents, but did not document any such discussions
(e) did not advise the Service User's parents on an effective, practical feeding plan to achieve satisfactory weight gain.
7. In respect of Case 7, you:
(a) did not obtain any and/or sufficient information about the infant's recent feeding history;
(b) did not undertake an accurate anthropometric assessment in that you did not plot the growth chart correctly;
(c) did not appropriately discuss your findings with the doctor;
(d) did not re-assess nutritional intake to compare with requirements when you realised that despite your request to the GP to prescribe SMA High Energy formula, the baby was still consuming standard formula.
8. On dates between 25 May 2011 and 2 June 2011 in relation to Case 7, you:
(a) did not assess the Service User's actual nutritional intake and/or document nutritional aims;
(b) did not record in the dietetic record the date when the infant's feed changed to SMA High Energy formula;
(c) did not record in the dietetic record any advice given regarding maximum length of time to feed.
9. On or around 18 May 2011 in relation to Case 8, you:
(a) did not make accurate records in that you did not make it clear whether the infant changed to SMA High Energy milk;
(b) [Not proven]
(c) [Not proven]
i. [Not proven]
ii. [Not proven]
iii. [Not proven]
iv. [Not proven]
v. [Not proven]
10. In respect to Case 9, you:
(a) did not communicate effectively with the Service User's parents in that, you:
i. provided the Service User's parents with conflicting and/or misleading information about the child's condition; and/ or
ii. gave the Service User's mother inadequate written supplementary information.
11. In respect of Case 10, you:
(a) did not measure the child's height accurately;
(b) did not plot available weights and lengths from medical correspondence and/or medical notes;
(c) did not carry out an adequate assessment in that you did not review and/or consider
i. the Service User's total fluid intake; and/or
ii. eating environment; and/or
iii. number of children in the household;
(d) did not provide appropriate advice based on nutritional strategies that are known to work with this service user group.
12. [Not proven]
13. The facts set out in paragraphs 1-12 constitute misconduct and/or a lack of competence.
14. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
Finding
Order
you must supply full details of your supervisor to the HCPC within 14 days of their appointment. You must attend upon that supervisor as required and follow their advice and recommendations.
(i) Record Keeping;
(ii) Time Management;
(iii) Clinical practice;
(iv) Communication with dietetic, nursing and medical colleagues.
(i) Record Keeping;
(ii) Time Management;
(iii) Clinical practice;
(iv) Communication with dietetic, nursing and medical colleagues.
A. Any organisation or person employing or contracting with you to undertake professional work as a Dietitian, at the time of application;
B. Any agency you are registered with or apply to be registered with as a Dietitian (at the time of application);
C. Any prospective employer, seeking to employ you as a Dietitian, (at the time of your application).
Notes
No notes available
Hearing History
History of Hearings for Mrs Louise Middleton
Date | Panel | Hearing type | Outcomes / Status |
---|---|---|---|
14/01/2022 | Conduct and Competence Committee | Voluntary Removal Agreement | Voluntary Removal agreed |
13/01/2021 | Conduct and Competence Committee | Review Hearing | Conditions of Practice |
15/01/2020 | Conduct and Competence Committee | Review Hearing | Conditions of Practice |