Mrs Jacqueline Daley
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Allegation
The below allegation was considered by a Panel at a Conduct and Competence Committee final hearing on 6 December 2019:
Allegation (As amended):
Whilst registered as an Occupational Therapist and employed by County Durham and Darlington NHS Trust:
1) In relation to Service User 1;
a) Following an initial assessment on or around 21 December 2017, you did not complete and/or record a follow up visit;
b) you discharged the service user without completing a full needs assessment.
2) In relation to Service User 2;
a) On or around 4 January 2018, you did not adequately assess and or record the assessment of Service User 2 in their home;
b) You did not monitor the patient when the discharge was delayed;
c) You discharged the patient without liaising with the physiotherapist regarding the patient’s mobility.
3) In February 2018, in relation to Service User 4, you discharged the service user without undertaking and/or recording a full assessment.
4) In relation to Service User 5;
a) after the service user refused to be assessed, you discharged them without a full assessment;
b) you completed a Continuation Sheet with no patient identifiable information and placed it in the patient’s records.
5) Between December 2017 and October 2018, you did not undertake and/or record an adequate assessment and/or plan for;
a) Service User 1;
b) Service User 3;
c) Service User 6;
d) Service User 7;
e) Service User 9;
f) Service User 10;
g) Service User 11;
h) Service User 12.
6) On 5 October 2018, during an environmental visit to Service User 8, you;
a) did not demonstrate an awareness of the service user’s functional abilities;
b) did not review the occupational therapy input prior to the visit;
c) required prompting from your supervisor to undertake measurements.
7) In October 2018, in relation to Service User 9 you;
a) did not hand over the outcome of the needs assessment in relation to Service User 9 to the ward staff;
b) sent a referral to a handyman for equipment that was not suitable;
c) saved the referral form, containing confidential information, on the shared system.
8) On 5 June 2018, you did not identify the equipment required for discharge of Service User 12;
9) In relation to Service User 13;
a) On or around 8 March 2018, you did not adequately complete and /or record a transfer assessment;
b) did not adequately undertake an environmental visit.
10) The matters described in paragraphs 1 – 9 amount to lack of competence.
11) By reason of your lack of competence, your fitness to practice is impaired.
At the final hearing, the Panel found all the facts proved and this amounted to a lack of competence. The Panel also decided that the Registrant’s fitness to practise to be impaired and imposed a Suspension Order for a period of 12 months.
Finding
Preliminary Matters
Service
1. The Panel had sight of the notice of today’s hearing which was emailed to the Registrant’s email address on 23 October 2020. The Panel had sight of information confirming that the Registrant’s email address to which the notice was sent on 23 October 2020 is recorded as her email address on the HCPC register.
2. The Panel also saw information that the HCPC email of 23 October 2020 was not delivered to the Registrant. On 12 November 2020 the notice of hearing was re-sent to an alternative email address of the Registrant’s. The Panel observed that the Registrant has a responsibility to keep the HCPC informed of her contact details.
3. The Panel took into account the HCPC’s published updated guidance that, in light of the government guidelines to contain the pandemic, and the closure of HCPC offices, service of notice of hearings will take place by email rather than post.
4. In all the circumstances, the Panel was satisfied that there had been good service.
Hearing in Private
5. Mr D’Alton, on behalf of the HCPC, applied for those parts of the hearing which dealt with matters of the Registrant’s health to be heard in private, on the basis that this would be required to protect her private life, pursuant to Rule 10(1)(a) of the Conduct and Competence Procedure Rules 2003.
6. The Panel took into account the HCPTS Practice Note entitled “Conducting Hearings in Private” and accepted the advice of the Legal Assessor. The Panel decided that it would hear those parts of the hearing which referred to the Registrant’s health in private, in order to protect her private life.
The Registrant’s application for an adjournment and the HCPC’s application for the hearing to proceed in the Registrant’s absence.
7. The Panel had before it two emails from the Registrant. The first, dated 19 November 2020 states as follows:
“Thank you for your email regarding the Review Hearing Scheduled for 24 November 2020. I am writing to you today to respectfully ask you if you could please postpone the review hearing until after 4th December. This is due to me having to attend an Employment Tribunal from 1st - 4th of December 2020. I was dismissed in December 2018 by County Durham & Darlington NHS Trust whilst working as an Occupational Therapist. I have brought an Employment Tribunal against the Trust for Unfair Dismissal & Discrimination.”
8. The second email from the Registrant, dated 23 November 2020 states:
“…I would appreciate it if the panel would delay the hearing until after the Tribunal which starts on 1st December 2020. It is scheduled for four days. The Tribunal hearing is going to decide on A) Unfair dismissal… On the advice of my solicitor we feel it would be best to delay the hearing until after the Tribunal, if that is at all possible. I can send in evidence once the Tribunal is concluded…”
9. Mr D’Alton stated that he opposed the application and applied for the hearing to proceed in the Registrant’s absence. Mr D’Alton submitted that the Registrant had had ample time to provide the relevant information for today’s hearing. Mr D’Alton submitted that while the result of the Employment Tribunal proceedings may provide some relevant information, it would not go to the key issues before the Panel today, namely remediation and insight. Mr D’Alton submitted that the Registrant has given no reason why she is unable to attend today.
10. The Panel carefully considered the Registrant’s two emails dated 19 and 23 November 2020.
11. The Panel took into account the HCPTS Practice Notes entitled “Postponement and Adjournment of Proceedings” and “Proceeding in the Absence of the Registrant” and accepted the advice of the Legal Assessor.
12. The Panel was of the view that it is not clear why the Registrant is requesting that today’s hearing should be adjourned until after the conclusion of the proceedings before the Employment Tribunal. It may be that the Registrant’s full attention is engaged by those proceedings and that she has been unable to prepare for today’s hearing. Alternatively, it may be because she believes that the result of the employment proceedings will be relevant to today’s review. The Panel was unable to speculate.
13. The Registrant has been aware since the Suspension Order was imposed in December 2019 that it would be reviewed and therefore has had advance notice of today’s hearing, and time to prepare. The substantive panel concluded its written determination with a list of further steps and evidence which the Registrant could take, and obtain, which it stated may assist today’s Panel. The Registrant has not sought to rely on any further information and has provided no further documentation for the Panel today. Rather, she seeks to rely on her application for an adjournment as set out in her two emails of 19 and 23 November 2020. In addition, the Panel was aware that today’s hearing would not go behind the factual decisions made by the substantive hearing panel, and that evidence going to insight and remediation by the Registrant is required. In light of this, the Panel could not see how the results of the employment proceedings would assist the Panel in determining the issues regarding the Registrants current impairment.
14. The Panel took into account the Registrant’s interests, the potential prejudice to her if it were to proceed today, as well as the public interest in the expeditious hearing of today’s case. In particular, the Panel noted that the current Order will expire on 3 January 2021. The Panel obtained information from the Hearings Officer of a possible listing of this case, if it were adjourned, for 14 or 15 December 2020. If the Panel were minded to consider this relisting, this would require a waiver from the Registrant of the statutory notice period for notice to be given of the adjourned hearing. Given the time of year, if this waiver were not granted there would be a significant risk that a hearing would not be able to be listed prior to expiry of the order.
15. The Panel considered the interests of justice as well as fairness to the Registrant. The Panel also considered the public interest in hearing this case expeditiously, in light of the public protection issues which are raised. In all the circumstances, the Panel decided that the public interest outweighed the Registrant’s interests, and decided to refuse the application for an adjournment, and to proceed in the Registrant’s absence.
Background
16. The Registrant is a registered Occupational Therapist. She was employed by County Durham and Darlington NHS Foundation Trust from January 2009 to December 2018.
17. Concerns about the Registrant’s competence initially came to light in early 2017 and an informal capability procedure commenced. In January 2018, a formal capability procedure commenced and the Registrant eventually progressed to a Stage 3 formal capability review. At the conclusion of the capability proceedings, the Registrant referred herself to the HCPC.
Submissions
18. Mr D’Alton submitted that the Registrant remains impaired and that the Suspension Order should be extended by a further 12 months. He referred the Panel to the evidence in the HCPC bundle.
19. There were no submissions from the Registrant before the Panel, apart from the emails of 19 and 23 November 2020 requesting an adjournment, as set out above.
Decision on Impairment
20. The Panel was aware that its purpose today was to conduct a comprehensive review of the Registrant’s fitness to return to unrestricted practice and considered the HCPTS Practice Note entitled “Review of Article 30 Sanction Orders”. The Panel accepted the advice of the Legal Assessor.
21. The Registrant has not followed the recommendations of the last reviewing panel in terms of useful evidence which she could rely on today. The Panel noted the Registrant has not submitted any evidence or information which goes to the issue of whether or not her fitness to practise remains impaired. The Panel was therefore of the view that nothing had changed since the substantive hearing to demonstrate a change in the level of the Registrant’s insight or in terms of evidence of remediation of the concerns found.
22. In light of this, the Panel was of the view that the Registrant has not yet achieved sufficient remediation or insight. As such, the Panel agreed with the previous panel that the Registrant is highly likely to repeat the actions and omissions which led to the factual findings of a lack of competence. The Registrant therefore remains impaired in respect of the personal component.
23. In view of the lack of sufficient remediation and insight, and the remaining risk, the Panel decided that the need to uphold proper standards and maintain confidence in the profession would be undermined if a finding of impairment were not made on public interest grounds. The Panel therefore decided that the Registrant remains impaired on the basis of the public component.
Decision on Sanction
24. The Panel then went on to consider the proportionate and appropriate sanction.
25. The Panel took into account the Sanctions Policy (SP) and accepted the advice of the Legal Assessor. The Panel bore in mind that sanction is a matter for its own independent judgment, and that the purpose of a sanction is not to punish the Registrant but to protect the public and uphold the public interest. Further, a sanction must be proportionate, so that any order made be the least restrictive order necessary to protect the public interest, including public protection.
26. The Panel first considered taking no action or mediation. The Panel concluded that these sanctions would not be appropriate in view of the lack of remediation and insight, and the risk that remains to public protection and the public interest. The Panel concluded that a Caution Order would also be inappropriate and insufficient to protect the public and meet the public interest concerns in that it would not place any restriction on the Registrant’s practise.
27. The Panel next considered a Conditions of Practice Order and decided that it could not be said to be an appropriate or workable sanction. The Registrant’s lack of competence, as found proved, was so wide-ranging, that any conditions would have to be so widely drafted that they would be tantamount to a suspension. In addition, there have been no submissions or evidence put before the Panel with regard to insight or remediation of the concerns, and therefore the Panel could not be satisfied that the Registrant would be willing or able to comply with conditions.
28. The Panel therefore decided that it would be proportionate to extend the Suspension Order to reflect the ongoing lack of sufficient insight and remediation, and to give the Registrant time to develop and demonstrate them. Such an order would protect the public and satisfy the wider public interest in declaring and upholding proper standards and in maintaining public confidence in the profession.
29. The Panel decided that it would be proportionate and appropriate to extend the Suspension Order for 12 months, to take into account the Registrant’s ongoing lack of insight and remediation.
30. The Registrant can ask for an early review if she has any new information or evidence to put before a panel.
31. The Panel was aware that a Striking Off Order is not available to it at this time.
32. This Order will take effect on the expiry of the current Order.
33. The Panel considered that a reviewing panel would be likely to be assisted by:
• The Registrant’s attendance at the next review hearing;
• A reflective piece from the Registrant with regard to the failings identified in the substantive hearing, together with their impact on service users, other professionals and the public;
• Evidence from the Registrant as to any steps she may have taken in order to remediate her failings;
• References and testimonials in respect of any employment or work, either paid or unpaid, which she may have undertaken since the events in question.
• Evidence of any Continuing Professional Development (CPD) undertaken by the Registrant to keep her professional skills up to date.
Order
ORDER: The Registrar is directed to extend the Suspension Order against the registration of Ms Jacqueline Daley for a further period of 12 months on the expiry of the existing order.
Notes
This is a Substantive Review hearing taking place via video conference on Tuesday 24 November 2020.
The Order imposed will apply from 3 January 2021.
This Order will be reviewed again before its expiry on 3 January 2022.
Hearing History
History of Hearings for Mrs Jacqueline Daley
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 06/12/2022 | Conduct and Competence Committee | Review Hearing | Struck off |
| 03/12/2021 | Conduct and Competence Committee | Review Hearing | Suspended |
| 24/11/2020 | Conduct and Competence Committee | Review Hearing | Suspended |
| 02/12/2019 | Conduct and Competence Committee | Final Hearing | Suspended |