Miss Karen Bennetts

Profession: Occupational therapist

Registration Number: OT60373

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 01/03/2021 End: 17:00 01/03/2021

Location: Virtual hearing - Video conference

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

Between April 2013 and December 2016, whilst registered as an Occupational Therapist:

1. Your clinical reasoning and/or recording of your clinical reasoning for the recommendations made in respect of the following Service Users and/or the clinical reasoning was inadequate:

a. Service User 1

b. [not proven]

c. [not proven]

d. Service User 13

e. Service User 15

f. Service User 22

g. [not proven]

2. In relation to Service User 2, you:

a. Did not provide Service User 2 with a copy of the final Therapy Review.

b. Assessed the suitability of a property without Service User 2 being present.

c. Did not promptly send a letter to Homechoice regarding the bathing assessment you conducted for Service User 2

d. Did not include the results of a bathing assessment in a letter to Homechoice, as was directed in supervision.

3. In relation to Service User 3, you:

a. Recorded contradictory statements within the assessment.

b. Did not make a case recording of the assessment visit carried out on 6 July 2015.

4. In relation to Service User 4, you:

a. Did not make a case recording of the home visit carried out on 31 July 2015.

b. Recorded an assessment which lacked sufficient detail and/or was contradictory in places

5. In relation to Service User 5, you:

a. [Not Proven]

b. Recorded an assessment which lacked sufficient detail and/or was contradictory in places.

c. In relation to Service User 6, you recommended equipment that did not match the needs of Service User 6 and/or provided the service user with an assessment document which was inadequate.

6. In relation to Service User 7, you:

7. Did not make a case recording of the assessment visit carried out on 15 July 2015 in a timely manner.

a. Recorded an assessment which lacked sufficient detail and/or was contradictory in places.

b. Recorded an assessment that lacked clinical analysis of Service User 7’s situation

8. In relation to Service User 8, you did not make a case recording of the joint home visit carried out on 29 July 2015 and/or the further actions to be taken in the case.

9. In relation to Service User 9, you:

a. Did not consider adequately, or at all, the service user’s bathing needs.

b. Did not schedule a review of Service User 9.

c. Did not make a case recording of the assessment visit carried out on 15 June 2015.

d. Did not promptly submit the major adaption request

10. In relation to Service User 10, you did not undertake and/or record undertaking a review before closing the case.

11. In relation to Service User 11, you did not undertake and/or record undertaking a review.

12. In relation to Service User 11, you sent a housing letter instead of a housing support statement.

13. In relation to Service User 13, you did not adequately record the bathing assessment.

14. In relation to Service User 15, you ordered equipment which was not suitable for Service User 15.

15. In relation to Service User 16, you did not submit the major adaptation paperwork in a timely manner.

16. In relation to Service User 17, you:

a. Acted outside the scope of your practice, in that you provided Service User 17 with dietary advice.

b. Did not record a risk assessment within the therapy assessment in relation to a straight stair-lift.

17. In relation to Service User 18, you did not record an adequate risk assessment within the therapy assessment.

18. [Not Proven]

19. In relation to Service User 20, you did not submit the major adaptation paperwork in a timely manner.

20. In relation to Service User 23:

a. You did not make a case recording of the home visit carried out on 31 July 2015.

b. The assessment form you completed lacked sufficient clinical reasoning for the recommendations made.

21. In relation to Service User 24, you:

a. Did not make a case recording of the assessment visit carried out on 30 July 2015 in a timely manner.

b. [Not Proven]

22. In relation to Service User 26, you:

a. Did not make a case recording of the disclosure of abuse by Service User 26 and/or the safeguarding alert raised in relation to the disclosure in a timely manner.

b. Did not submit the recommendation for a Disabled Facilities Grant in a timely manner.

23. The assessment form you completed in relation to Service User 29 lacked sufficient detail and/or was contradictory in places.

24. The matters described at particulars 1 to 23 constitute misconduct and/or lack of competence.

25. By reason of your misconduct and/or lack of competence you fitness to practise is impaired.

Finding

Preliminary Matters

Service

1. The Panel had sight of the Notice of Hearing which was posted on the 28 January 2021 to the Registrant’s registered postal address. Although there was no response from the Registrant to this, the Panel was aware that there was material (in particular an email to the HCPC sent by her on 6 November 2020) within the bundle to demonstrate that the Registrant was aware of the review hearing and clearly stated that she did not want to engage further with the HCPC or with any future hearings.

2. The Panel was satisfied that there had been proper service in this case.

Proceeding in the absence of the Registrant

3. In the knowledge that this is a mandatory review and that good service had been found, the Panel was satisfied that the Registrant had decided to wholly disengage from these proceedings. As such, there was no application to adjourn and the Panel determined it was both in the interests of the Registrant and the public that this hearing should proceed in the absence of the Registrant.

Background

4. The Registrant started employment with the Cornwall Council (the Council) as a band 5 Occupational Therapist in Adult Social Care in April 2013.

5. On 6 December 2016 the Council wrote to the HCPC outlining that the Registrant had been dismissed following the Council's Disciplinary and capability procedure, after concerns were raised around her capability in her registered role. It was confirmed the Registrant’s last day was to be the 12 of December 2016.

6. In March 2015 following a complaint from a service user the Registrant’s caseload was audited and several areas of concern were identified by the Council. The Council subsequently put an Improvement Plan in place in April 2015 for a period of 8 weeks. In June 2015 this plan was reviewed, and the Council concluded that significant concerns in relation to the Registrant’s practice remained. The Registrant was started on a formal capability procedure and was provided with additional support from a new allocated supervisor.

7. The process was escalated to stage 2 in January 2016 as the Council remained concerned that the Registrant’s assessments contained too many errors and omissions and lacked clinical reasoning.

8. Further support was implemented by the Council who assigned the Registrant a mentor to assist with her assessments.

9. In April 2016 the Registrant’s mentor commented that the Registrant would not be able to work without a high degree of supervision, much more than would normally be allowed for a Band 5 Occupational Therapist with the Registrant’s experience.

10. Following a further review in May 2016 an alternative mentor was assigned for a further 3 months intensive support to enable the Registrant to work more independently.

11. Following further review the Council progressed the matter to stage 3 of the capability process in October 2016. The continuing problems identified by the Council were the Registrant’s:

⦁ Clinical reasoning or lack thereof;
⦁ Omissions in assessments;
⦁ Poor recording of assessments;
⦁ Use of unprofessional language in recording of assessments;
⦁ Failure to follow the guidance and instructions of her supervisor.

12. The matter was subsequently investigated by the HCPC and substantial investigations in relation to the Registrant’s conduct were considered by a panel of the Conduct and Competence Committee at a substantive hearing which concluded on 4 December 2018. These allegations set out that the Registrant had demonstrated inadequate clinical reasoning; had failed to adequately record assessments in respect of multiple service users; made incorrect recommendations for service users in respect of equipment; provided advice outside scope of practise; and failed to submit paperwork in a timely manner.

13. The Panel made recommendations that the Registrant attend the next review, provide evidence of CPD, a reflective statement, and up to date testimonials.

14. At the first review held on the 29 November 2019, the Panel noted that none of the previous recommendations had been acted upon by the Registrant and a conclusion was drawn that the Registrant’s fitness to practise remained impaired and there was still a risk that service users could be put at unwarranted risk of harm. A further suspension order for 12 months was therefore imposed.

15. On that same date, the Registrant emailed the HCPC and described the hearing as “a pointless exercise”. She stated that she no longer wished to seek employment as an Occupational Therapist.

16. Thereafter, the Registrant was offered the opportunity to pursue voluntary removal from the Register by consent. In further communication with the HCPC the Registrant stated that she did not agree that her fitness to practise was impaired and therefore a voluntary removal application could not be approved.

17. On the 6 November 2020, during a telephone call to the Registrant from the HCPC, the Registrant stated that she wanted her case closed and had no intention of practising again. In the context of another explanation by the HCPC as to whether the case could be closed by a voluntary removal, the Registrant denied that her fitness to practise had been impaired and stated some robust words to describe her view of the proceedings. These culminated in a request “please strike me off. I never want to hear from you again”.

18. On 6 November 2020, the Registrant sent a letter to the HCPC outlining she no longer wished to engage with these matters and wished to move forward with her life. She confirmed she no longer wished to work as an Occupational Therapist.

19. There has been no communication from the Registrant since 6 November 2020.

Decision

20. Mr D’Alton submitted that the fitness to practise of the Registrant remained impaired and that the time has now come for the Panel to give consideration to the sanction of a Striking Off Order. He emphasised that the Registrant has shown no insight into her failings and that she had not followed up on the recommendations from the previous panels. Furthermore, there is no evidence to demonstrate that she has taken any steps to remediate matters. She has repeatedly said that she has no wish to return to her profession.

21. The Panel listened with care to these submissions and took into account the contents of the bundle. It paid due attention to the relevant Practice Note and accepted the advice of the Legal Assessor.

22. The Panel, throughout its considerations, noted that there has been no change since the last review and that the Registrant has continued her policy of non-engagement. As such, the Panel’s view is that the Registrant has failed to discharge the persuasive burden upon her to demonstrate that she has properly addressed the issues of concern that have been identified. It follows that the fitness to practise of the Registrant remains impaired on both the personal and public components.

23. The Panel reminded itself that its duty is to balance the interests of the Registrant with those of the public. The failings that were found proved in December 2018, although remediable, were nevertheless serious. They put service users at considerable risks. An aggravating factor in this case is the view of the Panel that the Registrant, who denies impairment, has demonstrated no insight into her failings throughout the proceedings.

24. In these circumstances, it is plain to the Panel that the only possible sanctions to consider now would be an extension of the Suspension Order or the imposition of the Striking Off Order, not least since the Registrant has not worked as an Occupational Therapist since 2016. Any more lenient sanctions would be inappropriate in this case in that they would fail to address the risk of harm to service users and the wider public interest considerations engaged in this case.

25. Conscious that the Registrant herself wishes to be struck off the Register, the Panel reminded itself of the relevant contents of the Sanctions Policy Guidance. Paragraph 131 recommends that this sanction of last resort would be appropriate when there is no evidence of insight, when over 2 years since the original suspension has passed and when the Registrant concerned is unwilling to resolve matters. In the view of the Panel, this case comes within all three of these criteria.

26. Thus, the Panel determines that the only appropriate and proportionate sanction to impose in this case is that of a Striking Off Order, with immediate effect.

Order

ORDER: That the Registrar is directed to strike the name of Miss Karen Bennetts from  the Register with immediate effect.

Notes

Right of Appeal

You may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made against you.

Under Articles 30(10) and 38 of the Health Professions Order 2001, any appeal must be made to the court not more than 28 days after the date when this notice is served on you.

Hearing History

History of Hearings for Miss Karen Bennetts

Date Panel Hearing type Outcomes / Status
01/03/2021 Conduct and Competence Committee Review Hearing Struck off
20/11/2020 Conduct and Competence Committee Review Hearing Suspended
29/11/2019 Conduct and Competence Committee Review Hearing Suspended
26/11/2018 Conduct and Competence Committee Final Hearing Suspended