HCPTS |

Profession: Occupational therapist

Registration Number: OT41405

Interim Order: Imposed on 14 Dec 2016

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 01/09/2022 End: 17:00 01/09/2022

Location: This hearing is being held virtually.

Panel: Conduct and Competence Committee

Outcome: Conditions of Practice

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Allegation

While registered as an Occupational Therapist and during the course of your employment as an Occupational Therapist for 2gether NHS Foundation Trust in a Band 5 post:

1. In relation to Service User 1, you:

a. Between 11 March 2015 and 08 April 2015, conducted and/or recorded an assessment using the Model of Human Occupation Screening Tool [MOHOST], which did not contain;
(i) A comprehensive analysis of Service User 1’s occupational health needs,
(ii) Adequate clinical reasoning and/or demonstrate understanding of the use of the MOHST tool,
(iii) A summary, and/or
(iv) Recommendations for care intervention.

b. On 13 April 2015, conducted and/or recorded an assessment of Service User 1’s activities of daily living which did not contain;
(i) A summary,
(ii) An overall analysis of the Service User’s needs, and/or
(iii) An intervention plan and/or recommendations for care intervention.

c. On 30 June 2015, conducted and/or recorded an assessment/observation of Service User 1 and did not report and/or make a record of reporting Service User 1’s mental state to ward staff.

d. On 07 July 2015, conducted and/or recorded an assessment/observation of Service User 1 walking in hospital grounds which did not contain;
(i) A proper analysis of the observation,
(ii) An intervention plan, and/or
(iii) Adequate clinical reasoning and/or explanation regarding the relationship between the observations and the service user’s occupational needs.

e. On 29 July 2015, conducted and/or recorded an assessment/observation of Service User 1 cleaning their environment which did not contain;
(i) A proper analysis of the observation,
(ii) An intervention plan, and/or
(iii) Adequate clinical reasoning and/or explanation regarding the relationship between the observations and the service user’s occupational needs.

f. On 26 August 2015, conducted and/or recorded an assessment/observation of Service User 1 adapting their routine to attend lunch which did not contain;
(i) A proper analysis of the Service User’s process skills,
(ii) A plan for further intervention, and/or
(iii) Adequate clinical reasoning and/or explanation regarding the relationship between the observations and the service user’s occupational needs.

g. On 28 August 2015, conducted and/or recorded an assessment/observation of Service User 1 attending a chapel service, which did not contain;
(i) A proper analysis of the observation,
(ii) An intervention plan, and/or
(iii) Adequate clinical reasoning and/or explanation regarding the relationship between the observations and the service user’s occupational needs.

h. On 31 August 2015, conducted and/or recorded an
assessment/observation with the purpose of increasing Service User’s
1’s attendance at music in mind group, which did not contain;
(i) A proper analysis of the observation,
(ii) An intervention plan, and/or
(iii) Adequate clinical reasoning and/or explanation regarding the relationship between the observations and the service user’s occupational needs.

i. On 03 September 2015, conducted and/or recorded an assessment/observation of Service User 1 using the bath, which did not contain a detailed analysis regarding;
(i) The Servicer User’s environment,
(ii) The limited use of transfers,
(iii) The Service User’s Mobility, and/or
(iv) The Service User’s use of equipment.

j. On 03 September 2015, conducted and/or recorded an assessment/observation of Service User 1’s shopping and banking, which did not contain;
(i) A detailed analysis of the activity and/or the environment in
which the activity was conducted, and/or
(ii) Adequate clinical reasoning and/or explanation regarding the relationship between the observations and the service user’s occupational needs.

k. On 04 September 2015, conducted and/or recorded an assessment/observation of Service User 1 attending a chapel service, which did not contain;
(i) A detailed analysis of the activity and/or the environment in
which the activity was conducted,
(ii) An intervention plan, and/or
(iii) Adequate clinical reasoning and/or explanation regarding the relationship between the observations and the service user’s occupational needs.

l. Between 11 March 2015 and 1 October 2015, you did not initiate a Care Plan in respect of Service User 1.

2. In relation to Service User 2, you:

a. On 09 July 2015, conducted and/or recorded a home visit assessment to assess bath transfer, which did not contain;
(i) A summary,
(ii) Adequate analysis and/or clinical reasoning regarding the relationship between the observations and the service user’s occupational needs, and/or
(iii) Did not provide a recommendation about suitability of environment.

b. Not proved.

c. On 17 August 2015, conducted and/or recorded an observation of Service User 2 engaging in an activity which could be adapted intotheir routine, which did not contain;
(i) Not proved,
(ii) Not proved.
(iii) Adequate analysis and/or clinical reasoning regarding the relationship between the observations and the service user’s occupational needs.

d. Did not add any new information to the Care Plan to reflect developments in Service User 2’s treatment, such as the completion of an Interests Checklist on 26 January 2015, Service User 2’s discharge on 10 February 2015 and his re-admittance in June 2015.

e. On 24 March 2016, at a joint assessment of Service User 2, completed a record of the assessment which did not contain adequate analysis of the service user’s physical presentation during the assessment.

3. In relation to Service User 3, you:

a. On 05 February 2016, conducted and/or recorded an assessment of Service User 3’s environment, which did not contain;
(i) A proper analysis of the observation and/or assessment findings,
(ii) An intervention plan, and/or
(iii) Adequate analysis and/or clinical reasoning regarding the relationship between the observations and the service user’s occupational needs.

b. Completed a draft Occupational Therapy Report dated 10 February 2016 which was inadequate for the following reasons:
(i) You used incorrect paperwork showing the wrong NHS Trust,
(ii) The report did not contain sufficient information about Service User 3’s occupational needs,
(iii) Not proved.

4. In relation to Service User 4 you:

a. On or around 19 November 2015, you completed a Care Plan and included the requirement for weekly reviews to be conducted by the Occupational Therapist, which you then did not carry out.

b.Not proved.

c. On 07 December 2015, completed an Occupational Therapy report, which did not contain;
(i) A proper analysis of the observation,
(ii) Detailed clinical reasoning,
(iii) Detailed information about the Service User’s new environment and/or the relationship between the new environment and the service user’s occupational needs,
(iv) an intervention plan

5. In relation to Service User 5 you:

a. On 18 November 2015, completed and/or recorded an assessment to adapt Service User 5‘s routine which contained the wrong Service User 5’s name.

b. On 30 November 2015, conducted and/or recorded an observation/assessment in relation to Service User 5’s cooking skills, which did not contain;
(i) A proper analysis of the observation and/or potential risk, and/or
(ii) A strategy to support Service User 5.

c. On 09 December 2015, made a record of a conversation with a doctor which did not contain any explanation why the Service User was said to have a lack of capacity towards treatment.

d. On 11 December 2015, conducted and/or recorded observation of Service User 5 in the hospital grounds, and:
(i) Did not identify the Service User’s behaviour as a potential significant risk in the written record of the observation,
(ii) Did not identify the Service User’s behaviour may indicate the presence of mental health concerns in the written record of the observation, and/or
(iii) Did not feedback the potential risks regarding Service User 5’s presentation during the observation to the ward.

6. In relation to Service User 6 you:

a. On 20 November 2015, conducted and/or recorded an observation of the Service User engaging in tasks to adapt routine, which did not make reference to the impact of the environment.

b. On 23 November 2015, conducted and/or recorded an observation of the Service User during a walk in the hospital grounds which did not contain:
(i) a proper analysis of the observation; and/or
(ii) a detailed analysis of the Service User’s ability to plan for the
future.

c. On 30 October 2015, conducted and/or recorded an observation/assessment of the Service User involving building rapport, which did not contain;
(i) A proper analysis of the Service User’s process skills, and/or
(ii) An intervention plan.

d. On 01 December 2015, completed an occupational therapy discharge summary, which did not contain a proper analysis of the Service User’s needs upon discharge.

e. On 01 December 2015, conducted and/or recorded an assessment using the Model of Human Occupation Screening Tool [MOHOST], which did not contain a comprehensive analysis of and/or adequate clinical reasoning regarding Service User 6’s occupational health
needs at home.

7. In relation to Service User 7 you:

a. On 10 May 2016, conducted and/or recorded an observation during an initial contact ,which did not contain;
(i). A proper analysis of the observation,
(ii) An intervention plan, and/or
(iii) Indicate what further assessments were/will be required.

b. On 12 May 2016, completed a written record of an observation of the Service User, which;
(i) Described the activity incorrectly, and/or
(ii) Did not include detailed analysis and/or clinical reasoning for the recommendations made.

c. On 18 May 2016, conducted and/or recorded an observation of the Service User which incorrectly referred to one purpose of the assessment being re-motivation.

d. On 20 May 2016, conducted and/or recorded an observation of the Service User, which;
(i) incorrectly referred to the purpose of the observation as being re-motivation,
(ii) Did not contain a proper analysis of the observation and/or a summary, and/or
(iii) Did not contain an adequate analysis and/or clinical reasoning regarding the relationship between the observations and the service user’s occupational needs.

e. On 25 May 2016, completed and/or recorded a record for an observation at a breakfast group which:
(i) incorrectly referred to the purpose of the observation as being re-motivation,
(ii) contained the wrong Service User’s name.

f. On 27 May 2016, conducted an ADL assessment in the community in relation to Service User 7, which was not required as this had already been completed on 17 May 2016.

g. On 01 June 2016, completed a written record of an observation involving a breakfast group activity, which incorrectly referred to one of the purposes of the intervention as being re-motivation.

8. In relation to Service User 8, on or around 16 April 2015 you completed a Care Plan which was inadequate, in that it:

a. did not reflect Service User 8’s Occupational Therapy needs, and/or

b. stated goals of exploring Service User 8’s routines and interests and engaging Service User 8 in meaningful activities which were insufficient to address Service User 8’s occupational needs.

9. You did not ensure that case notes entered on the RiO system were validated with a signed electronic signature in the cases of;

a. Service User 1, namely the entry dated 30 May 2016.

b. Service User 2, namely the entries dated:
(i). 08 July 2015,
(ii) 2 September 2015
(iii) 14 December 2015,
(iv) 14 March 2016 and/or
(v)14 April 2016.

c. Service User 3, namely the entries dated:
(i). 09 February 2016,
(ii). 11 February 2016, and/or
(iii) 23 February 2016 .

d. Service User 5, namely the entry dated 09 December 2015.

10. Your actions as described at paragraphs 1-9 amount to misconduct and/or lack of competence.

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

Finding

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, the Registrant 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 in the form of a reduced caseload, a less complex case load and supervision.

4. The substantive 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 substantive hearing panel decided that the appropriate and proportionate Order was a Suspension Order for a period of 12 months.

6. At the first review hearing, that review panel found that the Registrant’s fitness to practise remained impaired and extended the period of suspension for a further 12 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, during the course of her evidence, she had failed to focus on the most serious findings made by the panel at the substantive hearing. Her level of insight, the review panel added, was limited and it found no evidence that the Registrant had remediated her deficiencies to the full.

8. At the second review hearing, that panel found that the Registrant’s fitness to practise remained impaired, but considered that she had gained further insight into her deficiencies and decided to impose a Conditions of Practice Order for a period of 18 months.

9. At the third review hearing, the Registrant told the panel that she had applied for Band 5 OT positions but had not yet been successful. The Registrant told that Panel that she continued to work part-time as a support worker at the Alders Clinic, a hospital providing rehabilitation for women with personality disorders and submitted a reference from her manager. She also explained that she had begun another. part-time, role as a relief rehabilitation officer at Great Western Court (GWC), a rehabilitation unit for the elderly. She continued to work as a volunteer for CRUSE bereavement care, which involved its own training, and is studying for a qualification in counselling.

10. The Registrant provided the review panel with reflective case studies, appraisals and supervision records from her work and provided information about training she had undertaken for her roles and of Continuing Professional Development (CPD) training undertaken at the Royal College of Occupational Therapy. The Panel saw certificates attesting to that training, including training on risk assessments for OTs. She had also obtained support and guidance with a senior OT through online sessions, which had helped her reflect on the requirements of risk assessments from an OT perspective.

11. The review Panel acknowledged the proactive approach demonstrated by the Registrant, but noted that she had not worked as an OT and so had not been able to demonstrate remediation in accordance with the conditions which aimed to address the concerns found proved at the initial hearing. In particular, the Panel considered that the Registrant had not been able to provide substantive evidence of assessment observations, clinical reasoning, or treatment planning and observations to a standard commensurate with that expected of an OT. The review Panel observed that obtaining work as an OT assistant may assist the Registrant in re-entering the profession, whilst simultaneously allowing her to undertake the return to practice requirements.

12. The Panel’s conclusion at the third review hearing was that the Registrant remained impaired on both the personal and public components and concluded that conditions of practice remained the appropriate and proportionate order. The Panel made minor amendments to the wording of the conditions to achieve further clarity. The Panel decided to impose the Conditions of Practice Order for a further 12-month period.

Evidence at the fourth review hearing

13. The Registrant gave oral evidence and answered questions from Ms Khorassani and from the Panel. The Panel also took into account her written submission which appeared in the hearing bundles.

14. In summary, the Registrant told the Panel that since the last review hearing she has not worked in an occupational therapy role. She said she has applied for Band 5 occupational therapy posts but has not been successful. She told the Panel it appeared that the restrictions imposed on her registration caused potential employers concern and her applications have been rejected.

15. The Registrant told the Panel that she has done her best to comply with the conditions of practice which were effective. She provided a table showing how she says she has complied with each condition.

16. The Registrant told the Panel are that she successfully applied for the band 4 post of Health and Wellbeing Co-ordinator with the complex care team of Gloucestershire Health and Care NHS Foundation Trust (“the Trust”). She said that she is now taking an integrated approach, utilising occupational therapy skills, counselling and psychotherapy skills for the wellbeing of the service users.

17. The Registrant said that she is also working alongside a Band 6 occupational therapist, LL. LL had agreed to support her with her return to practice and she had arranged regular meetings with LL and AK, professional adviser at the Royal College of Occupational Therapists (RCOT), to achieve this. The Registrant said that she hoped that these efforts would enable her to obtain an occupational therapy post requiring HCPC registration.

18. The Registrant said that she has almost completed the second year of her counselling and psychotherapy course. She said she has passed all her examinations on the first attempt and is awaiting the result of her final assignment and presentation on integration.

19. The Registrant provided the reflective journals completed during her psychotherapy course. She provided an essay on integration together with a case study demonstrating how she has applied occupational therapy knowledge, skills and experience in her role as an integrated therapist.

20. The Registrant also attached certificates relating to CPD from the RCOT and Cruse, together with her supervisor’s report and other relevant documents.

21. The Registrant was asked by the Panel about her understanding of key concerns arising from the original allegations and how she has moved on. She said that she understands that the issues concerned her assessment of patients’ clinical needs and making treatment plans. She has done this in her role as a support worker and now as a health and well-being co-ordinator. The Registrant said that her current roles are different in that as a Band 4, she is required to follow what the Occupational Therapist has decided rather than undertaking the assessment herself.

22. The Registrant was asked what additional training she thinks she needs to meet requirements of a Band 5 post. She said she thought she would need refresher training on all areas because she has not practised as an Occupational Therapist since 2016. She intends to explore this with her new OT supervisor in her current role at the Trust.

23. In relation to the current Conditions of Practice Order, the Registrant was asked when she would complete the required return to practice course. She said she has been working with AK of the RCOT and now also with her manager G. They were all going to work together as a team. The Registrant said that she believes she needs to undertake 60 days refresher training and that she has time, as she works three days per week. She said that G has agreed to contact the OT lead for the Trust but she does not know the outcome yet.

24. When asked what she thought she would need to demonstrate to an employer in job applications for Band 5 in OT roles she said she would have to show that she can work to Band 5 level and that employers would expect a comprehensive answer regarding the risk assessments she would be doing and in respect of decision-making and documenting.

25. The Registrant thought that the core skills for Band 5 level were experience in engaging patients and identifying their needs. She believed she had been able to show these skills in her current roles. She believes her current manager would support her to join the team as an OT. She said that she does not think there is an OT assistant role in the team at the moment The Registrant thought that her role was not the same as an OT assistant but that she did a lot of things an OT assistant would do in her role as a Health and Well-being co-ordinator.

26. The Registrant was asked what OT jobs she has applied for since the last review hearing and she said two, but both applications were unsuccessful. She believed this was because the HCPC restrictions were a barrier.

27. The Registrant confirmed that she has not yet started a Return to Practice Course. She did not have the opportunity in her previous employments, but now it has been agreed. She accepted that she has not completed an OT Personal Development Plan, but referred to reports from her supervisor about her progress which she has submitted. In relation to CPD she has undertaken since the last review hearing, the Registrant said that she attends the regular journal club at RCOT and regular training in mental health forums. She has attended all mandatory training for her roles. She receives RCOT journals regularly.

Submissions

28. Ms Khorassani said that the HCPC’s position in relation to impairment of fitness to practise and any appropriate sanction order was neutral and was left for the application of the judgment of the Panel. Ms Khorassani noted that the Registrant has not yet found employment as an OT and so has not had an opportunity to practise as such and demonstrate remediation while subject to the conditions.

29. The Registrant asked the Panel to take account of her hard work since the last review hearing working towards her goal of being able to practise as an Occupational Therapist without restrictions. The Registrant did not believe her Fitness to Practise was currently impaired.

Decision on Impairment

30. The Panel received and accepted the advice of the Legal Assessor. The Panel was mindful of its powers upon a review of a Conditions of Practice Order under Article 30(1) of the Health Professions Order 2001 and referred to the HCPTS Practice Notes, Review of Article 30 Orders and Fitness to Practise Impairment. The Panel’s task is to conduct a comprehensive review of the current order. The Panel must first decide whether it finds the Registrant’s fitness to practise to be currently impaired by reason of lack of competence. In accordance with the guidance in the case of Abrahaem v GMC [2008] EWHC 183 (Admin), the persuasive burden to satisfy the Panel of fitness to practise at a review hearing is upon the Registrant.

31. The Panel considered the evidence of the Registrant as well as all the detailed documentation which she put before the Panel.

32. The Panel took into account that the Registrant now undertakes several roles, employed and voluntary. She has studied for her psychotherapy/counselling qualification and has undertaken training and CPD. It was evident to the Panel that the Registrant has worked diligently in these matters and she has shown commitment to her current roles. It was not clear to the Panel that the training undertaken had remediated the failures. In addition, the Panel was disappointed that the Registrant has told the Panel that she has only applied for two positions as an OT, both of which were unfortunately unsuccessful, within a 12 month period. This has meant that a number of the current conditions have not come into effect, as they only do so once the Registrant commences an OT role. Accordingly, she has not been able to work on the competencies and skills required to demonstrate to the Panel her fitness to practise as an OT. The Panel was also disappointed that the Registrant had not applied for an OT assistant role as recommended by the previous reviewing panel.

33. The Panel was also disappointed that the Registrant has not progressed with completing the Return to Practice course required by condition 1. The Registrant told the Panel today that she expects shortly to have a route to achieving this via her current employment with the Trust. She has therefore not complied with condition 1, which given her now long period out of OT practice since 2016, is a necessary prerequisite to achieving fitness to practise.

34. The Panel also remained concerned about the level of insight shown by the Registrant. When asked how she now reflects upon the allegations in her case, she demonstrated that she had gained understanding about the clinical issues raised, and has worked on remedying these in her current roles as far as she is able. However, the Panel was concerned that she did not demonstrate a clear understanding of the impact of the proven concerns upon patients and clients or upon her professional colleagues. This aspect was highlighted at the last review. When asked by this Panel about what she would need to demonstrate to an employer when applying for a Band 5 role, the Registrant did not refer to the need to demonstrate autonomous and safe practice.

35. In the light of the above, the Panel concluded that the Registrant’s insight has not developed significantly further since the last review hearing when the review panel said that she was “continuing to develop insight into her previous lack of competence and the impact of it upon service users and colleagues, as well as upon public confidence in her and the profession”.

36. This Panel therefore remained concerned that the Registrant has not yet fully recognised how to remediate her failings and has therefore not yet achieved complete insight into her lack of competence.

37. The Panel was mindful that the position remains that the Registrant has still not worked as an OT and therefore has not been able to demonstrate her remediation in line with the conditions which are specifically targeted at addressing the concerns found proved.

38. The Panel took the view that in the absence of working pursuant to the conditions, the Registrant has not demonstrated targeted and focused remediation. In particular, the Registrant was not able to provide the substantive evidence of assessment observations, clinical reasoning, or treatment planning and observations to a standard commensurate with that expected of an OT and required by the conditions imposed by previous panels.

39. This Panel agreed with the previous panel that, whilst the manner in which the Registrant seeks to address the concerns is a matter for her, it seemed to the Panel that obtaining work as an OT assistant could assist the Registrant in re-entering the profession, as well as simultaneously allowing her to undertake the return to practice requirements.

40. Therefore, without being tested in the OT environment, which has its own particular demands and responsibilities which are substantively different to the roles which the Registrant currently undertakes, and in light of the length of time during which the Registrant has not practised as an OT, the Panel concluded that there remains a real risk of repetition of the original concerns. Therefore, the Registrant’s fitness to practise remains impaired on the basis of the personal component.

41. The Panel was also of the view that in light of the wide-ranging lack of competence found proved, and the lack of sufficient evidence of remediation, the need to uphold proper professional standards and to maintain public confidence in the profession would be undermined if a finding of impairment were not made.

42. Thus the Panel found that the Registrant remains impaired on both the personal and public components.

Decision on Sanction

43. The Panel next went on to consider sanction and took into account the HCPC Sanctions Policy. The Panel bore in mind that sanction is a matter for its own independent judgement and that the purpose of a sanction is not to punish the Registrant. Any sanction must be proportionate, so that it is the least restrictive order necessary to protect the public interest.

44. The Panel first considered taking no action. The Panel concluded that, in view of the lack of sufficient remediation, it would be inappropriate to take no action. It would be insufficient to protect the public and maintain public confidence and uphold the reputation of the profession. The Panel concluded that a Caution Order would be inappropriate and insufficient for the same reasons.

45. The Panel next considered a Conditions of Practice Order. It carefully considered the conditions which are currently in place. The Panel considered that the current conditions are explicit as to what is required of the Registrant, but was concerned that the Registrant had not fully addressed them. The Panel made some further amendments and additions in order to ensure that the requirements with which the Registrant must comply are clear and comprehensive. The overall intention of the conditions has not changed.

46. The Panel was satisfied that the revised conditions are appropriate and proportionate, and balance the need to protect the public and the public interest, as well as allowing the Registrant to practise safely.

47. The Panel considered whether it should impose a suspension or a striking off order in this case. The Panel was concerned that since the last review hearing the Registrant does not appear to have focused her considerable work and efforts on meeting the specific terms of the conditions imposed by the previous panel in an OT setting. However, following very careful consideration, the Panel decided that, at this point, suspension or striking off would be disproportionate. However, the Panel wished to emphasise to the Registrant that she must now ensure she reads the amended conditions carefully and from this point works towards complying with them in preparation for the next review.

48. The Panel decided to impose the Conditions of Practice Order for a further 9 months, to begin when the current Order expires. The Panel considered that this shorter period would reinforce to the Registrant the priority she now needs to give to meeting the conditions in order to demonstrate her competence and fitness to practise as an OT to the next reviewing panel.

Order

Order: The Registrar is directed to annotate the HCPC Register to show that for 9 months from the date that this Order takes effect, you, Ms Victoria V Asirvatham, must comply with the following conditions of practice:

1. Before practising 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, who must be an OT registered by the HCPC or other appropriate statutory regulator, and supply details of your supervisor to the HCPC within one month of beginning in a post as a Registered OT.

3. You must receive clinical supervision from a Registered OT and follow their advice and recommendations, and supply details of your clinical supervisor to the HCPC within one month of beginning in a post as a Registered OT.

4. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

5. 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).

6. You must meet with your registered OT supervisor on a monthly basis:

(a) to formulate and document 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; and

(b) to document monthly progress against each of the above areas in the Personal Development Plan.

7. Within three months of beginning in a post as a Registered OT you must forward a copy of your Personal Development Plan, including the monthly progress updates, to the HCPC.

8. You must allow your OT supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

9. You must:

(a) Develop and submit at least 3 relevant case studies arising from your work which cover the OT therapy process in respect of conducting observations; conducting assessments; devising written clinical reasoning, treatment planning and evaluation and demonstrating good documentation; and

(b) You must submit a reflective piece which addresses the above areas of OT practice and sets out your progress in application and learning to the HCPC on a monthly basis, or confirm that there have been no such occasions in that period, the first reflective piece or confirmation to be provided within one month of your beginning in a post as a Registered OT.

Notes

The Order imposed today will apply from 30 September 2022.

Hearing History

History of Hearings for Mrs Victoria V Asirvatham

Date	Panel	Hearing type	Outcomes / Status
31/05/2023	Conduct and Competence Committee	Review Hearing	Hearing has not yet been held
01/09/2022	Conduct and Competence Committee	Review Hearing	Conditions of Practice
03/09/2021	Conduct and Competence Committee	Review Hearing	Conditions of Practice
27/02/2020	Conduct and Competence Committee	Review Hearing	Conditions of Practice
20/02/2019	Conduct and Competence Committee	Review Hearing	Suspended