Miss Jennifer Carlaw

Profession: Speech and language therapist
Registration Number: SL32091
Hearing Type: Review Hearing
Date and Time of hearing: 10:00 09/02/2022 End: 17:00 09/02/2022
Location: Virtual hearing - Video conference
Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

Please note that the decision can take up to 5 working days to be uploaded onto the HCPTS website. Please contact one of our Hearings Team Managers via tsteam@hcpts-uk.org or +44 (0)808 164 3084 if you require any further information.

 

Allegation Finding Order Notes Hearing History

Allegation

Allegation as proven at the final hearing:

While registered as a Speech and Language Therapist, and working at East Kent Hospitals University NHS Foundation Trust:

1. With regard to Patient 1, on or around 23 October 2017, you:

a) Did not consider and/or seek advice from a senior practitioner and/or nurse as to whether undertaking a speech and language therapy assessment was appropriate and/or did not record doing so;

b) Did not undertake and/or record an oro-motor assessment.

c) Contacted the patient’s son regarding food and drink preferences when it was not appropriate to do so.

d) Gave Patient 1 a wet teaspoon despite the patient’s medical notes indicating that no oral intake should have been attempted.

e) Did not check whether suctioning equipment was available prior to your session with Patient 1.

f) Did not record accurate and/or adequate notes in respect of your session with Patient 1.

g) Acted outside the scope of your practice, in that you recorded your conclusion as to Patient 1’s cause of death.

h) Did not seek advice from a senior colleague following your session with Patient 1.

2. With regard to Patient 2, on or around 4 April 2017, you:

a) Undertook an assessment when it was not appropriate to do so.

b) Did not escalate Patient 2 to a senior Speech and Language Therapist.

c) Acted outside the scope of your practice, in that you performed suctioning on Patient 2.

3. With regard to Patient 3, on or around 26 September 2017, you:

a) Did not adequately and/or accurately record the advice given to you by a senior colleague.

b) Recommended that Patient 3 could have sandwiches, but with accepted risk which was not clinically justified and/or in accordance with the advice of a senior Speech and Language Therapist.

c) Did not keep adequate and/or accurate records;

4. When assessing Patient 4, on or around 25 September 2017, you:

a) Did not use an appropriate communication test;

b) Did not keep adequate and/or accurate records.

5. The matters set out in paragraphs 1-4 constitute misconduct and/or lack of competence.

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

Finding

Preliminary Matters
 
Service
 
1. The Notice of Hearing was sent to the Registrant, by email,  to her email address, on the 7 January 2022. The HCPC wrote to the  Registrant  again on 19 January 2022.
 
2. The Registrant’s Solicitors, BLM, wrote to the HCPC on 8 February 2022 to state that the Registrant would not be attending today’s hearing nor would she be represented. 
 
3. In light of the  factors set out  above, the Panel is satisfied that the Registrant has had Notice of today’s hearing.
 
Proceeding in the absence of the  Registrant
 
4. Ms Welsh  applied  for the hearing to proceed in the absence of the Registrant. 
 
5. The Panel  accepted the  advice of  the Legal Assessor  and took into account the HCPTS Practice Note on “Proceeding in the Absence of the  Registrant”.
 
6. In deciding whether to  proceed in the  absence of the  Registrant, the  Panel  took into account the  following factors:-
 
• The Registrant was aware of the hearing date.
• Her solicitors wrote to the HCPC’s yesterday,  stating that she  would not be attending nor would she be  represented.
•   There was no request for an adjournment of the hearing. There was  no evidence that the Registrant would attend a hearing on a future occasion. 
•   This is a mandatory  hearing  and it is necessary for  the protection of the  public for  the hearing to  go ahead. The Order is due to expire on  6 March 2022.
 
7. In light of the  factors set out above, the  Panel has concluded that the  Registrant has  voluntarily absented herself and that no useful purpose would be served by an adjournment.  It found that  it is proportionate and in the interests of justice for today’s hearing to  proceed.
 
Background 
 
8. Following her graduation from University after studying psychology, the Registrant obtained employment in a special needs nursery where she worked as a learning assistant, and subsequently as a speech and language assistant. Her application to study speech and language therapy in order to become a Speech and Language Therapist (“SLT”) was supported by that employer. The Registrant completed her post- graduate diploma in speech and language therapy in 2013. During that training she completed three placements, one of which was undertaken with the East Kent Hospitals University NHS Foundation Trust (“the Trust”).
 
9. The Registrant commenced employment as a Band 5 SLT with the Trust on 1 September 2014. She was based at the Queen Elizabeth the Queen Mother Hospital in Margate (“the Hospital”). The Registrant’s employment continued until she submitted her resignation on 10 October 2017. Her last official working day was 7 November 2017, but she was on sick leave for some of the period between the submission of the resignation and the end of the employment.
 
10. The line management and formal supervision of the Registrant by JH from November 2016 will be described below when the Panel explains the role of the witnesses who attended the hearing to give evidence. However, before that date the supervision of the Registrant had been, at best, patchy, and for lengthy periods non-existent. By May 2017 JH had begun to notice significant concerns about the Registrant’s practice. This resulted in JH instigating an informal performance review from 24 May 2017 that lasted until 29 August 2017. An action plan was set up under this informal procedure. When  it was believed that the informal procedure had not achieved the goals set, a formal review meeting was scheduled for 29 September 2017 in line with the Trust’s HR Guidance for Performance Reviews. A further action plan was set under the formal procedure. The Registrant submitted her letter of resignation on 10 October 2017.
 
11. The incidents alleged in respect of the four patients, as reflected in the four principal particulars being considered by the Panel, are not advanced in chronological order. Listed in chronological order, the incidents are as follows:
 
• Patient 2, on or around 4 April 2017.
• Patient 4, on or around 25 September 2017.
• Patient 3, on or around 26 September 2017.
• Patient 1 on or around 23 October 2017.
 
The substantive hearing
 
12. At the substantive hearing, the panel found all of the  facts proved.
 
13. Although the Registrant did not attend the  substantive hearing, she provided a  statement, dated 28 January 2020, in which she accepted most of the  allegations against her. 
 
14. The panel at the substantive hearing found that the incidents, both individually and taken together, amounted to misconduct. In so doing, the panel found that the:-“knowledge and skills  required to  act appropriately with regard  to each  patient were fundamental. None  of them  was unusual or specialised and the  failings were serious”.   
 
15. The decision continued: “For the avoidance of doubt, there were no factual particulars that the Panel considered to be too insignificant to be included in this finding. Furthermore, the Panel was satisfied that no issue of lack of competence arises”.
 
16. The panel  found breaches  of the HCPC Standards of Conduct Performance  and Ethics, in respect  of  standards 2.3, 2.6, 3.1 & 3.2 6.1, 6.2 &10.1.
 
17. In relation to impairment, the panel found that the Registrant was impaired  in respect of both  the private  and public component. 
 
18. In respect of the  personal component, the panel noted:-
 
• The witnesses called by the  HCPC accepted  that the  Registrant was  hard working, caring and had a genuine regard for her patients and wished to advance their interests.
• The Registrant had shown some insight and had admitted many of the  failings found proved. 
• There was a likelihood of repetition  as the  Registrant had not been working and she would need  to undergo training and supervision, if she were to return to work.
 
19. In respect of the public component, the panel found that the public “would be dismayed if a practitioner against whom these serious findings have been made, and who has not remediated the shortcomings, were to be permitted to return to practise without restriction. Furthermore, if the Panel did make  a finding of current impairment of fitness to practise it would be failing in its obligation to declare and uphold proper professional standards”.
 
20. The panel imposed a two year Conditions of Practice Order which included  the  following conditions:
 
1. You must not accept any offer of employment for which your HCPC registration is required unless the post to which you would be appointed offers you weekly face to face supervision until such time as your Newly Qualified Practitioner (“NQP”) Competencies are signed off as having been met by your supervising SLT who must be working at Band 7 or above.
 
2. You must not work alone with the following categories of patients:
 
• patients with dysphagia;
• patients with acute onset;
• end of life patients; and,
• patients with tracheostomies.
 
To the extent that you need to see patients falling into these prohibited categories in order to satisfy competencies, you are to shadow and/or be directly supervised by a practitioner working at Band 7 or above.
 
3. You are to attend and satisfactorily complete a Royal College of Speech and Language Therapists (“RCSLT”) accredited course on dysphagia.
 
4. You are to successfully complete the RCSLT NQP Competencies, starting that task afresh.
 
5. You are to successfully complete the RCSLT Dysphagia Training Competency Framework at Level B.
 
6. You are to complete a significant event analysis, using the RCSLT CPD Toolkit, in relation to the four patients concerned in this case.
 
7. You must provide not less than 28 days before the date of the review of this Order, the following documents:
• A certificate of completion of the course required to be undertaken by condition 3.
• Proof that your RCSLT NQP Competencies have been signed off by your supervising SLT.
• A certificate of completion of the Dysphagia Training Competency Framework at Level B required by condition 5.
• Copies of the significant event analyses required by condition 6.
• A report from your supervisor commenting specifically on your progress since this Order was made and your readiness to practise without restriction.
• Your CPD portfolio, demonstrating adherence to the five HCPC’s CPD standards.
 
8. You must promptly inform the HCPC if you take up any employment for which your HCPC registration is required.
 
9. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.
 
10. 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).
 
Today’s Hearing
 
21. The Registrant  did not file any evidence for today’s hearing. Her solicitor  wrote  two  letters  to the  HCPC yesterday.  The first letter  began  in the following manner:-
 
“We are the solicitors instructed on behalf of Jennifer Ward (neé Carlaw) in respect of this matter. We have been on record with the HCPC as acting for Ms Ward since prior to the Investigating Committee stage and we acted on her behalf at the time of the Conduct and Competence Committee hearing. We are therefore extremely disappointed that you wrote directly to our client to provide her with notice of the upcoming review scheduled for 9 February 2022 without copying your correspondence to us”.
 
22. The letter  went on to state that the  Registrant has not  worked as a Speech and Language Therapist. It continued that the  Registrant  considered it “ unlikely  that she will wish to return  the profession of Speech and Language therapy”   The Registrant’s solicitor stressed that  the Registrant  meant no disrespect to  the Panel  by her  failure  to comply with  the Conditions  of Practice  or her failure to attend today’s hearing.
 
23. The second letter  stated that  the Registrant wished to make it plain  that her failure to comply with any of the conditions imposed by the previous panel  was not intended  as disrespect for the  earlier findings.   It continued  that she “acknowledges that there were failures  in her practice and is wholly understanding of  the conditions  that she would need to meet in order to practice”.
 
Submissions
 
24. The Panel heard submissions from Ms Welsh. She invited the Panel  to find that the Registrant’s fitness to practice remained impaired. She said that the Registrant had not addressed any of the failings found at the substantive hearing. The Registrant  had not worked since November 2017, and it therefore followed that,  she remained impaired in respect of both the private and  public component. 
 
25. Ms Welsh  invited the  Panel to  extend  the  current Conditions of Practice Order  for a further 12 months. She  stated that the Registrant could use this  period to  consider her position, either to take steps to  recommence her practice and begin to meet the conditions,  or to apply for Voluntary Removal from the  Register.
 
26. The Panel heard and accepted the advice of the Legal Assessor.
 
27. In reaching its decision, the  Panel has  considered that  this is a mandatory review  under Article 30 (1) of the Health and Social Work Professions Order 2001 (The Order). The Panel is aware that the process under Article 30 (1) of the Order is one of review and not one of appeal. Its function is to determine whether the Registrant’s fitness to practice is still impaired, and, if so, whether the  Conditions of  Practice  Order under review remains the appropriate and proportionate means of public protection or should be varied or replaced by some other Order.
 
28. The Panel first considered  whether  the Registrant’s  fitness to practise remains impaired.  It has taken account the submissions made by Ms Welsh, and has  noted that  the Registrant has not worked since November  2017. The Registrant has not  complied with any of the  conditions imposed by the previous panel. In light of these factors, the Panel has concluded that the Registrant’s fitness to practise remains impaired. 
 
29. Through her  solicitor  the Registrant  has acknowledged that  the conditions imposed by  the substantive hearing panel were necessary and appropriate.  She has acknowledged that  there were significant failings in  her practice. In light of  this, the Panel has concluded that, in all the circumstances, a restriction on the Registrant’s ability to practise is still necessary in order to protect service users and also to sustain public confidence in the profession of  Speech and Language therapy and in the HCPC as its Regulator.
 
30. In considering the appropriate sanction, the Panel had regard to the Sanctions Policy (SP) published in March 2019, and accepted  the  advice of the Legal Assessor. The Panel has applied the principle of proportionality. 
 
31. The Panel is aware that the purpose of sanction is not to be punitive  but that it must consider the risk the Registrant may pose to service users in the future and determine what degree of public protection is required. 
 
32. The Panel has considered the sanctions available in ascending order of severity. The Panel considered that to take no action or to impose a Caution Order would not be sufficient or appropriate, as neither outcome would afford the necessary public protection or satisfy the public interest.
 
33. The Panel next considered whether a Conditions of Practice Order would be proportionate. It noted that  the Registrant has not  practised since  the end of 2017 and has not complied with  any  of the Conditions of Practice imposed by the last panel. The HCPC invited the  Panel to extend the current order, which it deemed sufficient to protect the public.
 
34. As the  Registrant has  not practised  for a long time, and has not taken steps to  begin to  remediate over the  last two years,  the Panel considered whether the Conditions of Practice Order imposed by  the panel at the  substantive hearing was  still appropriate, and proportionate. 
 
35. The conditions imposed by the panel, who heard the substantive appeal   were stringent and involved considerable refresher training. The decision to impose a Conditions of Practice Order  was made  because the   Registrant had shown insight into her failings  and was considered by her colleagues to be  hardworking, wishing to advance the interests of her patients and caring. There were questions over the adequacy  of  the supervision that she had received, and the panel found that  her failings were remediable with training.
 
36. The real issue today  is whether  the  Registrant  wishes to  return to practice as a Speech and Language Therapist. It is also aware that she has indicated that she is  unlikely to  return to work as a Speech and Language therapist.  It is  regrettable that the HCPC did  not  send the  Notice of Hearing to her solicitor, on 7 January 2022. It is unclear whether the Registrant had full legal advice before today’s hearing and the Panel wish to ensure that she is not prejudiced  by this.  
 
37. Having balanced all of the competing interests, the  Panel has concluded  that  the current  order is sufficient to  protect the public.  It finds that  notwithstanding, the  fact that the Registrant  has not worked or attempted to take practical steps to update her knowledge, that it should maintain  the status quo. The Registrant should use the  next 12 months to consider her position. If she no longer wishes  to  remain on the  Register, she  should seek advice from her solicitor and take steps  to apply  for voluntary  removal. In the  event that  the  Registrant decides that  she does wish  to return to practice, the conditions imposed by the  previous panel are sufficiently stringent to  protect the public. In conclusion,  the  Conditions of  Practice  Order under review remains the appropriate and proportionate means of public protection.
 
38. The  Panel therefore extends the current Conditions of Practice Order for a period of 12 months.

 

Order

The Registrar is directed to extend the Conditions of Practice Order against the registration of Jennifer Carlaw (now Jennifer Ward) for a further period of 12 months on the expiry of the existing order.

Notes

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 Jennifer Carlaw

Date Panel Hearing type Outcomes / Status
09/02/2022 Conduct and Competence Committee Review Hearing Conditions of Practice
03/02/2020 Conduct and Competence Committee Final Hearing Conditions of Practice
;