Mr Iain R St Leger

Preliminary Matters

Application for parts of the hearing to be heard in private

1. During the course of his submissions, the Registrant made references to his health and it was indicated to him that it was appropriate that such matters should be heard in private in order to protect his private life. The Registrant agreed to that course and Mr Anderson supported the position.

2. Having heard and accepted the advice of the Legal Assessor, the Panel decided to hear in private those parts of the hearing which related to his health. It was satisfied that to do so was justified in order to protect the Registrant’s private life.

Background

3. The Registrant is an Occupational Therapist, who registered with the HCPC in 2005.

4. On 21 June 2023, the HCPC received a referral from Ms AW, the Deputy Team Manager of the North Hertfordshire Adult Disability Team. In her referral, she advised that the Registrant had worked in the Adult Disability Team at Hertfordshire County Council (the Council) between October 2022 and June 2023. She advised that in May 2023, she had undertaken an audit of five cases which she had allocated to him and discovered that no case notes of assessments had been undertaken by the Registrant.

5. On 2 August 2024, a subsequent referral was received from the Council, advising that following the Registrant’s departure on 2 June 2024, a wider audit of the Registrant’s cases was undertaken. The results of the audit identified further alleged inadequacies with the quality of work and issues with record keeping. The concerns raised in both of the referrals included that the Registrant had recorded work that had not been undertaken.

6. On 1 September 2023, a panel of the Investigating Committee (ICP) was convened to consider whether an Interim Order was necessary on the grounds of public protection and public interest. It imposed an Interim Suspension Order for a period of 18 months.

7. On 11 April 2024, an Interim Order review hearing was conducted, to determine whether the Interim Order remained necessary on the grounds of public protection and public interest. The Registrant attended that review and made oral submissions. During the course of his oralsubmissions, he denied that he had been working as an Occupational Therapist whilst on the Interim Suspension Order.

8. Following his departure from the Council, the Registrant was employed as an Occupational Therapist by the Government of Jersey from 5 June 2023 to 1 May 2024.

9. On 8 May 2024, the Registrant sent an email to the HCPC stating:
“I have continued to work as an Occupational Therapist despite being suspended. My current role was not made aware of this. I have worked with them since September 2023. I have now stopped working for them after they found out.”

Decision on Facts
Evidence

10. In advance of the hearing the Panel was provided with a bundle of witness statements and exhibits, which included the following:

a) The HCPC Case summary, dated 31 March 2025;

b) A witness statement, dated 6 March 2024, from Ms AW, a qualified Occupational Therapist and Deputy Team Manager of the North Hertfordshire Adult Disability Team. She was involved in interviewing the Registrant for the Occupational Therapist role at the Council in October 2022, and having been successful, he was allocated to the East Hertfordshire and Broxbourne Adult Disability Team Manager (the Broxbourne Team). In February 2023, following a review of the waiting lists across the teams, she allocated five cases to the Registrant from her team as they needed some support. Her evidence was to the effect that in May 2023, she carried out an audit on the five cases she had allocated to the Registrant and discovered that on four of the five cases, he had either failed to carry out home visits as required and/or complete reports. The cases were: Service User H (Schedules B and C), Service User M (Schedules B and C), Service User R (Schedules B, C and D) and Service User S (Schedule D);

c) A witness statement, dated 29 February 2024, from Mr IL, a registered Social Worker, who at the relevant time was employed by the Council as the Team Manager in the Broxbourne Team. The Registrant was under his management tree, although he was collectively managed by all the Occupational Therapists in the team;

d) A witness statement, dated 14 March 2024, from Ms SPM, who was an Advanced Practitioner Occupational Therapist within the Broxbourne Team. She was involved in the subsequent audit of 13 cases allocated to the Registrant, which was conducted once he had left the Council. Her evidence was to the effect that in respect of each of the cases, nothing had been done, in that the Registrant had failed to carry out home visits as required and had failed to complete reports and assessments;

e) A witness statement, dated 14 March 2023, from Ms KN, the Registered Manager at Popis Gardens and West Essex (the Popis Home), an assisted living residence that supported people with independent living. Her evidence was to the effect that the Registrant had not visited either Service User LB or Service User HS in the Popis Home in December 2022 or on any other date;

f) A witness statement, dated 26 February 2024, from Service User DR. His evidence was to the effect that in August 2022, he had made a self-referral to Hertfordshire Social Care requesting an assessment by an Occupational Therapist. His evidence was to the effect that the Registrant had not visited his home to conduct an assessment between February and March 2023 or at any other time, and nor had he ever heard the Registrant’s name;

g) A witness statement, dated 29 February 2024, from Mr DJ, the Care Team Manager at Hertfordshire Home for Petersell House (the Petersell Home). His evidence was to the effect that the Registrant had not attended Service User AM at the Petersell Home between February and March 2023;

h) A witness statement, dated 5 March 2024, from Mr PG, the father of and carer for Service User GG since his birth. His evidence was to the effect that the Registrant had not visited Service User GG between January and March 2023, nor had he previously heard the Registrant’s name;

i) A witness statement, dated 22 May 2024, from Ms EE, a Senior Occupational Therapist employed at the relevant time by the Government of Jersey within the Mental Health Directorate. Her evidence confirmed that the Registrant was employed by the Government of Jersey from 5 June 2023 to 1 May 2024 as a locum Occupational Therapist and she was his line manager. Her evidence was to the effect that the Registrant had been placed with the Government of Jersey by an Agency and she did not know that he was subject to regulatory proceedings until 1 May 2024, when the Registrant told her that a complaint had been raised about him and he requested a reference. Her evidence was that as his line manager she reviewed his work and checked his records and there were no concerns with his practice;

j) A witness statement, dated 6 June 2024, from Mr JC, who, at the relevant time was employed as the Head of Healthcare at Archer Resourcing Agency. His evidence was to the effect that the Registrant first contacted the Agency on 21 April 2023 in response to the Government of Jersey post of locum Occupational Therapist, and the Registrant was offered and accepted the post on 5 June 2023. He confirmed that the Agency did not know that the Registrant was subject to regulatory proceedings or that his practice was subject to an Interim Suspension Order until 1 May 2024, when informed by the Government of Jersey;

k) Copies of the case notes, reports and assessments in respect of each of the Service Users listed in Schedules A, B, C and D;

l) A copy of the table setting out the audit results conducted on the Registrant’s cases;

m) Relevant email correspondence;

n) A copy of the Registrant’s job description at the Council

o) The Registrant’s completed response pro-forma, dated 5 November 2024; and

p) A copy of the Registrant’s statement in respect of the allegations, prepared by him in July 2024.

Admissions

11. At the outset of the hearing, the Hearings Officer read out the particulars of the Allegation. After each factual particular had been read out, the Registrant was invited to indicate whether or not he admitted it. Through this process, the Registrant indicated that he admitted each of the factual particulars.

12. The Panel heard and accepted the advice of the Legal Assessor as to the standing of the Registrant’s admissions. She drew the Panel’s attention to the HCPTS Practice Note on Admissions (October 2024) and specifically the importance of not accepting any admissions unless satisfied that they were unequivocal. In particular, the Legal Assessor highlighted paragraph 13, which states:
In considering its approach to admissions, particularly admissions from registrants who are not represented, a panel must ensure that the overall fairness of the proceedings is secured. Panels will therefore want to ensure that, by way of example:

a) a registrant's admission is 'unequivocal' and that they are not making an admission for reasons of expediency or on some other inappropriate basis;
b) if a registrant admits an inference to be drawn from facts (for example, dishonesty or sexual motivation) the panel is satisfied that the registrant understands the legal test to be applied to that alleged fact;
c) a registrant understands that an allegation framed in terms of a ‘failure' to do something requires proof by the HCPC, or acceptance by the registrant, of a corresponding duty.

13. The Panel retired to consider whether the Registrant’s admissions were unequivocal, and therefore, whether to accept them so as to find the facts proved. The Panel noted from the transcript of the Interim Order Review on 11 April 2024, that it was clarified that the allegations in respect of Hertfordshire County Council related to 17 service users, and the Registrant, in his oral submissions, confirmed that he understood that the Hertfordshire County Council allegations related to 17 service users. The Panel noted that the Investigating Committee Panel (ICP) determined a case to answer on 16 August 2024 in respect of both the Hertfordshire County Council allegations and the practising in breach of an Interim Suspension Order allegations.

14. The Panel considered that the Registrant, although unrepresented, had had a significant amount of time to consider and understand the allegations. It noted that he had previously admitted them in the HCPC’s response pro-forma document, sent to the Registrant in advance of this Final Hearing. The Registrant had answered ‘yes’ in answer to the questions of whether he admitted the factual allegations, and had signed and dated that document on 5 November 2024. The Panel noted that he had not raised any specific points or mitigation in either the written response pro-forma or when the allegations were read out to him, which might raise concerns that his admissions were equivocal.

15. In all the circumstances, although the Registrant was unrepresented, the Panel was satisfied that it could accept his admissions to the factual allegations. Accordingly, the Panel found each of the factual particulars proved by reason of the Registrant’s admissions.

Decision on Grounds

16. Mr Anderson, on behalf of the HCPC, took the Panel through the HCPC case summary, and directed the Panel’s attention to the relevant case law in respect of both misconduct and lack of competence.

17. The Registrant accepted that the facts found proved amounted to misconduct and that his work in the relevant period at Hertfordshire County Council, based on the information provided, had been substandard. He advised the Panel that his health at that time had affected him and he did not think he had the right support or adequate training, particularly on the computer system. He explained that with hindsight he recognised he should have sought support, but had not felt confident to seek it; he had felt intimidated and therefore left, but had not felt comfortable letting them know he was leaving.

18. The Panel heard and accepted the advice of the Legal Assessor. In relation to misconduct, she advised the Panel in respect of a number of cases, including Roylance v GMC (No. 2) [2000] 1 AC 311. The Legal Assessor advised that for conduct to amount to professional misconduct, it must fall short of what would be expected in the circumstances and that such a falling short must be serious and fall far below the expected standards. The Legal Assessor advised that the question of whether or not the facts found proved amounted to misconduct as alleged, was a matter for the Panel’s professional judgement.

19. In relation to lack of competence, the Legal Assessor cited the cases of Calhaem v GMC [2007] EWHC 2606 (Admin) and Holton v GMC [2006] EWHC 2960 (Admin).

20. In relation to lack of competence, which was alleged in particulars 1.a and 1.b as an alternative to misconduct, the Panel did not consider that these admitted facts amounted to a lack of competence on the Registrant’s part. It was clear from the information provided by the Registrant regarding his career, that he had qualified in 2005 and no concerns had been raised before his time at Hertfordshire County Council. Furthermore, the evidence from his line manager, Ms EE at the Government of Jersey, where the Registrant worked after leaving the Council, indicated that he had been practising as an Occupational Therapist without concerns being raised about his practice. Accordingly, the Panel did not consider that this was a case regarding the Registrant’s competence.

21. The Panel next went on to consider whether the facts admitted and found proved amounted to the statutory ground of misconduct. In relation to each of the factual particulars, the Panel considered whether the Registrant had breached any of the Standards of Conduct, Performance and Ethics (the Standards) in existence at the time. It bore in mind that the relevant Standards were those from 2016.

22. In relation to particulars 1.a and 1.b and corresponding Schedules A and B, the Panel bore in mind that these related to repeated failures to communicate with vulnerable Service Users, requiring the services of the Adult Disability Team, in a timely manner or to conduct home visits at all. The Panel considered that these failures breached the following Standards:

1 – Promote and protect the interests of service users and carers

Treat service users and carers with respect
1.1 – You must treat service users and carers as individuals, respecting their privacy and dignity.
1.2 – You must work in partnership with service users and carers, involving them, where appropriate, in decisions about the care, treatment or other services to be provided.
2 – Communicate appropriately and effectively

Communicate with service users and carers
2.2 – You must listen to service users and carers and take account of their needs and wishes.
2.3 – You must give service users and carers, the information they want or need, in a way they can understand.

Work with colleagues
2.5 – you must work in partnership with colleagues, sharing your skills, knowledge, and experience where appropriate, for the benefit of service users and carers.
2.6 – You must share relevant information, where appropriate, with colleagues involved in the care, treatment, or other services provided to a service user.
6 – Manage Risk

Identify and minimise risk
6.1 – you must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible.
10 – Keep records of your work

Keep accurate records
10.1 – you must keep full, clear, and accurate records for everyone, you care for, treat, or provide other services to.
10.2 – you must complete all records, promptly and as soon as possible, after providing care, treatment or other services.

23. The Panel considered that the Registrant’s repeated failures in respect of particulars 1.a and 1.b were serious in that they breached a number of the Standards and would have placed Service Users at real risk of significant harm. It noted that his actions at particular 1.b were carried out dishonestly. In all the circumstances, the Panel considered that particulars 1.a and 1.b fell far below the standards expected of an Occupational Therapist and amounted to misconduct.

24. In relation to particular 1.c, the Panel considered that the repeated falsification of reports and case entries was to cover up the Registrant’s lack of communication with, or home visits to, a number of vulnerable Service Users, which was dishonest. The Panel considered that this conduct breached the following Standards:

9 – Be honest and trustworthy

Personal and professional behaviour
9.1 – you must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
10 – (see above)

25. The Panel considered that the Registrant’s repeated dishonest falsification of records was serious in that it breached a number of the Standards, including the fundamental requirement to act honestly. The lack of accurate records, in the Panel’s judgement, may also have compromised continuity of care and misled other practitioners, potentially placing Service Users at risk of harm. In all the circumstances, the Panel considered that particular 1.c fell far below the standards expected of an Occupational Therapist and amounted to misconduct.

26. In respect of particular 2.i, 2.ii and 2.iii, the Panel considered that the repeated failures to work on agreed actions following the identification of risk, breached the following Standards:
1, 1.1, 1.2, 6 and 6.1 – (see above)

27. The Panel considered that the Registrant’s repeated failures in respect of particular 2.i, 2.ii and 2.iii were serious in that they breached a number of the Standards and would have placed Service Users at real risk of significant harm. In all the circumstances, the Panel considered that particulars 2.i, 2.ii and 2.iii fell far below the standards expected of an Occupational Therapist and amounted to misconduct.

28. In respect of particular 3, the Panel considered that the period for which the Registrant had worked whilst subject to an Interim Suspension Order amounted to some eight months (between September 2023 and May 2024). The Panel considered that the Registrant had breached the following Standards:
9 and 9.1 – (see above)

29. The Panel considered that this breach of the Standards was serious. It was of the view that this was a significant period of time over which the Registrant had dishonestly acted contrary to the HCPC’s regulatory process aimed at protecting the public from risk of harm. In all the circumstances, the Panel concluded that particular 3 fell far below the standards expected of an Occupational Therapist and amounted to misconduct.

30. In respect of particular 4, the Panel bore in mind that the Registrant had, on 11 April 2024, told the panel of the Investigating Committee at the Interim Order review that he was not working as an Occupational Therapist. It noted that by this point he had been working at the Government of Jersey since 5 June 2023 and by the time of the review, had been working in breach of the Interim Suspension Order for some seven months. The Panel considered that the Registrant had breached the following Standards:
9 and 9.1 – (see above)

31. The Panel considered that this breach of the Standards was serious. It was of the view that he had sought to dishonestly mislead the reviewing panel that was conducting a risk assessment aimed at protecting the public. In all the circumstances, the Panel concluded that particular 4 fell far below the standards expected of an Occupational Therapist and amounted to misconduct.

32. In respect of particular 5, the Panel considered that the Registrant’s failure to inform his next employer, the Government of Jersey, of the HCPC proceedings and Interim Suspension Order imposed on his practice, was serious. It considered that his actions breached the following Standards:
9 and 9.1 – (see above)

33. The Panel considered that this breach of the Standards was serious. It was of the view that the Registrant omitted to provide his employer with all the relevant information so that it could make an informed decision as to his employment, given that he was not permitted to practise as an Occupational Therapist from 1 September 2023. In all the circumstances, the Panel concluded that particular 5 fell far below the standards expected of an Occupational Therapist and amounted to misconduct.

34. In relation to the dishonesty at particular 6, the Panel noted that it had already considered the dishonesty and how it specifically impacted each of particulars 1. b, 1.c, 2, 3 and 4. In addition, the Panel noted that the dishonesty related to multiple areas, arising both in respect of the Registrant’s practice at the Council, and, in the Panel’s judgement, his subsequent disregard for the Interim Suspension Order which had been imposed as a result of the concerns raised at the Council. The Panel considered that the Registrant had breached the following Standards:
9 and 9.1 – (see above)

35. The Panel considered that this breach of the Standards was serious. It was of the view that the Registrant had repeatedly acted dishonestly in a number of areas. In all the circumstances, the Panel concluded that particular 6 fell far below the standards expected of an Occupational Therapist and amounted to misconduct.

Decision on Impairment

36. Having decided that the facts found proved amount to misconduct, the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired as a consequence.

37. Mr Anderson, on behalf of the HCPC, submitted that the Registrant’s fitness to practise is currently impaired on both the personal and public components. He drew the Panel’s attention to the HCPTS Practice Note on Impairment and invited the Panel to consider each of the areas identified within it, namely character references, the personal component, the public component and the risk of harm.

38. The Registrant gave oral evidence under affirmation. He did not dispute that his fitness to practise was impaired by reason of his misconduct, but sought to demonstrate insight and that he understood the seriousness of his misconduct and its impact.

39. The Panel heard and accepted the advice of the Legal Assessor. It had regard to the HCPTS Practice Note on Impairment, and in particular the two elements of impairment, namely the personal component and the public component.

40. The Panel first considered whether the Registrant’s fitness to practise is currently impaired on the personal component, which looks at matters personal to the Registrant, such as, remorse, insight and remediation all of which inform in respect of whether there is a future risk to the public. The Panel considered that dishonesty is an attitudinal trait, so consequently, it may be more difficult to demonstrate remediation in respect of it than for practice failings.

41. In terms of insight, the Panel took account of the Registrant’s oral evidence. He had articulated his recognition of the seriousness of his actions, which he said were inexcusable on his part. He identified the unacceptable risk of harm he had exposed vulnerable Service Users to whilst at Hertfordshire, and expressed his remorse that he had not made their safety his priority, instead prioritising his own inhibitions in disclosing his failures and seeking support. He also described the severe damage to the public’s trust in the profession that his actions in working whilst subject to an Interim Suspension Order would have caused. He acknowledged that there would always be questions of doubt over someone like him and whether they could be trusted or believed in the future.

42. The Panel considered that the content of the Registrant’s oral evidence appeared to demonstrate some insight and understanding of the implications of his actions, in particular his dishonesty, on both public protection and public confidence in the profession. The difficulty for the Panel was whether it could trust whether his apparent insight was sincere, in light of his past history of dishonesty, especially as he had previously lied to a panel of the Investigating Committee at an Interim Order review.

43. In support of whether the Registrant’s evidence regarding insight was sincere, were his unequivocal admissions, including to the dishonesty allegations, both before the hearing itself and at the start of this Final Hearing; [redacted]; some limited practical steps he had taken towards remediation and his engagement with this HCPC Final Hearing, including the manner in which he had given evidence and allowed himself to be questioned about his misconduct.

44. Factors tending to undermine whether the Registrant’s evidence of insight was sincere, included that it appeared to have come at a late stage in proceedings, namely at this hearing. The Panel also considered that he had at times in his evidence, been inclined to focus on his own issues and perceived lack of support at Hertfordshire Council. The Panel noted that the Registrant had not provided any written reflections regarding his actions and their impact on public protection or public confidence in the profession, nor had he provided any independent evidence, such as, for example, recent testimonials as to his current behaviour and integrity, certificates of courses in relevant areas such as probity and ethics, or medical evidence from his GP. Whilst the Panel understood that the Registrant was not required to provide such evidence, the absence of objective and independent information, made it more difficult for the Panel to assess the sincerity of his oral evidence. The Panel did bear in mind that, as the Registrant was unrepresented, he may not have fully appreciated the significance of providing such independent information.

45. In terms of practical remediation, such as education and training, the Panel noted that it did not have any independent evidence, such as certificates, to support the Registrant’s evidence that he had undertaken the following courses: Record keeping (May 2023, whilst still at Hertfordshire County Council), Autism (September 2024), Dementia (October 2024), Manual Handling (November 2024) and Safeguarding (November 2024). Whilst the Panel noted that these courses may be relevant to occupational therapy, the Panel was of the view that none of them practically addressed the misconduct in respect of dishonesty. The Panel also noted the Registrant’s evidence that he had worked as a Health Care Assistant for an autistic Service User for six weeks in November 2024, however, it had no independent evidence, such as a reference, attesting to his honesty and integrity in that role.

46. On balance, in the Panel’s judgement, the Registrant had demonstrated some developing insight into his misconduct, but that it was at an early stage. The Panel was mindful that his practice failings had been repetitious against multiple Service Users, exposing them to a real risk of significant harm, and his dishonesty had been repeated across multiple areas. Given that the Registrant’s insight was at an early stage and was still developing, the Panel was of the view that there was an ongoing risk of repetition, particularly in times of stress, that the Registrant could revert to acting dishonestly to avoid facing up to difficult situations. Accordingly, the Panel concluded that the Registrant’s fitness to practise is currently impaired in respect of the personal component.

47. In respect of the public component, the Panel was mindful of its responsibility to protect the public, maintain public confidence in the profession and uphold professional standards. In terms of protecting the public, the Panel considered that vulnerable Service Users were entitled to expect professionals to address their needs and prioritise their interests, especially when resources meant waiting a long time for an assessment. The Panel had regard to the observations of the Registrant’s line manager at Hertfordshire County Council, Mr IL, who said “the Registrant’s actions showed a real lack of empathy and regard for another human being’s personal pain and the wider impact this can have within families”. The Panel was of the view that the public would be shocked and troubled at hearing an Occupational Therapist described in such terms, as such conduct brought the profession into disrepute.

48. In terms of maintaining public confidence and upholding professional standards, the Panel considered that the public was entitled to expect a registrant to prioritise service users and address their needs, as well as to act with honesty and integrity. The Panel was of the view that public confidence in the profession would be significantly damaged to hear of a Registrant dishonestly disregarding an order imposed by a regulatory panel charged with protecting the public and lying to a regulatory panel charged with reviewing such an order.

49. In all the circumstances, the Panel was of the view that public confidence in the profession would be undermined if no finding of current impairment were made in this case. In all the circumstances, the Panel concluded that the Registrant’s fitness to practise is currently impaired on the public component.

50. Accordingly, in the Panel’s judgement, the Registrant’s fitness to practise is currently impaired on both the personal and public components.

Decision on Sanction

51. Having determined that the Registrant’s fitness to practise is currently impaired by reason of misconduct, the Panel went on to consider whether it was impaired to a degree which required action to be taken on his registration. The Panel took account of the submissions of Mr Anderson on behalf of the HCPC and of the Registrant on his own behalf as well as all the material previously before it.

52. Mr Anderson made no positive submissions as to the type of sanction the Panel should impose. He took the Panel through the relevant sections of the HCPTS Sanctions Policy (the Policy) and identified what the HCPC considered were the mitigating and aggravating features.

53. The Registrant acknowledged the seriousness of his dishonesty and that he had not provided independent evidence to address it. He said he understood that it meant that the public could not be 100 per cent certain that he would not do it again. He said he accepted that action was needed to take him off the Register and he would be willing to work on any sanction.

54. The Panel accepted the advice of the Legal Assessor and it exercised its independent judgement. It had regard to the Policy and considered the sanctions in ascending order of severity. The Panel was aware that the purpose of a sanction is not to be punitive but to protect members of the public and to safeguard the public interest which includes upholding standards within the profession, together with maintaining public confidence in the profession and its regulatory process.

55. As part of its consideration in respect of sanction, the Panel considered the relevant mitigating and aggravating features in this case.

56. The Panel considered the following to be the relevant mitigating factors:

a) The Registrant has no previous fitness to practise history;
b) The Registrant had a history of 16 years’ practice as an Occupational Therapist and there was no evidence of any other concerns throughout that time;
c) The Registrant made full and unequivocal admissions prior to and at the hearing;
d) The Panel had concluded that, on balance, the Registrant demonstrated some insight into his misconduct, although it was at an early stage;
e) There was some limited evidence regarding the Registrant’s health at the time [redacted].

57. The Panel considered the following to be the relevant aggravating factors:

a) The Registrant’s dishonesty at Hertfordshire County Council had been an abuse of trust and had involved covering up his omissions in respect of carrying out home visits or taking action having identified risk;
b) The Registrant’s dishonesty had been repeated across a number of areas, including at Hertfordshire County Council, in disregarding the Interim Suspension Order by working in Jersey and failing to disclose the Interim Suspension Order to them and in lying to a panel of the Investigating Committee;
c) The Registrant’s dishonesty had included him taking an active role by falsifying multiple case notes and assessments;
d) The Registrant’s practice failings had been repetitious against multiple vulnerable Service Users;
e) The Registrant’s practice failings and dishonest falsification of records had exposed multiple Service Users a real risk of significant harm;
f) The Registrant failed to raise concerns about not having completed home visits and instead covered them up.

58. The Panel concluded that none of the options of mediation, taking no action or a Caution Order was appropriate in this case. The Panel was of the view that this case was far too serious and none of these options would address the ongoing risk of repetition which the Panel had identified or address the significant public interest considerations in this case.

59. The Panel next considered a Conditions of Practice Order. The Panel bore in mind that it had identified the dishonesty as an attitudinal trait and therefore more difficult remediate than practice failings. The Panel did not consider that conditions could be formulated to address the dishonesty in this case and therefore a Conditions of Practice Order would be insufficient to manage the risks identified. In any event, the Panel did not consider that conditions would be sufficient to address the seriousness of the misconduct and therefore maintain public confidence in the profession. Therefore, the Panel did not consider that a Conditions of Practice Order was the appropriate or proportionate response.

60. The Panel next considered a Suspension Order. The Panel had regard to the factors set out in the Policy which may make a Suspension Order appropriate, namely:

a) The concerns represent a serious breach of the Standards of conduct, performance and ethics;
b) The registrant has insight;
c) The issues are unlikely to be repeated; and
d) There is evidence to suggest the registrant is likely to be able to resolve or remedy their failings.

61. The Panel considered that paragraphs a), b) and d) above were engaged. It was satisfied that the misconduct represented serious and repeated breaches of the Standards, as had been identified at the misconduct stage. The Panel noted its finding that, on balance, the Registrant had some insight, albeit it was in its early stages, having come at a late stage in proceedings. The Panel, in its judgement, considered that this insight indicated that the Registrant may be able to resolve or remedy his misconduct, noting he had been able to articulate the risk of harm he had exposed Service Users to and the serious damage his dishonesty will have had on public confidence in the profession.

62. Nevertheless, in respect of paragraph c) above, the Panel was mindful of its finding at the impairment stage, that there was an ongoing risk of repetition, not just of the practice failings but also of acting dishonestly. The Panel considered that further development of insight may lessen the future risk of repetition, although in the Panel’s view it would take substantial effort on the Registrant’s part to achieve. However, the Panel was under no illusion that the totality of the misconduct in this case was extremely serious. Therefore, the question for the Panel to resolve was whether a Suspension Order would be sufficient, not simply in terms of public protection, but also in addressing the significant public confidence aspects of this case. Consequently, the Panel went on to look at the criteria set out in the Policy which may make a Striking-Off Order the appropriate sanction.

63. The Panel bore in mind the following:
A striking off order is a sanction of last resort for serious, persistent, deliberate or reckless acts involving:
• dishonesty

64. The Panel recognised that the serious, persistent and deliberate dishonesty made the Registrant’s misconduct particularly serious. It therefore gave serious consideration to whether a Striking-Off Order was the only appropriate and proportionate sanction in this case. The Panel bore in mind that the Policy identified a Striking-Off Order as being likely to be appropriate where the ‘nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process’.

65. In the circumstances of this case, the Panel considered that this was not a case where the lesser sanction of Suspension would be insufficient to protect the public or public confidence in the profession and the regulatory process. It was satisfied that, in practical terms, a Suspension Order would protect the public for the period that it was in place. In terms of public confidence, the Panel bore in mind the mitigation it had identified, specifically that the Registrant had started the journey towards developing his insight. It noted that the Registrant had come to this hearing to face the consequences of his misconduct, rather than to avoid them, and he had articulated his understanding of the highly damaging impact of his misconduct. In light of this, the Panel was satisfied that an informed and fair minded member of the public, in possession of all the facts, would have confidence in the profession and the regulatory process if a lengthy Suspension Order was imposed in this case.

66. The Panel was also mindful that it must act proportionately and not seek to simply punish a Registrant for his past misdoings. In all the circumstances, the Panel was satisfied that a Suspension Order was the appropriate and proportionate sanction.

67. The Panel determined to impose a Suspension Order of 12 months, the maximum period for such an Order. In deciding this length, the Panel considered that it was the minimum period necessary to achieve the appropriate level of public protection and to meet the public interest considerations. The Panel also considered that it would afford the Registrant the opportunity, should he decide to take it, to demonstrate further development of insight, address his dishonesty and remediate his misconduct which in turn would reduce the ongoing risk of repetition.

68. The Panel acknowledged that this Suspension Order would prevent the Registrant from working in the profession and he may, as a result, be caused financial and reputational hardship. However, the Panel considered that the Registrant’s personal interests were outweighed by the public interest in this regard.

ORDER: The Registrar is directed to suspend the registration of Mr Iain St Leger for a period of 12 months from the date this order comes into effect.

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 Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you. The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

Interim Order
Application

1. As the Panel imposed a substantive sanction which restricted or prohibited the Registrant’s right to practise as an Occupational Therapist, Mr Anderson applied for an Interim Order to cover the appeal period before the sanction takes effect, or if the Registrant were to appeal, the period before the appeal was determined or otherwise disposed of. Mr Anderson submitted that given the findings of the Panel that there was an ongoing risk, an Interim Suspension Order was necessary to protect the public and was otherwise in the public interest.

2. The Registrant did not oppose the application.

Decision

3. The Panel heard and accepted the advice of the Legal Assessor, who advised that the substantive Suspension Order of 12 months would not take effect until the appeal period of 28 days had expired, or if the Registrant were to appeal, until the appeal was determined or otherwise disposed of. She advised the Panel that it was open to it to impose an Interim Order of up to 18 months to cover that period if it was satisfied that an Interim Order was necessary to protect the public or was otherwise in the public interest.

4. The Panel was satisfied that an Interim Order was necessary to protect the public, given its findings of an ongoing risk of repetition. It was also satisfied that an Interim Order was required in the public interest to maintain public confidence in the profession and to uphold professional standards, being of the view that public confidence would be undermined if no Interim Order were imposed.

5. In light of its substantive conclusion that conditions would not address the public interest considerations, even if it were possible to formulate them, the Panel decided that an Interim Suspension Order was the appropriate and proportionate Interim Order.

The Panel makes an Interim Suspension Order of 18 months under Article 31(2) of the Health Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest.

This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Mr Iain R St Leger