The following allegation was heard by the Panel at a Conduct and Competence Committee final hearing on 16, 18 and 19 April 2013:
“During the course of your practise as an Occupational Therapist, you:
1. Were unable to work independently in that you required excessive support from your colleagues.
2. Were unable to manage your workload adequately, in particular that you:
a) Did not provide timely treatment to service users (this head of the allegation with regard to service user B was not made out in as much as the file notes appeared to support the Registrant’s assertion that he had contacted B);
b) Had difficulty making autonomous decisions on cases;
c) On some occasions, spent an excessive amount of time with service users
d) Demonstrated a lack of knowledge and understanding regarding necessary actions and the need to act urgently in some cases.
3. Did not keep accurate records in that:
a) You did not sign Subjective Objective Analysis Plan (SOAP) notes;
b) Risk assessments were not signed or dated;
c) Several home visits reports conducted were not filed in client files;
d) Notes did not include sufficient information to allow other members of staff to understand what action was required;
e) Treatment plans were not dated or signed;
f) Nine home visit reports were identified after 5 November 2007 as not being stored in the client’s case files;
g) Information was stored in the wrong client’s files;
h) In relation to Service User AAP, functional assessments were incomplete in that:
i. Observed scores were not recorded in any section of the standard-functional assessment form (STA); and
ii. The assessment was not signed or dated.
4. You did not complete thorough home visit assessments, in particular, on 7 March 2011, in relation to Service User PB, you did not:
a) Take Service User PB’s medical history into consideration (this head of the allegation was not made out);
b) Comment on the posture or positioning of the service user (this head of the allegation was not made out);
c) Conduct a holistic assessment of all transfers and needs of the client and/or carer; and
d) Consider the use of a hoist/ceiling track and/or adjustments to full height shower doors for low level access tray.
5. Following a performance/capability meeting that was held on 17 March 2011, it was identified that there were twenty two outstanding files that needed to be closed which you had not actioned.
6. This head of the allegation was not found proved (namely: On 25 October 2010, 22 March 2011 and 13 June 2011, you conducted a home visit for Service User GS, and you:
a) Did not issue recommendations either before or after the visit;
b) Did not update the service user regarding recommendations for a stair lift for approximately four months after 13 June 2011);
c) Did not conduct a thorough assessment, in that you did not assess the rear garden.
7. Did not undertake clinical reviews of:
a) Treatment goals; and
b) Treatment plans.
8. Did not work adequately with your colleagues, in that you did not provide the Occupational Therapy Assistants enough verbal or written information to allow them to do their jobs competently.
9. Did not make timely clinical decisions, in particular that:
a) On 13 June 2011, you assessed Service User GS and did not inform him of the outcome of that assessment; (This head of the allegation was not found proved);
b) On 2 January 2009, Service User CP was admitted and on 5 March 2009, she was discharged, but when the case was reviewed on 10 August 2009, no discharge outcome sheet or follow-up calls had been made.”
The matters set out in the allegation, save for paragraphs 4, 6 and 9(a) were held to constitute lack of competence. The Registrant’s lack of competence as found at the final hearing involved breach of the following Standards of Conduct, Performance and Ethics:
1. You must act in the best interests of service users.
6. You must act within the limits of your knowledge, skills and experience and, if necessary, refer the matter to another practitioner.
7. You must communicate properly and effectively with service users and other practitioners.
10. You must keep accurate records.
In relation to those heads of the allegation which were found proved at the Final Hearing, namely 1, 2, 3, 5, 7, 8 and 9b, it was held that the Registrant’s fitness to practise was impaired by reason of lack of competence.
The Registrant was made subject to a suspension order for twelve months.
1. Whilst employed as an Occupational Therapist by Kent County Council between May 2006 and October 2011, the Registrant underwent formal capability procedures on three occasions, the last of which was in July 2011. His employment was suspended on 27 September 2011 pending an investigation into his conduct and competence. He resigned on 3 October 2011 before the disciplinary procedure was completed.
2. The Panel at the final hearing considered that it was necessary to take action to provide adequate protection to the public in light of the Registrant’s long-standing and wide-ranging lack of competence. There were no conditions which would have been workable and verifiable. The sanction of a 12 month Suspension Order was deemed to be appropriate under the circumstances. The Registrant was reminded that he would need to present clear evidence to the reviewing Panel that he has been able to address his professional deficiencies so that his failings are unlikely to be repeated and that he has kept up to date with current practice.
3. The Panel read the bundle of documents. It heard the submissions made on behalf of the HCPC and on behalf of the Registrant, and the Registrant’s evidence outlining the steps he has taken during his suspension to address his shortcomings. The Panel took the advice of the Legal Assessor and referred to the Indicative Sanctions Policy and the HCPC’s Standards of Conduct, Performance and Ethics.
4. Whilst not opposing any extension of the current period of suspension, the Registrant stated that he is committed to resuming work as an Occupational Therapist and brought documentary evidence to show that he has attended several courses to maintain continuing professional development as best he can during his suspension: Basic Awareness in Child Protection Training (11 June 2013); Food Hygiene (6 July 2013); Safeguarding Vulnerable Adults (5 February 2014); Manual Handling (10 February 2014); Dementia Awareness (12 February 2014); Dementia/ Crisis Care (17 February 2014). The Registrant brought no current testimonials to support him. He stated that attempts to maintain professional development have been limited by health problems in his family and the fact of the suspension.
5. The Registrant has sought work as an Occupational Therapy Assistant but has not yet been successful. He is currently working as a care support worker with a charity assisting disabled children in the community. He believes that his current work allows him to maintain some skills relating to those of an Occupational Therapist.
6. The Panel addressed the question of impairment at present, taking into account whether the Registrant’s lack of competence was remediable, whether it been remedied and if there was any risk of repetition.
7. The Panel considered that the Registrant’s deficiencies are not easily remediable. Although the Registrant has taken some steps to remedy his lack of competence, he has not demonstrated that he has done enough to avoid the risk of repetition in the future.
8. The Panel finds that the Registrant’s fitness to practise is currently impaired.
9. The Panel kept in mind that the purpose of sanctions is not to be punitive but is designed to protect the public interest which includes protecting members of the public from possible harm, maintaining proper standards within the profession, the reputation of the profession and confidence in the regulatory functions of the Council.
10. The Panel, in considering whether to make an order and the nature of the order to be made, applied the principle of proportionality weighing the interests of the Registrant against the need to protect the public. In approaching this issue the Panel exercised its own professional judgment.
11. The Panel noted that the Registrant stated that he has made some attempts to address some aspects of his poor professional performance, for example with regard to record keeping, but found that he did not demonstrate clearly that the steps he has taken have addressed the wide-ranging deficiencies in his practice.
12. The Panel considered the sanctions available to it in ascending order of severity and in arriving at its decision took into account the Indicative Sanctions Policy.
13. The Panel concluded that having regard to the nature of the lack of competence, its wide reach and its long duration, to take no further action would be inappropriate and would undermine rather than sustain confidence in the profession and in the regulatory functions of the Council.
14. For similar reasons, a Caution Order would also be inappropriate. The Panel was reinforced in this view by the fact a Caution Order is not appropriate in relation to several years of poor performance affecting several service users and the Registrant’s ability to work with professional colleagues.
Conditions of Practice Order
15. The Panel did not consider that a Conditions of Practice order could be formulated which was appropriate, workable or relevant to the lack of competence found proven in this case.
16. The Panel concluded that the Registrant is not yet fit to be restored to practice. A suspension order for a period of 12 months was the appropriate sanction. In coming to this conclusion the Panel took into account the impact of a further suspension order on the Registrant. However having considered the wider public interest and in particular the need to maintain public confidence in the profession and its regulatory processes, the Panel concluded that a Suspension Order for a further period of 12 months was the appropriate and proportionate sanction. Such a sanction would not of itself preclude the Registrant from resuming his profession in due course. However, the Registrant should be aware that once he has been continuously suspended for a period of two years, a striking off order will be available to reviewing Panels, pursuant to article 29(6) of the Health and Social Work Professions Order 2001.
17. The Registrant is able to seek an early review of this Order should he be in a position to provide the requisite evidence to address the concerns.
18. A future Panel may be helped by clear evidence of the Registrant’s reflections on professional development and the impact of lack of competence on the public and public confidence in the profession of Occupational Therapy. The Registrant might find that a plan of action outlining how he would prepare for a return to practise might also be useful.
No notes available
History of Hearings for Manish Kaushik
|Date||Panel||Hearing type||Outcomes / Status|
|20/10/2017||Conduct and Competence Committee||Review Hearing||Struck off|
|20/04/2016||Conduct and Competence Committee||Review Hearing||Conditions of Practice|
|07/04/2015||Conduct and Competence Committee||Review Hearing||Suspended|
|25/04/2014||Conduct and Competence Committee||Review Hearing||Suspended|