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.
10. The matters set out in paragraphs 1-9 amount to misconduct and/or lack of competence.
11. By reason of this misconduct and/or lack of competence, your fitness to practise is impaired.
1) In April 2013 a panel of the Conduct and Competence Committee of the HCPC found the fitness to practise of Mr Kaushik to be impaired. Mr Kaushik was suspended from practice for a period of one year. In April 2014 the order of suspension was reviewed and a further order of Suspension was made to run for 12 months.
2) This is the second review of the Suspension Order made in April 2013.
3) The Panel has considered the evidence and submissions and has taken into account the HCPC Practice Note “Finding that Fitness to Practise is Impaired” and the HCPC Indicative Sanctions Policy together with the relevant HCPC Standards of Conduct, Performance and Ethics.
4) The original allegations are shown above. In summary, the Panel sitting in April 2013 found that Mr Kaushik:
(i) failed to act with reasonable confidence as an autonomous practitioner
(ii) failed to provide timely treatment and spent undue time carrying out duties
(iii) failed to keep adequate records
(iv) did not carry out effective assessments of service users
(v) did not reasonably progress necessary treatment steps and reviews.
5) The evidence given by Mr Kaushik to this Panel has been that he has worked as a Home and Community Care Support Worker in Kent and Medway. He has provided the Panel with documentation including a “Professional Development Action Plan”, some Reflective Logs and a letter dated 16 March 2015 from Renee Hepker of Kent & Medway NHS and Social Care Partnership Trust (“the Trust”). That last letter confirms an offer of a voluntary unpaid work experience placement for Mr Kaushik, likely to run on one day a week for 4 to 6 months.
6) The Panel has taken into account the range of deficiencies in professional practise that were found proved in the original hearing. The Panel has carefully considered the evidence and documentation provided today by Mr Kaushik but is not satisfied that that material demonstrates adequate remediation of the identified deficiencies. The material makes some effort to address those deficiencies but has not focused on all of the deficiencies identified in the original decision. Further, and importantly, the material contains little by way of objective evidence to demonstrate that previous failures or shortcomings have been remedied. The material contains considerable assertion as to the remedial steps that need to be taken but relatively little objective evidence that such steps have been accomplished.
7) The Panel is encouraged to see that Mr Kaushik remains committed to the profession of Occupational Therapy but is not satisfied that at the moment Mr Kaushik is safe to practise unrestricted or that there would be public confidence in the regulatory process if Mr Kaushik were to move at this point to unrestricted practise.
8) The Panel takes into account that the purpose of sanctions is not to be punitive. The primary purpose is to protect the public. The Panel finds there is a significant remaining degree of impairment to fitness to practise. It would not be appropriate today to make no order. Nor would a caution order provide adequate public protection.
9) As was found in the original hearing the range of deficiencies makes it difficult to identify a set of conditions of practice which would be workable. The Panel has concluded that the only practicable sanction which provides sufficient protection for the public and which is proportionate is a further suspension order for one year.
10) This renewed suspension order will be reviewed before it expires. The Panel which carries out the next review may well be assisted if Mr Kaushik produces evidence which shows how he has tried to remedy the previous specific failures that were identified in the original hearing in 2013.
11) It would also be of assistance to a future Panel if Mr Kaushik can show that he has carried out some level of Continuing Professional Development bearing in mind that he has now been out of practice since 2011. If possible that may include the completion of a Return to Practise course. The suggestions being made in that respect by this Panel are not to be seen as binding the discretion of a future Panel.
12) Mr Kaushik should be aware that at any future review hearing, the Panel will have the full range of sanctions available including striking off.
13) The Panel sitting today has been further encouraged to see the prospect of the work placement identified in the letter dated 16 March 2015 referred to above. It is likely to be helpful to a future Panel if Mr Kaushik in fact completes such a work placement and if he is able to provide clear evidence from someone such as Ms Hepker as to the extent to which he has been able to remediate the failures identified in the original hearing in April 2013.
Order: The Registrar is directed to suspend the name of Mr Manish Kaushik from the Register for period of 12 months from the date that this Order comes into effect (the Operative Date).
This order will be reviewed before it expires.
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|