Ranjana Varia

: Social worker

: SW64130

: Final Hearing

Date and Time of hearing:10:00 10/06/2016 End: 17:00 10/06/2016

: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

: Health Committee
: Suspended

Allegation

Your fitness to practise as a Social Worker is impaired by reason of your health.

Finding

Preliminary Matters

 

Service and Jurisdiction

 

1.             The Registrant participated in the hearing by telephone link. She was unrepresented. The Hearing Notice was sent to her registered address on 15 December 2015 in accordance with the Rules. Therefore, the Panel was satisfied that proper notification of this hearing had been given and it had jurisdiction to consider the case.

 

 

Background

 

2.             The Registrant worked at Leicestershire County Council (the Local Authority) from 31 May 2000 until 7 March 2014. She was a level 3 Social Worker within the Adult and Communities Department of the Mental Health Team. Her role involved working with adults with mental health problems. Her main responsibilities were undertaking assessments under the Community Care Act and determining access to services by carrying out eligibility assessments. She was also responsible for completing comprehensive risk assessments, identifying safeguarding concerns and undertaking safeguarding investigations. These elements were fundamental to the Registrant’s role, as was the requirement to ensure that accurate records were made of the work she carried out. During the period upon which the hearing has focused, it was stated by one of the HCPC witnesses and by the Registrant herself that the nature of the Social Worker’s role had changed. The work became more analytical and there was also more emphasis on electronic recording of events and assessments.

 

3.             The Registrant was diagnosed with a health condition in April 1998 when she was a student at Coventry University. Throughout the Registrant’s time at the Local Authority, adjustments had been put in place to assist her with aspects of her health condition. In the early part of the Registrant’s career, she had administrative support and the use of technological aids. Along with changes to the nature of the Social Worker’s role, the nature and extent of administrative support available to the Registrant changed over time. When the Registrant’s performance came under close scrutiny, from early 2013, further measures were put in place in order to assist the Registrant to manage her health condition. She was given technological training; her caseload was reduced; she was given more time to complete tasks; she was provided with a desk in a quiet room; and she received an enhanced level of supervision. She was also given additional training on safeguarding, capacity assessment, eligibility criteria and risk assessment.

 

4.             In the period from 2010 until she left her post, a number of events occurred in the Registrant’s personal life which, although not related to her work, appear to have had an impact on her ability to manage her health condition and to work consistently to an appropriate standard. These life events caused the Registrant significant stress. A diagnosis of a second health condition was made when the Registrant was examined and assessed by a medical professional instructed by the HCPC.

 

5.             The Local Authority had concerns about the Registrant’s capabilities. These had originally been identified sometime prior to 2010 and the series of debilitating life events. Whilst there was reference to performance issues prior to 2010, there were no written records of the issues or the outcome of any procedures that may have been initiated. Apart from noting that there been some issues raised previously, the Panel was unable to draw any reasonable inferences about the Registrant’s performance prior to 2010.

 

6.             In February 2013, a new Team Senior came into post. The ongoing concerns identified at this time were set out in a letter to the Registrant dated 8 May 2013. These included:

 

               Not accurately identifying safeguarding concerns and failure to follow the appropriate procedures;

 

               Not following advice, guidance or instruction about safeguarding cases;

 

               Not meeting the required minimum standards when undertaking community care, mental capacity and risk assessments;

 

               Not accurately determining correct eligibility for service users and subsequent correct levels of support and funding through the self-directed support process;

 

               Concerns about recording, including failure to record, not recording to the required minimum standards, not using support previously identified to ensure accurate recording and not following direction to ensure records were acceptable with the Team Senior;

 

               Concerns that poor health and falling asleep at work were having an impact on work standards and service delivery.

 

7.             The Registrant was placed on an informal capability process around April 2013. A formal stage of the Capability Procedure was initiated in May 2013. This involved a high level of intensive monitoring and support. A first Capability Hearing took place on 23 May 2013. The Registrant was then absent from work due to ill-health from shortly after this hearing until the end of October 2013.

 

8.             The Registrant had a phased return to work. A Return to Work Meeting was held on 1 November 2013, at which a Formal Performance Improvement Plan was instigated. This Plan was reviewed on 19 December 2013. The concerns about her practice remained. A Stress and Wellbeing Assessment was undertaken at the Return to Work meeting and later the Occupational Health Department was involved in carrying out an assessment of the Registrant. The Registrant left her post in March 2014.

 

9.             The matter was referred to the HCPC, who instructed two experts: Dr G, who gave evidence about his diagnosis in January 2015 that the Registrant was suffering from the second health condition; and Dr C, who gave evidence about the Registrant’s first health condition. The HCPC also called CJ, who was a locality manager at the Local Authority from 2012, and in that capacity she managed the Registrant’s immediate line manager.

 

10.           The Panel was careful to ensure that account was taken of the obligation placed on the Registrant’s employers to make reasonable adjustments in the light of her first health condition. It was clear to the Panel that it would be wrong to find the Registrant’s fitness to practise to be impaired merely because she has this health condition. The principal issue in the case was the Registrant’s ability to manage her condition, with reasonable adjustments being in place, so that she could carry out her role safely and effectively. The inter-relationship between the Registrant’s levels of stress and her ability to manage her health condition in a stressful work environment also formed an important part of the Panel’s deliberations.

 

The Registrant’s participation in the hearing

 

11.           The Panel took account of the HCPC Practice Notes on “Unrepresented Registrants” and “Equal Treatment”.

 

12.           In the interests of fairness, the Panel explored a number of issues in order to ensure that the Registrant was able to participate fully in the hearing and that a proportionate balance was struck between the interests of the Registrant, the interests of the HCPC and the interests of the wider public.

 

13.           Firstly, the Registrant’s reason for choosing to participate in the hearing via telephone link rather than through personal attendance was explored. It emerged that the Registrant was primarily concerned about seeing CJ as that would cause her anxiety. It was clarified for the Registrant that she could attend the hearing but absent herself for the time that CJ gave evidence, or she could hear CJ’s evidence over the telephone. The Panel was satisfied that the Registrant was aware of her options in order to make an informed decision on this point.

 

14.           The Registrant confirmed that she did not wish to question CJ or see her. The Registrant also confirmed that she agreed with the assessments and recommendations given by the experts and that she had no questions for them. She felt that they had been fair. The Registrant chose to proceed by telephone link.

 

15.           The Panel gave independent consideration to this issue. The Panel recognised that in an ideal situation a Registrant would be present to hear and see the witnesses giving evidence. However, the Registrant was entitled to participate in the hearing by telephone link. The Registrant had the bundle of documents and an email facility so that any additional documents could be sent to her. The Panel did not feel that there was an undue disadvantage to the Registrant such that her expressed wish to participate by telephone link should be overridden.

 

16.           Secondly, the Panel also ensured that the Registrant was aware of the right to make an application for the hearing venue to be changed. The Registrant raised the cost of travel to London as a reason to change the venue. This application was not pursued. In any event the Panel did not consider this to be a valid reason.

 

17.           Thirdly, The Registrant was alerted to the possibility of making an application to the HCPC for the cost of travel on the basis of exceptional hardship, which she did not pursue.

 

18.           The Registrant raised the possibility of an adjournment on the basis that she wanted to secure support or representation when it came to the presentation of her own case. The Panel explored this further with the Registrant at the close of the HCPC’s case and the Registrant did not pursue her application.

 

Holding the Hearing in Private

 

19.           The HCPC applied for the hearing to be held in private. The Registrant was neutral on whether the hearing should be in public or in private. The Panel received advice from the Legal Assessor. The Panel took account of the HCPC Practice note on “Conducting Hearings in Private”.

 

20.           The Panel recognised that hearings are generally held in public in order to respect the principles of open justice. The Panel was satisfied that it was necessary and proportionate to depart from that general rule in this case as there would be a disproportionate interference with the Registrant’s right to a private life if the details were made public about her health conditions, how they impacted on her, and circumstances in her home life. The case focused on the impact of the Registrant’s health condition on her ability to practise safely and effectively. It was unrealistic and impractical to hold parts of the hearing in private as the whole case was about the health conditions which needed to be referred to throughout. Accordingly, the Panel decided that it was appropriate to hold the entirety of the hearing in private.

 

The Hearing

 

21.           The Panel had read the HCPC case and Registrant’s representations before starting the hearing.

 

22.           The Registrant admitted the Allegation. The Panel proceeded to hear the case and was aware that the Registrant’s admission was not determinative but was a factor that could be taken into consideration if the Panel was satisfied that her admission was informed and unequivocal.

 

23.           Mr Mansell opened the HCPC case. He relied on a written Opening Note which had been sent to the Registrant. After one short adjournment, when telephone communication was reinstated with the Registrant, it became clear that she was now driving and there was another person in the car with her. She explained that she was on her way to a funeral. The Panel granted the Registrant’s application for an adjournment of one hour to enable her to attend the funeral. When the hearing resumed, the Panel was concerned that there was substantial background noise indicating that other persons were in close proximity to the Registrant. The Panel considered that this was not a suitable environment from which the Registrant could properly participate in this private hearing. Therefore, at the request of the Panel, the Registrant was able to find a quiet and secluded location. She did not have access to her laptop with the case papers on but she was content with the hearing proceeding. The Panel received advice from the Legal Assessor and reminded itself that the Registrant had previously indicated that she did not challenge Dr G’s report or diagnosis. Therefore the Panel decided to proceed.

 

24.           Mr Mansell called Dr G to give evidence. The Registrant had no questions for Dr G. The Panel clarified parts of Dr G’s evidence and addressed with him anything that the Registrant might have wished to explore such as the currency of the second health condition. The Legal Assessor was given an opportunity to address any questions that the Registrant may have wished to pursue but no additional areas were identified.

 

25.           On the second day of the hearing, Mr Mansell called CJ to give evidence. After the witness’s evidence-in-chief, the Panel allowed time for the Registrant to discuss with the Legal Assessor any questions that she may wish to put. A series of questions was identified.

 

26.           The Registrant then notified the Panel that a family emergency had arisen which required her to assist her daughter-in-law and she had to travel to London straightaway. She initially asked for an adjournment of the hearing of about two and a half hours to enable her to complete her journey prior to rejoining the hearing by telephone from her son and daughter-in-law’s address.

 

27.           The Panel explored with the Registrant, Mr Mansell and the Legal Assessor whether it might be possible to proceed with further questioning of CJ in the absence of the Registrant. The Registrant confirmed that she was content to proceed on this basis and the Legal Assessor advised the Panel that this was a matter for their discretion.

 

28.           The Panel decided that the Registrant had consented to the hearing proceeding in her absence, that her decision was clear as she had confirmed that she was not simply agreeing such a course for expediency, and that her absence was voluntary. The Panel was of the view that the disadvantage to the Registrant in being unable to hear the further evidence of CJ was mitigated by the fact that the questions she wished to address with the witness had already been identified, and she could be provided with a summary of the evidence when she rejoined the hearing. CJ was released, at the conclusion of her evidence, subject to her being available to be recalled by telephone the following day to give further evidence if the Registrant wished to clarify anything.

 

29.           The Legal Assessor put the Registrant’s questions to CJ and her evidence on those points was noted. The Panel asked its own questions.

 

30.           At the time proposed by the Registrant, the Hearings Officer tried unsuccessfully on a number of occasions to contact her. The Registrant had not made any attempt to contact the HCPC by telephone or email while the Panel was sitting during the afternoon of the second day. The Panel heard an application from the HCPC to proceed in the Registrant’s absence and to hear evidence from Dr C. The Panel received further advice from the Legal Assessor and again referred to the HCPC Practice Note on “Proceeding in the Absence of the Registrant”.

 

31.           The Panel decided that it was fair and proportionate to proceed in the Registrant’s absence. She had failed to make herself available for the telephone link at the allotted time. A number of attempts had been made to contact her. The hearing was delayed for 45 minutes beyond the two and a half hours requested by the Registrant. There was no communication from the Registrant. The Panel determined that the Registrant’s non-availability was deliberate and she had waived the right to be present. The Panel felt that any disadvantage to the Registrant was mitigated by the fact that she did not challenge the evidence of Dr C. The oral evidence from this witness could be summarised for her. The witness would also be released on the condition that she should be available by telephone to answer any questions arising from her evidence once the Registrant had considered the summary of that evidence.

 

32.           The Panel heard the evidence from Dr C. The Panel raised questions that the Registrant might have wished to explore. The Legal Assessor had the opportunity of asking any questions but no further questions were identified. Dr C also confirmed that she would be available by telephone on day 3 if the Registrant had any further questions. The Panel regarded this as additional safeguard to ensure the fairness of the proceedings with regard to the Registrant’s interest.

 

33.           On the third day of the hearing, the Registrant participated by telephone link from her son’s address. She confirmed she had access to the case documentation. She explained that when leaving for London the previous day she had left her mobile phone behind. This is why she had not been contactable during the previous afternoon. Her mobile phone had since been brought to her. She was provided by the Legal Assessor with a summary of the evidence from CJ and a written summary of the evidence from Dr C. The Registrant did not wish to recall either witness to address any questions from those summaries.

 

34.           Mr Mansell then closed the HCPC’s case. The Panel explored with the Registrant the options which were available to her. She was reminded that she could apply for an adjournment in order for her supporter to be present. The Panel explained that she could give evidence, perhaps with the Panel Chair asking her general questions to prompt her to address relevant areas that might be a benefit to her. The option of making unsworn representations, and the difference between that and sworn evidence, was explained to the Registrant by the Legal Assessor. The Registrant chose to give sworn evidence by telephone and to be prompted by questions from the Panel Chair. After her evidence-in-chief, Mr Mansell was able to question the Registrant and the Panel was also able to ask questions. The Registrant confirmed that there was no other evidence or documentation that she wished to place before the Panel.

 

35.           The Panel then heard the closing submissions on behalf of the HCPC. The Legal Assessor gave further guidance to the Registrant, to assist her in making her closing submissions.

36.           The Panel received advice from the Legal Assessor and retired to deliberate and draft its determination on the nature of the Registrant’s health conditions and whether her fitness to practise is currently impaired.

 

Assessment of Witnesses

 

37.           The Panel started its deliberations by considering the nature and quality of the evidence that had been presented by the parties. With regard to the evidence of Dr G and Dr C, the Panel was satisfied that the qualifications, experience and expertise of both witnesses enabled them to give expert opinion. Both witnesses were able to assist the Panel to gain a better understanding of the impact of the Registrant’s health conditions on her practice as a Social Worker, and of the interaction between those two conditions. The witnesses were careful to avoid comment on issues outside their respective fields of expertise. The Panel also noted that the Registrant accepted, and indeed welcomed, both reports and did not seek to challenge their evidence or conclusions. The Panel was confident that it could place significant reliance upon the written and oral evidence of both Dr G and Dr C.

 

38.           The Panel considered that CJ was a credible and reliable witness. She is a very experienced Social Worker and manager. Her evidence was very balanced, and she commented favourably on aspects of the Registrant's approach to her work, particularly with regard to her value base and her desire to achieve good outcomes for her service users. Where she identified areas of the Registrant's practice which caused concern, the Panel was satisfied that these were legitimately raised and were not in any way arbitrary or unjustified.

 

39.           The Panel was mindful of the pressure that registrants in general feel when giving evidence at disciplinary hearings. There is much at stake for a registrant in these circumstances. The Panel was also acutely aware of the Registrant's medical history, and of the fact that she was not present in person at the hearing. With those factors in mind, the Panel was pleased that the Registrant felt able to give evidence. This enabled the Panel to gain a better insight into her practice, motivation for being a Social Worker, and her understanding of the issues in the case. When the Registrant was responding to prompting questions from the Panel Chair, and thereby giving her evidence-in-chief, she spoke fluently and gave cogent examples to illustrate the points she was making. She spoke with passion about her desire to help others achieve their potential. The Panel found this part of her evidence to be compelling. However, when the Registrant was asked questions which sought to probe more deeply her understanding of the concerns raised about her practice, she was inconsistent and less convincing. The Panel was left with the impression that the Registrant had limited insight into the impact of her health conditions on her professional work, the extent of the failings in her practice, and of the consequences of those failings for her colleagues and service users.

 

 

Decision on Health Conditions

 

40.           The Panel was aware that the burden of proving that the Registrant suffered from either of these health conditions was on the HCPC, and that the case was only to be found proved if the Panel was satisfied on a balance of probabilities.

 

41.           The Panel was also aware that the Registrant did not have to prove anything and her admission did not alter the burden or standard of proof.

 

42.           The Panel was further aware that that if the fact of either health condition was established, it was a matter for the Panel’s professional assessment as to whether this impacted on the Registrant’s practice to such an extent that her practice could properly be said to be impaired.

 

The second health condition

 

43.           In his report dated 15 January 2015, Dr G was clear that the Registrant had undoubtedly been suffering from the second health condition. The Panel accepted the evidence and found that the Registrant was diagnosed with this second health condition in January 2015.

 

44.           The Panel was not persuaded that the diagnosis of the second health condition from January 2015 was current. It would have been open to the HCPC to obtain an update from Dr G nearer to the date of the hearing but this was not done. The evidence before the Panel was of a diagnosis over a year old, which was made at a time when the Registrant’s condition was already improving.

 

45.           The Panel accepted the Registrant’s evidence about her health. The Registrant said that she felt very well and that there were no remaining factors which adversely affected her. Whilst the Registrant had not returned to work as a Social Worker, she had remained active through her involvement with voluntary work twice a week.

 

46.           The net effect of all this evidence was that the Panel was satisfied that the Registrant had suffered from a second health condition in the past but this was no longer current. The Panel was of the view that the Registrant remained susceptible to heightened levels of stress, particularly if she returned to practice as a Social Worker. This could have a negative impact on her ability to manage her first health condition and the Panel gave further consideration to these issues in its assessment as to the Registrant’s current fitness to practise. But with regard to the factual assertion that the Registrant currently suffers from the second health condition, the Panel found this part of the Allegation not proved on the basis that the HCPC had not adduced sufficient evidence to establish on the balance of probabilities that the condition was current.

 

The first health condition

 

47.           The Panel accepted Dr C’s evidence and her diagnosis of 23 March 2015 that the Registrant has the first health condition. Her report was clear that there was evidence for it. This was consistent with the diagnosis from 1998 and the Registrant confirmed that the health condition remained a current issue for her.

 

48.           Dr C was clear that in the right conditions the effects of health condition could be managed, although the basic condition does not change over time. The Registrant’s evidence confirmed that her health condition remained a current issue for her. Therefore the Panel found the Allegation proved to the extent that the Registrant currently suffers from the first health condition.

 

 

Decision on Impairment

 

49.           In the light of its findings in relation to the Registrant’s health conditions, the Panel went on to consider whether the Registrant’s fitness to practise as a Social Worker is currently impaired.

 

50.           Although the Panel found that the Registrant was no longer suffering from the second health condition, the Panel was satisfied that she remained susceptible to the adverse impact of high levels of stress upon her ability to manage her health condition in such a way as to enable her to practise safely and effectively as a Social Worker. In this regard, it is not the second health condition itself, or the risk of that condition returning, but rather the general effects of stress which are of concern. In other words, if the Registrant were to undergo a further period of stress at work, this in itself could cause her significant difficulties in managing her health condition even if it did not amount to a recurrence of her second health condition.

 

51.           The Panel accepted Dr C’s evidence. Dr C explained that those subject to this health condition have to work harder to compensate and are subjected to many additional stresses. Where these stresses occur at levels over and above those experienced in their everyday life, the effect of stress on a person who has this health condition will be further exacerbated.

 

52.           The Panel also accepted Dr G’s evidence.

 

53.           Based on all the above evidence, the Panel concluded that there were a number of key areas of social work practice where the Registrant was not performing to the standard which could properly be expected of her, even taking into account the need for reasonable adjustments to be made because of her health condition. These key areas included: written communications; recalling and processing information, including knowledge about safeguarding and other core skills; concentration; exercising consistently sound professional judgments. The effective and timely completion of assessments is essential in order to manage the needs and expectations of service users. Social Workers support vulnerable members of the community and professional failings carry the potential consequence of vital services not being available when they are required, and the risk that service user needs are not met. The Panel reminded itself that the first Standard in the HCPC Standards of Conduct, Performance and Ethics (the HCPC Standards) requires that all registrants act in the best interests of service users.

 

54.           In the Panel’s view there was a clear link between the Registrant’s health condition (which includes her ability to manage her condition) and its impact on her practice. This confirmed to the Panel that the dominant issue in this case was the Registrant’s health rather than any perceived failure by her to actively engage with the adjustments or accommodations made for her. The Panel noted the evidence of CJ in this regard, that the Registrant remained motivated by a desire to help service users but that she appeared not to understand what was required of her, nor was she able to deliver work to the appropriate standard.

 

55.           The Panel next considered the extent to which the Registrant had demonstrated an ability to overcome these issues which had adversely impacted on her ability to practise. In considering this aspect the Panel has taken into account that the purpose of these proceedings is not to punish practitioners but to protect the public from those who are not fit to practise.

 

56.           As stated in paragraph 39 above, the Registrant’s evidence suggested that she had only developed some limited insight into the effect of her health condition on her practice as a Social Worker. The Panel was concerned about the lack of recognition by the Registrant about shortcomings in her practice. Even now, the Registrant’s evidence was that when concerns were raised with her it came as a surprise. The Registrant did not accept that her practice was deficient in the way that has been established by CJ’s evidence.

 

57.           The Panel is of the view that the Registrant has taken limited steps to develop effective strategies to manage her health condition in the workplace. The Registrant had not undertaken any additional formal training and so she was unable to provide the Panel with evidence to demonstrate the extent to which she had improved since she was at work. She has not accessed support from appropriate organisations. The Registrant has been working on a voluntary basis two days a week with Barnardo’s and with a women’s group. This is commendable, but the nature of that work is very different to that which would be expected in social work practice. She has not sought work in a social care context, for example as a Social Work Assistant, perhaps in the mistaken belief that such a role required registration. Such a step may have provided evidence of the Registrant putting what she had learned into practice, and of her ability to work effectively in a stressful environment.

 

58.           The Panel recognises that the Registrant’s current levels of stress are low. However, based on the evidence of the expert witnesses and the Registrant’s own admissions, returning to social work practice would be a challenging step for her to take. It would inevitably lead to a period of enhanced stress, particularly if the Registrant felt that her work was being scrutinised as would likely be the case, at least in the early stages of any new role.

 

59.           The Registrant explained how she would seek to manage her stress at work in the future, for example, by notifying her line manager, and by ensuring she took leave, by working on short term contracts that she could walk away from. The Panel was not reassured that the Registrant has demonstrated her ability at this stage to manage the fluctuations in her stress levels. The Panel noted the absence of evidence from her GP or any other appropriate person to support the fact that she has coping strategies in place. The Registrant has made some progress since the time she left the Local Authority, but she herself accepts that she would need support, over and above reasonable adjustments, in order to return to safe and effective practice as a Social Worker.

 

60.           Having carried out this detailed analysis of the interaction between the Registrant’s health condition, her ability to manage her levels of stress, and the impact of these factors on her professional practice, the Panel examined its conclusions in the light of the HCPC Practice Note on “Finding that Fitness to Practise is Impaired”. The Panel considered both the ‘personal’ and ‘public’ components. The Practice Note, which is based on recent caselaw, identifies the personal component as comprising “the current competence, behaviour etc. of the individual registrant” and the public component as comprising “the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession”.

 

61.           The Registrant’s health condition, and her inability to manage her condition, prevented her working safely and effectively as a Social Worker in the past. She has limited insight into the impact of her condition on her ability to practise, and has not demonstrated to any significant level that she has developed strategies to enable her to practise to an appropriate standard in the future. Therefore, based on the personal component, the Panel finds that the Registrant’s fitness to practise as a Social Worker is currently impaired by reason of her health condition.

 

62.           Given the Registrant’s lack of insight into the deficiencies in her practice at the time, the Panel is concerned that she will again be in a position of finding it difficult to manage her health condition if she returned to practice, particularly if she is to be exposed, as she would be inevitably be, to heightened levels of stress. For this reason, the Registrant continues to present a risk to service users. The areas of her practice where deficiencies were identified included record keeping, report writing, making professional judgements regarding safeguarding and risk, and applying assessment criteria with regard to capacity and eligibility. These are all factors that have been adversely affected in the Registrant's practice in the past. These could reoccur in the future if she does not manage her health condition.

 

63.           The Panel also considered the wider public interest and concluded that public confidence in the profession would be undermined if a finding of current impairment were not made. Members of the public would not be concerned to learn that a Social Worker had this health condition. Many people with this health condition work to a high standard across a range of professional and other roles. However, an objective observer with full knowledge of the circumstances of the Registrant’s case would rightly be concerned that her inability to manage her health condition, particularly at times of heightened stress, could adversely affect core aspects of her performance and could place service users at unwarranted risk of harm.

 

64.           The Panel further considered that there was a need in this case to declare and uphold proper standards of behaviour. The Panel has already alluded to Standard 1 of the HCPC Standards in paragraph 54 above. It is not in the best interests of service users that their needs are not properly assessed and that their access to services is potentially compromised. The Panel also noted Standard 12, which requires registrants to limit their work or to stop practising if their performance or judgement is affected by their health. In the Panel’s view, the Registrant failed to act in accordance with this Standard in the period between 2010 and her departure from the Local Authority in March 2014. If this were to be repeated in the future, this could again put service users at unwarranted risk of harm.

 

65.           In conclusion, the Panel finds that the Registrant’s fitness to practise is currently impaired on both the personal and public components.

 

66.           Accordingly, the HCPC’s case is well-founded.

 

 

Decision on Sanction

67.           At the reconvened hearing the HCPC was still represented by Mr Mansell and the Registrant participated by telephone link. The Registrant had consulted a representative or supporter about this hearing. She had expected that individual to represent or support her today. However, that individual was no longer available. The Registrant did not seek an adjournment and made it clear that she wished to continue as she had already had a consultation about the hearing. The Panel did not consider it necessary to adjourn the case.

 

68.           It was confirmed that the hearing remained in private.

 

69.           The Panel took account of the submissions made by Mr Mansell, who set out some of the sanctions available to the Panel and the approach that should be taken with reference to the HCPC Indicative Sanctions Policy.

 

70.           The Panel allowed time so that the Legal Assessor could give further guidance to the Registrant, to assist her in making her submissions.

 

71.           The Registrant submitted that she had learned how to use technology to assist with the management of her health condition. However, there was no independent evidence that she had done so. For example, it would have been open to the Registrant to provide evidence arising from, for example, the completion of courses on the use of the technology, but she had not done so.

 

72.           The Registrant has been involved in voluntary work. There was no evidence by way of testimonials from the organisations with which the Registrant has been carrying out such work. Such testimonials could have addressed issues about stress management and the Registrant’s effective use of technology.

 

73.           The Registrant acknowledged that she had been away from practice for over two years and that there had been some significant developments in social work law and practice in that time. She submitted evidence of CPD activity which was linked to her voluntary work. Whilst commendable, most of the CPD activity was not directly relevant or of a sufficient level for social work practice. The HCPC Return to Practice guidance shows that 30 days of CPD activity is required for Registrants who wish to return to practice after a gap of 2 – 5 years.

 

74.           In the Panel’s view the Registrant needs to update her knowledge of social work legislation and current practice, and demonstrate that she has carried out the necessary training before adding the stressful step of returning to work.

 

75.           The Registrant submitted that she did not consider a sanction was necessary. This demonstrated a lack of insight on her part as serious and essential social work tasks had been compromised by her failure to manage her health condition. It also indicated that the Registrant had not fully acknowledged that her fitness to practise had been found to be impaired.

 

76.           The Registrant submitted that she intended to work on a part time basis, as a locum and not as a Level 3 Social Worker. The Panel recognised that the intention to work part time and at a lower level showed a degree of insight as the Registrant had appreciated that this would reduce the stress associated with working full time at the same level as before. In the Panel’s view, however, the Registrant may wish to reconsider her intention to work on a locum basis in light of the fact that a greater level of the required support is likely to be available from a more permanent employer.

 

77.           The Registrant had researched the support that could be available from the appropriate institutes and submitted that useful packages and training are available. There was no evidence that the Registrant had accessed such packages or support.

 

78.           In all, the Panel felt that there was no evidence of relevant training activity or that the Registrant had succeeded in demonstrating that she had learned to use the technology and methods to effectively manage her health condition.

 

79.           In considering what, if any, sanction to impose the Panel had regard to the HCPC Indicative Sanctions Policy and the advice of the Legal Assessor.

 

80.           The Panel took into account the mitigation in this case, namely that this was the first time the Registrant was before the Regulator. She had suffered from two health conditions that had affected her greatly. One of those health conditions has now resolved. The Registrant does wish to practice in her chosen profession.

 

81.           The Panel reminded itself that this is a serious case, as highlighted in paragraph 53 above. There were departures from fundamental duties which involved the failure to take timely and necessary action. Vulnerable service users were affected and matters persisted over a prolonged period.

 

82.           Thus, the lapses cannot be regarded as being of a minor nature. Furthermore the lapses persisted over a number of years, and there is a significant risk of recurrence as the Registrant has shown a lack of insight. There is little evidence of remedial action.

 

83.           Accordingly, the seriousness of this case meant that taking no action was not an option and a Caution Order, even for the maximum duration, was inadequate as such an Order would not provide any protection against the risks that the Panel has identified.

 

84.           The Panel then considered and excluded the imposition of a Conditions of Practice Order at this point in time.

 

85.           The Panel came to this view in light of a combination of factors including the lack of evidence of updated knowledge, the lack of evidence of the Registrant’s ability to use technology or otherwise manage her health condition in a working environment (whether paid or voluntary) and the stress of returning to work even on a part-time basis. The combined effect of these factors meant that workable conditions could not be formulated. The Panel considered a number of conditions but on evaluation these included pre-conditions which the Panel considered would need to be met before the Registrant could safely return to any form of practice, even with restrictions. Furthermore, the number of outstanding issues, the lack of insight and the absence of remedial action rendered this Order insufficient. Such an Order would not adequately address the public reassurance requirements.

 

86.           The Panel then went on to consider the imposition of a Suspension Order for up to 12 months. The Panel concluded that a Suspension Order for 5 months would be a proportionate sanction. Such an Order is sufficient to reflect the seriousness of the situation and the need to protect the public whilst concerns remain outstanding. It would also maintain confidence in the profession and the regulatory process.

 

87.           The Panel considered that an order for 5 months was the minimum required to give the Registrant time to address the underlying concerns. This Order will be reviewed by another panel shortly before it expires.

 

88.           The Panel considered that a reviewing Panel may be assisted by the following:

 

(a)           The Registrant’s personal attendance.

 

(b) Evidence that the Registrant is able to use technology and other methods to assist with the management of her health condition.

 

(c) Evidence that the Registrant is able to apply, in a paid or voluntary work setting, her developing skills in managing her health condition.

 

(d) Evidence that the Registrant has updated her knowledge of social work legislation and practice particularly in the areas of safeguarding, mental capacity and community care with particular emphasis on the area in which she wishes to practise. The Panel would remind the Registrant that formal training courses would provide one method of demonstrating her activity in this regard but it may be the case that she will be unable to access some courses. Research may identify online modules, or the Registrant could seek guidance from BASW. The Registrant may wish to carry out private study of relevant legislation, journal articles or similar. She could produce a reflective piece or learning journal in which to demonstrate the learning from her study.

 

(e) Evidence from paid or voluntary work of the Registrant’s ability to operate effectively in the workplace and manage any associated stress.

 

89.           The Panel would encourage the Registrant to continue with her voluntary work. She could also give thought to seeking employment as a Social Work Assistant. This would not require registration as a Social Worker, but would provide her with a useful opportunity to demonstrate her ability to manage the stresses associated with a return to work, to develop strategies to manage her workload, and to show her ability to manage her health condition in the

working environment.

 

90.           In all the circumstances the Panel believes that the order is necessary and proportionate.

 

91.           The HCPC applied for an Interim Suspension Order to cover the next 28 days and any appeal period. The Registrant did not oppose the application.

 

92.           The Panel granted the HCPC application for an Interim Order of Suspension. The Panel was satisfied that the Registrant had been notified that such an application may be made when she was notified of this hearing. The Panel was satisfied that an interim order is necessary in the circumstances of this case rather than it being an automatic consequence, there being evidence that the Registrant was actively seeking employment as a Social Worker as recently as May 2016. The Panel made the order on two of the statutory grounds, namely the need to protect the public and it being otherwise in the wider public interest. The absence of an Order would have left the public at risk pending the substantive order coming into force. In the Panel’s view this would represent an unacceptable risk to public protection and would have also seriously undermined confidence in the profession and this regulatory process. Furthermore, in the event of an appeal, the public would be left at risk for an even longer period. The Panel adopts the reasons in the main decision as further justification for the exclusion of an Interim Conditions of Practice Order and the imposition of an Interim Suspension Order.

Order

That the Registrar is directed to suspend the registration of Mrs Ranjana Varia for a period of 5 months from the date this order comes into effect.

Notes

The order imposed today will apply from 8 July 2016 (the operative date).

This order will be reviewed again before its expiry on 8 December 2016.

Hearing history

History of Hearings for Ranjana Varia

Date Panel Hearing type Outcomes / Status
27/10/2017 Health Committee Review Hearing Suspended
07/11/2016 Health Committee Review Hearing Suspended
10/06/2016 Health Committee Final Hearing Suspended