Mrs Joel Deborah Birch

: Social worker

: SW91684

: Final Hearing

Date and Time of hearing:10:00 06/02/2017 End: 17:00 09/02/2017

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

: Conduct and Competence Committee
: Suspended

Allegation

During the course of your employment as a Social Worker at East Sussex County Council between September 2012 and 27 February 2015, you:

 

1. In the case of service user A, did not:

a) complete a carers assessment on the case file between January 2014 to April 2014

b) follow up a request for respite between January 2014 to April 2014

 

2. Advised person C that they would need to self-fund emergency respite in the case of service user B, which was not the case

 

3. Completed a review for service user B, without:

a) Completing a Mental Capacity Assessment

b) Considering the clients views and / or wishes

 

4. In the case of service user D, did not complete a safeguarding investigation report between 25 July 2013 and 28 February 2014

 

5. In the cases of service user E and service user F, did not:

a) complete follow up work with carer (s)

b) put funding in place for a keysafe

c) put funding in place for a lifeline

d) mitigate the risk of fire

e) follow up an occupational therapy referral

 

6. In the case of service user G, did not complete a Mental Capacity Assessment at the point of review

 

7. In the case of service user H, did not:

a) complete a Mental Capacity Assessment

b) offer a carers assessment between June 2013 and April 2014

 

8. In the case of service user I, did not complete a safeguarding alert for approximately 10 days, in relation to a domestic violence concern

 

9. In the case of service user J, made decision(s) for eligibility for services without completing an assessment

 

10. Did not complete diary sheets in the case of:

a) service user G between 29 October 2013 and 29 November 2013

b) service user J between November 2013 and February 2014.

c) service user K between 15 January 2013 and 06 February 2013

d) service user L between 19 December 2013 and 15 March 2013

e) service user M between 31 January 2013 and 14 May 2013.

f) service user N between approximately 17 December 2012 and 12 February 2013

g) service user O between 8 November 2013 and January 2014.

 

11. In the case of service user W, did not complete an urgent review between 10 January 2013 and 21 February 2013, despite concerns that service user W was not eating properly

 

12. Did not complete a review for safeguarding in the case of:

a) service user P between 03 October 2012 to 21 February 2013

b) service user M between 31 January 2013 and 14 May 2013

c) service user N between 07 December 2012 and 12 March 2013

 

13. Did not complete an assessment for:

a) service user Q prior to service user’s discharge from hospital

b) service user R in relation to residential care provision

 

14. In the case of service user S, did not contact the service placement team for the Local Authority to fund a nursing home placement

 

15. In the case of service user U, did not:

a) send out a provider report

b) complete a safeguarding investigation report

 

16. In the case of service user T, did not complete an urgent re-assessment between 10 January 2013 and 25 February 2013

 

17. In the case of service user Y, did not mitigate the risk of falling between 24 January 2014 and 4 March 2014.

 

18. Your actions described in paragraphs 1 - 17 constitute misconduct and/or lack of competence.

 

19. By reason of your misconduct and/or lack of competence, your fitness to practice is impaired

Finding

Preliminary matters:

Service of Notice

1.The notice of today’s hearing dated 5 October 2016 was sent to the Registrant at her address as it appeared in the Register. A copy of the notice without redaction was available. The notice contained the date, time and venue of today’s hearing. The Panel was satisfied that notice of today’s hearing has been served in accordance with the Rules.

Proceeding in the Absence of the Registrant

2.Ms Sharpe, on behalf of the HCPC, submitted that the hearing should proceed in the absence of the Registrant. She informed the Panel that there was limited correspondence from the Registrant prior to December 2016. On 21 December 2016 the Registrant submitted a form to the HCPC stating that she did not intend to attend the hearing or be represented. The Registrant denied all the particulars in the Allegation.

3.The Panel heard and accepted advice from the Legal Assessor. The Panel exercised its discretion with the utmost care and caution. It took into account the HCPC Practice Note entitled “Proceeding in the Absence of the Registrant”.

4.The Panel carefully considered the Registrant’s response form and concluded the form is clear and that the Registrant has voluntarily absented herself from today’s hearing. There was nothing to suggest that if the case was adjourned the Registrant might attend a hearing at a later date. The Panel took into account the Registrant’s interests, but decided that they were outweighed by the public interest in the expeditious disposal of the case. The Panel therefore exercised its discretion to proceed in the absence of the Registrant.

Application to amend

5.Ms Sharpe made an application to amend the allegation. An amended Notice of Allegation was sent to the Registrant on 29 January 2016. This proposed a number of changes to dates and other details, including the correction of the identity of one of the service users.

6.In addition Ms Sharpe proposed two further amendments which had not been notified to the Registrant. The first proposed amendment was to correct a typographical error in particular 11(d) which should read “service user L between 4 October 2012 and 15 March 2013”. The second proposed amendment was to amend the stem of the allegation so that it reads “During the course of your employment as a Resource Officer between September 2012 and February 2013 and as a Social Worker between February 2013 and 27 February 2015”. Ms Sharpe proposed this amendment because the Registrant was not a registered Social Worker in October 2012 and the stem of the allegation was therefore incorrect.

7.The Panel agreed to all the amendments set out in the amended Notice of Allegation sent to the Registrant on 29 January 2016. The Registrant had ample notice of these amendments and had the opportunity to respond to them. In the Panel’s view, there is no unfairness to her in allowing the amendments. The amendments were appropriate to reflect the evidence in the case.

8.The Panel also agreed to the minor amendment to particular 11(d) to correct a typographical error. Although the Registrant has not had notice of this proposed amendment, it is plain, on the face of the particular, that the first date is incorrect. The Panel concluded that this minor amendment does not prejudice the Registrant and that the amendment is appropriate.

9.During its deliberations on the proposed amendment to the stem the Panel requested further information. The Hearings Officer provided information that Registrant was first registered as a Social Worker on 26 February 2013. The Panel also requested further legal advice. The Legal Assessor advised that the Panel had discretion to amend the stem of the particular of its own volition. The hearing reconvened for the Panel to inform Ms Sharpe that it was considering making an amendment to the stem: “During the course of your employment as a Social Worker at East Sussex County Council from 26 February 2013 to 27 February 2015, you:”.

10.Ms Sharpe submitted that the period during which the Registrant was employed as a Resource Officer prior to her registration as a Social Worker was relevant as part of the context, and that her proposed amendment would enable the Panel to consider that context. She further submitted that the Panel had jurisdiction to consider the period of time before the Registrant became a registered Social Worker. This is under Article 22(3) of the Health and Social Work Professions Order 2001, which states that an allegation may be considered where it is based on a matter which is alleged to have occurred at a time when the person against whom the allegation is made was not registered.

11.The Legal Assessor confirmed that there is no legal reason to prevent the Panel considering the period of time prior to 26 February 2013. The Panel is entitled to take into account the factual position when considering whether or not to exercise its discretion to amend the allegation.

12.The Panel did not allow the amendment to the stem of the Allegation proposed by Ms Sharpe. The Panel considered that if the Panel allowed the amendment proposed it would put the Registrant at significant disadvantage and she might have responded differently.

13.The Panel took the view that the stem of the Allegation as currently drafted is unsatisfactory because it is inconsistent with the facts. The Panel therefore considered amending the stem of the Allegation to reduce the time period to the cover only the time the Registrant’s name was entered onto the HCPC register. Although an allegation can relate to a period of time when the Registrant is not registered, this Allegation concerns the Registrant’s performance of social work tasks. In the circumstances of this case, the Panel’s view was that the relevant period of time for the Allegation was the period the Registrant was qualified as a Social Worker and on the HCPC Register. The Panel accepted that the period when the Registrant worked as a Resource Officer provided context which it would bear in mind, but decided that this period should not be part of the Allegation.

14.The Panel was satisfied that the Panel’s amendment did not prejudice the Registrant. It narrowed the scope of the Allegation and it made clear the events that were covered by the Allegation and the events that were not. The Panel therefore decided, of its own motion, to amend the stem of the Allegation so that it reads: “during the course of your employment as a Social Worker at East Sussex County council between 26 February 2013 and 27 February 2015, you”.

15. Ms Sharpe made a further application to amend particular 13 to remove the words “for safeguarding”. The application was made after witness LR had given evidence that the Registrant had not completed a review for Service User M, but that this was not a review for safeguarding. LR’s witness statement in relation to Service Users P and N also referred to reviews rather than reviews for safeguarding.

16. The Panel did not agree to this proposed amendment. The proposed amendment would be a substantive change and is applied for at a very late stage. The amendment, if agreed, would be prejudicial and unfair to the Registrant. The Panel was not persuaded by Ms Sharpe’s argument that the position was clear from the evidence of witness LR and that the Registrant could have anticipated that particular 13 concerned reviews and not reviews for safeguarding. The Registrant is unrepresented and the Panel does not know the basis on which she has denied particular 13.

17. The Panel also noted that particular 13(a) is entirely outside the scope of the Allegation which is now limited to the period from 26 February 2013 and that particulars 13(b) and 13(c) are partially outside the scope of the Allegation, for the same reason.

18. After the Panel refused the application to amend Ms Sharpe stated that the HCPC offered no evidence on particulars 13(a), 13(b) and 13(c).
 

Evidence relating to Service Users J and K

19. During the evidence of witness LR, Ms Sharpe informed the Panel that the HCPC offered no evidence on particulars 10, 11(b) and 11(c). These particulars concern Service User J and Service User K. Ms Sharpe explained that the documents in the bundle which are labelled as the records for these service users are incorrect and relate to different service users. Ms Sharpe informed the Panel that she has made efforts to remedy the situation, but this had not been practicable.

20. The Panel has a role as the guardian of the public interest to ensure that there is no under prosecution, but noted in this case that the relevant evidence was absent.


Background:

21. The Registrant was employed at East Sussex County Council (“the Council”) from 1999. Initially she held a temporary administrator role. She moved to a permanent administrator role in 2000. From 2001 she was employed until February 2013 as a Resource Officer in the Adult Social Care department. At the Council a Resource Officer carries out similar duties to a Social Worker in assessing and reviewing social care needs for service users and carrying out safeguarding investigations. The more complex cases, however, were allocated to Social Workers.

22. Following a restructure, in September 2012 the Registrant transferred from the Eastbourne team to the Out of County Hospital Discharge Team. In the Discharge Team she was managed by witness HW, who was a Senior Practitioner. The Practice Manger of the Discharge Team was witness LR. The Registrant worked four days per week.

23. In October 2012 the Registrant completed her social work training. She was enrolled on the Assessed Supported Year in Employment (“ASYE”) from February 2013 until April 2014. The ASYE is a structured 12 month programme which newly qualified social workers undertake in their first year of employment. The ASYE year was extended to allow for the reduced hours worked by the Registrant.

24. Concerns were raised in relation to some of the Registrant’s cases and a performance support plan was implemented on 12th November 2013.

25. In April 2014, the final ASYE report was completed and presented with evidence to the ASYE moderation panel. It was recommended that the Registrant be issued with a fail.

26. Following this, the Registrant’s cases were reviewed and a number of record keeping issues were identified.


Decision on Facts

27. The Panel heard evidence from witness LR and witness HW. The Panel found that both witnesses were credible and genuine. They both had good recall of relevant events and the cases. The Panel was satisfied that the witnesses had no hostility towards the Registrant. Instead they had provided her consistently with support and constructive criticism.

28. The Panel has not received any written evidence from the Registrant.

29. The Registrant was provided with extensive support which exceeded the expected support normally provided to a Social Worker in the ASYE year. The support included additional one to one training, control and reduction of the Registrant’s case load, managerial guidance, and more frequent supervision. The Panel noted that the supervision records were very detailed.

Particular 1

In the case of service user A, did not:
a) Complete a carers assessment

30. The case was allocated to the Registrant on 16th October 2013 and she was asked to conduct a reassessment of SUA.  On 16th January 2014, the Registrant completed a Review and recorded on the Diary Sheet (record of contact with a service user) that a “carers assessment was to be completed.”

31. Service user A (SUA) lived with her husband and had complex health and social needs. The case was referred to review SUA’s needs and establish if there were any further supportive measures or equipment that would assist SUA or her husband, who was her main carer.
 
32. A carer’s assessment is a simple assessment completed with the carer, in this case, SUA’s husband. The purpose of the assessment is to understand the carer’s needs and identify if support is required to maintain their caring role.


33. The expectation in the Trust was that a carer’s assessment would be completed and written up approximately two to three weeks after requested. A carers assessment would be recorded on the carer’s electronic case record.

34. The Panel accepted the evidence of witness LR that she checked the records and that there was no record on the file of SUA or their carer between January 2014 and April 2014.

35. The Panel found that particular 1(a) is proved. The Panel was satisfied that the Registrant knew that a carer’s assessment was needed because she recorded this in the Diary Sheet on 16 January 2014.
b) Follow up a request for respite between January 2014 to April 2014

36. On 11 March 2014, a call was received and logged in the Diary Sheet by the duty Social Worker, from the homecare agency who supported SUA, requesting for a respite placement to be explored for SUA as “her husband is in poor health and is finding it difficult to maintain his caring role”.

37. On 9 April 2014, the Registrant recorded in the diary sheet a telephone conversation with SUA’s husband where he requested respite care for a period of 2 weeks. On 11 April 2014, a further telephone call was logged on the diary sheet asking the Registrant to return SUA’s husband’s telephone call “to discuss respite for his wife next week”. On 15 April 2014, SUA’s husband again raised the possibility of a nursing home placement.

38. On 17th April 2014 an administrator took a call from SUA’s husband who contacted the team in a state of distress, as he could no longer manage his caring role.

39. Witness LR sent an email raising various concerns in relation to SUA to the Registrant on 17 April 2014 and requested a meeting to discuss matters. The Registrant replied on 22 April 2014 and suggested meeting on 23 April 2014 The Registrant went on sickness absence from 23 April 2014 and the meeting did not take place.

40. The Panel found that particular 1(b) is partially proved. The evidence is that the earliest request for respite care was 11 March 2014, which was followed by several further requests. The Panel found particular 1(b) proved, but only from 11 March 2014.

Particular 2

Advised person C that they would need to self-fund emergency respite in the case of service user B, which was not the case.


41. Service user B (SUB) was a male service user in his 90s who suffered from dementia, poor mobility, osteoarthritis and a number of other conditions. Until November 2013, SUB was cared for at home by his wife, person C, aged 90. In November 2013, SUB suffered a fall and was admitted to hospital.

42. This case was allocated to the Registrant on the 29th November 2013 when SUB was ready for discharge from hospital. A care package was put in place to support SUB and Person C, which began on SUB’s discharge from hospital on 11 December 2013.

43. On 20 December 2013, Person C contacted the Registrant and informed her that she wished to cancel the care package, as she felt that she and SUB were managing well.

44. On 3 January 2014, Person C contacted the emergency duty team expressing concerns that she was not coping with caring for SUB. She reported that SUB had not slept for over 24 hours. SUB’s GP saw SUB and advised that he had dementia and a respite placement was recommended.


45. Where a SU has less than £23,250 in savings, the Council has a duty to fund care that meets their eligible social care needs. It was recorded by the Registrant on the diary sheet on 4 December 2013, that SUB had less than £23,250 in savings.

46. Following the GP recommendation on 3 January 2014, the Registrant recorded that a three-week self-funded respite placement would be arranged; it was also noted that “I have explained to Person C that ESCC funding will depend on the financial assessment”. On 21st January 2014, the Registrant confirmed in a review update, “Service User was placed for 3 weeks respite on a self-funding basis”.

47. The Panel found that particular 2 is not proved. The HCPC is required to prove that advice was given to person C that “they would need to self-fund emergency respite”. There is no evidence that the Registrant gave such advice. Person C offered to pay for the placement and the Registrant failed to advise that SUB and Person C may be eligible for Local Authority funding. This is not the same as giving positive advice to Person C that they would need to self-fund emergency respite.

Particular 3
Completed a review for service user B, without:
a) Completing a Mental Capacity Assessment

48. On 3 January 2014, service user B (SUB) was admitted to a placement for emergency respite care. A breakdown in carer relationship and SUB’s placement into emergency respite care constitutes a significant change in circumstances and, the Registrant as the social worker, was therefore required to carry out either a reassessment or review, including a Mental Capacity Assessment if required.

49. A Mental Capacity Assessment should be undertaken if, amongst other criteria, the SU has been diagnosed with an impairment or disturbance that affects the way their brain or mind works. SUB had a diagnosis of dementia and the staff had noted during his hospital stay that he had poor cognition. A Mental Capacity Assessment should therefore have been completed when a decision was being made regarding a permanent change in accommodation.

50. A Mental Capacity Assessment should be carried out face to face to assess the SU’s capacity. If the SU lacks capacity, the social worker is required to explore whether the SU had prior views that should be taken into consideration.

51. The Registrant did not carry out a Mental Capacity Assessment on SUB. In an email exchange with witness LR, the Registrant confirmed that no Mental Capacity Assessment had been carried out on 21 January 2014, because SUB was asleep when the Registrant visited. SUB was subsequently moved to another placement without a Mental Capacity Assessment being completed.

52. The Panel found that particular 3(a) is proved. The Registrant was aware of the diagnosis of SUB and his poor cognition. A Mental Capacity Assessment was required and the Registrant should have been proactive in finding a time to visit SUB when he was likely to be awake. Alternatively she should have made arrangements to return and visit again when SUB was awake to complete the Mental Capacity Assessment.


c) Considering the clients views and/or wishes

53. The Panel found that particular 3(b) is proved. There is no evidence that SUB’s wishes and views were taken into account for the same reason as given for particular 3(a), namely that during the review on 21 January 2014, SUB was asleep.

Particular 4
In the case of service user D, did not complete a safeguarding investigation report between 25 July 2013 and 28 February 2014
 
54. Service user D (SUD) was in receipt of home care support; SUD had been referred for a safeguarding investigation because healthcare professionals had raised concerns that SUD’s care agency were not administering the correct dose of his medication.

55. In accordance with section 5.2 of the Sussex Multi-Agency Policy and Procedures for Safeguarding Vulnerable Adults each safeguarding investigation has an investigation manager and officer. The Registrant was SUD’s investigating officer, whose role is to review the records and gather information in relation to the complaint and produce an investigation report to be presented at a case conference.

56. The report is to be completed within 14 days as per section 5.5 of the Policy and Procedures for Safeguarding Vulnerable Adults entitled “Implementing the investigation framework”. Although it is common for this deadline not to be met, the expectation is that the reports are completed as soon as possible.

57. In relation to SUD, the Registrant was appointed as investigating officer on 10 October 2013. By 3 April 2014, a report had not been completed. Witness LR emailed the Registrant on 3 April to ask that the report be completed as a priority by 16 April 2014, in preparation for the case conference scheduled for 24 April 2014.

58. The investigation report was not completed and witness HW took over as investigating officer on 12 September 2014 and completed the safeguarding investigation report.

59. The Panel found that particular 4 is partially proved. The allegation covers the period from 25 July 2013 to 28 February 2014. The Registrant was not appointed as the investigating officer until 10 October 2013. After that date she did not complete a safeguarding investigation report and the report remained outstanding on 28 February 2014.

Particular 5
In the case of service user E, you did not:

60. Service User E (SUE) had been admitted to hospital following a stroke and was referred to the team to ensure a safe discharge. SUE required two support visits a day. SUE was at high risk of falls.
a) put funding in place for a keysafe

61. A keysafe is a small box attached to the wall near a SU’s front door with a code. A spare set of keys to the house is stored in the box for carers. A keysafe is recommended for people who have mobility issues where carers need to gain access.

62.On 24 October 2013, the Registrant recorded on the diary sheets for SUE “keysafe to be installed”. The referral forms were not uploaded to SUE’s records. The keysafe was installed, but as the Registrant had not applied for funding, there was a delay in paying and this caused additional work for the Local Authority Contract Team.

63. The Panel accepted the evidence of witness LR that she checked SUE’s case records and that no funding request was made. The Panel therefore found that particular 5(a) is proved.


b) put funding in place for a lifeline

64. Lifeline is a personal alarm service where the alarm is worn around the SU’s wrist or neck. If an incident occurs, the alarm is pressed and a specified person or people will be notified.

65. As with the keysafe, it was recorded by the Registrant on 24 October 2013, “lifeline to be installed”. These referral forms were not uploaded to SUE’s records either. The lifeline was installed but, again, as the Registrant had not applied for funding, the contractors were not paid with the same consequences as for the keysafe.

66. The Panel found that particular 5(b) is proved.

c) mitigate the risk of fire;

67. From 2012, the local authority put an initiative in place with the East Sussex Fire and Rescue Service to reduce the numbers of deaths from fire in East Sussex. When the assessment forms for new service users are completed, there is a prompt to refer the client for a fire safety assessment.

68. The Registrant completed the assessment in relation to SUE on 31 October 2013. The Registrant did not refer SUE for a fire safety assessment and indicated on the form that this was because “Previously referred, no change in circumstances”.

69. The Panel found that particular 5(c) is proved. There were fire risks because SUE was sleeping downstairs with an open fire in the room. The Panel accepted witness LR’s evidence that there were no records that SUE had been previously referred by the Council, and that it was unlikely that anyone outside of the Council had referred SUE for an assessment.
 
d) follow up an occupational therapy referral

70. Whilst in hospital, a discharge planning meeting was arranged in relation to SUE on 24th October 2013.

71. At that meeting, the occupational therapist was in attendance and made various recommendations for the ongoing care of SUE, including “The OT has recommended that SUE does not access the upstairs rooms, the bath, the conservatory and the outside of the house…until the rehab team have assessed SUE when she returns home.”

72. Witness LR said there were no referral forms saved and there was no record in the notes of any discussion about or referral for occupational therapy support contained within the diary sheets.

73. The Panel found that particular 5(d) is proved. The Panel accepted the evidence of witness LR that there was no occupational therapy referral in the case record.

Particular 6
You did not complete a carer’s assessment for service user F

74. Service user F (SUF) was SUE’s sibling and main carer. This was identified by the Registrant on the assessment forms - “sister supports me with daily living tasks when carers are not in attendance and during the night when SUE needs access to the toilet during the day and using the commode at night”.

75. On 13 December 2013, the Registrant recorded on SUE’s diary sheet that she telephoned SUE’s main carer, (namely, SUF) who was not available and so the Registrant sent out a leaflet in relation to the carer’s assessment, and an appointment letter.

76. A carer’s assessment was not completed with SUF. This is confirmed by the record in the supervision record for 7 January 2014 (for SUE) which states that the Registrant informed witness HW that the family “have declined a carer’s assessment”.

77. The Panel found that particular 6 is proved.

Particular 7
In the case of service user G, did not complete a Mental Capacity Assessment at the point of review

78. Service user G (SUG) had a diagnosis of dementia and she was living in a community setting supported by a package of care.

79. SUG’s case was allocated to the Registrant on 4 June 2013 for a ‘robust review’ to ensure that the local authority was meeting the client’s eligible social care needs in a cost-effective way. A visit and review took place in July 2013 but was not written up by the Registrant. In November 2013 the Registrant was reminded in supervision of the need for a Mental Capacity Assessment because of a proposed change to the package of care. The Registrant did not discuss the potential for a Mental Capacity Assessment with SUG until 30 January 2014 as recorded in the diary sheets.

80. The point of review was 11 July 2013 and the evidence shows that the Mental Capacity Assessment had not been carried out by 29 November 2013.

81.The Panel found that particular 7 is proved.

Particular 8
In the case of service user H, did not:
a)Offer a carer’s assessment between June 2013 and April 2014

82. Service user H (SUH) is the daughter and main carer of SUG.

83. Carer’s assessments can be conducted yearly, or when there are a change of circumstances. It is good practice to offer a carer’s assessment when completing a review or reassessment.

84. Though a reassessment of SUG’s needs was completed (but not written up) by the Registrant in July 2013, no carer’s assessment was completed for SUH between June 2013 and April 2014, as evidenced by witness LR’s case audit.

85. The Panel found that particular 8 is proved.

Particular 9
In the case of service user I, did not complete a safeguarding alert for approximately 10 days, in relation to a domestic violence concern

86.Service user I (SUI) had been admitted to hospital on 22 October 2013 with bilateral cellulitis. SUI lived with her husband.

87. On 4 November 2013, SUI reported safeguarding concerns, which prompted the Registrant to make a safeguarding alert. Safeguarding alerts should be completed, with an outcome, within 24 hours as per section 5.5 of the Sussex Multi-Agency Policy and Procedures for Safeguarding Vulnerable Adults Guide.

88. At a weekly safeguarding meeting, witness LR noted that the Registrant had opened a Safeguarding Alert in relation to SUI on 15 November 2013, but only parts one and two of the six-part form had been completed. Witness LR emailed the Registrant in relation to this on 25 November 2013 and asked that she complete the form as a matter of urgency. In her evidence witness LR reported that the form was completed and reassigned to herself on 26 November 2013.

89. The Panel found that particular 9 is proved.

Particular 10
In the case of service user J, made decision(s) for eligibility for services without completing an assessment

90.The HCPC offered no evidence on this particular and the Panel found that it is not proved.

Particular 11
Did not complete diary sheets in the case of:
a) SUG between 12 December 2013 and 30 January 2014

91. The Registrant discussed SUG’s case with witness LR regarding SUG’s care package. LR later reviewed SUG’s file and noted that there was were no diary sheets completed between 12 December 2013 and 30 January 2014.

92. The Panel reviewed the diary sheets and found that particular 11(a) is proved.
b) SUJ between 8 October 2013 and 7 February 2014

93. The HCPC offered no evidence on this particular and the Panel found that it is not proved.
c) SUK between 15 January 2013 and 6 February 2013;

94. The Panel found that particular 11(c) is not proved. The HCPC offered no evidence on this particular.

95. Further, the particular relates to a period during which the Registrant was a Resource Officer and was not a registered Social Worker, and it is outside the period covered by the stem of the Allegation.
d) SUL between 4 October 2012 and 15 March 2013

96. Service user L (SUL) was in a placement in a residential home.

97. The Panel looked at the diary sheets for SUL. On 4th October 2012, the Registrant recorded in the diary sheets that she had informed the home that she would carry out a review and arrange a visit to SUL. The next diary entry in relation to SUL was completed on 15th March 2013.

98. The Panel found that particular 11(d) is partially proved in respect of the period from 26 February 2013 to 15 March 2013. Prior to 26 February 2013 this particular is not proved because it is outside the scope of the stem of the Allegation.

e) SUM between 9 October 2012 and 10 January 2013;

99. The Panel found that particular 11(e) is not proved. This particular covers a period of time during which the Registrant was a Resource Officer and not a registered Social Worker. It is outside the period of time covered by the stem of the Allegation.

f) SUN between approximately 9 October 2012 and 12t February 2013;

100. The Panel found that particular 11(f) is not proved. This particular covers a period of time during which the Registrant was a Resource Officer and not a registered Social Worker. It is entirely outside the period of time covered by the stem of the Allegation.
 
g) SUO between 6 December 2012 and 5 February 2013;

101.The Panel found that particular 11(g) is not proved. This particular covers a period of time during which the Registrant was a Resource Officer and not a registered Social Worker. It is outside the period of time covered by the stem of the Allegation.

h) SUV between 7 December 2012 and 21 March 2013

102. Service user V (SUV) was awaiting discharge from hospital when concerns were raised about her mobility. The case was allocated to the Registrant on 10th November 2012.

103. The Panel looked at the relevant diary sheets. On 7 December 2012, the Registrant recorded an exchange of emails about SUV’s discharge from hospital on the diary sheets. The next diary sheet entry was made by the Registrant on 21st March 2013 where the Registrant recorded that she had completed a telephone review.

104. The Panel found that particular 11(h) is partially proved in respect of the period from 26 February 2013 to 21 March 2013. Prior to 26 February 2013 this particular is not proved because it is outside the scope of the stem of the Allegation.

i) SUW between 7 November 2013 to 21 February 2014

105.Service User W (SUW) had been admitted to hospital following a fall where he had dislocated his shoulder. SUW had a complex medical history. A care package was to be put in place to support his discharge from hospital.

106.The Panel looked at the diary sheets. The Registrant recorded a diary entry on 7 November 2013 in relation to contact with various care agencies about the care package. The next diary sheet entry was completed on 21 February 2014 and related to an attempted telephone review.

107.The Panel found that particular 11(i) is proved.

Particular 12
In the case of service user O, did not complete an urgent review between 10 January 2013 and 21 February 2013, despite concerns that service user O was not eating properly

108. The Panel found that particular 12 is not proved. This particular falls entirely outside the time period covered by the stem of the Allegation.

Particular 13
Did not complete a review for safeguarding in the case of:

a) Service User P

109. Service user P (SUP) was admitted to hospital after she had a fall. In early November 2012, SUP was discharged from hospital after a care package had been put in place.

110. From the documentary evidence there were no safeguarding issues involved in this case. The Panel found that particular 13(a) is not proved because the HCPC has not discharged the burden of proof. Further, this particular relates entirely to a period of time outside the stem of the Allegation.
b) service user M

111. SUM had been admitted to hospital and was discharged from hospital on 28 September 2012 with a package of care. On 2 October 2012, SUM was readmitted to hospital. Some concerns about the care package were raised.

112. There is no evidence that the review, that should have taken place, was a review “for safeguarding” and the HCPC offered no evidence on this particular.

113. The Panel found that particular 13(b) is not proved because the HCPC has not discharged the burden of proof. The Panel also noted that the period of time covered by this particular is partly outside the stem of the Allegation.
 
c) service user N

114. SUN moved out of the area to a placement in Kent and the Registrant was required to complete a telephone review.

115. There is no evidence that the review that should have taken place was a review “for safeguarding” and the HCPC offered no evidence on this particular.

116. The Panel found that particular 13(c) is not proved because the HCPC has not discharged the burden of proof. The Panel also noted that the period of time covered by this particular is partly outside the stem of the Allegation.

Particular 14
Did not complete an assessment for:

a) service user R in relation to residential care provision

117. Service user Q (SUQ) wished to be discharged from hospital but the hospital had blocked the discharge as they were of the view that SUQ lacked capacity.

118. The Registrant completed a risk assessment that was dated 28 March 2014. The HCPC’s case was that although the Registrant completed a risk assessment for SUQ it had not been sent to a manager for authorisation and therefore was not complete. The diary sheets show that the Registrant completed the risk assessment and filed it on the electronic case file and emailed it to witness HW. The risk assessment form requires a signature from a manager. Therefore the Panel did not infer that the Registrant had not taken steps to ensure that a manager received the form. The Panel found that particular 14(a) is not proved.


b) service user R in relation to residential care provision.

119. Service user R (SUR) had been admitted to an acute hospital. SUR’s family asked that he be moved to a residential care placement, and the Registrant was required to carry out an assessment in order to determine SUR’s need.

120. On 22 January 2014, the Registrant recorded in the diary sheets “SUR does not meet the eligibility criteria for residential care.” However, witness LR stated there were was no completed assessment form on file.

121. The Panel found that particular 14(b) is proved.


Particular 15
In the case of service user S, did not contact the Service Placement Team for the Local Authority to fund a nursing home placement.

122. Service user S (SUS) was admitted to hospital. SUS had a history of heart disease and dementia. Whilst in hospital, SUS was assessed as having eligible social care needs which required a nursing home placement.

123. SUS was discharged to a Nursing Home after arrangements were made by SUS’s husband. This placement was self-funded. SUS was later moved to another Nursing Home, this too was a self-funded placement.

124. The Registrant began an assessment on 22 March 2014; there were also review forms completed by the Registrant on 14 February 2014 and 25 March 2014. The Registrant recorded that the service user was eligible for funded support from the Council. On identifying the need for nursing home care, the Registrant was required to contact the Service Placement Team (SPT), part of the local authority, who search for providers and negotiate the rates of care, once the assessment had been completed.

125. This was raised in supervision with the Registrant on 28 February 2014 where it was clear that as the SPT had not been contacted, no funding was in place for SUS’s nursing home placement.

126.The Panel found that particular 15 is proved.


Particular 16

In the case of service user U, did not:

a) Send out a provider report
b) Complete a safeguarding investigation report

127. On 16 August 2013, witness LR received an email from PD, Duty and Assessment Team Manager, in relation to a safeguarding investigation concerning service user U (SUU). The Registrant had been appointed investigating officer, although there was no evidence of when this was, and PD was the investigating manager.

128. At the beginning of a safeguarding investigation, a provider report is sent to the care home to enable them to give a response to the allegation.

129. The investigating officer is required to collate all the information that she has obtained concerning the safeguarding allegation and produce an investigation report to be presented at the Case Conference and sent out with the invitations to attendees at that meeting.

130. At the stage of sending out Case Conference Meeting invitations, it was noted by PD that there was no evidence of a Provider Report being sent to the home that had been providing SUU’s care and that the investigation report that was sent out was blank. In addition the care home had not been invited to the meeting.

131. The evidence to support this particular is in the form of hearsay evidence. The Panel gave weight to the hearsay evidence because is contemporaneous, and there is no evidence that it was disputed by the Registrant at the time or subsequently. The Panel found that particulars 16(a) and 16(b) are proved.

Particular 17
In the case of service user T, did not complete an urgent re-assessment in March 2013

132. Service user T (SUT) was admitted to hospital for rehabilitation. The Registrant was instructed to carry out a review and assess SUT’s needs.

133. The case was discussed with the Registrant in supervision on 15 March 2013, 26 April 2013, and 14 May 2013, where she was reminded to carry out a review. A review was completed on 19 June 2013.

134. The Panel found that particular 17 is not proved. There is no evidence, either in the supervision notes or in the oral evidence, that the required re-assessment was deemed urgent. 

Particular 18
In the case of service user Y, did not mitigate the risk of falling between 24 January 2014 and 4 March 2014

135. Service user Y (SUY) was admitted to hospital. An assessment was carried out on SUY on 13 February 2014 and it was identified that he would benefit from a Falls Detector. The Registrant did not arrange or request funding for the Falls Detector at this time.

136. SUY was discharged from hospital with a care package in place on 24 January 2014. Around 4 March 2014, SUY suffered a fall at home. On the same day the Registrant made an urgent application for funding for the Falls Detector.

137. The Panel found that particular 18 is partially proved. The need for a Falls Detector was identified on 13 February 2014. Therefore the particular is proved in relation to the period from 13 February 2014 to 4 March 2014.


Decision on Grounds

138. The question of whether the proven facts constitute misconduct or a lack of competence is for the judgment of the Panel and there is no burden or standard of proof.

139. There is no statutory definition of misconduct, but the Panel had regard to the guidance of Lord Clyde in Roylance v GMC (No2) [2001] 1 AC 311: “Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a …practitioner in the particular circumstances”. The conduct must be serious in that it falls well below the required standards.

140. A lack of competence is a standard of work which is unacceptably low. It will usually be demonstrated by a fair sample of the Registrant’s work. The Panel was satisfied that the proved particulars provided a fair sample of the Registrant’s work.

141. The Panel decided that particular 5(d) does not constitute misconduct or a lack of competence. An Occupational Therapist was also present at the discharge meeting and had responsibility for making the referral, but did not follow up a referral. It would have been good practice for the Registrant to follow this up, but in the Panel’s judgment it was not unreasonable for the Registrant to expect the Occupational Therapist to have carried this out without the need to follow up. The Registrant’s behaviour did not fall below the standards expected.

142. The Panel decided that particular 6 does not constitute misconduct or lack of competence. The Panel considered the supervision notes for 7 January 2014. The Registrant reported to HW that SUF declined a carer’s assessment. Although it was reported by witness LR and witness HW that the Registrant was not always a reliable reporter of tasks she said she had completed, the Panel decided that in this case it was not an inaccurate report. The Registrant’s failure to complete a carer’s assessment is explicable and it does not constitute a lack of competence or misconduct.

143. The Panel found that the proved and partially proved facts (particulars 1(a), 1(b), 3(a), 3(b), 4, 5(a), 5(b) and 5(c), 7, 8, 9, 11(a), 11(d), 11(h), 11(i), 14(b), 15, 16(a), 16(b), and 18) constitute a lack of competence. There is a pattern of failures in record keeping, failure to carry out assessments and reviews, failure to put in place either services or funding in a timely way, and failure to complete diary sheets. The failures occurred over a sustained period of time and despite the extensive support provided by the Registrant’s managers. The pattern of failure indicates that the Registrant lacked the ability to be pro-active and to manage her time effectively. There are repeated failures which indicates a lack of ability to critically analyse and reflect on her standard of work. The Registrant was not able to elevate her standard of work to the standards that are expected of Social Workers, as set out in the Standards of Proficiency. The proved particulars demonstrate that the standard of the Registrant’s work remained unacceptably low, with repetition of similar errors.

144. The Panel found that the proved particulars do not constitute misconduct. The Panel has found that the proved particulars (other than 5(d) and 6 are appropriately characterised as a lack of competence. The Registrant was not an experienced Social Worker. During her ASYE year she did not demonstrate that she was able to work at the level of a Social Worker. She reported that she was stressed at work in the second part of her ASYE year after she was subject to the informal performance support plan. In this context the Panel found that none of the proved particulars crossed the threshold of seriousness to constitute misconduct.

145. The Panel identified that the Registrant’s failures created risks for service users and reputational risks for the Council. For example for service user A there was a risk of the breakdown in the relationship between Service User A and her carer. For Service User B there was a risk of reputational damage to the Council. However, the Panel’s judgment was that none of the proved particulars involved negligence of a sufficiently high degree to constitute misconduct.

146. The Panel considered that some of the particulars were less serious, when they were considered in the context of the background circumstances. For example, the Registrant’s failure to complete the safeguarding investigation report for service user D (particular 4) was in the context that there had been a lack of urgency by the Council before the Registrant was involved. The safeguarding investigation was originally started in February 2013, but not allocated to the Registrant until October 2013. There was evidence of carrying out and documenting the investigation, albeit she did not complete the report.

147. In the Panel’s judgment particular 16 (SUU), in some circumstances, might be sufficiently serious to constitute misconduct. However, there was a lack of contextual evidence of the level of risk and the timescales involved.

148. The Panel noted that in the case of service user R the Registrant did not record that she had carried out an assessment. However, there are diary sheets showing that the Registrant did visit Service User R and was making an assessment. Her failure was that she did not complete the formal documentation.  

149. The failure to complete diary sheets (particular 11) could in many circumstances be sufficiently serious to constitute misconduct. However, in this case the proved particulars involved cases which were not high risk where visits to the service user were urgently required.

150. In the Panel’s judgment none of the proved particulars were sufficiently serious to constitute misconduct.


Decision on Impairment

151. The Panel applied the guidance in the HCPC Practice Note “Finding that Fitness to Practise is impaired” and accepted the advice of the Legal Assessor. The Panel considered the Registrant’s fitness to practise at today’s date.

152. The Panel first considered the personal component which is the Registrant’s current competence and behaviour. There is no information from the Registrant on her current situation. The lack of competence found by the Panel might be remediable. However, there is no evidence that it has been remedied. The Registrant has denied the Allegation and has not demonstrated insight. The Panel found that there was a high risk of repetition, given the nature of the Registrant’s failings and the fact that similar errors were repeated, despite the support provided by the Registrant’s managers.

153. The Panel noted that the Registrant was subject to intense supervision during her ASYE year and that this operated as a control in limiting the risk for Service Users. The Registrant may not be subject to this level of management in every Social Work position. The Panel identified a potential risk of harm to vulnerable Service Users if the Registrant is able to practise without a restriction on her practice. The risk is particularly high if more complex cases are allocated to the Registrant.

154. The Panel decided that the Registrant’s current fitness to practise is impaired, on the basis of the personal component.

155. The Panel next considered the public component which includes the protection of service users, the need to declare and uphold standards of conduct and behaviour, and to maintain confidence in the profession and the regulatory process. The Panel has found that there is a risk of harm to service users. Therefore the public component is engaged. Members of the public would expect the Regulator to take action where the standard of the Registrant’s work has been unacceptably low for a sustained period of time, despite a high level of supervision and additional training. If the Panel did not make a finding that the Registrant’s current fitness is impaired, confidence in the profession and the regulatory process would be damaged.

156. The Panel decided that the Registrant’s current fitness to practise is impaired on the basis of the public component.


Decision on Sanction:

157. The Panel accepted the advice of the Legal Assessor and applied the guidance in the HCPC Indicative Sanctions Policy (ISP).

158. The Panel identified the following aggravating circumstances:
•The Registrant’s denials and lack of insight;
•The Registrant’s reduced workload and allocation of less complex cases;
•Extra support and training provided to the Registrant by her employer;
•The Registrant had some familiarity with the Council’s systems from her ten year employment as a Resource Officer with her employer.

159.The Panel identified the following mitigating circumstances:
•The Registrant was newly qualified;
•The Registrant had recently moved teams within the Council;
•No misconduct.

160.The Panel considered the available sanctions in ascending order of severity. It would not be sufficient to impose no sanction in the circumstances of this case. There would not be any degree of protection for the public and it would not be sufficient in the public interest for the Panel to take no action.

161.A Caution Order permits the Registrant to practise or continue to practise as a Social Worker without restriction. In the Panel’s judgment this would not protect the public. It is not a sufficiently serious sanction to maintain confidence in the profession and the regulatory process.

162.The Panel considered a Conditions of Practice Order, but decided that it would not be sufficient to protect the public or the wider public interest. The Panel cannot be confident that conditions of practice would be workable or that the Registrant would comply with any conditions. In the Panel’s judgment this is a case where there are serious, persistent, overall failings and the Registrant lacks insight and denies wrongdoing. The guidance in the ISP is that a Conditions of Practice Order is unlikely to be suitable in these circumstances.

163.The Panel next considered a Suspension Order. This is the most serious sanction which is available in this case. This is not a case involving misconduct, therefore the Panel does not have the power to make a Striking Off Order. A Suspension Order is sufficient to protect the public because the Registrant cannot practise as a social worker while she is suspended. A Suspension Order is also in the wider public interest. The Panel decided that the most serious available sanction is appropriate in this case. This marks the seriousness of the case and is sufficient to maintain public confidence in the profession and the regulatory process.

164.The Panel took into account the Registrant’s interests, but decided that they were outweighed by the need to protect the public and by the wider public interest considerations.

165.The Panel decided that the Suspension Order should be for the maximum period of 12 months in order to give the Registrant time to address the findings of this Panel. In reaching this conclusion the Panel had regard to the aggravating factors and the persistent overall failings in this case.

166.The Suspension Order will be reviewed before it expires. A future reviewing Panel may be assisted by the following:

•Evidence that the Registrant has developed insight (for example by reflecting on the findings made by the Panel and considering the impact and potential impact on service users);
•Evidence of remediation;
•Evidence that the Registrant has maintained her CPD;
•Testimonials or other evidence covering the Registrant’s recent experience of collecting and analysing data, writing time sensitive reports, managing several tasks over a period of time and maintaining accurate and timely records of progress towards them.

 

Order

The Registrar is directed to suspend the registration of Joel Deborah Birch from the register for a period of 12 months from the date this order takes effect

Notes

An Interim Suspension Order was imposed to protect the public during the appeal period. 

Hearing history

History of Hearings for Mrs Joel Deborah Birch

Date Panel Hearing type Outcomes / Status
01/05/2018 Conduct and Competence Committee Final Hearing Voluntary Removal agreed
08/02/2018 Conduct and Competence Committee Review Hearing Suspended
06/02/2017 Conduct and Competence Committee Final Hearing Suspended