Mr David John Steare
During the course of your practice as a Social Worker employed by Staffordshire County Council you:
1. In or around February 2013 introduced and/or suggested changes to Service User A's intervention/care plan but did not:
a. Discuss the changes to Service User A's intervention/care plan with other professionals first; b. Undertake any or any adequate risk assessment of these changes;
3. Your actions at paragraph 1 above placed Service User A at risk of harm.
4. Introduced and/or suggested an intervention in relation to Service User A which was outside the scope of practice of a Social Worker;
5. On or around 5 November 2012, took a photograph of a Service User B on your own personal phone;
6. The matters described in paragraphs 1(a), 1(b) and 3 constituted misconduct.
7. By reason of that misconduct your fitness to practise is impaired.
1. The Panel considered the notice of hearing dated 13 January 2017, the certificate of registration, and the signed proof of posting by first class post also dated 13 January 2017. The Panel determined that there was good service of the Notice of Hearing in accordance with the Health and Care Professions Council Rules 2003.
Proceeding in absence
2. The Panel heard a submission by Ms Nadarajah on behalf of the HCPC to proceed in the absence of the Registrant under Rule 11 of the Health and Care Professions Council (Conduct and Competence Committee)(Procedure) Rules 2003. The Registrant was not present or represented, but he had submitted written representations for this review hearing by an email dated 27 January 2017, in which he also stated that he would not be attending the hearing. No adjournment was sought by the Registrant.
3. The Panel accepted the Legal Assessor’s advice to take account of the relevant HCPC Practice Note “Proceeding in the Absence of the Registrant” September 2016 and considered all the circumstances. The Panel noted that the Registrant has not applied for an adjournment of this mandatory review of a substantive order, and considered that there is a public interest in this review being dealt with expeditiously. The Panel has determined that the Registrant has exercised his choice not to attend the hearing today, and is therefore unlikely to attend on a future date if this hearing was to be adjourned. The Registrant has sent his detailed submissions in writing for the Panel to consider. It is therefore fair, proportionate and in the interests of justice to proceed in his absence.
4. The Registrant is a registered social worker. The Registrant worked as a senior practitioner in the Children & Adolescent Mental Health Services (CAMHS) Team of the South Staffordshire and Shropshire Healthcare NHS Foundation Trust (the Trust). He was employed by Staffordshire County Council (the Council).
5. In February 2013 concerns were raised about the care the Registrant had provided to Service User A. The intervention decided upon by the Registrant involved Service User A ‘only cutting’ herself on alternate days at set times with her mother attending to the wounds without comment. Although the intervention was not an approach advocated by CAMHS and did raise concerns in the way it was implemented with Service User A, the previous panel accepted the evidence that the intervention could be appropriate if implemented correctly. The Registrant had not discussed the intervention with other professionals first, and had performed a risk assessment ‘on the hoof’ and in his head during his session with Service User A and her mother in which the intervention was agreed. The previous panel determined that the Registrant should have undertaken a comprehensive risk assessment using the CAMHS risk assessment model.
6. Service User A was a child who, at the relevant time, had just been discharged from hospital and was in the highest category of risk. The previous panel concluded that the Registrant’s implementation of his chosen intervention had put Service User A at risk of harm, and that particulars 1(a), 1(b) and 3 individually and collectively amounted to misconduct.
7. This is a review under Article 30 of the 2001 Order. In reaching its decision today, this Panel has taken careful account of the findings of the previous panel. The Panel has accepted the Legal Assessor’s advice and exercised the principle of proportionality and the full guidance in the HCPC’s “Indicative Sanctions Policy” September 2015.
8. The previous panel indicated what a review panel might consider helpful evidence to demonstrate that the Registrant had insight and had taken action to remedy his impairment. The Registrant has not provided any of the evidence indicated by the previous panel, and has only sought to denigrate the regulatory process in rather inflammatory language within his written submissions. The Panel is satisfied the Registrant remains a risk to the public due to unresolved deficiencies in his professional practice. In these circumstances the Panel determined that the Registrant’s fitness to practise remains impaired on both personal and public components as referred to in the HCPC’s “Finding that Fitness to Practise is ‘Impaired’” September 2016.
9. The Panel has taken into account that HCPC sanctions are not intended to be punitive, but are only imposed when it is necessary to do so, to safeguard the public and the wider public interest. Further, the sanction imposed must be proportionate by being the minimum order that is sufficient to achieve that protection.
10. In reviewing the current Suspension Order, the Panel first considered taking no action or mediation and rejected these outcomes as, in the circumstances, it would be wholly inappropriate and inadequate to take no further action. Such a course would not protect the public or the wider public interest.
11. The Panel next considered imposing a Caution Order and rejected this sanction. The Panel determined that this sanction could not meet the safeguards required to protect the public in view of the seriousness of the misconduct and lack of acceptance by the Registrant of his failings and the consequent lack of any attempt at remedying that misconduct to avoid a repetition.
12. The Panel then considered replacing the current Suspension Order with a Conditions of Practice Order. The Panel was unable to formulate practicable or workable conditions which would be sufficient to protect the public or wider public interest in the present case. In addition, the Panel was concerned that the Registrant would not comply with conditions given his present expressed attitudes towards the regulatory process.
13. The Panel next considered whether to extend the existing period of suspension. The Panel took note of the fact that the misconduct concerned a single incident after a long and otherwise unblemished career. The Registrant had been working with little or no supervision by his employers for some time leading up to this incident, and the intervention had been decided upon by the Registrant with the best of motives. In addition, there is no evidence available to the Panel to show that the Registrant’s misconduct caused actual harm, only that it had raised a concern and a risk of harm. However, those mitigating factors were counter-balanced by the Registrant’s complete failure to date to acknowledge any error of judgment on his part, or, indeed, the findings of the previous panel.
14. In its written determination, the previous panel had warned the Registrant that if he was unable to develop insight during his six months’ suspension, he would risk a Striking Off Order, and that was the order sought by the HCPC today. This Panel has determined that it would be appropriate and proportionate to give the Registrant one, probably last, opportunity to reflect upon these proceedings and, in the words of the previous panel, “open his mind to the fact that although his motives were good, his proposed intervention was introduced in a fundamentally wrong way which carried serious risks.”
15. The Panel therefore determined that the appropriate, sufficient and proportionate sanction at this stage would be to extend the present Suspension Order for a further six months.
16. This Order will be reviewed shortly before its expiry. A future reviewing panel is likely to be assisted by the following:
• Evidence of insight, which may include written reflections upon his understanding of (a) the need to undertake assessments of risks (“Standards of Proficiency: Social workers in England” paragraph 1.3), and (b) the need to build and sustain collaborative professional relationships with colleagues as an autonomous practitioner (see “Standards of conduct, performance and ethics” paragraph 7, and “Standards of Proficiency: Social workers in England” paragraph 9.1)
• Evidence of his keeping up to date with current practice in care planning and risk management.
The order imposed today will apply from 7 March 2017.
This order will be reviewed again before its expiry on 7 September 2017.
History of Hearings for Mr David John Steare
|Date||Panel||Hearing type||Outcomes / Status|
|07/08/2017||Conduct and Competence Committee||Review Hearing||Struck off|
|10/02/2017||Conduct and Competence Committee||Review Hearing||Suspended|
|08/08/2016||Conduct and Competence Committee||Final Hearing||Suspended|
|18/04/2016||Conduct and Competence Committee||Final Hearing||Adjourned part heard|