Cavel Callender

: Operating department practitioner

: ODP33314

: Final Hearing

Date and Time of hearing:10:00 20/03/2017 End: 17:00 24/03/2017

:

: Conduct and Competence Committee
: Suspended

Allegation

Allegation (as amended on 20 March 2017)


While employed as an Operating Department Practitioner by the Heart of England NHS Foundation NHS Trust:

1. Between 16 June 2014 and 4 July 2014 you:

a) Did not check the anaesthetic machine correctly during a simulation exercise with Colleague A.

b) Did not demonstrate to Colleague C general knowledge about anaesthetic machines and how to check them.

2. On or around 4 July 2014, whilst recovering post-theatre patients, you copied observations and/or documentation from a previous recovery phase instead of taking and recording new observations and/or documentation of the patient.

3. On or around 28 July 2014, whilst being supervised by Colleague A:

a) you were unable to distinguish between safe and unsafe thoracic suctioning.

b) you incorrectly measured a patient’s respiration rates.

c) regarding at least one of your patients that day, you:

i) did not regularly measure the patient's respiration rate;

ii) did not regularly measure the patient's temperature ;

iii) did not accurately record the patient's respiration rate;

iv)   did not accurately record the patient's temperature.

4. On or around 31 July 2014, while recovering a patient who had undergone surgery, you did not conduct a complete handover to the medical team.

5. Whilst being observed assessing a patient by Colleague B, you did not identify that the patient had an obstructed airway and required a jaw thrust to enable effective breathing.

6. On or around 27 October 2014, whilst observed by Colleague C, you:

a) suggested an inappropriate and/or unsafe treatment plan for a patient with high blood pressure.

b) gave an incorrect handover to a medical team.

c) were unable to state the side effects of and/or appropriate dosages for cyclizine.

d)   did not identify that the wrong pressure had been set and/or  implement the correct chest drain pressure for a patient.

7. On or around 4 November 2014, while working with Colleague A, you:

a) did not regularly measure the respiratory rate for at least one patient.

b)  did not accurately record the respiratory rate for at least one patient.

8. On or around 21 November 2014, while being observed by Colleague C and/or Colleague D, you:

a) did not set up the theatre correctly.

b) did not complete the required paperwork as requested.

9. On or around 27 November 2014, while working with Colleague C, you did not load the echelon gun correctly.

10. On or around 3 December 2014, while working with Colleague D, you did not recall that a large swab was in the chest of a patient when performing a swab check.

11. The matters described in paragraphs 1-11 constitute misconduct    and/or lack of competence.

12. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.

Finding

Preliminary matters


Service and Proceeding in Absence

1. The Panel was satisfied that the letter and email dated 2 December 2016 addressed to the Registrant at her registered address informing her of the date, time and location of the hearing, constituted good service of notice of hearing.

2. Ms Sheridan referred the Panel to the letter of 2 December 2016 to the Registrant. As the Registrant was not present Ms Sheridan referred the Panel to the HCPC Practice Note on Proceeding in Absence. She submitted that the Registrant had waived her right to attend and had not sought an adjournment. She reminded the Panel that three witnesses were present today to give their evidence. She told the Panel that the only communication from the Registrant was a letter received by the HCPC on 30 November 2015 in which she refuted part of the allegation.

3. The Panel considers that good service had been carried out and that reasonable steps to contact the Registrant had been made. It took the advice of the Legal Assessor who referred it to the HCPC Practice Note on Proceeding in Absence and to the case of Adeogba v GMC [2016] EWCA Civ 162 and the guidance contained therein on balancing fairness to the Registrant with fairness to the HCPC and the public interest.  No adjournment has been sought by the Registrant and there was a public interest in proceeding expeditiously. The Registrant has not attended, although she is aware of these proceedings.  The Panel consider that she has voluntarily absented herself. In all the circumstances the Panel decided to proceed in the absence of the Registrant. It is satisfied that there are safeguards to ensure fairness to the Registrant.

 


Amendment of Allegation

4. Ms Sheridan sought an amendment to the allegation. The Registrant had been fully advised as to the terms of the proposed amendments in a letter setting out the proposed changes. This had been sent to the Registrant on 2 November 2016. 

5. She submitted that these amendments better particularised the allegation and did not raise the seriousness of it. She set out the changes and told the Panel that they better reflected the evidence which remained the same. She submitted that these were not material changes and that no prejudice to the Registrant arose.

6. The Panel took the advice of the Legal Assessor who reminded it to consider the issue of the materiality of the amendments and whether, in all the circumstances, the proposed amendments may cause prejudice to the Registrant. The Panel was satisfied that the proposed amendments were not material and served to further particularise the allegation. The Registrant had received notice of the proposed amendments on 2 November 2016. The Panel was satisfied they were not prejudicial to the Registrant and noted that the Registrant had not responded.  It determined to allow the proposed amendments.

Background

7. The Registrant was employed as an Operating Department Practitioner (ODP) at the Heart of England NHS Foundation NHS Trust (the Trust) on 16 June 2014. The Registrant was a Band 5 Operating Department Practitioner. During the course of the Registrant’s employment with the Trust she was exposed to all areas in which she would be expected to work i.e. Scrubs (Surgery), Anaesthetics and Recovery. Her probation period was meant to last 12 weeks but was extended for a further 3 months due to both the Registrant’s lack of progress and her sick leave. This additional time was to give her the best chance to improve her performance. In spite of the additional support the Registrant did not pass her probation.

8. Ms Sheridan for the HCPC set out in her opening statement the HCPC’s case and the evidence to be heard from each witness in relation to the particulars of the allegation.

Witness - Colleague A

9. The Witness told the Panel that he is an ODP at the Trust and a Student Educator. He had dealt with the Registrant as a new starter. On 25 June 2014 he provided the Registrant with training on checking the anaesthetic machine but despite there being a checklist attached to it, the Registrant failed to check that the monitor was functioning correctly and she also wrongly connected a ventilator bag. These were significant errors. He discussed them with the Registrant, but although she accepted her failure she did not respond further.

10. The witness explained that on 25 July 2014 he had instructed the Registrant on the differences between Thoracic and Standard suctioning devices. However, the Registrant continued to be unable to tell the difference between the two levels of suction despite having it demonstrated to her. This was serious as the lower thoracic suction level would not be strong enough to remove some fluids from airways such as vomit. He had written notes about it on the same day because of his concerns.

11. The witness explained that the Registrant had wrongly used the minute hand of the clock to time the respiratory rate when she should have used the second hand for a full minute. Using the minute hand would give an inaccurate reading. She had also failed to take a second reading, but had merely repeated the first readings for both respiratory rate and temperature. This was a serious matter which he spoke to the Registrant about and reported to senior colleagues.

12. On or around the 4 November 2015, the Registrant was tasked with checking and recording a patient’s respiratory rate every 5 minutes for a period of 30 minutes. The witness noticed that the Registrant’s figures were the same over the 30 minutes which was highly improbable. He questioned the Registrant and she admitted that she had copied the respiratory rates from the earlier recordings. He said that she seemed unaware that this was wrong. He had explained to her that the records were a legal document and had to be accurate. The Registrant acknowledged what he told her, but did not give any reasons for her behaviour. The witness said that the Registrant’s performance was below that expected of a student despite her receiving extra support and being supervised at all times in all areas of practice. He did not feel confident that the Registrant could work unsupervised and that she appeared to be having difficulty applying her knowledge to her practice.

Witness - Colleague E

13. The witness was a Staff Recovery Nurse at the Trust. She told the Panel that she worked with the Registrant in the Registrant’s fifth week in the recovery area.

14. The witness told the Panel that the Registrant was asked to write up a patient’s notes. She said that some good students were able to do so within three days and most after a week. The witness was not happy with the Registrant’s notes and showed her how they should be written in a logical order. She had asked the Registrant to follow this process, but the Registrant had not done so. The witness had re-written the documentation and given it to the Registrant as an example to follow.

15. However, the Registrant had later copied example documentation when completing another patient’s notes, although they were different.  The Registrant said she understood when challenged but the witness was not sure that she did understand. The witness said she was shocked at the Registrant’s behaviour as she should have learnt what to do by week 5. The witness said that the Registrant would acknowledge discussions but would look “vague” and she never explained why she had copied the documentation. The witness said she thought the Registrant needed more time and confidence.

16. The witness explained that the Registrant was not safe to look after a patient in the Recovery department. The Registrant did not exercise initiative and anticipation of possible events.
   
Application to Amend Particular 2

17. Ms Sheridan made an application to amend Particular two to cover observations “and/or documentation” on lines 2 and 3.  She submitted that would more properly reflect the evidence of witness E and was in the interests of justice.  Ms Sheridan also submitted that it was in the public interest to amend.  

18. The Panel took the advice of the Legal Assessor who reminded it of the need to consider the interests of justice and whether the proposed amendment materially changed the nature and gravity of the allegation. The Panel granted the application to amend Particular 2 on the basis that it did not widen the allegation to a material degree and was not prejudicial to the Registrant who had been given copies in advance of this hearing of all the statements relied upon by the HCPC. The Panel further determined that the amendment did not materially increase the seriousness of the allegation.  Amendment was also in the public interest.

Witness 2 

19. The witness is a Registered ODP and a Senior Lecturer at Birmingham University.  He worked with the Registrant at the Trust, as a mentor. 

20. The witness explained that he made notes at the time. He explained that the Registrant was tasked with the handover to nursing staff of a patient at risk of oesophageal rupture which if it occurs is very serious. The surgeon had specified what to do at each step to try to prevent it. Both Witness 2 and the Registrant had received the handover.

21. The witness explained that the Registrant had then done a practice handover to him.  He said that the Registrant had failed to mention type 2 diabetes and blood sugar status.  Both were crucial and basic.  The Registrant had also failed properly to explain the steps required for the care of a patient with oesophageal abrasion, as clearly indicated by the surgeon’s treatment plan. He explained to the Registrant what she had omitted, but when she did the proper handover to the nursing staff she still left out the key information leaving the receiving nurse without important instructions. He had subsequently discussed the handover in detail with the Registrant. She did not appear to understand at all and, despite being encouraged to do so, had never discussed matters further with him other than saying 2 days later that she was happy with matters.

22. As to lack of the Registrant’s understanding, the witness said it appeared to be a general lack of understanding of care. The Registrant never asked for a further discussion or reflection, asked no questions nor sought clarification.

Witness – Colleague C

23. The witness is a Registered ODP and was the team manager and line manager for the Registrant.

24. She explained that the Registrant’s probation was extended by 3 months because of competence issues in all areas of her practice.  She told the Panel that the Registrant had three capability interviews during her probation in which she was graded “poor” which upset the Registrant. She said she had never seen such a lack of improvement by an ODP on probation.  The Registrant did not seem to act on what she was told, although she seemed to accept the criticism.  The witness said she noted that the Registrant had taken a long time to get her qualifications but did not know why that was. 

25. The witness explained that the Registrant was always placed with an experienced member of staff and supervised at all times. The Registrant did not know how to check an anaesthetic machine and she did not know how to do the basics like setting up drips. She was unable to put theory into practice and was not competent. She did not retain information, made basic errors with blood pressure and handing over patients and was unable to explain the complications and dosage of cyclizine, a common drug used in recovery.  

26. The witness said that in her view the Registrant was not safe to practise. Feedback on the Registrant indicated she was not competent. It was clear that the Registrant was failing in her probation period but she asked to work in the “scrubs” role as she felt it was where she was most competent.  She was allowed to do so and worked with the witness. The Registrant received detailed feedback daily but did not seem to be engaged and did not exercise any initiative. The Registrant could not prepare cases and could not set out the theatre equipment correctly. The Registrant was told about the concerns about her practice but again there was no improvement.  The witness said that she felt she could not have done any more for the Registrant who was unable to do the job after 6 months. The witness said she had no doubt that the Registrant had tried and had not deliberately done anything wrong.

27. The witness told the Panel that on or around 27 November 2014 the Registrant wrongly loaded an echelon gun, although she had previously done so successfully on other occasions. The failure could have caused serious problems had it jammed on a blood vessel. The Registrant did not seem to appreciate its seriousness.

28. The Registrant was also not situationally aware and was not able to focus on more than one thing at a time, which was a real concern. The witness said the Registrant understood what she was told but did not seem to be able to act on it. The witness said the Registrant was a nice person who got on well with staff.

Witness – Colleague D

29. The witness interviewed the Registrant in 2014. She told the Panel that the Registrant informed her that she was keen to practise but had not practised since qualifying in 2010.

30. The witness told the Panel that the Registrant had been upset when she was told she had issues in her practice and she did accept criticism. The witness said the Registrant did not seem to fully understand her failings and would think she was improving when she was not.

31. The witness said the Trust gave excessive support to the Registrant.  She was a qualified ODP but could not work unsupervised and many students were far more advanced than she was. The witness described the Registrant’s performance as “woeful and dangerous.”  She would fail in the most basic areas, struggling with everything she did. The witness said that when she worked with the Registrant she always told her when she got things wrong, but despite being shown the correct procedure she still got it wrong. The Registrant would be vague and could not grasp procedures.

Submissions for the HCPC

32. Ms Sheridan referred the Panel to the HCPC Practice Note on Impairment and to the personal and public elements. She confirmed that the Registrant has not engaged in these proceedings since the letter of November 2015. The standard of proof is the balance of probabilities. She referred the Panel to the hearsay evidence of Colleague B in the bundle.

33. Ms Sheridan submitted that whilst the facts could amount to misconduct she submitted that the case was primarily one of lack of competence. The evidence did not indicate any deliberate acts but a continual failure to apply information, work autonomously and act with initiative.  She submitted that the evidence clearly indicated continuous failings by the Registrant throughout the 6 month period which witnesses described as “woeful and dangerous.” The Registrant’s practice fell well below the standard of behaviour expected of a registered ODP.

34. She referred the Panel to the Standards of Conduct, Performance and Ethics and to standards 1, 5, 6, 7 and 10.  As to the HCPC Standards of Proficiency for Operating Department Practitioners Ms Sheridan referred to 1 a (i) 1, 1 a (v), 1 a (vi), 2 a (ii), 2 b, (ii) b (iv), 2 b (v) and 3 a (iii).

35. Ms Sheridan referred to the HCPC Practice Note on Finding Fitness Practice is Impaired and to the public and private component.  The Registrant has not attended and there is nothing to suggest any insight, explanation, acknowledgement or remediation of her failings. She submitted there is a significant risk of repetition.

36. Ms Sheridan referred the Panel to GMC v Meadow [2006] EWCA Civ 1319 and to the guidance in Council for Healthcare Regulatory Excellence v Grant [2011] EWHC 927 (Admin). She reminded the Panel that it is required to consider impairment and the risk presented by the Registrant. She also referred the Panel to the need to have regard to the wider public interest and to declare and uphold proper standards of behaviour and confidence in the profession and the Regulator.

37. The Panel heard and accepted the advice of the Legal Assessor.  He reminded the Panel to consider and assess all the evidence and to apply the balance of probabilities to the facts.  He referred the Panel to the HCPC Practice Note on Impairment and to the guidance in Grant on impairment, risk and the central importance of the public interest.

Decision

38. The Panel carefully considered all of the evidence and the submissions from Ms Sheridan. The Panel heard and accepted the advice of the Legal Assessor. The Panel was aware that on matters of fact, as distinct from issues of lack of competence, misconduct and impairment, the burden of proof rested on the HCPC and that the standard of proof was the civil one, namely on the balance of probabilities. It had regard to the HCPC Practice Note on Impairment and the case law.
Witnesses

39. The Panel assessed the witnesses and it is satisfied that each gave their evidence honestly and to the best of their recollection and were credible. The Panel also carefully noted the letter of November 2015 from the Registrant.   

Findings of Fact


Particular 1 a) – Proved

40. The Panel found Colleague A to be clear, credible and consistent in his recollection of events.  He had directly observed the Registrant and the Panel accepts his evidence and finds this particular proved.

Particular 1 b) – Proved

41. The Panel found the evidence of Colleague C to be fair and balanced and she had a good knowledge of the Registrant. Colleague C’s evidence was that the Registrant had “no idea” how to check the anaesthetic machine.  The Panel finds this particular proved.

Particular 2 – Proved

42. The Panel found the evidence of Colleague E to be credible and reliable.  She worked with the Registrant in week five of her time in the recovery area. She explained that the Registrant had copied documentation from a previous patient instead of noting different information relating to the new patient in her care. The Panel finds this particular proved.

 


Particular 3 a) – Proved

43. The Panel relied on the evidence of Colleague A. He worked directly with the Registrant and explained that she did not understand the differences between Thorascic Standard suction and did not test the suction in the correct manner despite his instructions. The Panel found the particular proved.

Particular 3 b) – Proved

44. The Panel accepted the evidence of Colleague A.  He confirmed that the Registrant had wrongly taken respiratory rates using the minute hand rather than the second hand on the clock. Accordingly, the Registrant incorrectly measured a patient’s respiratory rates and the Panel found this particular proved.

Particular 3 c)(i)-(iv) – Proved

45. The Panel considered and accepted the evidence of Colleague A.  He clearly stated that the Registrant failed to measure and to accurately record a patient’s respiration and temperature. He said that the Registrant had copied figures from earlier observations. The Panel found this particular proved.

Particular 4 – Proved

46. The Panel considered and accepted the evidence of witness 2.  The Registrant failed, despite the information being available in the patient notes, to appropriately and correctly handover the patient who was at risk of oesophageal rupture. He explained that crucial information in the patient notes was not handed over by the Registrant thus placing the patient at risk.  The Panel found this particular proved.

 

Particular 5 – Not Proved

47. This is a serious allegation. The evidence presented in support was a written statement from Colleague B who had not attended. The Panel did not receive an application to explain the absence of this witness nor a proper basis on which to accept, and give the necessary weight to, this hearsay evidence. 

48. The Panel was mindful of the need to act fairly.  It did not hear why this witness was not called to give evidence or of any efforts made by the HCPC to secure her attendance. The Panel noted the guidance in Nursing and Midwifery Council v Ogbonna [2010] EWCA Civ 1216 as to hearsay evidence.  This case makes it clear that where fairness is a criterion, as here, sufficient enquiry and sufficient reasons need to be given as to why a relevant witness cannot attend, particularly where the evidence is deemed to be sole or critical in relation to an important finding of fact.

49. In the absence of an explanation and an application to receive this evidence, the Panel has determined that, following the guidance in Ogbonna, it is not prepared to attach weight to the hearsay evidence of Colleague B.  To do so would not be fair. As that statement was the only evidence in support of this particular, the Panel finds this particluar not proved.

Particulars 6 a), b), c) & d) – Proved

50. The Panel heard from and accepted the evidence of Colleague C.  She explained that the Registrant had not understood the correct management of high blood pressure and had thought that it should be treated by introducing more fluids, when that was likely to raise it further. The Registrant’s action was inappropriate and unsafe. The Panel finds 6 a) proved.

51. The witness clearly stated that the Registrant had incorrectly described the lung operation in the patient handover, wrongly describing the surgery as having removed a complete lobe of the lung.  The Panel finds 6 b) proved.

52. The witness described a lack of knowledge of Cyclizine by the Registrant who did not know, when asked by the witness, the appropriate dose or side effects.  The witness stated this was a very commonly used drug with which the Registrant ought to have been familiar and have a good understanding. The Panel finds 6 c) proved.

53. The witness stated that the Registrant had not checked the patient’s notes so she did not identify the correct setting and the disparity in the drain pressures in the notes.  The witness explained that the Registrant was not then able to identify the need to correct the chest drain pressures for the patient.  The Panel finds 6 d) proved.

Particular 7 a) & b) – Proved

54. The Panel accepted the evidence of Colleague A. He stated that he had explained to the Registrant the need for accurate measurement and recording of respiratory rates. He said that despite that, the Registrant had recorded observations, but had then copied those earlier results in to the records rather than taking further observations. When challenged by Colleague A, the Registrant admitted not carrying out the observations and copying the first set of earlier readings.  The Panel notes that the Registrant disputed this in her letter of November 2015.  The Panel prefers the evidence of Colleague A and finds parts a) and b) of this particular proved.
Particular 8 a) & b) – Proved

55. The Panel accepted the evidence of Colleagues C and D. Colleague C fully explained the setting up of cases for theatre by ODPs and that the Registrant had failed to correctly set up one case for theatre, getting basic things wrong, such as placing instruments upside down and dropping instruments. Colleague C also stated that the Registrant had failed to complete any paperwork for the case, even when asked to do so.  This was essential for a proper handover. The Panel finds parts a) and b) of this particluar proved.

Particular 9 – Proved

56. The Panel accepted the evidence of Colleague C.  She explained the proper use of the echelon gun and the importance of loading it correctly.  She explained that the Registrant had been taught how to use the gun and had previously used it correctly. On this occasion the gun misfired during surgery and on examination it was clear that the Registrant had not correctly loaded it.  The Panel finds this particular proved. 

Particular 10 – Proved

57. The Panel accepted the evidence of Colleague D.  She stated that when working with the Registrant in theatre, the Registrant did not seem to be able to account for all the swabs in use. The location of the large swab was recorded on the swab board, but the Registrant had no recollection of where it was despite the surgeon also having told her. The Panel finds 10 proved.

Findings on Competence and Misconduct

58. The Panel considered that a fair sample of the Registrant’s work has been considered and presented in the evidence.  It is satisfied that the Registrant did not act either deliberately or recklessly.  The Registrant was provided with considerable support, supervision and advice yet consistently failed over 6 months, to practise safely, autonomously and competently in all areas of her practice.

59. The Panel was mindful of the guidance in Roylance as to misconduct.  It is satisfied that the facts found proved do not amount to misconduct but to a serious and wide ranging lack of competence.

Finding on Impairment

60. The Panel carefully considered the issue of impairment and exercised its own professional judgement. It considered the relevant guidance in the case law, in particular the guidance in the case of Grant. It was mindful of the central importance of the public interest including public confidence both in the Profession and the Regulator.

61. The Panel has not heard from the Registrant apart from the letter she wrote to the HCPC in November 2015 refuting part of the allegation.  She has not engaged since then. The Panel has no evidence of remediation, such as courses or training.  The Panel has no evidence of any insight or any acknowledgement of her failings and the risk her actions posed to patients.  The Registrant has offered no explanation for her actions, either at the time or since.

62. The Registrant's lack of competence is wide ranging and profound.  Her performance was described by Colleague D as “woeful and dangerous.”  The Registrant was unable to act autonomously or exercise initiative thoughout the 6 month period. She breached fundamental tenets of the profession;


• She failed to act in the best interest of Service Users
• She failed to keep her professional knowledge and skills up to date.
• She failed to communicate properly and effectively with Service users and other practitioners.
• She failed to keep accurate records.

63. In these circumstances the Panel considers that the Registrant has in the past presented and continues to present a risk to the safety of patients.  The Panel has no evidence to indicate otherwise and nothing to indicate that the Registrant has developed any understanding or insight into her serious failings. The Panel has no information about the Registrant’s current circumstances.

64. With regard to the public interest, the Panel considers that in this case public confidence in the Profession and the Regulator would be undermined if it were not to find the Registrant’s fitness to practise impaired. The Panel accordingly finds that the Registrant’s fitness to practise is currently impaired.

Submissions on Sanction

65. The Panel heard submissions from Ms Sheridan.  She referred it to the HCPC’s Indicative Sanctions Policy and reminded the Panel to consider the degree of public protection required and stressed the proportionality of any sanction to be imposed.  She submitted that the Panel should consider the sanctions in ascending order. She submitted that Conditions of Practice were unworkable in this case given the findings as to Registrant’s performance despite 6 months of one to one of daily supervision. Further, the Registrant has not meaningfully engaged with these proceedings nor indicated any willingness to comply with any conditions.  Given the finding of lack of competence, Ms Sheridan reminded the Panel that it did not have the power to make a Striking Off Order.

66. The Panel took the advice of the Legal Assessor that it should  consider the HCPC Indicative Sanctions Policy. He reminded it to consider any sanction in ascending order and to apply the least restrictive sanction necessary to protect the public. It should also consider any aggravating and mitigating factors and bear in mind the public interest and that the primary purpose of sanction was protection of the public. 

Mitigating and Aggravating Factors

67. The Panel first identified what it considered to be the principle mitigating and aggravating factors in this case. The only mitigating factor the Panel could identify was that that the Registrant’s character and integrity were never called in to question. 

68. The aggravating factors identified were that the Registrant put patients at risk of harm and failed to retain and act on information.  There was no evidence of any insight by the Registrant into her failings or any attempt to remedy her practice.

Decision on Sanction

69. The Panel approached sanction beginning with the least restrictive, bearing in mind the importance of proportionality. Taking no further action and the sanction of a Caution Order would not reflect the seriousness of the allegation found proved and the finding of impairment. Further, these would not be adequate given the risk to patients and the wider public interest in maintaining confidence in both the Profession and the regulatory process.  Neither order is appropriate or proportionate in the circumstances of this case given the serious lack of competence in the Registrant’s practice.

70. The Panel next considered a Conditions of Practice Order. The allegation found proved is serious and the Registrant’s practice was seriously deficient and dangerous, even after intensive supervision and support.  Further, the Panel do not know whether the Registrant is able or willing to comply with any conditions.  In these circumstances the Panel could not formulate appropriate, workable or realistic conditions. A Conditions of Practice Order would, in any event, not be proportionate in the circumstances of this case and would not satisfy the public interest.

71. The Panel next considered a Suspension Order. The Registrant breached fundamental standards of the Profession and the Panel has found that she failed to acknowledge her failings or to show any insight, remorse or remediation.  The Panel considers that a less restrictive sanction would fail to protect the public and would undermine public confidence in the Profession and the Regulator.  The Panel considers that the maximum period of 12 months is the appropriate and proportionate period.

Order

No information currently available

Notes

Order: That the Registrar is directed to suspend the registration of Mrs Cavel Callender for a period of 12 months from the date this order comes into effect.


The order imposed today will apply from 19 April 2017 (the operative date). This order will be reviewed again before its expiry on 19 April 2018.

Hearing history

History of Hearings for Cavel Callender

Date Panel Hearing type Outcomes / Status
12/03/2018 Conduct and Competence Committee Review Hearing Suspended
20/03/2017 Conduct and Competence Committee Final Hearing Suspended