Miss Clare Lynette Bushell

: Social worker

: SW03023

: Final Hearing

Date and Time of hearing:10:00 02/05/2017 End: 17:00 08/06/2017

: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

: Conduct and Competence Committee
: Impaired - no further action

Allegation

As amended at the hearing and excluding those parts that were withdrawn or for which no evidence was offered at the hearing:


Between 1 September 2014 and 1 April 2015, during the course of your employment as a Social Worker by Kent County Council you:


1. In relation to Service User A:

a) Did not record your account of a meeting which took place on or around 3rd February 2015, until 9 April 2015;
b) Did not notify your manager about new information gathered at the meeting on or around 3rd February 2015;
c) Did not record and/or notify your manager of potential higher risk to Service User A following the meeting on or around 3rd February 2015
d) Your record of the assessment on 4th September 2014 was inaccurate and/or inadequate in that:
i. You incorrectly recorded that Service User A had no health issues;
ii. You were unclear as to whether Service User A was sexually active, when there was evidence to support that she was.

 

2. In relation to Service User B, following a visit on 21 October 2014, did not reference the author of the relevant case notes and/or make your own notes.
  
3. [no evidence]
      
4. In relation to Service User D:

a) Carried out a visit on 31 October 2014 and in the case entry did not reference the author and/or make your own notes;
b) Did not record the account of the visit carried out on 31 October 2014 until 22 December 2014;
c) Having alerted a senior practitioner on 18th February 2014 to new information received on 13th February 2014 you did not take further action           


5. In relation to Service User E, following a paediatrician appointment on 12th November 2014:

a) Recorded in the case notes that Service User E’s bruising was caused by raised APTT;
b) Did not alert your manager to the contents of a letter from the paediatrician, dated 5th December 2014, that potentially raised the level of risk to Service User E;
c) Did not critically analyse the cause of the service user’s injury noted on 22nd December 2014, or in the alternative, if you did critically analyse the injury noted on 22nd December 2014, you did not adequately record that analysis;
d) Did not respond appropriately to child protection risks in relation to the Service User.
e) [no evidence]
       
6. Did not record home visits within the required timescales, in that:
 
a) In relation to Service Users H and/or I, you did not record home visits which took place on 23rd October 2014 until 20 November 2014;
b) In relation to Service User J, you did not record a home visit which took place on 31st October 2014 until 22nd December 2014;
c) In relation to Service User K, you did not record a home visit which took place on 16th October 2014 until 20th November 2014;
d) In relation to Service User L, you did not record a home visit which took place on 23rd October 2014 until 20th November 2014;
e) In relation to Service User M, you did not record a home visit which took place on 16th October 2014 until 20th November 2014
f) In relation to Service User N, you did not record a home visit which took place on 16th October 2014 until 20th November 2014;
g) In relation to Service User O, you:
a) did not record a home visit which took place on 16th October 2014 until 20th November 2014;
b) did not record a discussion which took place on 30th September 2014 until 20th November 2014;
h) In relation to Service User P, you did not record a home visit which took place on 10th December 2014 until 8th January 2015;
i) In relation to Service User Q, you did not record a home visit which took place on 10th December 2014 until 8th January 2015

 

7. Did not record communications within the required timescales, in that you:

a) In relation to Service User K, you did not record a communication which took place on 30th September 2014 until 20th November 2014;
b) In relation to Service User R, you did not record a communication which took place on 2nd September 2014 until 3rd October 2014      

8. In relation to the visit to Service User J and D on 31st October 2014, you:

a) Entered the contact date of the record as 31st October 2014 when that record was created on 22nd December 2014;
b) Copied the content of the record from an email from a police officer dated 31st October 2014;
c) Your actions at 8(a) and/or 8(b) above were misleading and/or dishonest.  


9. In relation to the visit to Service Users K, M, N and/or O on 16th October 2014 you:

a) Entered the contact date of the record as 16th October 2014 when that record was created on 20th November 2014;
b) Your action at 9(a) above was misleading and/or dishonest.

 

10. Your record of the visit to Service Users K, M, N and/or O on 16th October 2014 was inadequate in that:

a) Your record of the visit did not provide adequate detail of how Service Users K, M, N and/or O presented;
b) There was no analysis of observations and interventions for Service Users K, M, N and/or O.
         
11. The matters described in particulars 1-10 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


Amendments to, and Withdrawal of Parts of, the Allegation


1. At the start of the hearing, Miss Sheridan applied to make amendments to the allegation. Notice of most of the amendments proposed had been given to the Registrant by the HCPC’s letter to her dated 19 December 2016. Mr Gil did not oppose these and other amendments sought on the day by Miss Sheridan. The amendments were clarificatory in nature. The Legal Assessor advised that the amendments could properly be made if they would not cause injustice to the Registrant. The Panel was satisfied that this was the case and allowed the amendments.


2. After oral evidence on behalf of the HCPC had been given, and before closing her case on the fourth day of the hearing, Miss Sheridan applied to make further amendments to particulars 5c), 8a) and 9a) of the allegation, in view of the evidence that had been given. Mr Gil did not oppose those amendments and the Panel decided that they could be made without injustice to the Registrant. The amendment to particular 5c) was based on an alleged failure to record an analysis, arising from the factual case advanced by the Registrant. The amendments to particulars 8a) and 9a) more accurately reflected the content of the documents referred to in those parts of the allegation.


3. Miss Sheridan offered no evidence in relation to particular 3 of the allegation in view of the state of the documentary evidence, which showed that the Registrant’s written assessment of Service User C had made reference to the fact that the siblings of Service User C had been removed from the family by the court. On the fifth day of the hearing, the Panel gave permission to Miss Sheridan to withdraw particular 5(e) of the allegation in view of the evidence that had been given and to amend particular 5(a) by deleting the words ‘unexplained and/or’, which added nothing to the case advanced in that sub particular of the allegation.  

Background


4. The Registrant started her employment on 11 November 2008 with Kent County Council (Kent C.C.) within Children’s Social Services. She transferred to the Assessment and Intervention Team in Thanet (‘the Thanet Team’) on 25 January 2011 and was promoted to the post of Senior Practitioner on 18 March 2013. On 2 February 2015, the Registrant was seconded to the Children in Care Team (‘CICT’) and returned to the Thanet Team on 19 March 2015. Her work was with children and families and she worked as part of ‘Pod 3’ of the Thanet Team. Her team manager was CH.


5. On 9 April 2015, GM in the Thanet Team received an alert on the computer system that a case note had been added by the Registrant to Service User A’s record, in relation to a meeting that had taken place on 3 February 2015. This triggered a review of that case and of the other cases handled by the Registrant over the previous 6 months. The review was carried out by DS, the Integrated Family Services Manager for Kent C.C, in the department for specialist children’s services. DS was tasked to report on the timeliness and quality of the Registrant’s record-keeping.


6. DS submitted the results of her review to JE, a Service Manager at Kent C.C., whose responsibilities included the work of the Thanet Team.   


7. An independent investigator was appointed after initial concerns had been expressed by DS. That investigator was CA, a self-employed investigator, who is not a Social Worker, but has a background in management, with experience of carrying out investigations into Human Resources matters.     

  
8. The Panel heard oral evidence from the following witnesses for the HCPC, -
• JE, Social Worker, Service Manager at Kent C.C.
• DS, Social Worker, Integrated Family Services Manager for Kent C.C.
• CH, Social Worker, team manager for the Children’s Social Work Team in the Margate and Thanet areas.
Each of these witnesses were honest, credible and did their best to assist the Panel. They gave oral evidence that was largely consistent with their witness statements. They made appropriate concessions on other aspects of their evidence. They were balanced in their approach, for example acknowledging that the Registrant had demonstrated good practice in a number of aspects of her work.         


9. The Panel heard oral evidence from the Registrant. She also relied on a number of written statements from colleagues, which set out what they said had been the difficult circumstances in which the Registrant and others had been working in Children’s Services within Kent C.C. and Thanet in particular. There were also written character references, which the Panel has taken into account so far as relevant, on the advice of the Legal Assessor. The Registrant was also an honest and credible witness. She was candid and accepted the shortcomings of those aspects of her work which she considered could have been done better in the circumstances. 


10. Both sides relied on documentary evidence, particularly case notes and supervision records relating to each of the service users relevant to the allegation, as well as interviews given to CA by those called as witnesses at this hearing and others who were not. In the case of the interviews given by persons who did not give evidence and other records and written statements made by persons not called to give evidence, the Panel bore in mind that there had been no opportunity for cross-examination of those persons, but gave the contents of those  documents due weight.


11. In making its decision on the factual part of the allegation (particulars 1-10), the Panel has taken into account such admissions as were made on behalf of the Registrant, all the evidence, both oral and documentary, and given it such weight as appropriate in the circumstances of the case.


12. It was common ground between Miss Sheridan and Mr Gil that each of the particulars in particulars 1-10 contained an explicit or implicit criticism of what the Registrant did or did not do in the circumstances. The case has been contested on that basis.  


13. The Panel has taken into account all the submissions made by Miss Sheridan and Mr Gil and has directed itself in accordance with the advice of the Legal Assessor.   

Decision on Facts


1. In relation to Service User A:

a) Did not record your account of a meeting which took place on or around 3rd February 2015, until 9 April 2015;

14. The Registrant admitted this part of the allegation. The written Recording Policy and Guidelines of Kent C.C (‘the Recording Policy’) required that records should be made within 24 hours and that if a record were made later, a ‘late entry’ note should be added to the record (to indicate that the record had been made later). The evidence showed that there was some latitude on the part of management in applying this part of the Policy in that it was accepted that records could be entered up to five days afterwards, though a shorter period of 48 hours was also mentioned in the evidence.

15. Service User A was a female young person at the time of the referral. Her case was allocated to the Registrant on 22 July 2014. The case was closed on 10 October 2014 and re-opened again on 31 October 2014 and was re-allocated to the Registrant. 

16. The meeting in question was attended by the Registrant and took place on 3 February 2015 at the school of Service User A. It was held against a background of concerns that Service User A had been groomed for sex by older males, that she had been missing from home for periods of time and had been having unprotected sex with the older males and taking drugs.

17. The case note shows that it was not created until 9 April 2015, following the Registrant’s return from secondment to the Children in Care Team. This was outside the required timescales for recording. 

18. In the circumstances, this part of the allegation has been found proved.

b) Did not notify your manager about new information gathered at the meeting on or around 3rd February 2015;

19. On 30 January 2015, Ms Bushell had a supervision meeting with CH about this case before going on secondment to the Children in Care Team. The record of the supervision meeting refers to the use of MDMA, completion of a CSE toolkit, reference to an upcoming CIN (Children In Need) meeting, transfer of the case to step-down and referral to the sexual health clinic.

20. The case notes showed that by the end of 2014 there were continuing concerns that Service User A had been subjected to grooming by older males, that she had been having sex with a number of them and had been taking drugs (MDMA and cannabis). The case notes of the meeting of 3 February 2015 (incorrectly dated 6 February 2015) recorded a discussion with the parents, who asked if Service User A ‘might be giving sex for drugs in return ..[,] … agreed that this was very likely.’

21. Mr Gil argued that in substance there was nothing new that arose out of the meeting. The concerns of grooming, taking drugs provided by older men and sex with the older males had been present for some months. He referred to the concession made by CH in her evidence in accepting that the information was not new.  

22. However, reviewing all the case notes and records, the Panel has concluded that new information was gathered at the meeting in that an explicit link was made for the first time that Service User A was exchanging sex for drugs. Although it may have been possible to infer this from the information available before 3 February 2015, this was the first time that the link had been made explicit.

23. The Registrant should have notified CH of this new information in view of the fact that a few days earlier (30 January 2015) it had been agreed between the Registrant and CH that the case should be stepped-down, in view of its reduced child protection risk, to the Troubled Families Service, an agency support service.          

24. Therefore, the Panel has found this part of the allegation to have been proved.

c) Did not record and/or notify your manager of potential higher risk to Service User A following the meeting on or around 3rd February 2015

25. Mr Gil submitted that the risk to Service User A was no higher in the light of the information she obtained at this meeting, because the concerns were in substance no different to those recorded in the case notes for the previous months. However, in view of the Panel’s finding under particular 1b) above, there was a potential higher risk to Service User A arising from the new information provided by the parents of Service User A. In those circumstances, the Registrant should have recorded that information both promptly in the case notes and also informed CH of what was a potential higher risk to Service User A.

26. Therefore, the Panel has found this part of the allegation to have been proved in that the Registrant did not record or notify her manager of potential higher risk to Service User A following the meeting on or around 3rd February 2015.

d) Your record of the assessment on 4th September 2014 was inaccurate and/or inadequate in that:

i. You incorrectly recorded that Service User A had no health issues;

27. The Registrant has admitted that her record of the assessment was both inaccurate and inadequate as alleged in this part of the allegation. The written record of the assessment of Service User A dated 4 September 2014 was prepared by the Registrant. Within the section of the report entitled, ‘The child/young person’s health and development’, the Registrant stated that there were, ‘no concerns in regards to the health … of [Service User A].’ However, Service User A had started to self-harm, as recorded in an earlier part of the report.

28. In the circumstances, the Panel has found proved the allegation that the Registrant’s record of 4th September 2014 that Service User A had no health issues was inaccurate and inadequate.

ii. You were unclear as to whether Service User A was sexually active, when there was evidence to support that she was.

29. The Registrant has admitted that her record of the assessment was both inaccurate and inadequate as alleged in this part of the allegation.

30. In her note of 4 September 2014, the Registrant recorded that she suspected that Service User A may be sexually active, however ‘she does not admit to this.’ The case records show that on 6 August 2014 there were concerns that she might be pregnant, which was evidence to support the concern that she was having unprotected sex.

31. In the circumstances, the Panel has found proved the allegation that the Registrant’s record of 4th September 2014 was both inadequate and inaccurate in that it was unclear as to whether Service User A was sexually active, when there was evidence to support that she was.

2. In relation to Service User B, following a visit on 21 October 2014, did not reference the author of the relevant case notes and/or make your own notes.

32. This was admitted. Service User B’s older brother made a referral alleging that Service User B had been hit by her father and that she had not eaten for four days. The case was allocated to the Registrant on 14 October 2014. She conducted a joint visit with the police on 21 October 2014.

33. The record of this visit was created by the Registrant on 23 October 2014. In making that record, she copied and pasted the notes of the accompanying police officer. The Panel has accepted the evidence of JE that someone as senior as the Registrant should have known that it is necessary to reference any information recorded by the Social Worker if not using their own words. 

34. Therefore, the Registrant should have made it clear on the record that the note was that of the police officer.

35. Also, the Registrant should have added her own opinion to the record. The Panel accepted the evidence of DS that the police and Social Workers are trained differently and observe different things, and the Social Worker’s own opinion was necessary and should have been included.

36. Therefore, the Panel has found proved in relation to Service User B, that following a visit on 21 October 2014, the Registrant did not reference the author of the relevant case notes or make her own notes.
       
3. [no evidence]

37. The HCPC offered no evidence on this particular of the allegation.


4. In relation to Service User D:

a) Carried out a visit on 31 October 2014 and in the case entry did not reference the author and/or make your own notes;

38. This was admitted. The Registrant was allocated this case on 17 October 2014. A joint visit to the home of Service User D was carried out by the Registrant and the police on 31 October 2014.

39. In making her record of the visit, the Registrant copied and pasted an email from the police officer to her dated 31 October 2014. Her record did not identify him as the author of this part of the note. In view of JE’s evidence (see the findings under particular 2 of the allegation, above) the Registrant should have made clear in her record that these were the observations of the police officer. 

40. For the same reasons found under particular 2 of the allegation, the Registrant should also have recorded her own observations and opinion in her record of the visit, but did not do so.

41. In the circumstances, the Panel has found proved that in relation to Service User D, the Registrant carried out a visit on 31 October 2014 and in the case entry did not reference the author and did not make her own notes.

b) Did not record the account of the visit carried out on 31 October 2014 until 22 December 2014;

42. The case note for this visit written by the Registrant shows that the case note was created by her on 22 December 2014. This was many weeks later than the permitted timescales.  The Registrant has admitted this part of the allegation.

43. In the circumstances, the Panel has found proved this part of the allegation.

c) Having alerted a senior practitioner on 18th February 2014 to new information received on 13th February 2014 you did not take further action.        

44. The Registrant left the Team on 2 February 2015 for her secondment, but the case showed on the office computer system as still allocated to her.

45. On 18 February 2015, the Registrant sent an email to FA, the other Senior Practitioner in the Pod 3 team. The email recorded that a transfer summary of the case had been prepared (by her) with a view to the case being stepped down, in this case passed to colleagues within ‘Early Help’ services, a third party agency which assisted Kent C.C. with certain child-related services.

46. The email recorded that the Registrant had received information from another Social Worker that she had heard aggressive shouting in the background when she had been making a telephone call to the home. In the email, the Registrant stated that step-down was no longer appropriate and stated, ‘Please come back to me if you would like me to call her.’

47. The case remained open with no further case recording and no involvement on the part of social services until 7 April 2015. 

48. The Registrant said that the fact that the case was showing as still allocated to her was contrary to the agreement she made with CH on 30 January 2015, that her cases would be re-assigned while she was on secondment, save for two cases for which she was required to attend court. The Registrant did not receive a reply to her email, and she assumed that the matter was being dealt with by another colleague in the Team. The Panel accepts that evidence. On returning to work with the Team on 7 April 2015, the Registrant went and spoke to CH about this case, as CH accepted in her evidence.

49. Therefore, the Panel has found not proved this part of the allegation.    

5. In relation to Service User E, following a paediatrician appointment on 12th November 2014:

a) Recorded in the case notes that Service User E’s bruising was … caused by raised APTT;

50. The case of Service User E was allocated to the Registrant from 10 September 2014 to early February 2015. Service User E was a three year old child. In view of a number of unexplained bruises sustained by the child, the Registrant referred her to a paediatrician, Dr K, who saw her in clinic on 12 November 2014. The Registrant made a case note that day. She recorded that, -
‘The paediatrician felt … the bruises were consistent with a child her age exploring .. He agreed that the one on her stomach was very large and she would have felt pain .… and that she probably would have cried [sic] therefore an adult should have known how it had happened.’  

 
51. The Registrant made a phone call on 2 December 2014 to chase up the results of a blood test that had been carried out and she noted in a case note that, ‘Blood test results for [SUE] received. She has a very slightly raised level of APPT which is related to bruising and clotting. It is only 0.8 higher.’ A raised APPT may indicate that a person is prone to bruising more easily. In her oral evidence, the Registrant said that when she spoke to Dr K’s secretary, she was informed that the APTT level was raised and she looked up what that meant. The impression she had, therefore, was that there was a medical reason why the service user might bruise more easily than other children. In his letter to the Registrant dated 5 December 2014 Dr K stated, -
‘She had a blood test done  ... which  ... came back all normal apart from clotting which shows mildly raised APTT which is 35.8 s. but I personally feel that this is not a cause for her bruise. She will need a repeat blood clotting test done in about 8 weeks.  .. Could you kindly arrange for this to happen. ..’
         
52. On 22 December 2014, the Registrant attended the home address and saw that Service User E had a black eye. Her record of that visit in a case note showed that she had spoken to the child and had asked her how she had sustained the injury. The child told her that she had fallen off a chair at the computer while in her mother’s house.  The record made by the Registrant in respect of that visit referred to the letter from Dr K and stated, ‘The raised [blood test] result related to bruising easily.’

53. However, nowhere in the case notes did the Registrant record that Service User E’s bruising was caused by raised APTT. Further, a raised APTT does not explain the cause of bruising.  Therefore, the Panel has found not proved this part of the allegation.

b) Did not alert your manager to the contents of a letter from the paediatrician, dated 5th December 2014, that potentially raised the level of risk to Service User E;

54. The Registrant, through Mr Gil, admitted this part of the allegation, though Mr Gil submitted that the contents of the letter did not raise the level of risk, because it told the reader nothing about the cause of the bruising. He also relied on a concession made by DS in her evidence to this effect.

55. The Registrant accepted that she did not read the letter or, if she did, she did not read it thoroughly. She did not expect it to say anything different to what she said she had been led to believe by Dr K’s secretary. The Registrant did not alert CH to the contents of the letter and in her oral evidence she accepted in hindsight that she should have done so.

56. The Panel has found that the information in the letter did raise the level of risk to Service User E in that the blood test results were equivocal and Dr K did not rule out the possibility that the cause of the bruising was non-accidental.

57. In those circumstances, the Panel accepts the evidence given by DS that the Registrant ought to have alerted CH to this potentially raised level of risk to Service User E. Therefore, this part of the allegation has been found proved.

c) Did not critically analyse the cause of the service user’s injury noted on 22nd December 2014, or in the alternative, if you did critically analyse the injury noted on 22nd December 2014, you did not adequately record that analysis;

58. It was submitted by Mr Gil that the Registrant did critically analyse the cause of the injury which she noted on 22 December 2014. He referred to the concessions made by DS, who accepted that a critical appraisal had been undertaken by the Registrant. He relied again on the point that a raised APTT tells one nothing of the actual cause of an injury. The Registrant’s evidence was that she made a judgment that the bruise was the result of poor parental supervision and not the result of any violence to the child. That judgment was based on the conclusions she drew from having spoken to the child that day and in view of earlier occasions she had witnessed, when she had seen the child fall and had looked to her mother for comfort. That she interpreted as a sign that the child was not being subjected to physical abuse. She also stated in her oral evidence that she was still looking for the cause of the bruises and was not ignoring the situation “because she has raised APTT.” However, the Registrant did accept that she did not adequately record her analysis in the notes she made.

59. The Panel has concluded that, in her analysis, the Registrant failed to consider a possible non-accidental cause of the injury by not taking into account the paediatrician’s letter of 5 December 2014, which suggested that while Service User E may have had a propensity to bruise more than would normally be the case, Dr K did not consider that this was the cause of her bruising.  Instead, she proceeded on an erroneous basis by relying on what she said she had been told by Dr K’s secretary, which led her to record in the case note that, “The raised result related to bruising easily”.  

60. In those circumstances, the Panel has concluded that the Registrant did not critically analyse the cause of the service user’s injury noted on 22 December 2014. Accordingly, this part of the allegation has been found proved.   

d) Did not respond appropriately to child protection risks in relation to the Service User;

61. Mr Gil submitted that there was no change in the overall picture following Dr K’s letter (there being no new medical information to suggest that the bruising was due to non-accidental injury) and referred to the Registrant’s evidence that she had been constantly talking this case over with CH as a child with bruises “is like a hot potato.”

62. The Panel has accepted the evidence of CH that the Registrant should have convened a Strategy Meeting. The Panel has concluded that such a step was necessary to discuss the possible child protection risks to the service user, which had become more elevated in view of the implications of Dr K’s letter set out above and the new injury to Service User E.  Therefore, this part of the allegation has been found proved.       

e) …….
63. This sub particular of the allegation was withdrawn.

6. Did not record home visits within the required timescales, in that:
 
a) In relation to Service Users H and/or I, you did not record home visits which took place on 23rd October 2014 until 20 November 2014;
b) In relation to Service User J, you did not record a home visit which took place on 31st October 2014 until 22nd December 2014;
c) In relation to Service User K, you did not record a home visit which took place on 16th October 2014 until 20th November 2014;
d) In relation to Service User L, you did not record a home visit which took place on 23rd October 2014 until 20th November 2014;
e) In relation to Service User M, you did not record a home visit which took place on 16th October 2014 until 20th November 2014
f) In relation to Service User N, you did not record a home visit which took place on 16th October 2014 until 20th November 2014;
g) In relation to Service User O, you:
i. did not record a home visit which took place on 16th October 2014 until 20th November 2014;
ii. did not record a discussion which took place on 30th September 2014 until 20th November 2014;
h) In relation to Service User P, you did not record a home visit which took place on 10th December 2014 until 8th January 2015;
i) In relation to Service User Q, you did not record a home visit which took place on 10th December 2014 until 8th January 2015.

64. It is convenient to set out in one place the decision of the Panel in respect of each of these parts of particular 6 of the allegation. The Registrant has made a full admission in respect of each and the Panel has concluded that each admission was well founded. The case notes each set out the dates on which the particular home visit and (in the single instance alleged) relevant discussion took place and also recorded the date on which the record had been created. These tallied with the dates in particular 6 of the allegation and on each occasion the Registrant had been the allocated Social Worker. The records created by the Registrant were each made several weeks beyond the maximum permitted period of five days from the date in question.

65. Therefore, the Panel has found proved each part of particular 6 of the allegation.  

7. Did not record communications within the required timescales, in that you:

a) In relation to Service User K, you did not record a communication which took place on 30th September 2014 until 20th November 2014;

66. The documents show that the Registrant wrote up a case note for Service User K on 20 November 2014, which arose from a conversation with another Social Worker. This communication was not recorded within the required timescales. The Registrant admitted this part of the allegation and in the circumstances, the Panel has found it to have been proved.    

b) In relation to Service User R, you did not record a communication which took place on 2nd September 2014 until 3rd October 2014.

67. Service User R was known to Children’s Services as a result of a court order. The court had requested that a statutory report and risk assessment be completed as there had been concerns regarding parental contact. The case was allocated to the Registrant on 2 September 2014. The case notes show that on 3 October 2014 the Registrant created a record of an attempted telephone call she had made on 2 September 2014 to the mother of Service User R, and that there had been no answer and the number was not in service. This communication was not recorded within the required timescales.

68. The Registrant admitted this part of the allegation and in the circumstances, the Panel has found it to have been proved.  

8. In relation to the visit to Service User J and D on 31st October 2014, you:

a) Entered the contact date of the record as 31st October 2014 when it was created on 22nd December 2014;

69. The Panel refers to its findings under particulars 4b) and 6b). The Registrant admitted this part of the allegation. The two case notes show at the end of each document that they were created by the Registrant on 22 December 2014 and that the date of the visit recorded on those documents was entered by her as 31 October 2014. It was established in evidence from CH that all entries relating to when an entry was created, finalised, and by whom were automatically generated by the IT system. The ‘contact date’ was able to be changed by the person making the entry to accord with the date of the event being reported.

70. Therefore, the Panel has found this part of the allegation to have been proved. 

b) Copied the content of the record from an email from a police officer dated 31st October 2014;

71. The Panel refers to its conclusions under particular 4a). The Registrant also admitted this part of the allegation. The relevant part of the case note for Service User J was in identical terms to that for Service User D. These reproduced the contents of the email dated 31 October 2014 from the police officer to the Registrant. The Registrant should have made her own note and referenced the name of the individual source. In substance, this allegation is no different as regards Service User D to that already made under particular 4(a). Therefore, this part of the allegation has been found proved.

Your actions at 8(a) and/or 8(b) above were misleading and/or dishonest.

Misleading


72. The Panel has concluded that the record of the visit created by the Registrant was not misleading in either of the respects alleged. The documents make clear the date on which each was created and also the contact date, being the date of the visit in question. Further, although the identity of the source was not given, it was clear from the disclaimer in the email of 31 October 2014, which was transposed into the record, that the Registrant had copied the information from the member of Kent Police, who had accompanied her on the joint visit.

73. Therefore, particular 8c) of the allegation in relation to ‘misleading’ has been found not proved in relation to particular 8a) and not proved in relation to particular 8b). 

Dishonest


74. Miss Sheridan submitted that the Registrant was dishonest by entering the contact date as she did and by copying the content from the police officer’s email.

75. CH accepted that changing the contact date was usual practice for all Social Workers to maintain chronological notes. The case note also recorded automatically the date on which it had been created, such date appearing at the conclusion of the document.

76. CH also accepted that, having made a note that this was a visit with Kent Police and included content that was clearly an email, the Registrant did not act dishonestly. The Panel has come to the same conclusion.  

77. Therefore, particular 8c) of the allegation in relation to ‘dishonest’ has been found not proved in relation to particular 8a) and not proved in relation to particular 8b). 

9. In relation to the visit to Service Users K, M, N and/or O on 16th October 2014 you:

a) Entered the contact date of the record as 16th October 2014 when that record was created on 20th November 2014;

78. These service users were siblings. The Panel refers to its findings under particular 6c). The case note showed that the home visit to Service User K and his siblings took place on 16 October 2014. That date was given as the contact date and the case note showed on its face that it was created on 20 November 2014. The Registrant has admitted this part of the allegation in relation to all four of these service users. In the circumstances, the Panel has found this part of the allegation to have been proved in relation to all four service users.

b) Your action at 9(a) above was misleading and/or dishonest.


Misleading


79. For the same reasons as the Panel gave in respect of 8c) under particular 8a) in respect of ‘misleading’, the Panel has found particular 9b) to have been not proved in relation to particular 9a) in respect of ‘misleading’.

Dishonest


80. For the same reasons as the Panel gave in respect of particular 8c) under particular 8a) in respect of ‘dishonest’, the Panel has found particular 9b) to have been not proved in relation to particular 9a) in respect of ‘dishonest.’

10. Your record of the visit to Service Users K, M, N and/or O on 16th October 2014 was inadequate in that:

a) Your record of the visit did not provide adequate detail of how Service Users K, M, N and/or O presented;

81. The Registrant admitted this part of the allegation in relation to all four service users. The referral of these service users took place on 18 July 2014. The Registrant became the allocated Social Worker for them on 23 July 2014. The referral related to concerns about drug use in the home, lack of care by parents, emotional and domestic abuse, financial difficulties and conflict with neighbours. In the case note for the visit that took place on 16 October 2014 the Registrant wrote, -

‘Spoke to [mother] about the threats she had been getting and praised her as she had reported these to the police. Also the house is looking better and [mother] is attending her appointments with KCA counselling and turning point.’

82. The earlier part of the case note showed that the Registrant had seen two of the children. However, the note only showed a discussion with the mother. There was no information about the children provided by the Registrant in the note, such as how the children behaved or how they were dressed. The Panel has accepted the evidence of JE that such information should have been recorded. In her oral evidence the Registrant expressed her embarrassment over the shortcomings in this case note.

83. In the circumstances, the Panel has found this part of the allegation to have been proved in relation to Service Users K, M, N and O. 

b) There was no analysis of observations and interventions for Service Users K, M, N and/or O.

84. The Registrant admitted this part of the allegation in relation to all four service users. JE’s evidence was that the Registrant should have made and recorded an analysis of her observations and any interventions she had with the service users. In the circumstances, the Panel has found this part of the allegation to have been proved.          

Decision on Grounds


85. Miss Sheridan submitted that the facts proved established that the Registrant had failed to comply with relevant standards and amounted to misconduct on the part of the Registrant. Mr Gil submitted that a finding of misconduct would not be appropriate in the circumstances. Mr Gil submitted that the Registrant’s conduct did not meet the required level of seriousness to constitute statutory misconduct. That was particularly so, he argued, because the Registrant’s workload had been excessive, unsustainable and contrary to the hours of work that had been agreed for her as a Senior Practitioner working part-time, four days a week. The Registrant’s evidence was that this workload was combined with a lack of support in supervision and lack of time for administrative tasks. The rare ‘working at home days’ were compromised too often by pressures to do other work. The sheer volume of work did not allow the Registrant to do her record-keeping properly.


86. The Panel has directed itself in accordance with the advice given by the Legal Assessor. To amount to the statutory ground the misconduct has to fall seriously short of what would be proper in the circumstances: Roylance v GMC [2000] 1 A.C. 311 at 330-331; see too Preiss v General Dental Council [2001] 1 WLR 1926 at [28], Nandi v GMC [2004] EWHC 2317 (Admin) and R (Campbell) v GMC [2005] 1 WLR 3488, CA at [19] - [21].


87. The facts, so far as proved established, that the Registrant did not comply with the following professional standards in force at the time, -


HCPC Standards of Conduct, Performance and Ethics
• Standard 1: You must act in the best interests of service users.
• Standard 10: You must keep accurate records.
Standards of Proficiency for Social Workers
• Standard 1.2: recognise the need to manage their own workload and resources and be able to practise accordingly.
• Standard 1.5: be able to recognise signs of harm, abuse and neglect and know how to respond appropriately.
• Standard 10: be able to maintain records appropriately.


88. The facts proved included a number of instances where the Registrant failed to complete records within the required timescales. The Panel accepts that in context, these failures (whether singly or in aggregate) did not cross the threshold of seriousness in view of the conditions in which the Registrant was working at the time.


89. The timely recording of information on the file of a service user is extremely important. It is essential that there exists an up-to-date record of each service user’s case available to all concerned in a social work team, and other relevant stakeholders.


90. The Registrant had a workload of around 30 cases. Pro-rata to her part-time role, the evidence established that her workload should have been 16-20 cases. CH also accepted that Thanet was understaffed at the time. The Registrant’s protected working time for catching up on paperwork was frequently compromised as other tasks were given to her. CH accepted that if there had been sufficient resources to allow her to check the records of her Social Workers, as she was required to do by the Recording Policy, she would have picked up the Registrant’s failure to record notes on time and drawn it to the attention of the Registrant so that she could rectify it.


91. Whilst the Panel was in no doubt that accurate and timely record-keeping was essential, it took the view that in the relevant extenuating circumstances, being those in which the Registrant was working, her shortcomings with regard to timely record-keeping were not sufficient to establish the statutory ground of misconduct.


92. The Panel has also concluded that the specific failures in respect of particulars 4a) and 9a) were not such as to require a finding of misconduct.


93. However, the Panel has concluded that some of the facts found proved did establish misconduct, notwithstanding the workplace conditions in which the Registrant was working at the time, as set out by Mr Gil in his closing submissions, in particular.
94. The facts that established misconduct in the circumstances were as follows. In relation to Service User A, particulars 1b), c) and d); Service User E, particulars 5b), c) and d). As regards Service Users K, M, N and O, particulars 10 a) and b).


95. These findings of fact showed a failure on the part of the Registrant to discharge fundamental requirements of practice as a Social Worker by appropriately assessing risk and responding to it. She also failed to include essential information in her case notes for four service users. These shortcomings could not be excused as a result of the difficulties in the Registrant’s working conditions at the time. The Registrant should have been able to carry out these tasks, despite those difficulties. The shortcomings fell seriously below the required standards and in all the circumstances they amounted to misconduct.


96. Therefore, particular 11 of the allegation has been established in that the facts proved under particulars 1b), c) and d), 5b), c) and d) and particulars 10a) and b) amounted to the statutory ground of misconduct.     
 

Decision on Impairment


97. Miss Sheridan submitted that the Registrant’s fitness to practise is impaired in view of her misconduct. Despite the Registrant’s admissions and remorse, Miss Sheridan submitted that the Registrant had placed service users at risk of potential harm and that there were still concerns in relation to the risk of repetition. Moreover, the need to declare and uphold proper standards so as to maintain public confidence in the profession required that a finding of impairment be made. In view of the public and personal components of impairment, she submitted that a finding of impairment was necessary.


98.  Mr Gil invited the Panel to take into account all the relevant factual circumstances at the time of the events to which the allegation related, and to contrast them with the relevant factors today. He submitted that the conduct was not only easily remediable, it had been remedied and was highly unlikely to be repeated. Public confidence in the profession would not be undermined in view of all the relevant circumstances if a finding of impairment were not made.   


99. The Panel received advice from the Legal Assessor and has directed itself in accordance with that advice in deciding whether or not the Registrant’s fitness to practise is currently impaired. He referred to passages from the judgments in CHRE v NMC & Grant [2011] EWHC 927 (Admin) and Cheatle v GMC [2009] EWHC 645 (Admin) and to the principles set out in the other cases and sources referred to in those passages, which identified in particular the personal and public components of impairment and the various considerations at play.


100. Since November 2015, the Registrant has been working as a Social Worker, employed by the National Crime Agency (‘NCA’) in the Child Exploitation and Online Protection Team as a Child Protection Adviser. The assessments of her work, which include dealing with child sexual exploitation cases, have been good. The Panel has also received very positive testimonial evidence relating to the Registrant’s current work. 


101. The Registrant now operates a spreadsheet system to keep track of her work, which gives those managing her insight into her professional activities, and also allows her to prioritise her work. She has recognised the need to speak up when her workload is too high. During the events in question, she had been too ready to accept additional work and responsibilities. She also informed the Panel that the difficulties in her personal life that existed at the time of the events, which she considered adversely affected her practice, had been resolved and were unlikely to recur.


102. In her oral evidence, and in the admissions she made, the Registrant also showed important insight into her shortcomings in relation to her work in the case of Service Users A and E, and she gave a frank assessment of her own shortcomings in failing to make a proper record in the cases of Service Users K, M, N and O. The Panel was impressed by her genuine insight and remorse.


103. In view of all these matters, the Panel has concluded that there is a low risk of repetition of the misconduct. The Registrant has demonstrated insight into her misconduct and remediated the shortcomings in her work shown by her misconduct. 


104. However, the Panel must also give appropriate weight to the public interest. The Panel considered that by failing appropriately to assess risk and respond to it in the case of Service Users A and E, the Registrant placed these vulnerable service users at potential risk and as a result breached one of the fundamental tenets of the social work profession; see Standard 1.5 of the Standards of Proficiency for Social Workers referred to at paragraph 87 above. The Panel has borne in mind that it was no part of the HCPC’s case that any harm came to any of the service users referred to in the allegation. However, regardless of whether or not any of the service users did or did not come to harm, the Registrant’s failure appropriately to assess and act on the separate risks to Service User A and Service User E brought the profession into disrepute.


105. The Panel has concluded, taking into account all the relevant matters, both past and present, including that there is a low risk of a repetition of the shortcomings in the Registrant’s work, that her failure as a Senior Practitioner to assess and act on risk appropriately in the cases of Service User A and Service User E requires a finding of impairment to be made in order to declare and uphold proper standards of conduct and behaviour so as to maintain public confidence in the profession.

Decision on Sanction


106. Neither party relied on further evidence at this further stage of the decision-making process.

107. Miss Sheridan referred to the Indicative Sanctions Policy dated 22 March 2017 (‘the ISP’). She referred to the purpose of sanctions. She referred to paragraph 8 in particular and submitted that in view of the Panel’s finding that Service Users A and E had been placed at potential risk of harm, taking ‘no action’ on Ms Bushell’s registration may not suffice to restore public confidence in the profession. She made no submission as to what sanction might be appropriate, stating that this was for the Panel to decide.   

108. Mr Gil made a number of introductory submissions. He referred to the purpose of the sanctions and pointed out that, although the purpose is not to be punitive, a sanction has a punitive effect, which should be borne in mind. He submitted that the Panel should weigh the public interests at play with the Registrant’s personal interests and strike an appropriate balance. In so doing, the Panel should bear in mind that no question of public safety arises in this case in view of the Panel’s findings on the issue of impairment and the events in question happened some time ago. The Registrant has also shown insight and remorse as recorded in that decision.

109. In weighing the private considerations at play, Mr Gil submitted that the Panel should bear in mind a number of factors, which included the following. The Registrant had expressed her sorrow, embarrassment and shame at her professional shortcomings. As a result of these fitness to practise proceedings, the Registrant had remedied those deficiencies in her work. Mr Gil referred the Panel to the reasons why the Registrant had wanted to be a Social Worker. Although the finding of impaired fitness to practise had been based on the public component only, that finding had had a profound effect on Ms Bushell, who, he said, had been “crushed’ by it.

110. Mr Gil referred to the approach set out in the ISP, which called on a panel to work upwards from the least restrictive means of securing public protection. He submitted that an outcome of ‘no action’ was appropriate in this case. There was no risk to public safety. Although impairment and sanction were distinct matters, the finding of impairment was on the record and the public interest will be sufficiently met by the findings of misconduct and impaired fitness to practise that have been made in this case. These public declarations constitute the necessary deterrent in all the circumstances and sufficiently protect the profession and public confidence in it.

111. Mr Gil submitted that a caution would be unnecessarily punitive. The Registrant accepted that she had put the young persons at potential risk and that her work had not been up to standard. The message contained in the Panel’s decision “had been received loud and clear” by the Registrant. He submitted that any more serious sanction would be even more inappropriate in view of the facts of this case.

112. The Legal Assessor drew attention to the overarching objective, to which the Panel must have regard and as set out in Article 3(4),(4A) and paragraph 18(10A) of Schedule 1 of the Health and Social Work Professions Order 2011, as amended. He referred to the purpose of sanctions, the principle of proportionality and the need to take into account any mitigating and aggravating factors, as well as all other relevant considerations. The Panel’s task was to come to a decision on the issue of sanction, which appropriately weighed the public and private interests at stake, the private interests being those of the Registrant, to produce an outcome which is a proportionate response to the finding of impairment. He referred to passages from the judgement of Ouseley J. in Brennan v HCPC [2011] EWHC 41 (Admin), at [47]-[53], which explained the approach to be taken by a Panel in weighing the wider public interest considerations in particular. 

113. The Panel has directed itself in accordance with the advice of the Legal Assessor and has borne in mind all the submissions for the HCPC and for Ms Bushell, the Panel’s findings at the prior stages of this case and all the evidence so far as relevant at this stage.

114. The following were the aggravating factors in this case. The Registrant was an experienced senior Social Worker who should have been aware that she was struggling, whatever the extenuating circumstances, to manage her workload and keep up to date with her case recording. Vulnerable young service users were put at potential risk of harm and appropriate safeguarding action was delayed due to the errors of judgment she made.

115. The mitigating factors included the following. The Registrant was working in an understaffed, overstretched and under-performing (according to the most recent Ofsted assessment) department. She did not receive regular supervision. There was a lax and ambiguous approach on the part of management to the Recording Policy, which provided for timely entries to case notes. Three different timescales were in use: 24 hours as per the policy, 48 hours and 5 days.

116. The Registrant had significant problems in her personal life. This was known to her managers who could have been more accommodating and supportive in the circumstances. The IT system did not include any flags to indicate to users, or management, that case entries were overdue; a facility that has since become available.

117. The Registrant’s work had been praised on a number of occasions and indeed her most recent performance review, concurrent with the events in question, had been positive and had led to the award of a salary enhancement. She has engaged fully throughout the fitness to practise process. She has shown genuine remorse, meaningful insight and a commitment to learn from her shortcomings. The Registrant has taken considerable steps to avoid any recurrence of the shortcomings in her work.

118. The Registrant has held a highly responsible Social Worker role at the NCA (National Crime Agency) for the past two years and has received positive performance appraisals. It is significant that her NCA line manager attended the latter part of the hearing to support her.

119. In considering the wider considerations, the Panel has borne in mind that it found impairment on the public component, reflecting in particular the serious nature of the Registrant’s failure to act appropriately in respect of two cases involving vulnerable young service users. The Panel has found, in terms of the personal component of impairment, that the Registrant has remediated the shortcomings which led to the finding of misconduct and that there is now a low risk of repetition.

120. The fitness to practise process is itself demanding of a Registrant and, in that regard, the Registrant has engaged fully and has taken the opportunity to reflect on her shortcomings and taken corrective action in terms of her personal and professional life. She has demonstrated the resolve to continue to work safely and effectively as a Social Worker. Moreover, she has done so in an area where her experience and understanding are of particular relevance.

121. The Panel has accepted the submissions of Mr Gil set out above and has concluded, after taking into account all the considerations in this case, that the public interest is sufficiently served by the findings of misconduct and impairment which followed an exhaustive examination of the evidence presented to the Panel at the end of a lengthy investigative process. Those findings are a public declaration that the Registrant’s misconduct was unacceptable, and in view of the circumstances of this case, they provide an adequate deterrent effect and are sufficient to uphold confidence in the profession and in the regulatory process. The fitness to practise process has served its purpose and no sanction is required. The public interest will be best served by allowing the Registrant, a dedicated and experienced Social Worker, to continue to work and to progress her career without the burden of a sanction. The Panel considered that a Caution Order would serve no productive purpose and would therefore be unnecessarily punitive.

122. Therefore, the Panel has decided that no action should be taken on the Registrant’s registration in all the circumstances of this case.

Order

No information currently available

Notes

 

Hearing history

History of Hearings for Miss Clare Lynette Bushell

Date Panel Hearing type Outcomes / Status
02/05/2017 Conduct and Competence Committee Final Hearing Impaired - no further action