Pauline Stidwell

: Social worker

: SW62293

Interim Order: Imposed on 14 Oct 2016

: Final Hearing

Date and Time of hearing:10:00 12/06/2017 End: 17:00 16/06/2017

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

: Conduct and Competence Committee
: Suspended

Allegation

During the course of your employment as a Social Worker at North Yorkshire County Council you:

 

1. In relation to Service User A:

a) Gave Service User A your mobile telephone number;

 

b) On or around 17 March 2015, whilst on leave, received a text message from Service User A indicating that he was "feeling really suicidal" or words to that effect, and:

i. Sent it to the office phone;

ii. Did not check that a member of staff had received the message;

iii. Did not contact Service User A;

iv. Did not reinforce the need for Service User A to contact the crisis team;

v. Upon your return to work did not check that the necessary follow up actions had been taken;

 

c) On or around 31 March 2015 did not discuss and/ or make a record of discussing the incident on 17 March 2015 with Service User A, in particular, the need to contact the crisis team.

 

2. In relation to Service User B, in approximately April 2015:

a) Did not update the Face Risk Assessment on referring Service User B to the Crisis Intervention Team;

 

b) Did not ensure that the Crisis Intervention Team were provided with all the relevant information;

 

c) Did not follow the advice of the Crisis Intervention Team to visit the Service User.

 

3. In relation to Service User C:

a) On or around 13 March 2015, received an urgent referral and did not reallocate it before going on leave;

 

b) Did not adequately record meetings held with Service User C:

i. On or around 7th April 2015;

ii. On or around 13 April 2015;

 

 

c) In approximately April 2015 inaccurately recorded that Service User C had been referred to your team Psychologist.

 

4. In relation to Service User D:

a) On or around 24 July 2014, received concerns from Service User D's mother that he was suicidal and:

i. Did not visit Service User D in a timely manner;

ii. Did not update the Face Risk Assessment;

 

b) On or around 31 July 2014, visited Service User D's home, found the door locked and:

i. Did not contact and / or make a record of contacting the Service User the next day;

ii. Did not contact and / or make a record of contacting the Service User's family;

iii. Did not escalate the matter to senior staff.

 

5. The matters set out in paragraphs 1 - 4 constitute misconduct and/or lack of competence.

 

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

Finding

Preliminary matters:


1. There were various preliminary and procedural matters that had to be dealt with by the Panel during the course of the hearing. On each occasion the Panel heard submissions from Ms Mitchell-Dunn, received advice from the Legal Assessor and considered the appropriate Practice Notes.

Service and proceeding in absence

2. The Panel was satisfied that the Registrant had been properly served with notice of the hearing. The Notice of Hearing had been sent to her address on the register by letter dated 3 March 2017.

3.  Ms Mitchell-Dunn therefore made an application for the Panel to proceed with the hearing in the Registrant’s absence.  She submitted that the Registrant had voluntarily absented herself from the hearing and had made no application for an adjournment.  In addition, on 16 January 2017, the Registrant had returned the Pre Hearing Information Form sent to her on 12 January 2017, which confirmed that she was not intending to attend the hearing and that she had no representative.  Ms Mitchell-Dunn also submitted that it was in the interests of justice that the case, involving allegations from 2014 and 2015, be expeditiously dealt with. Finally, she advised that HCPC witnesses (who had travelled from the North of England) were present and ready to give evidence.

4.  In reaching its decision the Panel took into account the HCPC’s Practice Note on Proceeding in the Absence of a Registrant and accepted the advice of the Legal Assessor. The Panel noted that the Registrant had engaged with the HCPC but had made no application for an adjournment. The Panel also took account of the fact that the Registrant appeared to have made a considered decision not to attend the hearing.  It therefore concluded that the Registrant had voluntarily absented herself from the hearing and that an adjournment was unlikely to guarantee her presence. The Panel also noted that these were allegations which were approaching three years old (it being in the public interest to deal expeditiously with regulatory matters) and that witnesses had travelled some distance to attend. Taking all these factors into account the Panel decided to proceed in the Registrant’s absence.

Application to allow a witness to give evidence by telephone

5. Ms Mitchell-Dunn also made an application for one of the HCPC’s witnesses to give evidence by telephone.  The witness concerned, Witness 3, was unable to attend to give evidence in person due to an on-going medical condition and the unpredictability of her symptoms.  Ms Mitchell-Dunn submitted that there would be no prejudice to the Registrant since the witness’ statement had been disclosed and the Panel would still be able to ask questions of the witness.  In answer to some questions from the Panel, Ms Mitchell-Dunn confirmed that Witness 3 had notified the HCPC on 31 May 2017 that she would not be able to attend but that there had been a delay in taking any action on this since the HCPC requested further information about her condition.

6. The Panel decided to allow the witness to give her evidence by telephone link.  It noted that she became unable to attend the hearing in person owing to matters beyond her control.  The Panel took account of the fact that her statement had been disclosed to the Registrant and that, as the Panel had decided that the Registrant had already voluntarily absented herself from the hearing, she had in any event rendered herself unable to cross-examine the witness.  Finally, the Panel was aware that it could still ask the witness clarification questions.      

Amendment of the Particulars of the Allegation

7.  Ms Mitchell-Dunn then applied to amend the Particulars of the Allegation in respect of which notice had been given to the Registrant by letter dated 31 January 2017.  She stated that the reason for the application to amend was to better reflect the evidence, and that there was no significant change to the case by way of the proposed amendments. She submitted that there was no prejudice to the Registrant by the application to amend as she had been given notice of this some five months earlier. In addition, the Registrant had not made any objection to the proposed amendments.

8. The Panel noted that there had been no response from the Registrant in relation to this application. The Panel asked itself whether, if the amendment was allowed, it would result in prejudice to the Registrant and whether she had been given a proper opportunity of preparing her defence to the Allegation as amended. The Panel decided to allow these amendments as it could not see any discernible prejudice to the Registrant given that significant notice of the intention to amend had been given; she had made no objections to them; none of the proposed amendments materially affected the nature of the Allegations; that several of the proposed amendments sought to clarify the particular Allegation and were essentially grammatical; and that some of the “amendments” indicated that the HCPC did not intend to offer any evidence on some of the allegations, and were therefore to the Registrant’s benefit.

Additional Matters


9. The Panel considers it appropriate to record that on the first day of the hearing, Ms Mitchell-Dunn indicated that she was also intending to make an application that the witness statement of Witness 5 be admitted into evidence as hearsay on the basis that Witness 5 had, shortly before the hearing, indicated that she was unable to either attend the hearing, or even to give her evidence over the telephone, due to a family bereavement.  The Panel suggested that, as no notification of this application had been given to the Registrant, in fairness to her she should be notified of the application so that she could comment thereon.  The Panel made this suggestion because the Registrant had been given notification shortly before the hearing of the HCPC’s intention to make the application for telephone evidence in relation to Witness 3, to which the Registrant had belatedly responded (after the Panel had granted the application) confirming that she had no objection thereto.  The Panel therefore formed the view that the Registrant was engaging with the hearing process, albeit to a limited extent, and that therefore she might respond to such notification.  An e-mail was therefore sent to her address on the first day of the hearing detailing the intended hearsay application.  The Registrant responded to that e-mail on the second day of the hearing stating that she had no objection to the statement of Witness 5 “being used as evidence”.  Ms Mitchell-Dunn therefore invited the Panel to receive the statement into evidence and did not make any hearsay application.

Background:


10. The Registrant commenced employment for North Yorkshire County Council (NYCC) on 29 September 2003. She was initially employed as a support worker, but became a Mental Health Social Worker from 22 March 2004.

11. The Registrant had been line managed by a number of health employed team managers until 22 September 2014 when her line management was transferred to Witness 4, Team Manager Social Care.

12. In September 2014 a Serious Untoward Incident Review Report (SUI report) was completed by Tees, Esk and Wear Valleys (TEWV) NHS Foundation Trust following the death of Service User D, who had been allocated to the Registrant. 

13. A letter was sent to Stuart Lomas, NYCC Lead Professional for Mental Health, and Witness 4, from the Trust Management, detailing their concerns around the death of Service User D. The letter referred to the actions that the Registrant had taken or not taken and they asked for a full investigation to be commenced into these concerns.

14. Witness 4 was asked to complete a preliminary investigation and provide a report.  Prior to this matter being allocated to Witness 4 to investigate, an interview had taken place on 5 September 2014 between the Registrant, her line manager at the relevant time, Diane Weatherill, and Stuart Lomas, in relation to the Registrant’s involvement with Service User D.

15. On 22 September 2014, Witness 4 took over as the Registrant’s Manager and the Registrant was placed on a developing performance support plan.  Subsequently, further issues were raised in relation to the Registrant’s practice concerning her management of cases relating to Service Users A, B and C.  As a result of these concerns, on 16 April 2015 the Registrant was suspended.

16. On 20 April 2015, Witness 1 was appointed as the investigating officer to investigate the allegations in relation to the Registrant. On various dates in May and June 2015 Witness 1 interviewed Witness 2, Manager of the Crisis and Home Treatment Team , who raised concerns in relation to Service User B; Dianne Weatherill, Team Manager of CMHT East, (who had been the Registrant’s line manager until this duty was transferred to Witness 4 in September 2014); Witness 5, the Team Secretary for CMHT East, who provided information in relation to the concerns raised in Service User A’s case; Witness 3, Clinical Psychologist, who raised concerns in relation to Service User C and had also been the Registrant’s clinical supervisor; and finally Witness 4, Team Manager for Social Care.  A disciplinary investigation meeting took place on 10 June 2015 in which the Registrant was interviewed.

17. Following this investigation disciplinary proceedings were initiated against the Registrant after which, on 8 March 2016, Witness 4 referred the Registrant to the HCPC due to her concerns in respect of the care she provided to Service Users A, B, C and D.

Decision on Facts


18. In considering this case the Panel bore in mind that the burden of proving the facts rests upon the HCPC and that the standard of proof is the civil standard of the balance of probabilities. It has taken account of all the evidence presented to it, namely the written and oral evidence of the witnesses listed below, together with the documentary evidence provided by the HCPC. It has also considered the detailed submissions of Ms Mitchell-Dunn, and has accepted the advice of the Legal Assessor.

19. The Panel heard from four witnesses on behalf of the HCPC namely:

- Witness 1 - Investigation Officer
- Witness 2 - Crisis and Intensive Home Treatment Team Manager
- Witness 3  - Clinical Psychologist
- Witness 4 - Line Manager

20. The Panel also read the witness statement of Witness 5 -Team Secretary


21. In addition, the Panel considered two bundles of documents from the HCPC, the first being a statement bundle of 47 pages, and the second being the exhibits bundle, amounting to some 565 pages.

22. Generally, the Panel saw no reason other than to conclude that all the witnesses who appeared before it were doing their best to honestly recall what had happened and how they interpreted the Registrant’s actions.  Having said that, however, the Panel did treat with some caution the evidence of Witness 4, who revealed that she had made the referral to the HCPC as she personally was disappointed with the outcome of the disciplinary proceedings brought against the Registrant by the local authority (it had imposed a final written warning upon the Registrant) in relation to the complaints concerning Service Users A, B and C.  She said she would not have referred the Registrant only in respect of Service User D.

23. The Panel made the following findings in relation to the Particulars:

During the course of your employment as a Social Worker at North Yorkshire County Council you:

1. In relation to Service User A:

a) Gave Service User A your mobile telephone number;

24. Proved – There is no dispute about this.  The Registrant admitted during her investigation meeting with Witness 1 on 10 June 2015 that she had given Service User A (“SUA”) her work mobile telephone number. 

b) On or around 17 March 2015, whilst on leave, received a text message from Service User A indicating that he was "feeling really suicidal" or words to that effect, and:

i. Sent it to the office phone;

25. Proved – There is no dispute about this.  The Registrant admitted during her investigation meeting with Witness 1 on 10 June 2015 that, whilst on leave, she had received such a message from SUA on her work mobile telephone number and had forwarded it to the office mobile telephone at 07.46 believing that it would be picked up by a member of staff.  At 07.49 she sent a further text message to Witness 5, the Team Secretary, asking for someone in the Team to contact the service user. These messages were not seen until the following day owing to Witness 5 not turning on the office mobile telephone.

26. The Panel notes that Witness 5 did log the text message onto the Paris electronic system on 18 March 2015 at 09.39 as follows:

“Text message received on office mobile (a phone available for staff to contact to request a call when they require patient related information such as a postcode or phone number when out in the community) from Pauline Stidwill, the message was received by her from SUA whilst she was on leave. Message reads:

Hi its [SUA] I know your going on holiday (sic) and [I] said l don't want anyone else from your team to take over.  And I don’t. But I’m feeling really suicidal and I don't know who to tum to.  I am really struggling to get just to get tejust get by (sic)  Please if I can just deal with you that would be good even just for one minute before you get someone else involved please. I don’t know who else to tum to.

27. This message was followed up by another text from Pauline asking Clare to ask someone in the team to contact SUA.

28. The texts were sent at 7.46am and 7.49am respectively on 17/03/2015 but not seen until 9.15am on 18/03/2015. 

ii. Did not check that a member of staff had received the message;

29. Proved – There is no dispute about this.  The Registrant admitted during her investigation meeting with Witness 1 on 10 June 2015 that she did not check that her messages had been received because she did not follow this up with a telephone call as she was on annual leave and that there was no reason to assume her message would not be picked up.

iii. Did not contact Service User A;

30. Proved – There is no dispute about this.  The Registrant admitted during her investigation meeting with Witness 1 on 10 June 2015 that she did not contact SUA in response to his message.

iv. Did not reinforce the need for Service User A to contact the crisis team;

31. Not Proved – The HCPC offered no evidence in support of this particular and therefore the Panel found it Not Proved.

v. Upon your return to work did not check that the necessary follow up actions had been taken;

32. Not Proved – The Panel noted that during her investigation meeting with Witness 1 on 10 June 2015 the Registrant was asked whether she had “discussed this incident with him” and that she replied “I can’t recall”.  It does not appear that Witness 1 showed the Registrant the note of her meeting with SUA which she prepared on 31 March 2015 at 13.21 before she answered that question.  The note records her meeting with SUA on 31 March 2015, the day after she returned from leave, 30 March 2015.  It states:

“Arrived at [SUA’s] home, initially no response from the intercom so message left on his mobile enquiring as to whether he had forgotten our appointment. A few minutes later sent a message stating that he had forgotten but that he would be back home in 10 minutes.

[SUA] continues to present low in mood and lacking in motivation although denied any feelings of suicidal thoughts/intent. 


33. The Panel considers that this note, made in respect of a meeting with SUA the day after the Registrant returned from leave, demonstrates that the Registrant did check that the necessary follow up actions had been taken by actually visiting SUA and discussing his current situation.  The Panel therefore finds this allegation not proved.

c) On or around 31 March 2015 did not discuss and/or make a record of discussing with Service User A:

i. the text message dated 17 March 2015; and/or

34. Not Proved – The Panel notes that Witness 1 maintained, in her report, that “There is nothing recorded within the Paris case note to evidence that this incident was discussed with him”.  The Panel disagrees.  It considers that the note made by the Registrant on 31 March 2015 does, by inference, indicate that his previous suicidal thoughts, which were last referred to in SUA’s text, were discussed – the extract “[SUA] continues to present low in mood and lacking in motivation although denied any feelings of suicidal thoughts/intent” (Panel’s emphasis) makes this clear.

ii. the need for Service User A to contact the crisis team.

35. Proved – it is clear that the note does not refer to the Registrant discussing with SUA the need for him to contact the crisis team.

2. In relation to Service User B, in March 2015:

a) Did not update the Face Risk Assessment before referring Service User B to the Crisis Intervention Team;

Not Proved

b) Did not ensure that the Crisis Intervention Team were provided with all the relevant and up-to-date information;

Not Proved

c) Did not follow the advice of the Crisis Intervention Team to visit Service User B before the referral to the Crisis Intervention Team.

Not Proved

36. The Panel noted how the HCPC had presented its case in relation to Service User B (“SUB”).  Concerns arose when on 20 March 2015, Witness 2 e-mailed the Registrant's line manager, Diane Weatherill, regarding Service User B.  The e-mail read as follows:

“Hi Diane

I'm just needing to advise you of the situation regarding a referral we've received from Dr Lough for one of East CMHT’s patients (Paris ID Service User B)

The patient's care co-ordinator Pauline Stidwell (sic) last week discussed referral to us following concerns having been raised by the patient’s family (?). Following discussion with Pauline it was established that referral was not at that (sic) appropriate but that Pauline had not seen the patient since 04/02/2014 and there was limited documentation on PARIS to suggest that things had deteriorated, therefore we advised Pauline to consider reviewing the patient documenting any deterioration and updating FACE to reflect deterioration/increase or risk before referring back to use (sic).

Following this discussion with Pauline the patient was seen Dr Lough (13/03/2014), who yesterday made a referral through to CRHTT however the only addition to the documentation on PARIS regarding the patient is Dr Lough's case note entry from 18/03/15 which Is limited to stating that the patient is 'getting worse'.

37. When asked by the Panel why she believed that the Registrant had telephoned Hayley Robertson, Witness 2 said that her perception was to “test the waters” for a referral.  From what she had been told by Hayley Robertson, the Registrant was “hoping to make a referral and wanted a conversation to take place”.  Witness 2 went on to say that sometimes a professional conversation about a potential referral took place and a referral did not subsequently always happen. She said that in the past when the Registrant had made a referral she had always complied with the policy

38. Witness 2 also said that when Dr Lough had made his referral, he had not expressed any concerns about any failure to refer SUB to the Crisis Team earlier – he had merely made a verbal referral.  This was done on the basis that the documentation would be updated later but, in this particular case, “despite our best efforts” it was not received.

39. In summary, therefore, the Panel considered that there was little or no evidence before it that the Registrant was actually making a referral to the Crisis Team when she telephoned Hayley Robertson.  Witness 2 indicated that her understanding was that the Registrant was exploring the possibility of making a referral and that others also contacted the Crisis Team to discuss possible referrals.  Moreover, the Panel notes that it was accepted that the Registrant had made other referrals to the Crisis Team in the correct way with up to date documentation.  Finally, the Panel notes that this discussion took place just before the Registrant went on leave and there is no evidence before it to suggest that she knew that Dr Lough intended to make a referral to the Crisis Team the following week.  The Panel therefore concludes that, on balance, the Registrant was not actually making a referral when she telephoned Hayley Robertson but was instead seeking advice.  The Panel therefore finds the totality of Particular 2 not proved.

3. In relation to Service User C:

a) On or around 13 March 2015, received an urgent referral and did not reallocate it before going on leave;

40. Proved – The Registrant admitted during her investigation meeting with Witness 1 on 10 June 2015 that she had received such a referral.  The relevant extract of her interview states:

“With regard to urgent referrals the team have ten days to respond to these, on the day I was finishing for annual leave I was on duty. A referral came in as an urgent. It is the practice of the team that this be allocated to the duty worker. It is expected that initial contact be made whilst on duty and/or the GP be contacted. However, if it comes in later it may be passed to the next Care Co-ordinator on the list. I can't remember what time that particular referral came in. As I was going on leave I left a note for Stacey (Team Secretary) to ask her to allocate to another Care Co-ordinator.”

41. On her return from leave, the Registrant placed a note on Paris, on 30 March 2015, which read:

“13/3/15 was my last day before going on a fortnights annual leave, this referral was received as an urgent. As I would be unable to make arrangements to meet with [SUC] a written message was left with Stacey Jones, team secretary to request another care coordinator to assess. On my return to work it came to my attention that this had not been dealt with by anyone as Stacey had been on sick leave despite the note been left on her desk.

I telephoned [SUC] at 16.40 today but there was no reply, message left advising her that I was hoping that I could meet with her tomorrow morning and that I would ring her to try and make an appointment with her.”

42. In her disciplinary interview the Registrant went on to say that it was the secretary’s job to relay messages within the team and that Stacey would have been able to contact the next care co-ordinator on the list.  There was a “buddy system” but her “buddy” was not always contactable.  She had been confident that Stacey would have picked up the message but she did not know that Stacey would be off sick.  The Registrant’s assumption was that “she would be there”.

43. The Panel considered that placing a note on a secretary’s desk did not amount to “reallocating” the referral.  It concluded that for a reallocation to have taken place, there had to be an acceptance from the person to whom the case had been reallocated – there was no such acceptance in this case.  The Panel therefore found this Particular proved.   

b) Did not adequately record meetings scheduled and/or held with Service User C:
i. On or around 7th April 2015
;

44. Proved – There is no dispute about this.  The Registrant admitted during her investigation meeting with Witness 1 on 10 June 2015 that she had not recorded scheduled or actual meetings with SUC on Paris within 24 hours of contact.  She indicated that it was not always possible to do so.  The Panel also notes that although the Registrant recorded on 31 March 2015 that she had arranged to see SUC on 7 April 2015 (and also noted this on her electronic “Outlook” diary) there is no subsequent entry detailing such a meeting.  The Panel therefore considers that, although the scheduling of this meeting was “adequately” recorded, the actual meeting was not and therefore that this Particular is found proved.  

ii. On or around 13 April 2015;

45. Proved – There is no dispute about this.  The Registrant admitted during her investigation meeting with Witness 1 on 10 June 2015 that she had not made any case note about this appointment on Paris.  The Panel notes that the Registrant had noted this appointment on her electronic “Outlook” diary; however, there is no entry on Paris detailing such a meeting.  The Panel therefore considers that, although the scheduling of this meeting might have been “adequately” recorded, the actual meeting was not and therefore that this Particular is found proved.  

46. The Panel also notes that the failure to document these two meetings with SUC came to light when Witness 3 informed Witness 4, on 24 April 2015, that Service User C had told her that she had been seen twice by the Registrant.

c) In approximately April 2015 inaccurately recorded that Service User C had been referred to your team Psychologist.

47. Not Proved – The HCPC offered no evidence in support of this particular and therefore the Panel found it Not Proved.

4. In relation to Service User D:

a) On or around 24 July 2014, received concerns from Service User D's mother that he was suicidal and:

i. Did not visit Service User D in a timely manner;

48. Proved - The Panel noted the evidence submitted to it in relation to Service User D (“SUD”), particularly as documented in the SUI Report dated 4 November 2014, which has not been challenged by the Registrant.  The Panel accepted that he was a 44 year old male at the time of his death.  He had a history of substance misuse. He was discharged, on 21 July 2014, from the Trust Mental Health Unit where he was an inpatient.  He was under the care of the Community Mental Health Team. The Registrant was SUD’s Identified Care Coordinator. SUD was found dead on 3 August 2014 by his family. 

49. On 24 July 2014, the Registrant had received a telephone call from SUD's mother raising concerns that SUD was suicidal. SUD's mother explained to the Registrant that it was his birthday and that he had made plans to spend time with his family and friends; however, had now declined to do so. The Registrant offered to visit Service User D, however, Service User D's mother advised her to leave it until the following day.

50. The Registrant therefore agreed to “try to catch up with” SUD the next day and this was recorded on the Paris system.  However, there is no record in SUD's case notes to show that contact was made on 25 July 2014 and there was no record of an appointment with SUD in the Registrant’s paper diary.  When asked about contact with SUD during the SUI investigation the Registrant stated that she could not recall if contact was made. In any event, the Registrant was required to visit SUD within seven days of his discharge from hospital in accordance with the accepted practice.

51. On 31 July 2014, the Registrant visited SUD's property. She noted in his records for the same date that there was post in his letter box and that the front door was locked, which was unusual as the door was usually unlocked. She also noted that she attempt to visit him on 1 August 2014.   There are no records to show that the Registrant made this contact on 1 August 2014.  On 4 August 2014, she was informed that SUD had been found dead.

52. The Panel considers that, notwithstanding SUD’s mother’s advice not to visit him on 24 July 2014, the Registrant should have arranged or attempted a visit on that day, simply due to the facts that he was reported as being suicidal, that he had isolated himself from friends and family, and that he had only recently been discharged from hospital.  At the very least, she should have visited him the following day as suggested.  Only visiting a week later, on 31 July 2014, was not “timely”.  The Panel therefore concludes that this Particular is proved. 

ii.   Did not update the Face Risk Assessment;

53. Not Proved – The Panel considered SUD’s last Face Risk Assessment and noted that it had been commenced on 22 July 2014, and recorded that his “mother recently contacted the team voicing her concerns”; and that it had been concluded by the Registrant on 30 July 2014.  It also noted that Witness 4 was unable to assist to any great degree with interpretation of the Face Risk Assessment since she was unfamiliar with that form.

54. The Panel noted Ms Mitchell-Dunn’s argument that the form also recorded SUD’s “current risk status” as “low” and therefore that this might indicate that it had not been updated following SUD’s mother’s contact on 24 July 2014, but the Panel considers that the form was updated following her contact on the basis that it records such contact.  The Panel is therefore led to the conclusion that the HCPC has failed to discharge the burden of proof upon it on this matter and therefore finds this Particular not proved.

b) On or around 31 July 2014, visited Service User D's home, found the door locked and:

i. Did not contact and/or make a record of contacting Service User D on 1 August 2014 as planned;

55. Proved – The Panel notes that there does not appear to be any dispute that there is no written evidence on Paris that the Registrant did not contact or make a record of contacting SUD on 1 August 2014 as planned.  The Panel observes that such contact would have been impossible in any event because the evidence before it was that, by that time, it was probable that SUD had died; however, there is likewise no written evidence that the Registrant made any attempt to contact SUD on that day.  The Panel therefore finds this Particular proved.

ii.    Did not contact and/or make a record of contacting the Service User's family;

56. Not Proved – The HCPC offered no evidence in support of this particular and therefore the Panel found it Not Proved.

iii. Did not escalate the matter to senior staff.

57. Proved – The Panel notes that there does not appear to be any dispute that the Registrant did not escalate the matter to senior staff having had failed to visit SUD’s home and found the door locked.  The Panel therefore finds this Particular proved. 
Decision on Grounds
58. Having found the facts proved in this matter, the Panel went on to consider whether the facts found proved, individually or collectively, amounted to misconduct and/or lack of competence. 

59. In relation to misconduct, the Panel noted the advice of the Legal Assessor who referred to the cases of Roylance v General Medical Council [2000] 1 A.C. 311, Cheatle v General Medical Council [2009] EWHC 645 (Admin), Nandi v. General Medical Council [2004] EWHC 2317, Spencer v General Osteopathic Council [2012] EWHC 3147 (Admin), R v. Nursing and Midwifery Council (ex parte Johnson and Maggs) (No 2) [2013] EWHC 2140 (Admin) and Schodlok v GMC [2015] EWCA Civ 769. The Panel noted that misconduct must be serious and amount to a registrant’s conduct falling far below the standards expected of a registered social worker.

60. In relation to lack of competence, the Panel noted the advice of the Legal Assessor that lack of competence connotes a standard of professional performance which is unacceptably low and which, (save in exceptional circumstances), has been demonstrated by reference to a fair sample of the Registrant’s work.  Moreover, the benchmark by which to gauge impairment is the standard required of a registered social worker.

61. The Panel noted Ms Mitchell-Dunn’s submissions that a number of standards in both the HCPC’s Standards of conduct, performance and ethics, and in the Standards of Proficiency for Social Workers, had potentially been breached.  The Panel agrees that the following Standards have been breached by the Registrant’s actions or failings:

Standards of conduct, performance and ethics:

6 - You must act within the limits of your knowledge, skills and experience and, if necessary, refer the matter to another practitioner.
7 - You must communicate properly and effectively with service users and other practitioners.
10 - You must keep accurate records.

Standards of Proficiency: Social Workers
 
1 - be able to practise safely and effectively within their scope of practice.
2 - be able to practise within the legal and ethical boundaries of their profession.
4 - be able to practise as an autonomous professional, exercising their own professional judgement.
8 - be able to communicate effectively.
9 - be able to work appropriately with others.
10 - be able to maintain records appropriately.
15 - be able to establish and maintain a safe practice environment.

62. In relation to Misconduct, the Panel considered each particular that had been proved in turn individually.


63. Particular 1(a) (In relation to Service User A gave Service User A your mobile telephone number) – The Panel found that this did not amount to Misconduct. 

64. It noted that the HCPC argued that the Registrant should not have given her work mobile telephone number to a service user. During her disciplinary interview the Registrant was asked about her understanding of policies regarding texting service users and had stated this was allowed and with some people it was more appropriate.  She had further stated that she would not give her number to all service users, just those who would not abuse it.

65. The Panel further noted the North Yorkshire County Council Procedure, on Professional Boundaries between Staff and Service Users. The Panel found the Policy to be ambiguous in that one part argued that personal mobile telephone numbers should not usually be given to service users but another part gives advice on texting service users. This was not the Registrant’s personal mobile phone but her work mobile. The Panel concluded that, although this was not good practice since it could be abused by service users, given that the motive behind it was to benefit the service user concerned, this was not conduct which fell far short of what was expected of a registered social worker. 

66. Particular 1(b)(i) (On or around 17 March 2015, whilst on leave, received a text message from Service User A indicating that he was "feeling really suicidal" or words to that effect, [and] sent it to the office phone) – The Panel found that this did not amount to Misconduct. 

67. The Panel noted the statement evidence of Witness 5, who said that the office mobile was for the use of the Team on home visits for checking post codes or telephone numbers and was not for anything urgent.  She maintained that this was understood by all staff and that e-mails had been sent to confirm this.  The Panel appreciated that the Registrant had consented to this statement being “used as evidence” but the Panel decided that, as the Registrant had made that concession without the benefit of legal advice, the statement of Witness 5 would not be treated as agreed evidence but simply as hearsay evidence.

68. The Panel also observed that this system of having an office mobile had been introduced to ensure that staff could always get through to the office without occupying the land line, which would then be free for service users, and that Witness 1 had indicated that she understood that it was also used for staff to notify the office if they were running late, so that service users could be informed which did indicate a type of “urgent” use for this mobile.

69. Accordingly, the Panel concluded that, although this was not good practice, it was an authorised method of communication between staff and the office, and therefore was not conduct which fell far short of what was expected of a registered social worker. 

70. Particular 1(b)(ii) (Did not check that a member of staff had received the message) – The Panel found that this did amount to Misconduct.

71. The Panel notes that the Registrant was asked whether she made any attempts after sending the message to follow this up and to ensure it had been acted upon. The Registrant responded that she did not follow this up with a telephone call as she was on annual leave. She stated there was no reason to assume it would not be picked up.


72. The Panel considered that, as simply forwarding the message from SUA and sending a message from herself did not involve actually speaking to a member of staff, the Registrant could not have been sure that the messages had been received.  There may be technical reasons why a text may be delayed in transmission and more importantly as there was a suggestion of urgency about the matter, common sense dictates that the Registrant should have checked that the messages had been received so that another member of staff could have been asked to contact SUA.  Finally, the Registrant’s argument about not following it up because she was on holiday is somewhat undermined by her becoming involved in the matter in the first place, notwithstanding that she was on holiday at the time.  Accordingly, the Panel was satisfied that this was conduct which fell far short of what was expected of a registered social worker and consequently amounted to Misconduct.    

73. Particular 1(b)(iii) (Did not contact Service User A) – The Panel found that this did not amount to Misconduct.

74. The Panel saw no reason why the Registrant should have contacted SUA.  In her own mind she had forwarded the concern to another member of staff, the purpose of that being to avoid becoming involved whilst she was on leave.  The Panel considers that this was a judgment call on her behalf, made “out of hours”, in respect of a service user whom she knew.  Accordingly, this was not conduct which fell far short of what was expected of a registered social worker.       

75. Particular 1(c)(ii) (On or around 31 March 2015 did not discuss and/or make a record of discussing with Service User A the need for Service User A to contact the crisis team) – The Panel found that this did not amount to Misconduct.

76. The Panel reminds itself that it has found that at the meeting with SUA on 31 March 2015, she had discussed his previous suicidal thoughts and had observed that he was now stable and not suicidal.  The Panel was also aware that this was a service user whom she knew.  The Panel concluded that, whilst it would have been best practice to remind SUA about contacting the crisis team, on this occasion it did not amount to conduct which fell far short of what was expected of a registered social worker.     


77. Particular 3(a) (In relation to Service User C, on or around 13 March 2015, received an urgent referral and did not reallocate it before going on leave) – The Panel found that this did not amount to Misconduct.

78. The difficulty the Panel had with this Particular was that it had not been advised of the nature of the referral, why it was considered to be urgent or from whom the referral came.  This has made it impossible to assess the level of seriousness regarding the Registrant’s apparent failing.  The Panel is also aware that an “urgent” matter was classified as one that has to be dealt within 10 working days, or two weeks, (as opposed to a “crisis” matter, which had to be dealt with in four hours).  In addition, the Panel notes that SUC was already receiving support from the Intensive Home Treatment Team (IHTT) starting at 2 March 2015 and ceasing on 25 March 2015.  Consequently, she was being seen on a very regular basis and in effect was subject to the highest level of intervention, apart from hospitalisation.  Finally, the Panel has not been advised of any harm resulting to SUC, although of course it appreciates that it cannot discount the potential for harm.  Accordingly, The Panel concluded that, whilst it would have been best practice to ensure that SUC’s case had been reallocated to a colleague, on this occasion it did not amount to conduct which fell far short of what was expected of a registered social worker.       

79. Particular (3)(b)(i) and(ii) (Did not adequately record meetings scheduled and/or held with Service User C : i. On or around 7th April 2015 and ii. On or around 13 April 2015) – The Panel found that this did not amount to Misconduct.

80. The Panel notes that, whilst the Registrant had adequately recorded the scheduled meeting with SUC in her electronic diary, and whilst the meetings had apparently (according to SUC) gone ahead, they had not otherwise been recorded on Paris.  The Panel is aware that, according to the Minimum standards for Clinical Recording Keeping policy, entries should be made at the time an event or activity takes place or at least within 24 hours, i.e contemporaneous record keeping.

81. However, the Panel has not been advised of any harm resulting to SUC as a result of this failure to record these meetings, although of course it appreciates that it cannot discount the potential for harm.  Moreover, the Registrant did indicate that it was not always possible, due to pressure of work (which was accepted by Witness 4 might have been a factor in the service at that time) to keep on top of record keeping.  Accordingly, the Panel concluded that, whilst it would have been good practice to have documented the outcomes of these meetings, this was in reality an isolated incident of poor record keeping and therefore, on this one occasion in 2015, it did not amount to conduct which fell far short of what was expected of a registered social worker.       

82. Particular 4(a)(i) (On or around 24 July 2014, received concerns from Service User D's mother that he was suicidal and did not visit Service User D in a timely manner) – The Panel found that this did amount to Misconduct.

83. The Panel had little hesitation in concluding that this amounted to Misconduct.  The Registrant had received a report from SUD’s mother indicating that he had suffered a potential deterioration in his mental state that day and, although she did not visit him on 24 July 2014 on the advice of his mother, she should have, as she effectively agreed, visited him the next day or in any event within the seven day review period.   


84. Accordingly, the Panel was satisfied that this was conduct which fell far short of what was expected of a registered social worker and consequently amounted to Misconduct.    


85. Particular 4(b)(i) (On or around 31 July 2014, visited Service User D's home, found the door locked and did not contact and/or make a record of contacting Service User D on 1 August 2014 as planned) – The Panel found that this did amount to Misconduct.

86. The Panel reminds itself that when the Registrant visited SUD’s home on 31 July, 2014, she found not only the door locked but also uncollected post, which should have alerted her to the possibility that either SUD had left the property (and therefore might have been in a very vulnerable position) or had self-harmed in some way, especially given what she last had heard about him.  These possibilities should have ensured that she at the very least attempted to contact him the next day.

87. Accordingly, the Panel was satisfied that this was conduct which fell far short of what was expected of a registered social worker and consequently amounted to Misconduct.    

88. Particular 4(b)(iii) (Did not escalate the matter to senior staff.) – The Panel found that this did amount to Misconduct.

89. The Panel considered that, given the possibilities that should have become obvious to the Registrant when she observed the uncollected post and the locked door to SUD’s property, as outlined in the discussion relating to Particular 4(b)(i) above. The Panel concludes that it should have been obvious to the Registrant that at the very least, senior staff should be alerted to an apparent escalation of risk to SUD.


90. Accordingly, the Panel was satisfied that this was conduct which fell far short of what was expected of a registered social worker and consequently amounted to Misconduct.    

91. The Panel therefore concludes that the proved Particulars 1 (b) (ii), 4 (a) (i), 4 (b) (i) and 4 (b) (iii) amount to Misconduct.


92. The Panel went on to consider whether any of the remaining Particulars found proved amounted to a lack of competence, but concluded that, although a number of those Particulars did not amount to good practice, they did not amount to a standard of professional performance which is unacceptably low.  Moreover, the Panel had doubts about whether a fair sample of the Registrant’s work had been assessed.  Accordingly, the Panel concluded that the remaining Particulars found proved did not amount to a lack of competence. 


Decision on Impairment 


95. In reaching its decision on impairment, the Panel took account of the submissions of Ms Mitchell-Dunn, the documentary and oral evidence given during the hearing, and the advice of the Legal Assessor. It also took account of the HCPC Practice Notes “Finding that Fitness to Practise is “Impaired” and “Fitness to Practise – What does it Mean”.

96. The Panel was aware that, in determining whether fitness to practise is impaired, it must take account of a range of issues which, in essence, comprise two components, namely the ‘personal’ component (the current competence and behaviour of the individual Registrant) and the ‘public’ component (the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession). The Panel was aware that not every finding of misconduct would result in a finding that fitness to practise is impaired.

97. The Panel reminds itself that it has found that the Registrant’s actions, namely failing to check that a member of staff had received the messages in relation to SUA; failing to visit SUD in a timely manner; failing to contact and/or make a record of contacting SUD on 1 August 2014 as planned having visited SUD's home on or around 31 July 2014 and having found the door locked; and having failed to escalate SUD’s matter to senior staff, all amounted to Misconduct.

98. The Panel has concluded that the Registrant’s fitness to practise is impaired on both the personal and public component grounds.


99. The Panel first of all considered the personal component.  It noted that it has no information before it about the Registrant’s current circumstances or employment, nor any indication that she has reflected upon the events of 2014 and 2015 since the conclusion of the disciplinary proceedings against her in 2016.


100. The Panel first of all considered whether her misconduct as found was capable of being remedied – it decided that it was capable of being remedied by appropriate training in risk awareness and risk management, and by personal reflection. 

101. The Panel next considered whether the Registrant had remedied her failings as identified by it but concluded that there was no information before the Panel to suggest that the Registrant had undertaken such a step.


102. The Panel next considered whether there was a risk of repetition.  Given that there was no evidence before it that these failings had been addressed by her, the Panel was left with little alternative but to conclude that there was a significant risk of repetition.


103. The Panel also considered whether the Registrant had demonstrated insight into her actions.  It appreciated that she had engaged to a limited, albeit helpful, extent with the hearing process but otherwise there was no evidence before the Panel to enable it to conclude that the Registrant was able to demonstrate that she had insight into these matters.


104. Accordingly, the Panel concluded that the Registrant was currently impaired in relation to the personal component.


105. In relation to the public component, the Panel concluded that a reasonable member of the public, aware that the Registrant had not ensured that a service user’s request for assistance had been drawn to the attention of a colleague for them to deal with in her absence; and further had not responded appropriately to notification by another service user’s mother that her son’s mental state had potentially deteriorated (by failing to visit him in a timely manner); and had not subsequently acted swiftly upon indications that he might otherwise be in difficulties (by failing to visit him and to escalate concerns) would expect a Panel considering these matters to find that fitness to practise is impaired. The public has a right to expect social workers to respond appropriately to what might be considered as urgent adverse developments with their service users and to ensure that their actions do not fall far below acceptable and professional standards such that the public’s confidence in the profession is damaged. Responding to such contact from vulnerable members of the public is a fundamental expectation of the social work profession. The Registrant’s failure to comply with this expectation brings the profession into disrepute. The public also has a right to expect that the proper standards of behaviour and conduct expected of social workers are upheld on behalf of all members of that profession.


106. The Panel was, therefore, satisfied that public confidence in the Social Work profession would be undermined if it did not make such a finding. It was also of the view that such a finding was required in order to uphold proper standards of conduct and behaviour in the profession. Accordingly, the Panel concluded that the Registrant’s fitness to practise is impaired on public interest grounds.     

Decision on sanction

107. In reaching its decision on sanction the Panel took account of Ms Mitchell-Dunn’s submissions, the Indicative Sanctions Policy (“ISP”) document and the advice of the Legal Assessor, which it accepted. The Panel was mindful that the purpose of sanctions is not to be punitive, although they may have that effect. It appreciated that the primary purpose of any sanction is to address public safety from the perspective of the risk which the registrant concerned may pose to those who use or need his or her services. It noted, however, that in reaching its decision, panels must also give appropriate weight to the wider public interest, which includes: the deterrent effect to other registrants; the reputation of the profession concerned; and public confidence in the regulatory process. In addition, the Panel noted that it must act proportionately, which requires it to strike a balance between the interests of the public and those of the Registrant.

Mitigating and Aggravating factors

108. The Panel took account of the various mitigating factors namely:

109. The Registrant’s previous good character and service for 10 years up to these incidents;  

110. These matters essentially were two isolated incidents separated by a time period of eight months;

111. The Panel had received indications from Witness 4 that the Registrant had significant health issues, one of which may have left her with continuing cognitive problems; however, it did not have before it any further, or current, medical information; 

112. The Panel also received indications from Witness 4 that the service was, at the time of these incidents, undergoing a troublesome period due to the fragmentation of the administration of the service, with the Registrant being employed by the local authority yet being managed on a daily basis by the health authority.  Consequently, Witness 4 stated that social workers had felt abandoned and without professional social worker supervision and that the service was poorly staffed and poorly managed:

113. However, the Panel also noted the following aggravating features and in particular:

114. The Registrant breached a fundamental expectation of social workers which is that they will respond to requests for assistance from vulnerable members of the public such as their service users;

115. There were suggestions from that the Registrant had sought to place blame for these incidents on the conditions of her employment, being employed by the local authority yet managed by the heath service; however, the Panel considers that this is tempered by Witness 4’s further evidence that the “fragmented administration” factor was accepted by the local authority as a mitigating feature in the Registrant’s disciplinary hearing; 

116. The Panel has no evidence of reflection by the Registrant about these incident before it nor any indication that the Registrant has changed, or would change, her practice because of them;

117. The Panel has found that there is a significant risk of repetition;

118. The Registrant has not supplied any evidence of her current position, her Continuing Professional Development (CPD) nor any relevant testimonials or reports;

119. The Panel has treated the death of SUD as neither an aggravating nor a mitigating factor. The information before the Panel was that the report to the Inquest made it clear that there was no suggestion that the Registrant’s actions had contributed to SUD’s death, but it is part of the context of this matter which serves as a timely reminder to social workers that their actions or omissions might have serious consequences.

Consideration of Sanction

120. Given the seriousness of the misconduct and the aggravating factors the Panel took the view that this was not a case that could be appropriately dealt with without a sanction.  The Panel therefore went on to consider the various sanctions, beginning with the least onerous.

121. The Panel first considered the sanction of mediation and concluded that it was not appropriate. There was no evidence before it that her employers (previous or otherwise – the Panel had no information as to whether she was still employed by the same employers) or the Registrant would co-operate in such a process, and in any event the matter was too serious to be resolved in this way.

122. The Panel next considered a Caution Order, which is deemed to be appropriate:

“where the lapse is isolated, limited or relatively minor in nature, there is a low risk of recurrence, the registrant has shown insight and taken appropriate remedial action”

123. The Panel noted that, although these matters could be described as isolated lapses since they occurred eight months apart, the Particulars found proved were serious and suggested a possible pattern of failure to respond adequately to service users in potentially urgent situations. Moreover, the Panel had found that there remained a real risk of repetition. Consequently, the Panel concluded that, especially given that the Panel had no information before it in relation to the Registrant’s current insight, such a sanction would be insufficient to address the Panel’s concerns in relation to the public interest grounds or to provide adequate protection to the public.

124. The Panel then considered the next most onerous sanction, that of a Conditions of Practice Order, and noted that this is appropriate where a failure or deficiency is capable of being remedied and where the Panel is satisfied that allowing the Registrant to remain in, or return to, practice, while subject to conditions, minimises the risk of future harm to service users.

125. The Panel determined that, despite the breaches being serious, the Registrant’s failings were capable of being remedied. However, the Panel noted paragraph 13 of the ISP which states:

“A key factor in many cases will be the extent to which a registrant recognises his or her failings and is willing to address them.”

126. Furthermore, paragraph 27 states that

“The imposition of conditions requires a commitment on the part of the registrant to resolve matters”

127. and goes on to say that conditions may be inappropriate where

“the registrant lacks insight or denies any wrongdoing”.

128. The Panel noted Ms Mitchell-Dunn’s submissions that the Registrant did not appear to have acknowledged any error on her part in relation to these incidents; that she had displayed little or no insight into her actions in this matter; and that she had failed to take due responsibility or to have reflected properly about what she could have done differently and how her actions might have affected service users or the public’s view of her profession.

129. Based on the information before it, the Panel felt unable to draft workable, appropriate, realistic or verifiable Conditions of Practice. It concluded that there was no evidence before it that the Registrant would or could comply with such an order.

130. The Panel next considered imposing the next most onerous sanctions. It decided that it would be appropriate to consider the alternative orders of Suspension and Striking Off together since these remained the only two options open to it.

131. The Panel noted that the ISP indicated that a Suspension Order should be considered where a Panel believes that a caution or conditions of practice would provide insufficient public protection or where the allegation is of a serious nature but unlikely to be repeated and, thus, striking off is not merited. Where there were no psychological or other difficulties preventing a registrant from understanding and seeking to remedy the failings, then suspension might be appropriate. The ISP states, however, that if the evidence suggests that a registrant would be unable to resolve or remedy his or her failings then striking off might be the more appropriate option.


132. The Panel reminded itself that it had little information before it as to the Registrant’s current situation or whether she has any real intention of correcting her practice.  The Panel has decided to give her an opportunity to show that she is willing to remedy her failings by imposing a Suspension Order for a period of 6 months to enable her to demonstrate that she has gained insight into her failings and wishes to remedy them.

133. The Panel noted that the ISP indicates that a Striking Off Order was not only a sanction of last resort for serious, deliberate or reckless acts involving abuse of trust such as sexual abuse, dishonesty or persistent failure but also that it should be used where there was no other way to protect the public. A registrant’s inability or unwillingness to resolve matters would suggest that a lower sanction may not be appropriate. The Panel considered that, at this stage, a Striking Off Order would be disproportionate in relation to the misconduct found.

134. The Suspension Order will be reviewed towards the end of that period and the HCPC will arrange for a Review hearing to take place. At that hearing, the reviewing Panel may be assisted by:

• The Registrant’s attendance;
• Evidence of reflection about what went wrong in connection with these incidents, together with how they could be avoided in the future;
• Evidence of insight and remorse, particularly as to how her actions impacted upon others;
• Evidence that the Registrant has kept her skills and knowledge up to date, together with evidence of CPD, particularly in relation to risk assessment, risk management and record keeping;
• Evidence of the Registrant’s future intentions about practising as a social worker and details of her plans, if any, for such a return;
• Up to date and relevant testimonials (including from any current or previous line managers) and medical reports, if relevant;
• The Registrant’s continued engagement with the HCPC.

Order

ORDER: That the Registrar is directed to suspend the registration of Mrs Pauline Stidwill for a period of 6 months from the date this order comes into effect

Notes

The order imposed today will apply from 14 July 2017 (the operative date)
This order will be reviewed again before its expiry on 14 January 2018.
 

Hearing history

History of Hearings for Pauline Stidwell

Date Panel Hearing type Outcomes / Status
01/12/2017 Conduct and Competence Committee Review Hearing Suspended
12/06/2017 Conduct and Competence Committee Final Hearing Suspended
10/04/2017 Conduct and Competence Committee Interim Order Review Interim Suspension