Miss Sarah Neita

: Occupational therapist

: OT52913

: Review Hearing

Date and Time of hearing:10:00 27/10/2017 End: 17:00 27/10/2017

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

: Conduct and Competence Committee
: Conditions of Practice

Allegation

The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing on 20-28 February 2017:

Between 5 May 2010 and 28 March 2012, during the course of your employment as an Occupational Therapist at the Lewisham Healthcare NHS Trust:

1. You demonstrated poor record keeping and/or record keeping that was not undertaken within the required timescales, in that:

a. On or around 17 October 2011, you:

(i) Had not written a report for a child who had been allocated to you on or around 11 November 2010;

(ii) Not Proved;

b. Not Proved:

(i) Not Proved

(ii) Not Proved

(iii) Not Proved

c. In March 2012 you did not complete the relevant paperwork following assessments with 3 children for 4 weeks or more;

d. In relation to Case 1:

(i) Not Proved;

(ii) You did not send the Occupational Therapy report to the child’s school in time for the child’s annual review on or around 30 June 2010;

(iii) Not Proved; and

(iv) You did not write any progress notes regarding the school visit you made on or around 28 March 2011.

e. In relation to Case 2, allocated to you on or around 11 August 2011;

(i) You did not complete the required assessments until 5 October 2011; and

(ii) You did not send the child’s report until on or around 18 January 2012;

f. In relation to Case 3, you did not write any notes for the handwriting groups which were held on or around 13 June 2011 and 22 June 2011.

g. Not Proved.

h. Not Proved.

i. Not Proved;

2. You did not demonstrate satisfactory clinical practice in that in relation to Case 1, you failed to follow up on your recommendation for a weighted hand splint.

3. Did not respect the confidentiality of service users, during the course of your employment and after you had resigned from Lewisham Healthcare NHS Trust you:

a. Took with you a number of documents which contained confidential children/family information and kept them at your home;

4. Not Proved.

5. The matters described in paragraphs 1, 2 and 4 constitute misconduct and/or lack of competence.

6. The matters described in paragraph 3 constitutes misconduct.

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

Finding

Preliminary Matters

Proceeding in private

1. An unopposed application was made by Ms Corbett for those parts of the hearing which dealt with the Registrant’s health to be heard in private. This application was granted.

Background

2. The Registrant was employed as an Occupational Therapist at the Lewisham Healthcare NHS Trust (the Trust) from November 2009. The Registrant was primarily responsible for working with children with co-ordination difficulties in mainstream schools and with children with severe learning and movement disorders within Special Schools. The Registrant’s role was to meet patients and their families on both a one-to-one and group basis, assess patients, and set goals and targets for development of their coordination.

3. There were some concerns within the Trust about the Registrant’s performance, which led to a Performance Management Plan being instituted, which was satisfactorily completed in May 2011. By then, in April 2011, the Registrant had been promoted to a Band 6 role which required, on her part, more complex clinical reasoning and assessment. It also needed her to work at an increased pace.

4. In November 2010, Child 6 had been allocated to the Registrant and she carried out an Initial Assessment in November 2010. By October 2011, 13 months later, the Registrant had still not written a report on this child.

5. The Registrant demonstrated further poor record-keeping by a failure to complete relevant paperwork following her assessment of three other children. There were other examples of poor record-keeping and failure to complete records within required timescales in June 2010, March 2011, October 2011 and January 2012. All these matters were found by the Panel of the Substantive Hearing in February 2017 to amount to examples of lack of competence.

6. Particular 2 alleged that the Registrant had not demonstrated satisfactory clinical practice in that, in a particular case, she had failed to follow up on her recommendation for a weighted hand-splint. In the view of the Substantive Hearing panel, this allegation, which was found proved, was linked to the failures of record-keeping and amounted to another example of lack of competence. That Panel determined that there had been a pattern of failure on the Registrant’s part to take required action on cases in a timely manner. Although, in that panel’s stated view, health reasons had contributed to the level of the Registrant’s ability to meet the required standards, she was unable sufficiently or consistently to improve the standard of her work.

7. In March 2012, the Registrant submitted her resignation to the Trust. She took with her, on leaving, a number of documents which contained confidential information about children who had been allocated to her and their families. These papers included supervision forms, case load forms, reports, and notes of action plans. The Substantive Hearing panel determined that there was no justification for removing these documents and that the decision of the Registrant to do so amounted to disrespect of the confidentiality of service users; as such, this amounted to misconduct.

Decision

8. The Panel was aware that the process under Article 30 of the Health and Social Work Professions Order 2001 was one of review and not one of appeal, and that its function was to determine whether the Registrant’s fitness to practise was still impaired and, if so, what the appropriate and proportionate sanction or outcome should be, so as to protect the public and safeguard the public interest.

9. The Registrant gave evidence and produced a number of documents on her behalf. These included a certificate to the effect that she had completed a Data Protection training course on 24 October 2017 and a Reflective Learning piece that she had written for these proceedings, which bore the date of October 2017.

10. Ms Corbett acknowledged the relevance of these documents and submitted that conditions 1 and 2 of the Order should no longer be applied. However, she argued that the fitness to practise of the Registrant was still impaired and it was necessary to maintain the remaining Conditions of Practice. It would be, she maintained, in the public interest and in the interests of protecting the public that the Registrant should not be allowed to return to unrestricted practice, and that conditions 3 to 8 were sufficient to address the issues identified.

11. The Registrant contended in her evidence that, for her, the conditions were “harsh” and that it was inappropriate for her practice to be subjected to any restrictions at all. In her oral evidence, the Registrant said that having a Conditions of Practice Order and her health issues would prevent her from obtaining employment as an Occupational Therapist. She stressed that the particulars found proved at the Substantive Hearing in February 2017 related to events which had taken place some time in the past, and that no service user had ever complained about her conduct or competence. She did, nevertheless, accept that she had made errors, albeit she attributed some of these to her health and what she considered was a general lack of support from the Trust. She added that she has learnt from her errors and has corrected herself since.

12. Since the Substantive Hearing, the Registrant told the Panel that she had not applied for any post as an Occupational Therapist but had continued to be employed as a Functional Analyst. She has, however, been certified as being ‘long-term sick’ due to her health since the Substantive Hearing in February. It seems, though, that the Registrant may shortly be at risk of losing her job.

13. Paying due regard to the HCPTS Practice Note “Finding That Fitness to Practise is ‘Impaired’”, the Panel’s view, after considering the documentary and oral evidence adduced from both parties, was that the Registrant’s fitness to practise remains impaired. The failings identified at the Substantive Hearing were serious ones, albeit remediable, and could have put at risk the children that were part of her case load. Both statutory grounds applied, namely public protection and the public interest. The Panel considered that the Registrant was genuinely remorseful and had developed some further insight into her failings, but that she had not fully remediated them and the Panel considered that without such evidence of remediation and full insight, there still exists a risk of repetition if restrictions are not placed upon her practice.

14. The Panel considered what, if any, sanction to impose and referred to the HCPC Indicative Sanction Policy.

15. The Panel first considered taking No Further Action, mediation or a Caution Order. It concluded that these were not appropriate due to the serious nature of the findings concerning 8/9 children over a period of two years, and that such sanctions would not restrict the Registrant’s practice and therefore would not protect the public.

16. The Panel decided that a Conditions of Practice Order remained appropriate and proportionate, in that it would strike a balance between the interests of the Registrant and those of the public.

17. The Panel accepted that the provisions of conditions 1 and 2 of the current Order have been fulfilled, but still recognised that the Registrant’s practice should be fettered by way of maintaining the other 6 conditions. The Panel also considered that it would be helpful to amend condition 4 by removing parts c) and d) and replacing them with a new c), in which the Registrant should provide to the HCPC three-monthly updates regarding her Personal Development Plan, endorsed by her supervisor. Such a course, in the view of the Panel, would be consistent with upholding the principle of proportionality.

18. The Panel considered the length of the Order and concluded that no amendment to its length was necessary, as the current length of the Order gives the Registrant sufficient time to remedy any deficiencies.

19. This Order will be reviewed before its expiry and a future reviewing panel may be assisted by:

• Testimonials from any current or recent employers, either in Occupational Therapy or otherwise (e.g. any paid or voluntary work).

• Evidence that the Registrant has kept up-to-date with the profession.

Order

The Registrar is directed to annotate the HCPC Register to show that, for the remaining period of the Order, you, Miss Sarah Neita, must comply with the following conditions of practice:

1. If you engage in professional work as an Occupational Therapist you must place yourself and remain under the supervision of a supervisor and supply details of your supervisor to the HCPC within fourteen days of commencing such work.

2. If you engage in professional work as an Occupational Therapist you must:

(a) Work with your supervisor to formulate a Personal Development Plan designed to address the following areas of your practice:

(i) Completing written assessments within the required timeframe;

(ii) Completing clinical records within the required timeframe;

(iii) Progressing cases by following up on recommendations for intervention.

(b) Within three months of commencing work as an Occupational Therapist you must forward a copy of your Personal Development Plan to the HCPC.

(c) Following the submission of your Personal Development Plan in accordance with (b) above, you must then provide, every three months, an updated Progress Report on your Personal Development Plan to the HCPC, to be endorsed by your supervisor.

3. You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.

4. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

5. You must inform the following parties that your registration is subject to these conditions:

A. any organisation or person employing or contracting with you to undertake professional work

B. any agency you are registered with or apply to be registered with (at the time of application); and

C. any prospective employer (at the time of your application)

6. You will be responsible for meeting any and all costs associated with complying with these conditions.

Notes

This order will be reviewed again before its expiry on 28 March 2019.

Hearing history

History of Hearings for Miss Sarah Neita

Date Panel Hearing type Outcomes / Status
27/10/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
20/02/2017 Conduct and Competence Committee Final Hearing Conditions of Practice