Mrs Kerri S Clark

: Occupational therapist

: OT60299

: Final Hearing

Date and Time of hearing:10:00 15/12/2017 End: 12:00 15/12/2017

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

: Conduct and Competence Committee
: Struck off

Allegation

Allegation (as found proved at Substantive Hearing):

Whilst registered as an Occupational Therapist and working for Hertfordshire County Council from 5 August 2015 to 30 October 2015:

1. In relation to Case 1, you did not maintain an adequate case file, in that you did not complete and/or record on ACSIS (Adult Care Services Information System):
a) Case notes;
b) Contacts with the service user and/or carers;
e) Assessment reports;
f) Care plans;

2. In relation to Case 2, you did not maintain an adequate case file, in that you did not complete and/or record on ACSIS:
a) Case notes;
b) Contacts with the service user and/or carers;
e) Assessment reports;
f) Care plans;

3. In relation to Case 3, you did not maintain an adequate case file, in that you did not:
a) Complete and/or record on ACSIS:
i. Assessment reports;
ii. Care plans;
iii. Written recommendations following the hoisting assessment;
b) Record on ACSIS confirmation of having organised and/or conducted a follow-up visit to the service user for a hoisting assessment;

5. In relation to Case 5:
b) You did not arrange and/or record making arrangements for a therapist to visit the service user

6. In relation to Case 6:
a) you did not maintain an adequate case file, in that you did not complete and/or record on ACSIS:
ii. Case notes;
iii. Contacts with the service user and/or carers;

7. In relation to Case 7, you did not maintain an adequate case file, in that you did not:
b) Record on ACSIS confirmation of having organised and/or conducted a visit to the service user on 23 October 2015;

8. In relation to Case 8, you did not maintain an adequate case file, in that you did not complete and/or record on ACSIS:
a) Case notes;
b) Contacts with the service user and/or carers;

9. In relation to Case 9, you did not maintain an adequate case file, in that you did not complete and/or record on ACSIS:
a) Case notes;
b) Contacts with the service user and/or carers;

12. In relation to Case 12, you did not provide the service user's family with recommendations in relation to equipment;

Finding

Preliminary matters:

Proof of Service

1. The Panel has been convened to undertake the review of a substantive order of suspension on the registration of the Registrant, Mrs Kerri Clark, for a period of 6 months.  The suspension order was made on 29 June 2017 by a panel that conducted the final hearing of the HCPC’s allegations.

2. The Registrant has neither attended the hearing nor been represented at it.

3. The Panel first considered whether a valid notice of hearing had been sent to the Registrant.  The conclusion of the Panel was that the letter dated 14 November 2017, informing the Registrant of the date, time and location of the hearing satisfied this requirement.

Proceeding in Absence

4. The Panel next considered the application made on behalf of the HCPC that the hearing should proceed in the absence of the Registrant.  The Panel gave careful consideration to this application and heeded the advice of the Legal Assessor and had regard to the factors identified in the HCPTS Practice Note on the topic.  The conclusion of the Panel was that the hearing should proceed in the Registrant’s absence for the following reasons:

• Notice of the hearing had been provided in proper form to the Registrant by the letter dated 14 November 2017, to which reference has already been made.  The same information was contained in an email sent on the same day.  Furthermore, the hearing bundle, which also clearly stated the date of the review, was sent to the Registrant on 5 December 2017.

• There had been no engagement in the HCPC fitness to practise process on the part of the Registrant since she wrote a letter dated 13 May 2016.  This lack of engagement included her absence from the final hearing in late June 2017.

• The absence of the Registrant at this review is despite the suggestions of the final hearing panel that it would be in her interest to attend.

• The Registrant has not applied for an adjournment of the present hearing.

• The review of the Order is required to be undertaken before 27 January 2018, because once the Order expires jurisdiction to undertake a review will be lost.

• In the light of these matters, the Panel was unable conclude that the Registrant would be likely to attend the hearing, or otherwise engage in the hearing to a greater extent, before 27 January 2018, if the present hearing were to be adjourned.

• In these circumstances the clear public interest in the review proceeding outweighs the absence of the Registrant.

Background:

5. The background to the case considered at the final hearing is that at the relevant time the Registrant was working as an Occupational Therapist on a locum basis for Hertfordshire County Council (“the local authority”).  The period of the locum appointment was between 5 August 2015 and 30 October 2015. However, the evidence suggested that the Registrant only worked as an Occupational Therapist for approximately two months in that period.

6. In referring the Registrant to the HCPC, the local authority contended that the Registrant had failed to complete tasks and make adequate records in 12 of the cases allocated to her.  The allegations referred to the Conduct and Competent Committee by the Investigating Committee reflected the local authority’s referral.

7. The final hearing panel did not find all the factual particulars to be proved.  There were no findings in relation to three of the cases that had been allocated to her.  In relation to the nine cases in which there were findings, in all but one there were aspects of the HCPC’s case that were not proved.  The proved particulars are set out at the head of this determination.

8. When the final hearing panel considered the statutory grounds, it decided that it was not appropriate to make a finding of lack of competence, not least because it was not satisfied that it had been presented with a fair sample of the Registrant’s work.  The final hearing panel did, however, find that in breaching significant elements of the HCPC’s Standards of conduct, performance and ethics and the Standards of Proficiency for Occupational Therapists, and putting vulnerable service users at risk of harm, the Registrant’s actions fell seriously short of the standards of the profession.  Accordingly, that panel decided that it was appropriate to make a finding of misconduct.

9. The final hearing panel found that the Registrant’s fitness to practise was impaired at the time of the final hearing by reference to both the personal and public components.  The personal component was satisfied by the fact that the Registrant displayed a reckless disregard for the risks inherent in failing to make proper records, coupled with incomplete insight into the failings.  These factors, coupled with the statement made by the Registrant in her letter dated 13 May 2016 that she did not wish to practise as an Occupational Therapist, and the absence of evidence of remediation, resulted in the final hearing panel finding that there was a risk of repetition.  That panel also found that a finding of impairment of fitness to practise was also required to satisfy the wider public interest.

10. When the final hearing Panel considered the appropriate sanction to be imposed, it decided that it should be a Suspension Order for a period of 6 months.  That panel decided that there was no evidence that would suggest that the Registrant was prevented from understanding and seeking to remedy her shortcomings.  A Suspension Order for a period of six months would protect the public and would also allow the Registrant an opportunity to reflect, demonstrate full insight and remediate the failings identified.  The final hearing panel suggested to the Registrant that for the purposes of the review of the suspension it was ordering, she should personally attend the review hearing, provide evidence such as reflective statements, training records, references or testimonials to demonstrate that she could effectively manage her practice and raise concerns impacting on her performance, and provide evidence that she had developed full insight.

11. There has been no engagement on the part of the Registrant since the final hearing.

Submissions at the present review:

12. The Presenting Officer opened the case, explained the background to the allegations and summarised the findings of the final hearing panel.  He made submissions as to the approach the present Panel should take in deciding the matter and identified the available sanctions.

13. There were no submissions made by or on behalf of the Registrant.  The Panel did, however, ask to be provided with a copy of the letter written by the Registrant dated 13 May 2016 that was considered by the final hearing panel.  The Panel carefully considered the contents of that letter.

Decision:

14. The Panel has approached the review of the Suspension Order on the basis that it was first required to decide if the finding of misconduct made by the final hearing panel in June 2017, is still impairing the Registrant’s fitness to practise.  If the conclusion of that first decision is that there is no continuing impairment of fitness to practise, then there should be no further sanction imposed upon the expiry of the present period of suspension.  If, on the other hand, there is continuing impairment of fitness to practise, then the consideration of a sanction would be required, applying the usual sanction criteria.  As the finding was one of misconduct, the entire sanction range up to, and including, the making of a striking-off order, is available.

15. The Panel approached its decision of the issue of impairment of fitness to practise by considering both the personal and public components.

16. The conclusion of the present Panel is that there are no reasons to conclude that the Registrant’s fitness to practise is any less impaired than it was when the final hearing was conducted.  There is no information to suggest that the Registrant has changed her mind from the view expressed in her letter dated 13 May 2016, that she does not wish to return to practise as an Occupational Therapist, and the effect of the Suspension Order is that she will not have in fact returned to practise since the final hearing was conducted.  There is no evidence of reflection, insight or of any steps taken towards remediation.  In these circumstances, the risk of repetition identified by the final hearing panel still exists, and this fact requires a finding of impairment of fitness to practise on consideration of the personal component.  The present Panel is also satisfied that a finding of current impairment of fitness to practise is required in the wider public interest as fair minded and fully informed members of the public would be dismayed at the prospect of an Occupational Therapist in the present position of the Registrant being permitted to return to unrestricted practice.

17. The Panel concluded that a sanction will remain necessary upon the expiry of the present period of suspension.  A Caution Order would not offer a suitable degree of protection against the risk of repetition.  In the judgement of the Panel, conditions of practice are not appropriate as this is a case involving persistent failures and there is no suggestion that the Registrant wishes to return to practise as an Occupational Therapist, or that she would be committed to resolve matters if she did so.

18. The rejection of conditions of practice as a suitable disposal meant that the Panel next considered ordering a further period of suspension.  The failings identified in this case were of a type that are capable of being remedied.  That being the case, the present Panel takes the view that if there were grounds for believing that the Registrant would seek to remedy the identified shortcomings, suspension would be appropriate until she could safely be permitted to return to practice.  In those circumstances striking-off would be disproportionate while that possibility remains.  However, having given the matter careful consideration, the present Panel has concluded that there are no grounds for believing that the Registrant will seek to remedy her shortcomings.  In her letter dated 13 May 2016 the Registrant stated that she would not be practising as an Occupational Therapist, and there has been no communication from her since that time, despite the suggestions made by the final hearing panel.  In these circumstances the present Panel is unable to conclude that there is a realistic prospect that the Registrant will seek to address the shortcomings in the future.  In these circumstances the Panel has concluded that the making of a further Suspension Order cannot be justified.

19. The rejection of a Suspension Order as an appropriate outcome means that the Panel has determined that a striking-off order is required.  The Panel is satisfied that in circumstances where the Registrant cannot be permitted to return to unrestricted practice because of the risk of harm to service users, yet there are no grounds for thinking that the deficiencies will be addressed, a Striking-off Order is both necessary and proportionate.

 

Order

Order: Upon the expiry of the present period of suspension, namely with effect from 27 January 2018, the Registrar is directed to strike the name of Mrs Kerri Clark from the register.

Notes

No notes available

Hearing history

History of Hearings for Mrs Kerri S Clark

Date Panel Hearing type Outcomes / Status
15/12/2017 Conduct and Competence Committee Final Hearing Struck off
26/06/2017 Conduct and Competence Committee Final Hearing Suspended