Ms Doreen Claire Ruta

: Social worker

: SW80293

: Final Hearing

Date and Time of hearing:10:00 18/12/2017 End: 17:00 20/12/2017

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

: Conduct and Competence Committee
: Conditions of Practice

Allegation

During the course of your employment as a Social Worker with Oxfordshire County Council, between October 2013 and October 2014, you:


1. Upon receipt of information on or around 23 October 2013 that Client A was at risk of financial exploitation by others;
a) did not carry out a Mental Capacity Assessment on Client A, as requested by your supervisor, until April 2014.
b) did not record the outcome of the Mental Capacity Assessment on Client A's file until July 2014.


2. Upon receipt of a report on or around 4 November 2013 that Client A was in possession of a knife:
a) did not undertake and/or record a Risk Assessment in relation to Client A and his family;
b) did not carry out and/or record an investigation into the event;
c)  did not raise an alert on Oxfordshire County Council's Safeguarding Adults alert system;
d) did not report the incident to Thames Valley Police.


3. Upon receipt of a report from a General Practitioner on or around 21 October 2013 that Client A looked malnourished and had no food available:
a) did not put in place and/or record a Care Plan in relation to Client A;
b) did not undertake and/or record a Risk Assessment in relation to Client A.


4. Upon receiving information on or around 25 November 2013, that Client A was missing, had caused damage to his television and fridge, and made threats to kill his cousin:
a) did not undertake and/or record a Risk Assessment;
b) did not adequately undertake and/or record an investigation into the event;
c) did not make a General Practitioner and/or Mental Health Referral as required;
d) did not advise the Safeguarding Manager that Client A had made threats to kill his cousin.


5. Did not fully complete a Mental Capacity Assessment in relation to Client A until July 2014.


6. On or around 27 February 2014, on receiving a request from Client A's General Practitioner for a safeguarding meeting:
a) advised the General Practitioner that Client A was already under Safeguarding when this was not the case:
b) did not discuss the request with a Safeguarding Manager.


7. In May 2014, when facilitating Client A's change of address:
a) Did not carry out a Best Interest Meeting as required under the Mental Capacity Act 2005 and /or the Mental Capacity Act 2005 Code of Practice.
b) Did not inform the following authorities of Client A's change of address as required:
i. Thames Valley Police.
ii. Client A's General Practitioner.
c) Did not carry out and/or record a Risk Assessment in relation to the impact that the change of address would have on Client A.


8. Between 27 May 2014 and 6 June 2014, upon receipt of information that Client A had not received their medication for nine days:
a) Did not undertake and/or record an assessment into Client A's family's ability to provide Client A with the medication.
b) Did not undertake and/or record an appropriate Risk Assessment.

9. Upon receipt of information on or around 9 October 2014 that a heroin addict had visited Client A's residence, you did not raise an alert on Oxfordshire County Council's Safeguarding Adults alert system until 17 October 2014.


10. The particulars set out in paragraph 1 - 9 constitute misconduct and/or lack of competence.


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

Finding

Preliminary Matters


Application for the Hearing to be Held in Private
1. The Panel determined that it would hear those parts of the case in which reference was made to the health and private life of the Registrant or the witnesses, in private, under Rule 10 (1)(a) of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 (‘the Rules’).  In making this decision the Panel acknowledged that there is a presumption that hearings will be held in public. The decision is to protect the private life of the Registrant and the witnesses which the Panel considers outweighs the public interest in this instance.

Application to Amend the Allegation as detailed above
1. The Panel next heard an application by Ms Turner on behalf of the HCPC to amend the Allegation as particularised above. The Registrant had not been notified of the application in advance of the hearing.  Nevertheless, Dr Mavaza did not object to the amendment on behalf of the Registrant. The Panel received and accepted the advice of the Legal Assessor. It was satisfied that the amendments were necessary and desirable as they provided greater clarity, did not substantively change the nature of the Allegation and were not prejudicial to the Registrant.


Application to Adjourn/Proceed in Absence of the Registrant
2. The HCPC case was closed on Day 2 of the hearing.  On Day 3 of the hearing, the Registrant did not attend, having previously indicated that she wished to give evidence in support of her case. Dr Mavaza applied for an adjournment of the hearing under Rule 10(1)(f) of the Rules. 


3. He further submitted that it would be prejudicial to the Registrant if she were denied the opportunity to give her evidence as there were matters relevant to the particulars and associated risks which she wished to clarify now she had heard the evidence of the HCPC witnesses. She fully intended to attend the hearing and give evidence today, but has been unable to do so due to her ill health.


4. Ms Turner objected to the application and expressed some reservations regarding the credibility of the events which had been relayed to the Panel on behalf of the Registrant. She submitted that there was no direct medical evidence that the Registrant was unfit to attend the hearing and reminded the Panel of the public interest in proceeding expeditiously. Furthermore, there had been mixed messages regarding the Registrant’s intention to give evidence in the case given that she had previously indicated that she would not be in attendance and that she was content for the hearing to proceed, in the presence of her legal representative.  Accordingly, on behalf of the HCPC she invited the Panel to proceed in the Registrant’s absence in accordance with Rule 11 of the Rules, in the public interest.


5. The Panel accepted the advice of the Legal Assessor, that the decision to adjourn and proceed in the absence of the Registrant was to be taken with the utmost care and caution. The Panel had regard to the HCPC Practice Notes, ‘Proceeding in the Absence of the Registrant’ and ‘Postponements and Adjournments’ both dated September 2015. It applied the criteria set out in R v Jones [2002] UKHL 5 and the recent guidance in General Medical Council v Adeogba/ Visvardis [2016] EWCA Civ 162. It also noted the case of Anastasi v Police Appeal Tribunal [2015] EWHC 4156 (Admin).


6. After retiring to consider its decision, the Panel were handed an e-mail sent directly to the HCPC, purporting to be from a friend/acquaintance of the Registrant. The representatives did not wish to make further representations and relied on the Panel’s assessment as to the weight it should give to this evidence.


7. The Panel noted the discrepancies in the representations made and the text/ e-mail received. It had concerns regarding the general reliability of the information provided to it. Nevertheless, it was clear that the Registrant was potentially suffering from a medical condition which may affect her ability to attend the hearing. She had engaged in the hearing thus far and she had indicated to the Panel on Day 2 that she was in ill health (at which point the Panel had made arrangements to accommodate her by allowing her late arrival and providing regular breaks). This was consistent with the reason given for her non-attendance on Day 3.


8. The Panel was satisfied that if the case was adjourned at this stage no prejudice or inconvenience would be caused to the HCPC witnesses as they had already given evidence. Most importantly, the Panel was sure that the case was inevitably going to have to be adjourned part-heard at the end of the time allocated to it, in any event, notwithstanding the Registrant’s non-attendance today. Accordingly, the Panel was satisfied that the public interest in dealing with the case expeditiously, would be no more prejudiced by an adjournment on Day 3 than at a later stage in the hearing. Effectively, any delay would not be increased by adjourning now rather than later.


9. It was clear that the Registrant could be potentially prejudiced in not being given the opportunity to give her own evidence, notwithstanding the presence of her legal representative, as there were relevant matters which only she could clarify in evidence, the absence of which could not form the basis of legal submission alone.


10. In all of these circumstances, the Panel is satisfied that it is in the interests of justice to adjourn the case, in order to allow the Registrant to give evidence and to facilitate a resumed hearing which will allow an appropriate amount of time for the Panel to consider the matter and bring the hearing to a conclusion.


Background


11. The Registrant was employed as a Social Worker at Oxfordshire County Council (‘the Council’) between February 2009 and January 2015. At the relevant time she was employed in the Adult Social Care Team and was responsible for safeguarding individuals who were identified as being at potential or actual risk of harm.


12. Client A was a 65-year-old service user who had been allocated to the Registrant’s caseload on 7 October 2013. There were safeguarding concerns that he was being abused by drug and alcohol misusers in his social circle who were allegedly taking his money and locking him out of his accommodation. Further concerns arose in terms of Client A’s memory, his living conditions and self-neglect. Client A was, himself, a heavy drinker.


13. In July 2013 concerns were raised at the Council in relation to the Registrant’s practice in respect of Client A. Consequently, the Registrant’s work was internally audited.


14. Between 18 July 2014 and 1 September 2014, the Registrant took a period of extended unpaid leave (special leave) for personal reasons.


15. Failings were identified during the internal audit and, as such, the matter was escalated. On 24 October 2014, the Registrant was suspended from work. An internal investigation was carried out in respect of the Registrant’s practice in connection with Client A, commencing in November 2014.


16. A disciplinary hearing took place at the Council on 19 January 2015, following which, the Registrant was dismissed from the Council.


17. A referral to the HCPC was made on 13 February 2015 in respect of the matters which form the basis of the Allegation.


Further Preliminary Matter


Admissibility of Determination of Employment Tribunal Judgement Dated 11 August 2016/Consideration of Adjournment to Recall Witnesses
18. At the outset of the resumed hearing, Ms Hewitt, on behalf of the Registrant applied to admit the judgement of the Employment Tribunal [ET] hearing in the case for wrongful dismissal brought against the Council by the Registrant. She submitted that ordinarily the judgement would not be relevant in the regulatory hearings and, as such, it would be inadmissible. Nevertheless, it was clear from the transcripts of the first part of this case (in which she was not involved) that a number of matters were not put to the witnesses for the HCPC in the degree of detail required, and as such, the determination of the ET would be relevant in a number of respects.


19. Ms Hewitt drew the Panel’s attention to the part of the transcript which captured a question from the Chair to Witness 2 on 24 January 2017, in which she clarified a line of enquiry being pursued by Dr Mavaza as follows: “Well, the question was, were you ever asked about a lack of supervisory ability in respect of Doreen.” Witness 2 responded “No”. No further questions were put to the witness regarding this matter. Ms Hewitt submitted that matters recorded within the ET were now relevant to this case as it recorded the fact that Witness 2 was, in fact, placed on a Performance Improvement Programme [PIP] in relation to her supervisory capabilities as a direct result of the grievance lodged against her by the Registrant. The PIP had been in place before she gave evidence on 24 January 2017 yet she made no reference to it, neither was she asked any questions about it. The part of the judgement relating to this matter was therefore relevant to the candour, reliability and integrity of Witness 2.


20. Furthermore, she submitted that it was relevant in terms of demonstrating the fact that the Registrant has been consistent, over a prolonged period, in asserting that concerns raised regarding her professional practice were directly related to Witness 2 and her methods of supervision.


21. Finally, the judgement was relevant, she said, to demonstrate that the Council’s internal processes were flawed. The ET had determined that assumptions in favour of Witness 2’s supervisory abilities were made as a result of the fact that no consideration was given (during the internal investigation and disciplinary processes) to the relevance of the Registrant’s grievance against Witness 2. This matter was not put to Witness 1 during the regulatory hearing in January 2017 and it was therefore fair, and in the interests of justice, that her evidence should now be considered by the Panel in that light.


22. It was an option to consider recalling Witnesses 1 and 2 to give further evidence.  However, this would inevitably lead to further delays in the case and given the history of this matter and the public interest in having the matter concluded expeditiously, Ms Hewitt submitted that admitting the judgement from the ET was the fairest and most expeditious way forward at this stage.


23. Ms Manning-Rees, on behalf of the HCPC, submitted that she was taking a neutral stance in respect of the application. She reminded the Panel that ordinarily the judgement would not be admissible, in order to address the risk that the Panel might be unduly and inappropriately influenced by the findings of a different tribunal. However she conceded that, it was clear in this case, that relevant lines of questioning were not put to the witnesses.


24. The Panel received the advice of the Legal Assessor and noted that it has a general discretion to admit documents into evidence pursuant to The Civil Procedure Rules 1998 where: they are relevant to the matters in issue in the case; it is fair to do so; it is in the interests of justice.


25. In the first instance the Panel considered whether an appropriate way forward would be to take judicial notice of the fact that Witness 2 had been subject to a PIP which might negate the need for consideration of the ET judgement as a whole. Nevertheless, it noted the basis upon which Ms Hewitt made her application, and the fact that she had suggested the document was relevant in respect of matters other than the fact that Witness 2 had been made subject to a PIP.  It therefore determined that consideration of the document was required, in order to determine its relevance, before making its determination on admissibility.


26. The Panel noted the principles in the case of Mahfouz v GMC [2004] EWCA Civ 233 in which it was held that, in considering the admissibility of a document, the Panel can be assumed to understand the proper approach to issues of law and to be aware of the need to disregard irrelevant material if it was not admitted into evidence.


27. The Panel also had regard to the principles in Enemuwe v Nursing and Midwifery Council [2015] EWHC 2081 and noted that it should ensure that it disregarded the findings of the internal investigation and disciplinary processes conducted by the Council. Furthermore, the Panel must ensure that it was not influenced in its deliberations by its knowledge of those internal processes. The Panel accepted that these principles were equally applicable to the findings of the ET which related to a different complaint than the Allegation before the Panel in this case, and which applied a different legislative framework within an entirely different tribunal.


28. The Panel determined that the judgement of the ET was relevant in the following respects:


• The credibility and reliability of Witness 1. It noted at Paragraph 31 of the ET Judgement that Witness 1 conducted the investigation into the Registrant’s grievance against Witness 2 and that she had found that there had been failings on the part of management relating to standards of supervision. However, in her evidence before the Panel, Witness 1 had asserted that “whilst I am aware that [the Registrant] raised a grievance in relation to her supervisor, I was not involved in investigating this and do not know the details of the grievance”.
• The credibility and reliability of Witness 2. It noted the fact that she had been subject to a PIP in order to improve the standards of her supervision as a result of the grievance brought by the Registrant. The Panel was satisfied that, had it been aware of the PIP during the evidence of Witness 2, it would have posed a number of questions relevant to it. In the event, given that the Panel’s attention was not drawn to the existence of the PIP, it was effectively precluded from pursuing a whole line of relevant questions which would have flowed from that knowledge.
• The consistency of the Registrant. The Panel noted that issues relating to the removal/editing of information which the Registrant had recorded on the Council’s computer system [SWIFT] were raised within the ET proceedings as were her concerns that issues about her practice were related to her relationship with Witness 2 and her supervisory abilities.


29. Notwithstanding the potential relevance of parts of this document, the Panel nevertheless considered that it would be preferable, in the first instance, given the number of important lines of enquiry which were not put to the HCPC witnesses that enquiries should be made as to whether the witnesses can be recalled.  This would address any issues of fairness to the HCPC, the witnesses and the Registrant so that all matters can be dealt with openly and transparently. Once the results of those enquiries were known to the Panel, it confirmed it would determine the most appropriate way forward in the case by reference to all matters relevant to the interests of the Registrant, the wider public interest and the interests of the HCPC and its witnesses.


30.  Having made appropriate enquiries, Miss Manning-Rees submitted that it would not be possible to recall the witnesses during the time allocated to this hearing. She submitted that the HCPC had closed its case on 25 January 2017 and did not apply for an adjournment to recall the witnesses. Any further delay in the case would be disproportionate to the potential outcome which was unlikely to be a sanction of suspension or strike off even if all particulars were found proved. She reminded the Panel that the judgement of the ET had been available for cross examination purposes in January 2017. In any event, the HCPC’s position was that any issues surrounding inadequacy of supervision amounted to mitigation rather than a defence to any of the particulars still denied by the Registrant.


31. Ms Hewitt submitted that it is in the discretion of the Panel at this stage as to how it preserves fairness and proportionality in its proceedings. She drew the Panel’s attention to the fact that the Registrant has endured the stress and expense of the ongoing regulatory proceedings for more than three years and she had been unable to secure permanent or well-paid employment as a result. To delay hearing the matter any further by way of an adjournment would present a grave danger of prejudice to the Registrant who is keen to be heard by the Panel.  The consistency and weight to be attached to the relevant parts of the judgement of the ET, and of   the evidence of the HCPC witnesses, were matters for the Panel to evaluate at the conclusion of the case alongside all of the other evidence in the case, including that of the Registrant.


32. The Panel accepted the advice of the Legal Assessor, it noted the contents of the HCPTS Practice Note ‘Postponement and Adjournment of Proceedings’, 22 March 2017 and the criteria in CPS v Picton [2006] EWHC 1108.


33. The Panel determined that, in all of the circumstances, it would not grant an adjournment in order to pursue the potential recall of the HCPC witnesses.  It would clearly be preferable to hear and evaluate their responses to the appropriate lines of questioning identified. However, it was uncertain when, or indeed if, the witnesses would be available/willing to be recalled in the future. The prejudicial effect of delaying these proceedings any further would outweigh the benefits. In particular, the Panel noted the impact of delay upon the Registrant as outlined in the submissions of Ms Hewitt. The events, upon which the Allegation is based, occurred in 2013/14, and the final hearing commenced some nine months ago in January 2017. Neither of the parties sought an adjournment in order to recall the witnesses and there had already been one lengthy adjournment in this case in order to bring the case to a fair conclusion.  The Panel was satisfied that, having appropriately considered the possibility of recalling the witnesses, any further delay to pursue this matter would be contrary to the public interest in dealing with cases expeditiously as well as the interests of the Registrant. In all of these circumstances, the Panel determined that the case should proceed without further delay.


34. The Panel next reminded itself of the advice given by the Legal Assessor in respect of the admissibility of the judgement of the ET. It was satisfied that to admit the relevant parts of this document was in the interests of justice, transparency and fairness to the Registrant given that essential lines of questioning had not been pursued on her behalf. This document provides information which relates directly to the reliability of the evidence presented by both parties in this case. Any potential unfairness to the HCPC and its witnesses could be addressed in closing submissions and in the Panel’s assessment of the weight to be given to this evidence (if any) at the conclusion of the case, and in light of any corroborative (or inconsistent) evidence identified. The Panel also noted a further protection in dealing with this evidence, in that it would have the benefit of ongoing legal advice in respect of the evaluation of hearsay evidence which was applicable to the document in question. The Panel was satisfied that this was a fair and proportionate response to the unusual circumstances in which it found itself.


35. The Panel considered that, in all other respects, the document was not relevant to the issues before it and, as such, any matters not directly relevant to the issues listed at paragraph 18 above would be put out of the Panel’s collective mind in accordance with the cases of Mahfouz v GMC [2004] EWCA Civ 233 and Enemuwe v Nursing and Midwifery Council [2015] EWHC 2081.


Decision on Facts


36. The Panel carefully considered all of the evidence in the case. It noted the submissions of Ms Hewitt and Ms Manning-Rees.  It accepted the advice of the Legal Assessor. On behalf of the HCPC, the Panel heard oral evidence from Witnesses 1 and 2 in January 2017. At the resumed hearing in October 2017, the Registrant gave evidence on her own behalf.

37. The Panel also received two bundles of documentation from the HCPC, comprising the witness statements of those who gave evidence and 988 pages of exhibits. On behalf of the Registrant, a bundle of documents was submitted at the outset of the hearing in January 2017, comprising 30 pages of documentation which was originally submitted for the attention of the Investigating Committee. It included a chronology and other matters relevant to the particulars, which the Registrant invited the Panel to consider. At the resumed hearing on 2 October 2017, The Registrant submitted a revised bundle of documentation comprising 140 pages. This bundle included the Registrant’s witness statement, testimonials, Continuous Professional Development (CPD) Certificates, a reflective statement, case records of Client A and other documents which were relevant to the Registrant’s practice.


38. The Panel disregarded any reference to incidents which do not form part of the Allegation and reminded itself that the burden of proving the facts is on the HCPC alone and that the standard of proof is the ordinary civil standard, namely the balance of probabilities.


39. The Panel noted the case of Enemuwe v Nursing and Midwifery Council [2015] EWHC 2081 and disregarded the findings of the internal investigation and disciplinary processes conducted by the Council. Similarly it disregarded the findings of the Employment Tribunal, subject to the comments below. Furthermore, the Panel ensured that it was not influenced in its deliberations by its knowledge of the internal processes/employment tribunal.


Credibility of the Witnesses and Assessment of the Evidence
40. The Panel first made an assessment of the credibility of the witnesses and the reliability of all of the evidence presented to it:


Witness 1
41. Witness 1 carried out the internal investigation at the Council.  She exhibited documents and records produced during the internal investigation and disciplinary hearing. The Panel considered there was a discrepancy in the way in which she identified her role, which could have influenced her evidence. She asserted that her role was to conduct an independent investigation prior to the Council’s disciplinary hearing.  In her evidence she said “whilst I am aware that [the Registrant] raised a grievance in relation to her supervisor, I was not involved in investigating this and do not know the details of the grievance”. However, at Paragraph 31 of the ET Judgement, an official court document, Witness 1 was identified as having conducted the investigation into the Registrant’s grievance against Witness 2. It was also clear, in the present proceedings that her evidence drew in large part on what she had been told by Witness 2, which may have been unreliable.  The Panel therefore exercised caution in assessing the evidence of Witness 1 and looked for corroborative evidence where it was available.


Witness 2
42. Witness 2 was the Registrant’s line manager at the relevant time. She was responsible for supervising the Registrant’s work and was a Safeguarding Manager. The Panel considered her evidence lacked consistency and credibility in many respects. In several key areas there was a direct conflict between the evidence of the Registrant and Witness 2. For example:


• The time at which Witness 2 became aware of Client A’s move from Area B back to Area A;
• Whether the Registrant had complained to Witness 2 that her case load was too high;
• Issues surrounding the frequency with which Witness 2 required the Registrant to cover the Duty Social Worker role - which took the Registrant away from her usual case load.
• Whether the Registrant had discussed the matter of the knife detailed at particular 2 of the Allegation with Witness 2.


43. Whilst giving her evidence, Witness 2 obfuscated and appeared reluctant to answer questions put to her, particularly those regarding her abilities as a supervisor.  Specifically, when she was asked directly whether the issue of a lack of supervisory ability in respect of the Registrant had ever been raised with her, Witness 2 responded “No”. It later became apparent that Witness 2 had been made subject to a PIP as a direct result of the Registrant’s grievance against her, which focused on Witness 2’s supervisory abilities.  Witness 2 had been placed on the PIP before she gave evidence to the Panel. Witness 2 failed to mention this in her evidence which gave a misleading impression. The Panel considered therefore, that Witness 2’s evidence was unreliable, evasive and lacking in credibility in areas pertinent to the Allegation. The Panel therefore exercised caution in assessing the evidence of Witness 2 and looked for corroborative evidence where it was available.


The Registrant
44. The Registrant presented as honest and credible in the way she gave her evidence.  She was prepared to make concessions and clarify matters if she could not remember a particular matter. She acknowledged that, in many respects, she would do things differently now and made a number of admissions in respect of the Allegation.  The Registrant also expressed care and concern towards her service users during her evidence.


45. The Panel noted that the Registrant gave evidence for approximately 12 hours over a period of two days.  She was consistent throughout.  Her evidence was also consistent with the evidence she gave during the internal investigation, the Council’s disciplinary hearing and the Employment Tribunal.  Whilst she accepted there were things she could have done better, she had a strong belief that she had been the victim of injustice which she expressed well. For example, the Registrant spoke of being given edited supervision notes during the internal investigation at the Council.  These notes had been edited by Witness 2 after the Registrant had been given a copy (although they were not signed). The edits were not favorable to the Registrant. The Registrant said she had noticed the discrepancy in the notes only because she had taken the precaution of printing off hard copies of the originals in advance.  Witness 2’s response was that this was legitimate as the notes had only been in draft form originally. The Registrant expressed concerns at this practice and raised some concerns about the possible selective production of documentation within the present hearing. There was no evidence of this but the Panel noted the Registrant’s feeling of injustice. It reassured the Registrant that it would scrutinise the evidence in this case, as it always does, with the highest standards of objectivity and transparency.


46. Where the Registrant’s evidence differed with that of Witness 2, the Panel looked for independent corroborative evidence but, in general, it accepted that of the Registrant when considering the factual particulars for the reasons outlined above.


Hearsay Evidence
47. The Panel exercised caution in considering all of the hearsay evidence.  It attached weight to the hearsay evidence, only to the extent that it was appropriate, where this evidence was corroborated or consistent with other evidence received. The Panel was particularly cautious when considering the judgement of the Employment Tribunal in accordance with the legal advice given. It had regard only to the relevant admissible parts (detailed at paragraph 29 above) and considered those parts in the context of all of the other evidence available to it.


The Working Environment at the Relevant Time
48. The witnesses and the Registrant gave a detailed picture of the context within which the Registrant was working. The Panel was clear in its understanding that this information did not go directly to the factual particulars.  It formed part of the background to the case and did not excuse the Registrant from her professional duty to practise autonomously and in the best interests of service users, to acceptable professional standards.  Nevertheless, it is useful to set out the details here, in order to provide context to the Panel’s consideration of the factual particulars and it may become relevant at later stages in the regulatory proceedings, should they be reached.

49. Some of the Registrant’s evidence in this respect focused on the fact that, she said, her work was frequently delayed by Witness 2’s refusal to sign it off.  Witness 2 gave evidence that she would indeed refuse to sign off pieces of work (including safeguarding cases) where she considered that it fell below the expected standard.  Witness 2 admitted that, on occasion, she would reject the Registrant’s work if, for example, a lower case letter had been used instead of a capital letter, rather than the work bearing any substantive errors. The records exhibited bore out the fact that some documents were not being signed off promptly by Witness 2.


50. It was clear that the department was under a lot of pressure during the relevant period. The Registrant had a high case-load and this was not reduced when she reduced her working pattern to 30 hours per week. She was, at times, called upon to cover the Duty Rota up to 4 days per week to cover absences of colleagues, which meant that she could not focus on her own case load.  The Panel noted that there were efforts by the Council to support the Registrant.  For example, there were periods when she was removed from the Duty Rota and monthly case allocations, in order that she could focus on closing her own cases.  She also had the benefit of case audits with actions, meetings with supervisors/management to address issues and 6 weeks extended leave to accommodate her personal circumstances. Witnesses 1 and 2 commented on general concerns regarding the standard of the Registrant’s work.  The Panel emphasises (as it has done above) that it has entirely disregarded references to matters which do not form part of the Allegation.  It noted that the Registrant was not placed on a PIP or a Six Step Process, both of which were formal measures available to the Council to improve performance. Nevertheless, some of the support measures put in place for the Registrant did mirror some features of a PIP/Six Step Process.


51. Against this background, it was plain that the relationship between Witness 2 and the Registrant was breaking down during the relevant period.  No clear explanation was given to account for this by either party. It is also a fact that the Registrant’s supervisor, Witness 2, was placed on a PIP as a direct result of the grievance brought against her by the Registrant which found its focus in the standard of Witness 2’s supervision of the Registrant’s work.
Findings on the Factual Particulars
During the course of your employment as a Social Worker with Oxfordshire County Council, between October 2013 and October 2014, you:  


52. The Registrant agreed that she was employed as a Social Worker at the Council during the relevant period.  The documents exhibited corroborated this fact. 

1. Upon receipt of information on or around 23 October 2013 that Client A was at risk of financial exploitation by others;     
PROVED


53. Prior to the case of Client A being allocated to the Registrant on 7 October 2013, there had been two previous alerts received by the Council in respect of possible financial abuse of Client A.  These alerts were received on 4 March 2013 and 2 September 2013 and allocated to other Social Workers.  On each of these previous occasions the matter was assessed and the case closed with ‘No further Action’ being taken.  This was noted on the SWIFT system at the Council.  This means that the alert was not substantiated and the case was not therefore accepted as a safeguarding case.

54. The third alert was received by the Emergency Duty Team [EDT] which deals with calls received outside the usual working hours of the Adult Social Care Team.  It raised concerns which included the potential financial abuse of Client A by drug and alcohol users within his social circle (one of whom may have been his lodger).  In her evidence, the Registrant accepted that she was aware of this information. She acted upon it by arranging a visit to Client A (this visit took place on 23 October 2013) and immediately completing an Overview Assessment [OA] which was sent to her supervisor for approval. An OA is a full assessment form completed at the outset of a case to assess all of a service user’s needs. Her supervisor at this time was EP, who had assumed supervisory responsibilities for the Registrant during a period when Witness 2 was absent from work. Accordingly, the stem of particular 1 was found proved.


(a) did not carry out a Mental Capacity Assessment on Client A, as requested by your supervisor, until April 2014.      
PROVED


55. A Mental Capacity Assessment [MCA] is a formal assessment pursuant to the Mental Capacity Act 2005.  It is decision and time specific, in that it relates to a service user’s ability to make a specific decision at a specific point in time.


56. The Registrant admitted this particular. In an e-mail dated 23 October 2013 from EP, the Registrant was asked to carry out a ‘capacity assessment’ for Client A in relation to his finances. The Registrant’s evidence was that she understood that this meant that she was being asked to establish whether Client A had full mental capacity to make decisions regarding his finances at that time. The evidence of Witness 1 and the Registrant was that a MCA was not completed until April 2014 when the Registrant visited Client A with CW, a Mental Health Social Worker [MHSW], following a referral from Client A’s General Practitioner [GP].  A MCA was therefore carried out in April 2014.  The Panel noted that the MCA in April 2014 was not written up by the Registrant, and it was never formally documented as CW did not share a written MCA with the Registrant.  Nevertheless, the Panel was satisfied that the Registrant did not carry out a MCA when requested to do so by EP in response to the information received in October 2013 relating to financial exploitation. She was present at and clearly involved in carrying out the MCA in April 2014. Accordingly, particular 1(a) was found proved.


(b) did not record the outcome of the Mental Capacity Assessment on Client A's file until July 2014.        
NOT PROVED


57. The Registrant admitted this particular on the basis that the first MCA recorded on Client A’s file was dated 4 July 2017. The evidence of Witness 1 and the documents exhibited corroborated this fact. However, the Panel accepted the Registrant’s explanation that an MCA is decision and time specific. The MCA completed in July was in respect of A’s ability to make financial decisions, however it was carried out in response to a change in circumstances at that time, and not in relation to the circumstances which prevailed in October 2013.  In July 2014, Client A’s cousin [JF], his informal care provider, had indicated that she no longer wished to be responsible for his finances.  This was the trigger to assess Client A’s capacity to make decisions regarding his finances in July 2014 and not the information received on or around 23 October 2013.  The Panel was satisfied that the MCA recorded in July 2014 was not the MCA referred to in the stem of this particular. Accordingly, particular 1(b) was found not proved.

2.  Upon receipt of a report on or around 4 November 2013 that Client A was in possession of a knife:           
 PROVED


58. The Registrant accepted that she received a report on 4 November 2013 stating that Client A’s cousin [JF], his informal carer, had reported that Client A had been in possession of a knife, in response to which JF had called an ambulance and the police. Accordingly, the stem of particular 2 was found proved.


(a) did not undertake and/or record a Risk Assessment in relation to Client A and his family;        
PROVED IN RESPECT OF BOTH LIMBS

59. A Risk Assessment [RA] is a form, separate to an Overview Assessment [OA], which is designed to identify and record risks to a service user and to plan actions to reduce, manage or eliminate those risks. The OA includes a section on risk assessment but is less detailed than the formal RA form.  The evidence of Witness 1 was that, in accordance with safeguarding procedure which underpins the Council’s practice, an OA was insufficient in respect of the risks associated with this incident and a full RA should have been completed.  The Registrant admitted that she did not record a formal RA and this was corroborated by the other evidence in the case. Accordingly, the second limb of particular 2(a) was found proved.


60. However, the Registrant asserted that she did, in fact, undertake a RA and that she competed the relevant section of the OA detailing her assessment. She confirmed that, upon receipt of the report on 4 November 2013, she had spoken to JF who said she had called an ambulance and the police, because JF thought Client A required a mental health assessment and not because she had felt threatened by Client A. 


61. The Registrant said she then had a conversation with Witness 2, her supervisor, about the matter and Witness 2 had indicated the matter did not require escalation. In this conversation Witness 2 identified Client A as a victim rather than a perpetrator and pointed out that it was what Client A had done with the knife which was important, rather than the fact that he was in possession of one.  Witness 2 denied that this conversation had taken place or that this would have been her advice if it had taken place. The Panel preferred the evidence of the Registrant in this respect, and was satisfied that the conversation described by the Registrant had taken place on or around 4 November 2013. The Panel is satisfied that this conversation influenced the Registrant’s subsequent thinking and actions.


62. Nevertheless, the Registrant admitted that she did not raise the incident directly with Client A, which she now recognises that she should have done. Neither did she raise the incident with JF in a subsequent telephone conversation about Client A’s bank card, nor did she speak to the Police or the Ambulance Service, both of which were allegedly contacted by JF. The Panel also noted that, whilst other risks associated with Client A were detailed in the OA, there was no mention of the incident with the knife and the risks associated with it. Accordingly, the first limb of particular 2(a) was found proved.


(b) did not carry out and/or record an investigation into the event;
PROVED IN RESPECT OF BOTH LIMBS


63. The Registrant admitted that she did not record details of an investigation and this was corroborated by the other evidence in the case. Witness 1 gave evidence that she was unable to locate any evidence recording an investigation in this respect, during the Council’s internal investigation. Accordingly, the second limb of particular 2(b) was found proved.


64. The Registrant asserted that she did, in fact, carry out an investigation in that she spoke to JF about the incident, established the details of what had happened from JF’s point of view and assessed that there were no risks. Nevertheless, the Panel determined that this did not amount to an investigation given that the Registrant did not raise the matter with Client A, the Police or the Ambulance Service.  Whilst some actions were recorded, there was no evidence that an investigation was carried out. Accordingly, the first limb of particular 2(b) was found proved.


(b) did not raise an alert on Oxfordshire County Council's Safeguarding Adults alert system;
PROVED


65. The Safeguarding Adult Alert is the Council’s system used to raise concerns which pose potentially serious risks to safety. The Registrant admitted this particular.  She confirmed that there was no mention of the incident recorded on the OA and that she did not raise a safeguarding alert which would have identified it as a new concern on the SWIFT system. This was corroborated by Witness 1 and the documents exhibited. The Panel considered that the advice given by Witness 2, influenced the Registrant’s response to this incident such that, following the conversation with Witness 2, the Registrant did not consider the matter to be a safeguarding concern. Nevertheless, it was a fact that the Registrant did not raise a Safeguarding Alert. Accordingly, particular 2(c) was found proved.


(c) did not report the incident to Thames Valley Police.      
PROVED


66. The Registrant admitted that she did not report the incident to the police because JF had advised her that the police were called at the time of the incident. Witness 1 and the documents exhibited corroborated the fact that the Registrant did not report the incident to the Police.  Accordingly, particular 2(d) was found proved.


3.Upon receipt of a report from a General Practitioner on or around 21 October 2013 that Client A looked malnourished and had no food available: 
PROVED


67. Chronologically this was the first concern, during the relevant period, in respect of Client A. It pre-dated the visit by the Registrant to Client A and the completion of the OA (see particular 1) by two days. The Registrant accepted that she received a notification from Client A’s GP, indicating that Client A appeared malnourished, and that he had no food in his house. This was recorded by the Registrant on the SWIFT system on 23 October 2013.  Accordingly, the stem to particular 3 was found proved.


(a) did not put in place and/or record a Care Plan in relation to Client A;
NOT PROVED IN RESPECT OF BOTH LIMBS

68. The Registrant admitted that she did not record a Care Plan. This was corroborated by the evidence of Witness 1. The notes of supervision sessions recorded by Witness 2 refer to the need to complete a Care Plan.


69. However, the Registrant’s evidence, which was corroborated by documentation exhibited, was that she did identify Client A’s needs and that she put an informal care plan in place which addressed those needs and which was recorded. On 21 October 2013, she had an arrangement in place to visit Client A for the first time on 29 October 2013.  However, as concerns increased, she brought that visit forward to 23 October 2013.  She evaluated Client A’s needs and submitted a ‘Summary of Needs’ to Witness 2 on 23 October 2013 the same day as the visit. This was not signed off by Witness 2 until 6 December 2013.


70. The details of the informal care plan were that, as Client A was not content to accept formal carers attending to his needs in his home, the quickest way to support Client A was to arrange for a carers grant for JF to support him informally.  JF had agreed to help Client A with his finances, shopping, cooking and personal hygiene.


71. There was evidence that this was recorded on Client A’s file and submitted for approval to Witness 2 as detailed above. Accordingly, particular 3(a) was found not proved in its entirety.


(b) did not undertake and/or record a Risk Assessment in relation to Client A.
NOT PROVED IN RESPECT OF THE FIRST LIMB
PROVED IN RESPECT OF THE SECOND LIMB

72. The Registrant admitted that she did not record a RA. This was corroborated by the evidence of Witness 1 and the documents exhibited. Accordingly, particular 3(b) was found proved in respect of the second limb.


73. The Registrant’s evidence was that whilst she did not make a formal recording on a RA form, she nevertheless did assess and record the risks in the OA, wherein she identified the quickest way of supporting Client A (as detailed above). Her strategy of appointing JF as the informal carer, she said, was in Client A’s best interests as JF was the person who could influence Client A to accept care, either from herself or from the formal carers who also visited from the Connections Agency. In putting this care into place, the risks relating to the malnourishment (as well as potential financial abuse and personal care issues) were addressed.  The risks in respect of the squalid environment in which he was living were about to be addressed as Client A was moving from Area A to Area B imminently (the move happened on 10 November 2013). There was no evidence that JF was not adequately supporting Client A at this time. The Panel determined that the Registrant’s actions amounted to an assessment of the risks associated with Client A.  Accordingly, the first limb of particular 3(b) was found not proved.


4. Upon receiving information on or around 25 November 2013, that Client A was missing, had caused damage to his television and fridge, and made threats to kill his cousin:            
PROVED


74. The records exhibited evidenced the following chronology:
• On 20 November 2013 Client A was reported missing by his sister-in-law. The Registrant received an alert from a support worker, that he had gone missing, smashed his television and left cigarette butts on the floor. The Registrant completed a Safeguarding Adults Referral/Alert.  Client A was found by his brother and the Police the same day.
• On 22 November 2013 Witness 2 closed the Safeguarding Alert, marking it as ‘No Further Action’. There was no evidence that the Registrant was aware of this or that Witness 2 had discussed her actions or rationale with the Registrant. This was after the date on which the Panel has found that Witness 2 became aware of the incident with the knife as particularised at paragraph 2 of the Allegation.
• On 25 November 2013, the Registrant was informed by JF that Client A had smashed his television and fridge.  He had been confused about where he lived and had made a written threat to kill her (JF). 
In her evidence, the Registrant accepted receiving the alerts. Accordingly, the stem of particular 4 was found proved.

(a) did not undertake and/or record a Risk Assessment;
PROVED IN RESPECT OF BOTH LIMBS

(b) did not adequately undertake and/or record an investigation into the event;
PROVED IN RESPECT OF BOTH LIMBS


75. The Registrant admitted that she did not record her thought processes and actions by way of a RA or a record of her investigation due to being behind with her workload. The absence of these records was corroborated by Witness 1.  Accordingly, the second limbs of particulars 4(a) and 4(b) were found proved.


76. The Registrant considered that she had conducted an adequate assessment of risks and an appropriate investigation, which she said was a continuous process.  She submitted that she had actioned Client A’s safety first rather than the paperwork. 

 
77. The Registrant asserted that on 23 November 2013, when the Registrant was absent from work, Witness 2 had put a formal care package in place in response to concerns raised pursuant to the first alert received on 20 November 2013.  Carers from Oxford Enablement Service had attended, against Client’s A’s previously expressed wishes that he did not want or consent to formal carers attending his home. He had therefore become upset when they attended. There were also some family tensions with his brother who was temporarily assisting him, with whom JF did not want to share caring responsibilities. Client A was also generally unhappy in his new home in Area B as he was lonely.  It was within this context that, as a result of his frustration, he had smashed his property and left his home. The Registrant had spoken to Client A’s sister in law and JF and identified that Client A would go to his friend’s house, when the formal careers attended, to consume alcohol and sometimes he could not find his way home as a result of inebriation.  She said, therefore, that she addressed the risk by obtaining the friends phone number so carers could contact him to establish Client A’s location if he was not at home when they attended. Following this, he was not reported missing again. His drinking was being managed and reduced with the help of JF.  Assistive technology was not considered by the Registrant.


78. However, the Panel noted that, whilst there was evidence that discussions with JF and Client A’s sister in law had taken place as described in a narrative, there was no evidence that the Registrant had properly analysed the risks associated with Client A’s situation or identified specific risks to Client A given his pattern of behaviour. For example, the Registrant had not considered assistive technology to monitor the Registrant’s movements, neither did she identify a risk of harm in respect of the threat to kill JF despite it coming shortly after the incident when he attended JF’s home with a knife (see particular 2). In these circumstances, the Panel determined that a RA was not undertaken. Furthermore, given that the Registrant did not speak directly to Client A about the situation, the Panel determined that an adequate investigation was not undertaken. Accordingly, the first limbs of particulars 4(a) and 4(b) were found proved.

(c) did not make a General Practitioner and/or Mental Health Referral as required;
NOT PROVED


79. The HCPC evidence was that, after receiving the alerts in November 2013, the Registrant should have referred Client A to his GP to investigate whether there was any medical reason for his behaviour. When or if medical explanations were ruled out, the correct course of action then would be for the Registrant to request that the GP refer Client A to the Mental Health Services. There was no evidence on Client A’s file that this had happened.


80. The Registrant denied this particular.  Her evidence was that, at this time, she was in regular contact with Client A’s GP in order to request a referral to the Mental Heath Services for Client A. A mental health referral could not come directly from her as it had to be actioned by the GP.


81. The Panel noted that this particular is qualified by the words ‘as required’. No formal policy requiring such a referral in the circumstances described was drawn to its attention. Furthermore, Witness 2 had closed the safeguarding alert on 22 November, she clearly considered that onward referrals were not required.  Whilst Witness 2 was not aware of the written threats to kill JF when she closed the safeguarding alert on 22 November 2013, she nevertheless closed it despite having been informed by the Registrant of the incident with the knife some 18 days earlier.  In these circumstances, not only was there no formal policy requiring a GP/MH referral, Witness 2, the safeguarding manager, did not consider onward referrals were required despite Client A’s unpredictable behavior.  Accordingly, particular 4(c) was found not proved.


(d) did not advise the Safeguarding Manager that Client A had made threats to kill his cousin.            
PROVED


82. The Registrant admitted this particular.  She submitted that, having built a relationship with Client A, she had formed the view that he would not harm anyone. Witness 2, who was the Safeguarding Manager, corroborated the fact that the Registrant did not advise her that Client A had made threats to kill his cousin. Accordingly, particular 4(d) was found proved.


5. Did not fully complete a Mental Capacity Assessment in relation to Client A until July 2014.        
PROVED


83. A MCA dated 4 July 2014 was exhibited which assessed Client A as lacking capacity regarding financial management. The Registrant admitted this particular.  She submitted that this MCA related to a different issue than the one in October 2013 (referred to in particular 1(b)), this one being triggered by JF having indicated that she wished to withdraw her informal support regarding Clients A’s money management. The Panel accepted this explanation. A MCA was therefore undertaken to address this specific issue. The evidence of Witness 1 was that this was the only time during the relevant period that the Registrant had fully completed a MCA in respect of Client A.  The Registrant had started completing a MCA on 6 December 2013 but that was a draft which had not been concluded.  Accordingly, particular 5 was found proved.


6. On or around 27 February 2014, on receiving a request from Client A's General Practitioner for a safeguarding meeting:       
PROVED


84. An e-mail dated 27 February 2014, sent to the Registrant from Client A’s GP was exhibited.  Within that e-mail the GP requested a safeguarding meeting be arranged. In her evidence, the Registrant accepted that she received this request.  Accordingly, the stem of Particular 6 was found proved.


(a) advised the General Practitioner that Client A was already under Safeguarding when this was not the case:      
PROVED


85. The Registrant admitted this particular. This was corroborated by an e-mail from the Registrant dated 28 February 2014 within which she stated that ‘Client A is already under safeguarding’.  This was incorrect as the previous safeguarding alerts had been closed by Witness 2 as detailed above on 20 November 2013. The Panel accepted that the Registrant was unaware that the safeguarding alerts had been closed. Nevertheless, particular 6(a) was found proved on a factual basis.


(b) did not discuss the request with a Safeguarding Manager.    
PROVED


86. The Registrant admitted this particular. The evidence of Witness 1 was that the Safeguarding Manager’s role was to determine which course of action is best in each case and to oversee the safeguarding process. Accordingly, the Registrant should have discussed the matter with Witness 2, the Safeguarding Manager, when the GP requested a safeguarding meeting. The Registrant admitted that she did not do so.  The Panel accepted the Registrants explanation that this was because she was already dealing with safeguarding issues in respect of Client A.  The Panel noted that the referral did not raise any new safeguarding issues, as evidenced by a communication from Client A’s GP on 3 March 2014. Accordingly, particular 6(b) was found proved.


7. In May 2014, when facilitating Client A's change of address:   
PROVED


87. On 10 November 2013, Client A had moved from Area A to Area B because, in Area A, there were concerns that he was being financially exploited by his friends, one of whom was his unofficial lodger.  He was moved to Area B to reduce associated risks and place him away from these individuals. Client B was unhappy and lonely in Area B, it was the first time he had lived alone and Area B was some distance away from JF, his cousin/carer. In addition to this, documents exhibited, demonstrate that, in February and March 2014, JF requested that Client A be moved back, near to place A, as it was proving difficult for her to travel to Area B to provide appropriate support.  On 17 May 2014, Client A moved back to a different location within Area A.  The Registrant’s evidence was that she was not involved in facilitating this move. 


88. She was aware of the move and also that Client A had moved a few months earlier from Area A to Area B without any Social Worker involvement.  The earlier move had been facilitated by housing officers, JF and Client A.  It was the Registrant’s judgement that nothing had changed in their ability to manage the move in May 2014.


89. In respect of the later move, the Registrant was made aware that Client A and JF were working on a mutual exchange of property with housing officers at Oxfordshire County Council. She did not take the lead on this move, it was led again by housing officers and not her.  Housing officers were bound by the provisions of the Mental Capacity Act 2005 just as she was, in that they had a duty to ensure that Client A had capacity to sign a tenancy agreement with them when he moved.


90. In light of its finding that the housing officers took the lead on Client A’s move, the Panel considered the definition of the word ‘facilitate’.  The Oxford English Dictionary defines facilitate as ‘to make a process easier or possible’. Given that the Registrant was aware of the move, was Client A’s allocated Social Worker and, as such, had responsibility to act in his best interests and manage associated risks in relation to his lifestyle choices, the Panel was satisfied that the Registrant did ‘facilitate‘ the move. Without further liaison with the housing officers, JF and Client A or further scrutiny of the associated risks she made the process easier in the circumstances. Accordingly, the stem of particular 7 was found proved.


(a) Did not carry out a Best Interest Meeting as required under the Mental Capacity Act 2005 and/or the Mental Capacity Act 2005 Code of Practice.
NOT PROVED


91. The Registrant admitted that she did not carry out a Best Interest Meeting [BIM]. However, she asserted that it was not required under the Mental Capacity Act 2005 (‘the Act’) as the Registrant had not been assessed as lacking in the capacity to make a decision about his move at that stage. The Panel noted that the Act relates to people who lack capacity.  There is an assumption embodied in this act that people have capacity, unless they are assessed as lacking capacity to make a particular decision, after all practicable steps have been taken to help them. When capacity is assessed as lacking, a social worker would then convene a Best Interest Meeting. Section 4 of the Act makes provision for a Best Interest Meeting.  This is a multi-agency meeting to be convened after a lack of capacity is established in order to make a collective decision on behalf of the service user in his best interests.


92. Witness 2 asserted that Client A was assessed as lacking in capacity in April 2014 following the joint visit by the Registrant and CW (MHSW), therefore a BIM was required. This MCA was not documented. The Registrant confirmed that she knew CW had assessed Client A as lacking in capacity in relation to ‘health, welfare and financial decisions’ in April 2014. The first documented MCA was in July 2014 after Client A had moved, wherein he was assessed as lacking in capacity in relation to his financial affairs.  There was no evidence that Client A had been assessed as lacking in capacity prior to May 2014 specifically in relation to his ability to make the decision to move house. Therefore, there was no requirement pursuant to the Act to carry out a BIM. Accordingly, particular 7(a) was found not proved.


(b) Did not inform the following authorities of Client A's change of address as required:
(i) Thames Valley Police.          
PROVED
(ii) Client A's General Practitioner.           
PROVED


93. The Registrant admitted these sub-particulars. The HCPC’s case was that, in addition to holding a BIM, the Registrant should have updated all key parties involved with Client A of his change of address as required under the Act. There was no evidence within the case records that the Registrant informed the relevant parties.


94. Given that the Panel has found that the Act was not applicable in these circumstances, there was no explicit requirement upon the Registrant to update the parties.  Nevertheless, the Panel considered that it would have been good practice for her to do so particularly in light of the enquiry made by the GP on 21 May 2014 when he actively sought out Client A’s address to ensure that he received his medication. Furthermore, in her evidence, the Registrant acknowledged that it was important for the Police to know Client A’s address as they would have to return him home in the event that he went missing and could not recall where he lived. In respect of the GP, her evidence was that she did not inform the GP as she was assured that JF would do so, and thus placed too much reliance upon JF. In all of these circumstances, the Panel was satisfied that there was an obligation upon the Registrant to notify the Police and the GP of the change of address. Accordingly, particulars 7(b)(i) and (ii) were found proved.


(c) Did not carry out and/or record a Risk Assessment in relation to the impact that the change of address would have on Client A.
PROVED IN RESPECT OF BOTH LIMBS


95. The Registrant admitted that she did not formally record a RA in respect of the impact which the change of address would have upon Client A.  The absence of a record to this effect was corroborated by Witness 1.  Accordingly, the second limb of particular 7(c) was found proved.


96. The move meant Client A returned to Area A where the original safeguarding concerns had been raised.  The HCPC asserted that, in these circumstances, the Registrant should have carried out a RA to examine the risks involved. The need to carry out a RA is set out in the Council’s Safeguarding Policy.


97. The Registrant asserted that she did, in fact assess the risks, albeit they were not formally recorded.  She considered that there were sufficient strategies in place by the time of the move, to address the risks via the package of formal and informal care. The Panel did not accept this explanation.  It was plain that the increased support which JF was able to provide Client A in Area A was considered by the Registrant.  However, she did not explore or document any other potential risks.  Most notably, the risks associated with the acquaintances of the Registrant who lived in Area A and who had previously been suspected of financially abusing Client A, were not explored.  Accordingly, the first limb of particular 7(c) was found proved.


8. Between 27 May 2014 and 6 June 2014, upon receipt of information that Client A had not received their medication for nine days:    
PROVED


98. The documentary evidence demonstrated that:
• On 15 May 2014 JF confirmed that she would inform Client A’s GP and chemist of his change of address.
• On 21 May 2014, Client A’s GP contacted the Registrant to ask where Client A was living. An attempt had been made by a chemist to deliver medication (to the address in Area B) and found that Client A was no longer living there;
• On 22 May 2014, the Registrant left a telephone message with the GP indicating that Client A had moved back to Area A but did not give the specific address.  Later, on this date, the Registrant telephoned the surgery to indicate that she had spoken to JF who confirmed  that Client A had 7 days’ of medication left and that he had moved to a different GP’s surgery.  She confirmed that the GP should send the prescription to a chemist in Area A and they would deliver it to Client A;
• On 27 May 2014, the Registrant was advised that JF’s husband had collected Client A’s medication the previous week.  On this date Client A’s carers also informed the Registrant that Client A had not received his medication;
• On 6 June 2014, the care co-ordinator from Client A’s formal care providers reported that Client A had run out of medication on 28 May 2014.  As this was reported on 6 June 2014, Client A had not had his medication for 9 days.
The Registrant admitted that she received this information.  Accordingly, the stem of particular 8 was found proved.


(a) Did not undertake and/or record an assessment into Client A's family's ability to provide Client A with the medication.
PROVED IN RESPECT OF BOTH LIMBS


99. The Registrant admitted that she did not formally record an assessment in this respect.  The absence of a record to this effect was corroborated by Witness 1 and the documents exhibited.  Accordingly, the second limb of particular 8(a) was found proved.


100. The HCPC’s case was that the family of Client A appeared not to be providing Client A with his medication, despite their assurances they would care for him.  Evidence of these assurances were exhibited in Client A’s notes dated 22 and 26 May 2014. Furthermore, the requirement to assess the family was part of the Council’s policy, which according to Witness 1, mirrors those provisions now set out in the Care Act 2014. Witness 1 asserted that, in any event, the family’s unreliability should have triggered an assessment of their capabilities at this stage.


101. The Registrant denied that she did not undertake an assessment of the family. She was assured by JF that she (JF) would register Client A at a new GP’s surgery and collect his medication. There were assurances from JF that she would care for Client A which the Registrant said she had no reason to doubt.  The Panel did not accept that this amounted to an investigation into the family’s ability to provide Client A with his medication, particularly when information was received that Client A was not receiving his medication despite members of his family having collected it on his behalf.  Witness 1 gave evidence that, in her internal interview, the Registrant had stated that JF and her husband had claimed that they took the medication to Client A’s house but that the carers did not find it. The Registrant did not assess whether the family might have kept the medication for themselves, hidden it from Client A, or whether Client A might have hidden it from the carers or given it away himself. Accordingly, the first limb of particular 8(a) was found proved.


(b) Did not undertake and/or record an appropriate Risk Assessment.
NOT PROVED IN RESPECT OF THE FIRST LIMB
PROVED IN RESPECT OF THE SECOND LIMB

102. After discovering that Client A had not had his medication for 9 days, the evidence of the HCPC was that, the Registrant should have carried out a RA to establish why this happened and how to mitigate the risk of reoccurrence. According to Witness 1, this was what was required as part of the Council’s best practice, upon which the Registrant had received training.


103. The Registrant admitted that she did not record a RA and there was no documentary evidence to show that she did this. Accordingly, the second limb of particular 8(b) was found proved.


104. The Registrant asserted that she did, in fact assess the risks, albeit they were not formally recorded.  She considered that  her response to the situation was an appropriate response which addressed the risks involved.


105. The Registrant asserted that, upon becoming aware that Client A had not had his medication on 6 June, she immediately assessed the risks and addressed the issues by calling all parties.  She put a new system into place by arranging for the formal carers to collect the medication.  She also said that she e-mailed the GP to ascertain what risks were associated with Client A not having taken his medication for 9 days.  She stated that the GP was unconcerned, as the medication in question was paracetamol. (No evidence to this effect was adduced). The Registrant was reassured to be informed that this was not a safeguarding issue at this stage.  The Registrant considered that she did all she could in the circumstances.  The Panel accepted this and was satisfied that her actions did amount to a RA on the day upon which she became aware that Client A had not received his medication for 9 days.  Accordingly, the first limb of particular 8(b) was found not proved.


9. Upon receipt of information on or around 9 October 2014 that a heroin addict had visited Client A's residence, you did not raise an alert on Oxfordshire County Council's Safeguarding Adults alert system until 17 October 2014.  
PROVED


106. The Registrant admitted this particular. There was evidence that she had received information on or around 9 October that a heroin addict had visited Client A at his home in Area A after his return to that area. The safeguarding alert was not raised until 17 October 2014.  Accordingly, particular 9 was found proved.

Decision on Grounds


Further Preliminary Matter
107. At the resumed hearing on 18 December 2017, Ms Hewitt, on behalf of the Registrant, invited the Panel to proceed in the absence of the Registrant. She reminded the Panel that the Registrant had indicated, during the earlier part of the hearing in October 2017, that she would be unable to attend due to a planned holiday, but that she wished the matter to proceed to a conclusion at the earliest date convenient to both the Panel and the advocates in the case. Ms Hewitt informed the Panel that her client had recently confirmed that her views had not changed in this respect and the Registrant was content for the hearing to go ahead in her absence. Ms Manning-Rees, on behalf of the HCPC, did not object.


108. The Panel noted that the Registrant had not sought an adjournment and that she had invited the Panel to proceed in her absence.  Furthermore, her interests continued to be represented by Ms Hewitt and she had already given evidence in respect of matters relevant to the later stages of the hearing.  In all of these circumstances, and given the lengthy history of this case, the Panel was satisfied that it was in both the public interest and the interests of the Registrant to consider the remaining issues associated with this case expeditiously.  The Registrant would suffer no prejudice in proceeding in this way, it was therefore appropriate and fair to proceed in her absence today. The Panel would draw no adverse inferences from her non-attendance.

Misconduct - Proved
109. The Panel next determined whether the facts found proved amounted to misconduct. The Panel accepted the advice of the Legal Assessor. It bore in mind that there is no standard of proof to be applied at this stage; consideration as to whether the threshold for misconduct has been reached is a matter for its own judgment.


110. The Panel had specific regard to the helpful guidance provided in Roylance -v- GMC (No 2) [2000] 1 AC 311, Meadows v GMC [2007] QB 462 and Shaw v GOsC [2015] EWHC 2721. It noted that misconduct involves an act or omission which falls short of what would be proper in the circumstances and that in order to amount to misconduct, the act or omission needs to be serious and one which would attract a degree of strong public disapproval.


111. The Panel considered whether the proven facts amounted to breaches of the HCPC Standards of Conduct, Performance and Ethics 2012 (“the HCPC Standards”), and/or breaches of the HCPC Standards of Proficiency applicable to Social Workers in England, 2012, which were relevant at the time. It bore in mind that breaches of any of these Standards did not, in themselves, necessarily constitute misconduct. 


112. The Panel determined that the following HCPC Standards had been breached:


 1.You must act in the best interests of service users;
 7. You must communicate properly and effectively with service users and   other practitioners;
 10. You must keep accurate records.


113. The Panel also determined that the following HCPC Standards of Proficiency applicable to Social Workers had been breached:


 1. be able to practise safely and effectively within their scope of practice
1.3 be able to undertake assessments of risk, need and capacity and respond appropriately
1.5 be able to recognise signs of harm, abuse and neglect and know how to respond appropriately
2. be able to practise within the legal and ethical boundaries of their   profession
2.3 understand the need to protect, safeguard and promote the wellbeing of …… vulnerable adults
 4. be able to practise as an autonomous professional, exercising their own   professional judgement
  4.1 be able to assess a situation, determine its nature and severity and    call upon the required knowledge and experience to deal with it
  4.4 be able to make informed judgements on complex issues using the    information available
 10. be able to maintain records appropriately
   10.1 be able to keep accurate, comprehensive and comprehensible    records in accordance with applicable legislation protocols and     guidelines


114. In considering the ground of misconduct, the Panel first considered the individual particulars found proved and then the behaviour in the round.


Particular 1(a)
115. The Registrant did not carry out a MCA as requested by her supervisor on 23 October 2013 in response to concerns that Client A was the subject of financial exploitation in Area A. However, the Panel accepted the Registrant’s explanation that she did not undertake the MCA because the risks relating to Client A’s financial exploitation were substantially mitigated very soon after the request was made, when Client A moved to Area B. In doing so, Client A moved away from the risks identified and a formal care package was put in place to support him. In these circumstances, the Panel did not consider that the failing identified was sufficiently serious to meet the threshold for misconduct.


Particular 2 (a) - (d)
116. The Panel accepted that there was a conversation on 4 November 2013 between the Registrant and her supervisor in which the Registrant was told that the incident in which Client A had been in possession of a knife did not require escalation.  The supervisor identified Client A as a victim rather than a perpetrator in relation to the incident and did not enquire about the type and size of the knife that Client A had been in possession of. It was this conversation with her supervisor, who was also the Safeguarding Manager, which minimised the Registrant’s view of the seriousness of the matter and influenced her subsequent thinking and actions. At this time the Registrant was not sufficiently experienced in dealing with service users with the complexity of needs of Client A, that she could challenge the guidance she was given.  She was reliant upon her supervisor’s experience and advice in this respect. Furthermore, the police were aware of the incident, having been notified by JF at the time it occurred.  In these circumstances, the Panel did not consider that the failings attributable to the Registrant in this scenario, were sufficiently serious to meet the threshold for misconduct.


Particular 3(b)
117. The Panel was satisfied that the Registrant did undertake a Risk Assessment [RA] in respect of the concerns relating to Client A’s malnourishment and lack of food. Whilst she did not formally document the identified risks in an official RA proforma, the Registrant nevertheless clearly documented the risks identified in the Overview Assessment [OA]. The OA was easily accessible to other professionals on the SWIFT system should decisions need to be made in the absence of the Registrant in respect of Client A.  Accordingly, the Panel did not consider this failing was sufficiently serious such that it was capable of amounting to misconduct.


Particular 4 (a), (b) and (d)
118. Notwithstanding the comments above in respect of particular 2, the established facts surrounding particular 4 demonstrate that the situation escalated further only three weeks later. Against the background that Client A had previously been in possession of a knife, there was information that he had threatened to kill JF (his informal carer), that he had also gone missing and caused damage to his property.  The Registrant should have recognised the importance of the deterioration in Client A’s behaviour. In these circumstances, the Registrant had a duty to undertake and record a thorough investigation and risk assessment and to immediately escalate the matter to the Safeguarding Manager. The Safeguarding Manager had closed down the safeguarding alert in respect of Client A on 20 November 2013, four days before the information relating to this particular came to the attention of the Registrant, and had not informed the Registrant of this fact.  Had the Registrant informed the Safeguarding Manager, her supervisor, of the escalation in the situation on 24 November 2013, it is more likely than not that the Safeguarding Manager would have revisited her decision to close the safeguarding alert and that the matter would have been further investigated. In all the circumstances, the Registrant’s failings in this respect created a significant risk of potential harm to Client A and anyone who came into contact with him. The Panel was satisfied that these failings would attract a degree of strong public disapproval and as such represented a serious departure from the standards expected of a registered Social Worker and did amount to misconduct.


Particular 5
119. The Registrant explained that, whilst she was trained to undertake MCA’s, she did not wish to complete one in respect of Client A during the period from October 2013 to July 2014, as historically, she had worked with people with a medical diagnosis to explain their needs.  There was no formal diagnosis in respect of Client A apart from the assumption that Client A’s alcohol abuse was causing memory loss. She submitted that, given her lack of experience in assessing service users with such complex needs as Client A, she did not want to assess Client A’s capacity incorrectly in the absence of a diagnosis. Nevertheless, she asserted that she believed she was assessing his capacity as she was ‘going along’ and just did not document it formally on the correct form.


120. The Panel did not accept this explanation. From October 2013 to July 2014 high risk concerns which potentially related to issues of capacity came up repeatedly regarding Client A, including: self-neglect, excessive consumption of alcohol, going missing, confusion, increasingly volatile behaviour, threats to kill and destruction of property.  However, the Registrant did not complete and record a MCA until July 2014. It appeared that the Registrant was present at and participated in a MCA in April 2014 with CW, a Mental Health Social Worker. However, there was no record of the issues in respect of which that MCA had been undertaken, neither was there a record of the outcome of that MCA in the Registrant’s records about Client A. The Registrant had oversight of this case and a duty to act in the best interests of Client A. In these circumstances, the Panel was satisfied that a delay of nine months in the completion of a MCA in respect of a service user with such complex needs, represented a serious departure from the standards expected of a registered Social Worker and did amount to misconduct.


Particular 6 (a)-(b)
121. The Panel found that, on 27 February 2014 when Client A’s GP requested a safeguarding meeting, the Registrant informed the GP that Client A was already under safeguarding. This was inaccurate as the Safeguarding Manager had closed the safeguarding alerts in respect of Client A on 20 November 2013.  However, it was plain that the Safeguarding Manager had not informed the Registrant of this fact, and as such, the Registrant was unaware that the safeguarding alerts had been closed. There was no reason for the Registrant to question whether Client A was still subject to safeguarding, to interrogate the SWIFT system in this respect or to discuss the GP’s request with the Safeguarding Manager because, not only had the Registrant not been informed that the safeguarding alerts had been closed, but she was actively working on Client A’s safeguarding issues at the time. In these circumstances, the Panel did not consider that the Registrant bore any culpability in relation to these failings and no risk was created thereby. The GP had not raised any new safeguarding issues. Accordingly, the Panel did not find the failings in respect of particular 6 were capable of amounting to misconduct.


Particular 7 (b)(i) - (ii)
122. The Panel considered, that whilst it would have been good practice for the Registrant to inform the police and Client A’s GP of his change of address, there was no obligation upon her to do so.  Furthermore, at the relevant time, the Registrant had had discussions with JF and was confident that she could rely upon JF to inform the GP of the change of address and that JF would report any matters requiring police attention directly to them. There was also a strategy in place to ensure Client A could be located in the event that he went missing. Whilst there are some concerns that the Registrant placed too much reliance upon JF in these circumstances, the Panel did not consider that these failings were sufficiently serious to reach the threshold for misconduct.


Particular 7(c)
123. Client A was a vulnerable and older service user associated with a number of high risk concerns. The Registrant was aware that in moving from Area B back to Area A, Client A was returning to an area where he had been identified previously as being at risk of abuse or exploitation.  As his Social Worker, the Registrant had a duty to carry out and record a Risk Assessment [RA] in respect of the move in order to identify any continuing or new risks. (The Panel noted that a comprehensive risk assessment regarding the move could have prevented the issues under particulars 8 and 9 from arising subsequently). In failing to complete a RA, Client A was exposed to a risk of harm. Accordingly, the Panel was satisfied that this failing represented a serious departure from the standards expected and as such it constituted misconduct.


Particular 8(a) & the second limb of Particular 8(b)
124. The Panel found that the Registrant did not undertake and record an assessment into Client A's family's ability to provide Client A with his medication, upon discovering that he had not received the medication for nine days. She also failed to record the associated RA. However, the Panel considered there was a considerable body of evidence to suggest that, notwithstanding this, the Registrant had a good understanding of the importance of resolving the situation and that she immediately undertook sufficient practical steps in order to deal with it as soon as she became aware of it. She undertook a RA immediately and contacted all concerned parties.  She put a new system into place for collection of the medication by Client A’s formal carers and e-mailed the GP to ascertain any medical risks arising from Client A being without his medication for nine days. There was no evidence adduced by the HCPC that Client A was exposed to any risks. The only evidence received in respect of the nature of the medication came from the Registrant who asserted that the medication was paracetamol.  This was not contested by the HCPC.  Furthermore, the GP was unconcerned, did not identify any medical risks and the Registrant was reassured to be informed (by the GP) that this was not a safeguarding issue. In these circumstances, the Panel did not consider these failings were sufficiently serious to meet the threshold for misconduct.


Particular 9
125. The Registrant received information on or around 9 October 2014 that a heroin addict had visited Client A when he had returned to live in Area A.  This person had been suspected of financially abusing Client A when he had lived in Area A originally (before his move to Area B in November 2013). This was one of the risks which the Registrant should have identified pursuant to particular 7, before Client A returned to live in Area A. The Registrant failed to raise a Safeguarding Alert for 8 days and therefore exposed Client A to a risk of further exploitation or abuse during that period.  The Panel is therefore satisfied that this failing was a sufficiently serious departure from the expected standards to constitute misconduct.


Behaviour in the Round
126. The Panel has found that each of the facts found proved at particulars 4(a), 4(b), 4(d), 5, 7(c) and 9 amounted to misconduct. The Panel noted that the Registrant acted with care and good intentions towards Client A and he suffered no actual harm. It was also mindful that the Registrant was inexperienced in dealing with service users with the complex care needs of Client A and that some of the failings identified were explained by the Registrant’s working environment, as detailed in paragraphs 49 to 52 above.  However, this did not excuse the Registrant from her professional duty to practise in the best interests of Client A, to acceptable professional standards.  Client A was a vulnerable, older service user with complex needs.


127. The Panel determined that the facts identified above amounted to serious failings in respect of the fundamental responsibilities of a Social Worker. The standards of the Registrant’s practice in the above instances fell far short of what would be expected and, by departing from those standards, the Registrant exposed Client A, and those who came into contact with him, to a risk of serious harm. The Registrant’s conduct amounted to a breach of a fundamental tenet of her profession, in that the public is entitled to expect that the needs of such vulnerable service users are prioritised and acted upon immediately, in their best interests, whatever the working environment.


128. The Registrant also failed to maintain accurate and contemporaneous records.  In so doing, her conduct potentially inhibited the ability of others to make fully informed decisions about Client A in the absence of the Registrant.


129. In all of these circumstances, the Panel was satisfied that the Registrant’s conduct detailed at particulars 4(a), 4(b), 4(d), 5, 7(c) and 9, both individually and collectively, would attract a degree of strong public disapproval.  Accordingly, it determined that the Registrant’s actions amounted to misconduct.


Lack of Competence- Not Proved
130. The Panel next considered the alternate statutory ground of lack of competence. The Panel accepted the advice of the Legal Assessor and had regard to the guidance in Calhaem v GMC [2007] EWHC 2606.


131. Having determined that some of the proven facts amounted to misconduct, the Panel noted that the alternate statutory ground of lack of competence was also pleaded.  In view of its findings on misconduct, the Panel was satisfied that the Registrant knew how to perform her professional duties competently, but failed to do so on the occasions referred to. The Panel considered that the Registrant’s actions were more appropriately identified as misconduct rather than lack of competence.


132. This conclusion is corroborated by EP who provided evidence that the Registrant was competent prior to the period during which Witness 2 had supervised her. The Panel also noted the comments contained within a testimonial provided on behalf of the Registrant in which IR, a person who had oversight of the Registrant’s work prior to the relevant period, confirmed there were no concerns about the standard of the Registrant’s work at that time.  Furthermore, the failings related to one service user during a period when the Registrant was managing a high number of cases, many of which were complex.  Accordingly, the Panel was not satisfied that the evidence it had considered related to a fair sample of the Registrant’s work.


133. In all of these circumstances, the Panel did not consider the Registrant’s failings amounted to a lack of competence.

Decision on Impairment


134. The Panel next determined whether, by reason of her misconduct, the Registrant’s fitness to practise is impaired. The Panel accepted the advice of the Legal Assessor and had regard to the HCPC Practice Note “Finding that Fitness to Practise is Impaired”, dated March 2017. It bore in mind that not every finding of misconduct will automatically result in a conclusion that fitness to practise is impaired and noted that impairment is ‘forward looking’.  The Panel had specific regard to the guidance in the case of Meadows v GMC [2007]1 All ER 1, and Council for Healthcare Regulatory Excellence (CHRE) v NMC and Grant [2011] EWHC 927.


135. The starting point for the Panel was that the misconduct identified was serious. By demonstrating failings in respect of fundamental areas of her practice, which fell far short of that which would be expected of a registered Social Worker, the Registrant has breached a fundamental tenet of her profession. Furthermore, by failing to adequately protect a vulnerable, older service user, and those who came into contact with him, from the risk of harm, the Registrant has brought the reputation of her profession into disrepute.

136. The Panel first considered whether the Registrant’s fitness to practise is currently impaired on a personal basis. It determined that the failings identified are, in principle, remediable.


137. The Panel noted that the Registrant has not practised as a Social Worker since she was suspended from the Council in October 2014.  She has undertaken work in a social care role for a care agency as bank staff, in a role which includes undertaking care assessments for clients, writing up care plans, following up safeguarding issues and carrying out risk assessments. The Panel noted that there was a positive reference in this respect and there was no suggestion there has been a repetition of the failings identified. The Panel also noted that the Registrant has undertaken relevant on-line training which included safeguarding of vulnerable adults, assessment of mental capacity, record keeping and risk assessment.


138. However, the Panel was mindful that, in her current position with the care agency, the Registrant has not had the responsibility of taking a statutory lead for service users, in a role which mirrors the duties of a Social Worker. Furthermore, despite the online training she has undertaken, she has not had the opportunity to demonstrate that she is able to put that learning into practice. She has had no practical experience in the past 3 years within which she has been able to demonstrate that the failings have been fully remedied. In particular, she has not yet demonstrated that her knowledge, learning and understanding of MCA’s has improved in any practical way.


139. Whilst the Panel was encouraged by the steps taken thus far and her commitment to working in a social care role, it considers that the Registrant’s remediation is ongoing and not yet complete.


140. The Panel also considered the Registrant’s reflective piece and associated oral evidence, and noted that she has reflected upon the relevant events and demonstrated a degree of insight, in that she recognises how things should have been done differently. However, the Panel considered that the Registrant’s evidence of reflection exposed the fact that she has not yet developed a full appreciation of the importance of MCA’s and the circumstances in which an early MCA is required. Furthermore, there was insufficient reflection upon the specific incidents identified by the Panel as high risk and a lack of recognition of the need to escalate such matters with expedition.


141. It was clear that the Registrant is committed to social care work. She expressed care and concern for her service users and her compassion is evident in the testimonials produced on her behalf. There were many examples of good practice on the part of the Registrant in her care of Client A, particularly when it is considered in the context of the environment within which she was working at the relevant time. The Panel also noted that the Registrant has fully engaged in the regulatory process as well as the internal disciplinary process and the Employment Tribunal over a period of three years.


142. Nevertheless, given that the Registrant’s remediation is ongoing and her insight not yet fully developed, there remains some risk of repetition of the failings identified. Accordingly, the Panel found that the Registrant’s fitness to practise is currently impaired on a personal level.


143. The Panel then went on to consider whether the wider public interest dictated that a finding of impairment was required in this case. The Panel is satisfied that the public interest is engaged. Client A belongs to a rapidly expanding cohort of service users who are older, vulnerable who have complex combination of needs and associated risks. The public is entitled to expect that vulnerable service users are adequately protected and that their needs will be prioritised and acted upon immediately and appropriately, in their best interests, whatever the working environment.


144. The Registrant’s misconduct was such that it presented a risk to the reputation of her profession as a whole. The wider public interest in upholding proper professional standards and public confidence in the profession and the regulatory process would be undermined if a finding of impairment was not made in these circumstances.


145. Accordingly, the Panel finds that the Registrant’s fitness to practise is also currently impaired in the wider public interest.


Decision on Sanction

146. The Panel considered the submissions made by Ms Manning-Rees and Ms Hewitt. It accepted the advice of the Legal Assessor.

147. The Panel is aware that the purpose of any sanction is not to be punitive, though it may have a punitive effect. The Panel has borne in mind that its primary function at this stage is to protect the public, while reaching a proportionate sanction, taking into account the wider public interest and the interests of the Registrant. The Panel has taken into account the HCPC Indicative Sanctions Policy [“the ISP”] and applied it to the Registrant’s case on its own facts and circumstances.

148. The starting point for the Panel was that the misconduct was serious. It constituted numerous breaches of the HCPC Standards and the failings were associated with fundamental areas of the Registrant’s practice.

149. The Panel identified the following aggravating factors in this case:

• Client A was a high risk, vulnerable service user with complex needs;
• The misconduct created a serious potential risk to Client A and those who came into contact with him;
• The absence of good record keeping by the Registrant potentially compromised the care of Client A in the absence of the Registrant;
• The misconduct continued for a relatively long duration, during which the Registrant failed to complete some essential assessments;
• There was an over-reliance on Client A’s informal carer to meet his needs.


150. To balance against those issues, the Panel identified the following mitigating factors;
• The Registrant has fully engaged in the regulatory process;
• The Registrant made admissions without prevarication to a number of particulars;
• There have been no previous regulatory issues;
• The events in question related to one service user.
• The Registrant has demonstrated some insight.  She recognised that her work fell below the standard expected of her and that she would do things differently now;
• The Registrant has continued with her Continuous Professional Development, reflected upon what happened and recognised her personal responsibility for what occurred despite the lack of adequate supervisory support available to her at the time;
• No actual harm was caused to Client A or associated people;
• Of her own volition, the Registrant has taken remedial action by undertaking a number of on-line training courses.  She has also undertaken some safeguarding and risk assessment work in her current role;
• There were a number of positive testimonials;
• The Panel considers that the risk of repetition is low.


151. Nevertheless, the Panel has found that the Registrant damaged the reputation of the profession and the failings identified constituted a breach of a fundamental tenet of her profession. In light of all of these matters, the Panel has considered what sanction, if any, should be applied, in ascending order of seriousness.


No Further Action
152. The wider public interest would not be upheld if the Panel were to take no further action in a case of this nature which would inevitably attract a degree of strong public disapproval. 


Mediation
153. The Panel considered that mediation has no applicability to the nature of the misconduct found proved.


Caution
154. A Caution Order would be insufficient to mark the seriousness of the Panel’s findings. It would offer no restriction on the Registrant’s practice and would not afford the Registrant the opportunity to demonstrate that she has improved in the areas of her practice which   require attention.  A caution would therefore be insufficient to protect the public and uphold the wider public interest.


Conditions of Practice
155. The Panel was mindful of the fact that this was a lapse relating to one service user during a period when the Registrant had a high caseload and was poorly supervised. No harm was caused and the failings identified relate to specific and discrete areas of the Registrant’s practice. In these circumstances, the Panel concluded that it would be possible to formulate workable and practicable conditions that would adequately address the issues identified and also reflect the wider public interest. The Panel has identified that the Registrant’s failings are capable of being remedied and it is satisfied that allowing the Registrant to remain in practice, albeit subject to conditions, will address the risks identified. Beyond the conditions imposed, the Registrant is capable of practising safely and effectively. Furthermore, the Panel considered the Registrant to be a person of integrity and, given the proactive and positive way in which she has engaged in the case, it is confident that she will comply with any conditions imposed.


156. The Panel is mindful of the potential impact this order may have upon the Registrant.  However, it is satisfied that a Conditions of Practice Order for 12 months is an appropriate and proportionate sanction in these circumstances.  This is sufficient time for the Registrant to address the issues identified. The conditions are designed to cover a period when she may secure work as a Social Worker.  Any shorter period would not address the public protection issues raised nor would it allow sufficient time for full remediation.


157. The Panel is satisfied that the need to protect the public, and maintain confidence in the profession and the regulatory process, outweighs the impact upon the Registrant of working subject to conditions of practice for a period of 12 months.


Suspension and Striking Off Order
158. In the judgement of the Panel, a Suspension or Striking Off Order would be disproportionate and unduly punitive in the circumstances described. Furthermore, it would deprive the public of a practitioner who is capable of practising without restriction in due course, after a period wherein she is subject to Conditions of Practice, which would be contrary to the wider public interest.


159. Accordingly, the Panel determined that a Conditions of Practice Order, was the necessary and proportionate order at this time.

Order

ORDER: The Registrar is directed to annotate the Register to show that, for a period of one year from the date that this Order comes into effect you, Ms Doreen Claire Ruta, must comply with the following conditions of practice:


1. Within 28 Days of obtaining work which requires your registration with the HCPC, you must place yourself and remain under the supervision of a workplace supervisor, registered by the HCPC, and supply details of your supervisor to the HCPC. You must attend upon that supervisor as required and follow their advice and recommendations. You must promptly inform the HCPC of any change of supervisor.


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


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


4. 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).


5. You must work with your supervisor to formulate a Personal Development Plan designed to address the deficiencies in the following areas of your practice:


i. Record Keeping

ii. Knowledge, understanding and application of the Mental Capacity Act 2005

iii. Production of timely Risk Assessments, incorporating a multi-agency approach.

6. Within three months of obtaining work as a Social Worker you must forward a copy of your Personal Development Plan to the HCPC.

7. You must meet with your supervisor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan.

8. You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

9. You must keep a reflective log of issues relating to all Mental Capacity Assessments which you undertake during the period of the order.

Notes

This Order will be reviewed before its expiry on 16 January 2019.


It would assist the Reviewing Panel for the Registrant to provide the following:


1. A report from the workplace supervisor evidencing the extent to which you have demonstrated your abilities in respect of the following areas:


(i) Record Keeping
(ii) Knowledge, understanding and application of the Mental Capacity Act 2005
(iii) Production of timely Risk Assessments, incorporating a multi-agency approach.


2. A copy of the reflective log detailed at Condition 9 above.

Hearing history

History of Hearings for Ms Doreen Claire Ruta

Date Panel Hearing type Outcomes / Status
18/12/2017 Conduct and Competence Committee Final Hearing Conditions of Practice
02/10/2017 Conduct and Competence Committee Final Hearing Adjourned part heard
23/01/2017 Conduct and Competence Committee Final Hearing Adjourned part heard