Emily Harrison

: Social worker

: SW98011

Interim Order: Imposed on 17 Aug 2016

: Final Hearing

Date and Time of hearing:10:00 22/01/2018 End: 17:00 26/01/2018

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

: Conduct and Competence Committee
: Struck off

Allegation

During the course of your employment as a Social Worker for Dorset County Council (‘the Council’) between 2014 and 9 July 2016:

 

1. You breached professional boundaries in relation to Service User A, in that you:

a) Conducted an inappropriate friendship and/or relationship with Service User A;

b) Attended Service User A’s home for non-work related reasons;

c) Allowed Service User A to babysit your children;

d) In or around October 2015, invited and/or allowed Service User A to spend time with you on your holiday;

e) Encouraged Service User A to take drugs;

f) Contacted Service User A whilst on leave from the Council despite written instructions from management not to do so;

 

2. Between around 1 April 2015 and 4 May 2016, you breached professional boundaries in relation to Service User B, in that you:

a) Conducted an inappropriate relationship with Service User B;

b) Engaged in a sexual relationship with Service User B;

c) Went on one or more holiday(s) with Service User B;

d) Attended Service User B’s home for non-work related reasons;

e) Used illegal drugs in Service User B’s home and/or in the presence of Service User B;

f) Encouraged Service User B to use illegal drugs;

 

3. In or around December 2015, you breached professional boundaries in relation to Service User C, in that you:

a) Went Christmas shopping with Service User C;

b) Stored your Christmas presents at Service User C’s house;

 

4. You breached professional boundaries in relation to Service User D, in that you:

a) Conducted an inappropriate friendship and/or relationship with Service User D;

b) Saw Service User D for non-work related reasons;

c) Invited Service User D on a night out to celebrate your birthday;

d) Attended a night out with Service User D and another service user;

e) Used illegal drugs during a night out with Service User D and/or told Service User D that you had taken illegal drugs;

 

5. You did not record any visits to Service User D in the case record between the following dates:

a) From around 11 December 2014 to 8 July 2015;

b) From around 10 July 2015 to 22 January 2016;

 

6. Your actions described in particulars 2a) – d) were sexually motivated;

 

7. Your actions described in particulars 1, 2, 3, 4, and 6 constitute misconduct;

 

8. Your actions described in particular 5 constitute misconduct and/or lack of competence;

 

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

Finding

Preliminary Matters


Proof of Service
1. The Panel heard that notice in respect of this hearing was sent by first class post to the Registrant’s registered address on 29 June 2017 in accordance with Rules 3 and 6 of the Conduct and Competence Procedure Rules 2003.

2. The Panel heard and accepted the advice of the Legal Assessor and determined that the notice had been served in accordance with the Rules.


Proceeding in the absence of the Registrant
3. Mr Dite, on behalf of the HCPC, invited the Panel to proceed in the absence of the Registrant. He drew the Panel’s attention to the Registrant’s completed Response Pro-forma of 19 October 2017, in which she indicated that she was not planning to attend the hearing, as well as to an email of the same date and to the same effect sent to the HCPC on her behalf. Mr Dite also drew the Panel’s attention to an additional email dated 4 January 2018 to the HCPC on behalf of the Registrant which stated:                                                                    

“Emily still is very unwell and she does not wish to have the hearing postponed and she would like the matter to be dealt with. Emily also wants to let the panel know that she supports this process and understands how vitally important it is.”                  

The Panel noted that no medical evidence was provided by her.                                                 

4. Mr Dite referred the Panel to the guidance contained in the HCPTS Practice Note on Proceeding in the Absence of the Registrant and submitted that it was appropriate for the Panel to exercise its discretion to proceed on the basis that the Registrant had chosen not to attend the hearing and had waived the right to appear. He pointed out that there had been no request from the Registrant for an adjournment and that she had indicated her wish that the hearing proceed. He submitted that the public interest in the expeditious disposal of the allegation outweighed any disadvantage to the Registrant in proceeding in her absence.


5. The Panel heard and accepted the advice of the Legal Assessor who reminded it of the guidance provided in the cases of R v Jones [2002] UKHL5, Adeogba v the General Medical Council [2016] EWCA Civ 162 and Davies v HCPC [2016] EWHC 1593 (Admin).


6. The Panel recognised that the discretion to proceed in the absence of a Registrant is one which must be exercised with the utmost care and caution and that its decision should be guided by the overarching objective to protect the public.


7. In reaching its decision, the Panel had regard to the nature and circumstances of the Registrant’s behaviour in absenting herself; in particular, whether the behaviour was voluntary and thus had waived her right to be present. The Panel balanced the public interest in the timely disposal of the allegation with the disadvantage to the Registrant should the hearing proceed in her absence. It also noted the inconvenience to the witnesses, in attendance or scheduled to attend, if the hearing were not to proceed.


8. The Panel had no reason to believe that, if it were to adjourn the hearing, Mrs Harrison would attend on the next occasion.


9. On the basis of the information before it, the Panel concluded that Mrs Harrison had deliberately absented herself and waived the right to be present. It determined that it would be fair and in the interests of justice to proceed in the absence of the Registrant.

Background 


10. The Registrant was employed by Dorset County Council (‘the Council’) within the Blandford Adult Community Mental Health Team between January 2014 and 9 July 2016. She had previously been employed since 2004 by the Council as a Support Worker.


11. In December 2015, Service User A made a verbal complaint about the Registrant behaving inappropriately, including allowing Service User A to babysit the Registrant’s children and inviting Service User A on holiday with the Registrant. 

 
12. Ms1, Integrated Community Mental Health Team Manager, was appointed as Investigating officer. Further concerns also came to light in relation to other service users. The matter was subsequently referred to the HCPC.

Decision on Facts


13. In considering the particulars, the Panel applied the principles that the burden of proving the facts is on the HCPC, that the Registrant is not required to prove anything and that a fact alleged is only to be found proven if the Panel is satisfied on the balance of probabilities that it is correct.


14. In reaching its decisions, the Panel had careful regard to all the evidence put before it and to the submissions of Mr Dite on behalf of the HCPC as well as to the written representations of the Registrant.


15. The Panel heard oral evidence from:
• Ms 1, Integrated Community Mental Health Team Manager, who led the employer’s investigation into this matter. Although her memory was at times diminished by the passage of time, the Panel found Ms 1 to be a clear, consistent and credible witness.
• Ms 2, Support Time Recovery Worker within the Blandford Community Mental Health Team. The Panel found Ms 2 to be a clear and reliable witness.
• Mr 1 who, at the times in question, was employed as a Team leader in the Blandford Adult Community Mental Health Team. The Panel found Mr 1 to be a credible witness.
• Service User B. Despite the stress of giving evidence, the Panel found Service User B to be an honest witness who gave the Panel clear, consistent and reliable evidence.
• Service user D. Despite the stress of giving evidence, the Panel found Service User D to be an honest witness who assisted the Panel with clear, consistent and reliable evidence.


16. The documentary evidence before the Panel included:
• Witness statements from Ms 1, Ms 2, Mr 1, Service User B and Service User D.
• Correspondence between the HCPC and the Registrant
• Notes of Step 2 Disciplinary Meeting on 21 March 2016
• Records of Investigatory Interviews
• Record of text messages between Service User A and the Registrant
• Case Notes of Service Users A, B and D
• Photographs  provided by Service User B
• Written representations from the Registrant


17. The Panel accepted the advice of the Legal Assessor.

Particular 1
You breached professional boundaries in relation to Service User A, in that you:                                                                                         
a) Conducted an inappropriate friendship and / or relationship with Service  User; Found Proved

18. Ms 1 referred the Panel to a series of text messages which she said had been disclosed by Service User A. Ms 1 told the Panel that these had been sent between the Registrant and Service User A in the period October to mid December 2015.  The Panel noted that the texts included references to Service User A as “hun”, “my lovely”  and “my darling”. They often concluded with an x or the word “mwah” to denote kisses. They also contained swear words. Their subject matter did not reflect a professional relationship between Social Worker and Service User. They appeared to refer more to the Registrant’s personal life than the service user’s, and appeared to show Service User A providing the Registrant with support rather than the other way around.

19. Ms 1 told the Panel that the relationship indicated by the texts was inappropriate and unacceptable. She said that by forming a friendship with Service User A, rather than a professional relationship, the Registrant had failed to provide Service User A with the care that should have been provided.

20. Ms 1 referred the Panel to the notes of a Step 2 Disciplinary Meeting she had held with the Registrant on 21 March 2016. The Panel noted that during the course of this meeting, it had apparently been put to the Registrant that she had texted Service User A from her personal phone using language and words indicative of a personal rather than professional relationship. The Registrant is reported to have admitted that she and Service User A did have a friendship, but said “it was something [Service User A] had pushed for…” The Panel noted that at the Disciplinary meeting an email from the Registrant had been read out. This stated: “I deeply regret what was a judgement lapse to make a friendship with a person, who clearly formed a dependence upon me. I am guilty of not knowing how to handle her request for a friendship in a way that wouldn’t offend. It was my awareness of this and then my sharing this with her and distancing myself personally that caused the greatest offence.”


b) Attended Service User A’s home for non-work related reasons; Found Proved.


21. The Panel did not receive evidence from Service User A. However, Ms 1 referred the Panel to the notes of an Investigatory Interview she had conducted with Service User A on 16 December 2015. Ms 1 told the Panel that the notes were an accurate record of what was said. The Panel observed that the notes had apparently been signed by Service User A on 7 April 2016, when Ms 1 conducted a second Investigatory Interview of Service User A. Due to subsequent redaction the Panel was unable to read the signature and Ms 1 was unable to identify it.  In these notes, Service User A is reported to have stated that “Emilie would come around and go on and on about her life and her kids…Emilie would also pop in on her way home from work about 6pm in the evening.” 

22. Ms 1 also referred the Panel to the unsigned notes of the Investigatory Interview she had conducted with Service User A on 7 April 2016. Ms 1 told the Panel that the notes were an accurate record of what was said. The notes indicated that Service User A “said that some weeks [the Registrant] popped in every day and other weeks not at all. [Service User A] said that when she popped in from work she would sometimes stay for a while and raid her cupboards. Sometimes [the Registrant] would pop in to [Service User A’s] house during the day too if she was early for her next visit.”

23. Ms 1 further referred the Panel to the notes of the Disciplinary Meeting she had held with the Registrant on 21 March 2016. The Panel noted that during the course of this meeting, it had apparently been put to the Registrant that she had regularly attended Service User A’s home for personal and not work reasons. The Registrant had denied the allegation. Ms 1 told the Panel that it was not permissible for the Registrant to visit Service User A for non-professional reasons.

24. The Panel recognised that only the notes of the first Investigatory Interview with Service User A had been signed. In the absence of direct testimony from Service user A, the Panel was not able to afford the reported accounts of what Service User A had said as much weight as might otherwise have been the case, and the Panel afforded the unsigned notes less weight than the signed notes. Nonetheless, the Panel was satisfied that, on the balance of probabilities, the Registrant had acted as alleged.

c) Allowed Service User A to babysit your children; Found proved.


25. Ms 1 referred the Panel to the notes of the two Investigatory Interviews she had conducted with Service user A. In the signed notes of the first interview, Service User A stated that she had looked after the Registrant’s children a few times on Thursdays and Fridays from the middle of October 2015. In the unsigned notes of the April interview, Service User A is reported to have stated that she had felt sorry for the Registrant and for her children and that the Registrant was “always whinging” about her babysitter, so in the end she had offered to look after the children. She said the Registrant had never said to her that it was inappropriate for her to look after the Registrant’s children. Ms 1 told the Panel that it would have been inappropriate for the Registrant to allow Service User A to babysit for her because it would give the impression they were friends, when in fact, the Registrant was a professional providing a professional service to Service user A.

26. Ms 1 referred the Panel to the notes of the Disciplinary Meeting she had held with the Registrant on 21 March 2016. The Panel noted that during the course of this meeting, it had apparently been put to the Registrant that, while she was at work, she had allowed Service User A to look after the Registrant’s children. The notes indicate that the Registrant had indicated that “this was something Service User A had offered and she did it twice.”

27. For the same reasons set out above, the Panel was not able to afford the reported account of Service User A the weight it might have done had it heard and accepted her account directly. However, and in light of the Registrant’s reported admission, the Panel was nevertheless satisfied, on the balance of probabilities, that the Registrant had acted as alleged.


d) In or around October 2015, invited and/or allowed Service User A to spend time with you on your holiday; Found Proved.


28. Ms 1 told the Panel that, in the course of the first Investigatory Interview of Service User A, she stated that she had gone on holiday to Weymouth with the Registrant and the Registrant’s children during a school half term break, and that they had stayed in a caravan park.

29.  Ms 1 referred the Panel to the notes of the Disciplinary Meeting she had held with the Registrant on 21 March 2016. The Panel noted that during the course of this meeting, it had apparently been put to the Registrant that she had invited Service User A to spend time with her whilst on holiday in Weymouth. The Registrant is reported to have stated that she had “told [Service User A] in the context of work that she was going on holiday to Weymouth”, and that Service User A “had invited herself and [the Registrant] felt awkward and didn’t want to offend her by saying that she couldn’t come.”

30. Ms 1 told the Panel that, for the same reasons it was inappropriate for the Registrant to allow Service User A to babysit for her, it had not been appropriate to invite or go on holiday with Service User A. Although the Panel did not receive direct evidence from Service User A, in light of the Registrant’s reported admission and the transcript of the text messages, and for the reasons set out above in respect of other allegations derived from the notes of the Investigatory Interviews with Service User A, the Panel was satisfied on the balance of probabilities that the Registrant had acted as alleged. 

e) Encouraged Service User A to take drugs; Found proved.

31. Ms 1 referred the Panel to the notes of the Investigatory Interviews referred to above, and stated that Service User A had said that during the holiday in Weymouth the Registrant had suggested that “It will be a giggle” if she and Service User A took cocaine. Service User A told Ms 1 that they did not do so, and that “she had never seen [the Registrant] with drugs but knew the signs of drug taking and knew [the Registrant] was on them.” Further, when the Registrant stayed at Service User A’s house for two nights after the holiday, she “was on a right come down.” Ms 1 also told the Panel that during the course of the December Investigatory Interview, Person A, the son of Service User A had agreed with Service User A’s assessment and had stated “I know what a person looks like when they are coming down, she looked bad and she was sniffing from one nostril.”

32. Ms 1 referred the Panel to the unsigned notes of the Disciplinary Meeting held with the Registrant on 21 March 2016. The Panel noted that during the course of this meeting, it had apparently been put to the Registrant that she had encouraged Service User A to take drugs with her. The Registrant had replied that the allegation was “absolute rubbish.”

33. For the reasons set out above in respect of other allegations derived from the notes of the Investigatory Interviews, while the Panel was unable to afford the notes the full weight it might have done had it received direct evidence from Service User A, it was satisfied on the balance of probabilities that the Registrant had acted as alleged. 

f) Contacted Service User A whilst on leave from the Council despite written instructions from management not to do so; Found Proved.

34. Ms 1 referred the Panel to a letter dated 10 December 2015 which she sent to the Registrant confirming that she had been placed on paid leave of absence. The Panel noted that the letter informed the Registrant that “under no circumstances should you make contact with any service users.”

35. Ms 1 referred the Panel to the exchange of text messages between the Registrant and Service User A. The Panel noted that on 13 December 2015 the Registrant had apparently sent Service User A a text which read: “Sorry i haven’t rung u hun.had more issues this end with things.hope u all I have a peaceful xmas.love as always x”. On 14 December 2015, a text from the Registrant said “….let me know if you need a chat” and further on “perhaps we could meet up quietly in the new year”.

36. Ms 1 referred the Panel to the notes of the Disciplinary Meeting she had held with the Registrant on 21 March 2016. The Panel noted that during the course of this meeting, it had apparently been put to the Registrant that she had contacted Service User A whilst on paid leave in spite of receiving clear written instruction from Ms 1 not to do so. The Registrant is reported to have admitted this, saying that “in her defence they had formed a friendship and she had not seen [Service user A] since 27 November 2015.” The Panel accepted this evidence.


Particular 2
Between around 1 April 2015 and 4 May 2016, you breached professional boundaries in relation to Service User B, in that you:

a) Conducted an inappropriate relationship with Service User B; Found Proved.


37. The Panel heard oral evidence by way of video link from Service User B. It also had careful regard to his sworn witness statement. The Registrant was allocated Service User B’s case in April 2015. Service User B told the Panel that in May 2015 he started receiving text messages from the Registrant asking if he had a Twitter account. The Panel was shown screen shots of the text exchange which culminated in Service User B providing the Registrant with his Twitter details. He told the Panel that they discussed the implications of their pursuing a personal relationship, but decided to do so anyway. Service User B told the Panel that their first date occurred on 27 May 2015. He said that they would usually meet once or twice a week and that the Registrant would mostly visit and stay at his house. The Registrant often discussed her own personal issues and involved Service User B with her childcare responsibilities.

38. The Panel had regard to the sworn statement to the HCPC provided by Mr 1 and to his oral evidence to the Panel. Mr 1 stated that, during a conversation with Service User B, the Service User “explained in some detail that he and [the Registrant] had been seeing each other for a while outside of the professional relationship…He said that they had agreed to go out socially and things had developed between them from that point on.” The Panel accepted the evidence of Mr 1 and Service User B.

b) Engaged in a sexual relationship with Service User B;  Found proved.

39. Mr 1 told the Panel that at a meeting with Service User B on 26 May 2016, Service User B disclosed photographs of himself and the Registrant together. Mr 1 told the Panel that he was surprised by the photos, which were clearly inappropriate, although they were not sexually explicit. Mr 1 identified the photographs before the Panel as being those which had been disclosed by Service User B. One showed Service User B and the Registrant kissing.

40. Service User B told the Panel that he and the Registrant had a sexual relationship from their first date on 27 May 2015 until the last time he saw her in February 2016. He told the Panel how the sexual relationship had started and how it had ended. Service User B said he gave the Registrant the key to his house, and would often receive text messages all day from the Registrant saying, “I need to have sex with you”. Service User B had been told by the Registrant that she was pregnant with his baby and he attended a scan in December 2015. He told the Panel the scan revealed the baby was due in August 2016. The Panel accepted his evidence.


c) Went on one or more holiday(s) with Service User B; Found Proved.


41. The Panel noted that in his sworn statement to the HCPC, Service User B stated that he and the Registrant had gone on holiday together to Bude in Devon for two days in July 2015. Service User B referred the Panel to two photographs which he said were of himself and the Registrant together on that holiday. The Panel noted that in one of the photographs they were kissing. The Panel accepted Service User B’s evidence.

d) Attended Service User B’s home for non-work related reasons; Found Proved     
       

42. Service User B gave the Panel detailed evidence in relation to occasions when he and the Registrant had met outside the clinical environment of the Milldown Unit. Further, he told the Panel that when he saw the Registrant outside of work “she would mostly come and stay at my house.” The Panel accepted Service user B’s evidence.


e) Used illegal drugs in Service User B’s home and/or in the presence of Service User B; Found Proved


43. In his sworn statement for the HCPC, Service User B stated that the Registrant had “a regular drug habit. She would take cocaine, speed and another drug but I am not familiar with the name of it. I am aware that [the Registrant] took drugs in my house. She would disappear into the bathroom or the kitchen for ten minutes as [sic] a time and she sometimes left residue of drugs behind. I cannot say how many times she took drugs, but there were more than a few instances when [the Registrant] was on a comedown from having binged on speed.”  The Panel found the charge proved on the balance of probabilities.

f) Encouraged Service User B to use illegal drugs; Found Proved

44. The Panel noted that in his sworn witness statement to the HCPC, Service User B had stated: “From an early stage in our relationship [the Registrant] encouraged me to take drugs. She never put drugs in front of me, but she would say things such as she thought that cocaine would do me the world of good. My shifts at work were quite long and [the Registrant] would say to me ‘take a bit of speed, it will help you get through the day.’ “ The Panel accepted Service User B’s evidence in this regard.


Particular 3
3. In or around December 2015, you breached professional boundaries in relation to Service User C, in that you:

a) Went Christmas shopping with Service User C; Found not proved.

45. The Panel received no evidence to support the assertion that the Registrant had breached professional boundaries in this way.

b) Stored your Christmas presents at Service User C’s house; Found proved in respect of a single Christmas present only.

46. The Panel had careful regard to the sworn statement to the HCPC provided by Ms 2 and to her oral evidence to the Panel. Ms 2 stated that on 22 December 2015 she had attended Service User C’s property with a colleague. She stated: “When we arrived at the property, Service User C handed us a bag and explained that the bag contained a large toy truck belonging to [the Registrant] that she had bought for her son while [she] and Service User C had been out shopping…Service User C did not seem to mind that [the Registrant] had stored the toy at her house and stated that [the Registrant] had told her that she wanted to hide the toy from her son until Christmas. It was not appropriate for [the Registrant] to store the toy at Service User C’s house. We are professionals providing a service to service users and this type of behaviour crosses professional boundaries.”

47. The Panel noted that, in her written representations, the Registrant had stated that she had “innocently with no agenda” accepted the Service user’s suggestion that she hide Christmas presents at the Service user’s home.

48. In her sworn statement to the HCPC, Ms 1 stated: “it would not be usual practice for a social worker to store Christmas presents at a service user’s house. This is because behaviour such as this blurs the line between what is a professional relationship and a friendship and makes it difficult to maintain professional boundaries.”


Particular 4
4. You breached professional boundaries in relation to Service User D, in that you:                       
                                                                                        
a) Conducted an inappropriate friendship and/or relationship with Service User D;  Found Proved.

49. The Panel had careful regard to the sworn statement to the HCPC provided by Service User D and to her oral evidence to the Panel. Service User D stated: “At the beginning, I would see [the Registrant] on a fortnightly basis. I would sometimes see her at the Milldown Unit, but also sometimes outside of the unit. At this time, I was not aware that it was not permitted for me to see her outside of the Milldown Unit. On the first occasion that I saw her outside of the Milldown Unit, she initiated this. [The Registrant] and I would meet in the town centre, at my house or my Mum’s house…After a while, my meetings with [the Registrant] turned into more of a friendship.”  The Panel accepted the evidence of Service User D.

50. The Panel also had regard to the sworn statement to the HCPC provided by Ms 1 and to her oral evidence to the Panel. Ms 1 stated “If [the Registrant] had been socialising with Service User D, this would be a breach of professional boundaries. As a Social Worker, [the Registrant] owed a duty of care to Service User D to act in her best interests…Service User D was not receiving the standard of care she should have been. [The Registrant] was not having the kind of therapeutic relationship with Service User D that she was supposed to have been having and this hindered Service User D’s recovery.” The Panel accepted the evidence of Ms 1.


b) Saw Service User D for non-work related reasons; Found Proved.


51. The Panel had regard to the evidence of Ms 1 as set out in the previous paragraph. The Panel also had regard to the sworn statement to the HCPC provided by Service User D and to her oral evidence to the Panel. Service User D stated: “…my meetings with [the Registrant] turned into more of a friendship. We would go for picnics, or walk around the town centre and look in the shops. We did things together that friends would normally do…We would arrange to meet every two weeks, but sometimes [the Registrant] would call me and ask me if I was free and whether I wanted to pop into town for a coffee.” Service User D also stated: “My meetings with [the Registrant] would usually start with us talking about me and how I was getting on. However, the meetings would always turn to talking about [the Registrant], her children and what was going on in her life.” Service User D told the Panel: “[The Registrant] was meant to be my Social Worker but …I felt I helped her more than she helped me.” The Panel accepted the evidence of Service User D.

c) Invited Service User D on a night out to celebrate your birthday;  Found not proved.

52. The Panel received no evidence to support the allegation that the Registrant had invited Service User D.             


d) Attended a night out with Service User D and another service user; Found Proved.

53. The Panel had regard to the sworn statement to the HCPC provided by Service User D and to her oral evidence to the Panel. Service User D stated: “On 29 August 2015, [the Registrant’s] birthday, I went on a night out with [the Registrant]…My ex-boyfriend, Person D and his brother Person C also came with us.” Service User D told the Panel that Person C was one of [the Registrant’s] other service users at the time. The Panel accepted the evidence of Service User D.


e) Used illegal drugs during a night out with Service User D and/or told Service User D that you had taken illegal drugs; Found Proved.


54. The Panel had regard to the sworn statement to the HCPC provided by Service User D and to her oral evidence to the Panel concerning the night out on the Registrant’s birthday. Service User D told the Panel that the night out began at one bar and then moved on to a second. Service User D stated that, at the second bar, “we kept losing [the Registrant]…she told me that she had taken the drug, speed. She said to me that it was really good…I did not see [the Registrant] taking drugs.” Service User D told the Panel that the Registrant said “ssh I have taken speed” and that the Registrant came out of the toilet sniffing and pressing her nose. Service User D said she made it clear to the Registrant she did not want to take drugs. The Panel accepted the evidence of Service User D.


Particular 5
5. You did not record any visits to Service User D in the case record between the following dates:

a) From around 11 December 2014 to 8 July 2015;
b) From around 10 July 2015 to 22 January 2016; Found Proved.


55. The Panel had regard to the sworn statement to the HCPC provided by Ms 1 and to her oral evidence to the Panel. Ms 1 stated “Visits to Service User D should have been on a monthly basis, as set out in her Care Plan. A record of each visit should have been recorded in the Rio system. I can confirm there is no record of visits having taken place to Service User D between 11 December 2014 and 8 July 2015. I can also confirm that there is no record of any visits taking place to Service User D between 10 July 2015 and 22 January 2016.”

56. The Panel examined the records and satisfied itself that there were no entries in relation to visits to Service User D between the dates specified. The Panel noted that there was an entry dated 22 January 2016 which stated “No contact with Service User D since July 2015 therefore discharged.” The Panel noted an email from Ms 1 dated 18 April 2016 in relation to Service User D. “Emily saw her on 9 July 2015 but there are no other entries. As she was not recording visits Service User D was discharged from the service”. The Panel also noted the evidence of Ms 1 that “it is important to have a running record of visits, so that if another professional is required to work on this case at any time, there is contemporaneous record of what is happening with that individual. These records are also important so that if there is an out of hours emergency with a service user then the crisis service can be aware of any issues or concerns recorded within the records.”

57. In her sworn statement to the HCPC and in her oral evidence to the Panel, Service User D stated that on 18 April 2016 she had visited the Milldown Unit because she had not heard from the Registrant “for a long time” and had not been invited to any more treatment sessions at the Unit. It was Service User D’s evidence that she was told at the Unit that they had sent her a number of letters and that she had been discharged from the Unit because they had no record of meetings between her and the Registrant after 9 July 2015. Service User D stated that “it became clear that the letters had been sent to my previous address. I had informed [the Registrant] that I had moved…[the Registrant] did not change my address on the system so the letters had been sent to my old address. I was not happy to be discharged by the Milldown Unit at that point as I still felt like I needed to talk to someone. I had been seeing [the Registrant] for the period that I was told I had not attended any meetings…” The Panel accepted the evidence of Service User D.


Particular 6
6. Your actions described in particulars 2a) – d) were sexually motivated; Particular 2a Found Not Proved. Particulars 2b,c and d Found Proved.

58. The Panel noted that section 78 of the Sexual Offences Act 2003 states that “…touching or any other activity is sexual if a reasonable person would consider that…because of its nature it may be sexual and because of its circumstances or the purpose of any person in relation to it (or both) it is sexual.”

59. Further, and in accordance with the guidance provided by Woolf LCJ in the case of R v Karl Anthony H [2005] EWCA Crim 732, the Panel first considered the question “do you, as reasonable people, consider that because of its nature what took place could be sexual?” In answering this question, the Panel was not concerned with the circumstances before or after what took place, or any evidence as to the purpose of any person in relation to what took place. The Panel considered that the answer in respect of each particular was yes.

60. The Panel then considered the question “Do you, as reasonable people, consider that in view of the circumstances and / or the purpose of the registrant that it was in fact sexual?” The Panel considered, on the basis of the evidence before it, that the Registrant’s actions in engaging in the sexual relationship, going on the holiday to Bude and attending Service User B’s home were in fact sexual. The Panel concluded that, outside of the sexual relationship, the Registrant had an inappropriate relationship with Service User B, including trips with her children on occasion and the emphasis the Registrant placed on her own personal issues rather than Service User B’s needs.

Decision on Grounds


61. The Panel had careful regard to the submissions of Mr Dite and accepted the advice of the Legal Assessor.

62. Mr Dite referred the Panel to the Privy Council case of Roylance v GMC (No2) [2001] 1 AC 311 in which Lord Clyde stated: “Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a …practitioner in the particular circumstances.”

63. Mr Dite submitted that the Registrant had fallen seriously below the standards expected of a Social Worker set out in the 2012 edition of the HCPC Standards of Conduct, Performance and Ethics, in particular Standards 1, 3, 10 and 13.

64. The Panel bore in mind that not every breach of the Standards and not every falling short of what would be proper in the circumstances will constitute misconduct; the breach must be serious, or as Elias LJ put it in R (on the Application of Remedy UK Ltd) v GMC [2010] EWHC 1245 (Admin) “sufficiently serious.... that it can properly be described as misconduct going to fitness to practise.”

65. The Panel found that The Registrant was in clear breach of the following Standards of the HCPC’s Standards of Conduct, Performance and Ethics:
“ 1 - You must act in the best interests of service users.
 3 - You must keep high standards of personal conduct.
 10 - You must keep accurate records.
 13 - You must behave with honesty and integrity and make sure that  your behaviour does not damage the public’s confidence in you and  your profession.”


66. The Panel considered that the Registrant’s breaching of professional boundaries in respect of Service Users A, B, C and D, breached the trust placed in her by society and by her colleagues and service users. It exposed vulnerable service users to unwarranted risk of harm and undermined public confidence in Social Workers, Community Mental Health Teams in general and the Blandford Adult Community Mental Health Team in particular.

67. The Panel recognised that, viewed in isolation, the Registrant’s breach of professional boundaries in storing a Christmas present at Service User C’s house, might not be sufficiently serious to raise the issue of fitness to practise. However, this was but one of a catalogue of breaches involving four vulnerable service users which demonstrated serious fallings short of the standards to be expected of a Registered Social Worker.

68. In respect of Service User B, the seriousness of the breaches was exacerbated by the Registrant’s sexually motivated actions and the impact of this conduct on Service User B. In respect of Service User D, the seriousness was exacerbated by the Registrant not recording visits to Service User D which resulted in the Service User being discharged from the Unit when she was still in need of the Unit’s services. In addition, the matters found proved in relation to illegal drugs, particularly encouraging vulnerable service users to take drugs, further exacerbated the seriousness of the Registrant’s failings in respect of Service Users A, B and D. In all the circumstances, the Panel had no doubt that the fallings short in relation to the matters found proved in Particulars 1 - 6 are so serious as to amount to misconduct going to fitness to practise.

69. The Panel noted that Mr Dite had also submitted that the matters found proved in relation to Particular 5 amounted to lack of competence. He submitted that the Registrant had fallen seriously below the standards expected of a Social Worker set out in the 2012 edition of the HCPC Standards of Proficiency for Social Workers.

70. The Panel also noted the guidance provided in the case of Calhaem v GMC that lack of competence “connotes a standard of professional performance which is unacceptably low and which, save in exceptional circumstances, has been demonstrated by reference to a fair sample of the [Registrant’s] work.” The Panel did not consider that the matters set out in Particular 5 represented a fair sample of the Registrant’s work. Further, it considered that they did not indicate that the Registrant was not capable of performing to the correct standard but rather that she was unwilling to do so. For these reasons, the Panel concluded that the matters found proved in Particular 5 do not constitute lack of competence.

Decision on Impairment


71. The Panel then went on to consider whether the Registrant’s fitness to practise is impaired by reason of her misconduct. It had careful regard to all the evidence before it and to the submissions of Mr Dite as well as The Registrant’s written representations. It accepted the advice of the Legal Assessor and had particular regard to the HCPC’s Practice Note on Impairment.

72. Having found that the Registrant’s misconduct had put vulnerable service users at unwarranted risk of harm, had brought the profession into disrepute and had breached key standards of the HCPC’s Standards of Conduct, Performance and Ethics as set out above, the Panel had no doubt that the Registrant’s fitness to practise had been impaired by reason of her misconduct.

73. The Panel then went on to consider whether the Registrant’s fitness to practise is currently impaired by reason of her misconduct. In addressing the personal component of impairment, the Panel asked itself whether the Registrant is liable, now and in the future, to repeat misconduct of the kind found proved. In reaching its decision, the Panel had particular regard to the issues of insight and remediation.

74. The Panel noted some remorse had been expressed by the Registrant at her Disciplinary Meeting in respect of her actions with regard to Service User A. It also noted her written representations in which she stated “I feel a huge amount of regret for any hurt or damage I have cause. [sic]” The Panel had careful regard to the Registrant’s written representations concerning the difficulties she states she was experiencing in her private life at the times in question. However, the Panel did not consider that such difficulties could excuse her deliberate breaching of professional boundaries in respect of four vulnerable service users.

75. The Panel was particularly concerned that the Registrant does not appear to understand why it was unacceptable for her to breach professional boundaries in the ways she did, nor does she seem to have any meaningful understanding of the impact such breaches could have had on vulnerable service users. This is illustrated in her written representations when the Registrant sought to justify:
a) giving her personal telephone number to Service User D, stating that    it was her right to give the number to whom she pleased;
b) celebrating her birthday with Service User D at bars in town, stating  that by that time she no longer viewed Service User D as a patient.

75. While, in the Panel’s view, the Registrant has demonstrated minimal insight into her failings and no meaningful reflection, it did note in her written representations her statement that “…I hope at some stage i can start rebuilding my sense of who i am. i need to [sic] time to recover, reflect and review my life and i see in hindsight this is exactly what i should of done last year but to a greater extent.”

76. The Panel considered that the Registrant’s misconduct was demonstrative of entrenched attitudinal problems which would make remediation difficult. It had received no evidence of any steps taken by the Registrant to remediate her misconduct in breaching professional boundaries with highly vulnerable service users. In light of its findings in relation to insight, the Panel considered that there is currently a high risk that the Registrant would repeat matters of the kind found proved.

77. For all these reasons, the Panel determined that a finding of impairment is required on the ground of public protection.

78. The Panel then went on to consider whether a finding of impairment is necessary on public interest grounds.  In addressing this component of impairment, the Panel had careful regard to the critically important public issues identified by Silber J in the case of Cohen when he said:
 “Any approach to the issue of whether .... fitness to practise should be regarded as ‘impaired’ must take account of ‘the need to protect the individual patient, and the collective need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour.”

79. The Panel considered that maintaining professional boundaries is a fundamental requirement of the profession of Social Work and that the public would be concerned to learn of these breaches in respect of vulnerable service users by a Registered Social Worker. The Panel had no doubt that the need to maintain public confidence in the profession, and to declare and uphold proper standards, would be undermined if a finding of impairment of fitness to practise were not made in the circumstances of this case. 

80. For all the reasons set out above, the Panel determined that the Registrant’s fitness to practise is currently impaired, both on the grounds of public protection and in the public interest. 

Decision on Sanction


81. The Panel next considered what, if any, sanction to impose on the Registrant’s registration.

82. Mr Dite drew the Panel’s attention to the HCPC’s Indicative Sanctions Policy and submitted that the question of sanction is a matter for the Panel’s own independent judgment.

83. In reaching its decision the Panel had at the forefront of its thinking the principle of proportionality and the need to balance the interests of the Registrant with the protection of the public and the wider public interest in maintaining confidence in the profession and the HCPC, and declaring and upholding proper standards of conduct and performance.

84. In reaching its decision, the Panel had regard to all the circumstances, including the following mitigating and aggravating features of the case:


Mitigating -
• The Registrant’s written representations made reference to a range of difficulties in her private life at the times in question which had the potential to impact negatively on her judgment;

• The Registrant’s written representations made reference to a range of serious health issues at the times in question, although the Panel received no formal medical evidence in corroboration.


Aggravating -
• The misconduct was in relation to multiple vulnerable service users with whom the Registrant deliberately breached professional boundaries over an extended period of time;

• The misconduct put vulnerable service users at unwarranted risk of harm, and the Panel received evidence of the impact of the misconduct on individual service users which ranged from a service user being discharged before she considered herself ready, distrust of the service and its providers and, in one case, attempted suicide;

• The misconduct was at the higher end of the scale of seriousness and involved sexually motivated actions towards one service user and encouraging the use of illegal drugs in respect of three service users;

• The misconduct involved an abuse of the trust placed in the Registrant by the public, colleagues and the individual service users concerned;

• The misconduct involved exploitation of service users for the Registrant’s own benefit, in the form of free baby-sitting and in the form of emotional support which resulted in some service users stating that they felt they were providing the Registrant with support when it was her role to provide them with support;

• The misconduct demonstrated entrenched attitudinal problems on the part of the Registrant.

85. The Panel first considered whether it would be appropriate to impose no sanction in this case. It gave careful consideration to Paragraph 8 of the Indicative Sanctions Policy. The Panel determined that in light of its findings that the Registrant has demonstrated minimal insight and no remediation and that there remains a high risk of repetition, the imposition of no sanction would neither protect the public nor serve the wider public interest in maintaining confidence and declaring and upholding proper standards.

86. The Panel next considered the imposition of a Caution Order. It gave careful consideration to the factors set out in the Indicative Sanctions Policy. The Panel considered that the risk of repetition is high, the Registrant has demonstrated minimal insight and no remediation, and the misconduct was neither isolated nor minor in nature. For these reasons, the Panel determined that a Caution Order would be inappropriate as it would neither protect the public nor be sufficient to mark the wider public interest.

87. The Panel then considered the imposition of a Conditions of Practice Order. It gave careful consideration to Paragraphs 30 - 38 of the Indicative Sanctions Policy. In considering the suitability of a Conditions of Practice Order, the Panel noted that the Registrant’s engagement with this process has been minimal, that she has demonstrated attitudinal problems, minimal insight and has made no formal admissions. Overall, her failings are at the high end of seriousness; they occurred over a sustained period of time, involved several vulnerable service users, deliberate breach of trust, illegal drugs and in one case, sexually motivated misconduct. In the panel’s view they demonstrate attitudinal problems which are unlikely to be remediated through conditions. The Panel found itself unable to formulate workable conditions which would sufficiently protect the public and adequately address the wider public interest concerns.

88. The Panel went on to consider the imposition of a Suspension Order. It gave careful consideration to Paragraphs 39-45 of the Indicative Sanctions Policy. Such an order would, in the short term, protect the public while providing the Registrant with an opportunity to reflect on her failings and take steps to address her personal difficulties. However, in light of her entrenched attitudinal problems, the Panel had no confidence that the Registrant would avail herself of such an opportunity and considered that the seriousness of the misconduct in this case is such that a period of suspension would be insufficient to adequately address the public interest in this matter.

89. The Panel recognised that a Striking-off Order is a sanction of last resort for serious, deliberate or reckless acts involving abuse of trust. It considered that each of these elements is present in this case and that the nature and gravity of the Registrant’s misconduct is such that any lesser sanction would undermine confidence in the Social Work profession and in the regulatory process. In the Panel’s view, informed members of the public would be appalled if a Registered Social Worker who had deliberately breached professional boundaries with vulnerable service users over a sustained period of time, had encouraged such service users to take illegal drugs and had engaged in a lengthy sexual relationship with one of those service users, was permitted to retain her membership of the profession.

90. For all these reasons the Panel decided that a striking-off order is the only appropriate and proportionate sanction in this case.

 

Order

ORDER: The Registrar is directed to strike the name of Mrs Emily Harrison from the Register.

Notes

 

Hearing history

History of Hearings for Emily Harrison

Date Panel Hearing type Outcomes / Status
22/01/2018 Conduct and Competence Committee Final Hearing Struck off
13/02/2017 Conduct and Competence Committee Interim Order Review Interim Suspension