Investigating Committee Interim Order Review Hearing 26 October 2016 Nursing and Midwifery Council, 61 Aldwych, London WC2B 4AE Name of registrant: NMC Pin: Mrs Elizabeth West 01A1151O Part(s) of the register: Registered Nurse Sub Part 1 Adult Nurse January 2001 Area of registered address: England Panel members: Legal Assessor: Panel Secretary: Nursing and Midwifery Council: Mrs West: Nina Wrightson (Chair, lay member) Satya Schofield (Lay member) Jane Bryant (Registrant member) Graeme Sampson Patrick Browne Represented by Ayesha Omar, Case Presenter, instructed by NMC Regulatory Legal Team Present and represented by Nasreen Anderson, instructed by the Royal College of Nursing Interim Order to be reviewed: Outcome of Review: Interim conditions of practice order Current interim conditions of practice order replaced with an interim suspension order Page 1 of 6
Decision on Interim Order: The panel decided to replace the current interim conditions of practice order with an interim suspension order. This is the second review of an interim conditions of practice order imposed on 25 January 2016. The panel considered the documentation before it. It heard submissions from Ms Omar on behalf of the NMC and Ms Anderson, on your behalf. The panel accepted the advice of the legal assessor and took account of the guidance issued by the NMC to panels considering interim orders and the appropriate test as set out at Article 31 of The Nursing and Midwifery Order 2001. It may only continue an interim order if it is satisfied that it is necessary for the protection of the public, is otherwise in the public interest or is in your own interest. The panel was mindful that its role was to undertake a risk assessment based on the information before it, and not to determine the facts of the case. At the time of the initial allegations you were the registered home manager of the Birdsgrove Nursing Home (the Home). The Home cared for 87 service users and the majority of the residents were elderly and vulnerable. The Care Quality Commission (CQC) cancelled your registration as a registered manager, after it had investigated and audited the Home. You were then dismissed by the Home on 9 July 2015, due to numerous allegations, including the following: 1. You failed to maintain the safety and well-being of the people living in the Home, as identified in the CQC report. 2. You had a duty of care for the people living in the Home and failed to provide for their safety and well-being. 3. You failed to comply with enforcement action which had previously been required. Page 2 of 6
4. The oversight of care and treatment given to service users was inappropriate and failed to meet their needs or reflect their preferences. 5. You failed to ensure that there were appropriate systems in place to ensure the quality of the service was regularly monitored and assessed. After your dismissal you commenced employment with Forest Care at Holly Lodge, in September 2015 as the Head of Care. It is alleged that you were dismissed from this role about three months later due to concerns regarding your performance, the mismanagement of staff, the staff rota, increased use of agency staff unnecessarily, concerns regarding tissue viability, concerns regarding your assessment of a patient s pressure sore, not following the policy on mandatory training and a lack of communication. Ms Omar referred the panel to the first panel s decision and their reasoning in imposing an interim conditions of practice order. She reminded the panel that the first panel noted that the allegations were in regards to your managerial ability. Ms Omar informed the panel that you are currently working as a registered nurse at The Grange Retirement Home and that they are aware of the interim conditions of practice order and that you are working subject to those conditions. She also referred the panel to the positive reference from the Home Manager at The Grange Retirement Home dated 20 July 2016. [PRIVATE]. Ms Omar submitted that an interim order remained necessary on the grounds of public protection and in the public interest. She invited it to escalate the interim conditions of practice order to an interim suspension order [PRIVATE]. Ms Anderson, on your behalf, informed the panel that she did not seek to undermine the current interim conditions of practice order conditions. She submitted that the current Page 3 of 6
conditions of practice should be confirmed and continued as they cover the fears any member of the public would have regarding your practice. [PRIVATE]. Ms Anderson brought the panel s attention to a number of positive testimonials regarding your practice that had been submitted to a previous panel. Ms Anderson also informed the panel of the remedial action you have taken since the last hearing. In particular you have undertaken training in relation to wound management and patient care. This panel was not bound by the decisions of the previous panel on 25 July 2016. Accordingly, the panel concluded that due to the seriousness of the allegations an interim order remained appropriate and proportionate on the grounds of public protection and the panel also formed the view that an interim order is otherwise in the public interest to protect the reputation of the professions and to declare and uphold proper standards of conduct. In all the circumstances the panel has concluded, on the basis of the information before it, that there remains a real risk of significant harm to the public and a risk of repetition. The panel had regard to the new information before it. [PRIVATE]. There are also other serious issues regarding your practice including: two separate employer s concerns which resulted in your dismissal; CQC concerns that had removed you as a registered manager after you failed to act on CQC recommendations and [PRIVATE]. The panel next considered whether an interim conditions of practice order remains the appropriate and proportionate response in this case. The panel was of the view that the current interim conditions of practice order does not sufficiently protect the public and concluded that, given the circumstances of this case, an interim suspension order was the appropriate and proportionate interim order and therefore decided to replace the current interim conditions of practice order with an interim suspension order. Page 4 of 6
The panel was also of the view that the public interest dictated that an interim suspension order is appropriate. This was having regard to the nature and seriousness of the allegations and their consequences. The panel was of the view that the confidence of members of the public in the professions and the NMC as a regulator would be seriously damaged if you were allowed to practise whilst awaiting the outcome of this case. The panel considered the potential financial hardship to you of imposing an interim suspension order. However, the panel considered that the public interest and the requirements of public safety in this regard outweighed your interest. In all the circumstances, the panel determined that an interim suspension order is the proportionate response. Unless there has been a material change of circumstances, the panel will review the interim suspension order at an administrative meeting within the next three months. The panel will be invited by the NMC to confirm the interim order at this meeting and you will be notified of the panel s decision in writing following that meeting. Alternatively, you are entitled to have the interim suspension order reviewed at a hearing. This means that you will be able to attend and make representations, send a representative on your behalf or submit written representations about whether the interim order continues to be necessary. You must inform your case officer if you would like the interim suspension order to be reviewed at a hearing. Even if you do not request a hearing, where there has been a material change of circumstances that might mean that the interim order should be revoked or replaced, the panel will review the interim order at a hearing to which you will be invited to attend. You should notify the NMC immediately of any material change of circumstances that may affect the interim order. Page 5 of 6
At any time, you or the NMC may ask for the interim order to be reviewed by a panel if any relevant new information becomes available. This decision will be confirmed to you in writing. The NMC Case Examiners are yet to decide whether there is a case to answer in relation to the allegation made against you. The NMC will write to you when the case is ready for the next stage of the fitness to practise process. That concludes this determination. Page 6 of 6