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	England and Wales High Court (Administrative Court) Decisions
You are here: BAILII >> Databases >> England and Wales High Court (Administrative Court) Decisions >> Redmond v Health and Care Professions Council [2016] EWHC 2490 (Admin) (12 October 2016) URL: http://www.bailii.org/ew/cases/EWHC/Admin/2016/2490.html Cite as: [2016] EWHC 2490 (Admin)

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IN THE HIGH COURT OF JUSTICE
QUEEN'S BENCH DIVISION
ADMINISTRATIVE COURT

		Birmingham Civil Justice Centre Bull St Birmingham B4 6DS
		12/10/2016

HHJ David Cooke :

Introduction

1. Ms Redmond, who is a registered social worker, appeals against the decision of a panel of the Conduct and Competence Committee ("the Panel") of the Health and Care Professions Council made on 9 March 2016 finding that her fitness to practise was impaired and imposing a sanction of 9 months suspension of her registration, subject to review.
2. Ms Redmond had been employed between 2009 and 2012 by Nottingham City Council as a case manager in its Youth Offending Team. A key part of her duties was to carry out assessments of young offenders and prepare reports in relation to them. National standards then in force (the National Standards for Youth Justice Services) required, for instance that "risk of serious harm assessments" be prepared within five days of the need for such an assessment arising, and that core assessments be prepared within 10 working days of a young offender receiving a court order. She was also required to prepare pre-sentence reports as might be required by court order.
3. The thrust of the complaint by her employer that led to the reference to the Panel was that Ms Redmond had persistently failed over a period of some years to produce reports and assessments in accordance with these standards, despite implementation by management of various systems for intensive support, monitoring and supervision of her work. She was dismissed from her employment, following a disciplinary hearing, in June 2012.
4. The Panel concluded that most of the factual allegations against Ms Redmond were made out and that her failure to produce assessments and reports in a timely manner was as a result of deliberate choice by her as to her method of work, which she was not willing to change despite the management interventions and support provided. She regarded such paperwork as inherently less important than other aspects of her work, such as face to face meetings and work with the young offenders concerned. At paragraphs 58 and 59 of its determination, the Panel said:

"58. … The Registrant [i.e. Ms Redmond] had the knowledge, experience and skill necessary in order to manage an average caseload and her time effectively. The Registrant knew the importance of her public protection work. The Registrant failed to manage her time effectively and failed to undertake key parts of her role through choice rather than through shortcomings in her knowledge or skill… The Registrant's philosophy of intervention and quality being prioritised over the timeliness of assessments and the effective management of her practice was unacceptable. The Panel found the Registrant was not willing to change this philosophy despite it being demonstrated to her that assessments needed to be prioritised when there were restricted timescales imposed by National Standards. The need to prioritise assessments [was] specifically highlighted for the Registrant. Despite this she chose not to do so, resulting in significant delays in the completion of assessments. The Panel felt that the Registrant did not implement the training that she had been given on techniques on how to effectively manage her time and practice. She did not use supervision effectively and did not manage her practice properly.

59. Despite an unremarkable caseload and lengthy capability procedures, there was no sustained improvement. The Registrant chose to revert back to not prioritising the assessments that she was required to undertake. It was clear that the Registrant did not at the time reflect on her failings but chose to continue to work in her own entrenched way without taking account of the need to evolve her practice. Therefore the failures to bring about any change were deliberate "

5. In her Grounds for Appeal, amplified in her skeleton argument and as pursued at the hearing, Ms Redmond contends in summary that the Panel had no proper basis to reach the factual conclusions on the evidence presented to it, and that the sanction imposed was excessive.
6. The appeal is brought pursuant to article 38 of the Health and Social Work Professions Order 2001. It is a statutory appeal, governed by the relevant provisions of part 52 of the CPR, and by PD52D. It proceeds on a similar basis to appeals from the equivalent decision-making bodies of the General Medical Council, and authorities relating to those proceedings are therefore directly relevant.
7. CPR52.11 provides that the appeal should be allowed if the court determines that the decision of the Panel was wrong, or that it was unjust by virtue of a serious procedural or other irregularity in its proceedings. Paragraph 19(2) of that Practice Direction provides that the appeal is by way of rehearing, and that the court may order that oral evidence will be given. It is however exceptional to direct oral evidence (no such direction has been given in this case) and in the absence of such an order the appeal proceeds on the basis of the transcript of the hearing below. This means that the court will be very slow to depart from conclusions of fact reached by the Panel, particularly where these are reached as a result of evaluation of the credibility of witness evidence. In Southall v General Medical Council [2010] EWCA Civ 407 Leveson LJ, dealing with the submission that a particularly serious finding of fact was not warranted by the evidence, said as follows:

"47 How is this submission to be approached? First, as a matter of general law, it is very well established that findings of primary fact, particularly if founded upon an assessment of the credibility of witnesses, are virtually unassailable (see Benmax v Austin Motor Co Ltd [1955] AC 370); more recently, the test has been put that an appellant must establish that the fact-finder was plainly wrong (per Stuart-Smith LJ in National Justice Cia Naviera SA v Prudential Assurance Co Ltd (The Ikarian Reefer) [1995] 1 Lloyd's Rep 455 at 458). Further, the court should only reverse a finding on the facts if it "can be shown that the findings … were sufficiently out of tune with the evidence to indicate with reasonable certainty that the evidence had been misread" (per Lord Hailsham of St Marylebone LC in Libman v General Medical Council [1972] AC 217 at 221F more recently confirmed in R(Campbell) v General Medical Council [2005] 1 WLR 3488 at [23] per Judge LJ). Finally, in Gupta v General Medical Council [2002] 1 WLR 1691, Lord Rodger put the matter in this way (at [10] page 1697D):

"In all such cases the appeal court readily acknowledges that the first instance body enjoys an advantage which the appeal court does not have, precisely because that body is in a better position to judge the credibility and reliability of the evidence given by the witnesses. In some appeals that advantage may not be significant since the witnesses' credibility and reliability are not in issue. But in many cases the advantage is very significant and the appeal court recognises that it should accordingly be slow to interfere with the decisions on matters of fact taken by the first instance body. This reluctance to interfere is not due to any lack of jurisdiction to do so. Rather, in exercising its full jurisdiction, the appeal court acknowledges that, if the first instance body has observed the witnesses and weighed their evidence, its decision on such matters is more likely to be correct than any decision of a court which cannot deploy those factors when assessing the position. ." "

8. Further, the court will give due deference to, though not be bound by, the judgment of the professional panel as to the standards required of the profession, whether the facts found show that the conduct of a medical professional fell below those standards and if so what is the appropriate sanction. In Raschid v General Medical Council [2007] 1 WLR 1460 Laws LJ said:

"19. ….the fact that a principal purpose of the panel's jurisdiction in relation to sanctions is the preservation and maintenance of public confidence in the profession rather than the administration of retributive justice, particular force is given to the need to accord special respect to the judgment of the professional decision-making body in the shape of the panel. That I think is reflected in the last citation I need give. It consists in Lord Millett's observations in Ghosh v General Medical Council [2001] 1 WLR 1915, 1923, para 34:

"the Board will afford an appropriate measure of respect to the judgment of the committee whether the practitioner's failings amount to serious professional misconduct and on the measures necessary to maintain professional standards and provide adequate protection to the public. But the Board will not defer to the committee's judgment more than is warranted by the circumstances."

20. These strands in the learning then, as it seems to me, constitute the essential approach to be applied by the High Court on a section 40 appeal. The approach they commend does not emasculate the High Court's role in section 40 appeals: the High Court will correct material errors of fact and of course of law and it will exercise a judgment, though distinctly and firmly a secondary judgment, as to the application of the principles to the facts of the case"

The grounds of appeal

Ground 1(a): The allegations and amendments to them

9. Ms Redmond originally alleged that the description of her employment in the allegations was changed from "Social Worker" to "Social Worker employed as a Case Manager/Court Officer" and that this was done "to fit with the evidence" and raised doubt about whether the charges should have been brought. She withdrew this allegation however before the hearing (letter of 15 August 2016, bundle p1). It was plainly unsustainable since it appears from the decision (see paragraphs 21 to 23) that the amendment was made in response to her own description of her role and was accepted by her at the time.
10. The statement of allegations was amended at the hearing in a much more radical way, recasting general allegations and allegations that did not refer to identifiable cases into three categories:

i) That Ms Redmond had not completed assessments in a timely manner and/or maintained adequate documentation in respect of 17 service users, each identified by a number. The Panel found that this allegation proved in respect of 13 service users, but not proved in respect of the other four.

ii) That Ms Redmond had failed to file an intensive supervision and surveillance assessment in respect of service user 5 in preparation for a court hearing in November 2011. The Panel found this proved.

iii) That Ms Redmond was unable to practise autonomously in that she did not manage her caseload without the frequent intervention of managers. The Panel found this proved.

There was no objection made to these changes, which in my view clearly had the desirable effect of focusing the allegations that Ms Redmond had to meet.

Challenges to conclusions on the evidence

11. I group under this heading three of Ms Redmond's grounds:

i) Ground 1(b): Allegation 2 was accepted as proved although it had been described as "not fully tested"

ii) Ground 2(a): The decision was unjust because it was "contrary to the evidence provided by the respondent's two witnesses, particularly allegations 1 and 2", and

iii) Ground 2 (b): "Further evidence is available to reinforce evidence already provided by the appellant". In fact, no such further evidence was referred to at the hearing, and no application was made to rely on further evidence.

12. The Panel hearing took place over four days between 1 and 4 December 2015, and a further two days on 8 and 9 March 2016. Ms Redmond gave evidence herself. There were two witnesses called in support of the allegations; Ms Redmond's Team Manager, referred to by the initials PA, and SN, who held the title Service Manager and was PA's line manager. Ms Redmond did not attend on the first day of the hearing, by her own deliberate choice. She did attend on the second day, but left whilst the other witnesses gave evidence. She said she did not wish to be present while this happened, and accepted that it meant she would not be able to ask any questions of those witnesses. In her absence, the Presenting Officer and panel members put questions to the witnesses dealing with those points that Ms Redmond had taken in her written submissions. She attended again on the third day to give her own evidence and answer questions from the panel. She did not attend in person on the fourth day, but was present by telephone. She was also present by telephone on 9 March 2016.
13. It is unfortunate that I do not have in the bundle the witness statements provided by these witnesses to the Panel, which were adopted as their evidence in chief. I must bear in mind that their answers to questions are not the whole of their evidence on the relevant points, and that if they seem to be incomplete or not comprehensive, it may well be because they were only amplifying their written evidence in response to specific points put to them. Ms Redmond did not refer me to any material from the original witness statements in support of her case.
14. Allegation 2 related to a pre-sentence report in respect of Service User 5, who was due in court on 23 November 2011. The decision (paragraph 53ff) records that the report was due the previous day. It appears from the evidence that the report should have been submitted on the day before the court hearing to the authority's court team, whose job it was to ensure that it was complete before delivery to the court, which had to be done by 9:30 am on the day of the scheduled court appearance. On 22 November the court section contacted SN (it appears that Ms Redmond's immediate superior PA was not available) and said that the report was not complete because it did not include an Intensive Supervision and Surveillance (ISS) assessment. SN gave evidence that this was an assessment of whether a particular offender would be suitable for, and comply with, a programme of intensive supervision and surveillance as an alternative to custody. She said that Ms Redmond was responsible for preparing the pre-sentence report and that she had asked Ms Redmond to prepare an addendum report dealing with the ISS element. That was not done in time to enable the report to be submitted to the court, although it appears that it was completed, or mostly completed, later in the day on 23 November, with the result that there was some hold up to the hearing but it proceeded after a delay of some four hours.
15. Ms Redmond's written submission to the Panel had said that she denied this allegation "as I was not responsible for completing the intensive supervision and surveillance report." SN gave evidence that although there was a specialist ISS team that could support Ms Redmond in dealing with that aspect, it was her responsibility to coordinate the report and obtain any necessary information and input from the specialist team in order that the court report could be submitted on time. She said (bundle page 234) "… Her responsibility was to actually talk to the ISS team, tell them what she wanted and get the information and my recollection, I do not recall it absolutely clearly, but that information was not there and therefore the onus was on her to get it. There was no suggestion that the ISS team had not completed something that had been asked of them".
16. PA's evidence (p338) was that he recalled the episode, and that it would not have become the issue it had been at the time if it had not been regarded as Ms Redmond's responsibility to ensure the ISS report was done. He could not recall Ms Redmond having raised with him in supervision that she was not the person responsible. Given the intensive supervision regime then in place, there would clearly have been the opportunity to do so.
17. Ms Redmond's case to the Panel was that the ISS assessment was a separate report, and that she was not responsible for the failure to file it in good time. Her own evidence (bundle page 178-9) was that she had been waiting for this report from the ISS team, had been chasing it for a week, and the failure to provide it was "communication between the two managers that was holding up the process".
18. In relation to this, the Panel's decision was:

"The Panel found that the Registrant was responsible for collating and submitting the report. The Registrant was entitled to rely on support and input from specialist teams… The Registrant appeared to suggest that there were two reports but the Panel preferred SN's evidence that there was one report with input from others. SN was clear that she had made a direct request to the Registrant for an addendum report. The Registrant did not accept that she was responsible for the late filing of the report as she needed the managers of both teams to agree a recommendation before she could proceed. However this was inconsistent with the evidence that the Registrant was able to prepare a significant part of the report, which she then lost, within 30 minutes on the day of the hearing. The panel preferred SN's account which was fully tested in live evidence on these points. SN was an eyewitness to the events as she was in court on the day. She was the Registrant's manager and had a detailed understanding of the situation. The Registrant's account was not fully put to SN and was therefore partially untested. "

19. Ms Redmond's complaint in this respect seems to me to be misconceived. The Panel did not accept an allegation despite finding that it had not been "fully tested"; the decision makes clear that they accepted SN's evidence, which they regarded as having been fully tested by putting to SN Ms Redmond's submissions made in writing, and that it was Ms Redmond's oral evidence subsequently given which was "partially untested" in that she had chosen not to attend to put that version of events to SN.
20. I bear in mind also that in assessing the relative credibility of these two accounts the Panel is to be regarded as a specialist tribunal with its own knowledge and experience of which of them is more likely to be accurate. The Panel was in my judgment fully entitled to prefer the evidence of SN when she said, in terms, that there had been no suggestion at the time that Ms Redmond's failure to complete the ISS assessment requested of her was because she was awaiting something from the ISS team. I would not disturb its finding, which is one of primary fact, and therefore reject this ground.
21. Ground 2(a) is remarkable in that it is Ms Redmond's pleaded case that the findings in relation to the principal factual allegations were contrary to the evidence of the witnesses called against her. In her oral submissions however to a large extent Ms Redmond's argument was that the decision was contrary to her own evidence, which she felt should have been accepted.
22. In this respect she referred to a document she had prepared in 2012 in response to a "Capability Concerns Report" (p375) in which she said she had been told by a trainer allocated to assist her that there were "few concerns" with her work. It is plain from that document however that she was aware that there were substantial concerns held by others, and indeed the trainer had been appointed to assist her precisely because of those concerns. She said in that document that she had asked for management support and complained that her induction was insufficient by comparison with students. Her principal position in that document appears to have been that she had been unable to deal with her cases because of anxieties generated by the "micro management" that was intended to support her.
23. Ms Redmond argued, as she had in her written submissions to the Panel (p354) that her caseload was excessive, and consisted disproportionately of Referral Orders, which required more intensive work on her part. Despite that, she said, and contrary to the findings of the Panel, she was handling a caseload at least on a par with her colleagues and, allowing for the fact she worked part time (90%), arguably greater. She referred to a table of cases held, month by month, by each worker in the team (p353) which she said had been prepared for Employment Tribunal proceedings. That shows, broadly, that other practitioners were managing 11 or 12 cases. Ms Redmond's case load builds up from her appointment in September 2009 to a point by August 2011 where she is shown as having 11 cases, matching the average in that month for the others. In fact, according to that table, she held 11 cases in only 3 months and from November 2011 her caseload fell in the range 8-10 compared with the average of 11-12.
24. Ms Redmond disputed the figures in this table and had inserted her own in manuscript, which she said were accurate. These would have brought her up to 11 cases in 3 other months, and up to 16 in Oct 2011. She relied also on a list of cases referred to her in June to November 2011, with her own assessments of the difficulties they presented (p352). She said she had made reference to the stress caused by having difficult cases in a document prepared by her as part of a "Stress Action Plan" (p389).
25. PA's evidence as Ms Redmond's manager was that her caseload had built up over time, that he began to have concerns about her performance in 2010 and that his supervision showed a clear difference between Ms Redmond and other team members in terms of delay in completing work and the number of documents missing that she should have prepared. He refers to his having agreed with another manager that the backlog was "overwhelming". He was taken through the specific allegations in relation to individual service users and the reports and assessments that were overdue in their cases. He was shown the caseload report (p329) though he was not clear (p336) who had made the manuscript amendments to it. Ms Redmond's point that it showed she was working an average caseload was put to him. The figures in it he said had to be treated with caution; a case might be included in the figures as outstanding even if it should have been concluded by that time if it had been properly dealt with. He could not say immediately whether this affected the figures shown for Ms Redmond, but commented that "most of Janet's paperwork was generally running behind".
26. His concerns about Ms Redmond were not that she lacked knowledge or skill, but with the lack of speed and efficiency in her work, and particularly the lack of documentation which meant that her cases could not easily be handed over or dealt with by others if she as absent.
27. In relation to the level of supervision he said (p329) he could not take the risk that without that level of intervention things would not get better. Ms Redmond had been provided with all the professional support she had requested (p333). He said (p334) that her caseload had reflected her part time hours, there were other part time team members and all had a mix of cases. He did not regard Ms Redmond's caseload as excessive (p341) though he did accept that the figure she had given, that 12 of her 16 cases were Referral Orders, as being very high. I do not read this as accepting the accuracy of Ms Redmond's figure.
28. SN said that induction for new team members was based on their previous experience and part of it involved learning on the job with other team members. The team Ms Redmond had joined was not overburdened at the time and she was confident the induction was adequate (p 225). Ms Redmond had said she was happy with it at the time and had the opportunity to raise any concerns later. She did accept that it could have been improved, but said that this would not have made any substantive difference in Ms Redmond's performance. Two other social workers, who were newly qualified whereas Ms Redmond had considerable past experience, had a similar induction but they both were more quickly and more effectively able to manage their caseloads than she had been (p 226).
29. Ms Redmond's contention that she had been given an excessive workload was put to her, and SN said that she had looked at the work allocated to Ms Redmond and discussed the concerns about her with PA. SN "did not feel at any point that she had an excessive workload. There were times when it was high, but I felt there were things in place to try and support her with that." The periods of high workload had affected all team members and not just Ms Redmond. Other team members had complained to her on a number of occasions "that her workload seemed not to rise at the same rate as theirs when the pressure was higher".
30. The caseload table relied on by Ms Redmond was also put to SN (p 241). She also said that the fact that Ms Redmond was working part-time had been taken into account, and that one other member of the team had additional responsibilities and yet was able to manage a caseload as high as anyone else's.
31. SN was also asked whether the deficiencies in Ms Redmond's performance had caused any actual harm to service users. In that respect she said (p 242) that there had been a specific risk of harm to service user 5, whose court report was late. The result was that his hearing had been delayed and he had been kept in custody for an additional four hours. In my view, that would have justified a finding of actual harm, not merely risk.
32. Ms Redmond disputed the conclusion that she had worked in an entrenched way and deliberately failed to change her practice. She pointed out that SN had accepted (p249) that the slowness complained of appeared to be Ms Redmond's natural way of working rather than a deliberate intention to be slow.
33. However SN was questioned in some detail about Ms Redmond's attitude to her work and response to interventions. She said that the issue appeared to be the length of documentation that Ms Redmond would submit, and the unnecessary detail it contained. She said that in the case of review reports, which needed primarily to address matters that had changed since the previous report "it appeared that whenever Janet approached documentation it almost felt like she was starting again". She said (p248) that she had discussed this on occasion with Ms Redmond "it was almost a paralysis of … with a time pressure, having to get something done, so in a sense starting something from scratch was her sort of default position, but then she found that she could not get to it and … she worked very late to try and catch up but then documents would be left blank… It was part of her slowness, I suppose, and thoroughness which we explored with her and I believe PA and I did try and use that to actually give her some positives, to say… that actually she could do some good work, but it was difficult to do anything that would actually change that speed of approach… She did not seem able to shift in an approach…. She was difficult to change from her course… as was evident [by] the service manager saying to her 'you need to get this done by here', I recall her response that she had got home visits to do… They could have been rearranged, probably, possibly and I would expect most employees … having been required to do something like that by the service manager to actually follow that instruction … It was not a deliberate or rude response. It felt almost an inability to accept that she should reprioritise."
34. Ms Redmond in her own evidence made her points about the excessive workload she says she was given and the caseload table which she said showed that she was handling at least as many cases as others. She said that since leaving her employment Nottingham she had undertaken agency work on a total of six contracts, and that she had taken criticism of her work practices on board and showed, within those engagements, that she was able to produce reports quickly when required.
35. It is apparent from the transcript that members of the panel and the presenting officer took pains to put Ms Redmond's case to the witnesses before them conscientiously in circumstances in which she had deliberately absented herself from the hearing and expressly chosen not to do so herself. It is in my view clear from the summary of their responses that I have set out above that it is simply unsustainable to say that conclusions the Panel came to were "contrary" to the evidence of those witnesses. It is right to say that there were points at which the witnesses partially accepted points put to them from Ms Redmond's submissions, but the thrust of their evidence was clearly such as to support the allegations found proved. I do not accept that, to the extent the witness accepted Ms Redmond's points, their evidence was, as she submitted, so inconsistent that it did not support the Panel's conclusions. On the contrary, the witnesses clearly rejected the substance of the defence submissions. Insofar as the panel accepted the evidence of those witnesses in preference to that Ms Redmond, there can be no basis for suggesting that they must have misunderstood the evidence before them.
36. There is nothing in the material that Ms Redmond has produced which deals a knockout blow to any of the evidence against her, such as might indicate that the Panel could not properly have accepted that evidence. The caseload table in particular is by no means conclusive, even if Ms Redmond's amendments to it are accepted as being accurate. The intensity and difficulty of the cases she had to deal with as compared with those handled by others and the speed and efficiency with which she dealt with those cases are matters that require evaluation by those with knowledge of the details of the cases and the circumstances at the time. If it were the case that she had failed to complete and close off cases in good time, that would have the effect of artificially inflating the number of open cases on her list. The Panel accepted the evidence of both of the managers, whose responses to the questions put to them they had the opportunity to evaluate, that Ms Redmond's workload was not excessively high or complex and that her performance in dealing with that workload, and particularly in producing the documentation reports required, was unacceptably poor. Given the intensity of supervision in place, those witnesses were clearly in a position to have evaluated these matters and so speak from direct knowledge.
37. These are findings of primary fact. Bearing in mind the principles to be applied, which I have set out above, there is in my judgment no basis for disturbing any of them.
38. As to whether the failure of Ms Redmond to change her practice was appropriately described by the panel as "deliberate", that in my view was an evaluative judgment on its part. It is right to say that the witnesses did not suggest that she had openly refused to carry out instructions, or responded rudely when told that changes were required. SN had said that Ms Redmond appeared to be paralysed and incapable of accepting the need to re-prioritise. However it is also clear that the witnesses did not regard this as a matter of lack of skill, experience or ability, and Ms Redmond herself referred to differences over her method of practice as being due to differences in ethical standards and approach. She also said that in her subsequent contract work she had been able to deal with documentation with urgency and that she accepted that she was required to do so.
39. Ms Redmond no doubt continued to work in what she regarded as her natural way, and did not make changes to her practice although she plainly had it made clear to her over a very extended period that change was required. To the extent that the witnesses said she seemed "incapable" of accepting the need to make such change, it is clear that what the panel considered them to be saying was not that Ms Redmond suffered from any fundamental incapacity of understanding or ability, but that she was unwilling to accept that she should make the changes required. In that sense, her failure to do so was deliberate.
40. In the circumstances, and again bearing in mind that the Panel had the opportunity to evaluate her attitude to these matters when receiving her evidence, there is in my judgment no basis to interfere with the conclusion that the panel reached.

Ground 2(c): The sanction was disproportionate

41. Ms Redmond argued that the sanction imposed was disproportionate on three bases:

i) no harm had been caused by her practice:

ii) it had taken three years for the complaints against her to lead to a conclusion, in which time she said there had been no issues relating to her practice raised in her subsequent work; and

iii) an alternative sanction was likely to be more effective. Suspension prevented her implementing any continuing professional development.

42. In her oral submissions she said that significant contributory factors to her performance had been the impact on her health of the criticisms to which she had been subjected, including as she said some 17 HR procedures, most of which she said had either been withdrawn or held to be unfounded. These factors she said no longer exist; she has undertaken the Stress Action Plan referred to, and produced a letter dated 17 January 2013 (p394) from a Homeopathic Practitioner stating that she was receiving homeopathic treatment said to be "good for people who feel under attack".
43. Ms Redmond also said that there was no need for any sanction because she had clearly recognised the need to change her practice and had done so. The Panel had been wrong, she said, to regard her evidence in this respect as amounting only to "limited insight" in to the faults in her practice.
44. In relation to harm, it is correct to say that the Panel framed its decision in terms of risk of harm, though as I have indicated, in my view a finding of actual harm to service user 5 would have been justified. But in any event the risk of harm in other cases was significant, in that the absence of proper documentation meant that other professionals involved in relation to young offenders were unable to see what work had been done, what assessments have been performed, and what risks were assessed to be presented by them. That risk plainly continues so long as Ms Redmond has not in fact corrected the deficiencies found in her practice. The Panel also noted (paragraph 69 of the decision) that Ms Redmond's failure had had an impact on colleagues who had to step in to complete work that she should have performed. On SN's evidence, other colleagues had to shoulder a greater level of work to make up for Ms Redmond's slowness.
45. As to whether she has now fully taken on board the need for change and implemented it, Mr Mant was right in my judgment to emphasise that the Panel had the opportunity of considering Ms Redmond's evidence and evaluating for itself the extent to which she was being frank and sincere in what she said about changes to her practice.
46. Ms Redmond said in her evidence to the Panel that she had had six subsequent short-term contracts as an independent social worker, and criticised paragraph 72 of the decision which said:

"She self reported good practice for four out of the six short term contracts since her employment at the Local Authority including one in which she was meeting deadlines in a highly pressurised environment completing Initial Assessments. However, there was no independent evidence of this."

47. This Ms Redmond said ignored a reference from one of those contract employers (p396) in which another local authority rated her "quality of work" and "assessment" as "excellent", her performance in other areas as "good" and commented "Janet is a very committed worker who is always willing to share knowledge with other team members." I accept that this is some evidence in her favour. I do not however read the extract quoted above as saying there was no independent evidence of any improvement in her performance, but that there was no independent evidence supporting her specific contention that she had been able in a subsequent role to meet reporting deadlines under pressure. The reference she provided is not inconsistent with what she said, but it is too brief to provide any significant positive support for her position.
48. As Mr Mant submitted, the Panel was also entitled to have regard to the fact that the last two contracts appear to have ended in circumstances in which the employer had very similar concerns about slowness of work. In one case the contract was terminated early by the employer, and in another it was not renewed, apparently expressly on that basis.
49. It is plain that the Panel's assessment was substantially based on the impression that it formed from Ms Redmond's testimony on these issues. The decision refers to remarks made to it by Ms Redmond minimising the importance of failing to complete documentation, from which it concluded that she had not taken on board the need to prioritise her work appropriately. It said at paragraph 72 that although she had initially demonstrated limited insight, her live evidence showed "some developing insight". Nevertheless it concluded:

"73. In the panel's view the Registrant lacks full insight into her failings, has declined to take full responsibility and has not taken sufficient remedial action. It is clear to the Panel that the underlying reason for the misconduct is not easily irremediable and certainly has not been adequately remedied.

74. … The Panel is of the view that there remains a risk of repetition as it cannot be satisfied that the Registrant will practise safely and effectively in the future. The risk of harm to young offenders and the public is high when risks are not assessed, mitigated or managed in a timely fashion.

75. Therefore the Panel is satisfied that the Registrant's fitness to practise is still impaired...

77. The Registrant has damaged public confidence in her. Members of the public and colleagues would find it difficult to place confidence in her with the completion of important assessments when such serious misconduct has been established and has not been remedied.

78. … Late filing of reports at court undermines public confidence in the Social Work profession… Through a finding of current impairment, the Panel seeks to restore confidence in the profession and to declare that the misconduct in this case is unacceptable. "

50. Plainly therefore the passage of time had not resulted in a sufficient change in Ms Redmond's practice such that a sanction would no longer serve any purpose.
51. In her submissions to me Ms Redmond said that the Panel had ignored the matters she had presented as mitigation. The decision however records (paragraph 84) that Ms Redmond chose not to make any submissions as to mitigation. It nevertheless found a number of mitigating factors (paragraph 87) which included its evaluation of the matters that Ms Redmond had raised in relation to her acceptance of failings and her subsequent work.
52. The Panel considered whether a lesser sanction than suspension would be adequate in circumstances. It concluded that taking no action was not an acceptable option as it would do nothing to protect the public or reflect the seriousness of the case, and that a simple caution would be insufficient in the light of its conclusions as to the limited nature of Ms Redmond's insight into her failings. For similar reasons, it concluded that the imposition of conditions on her continuing to practise would be insufficient, recording that in the light of what it regarded as her entrenched views it was not satisfied that she would engage with such an order and there was accordingly a risk of repetition of the conduct complained of. Further, such an order would not sufficiently reassure the public that the faults identified had been addressed, or act as a deterrent to others.
53. On the other hand, a suspension of registration was considered to offer a realistic possibility that Ms Redmond would be able to demonstrate that she had gained a sufficient level of insight and taken appropriate remedial action. It set out at paragraph 103 matters which would assist on the review of such a suspension, including evidence from Ms Redmond herself demonstrating a sufficient change in attitude and references from work, paid or unpaid, in a social care environment. Thus it envisaged that she would be able to undertake related work, though obviously not work requiring a registered practitioner.
54. I do not consider that this can be said to be disproportionate or otherwise unjust. In the light of the assessment, which there is no basis to overturn, that Ms Redmond's expressed acknowledgement of the faults in her practice amounted only to limited insight and not a sufficient change in her entrenched attitudes, it was plainly appropriate to impose a sanction which would sufficiently bring home to her the seriousness of the faults found, and the need to provide tangible evidence of change. A simple caution would not achieve this. Allowing her to continue to practise subject to the imposition of conditions such as supervision and reporting would in effect replicate the regime put in place by Nottingham, which Ms Redmond did not respond to. The period of suspension can by no means be regarded as excessive. The requirement for review is plainly appropriate; little would be served by allowing Ms Redmond simply to wait out the term of her suspension and resume practice as she had before.
55. For these reasons, the appeal is dismissed.