A care home nurse used inappropriate physical force to move a resident in the home and left them isolated, resulting in a fitness-to-practise hearing
The charges
That Nurse A, working in a care home:
1a. On one or more occasions used unnecessary and/or inappropriate physical force to move Resident A into a corridor;
1b. On one or more occasions left Resident A isolated in a corridor from which they were unable to exit on their own;
1c. Said to Resident A, “Get out of here you horrible person” or words to that effect;
1d. Attempted to isolate Resident B in their room and/or instructed staff not to bring Resident B out of their room, without any clinical justification for doing so;
1e. Attempted to isolate Resident C in their room and/or instructed staff not to bring Resident C out of their room, without any clinical justification for doing so.
1f. On one or more occasions shouted at and/or spoke inappropriately to Colleague A;
2. Incorrectly informed a panel of the Conduct and Competence Committee during their review of their interim conditions of practice order that no concerns about their practice had been raised;
3. The conduct in Charge 2 was dishonest.
The background
Allegations arose due to concerns raised by staff members in relation to Nurse A’s alleged mistreatment of particular service users. It is alleged that Nurse A: physically moved Resident A against the resident’s wishes; left Resident B and Resident C in their rooms for long periods of time and requested staff not to let them out; and shouted at Colleague A in the presence of residents and other staff members.
It is alleged that Nurse A dishonestly informed a panel of the Conduct and Competence Committee that no concerns about their practice had been raised during their employment at the home.
At the hearing
During the course of their oral evidence, Nurse A admitted charges 1b, 2 and 3, which were therefore found proved. Charge 1a, 1e and 1f were also later found proved. Charges 1c and 1d were found not proved.
The NMC’s representative submitted that Nurse A’s fitness to practise was impaired. Nurse A submitted that their fitness to practise was not impaired. Nurse A apologised to the panel for being dishonest to a panel of the Conduct and Competence Committee reviewing their interim conditions of practice order. Nurse A further submitted that, at the time of the events, they were under stress from working over 60 hours per week as a registered nurse, unit manager and the home’s acting manager.
The panel considered whether Nurse A had put patients at unwarranted risk of harm, brought the profession into disrepute, breached the fundamental tenets of the profession and/or acted dishonestly – and whether they might do so in future.
The panel noted that Nurse A had put residents at unwarranted risk of harm through mistreatment. By lying to the regulator, Nurse A had acted dishonestly in the past. Regarding insight, the panel considered that Nurse A acknowledged that they had taken on too much responsibility at the home, as well as their failure to implement and update care plans for Residents A and C.
In its consideration of whether Nurse A had remedied their practice, the panel took into account the additional training they had undertaken.
The panel considered that there was a risk of repetition of failings based on Nurse A’s limited insight and lack of remediation. The panel, therefore, decided that a finding of impairment was necessary on the grounds of public protection.
Results of the fitness-to-practise panel
The FtP panel can impose four different sanctions:
- Caution: the nurse or midwife is cautioned for their behaviour, but is allowed to practise without restriction
- Conditions of practice: this will prevent a registrant from carrying out certain types of work or working in a particular setting, it may require them to attend occupational health or do retraining. The order can be applied for up to three years and must be reviewed by an FTP panel again before expiry
- Suspension: the nurse or midwife will be suspended from practice for a period of initially not longer than one year, but this can be extended after review by an FTP panel
- Striking off: a nurse or midwife is removed from the register and not allowed to practise in the UK. The nurse or midwife must apply to be readmitted to the register