[2024] UKUT 442 (AAC)

On 17 August 2023, the Applicant received notification from the Respondent that it was minded to include her in the Adults’ and Children’s barred lists. On 12 October 2023, the Applicant provided written representations in respect of that. It made reference to, inter alia, her 16 year unblemished career in nursing, 11 of which were with BUPA as well as:

On 23 October 2023, the Respondent issued a Final Decision letter to the Applicant, confirming that she was to be included indefinitely on the Children’s and Adults’ Barred Lists. The crux of the DBS decision was as follows:

“DBS is satisfied you engaged in relevant conduct in relation to vulnerable adults. This is because you have engaged in conduct which endangered a vulnerable adult or was likely to endanger a vulnerable adult. It is also considered that you have engaged in relevant conduct in relation to children, specifically conduct which, if repeated against or in relation to a child, would endanger that child or would be likely to endanger him or her.

We are satisfied a barring decision is appropriate. This is because we are satisfied [that your actions involved] not ensuring that the residents in your care received appropriate care and supervision. We are satisfied that this behaviour endangered a number of vulnerable adults and as such that it would represent relevant conduct.

Your behaviour was assessed and this raised concerns about irresponsibility and lack of empathy, your representations were then considered alongside the existing case information as follows: Whilst it is acknowledged that during your disciplinary hearing you apologised for your behaviour, we are satisfied that you did not ensure that routine checks and re-positioning of immobile service users was carried out as required, either by yourself or the two care assistants you were responsible for supervising, or that it was accurately recorded. We are satisfied that many charts and notes were pre-filled ahead of time, collected up for staff convenience and left stacked insecurely on a trolley, we are also satisfied that you had indicated that this was your usual working method on night shift. We are satisfied that you left immobile service users, some of whom were unable to buzz for assistance, completely unattended by taking a break at the same time as you knew the other two staff on duty were doing the same. During this period all three of you had prepared chairs with bedding and were stated to be asleep in darkened rooms, with the doors shut, when an unannounced night visit occurred. Further concerns were raised that you stated you would assume everything was OK unless a resident used their call buzzer and as such would not routinely check upon them. Following your representations it is acknowledged you had worked for BUPA for 11 years before this incident without prior referral to DBS, however, due to this experience you would have been fully aware that such behaviour was unacceptable as it endangers service users. Whilst you inform that you have continued working in the health sector without concerns being raised, you have provided no documentary evidence of this. It is also acknowledged that you state you have reflected upon your practice, including how you would manage things differently in the future, however, other than referring in a general manner to patient-centred practice you have provided no insight into what these changes might look like. As such we are satisfied that you had failed to fulfil the responsibilities of your role as the nurse in charge, and it is likely you would again cut corners for convenience in any future regulated activity roles. As such our concerns remain about irresponsibility. Whilst we are satisfied that you did not intend to cause harm to the vulnerable adult residents in your care, we are also satisfied that you gave little regard to the emotional and physical experiences of residents, some of whom appear to have been unable to turn themselves or call for assistance. We are satisfied that you gave a higher priority to making the shift easier for yourself and your colleagues, than you did to the needs of the residents. We are also satisfied that you placed a higher priority upon paperwork having the appearance of being fully completed, than upon the accuracy of that paperwork and were either unable or unwilling to understand or elaborate upon the potential consequences of it being pre-filled or inaccurate. It is acknowledged that within your representations, you offer unreserved apologies to all concerned for your behaviour and that you say you now know that patient safety is paramount in all circumstances, however, we are satisfied that your representations do little to demonstrate an understanding of the lived experience of the vulnerable adults whom were effectively left unsupported whilst you, and the colleagues you were responsible for supervising, slept. The pre-filling of paperwork further emphasises the deliberate nature of your disregard for their welfare. As such we are satisfied that you were willing to overlook the feelings of the residents for your own convenience, and concerns remain regarding a lack of empathy for others.

If you were to be afforded a further regulated activity role with vulnerable adults, you would always be expected to ensure that those adults were provided with the required level of care to keep them safe and comfortable. However, we are satisfied that in this role you failed to meet these needs for frail, elderly residents, failed to properly account for care given or not given, and also allowed staff under your supervision to do the same. We are satisfied that this behaviour endangered those vulnerable adults and as such would represent relevant conduct for Adults. We are satisfied that this was done for staff convenience and without empathy for the impact upon the vulnerable adults, and concerns remain that you are likely to repeat similar behaviour. As such we are satisfied that it is appropriate to include you on the Adults’ Barred List. Whilst this behaviour was not against or in relation to a child, in any regulated activity role with children you would be required to ensure that service users receive all the recommended support and supervision, and that this is properly documented. We are satisfied that in this role you did not do so, and that this was for the convenience of yourself and other staff. As such concerns remain that it is likely to be repeated, given the opportunity. If such or similar behaviour, were to be repeated against or in relation to a child it could cause harm to or endanger that child and as such we are satisfied that it would represent relevant conduct for Children also. As such we are satisfied that it is appropriate to include you on the Children’s Barred List.”