The past and future of the GSCC conduct system

The GSCC’s conduct system is set for a major overhaul

The General Social Care Council’s system for regulating social workers’ conduct got off to a shaky start with its first ever hearing in April 2006.

Yvonne Doyle, a fostering agency manager from Darlington, was summoned to Jury’s Inn Hotel in Newcastle to hear accusations that she was moonlighting as an escort, but the married practitioner refused to attend because of the presence of reporters. The chairman agreed to hold the hearing in private, but then adjourned the matter after the committee failed to reach a decision in the time allowed. Doyle was finally found guilty of misconduct and received a two-year suspension after waiting two months for the verdict.

Since then, 97 conduct hearings have resulted in 27 admonishments, 11 suspensions, and, earlier this month, the inauspicious milestone of 50 removals from the social care register was reached.

The most common reason leading to hearings has been professional boundary transgressions and relationships with clients, and the 50th removal was no exception.

Stan Lansdell, who, in a strange twist of fate, also worked in Darlington, was banned for sending sexually explicit text messages to a female service user, in addition to verbally abusing a child service user and repeated failings in child protection casework.

Overturned removals from register

Of these cases two social workers successfully overturned removals after appealing to the Care Standards Tribunal.

The GSCC concluded in its 2008 report, Raising Standards, Social Work Conduct in England 2003-08, that the system was fulfilling its objectives, set out in the Care Standards Act 2000, of regulating the “standards of conduct and practice expected of social care workers” in England.

It identified some areas of improvement, such as increasing its regulatory powers over employers, but the appraisal did little to prepare the sector for the damning criticism to come from the Council for Healthcare Regulatory Excellence last November.

Despite only 1% of the 82,000 registered social workers in England having been investigated by the GSCC because of suitability concerns, and 0.2% having been the subject of conduct proceedings – the same proportion as that reported by the Nursing and Midwifery Council – the CHRE found the confusion and delays which dogged the first hearing were a sign of things to come.

Describing the GSCC’s conduct function as “not effective, efficient or well governed”, the CHRE highlighted multiple failings in management and weaknesses in the system.

A huge backlog of cases had built up and only cases with a strong chance of removal were referred to conduct committees.

The review recommended a major overhaul, which included replacing the conduct system with a fitness-to-practise regime focusing more on competence, bringing the GSCC in line with healthcare regulation.

The Department of Health promised “a comprehensive review of the GSCC’s rules and powers” in response to the CHRE report, and said further consideration was needed regarding the fitness-to-practise proposal “in view of the different context in which social workers work” to healthcare professions.

Rosie Varley, the chair of the GSCC who is overseeing an emergency recovery plan, says: “There were gaps in our system; it was embryonic and needed modernising.”

Growth in complaints

As the system has developed, the number of complaints about registered social workers and social work students relating to their conduct or registration has risen hugely. From an average of 10 per week in 2007-8, it increased to 83 since September 2009, which Varley puts down to more awareness of the need to protect vulnerable people.

The number of hearings has also risen each year, from 10 in 2006-7 to 26 in 2007-8 and 27 in 2008-9. This figure is expected to double, if not triple, over the next 12 months, as the regulator clears the backlog of cases and more practice-related cases are referred to committees.

There are question marks over whether the regulator will be able to deal with so many cases, and Varley says: “The GSCC is building the capacity to deal with this.”

The British Association of Social Workers backs the move to a fitness-to-practise regime. Lily Robertson, who supports social workers faced with conduct proceedings as one of five full-time advice and representation officers at BASW, says: “The current conduct system is punitive, not developmental, and the word misconduct itself carries connotations about a person’s character. However, many cases are actually practice-related and to do with people’s competence, which is not the same as misconduct.”

Extending range of sanctions

In broad acceptance of these arguments, Varley has made extending the range of sanctions the GSCC’s first priority for strategic reform. The CHRE recommended giving conduct committees the power to impose conditions of practice on social workers where necessary, in addition to the power to admonish, suspend or remove individuals from the register.

The current range is “too black and white”, according to Varley, who would like to see social workers being ordered to carry out training in a particular area, work under increased supervision, or with certain client groups where it would aid their rehabilitation. The regulator will begin a consultation in April on the subject.

Marcia Stewart, principal lecturer in social work at De Montfort University in Leicester, agrees with Robertson that taking the concept of “conduct” as the system’s baseline is unhelpful.

“I’ve always found the definition of conduct very difficult because it’s about behaviour, which is subjective.”

Some commentators, such as June Thoburn, emeritus professor at the University of East Anglia and former vice-chair of the GSCC,have argued that the complexities of social work make it unsuitable for a fitness-to-practise system. Stewart disagrees: “The healthcare model has been around for a while, and what we have isn’t working.”

Employers’ input

The Association of Directors of Adult Social Services says that stronger input from employers in upholding the standards of the workforce could reduce the number of referrals to the GSCC.

John Nawrockyi, director of adult services at the London Borough of Greenwich and Adass workforce development committee member, says: “Poor practice is not always a case of wrongdoing, it’s just that you don’t have the skills to deal with certain situations. This should be picked up by good supervision.”

Varley promises that when the reforms are in place, the GSCC will become more proactive in responding to the most common practice failings: “The conduct process is not only about taking people out of the workforce who shouldn’t be there, but about how we use the learning gathered in the process to disseminate among the workforce and educate them to raise standards.”

Links:

Expert guide to conduct cases

Relationships dominate GSCC caseload

Surge in dishonesty cases sparks vetting call by GSCC

GSCC may issue guidance on sexual boundaries with users

Read Community Care’s special report on conduct from September 2008

The realisation that there was a backlog of more than 200 conduct cases in July 2008 led to an urgent review of the GSCC’s conduct function.

In November the Council for Healthcare Regulatory Excellence published its report, which identified serious operational failings in three main areas: a lack of scrutiny; the quality of information provided to committees; and the standard of risk assessments.

The backlog of cases, which at one point stood at more than 700, was caused by a management policy, led by the body’s then chief executive Mike Wardle, to shelve non-urgent cases due to a departmental overspend. The report found the GSCC had failed to ensure public safety as a result.

It also found the GSCC lacked independence from government, had a poor relationship with employers, and the range of sanctions available to conduct committees was limited.

The review made these recommendations:

● A fitness-to-practise regime, similar to those used in healthcare regulation, should be used.

● Conditions – such as retraining during suspension – should be introduced as an additional sanction (see page 18).

● A lower threshold of referral of cases to the conduct committee should be adopted.

● GSCC should become financially independent of the Department of Health.

● GSCC should be given additional powers to require employers to pass on or concerns about a social worker’s fitness to practise.

● Appeals against GSCC decisions should be made to the High Court.

● GSCC should be given a clearer public protection role.

Case study: case of Keith Stockdale shows ‘no power to compel social worker to attend training’

In September 2008 a GSCC conduct committee heard the case of Keith Stockdale, a social worker employed by Sunderland Council, who was suspended for two years for inappropriately restraining a female service user with learning disabilities.

Conduct officials brought the evidence before a preliminary hearing of a conduct committee, which decided to proceed with a full hearing because there was a real prospect of finding misconduct due to the evidence available.

During the incident, Stockdale shouted at the woman and pinned her arms against her sides, behaviour which breached national and local guidelines on restraint.

Although Stockdale admitted his part in the incident, he did not accept that his actions were inappropriate.

The committee found otherwise and decided his actions amounted to abuse of a vulnerable service user and resulted in seven breaches of the code of practice, in areas such as placing service users and yourself at risk and maintaining the dignity of service users.

In suspending Stockdale for two years, the committee recommended he complete a training course in dealing with challenging behaviour before returning to social work duties, and reflect on the seriousness of his actions through mentoring or counselling.

However, because the conduct committee did not have conditions for practice available as a sanction, it had no power to compel him to undertake the training. It is likely that in future, fitness-to-practise committees will insist on registrants completing training requirements when confronted with similar cases, either as conditions for practising again, or before re-applying for their license to practise in the event of a suspension.

Case study: case of Margaret Ann Gribbon Scotland’s use of conditions-for-practise sanction

The Scottish Social Services Council has had the power to impose conditions for practise on social workers since the first conduct hearing was held in Scotland in 2006. So far, three social workers have been issued with this sanction after misconduct was proved against them in hearings.

One of these was Margaret Ann Gribbon, the deputy manager of a children’s home run by West Dunbartonshire Council.

Gribbon was found to have colluded in a “general culture of mismanagement of funds”, falsified financial records and allowed an “intimidating, hostile and humiliating environment for staff” to develop in the workplace.

However, there was no evidence of harm to any service user, and the members concluded that although admonishment was an insufficient sanction and removal too harsh, suspension provided no remedy for the deficiencies in the registrant’s practice.

As a result, she was ordered to complete an SSSC-approved management training course including modules on leadership, staff supervision, financial management, and health and safety, before being allowed to work as a social work manager again.

Geraldine Doherty, registrar of the SSSC, says this approach helps ensure that social workers like Gribbon can continue to practise “but with conditions that address their misconduct.”

She says conditions could involve specific training or restrictions on practice.

“Our experience to date shows that workers have received good support from their employers in meeting conditions placed on their registration.”