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Failure to maintain adequate records

Our case studies are based on real life fitness to practise concerns we have received

Type of concern: Failure to maintain adequate records

Profession: Dietitian

Standards

When these events happened, previous versions of the standards were in place (standards of proficiency for dietitians 2013 and standards of conduct, performance and ethics 2012). To avoid confusion the most recent versions are shown.

Standards of conduct, performance and ethics (1 September 2024)

  • 3.3 You must refer a service user to an appropriate practitioner if the care, treatment or other services they need are beyond your scope of practice. This person must hold the appropriate knowledge, skills and experience to meet the needs of the service user safely and effectively.
  • 6.1 You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible.
  • 10.1 You must keep full, clear, and accurate records for everyone you care for, treat, or provide other services to.

Standards of proficiency for dietitians (1 September 2023)

  • 1. practise safely and effectively within their scope of practice
  • 7. communicate effectively
  • 9. maintain records appropriately
  • 10. reflect on and review practice
  • 11. assure the quality of their practice
  • 13. draw on appropriate knowledge and skills to inform practice

Case study

A dietitian’s employer raised concerns about their clinical practice and conduct, following a number of incidents relating to six different service users. This included a failure to record sufficient details of dietetic assessments, failure to address the needs of a service user adequately and failure to make the necessary referrals within a reasonable timeframe.

The registrant was not present at the hearing nor was represented. The Panel considered that the shortcomings occurred during a period when additional supervision and support for the registrant had been put in place. The evidence given suggested that the registrant’s failure to perform tasks was not wilful or deliberate. However, the Panel agreed that the shortcomings were serious because they had the potential to result in harm to the service users concerned. The Panel determined that the matters constituted a lack of competence and found that the registrant’s fitness to practise was impaired.

The Panel agreed that the registrant’s failings had not been remediated. Moreover, the Panel found it necessary to reassure members of the public. Otherwise, they would lose confidence in the profession and the regulatory process if a practitioner whom had not remediated their shortcomings were permitted to return to practise unrestricted. The Panel then went on to consider which sanction to impose to protect the public. It decided that a twelve-month suspension order would prevent the registrant from practicing until they were able to demonstrate safe and effective practice.

Measures we put in place to protect the public

The Conduct and Competence Committee imposed a twelve-month suspension order.

 

Published:
14/01/2019
Resources
Learning material
Subcategory:
Case study
Profession
Dietitians
Page updated on: 31/08/2024
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