Jeffrey Wager

As a registered Speech and Language Therapist (SL35174) your fitness to practise is impaired by reason of misconduct and/or lack of competence. In that:

1. In or around June 2021, you falsified a certificate to indicate you passed a course on assessment and management of adults with dysphagia and you:

a. Provided this to your locum agent, Maxxima, as proof of qualification and/or

b. On 8 June 2021, when you emailed Maxxima to retract the falsified document, you stated that you had received further correspondence when this not the case.

2. On 9 April 2021, you did not maintain accurate and complete records for a referral for Patient A, in that you:

a. Did not document the reason for Patient A’s admission to the Speech and Language Therapy department;

b. Did not document their chest status, communication needs, medical history, or allergy information; and/or

c. Did not detail what was carried out in the brief swallow assessment.

3. On 13 April 2021, you did not maintain accurate and complete records for a referral for Patient E, in that you:

a. Did not document their chest status;

b. Did not detail what was carried out in the swallow assessment;

c. Did not document an oromotor assessment;

d. Did not document how much level 0 fluids of the International Dysphagia Diet Standards Initiative were given;

e. Did not assess whether there was any residue on Patient E’s drooped left side;

f. Started with level 7 of the International Dysphagia Diet Standards Initiative and did not build up to this nor document what was consumed;

g. Did not describe the sprout of the beaker used to assist with fluid intake; and/or

h. Discharged Patient E too soon without permitting further review of their requirement for a spout and their ongoing drooping left side.

4. On 15 April 2021, you did not maintain accurate and complete records for a referral for Patient D, in that you:

a. Did not detail what was carried out in the swallow assessment.

b. Did not perform an oromotor assessment;

c. Did not describe the fluids, diet trialled, laryngeal movements, oral clearance or chewing; and/or

d. Did not indicate the reason for a review of Patient D, how this was communicated to the care home and to whom.

5. On 21 April 2021, you did not maintain accurate and complete records during a review appointment with for Patient C in that you:

a. Did not explain your reasoning for upgrading Patient C to level 1 fluids of the International Dysphagia Diet Standards Initiative;

b. Did not describe how level 2 fluids of the International Dysphagia Diet Standards Initiative were given and what they were; and/or

c. Did not explain why you did not try a higher level of the International Dysphagia Diet Standards Initiative diet.

6. On 22 April 2021, you did not maintain accurate and complete records regarding an initial assessment of Patient F in that you:

a. Did not perform an oromotor assessment;

b. Did not document what initial trials were given;

c. Did not specify what level 6 foods of the International Dysphagia Diet Standards Initiative were given and why that level was chosen;

d. Did not specify any detail about laryngeal movements, chewing, oral clearance or check for residue; and/or

e. Did not indicate where in the throat the food was stuck and what action was taken to clear the throat.

7. On 26 April 2021, you did not maintain accurate and complete records regarding a review assessment of Patient F in that you:

a. Did not refer to their dysarthria from the initial assessment; and/or

b. Did not describe any tests performed to diagnose the dysarthria nor the degree of dysarthria.

8. On 27 April 2021 you did not maintain accurate and complete records regarding an initial assessment of Patient B in that you:

a. Did not perform an oromotor assessment;

b. Did not comment on their facial droop from their case history.

c. Did not document adverse signs from levels 0 and 1 fluids of the International Dysphagia Diet Standards Initiative given;

d. Did not describe what level 2 fluids of the International Dysphagia Diet Standards Initiative were given or use this level as a starting point; and/or

e. Did not document your reasoning as to why you only trialled level 4 foods of the International Dysphagia Diet Standards Initiative during the initial assessment when there were no adverse signs.

9. On 28 April 2021, you did not delete irrelevant information relating to Patient F’s discharge from their discharge letter.

10. On 29 April 2021 you did not maintain accurate and complete records regarding a review of Patient B in that you:

a. Did not document your reasoning as to why you only trialled level 5 foods of the International Dysphagia Diet Standards Initiative during the initial assessment when there were no adverse signs.

11. On 29 April 2021 you did not maintain accurate and complete records regarding an initial communication assessment of Patient G in that you:

a. Did not document the assessment carried out.

b. Did not document Patient G’s attempts to communicate.

c. Did not describe the language comprehension tasks or commands, how many questions there were or to what extent this was assessed.

d. Did not devise a plan in respect of Patient G’s aphasia diagnosis.

e. Did not document whether the use of pen and paper had been trialled for Patient G.

12. On 4 May 2021 you did not maintain accurate and complete records regarding a review of Patient B in that you:

a. Did not document your reasoning as to why you only trialled level 6 foods of the International Dysphagia Diet Standards Initiative during the initial assessment when there were no adverse signs

13. On 10 May 2021 you did not detail the process for Patient B’s discharge in their case notes and letter.

14. On 10 May 2021 you did not maintain accurate and complete records for Patient G in that you did not include pertinent medical information with regard to Patient G’s discharge, including why they had aphasia.

15. On 13 May 2021 you did not maintain accurate and complete records regarding an initial assessment of Patient J in that you:

a. Did not perform an oromotor assessment;

b. Did not start with level 0 fluids of the International Dysphagia Diet Standards Initiative;

c. Did not describe the swallow assessment in sufficient detail;

d. Did not explain your rationale for proceeding with level 3 and then level 5 of the International Dysphagia Diet Standards Initiative foods;

e. Did not assess communication;

f. Did not diagnose dysarthria;

g. Did not explain the rationale for the moderate aphasia diagnosis; and/or

h. Did not make a recommendation for further assessment or therapy regarding the aphasia diagnosis.

16. On 14 May 2021 you did not maintain accurate and complete records regarding an initial assessment of Patient I in that you:

a. Did not perform an oromotor assessment;

b. Did not describe how much fluids at levels 0,1 and 2 of the International Dysphagia Diet Standards Initiative were given and how these were administered;

c. Did not describe how level 3 foods of the International Dysphagia Diet Standards Initiative were administered;

d. Did not document why levels beyond level 4 of the International Dysphagia Diet Standards Initiative were not trialled; and/or

e. Did not document that Patient I required a communication assessment.

17. On 18 May 2021 you did not maintain accurate and complete records regarding an initial assessment of Patient H in that you:

a. Did not perform an oromotor assessment;

b. Did not describe what format levels 0 and 1 of the International Dysphagia Diet Standards Initiative were tried;

c. Did not describe laryngeal movement in sufficient detail;

d. Did not describe your rationale as to why level 5 of the International Dysphagia Diet Standards Initiative was started with after Patient H had consumed a pot of rice pudding; and/or

e. Made a dysphagia diagnosis without performing a full assessment.

18. On 20 May 2021 you did not maintain accurate and complete records regarding a communication assessment of Patient I in that you:

a. Did not document what communication assessment was performed and how long for.

19. Your conduct in relation to particular 1 above was dishonest.

20. The matters set out in particulars 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15,16, 17, 18, and/or 19 above constitute misconduct.

21. The matters set out in particulars 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15,16, 17, and/or 18 above constitute lack of competence.

22. By reason of your misconduct and/or lack of competence your fitness to practice is impaired.