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CQC defence lawyers case studies

Our specialist CQC lawyers have gained an excellent reputation for providing high quality advice and representation to businesses and individuals in the health and adult social care sectors, particularly in relation to challenging decisions, inspection reports and ratings issued by the Care Quality Commission (CQC).            

We pride ourselves on achieving the best possible results for our clients and have achieved successful outcomes for numerous clients nationwide. Our team has specialist experience of dealing with a wide range of cases including factual accuracy challenges, ratings reviews, criminal investigations and prosecutions, enforcement action and appeals to the first tier tribunal (care standards).

The following cases provide a brief overview of our experience in this area. If you would like to discuss your case, please contact our specialist lawyers on 01616 966 229 without delay.

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CQC registration

Registration advice

Advice on the regulated activity of ‘personal care’

Our specialist lawyers were instructed by a carer who had been notified by the CQC that they were investigating them for the offence of carrying out the regulated activity of personal care without registration, contrary to Section 10 of the Health and Social Care Act 2008. The CQC believed that the individual was operating a domiciliary care company providing care packages to people in receipt of direct payments from the local council, which included the provision of personal care. 

The carer instructed our specialist lawyers to advice on whether their current activities fell within the scope of CQC registration and whether the CQC were likely to prosecute, and to make a response to the CQC on their behalf as to why the carer did not require registration.

Advice on the regulated activity of ‘accommodation for persons who require treatment for substance misuse’

Our specialist lawyers acted for a charitable organisation providing accommodation and a therapeutic recovery programme for addicts and alcoholics. The organisation was previously registered with the CQC but their registration lapsed when they lost their primary accommodation. After obtaining new funding, they became operational again in their new premises, with the intention of re-registering with the CQC. However, due to staff changes and continued uncertainty with the CQC as to whether the company needed to be registered, there was a delay in submitting their application for registration to the CQC. The organisation were subsequently contacted by the CQC, who advised that they were investigating them for an offence of carrying on the regulated activity of ‘accommodation for persons who require treatment for substance misuse’ without registration pursuant to Section 10 of the HSCA 2008. 

Our lawyers were instructed to advise the organisation on the scope of their CQC registration, particularly the regulated activity of ‘accommodation for persons who require treatment for substance misuse’ and the services they could continue to provide pending their registration. Our lawyers were also to make robust submissions to the CQC as to why it was not proportionate or in the public interest to take any criminal enforcement action against the organisation. Following our advice, the organisation restructured the service to ensure that their operations fell outside of the scope of CQC registration pending a successful application to register with the CQC. In addition, after considering our submissions, the CQC also confirmed that they would be taking no further action. 

Advice on CQC registration restructure & continuing regulatory history

Our specialist lawyers were instructed by a large domiciliary care provider to provide a bespoke written advice on a proposed company restructure and the implications of this on their CQC registrations. The company owned two locations; the first location provided care and support primarily to older adults living in their own homes, and the second location provided personal care to older adults and end of life care to people living in their own houses and flats in the community. The first location had approximately 200 members of staff and between 250 – 300 service users, but the second location was not operating.

The first location had a history of ‘Requires Improvement’ ratings, whereas the second location did not. The company sought to restructure with the principal aim of seeking to remove any links to their previous history of CQC inspections. Following a conference with the directors of the company, we advised the company in respect of their restructuring options and the implications of these, with reference to the CQC’s continuing regulatory histories guidance.

Refusal of registration

Notice of proposal to refuse registration – learning disability provider

Our specialist lawyers represented a specialist independent provider of services for adults with learning disabilities and associated developmental impairments, who had made an application to the CQC to register as a service provider of the regulated activity: accommodation for persons who require nursing or personal care. It was their intention to provide accommodation for up to six people in a community setting (rather than a hospital setting) to those with learning disabilities in crisis.

Following the submission of their application, the CQC issued them with a notice of proposal to refuse their registration. One of the grounds for this refusal was that this service had been developed as part of a ‘campus style’ development or congregate setting, rather than a small local community-based setting with its own staff and separate facilities. The CQC stated that this was in direct contravention of its own guidance, “registering the right support”, as well as other publications such as, ‘The Mansell Report’ (October 2007) and The Department of Health report, “Transforming care: A national response to Winterbourne View Hospital” (December 2012).

Our lawyers were instructed on behalf of the company to draft detailed representations against this Notice to invite the CQC not to adopt their proposal and instead, register the service. Our representations sought to apply the relevant guidance; case law; definitions; and reports to demonstrate that the proposed service did not constitute a campus style or congregate setting and provide evidence of the extensive involvement of service users and their representatives in the design of the service. After consideration of these representations, and recent case law on this matter, the CQC agreed to register the company to provide this regulated activity.

Notice of proposal to refuse registration – mental health crisis services 

Our specialist lawyers were instructed by a provider of mental health crisis services for young people to assist with challenging a Notice of Proposal to refuse their registration with the CQC. The reasons for refusal related to concerns about the location of the premises, and the layout of the premises. Detailed representations were made to CQC on behalf of the provider, highlighting the purpose of the service and why the specific location was chosen, as well as detailing steps taken by the provider to address the issues with the internal layout. Following consideration of the representations, the CQC confirmed that they would not be adopting their proposal and registration was subsequently granted. 

Notice of proposal to refuse registration – adult mental health services 

Our specialist lawyers represented a provider of adult mental health services and crisis care, who had received a Notice of Proposal to refuse their registration application from the CQC. The main reasons for the refusal related to concerns about the location of the premises, and concerns that the provider had not obtained the views of those who would benefit from the service. Our specialist CQC lawyers made robust representations to CQC, which set out why the specific location was appropriate for the service and detailed the steps that had been taken by the provider to seek views from a variety of people who would be involved in or use the service. Following a review of our representations, the CQC withdrew their proposal and granted the provider’s registration.

Notice of proposal to refuse registration – online GP service

Our specialist lawyers were instructed by an online GP service to make representations to the CQC against a Notice of Proposal to refuse their registration. The CQC were proposing to refuse their registration as they were concerned that the manner in which the regulated activities would be carried on would not be compliant with a number of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Our specialist lawyers made detailed representations to the CQC challenging their reasons for this proposed refusal of registration, which provided evidence of the steps taken by the provider to address the issues raised by the CQC. Following consideration of the representations, the CQC confirmed that they would not be adopting their proposal and the provider was able to continue with the registration process. 

Notice of decision to refuse registration – residential care home

Our specialist lawyers acted for a provider of a residential care home who had made an application to the CQC to vary one of the conditions of its registration. The application was to increase the number of service users that could be accommodated at the care home following an extension to the existing building. The CQC refused the application on a number of different grounds, including that the extension was not specifically designed for the purpose of supporting service users living with Dementia. The CQC raised concerns with the design and layout of the extension; signage; furniture; and the availability of a sluice room and hand washing facilities, amongst other things. 

Despite the submission of detailed representations addressing the issues highlighted, the CQC proceeded to issue the provider with a Notice of Decision confirming their proposal to refuse this application. Our specialist lawyers assisted the provider to lodge an appeal against this decision to the First-tier Tribunal (Care Standards Chamber). Following negotiations with the CQC, and a stay of proceedings to allow for a further registration visit, the appeal was withdrawn and an agreement was reached for any further application to be expedited upon completion of an agreed list of actions. 

Challenging inspection reports and ratings

Factual accuracy challenge – increase in rating to ‘outstanding’ (May 2023)

Our specialist lawyers were instructed to act on behalf of a care home provider, which is registered to accommodate people with physical disability and/or complex healthcare needs. The CQC carried out a comprehensive inspection of their service and the draft inspection report set out a rating of ‘good’ in four of the key domains and ‘outstanding’ in the fifth domain, with an overall ‘good’ rating.

We were instructed to submit a factual accuracy challenge in response to the draft inspection report, which included a challenge of the ratings and a submission that the overall rating should be upgraded to ‘outstanding’. Within that challenge, we made detailed submissions as to why the inspector had incorrectly rated the service with reference to the inspector’s own findings and the CQC’s key lines of enquiry and ratings characteristics.

One of the CQC’s key ratings principles is that at least two of the five key questions would normally need to be rated as ‘outstanding’ and three key questions rated as ‘good’ before an aggregated rating of ‘outstanding’ can be awarded. We therefore needed to successfully challenge at least one of the ‘good’ ratings in order to change the overall rating of the service.

The CQC responded to our factual accuracy response to confirm that the rating in the ‘responsive’ key question had been changed from ‘good’ to ‘outstanding’ and as a result of their re-evaluation of the available evidence, and the change to this rating, the overall rating for the service had been changed to ‘outstanding’.

Factual accuracy challenge – increase in rating to ‘good’ (July 2023)

Our specialist lawyers were instructed to act on behalf of a large care home provider to make a factual accuracy challenge against a draft inspection report following an inspection at one of its residential care home locations.

The CQC had carried out a focused inspection of this location in March 2023. Whilst the provider was found to be in breach of regulation 12 (safe care and treatment) and regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 at its previous inspection, the inspectors found that the provider had made improvements and was no longer be in breach of these regulations. Despite this, the CQC rated the care home as ‘requires improvement’ in respect of both safe and well-led.

Our lawyers made detailed factual accuracy comments on the accuracy of some of the findings within the report and made submissions on why the care home should be rated ‘good’ in the safe domain in line with the CQC’s ratings guidance.

After considering our factual accuracy comments, the CQC confirmed that after reviewing their evidence again and carefully considered their judgements, the rating for the ‘safe’ key question would be amended to ‘good’. As four out of the five key questions were now rated ‘good’ , this changed the overall rating of the care home to ‘good’.

Factual accuracy challenge – removal of breaches and increase in ratings

Our specialist lawyers were instructed to draft factual accuracy comments for a residential care home following a comprehensive inspection, which saw the home’s ratings drop from an overall ‘outstanding’, consisting of three ‘outstanding’ and two ‘good’ ratings, to three ‘requires improvement’ ratings and two ‘good’. The CQC stated within the draft report that the provider was in breach of regulations 12 and 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Not only were there numerous typographical errors, but there were also a number of factually inaccurate statements throughout the report and missing references to positive aspects of the service. Our lawyers therefore made robust comments, supported by documentary evidence, to demonstrate that the CQC inspector had in some circumstances failed to follow the appropriate key lines of enquiry and consider all evidence relevant to the judgments and ratings.

After considering our factual accuracy comments, the CQC agreed to make a number of changes to the published report. In particular, the CQC agreed to remove the breaches of regulation based on the evidence and submissions put forward during the factual accuracy process and instead, noted these as recommendations to encourage improvement. This also led to an increase in ratings in one of the domains from ‘requires improvement’ to ‘good’.

Ratings review – withdrawal of inspection report & change in ratings (February 2023)

Our specialist lawyers were recently instructed by a care home provider to request a review of their ratings. They had already submitted a detailed factual accuracy challenge which resulted in a number of changes to the report, however, the ratings remained the same. We made a request with reference to the CQC’s ratings guidance and the provider’s factual accuracy challenge within 15 days of publication.

After considering our request, the CQC accepted that their findings within the ‘safe’ and ‘well-led’ domains should be reviewed again against the ratings characteristics and the report was sent back to the inspection team to consider the impact of these changes on the ratings. In the meantime, the inspection report was withdrawn from publication.

Ratings review - fresh inspection

Our specialist lawyers represented a registered provider of a home care service which has been rated overall as ‘requires improvement’ following a comprehensive inspection. After an unsuccessful attempt to challenge the factual accuracy of the report and the resulting ratings, the provider instructed our lawyers to make a ratings review request on their behalf.

Our lawyers made representations to the CQC challenging the ratings of ‘requires improvement’ for the ‘safe’ and ‘well-led’ domains on the ground that the CQC had failed to follow their own published processes. It was clear in this case that the inspector did not have a sufficient understanding of how a home care service operated and this had led them to make inaccurate conclusions upon which they based their ratings decisions in these domains. All other ratings within the report were ‘good’.

After considering our request, the CQC decided to withdraw the inspection report from publication and carry out a fresh inspection by a different inspector. This inspection resulted in the service being rated as ‘good’ in all areas. 

Criminal investigations and prosecutions by the CQC

Section 10 of the Health and Social Care Act 2008 – Carrying out a regulated activity without CQC registration

Allegations of providing ‘personal care’ without registration

Our specialist lawyers represented the directors of a homecare agency, who had been assisting with and supervising the provision of physical and domestic activities for vulnerable adults.

Upon applying for registration as a service provider with the CQC, our clients were invited to attend an interview under caution as the directors of the company. The CQC alleged that the agency had been providing the regulated activity of ‘personal care’ without the appropriate CQC registration. It was alleged that the agency were therefore committing a criminal offence contrary to Section 10 of the Health and Social Care Act 2008.

Following our representation at the interview under caution, and further written submissions, the CQC decided to take no further action against our clients and the homecare agency was subsequently registered as a service provider with the CQC.

Allegations of providing ‘accommodation for person who require treatment for substance misuse’ with registration

Our specialist lawyers acted for a charitable organisation providing accommodation and a therapeutic recovery programme for addicts and alcoholics. The organisation was previously registered with the CQC but their registration lapsed when they lost their primary accommodation. After obtaining new funding, they became operational again in their new premises, with the intention of re-registering with the CQC. However, due to staff changes and continued uncertainty with the CQC as to whether the company needed to be registered, there was a delay in submitting their application for registration to the CQC. The organisation were subsequently contacted by the CQC, who advised that they were investigating them for an offence of carrying on the regulated activity of ‘accommodation for persons who require treatment for substance misuse’ without registration pursuant to Section 10 of the HSCA 2008.

Our lawyers advised the organisation on the scope of CQC registration and made robust submissions to the CQC as to why it was not proportionate or in the public interest to take any criminal enforcement action against the organisation. Following our advice, the organisation restructured the service to ensure that their operations fell outside the scope of CQC registration pending a successful application to register with the CQC. After considering our submissions, the CQC also confirmed that they would be taking no further action.

Allegations of carrying out ‘surgical procedures’ without registration

Our specialist lawyers represented a doctor who was being investigated by the CQC for carrying out the regulated activity of ‘surgical procedures’ without registration contrary to Section 10 of the HSCA 2008. The doctor had been operating a private clinic from the medical centre at which he was a partner. The medical centre was registered as a service provider with the CQC.

The CQC discovered the doctor’s private clinic during a visit to the medical centre to carry out an unannounced inspection. The doctor had mistakenly believed that the clinic was covered by the medical centre’s registration. However, the CQC advised the doctor that they were carrying out a regulated activity which required individual registration. The doctor therefore submitted an application for registration in respect of that separate regulated activity immediately.

The CQC commenced a criminal investigation against the doctor and invited the doctor to an interview under caution. Following our representation at the interview and subsequent written submissions, the CQC issued the doctor with a Fixed Penalty Notice for £4,000. This avoided a criminal prosecution and the doctor therefore did not receive a criminal record. The CQC also approved the doctor’s registration in respect of this regulated activity.

Allegations of providing ‘treatment of disease, disorder or injury’ and ‘diagnostic and screening procedures’ without registration

Our specialist lawyers were instructed by a limited company who was operating a private medical practice and had been charged with two offences of carrying on the regulated activities of ‘treatment of disease, disorder or injury’ and ‘diagnostic and screening procedures’ without CQC registration pursuant to Section 10 of the Health and Social Care Act 2008. The company pleaded Guilty and our lawyers were instructed to represent the company at the sentencing hearing. In line with the sentencing guidelines, the company was at risk of receiving an unlimited fine; a term of imprisonment not exceeding 12 months; or both. At the sentencing hearing, after hearing submissions from both sides, the Magistrates’ Court imposed a fine of just £8,000 and ordered the company to pay the CQC’s prosecution costs of £4,962.55 plus a victim surcharge of £170.

Breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009

Allegations of failing to notify the CQC of specified incidents (DoLS authorisations)

Our specialist lawyers represented a care home provider who had received a letter from the CQC alleging that they had grounds to suspect that our client had committed the offence of failing without delay to notify the Commission of incidents specified in Regulation 18(5) of the Care Quality Commission (Registration) Regulations 2009. It was alleged that, during a comprehensive inspection, CQC inspectors found that there were six people who were subject to a DoLS authorisation, which had not been notified to the CQC.

Our specialist lawyers submitted a detailed and robust written response to the CQC on behalf of our client, supported by the appropriate evidence and submissions in respect of the CQC’s prosecution criteria. Following the consideration of our submissions, the CQC determined that there was not a realistic prospect of conviction in this case and therefore decided to take no further action against our client.

Allegations of failing without delay to notify the CQC (allegations of abuse)

Our specialist lawyers represented an adult social care provider who had been accused of committing the offence of failing without delay to notify the Commission of an incident specified in Regulation 18(2) of the Care Quality Commission (Registration) Regulations 2009. The CQC alleged that four incidents had occurred at the service, which gave rise to allegations of abuse and the CQC had not received a statutory notification in respect of these incidents.

Our lawyers submitted detailed representations to the CQC, querying the need for a statutory notifications in respect of some of the incidents and acknowledging the reasons why other notifications were not made. Substantial mitigation was put forward, including evidence of the safeguarding procedures in place at the service; the Registered Manager’s substantial experience and training; and the service’s positive compliance and inspection history. It was further submitted that there would be no real public interest in pursuing any further action this provider in all the circumstances.

After considering these representations, the CQC confirmed that they would not be taking any further action as they were satisfied that the provider was complying with Regulation 18(2) and it would therefore not be in the public interest to pursue a prosecution.

Allegations of failing without delay to notify the CQC of specified incidents

Our specialist lawyers represented a care home provider who had received two letters from the CQC alleging that they had grounds to suspect that our client had committed two offences. The first offence was failing without delay to notify the Commission of incidents specified in Regulation 18(5) of the Care Quality Commission (Registration) Regulations 2009, namely that they had failed to notify the CQC of four separate incidents in which four residents sustained injuries, such as fractured hips and head wounds. The second offence was failing without delay to notify the CQC of the death of a service user under Regulation 16 of the 2009 Regulations. It was alleged that our client had failed to notify the CQC of nine service user deaths over a period of 10 months.

Our specialist lawyers submitted a written response to the CQC on behalf of our clients, admitting the offence and putting forward the appropriate mitigation, together with robust submissions on why a prosecution was not proportionate or in the public interest in this case. Following the consideration of our submissions, the CQC decided not to prosecute our clients and instead, issued our client with a Fixed Penalty Notice of £1,250 in respect of each offence.

Section 33 of the Health and Social Care Act 2008

Allegation of accommodating more than the permitted number of service users

Our specialist lawyers were instructed by a care home provider who had been accused of committing two offences, namely failing without delay to notify the CQC of incidents specified in Regulation 18(2) of the Care Quality Commission (Registration) Regulations 2009 and failing to comply with the conditions of their CQC registration contrary to Section 33 of the Health and Social Care Act 2008 by providing accommodation to six people in the care home, rather than the permitted five people. The CQC alleged that the provider had failed to notify them of five incidents or allegations of abuse relating to two service users

Our specialist CQC lawyers submitted detailed representations to the CQC on behalf of the provider, putting forward substantial mitigation including evidence of the safeguarding procedures in place at the service; the implementation of a new, robust management team; and the service’s positive compliance and inspection history. It was further submitted that there would be no real public interest in pursuing any further action against this provider in all the circumstances. After considering these representations, the CQC confirmed that they would not be taking any further action against the provider in respect of either offence.

Breach of Registered Manager Condition

Our specialist lawyers were instructed by a care home provider who was subject to a criminal investigation by the CQC for failing to comply with the conditions of their registration contrary to Section 33 of the Health and Social Care Act 2008. It was a condition of their registration that the regulated activity of ‘accommodation for persons who require nursing or personal care’ was managed by an individual who was registered with the CQC. The CQC alleged that there was no registered manager in place at the care home for a period of 10 months.

The provider acknowledged this fact and our specialist lawyers therefore made detailed representations to the CQC, putting forward appropriate mitigation and making submissions as to why it was not proportionate or in the public interest to pursue any criminal enforcement action, particularly a prosecution. Following consideration of our representations, the CQC confirmed that they would be taking no further action in respect of this matter.

Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Failure to provide safe care and treatment

Our specialist lawyers were instructed on behalf of a non-profit organisation who was being prosecuted by the CQC, as the registered provider of a care home, for an offence of failing to provide safe care and treatment resulting in a resident sustaining actual harm or being exposed to a significant risk of exposure to avoidable harm pursuant to Regulations 12(1) and 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The CQC’s prosecution arose out of an incident at the care home involving an elderly resident, who had been found on the floor of her room and was admitted to hospital, where they were found to have suffered a hip fracture. Unfortunately, the resident sadly passed away following surgery. The injuries suffered during their fall were cited on her death certificate as a contributing factor.

The CQC alleged that a robust assessment of the resident’s needs was not undertaken prior to their admission and a plan was not implemented to monitor the resident throughout the night. The CQC stated that the risk of this resident suffering an injury was also increased by a failure to use any assistive technology.

The organisation pleaded Guilty at the first opportunity and our specialist lawyers represented them at the sentencing hearing before the Magistrates Court. In line with the sentencing guidelines, the CQC argued that based on the organisation’s turnover of £13 million, the category fine range should be £220,000 – £1,200,000, with a starting point of £450,000. Our lawyers submitted that the starting point for a fine should be £240,000, within a range of £100,000 - 600,000.

After taking into account the mitigation put forward on the organisation’s behalf, including the extensive actions taken following the incident, and providing the maximum credit for an early guilty plea of one third, the Judge imposed a fine of £200,000 and ordered the organisation to pay the CQC’ s prosecution costs of £19,305.94 costs, plus a victim surcharge of £170.

Civil enforcement action

Notice of proposal to cancel registration – residential care home

Our specialist lawyers represented a provider of residential accommodation for people with learning disabilities, who had been issued with a Notice of Proposal to cancel their registration as a service provider under section 26(4)(a) of the HSCA 2008 in respect of the regulated activity: ‘accommodation for persons who require nursing or personal care’.

The CQC alleged that it had identified a number breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during an inspection and found that the provider had ‘failed to take reasonable steps to address those breaches’ at a subsequent focused inspection.

The provider had 28 days to make representations against the notice of proposal. Our lawyers made careful and detailed representations on the provider’s behalf, persuading the CQC to review the position of the service once the provider was able to implement the improvements outlined in their updated action plan, with the assistance of a specialist care consultant.

The CQC agreed to our proposal and inspected the service around three months later. Having noted significant improvements within the service at that inspection, the CQC agreed to withdraw their notice of proposal and the service’s registration was allowed to continue without restriction.

Notice of proposal to impose conditions – private hospital

Our specialist CQC lawyers acted for a private hospital, who had been issued with a Notice of Proposal to impose conditions on their registration following a comprehensive inspection. The CQC raised concerns in relation to the hospital’s safeguarding practices and proposed to impose conditions requiring the hospital to provide evidence of safeguarding training; competency assessments; and an updated safeguarding policy, as well as appoint a named professional for safeguarding, within a short timescale. Our lawyers made detailed representations outlining why this proposal was not necessary or proportionate and outlined the steps the hospital had taken since the inspection. After the submission of further supplementary representations and correspondence, the CQC confirmed that they would not be adopting the proposal and the Notice was therefore withdrawn.

Appeals to the first-tier tribunal (care standards)

Appeal against notice of decision to cancel registration

Our specialist CQC lawyers were instructed to assist a care home who had received a Notice of Decision to cancel their registration in respect of one of their locations. This was due to the CQC’s concerns that the home was unable to meet the requirements of the regulations and as a result, were placing residents in the home at risk. Our lawyers assisted the home in lodging an appeal to the First-tier Tribunal against the Notice, detailing why cancellation was not necessary or proportionate. Upon receiving our appeal, the CQC reconsidered their position and agreed to re-inspect the home before making a final decision. Following the inspection, the CQC confirmed that they did not oppose the appeal and the home retained its registration.

Appeal against notice of decision to vary registration (final hearing)

Our specialist lawyers acted for a large company, who owned multiple care home locations registered by the CQC. Our lawyers were instructed to appeal against the CQC’s notice of decision to vary the company’s registration to remove one of the locations from which it was authorised to carry out regulated activities. This notice had been issued on the basis that several breaches of the 2014 regulations were identified following a comprehensive inspection the company’s previous enforcement action and inspection history, and the absence of a registered manager at the location.

An appeal was lodged to the first-tier tribunal (care standards chamber) on behalf of the company on the basis that improvements had been, and continued to be, made since the last inspection and a new acting manager had been appointed. There were a total of nine witnesses between the parties, seven of which were called to give live evidence. A final hearing was listed for three days but this hearing went part heard and was listed a further two days due to the amount of witness evidence and a late and unsuccessful application by the CQC to adjourn the hearing.

On the first day of the resumed hearing, a number of legal issues arose which prevented the hearing from proceeding. The first issue was in relation to the registration of the current acting manager of the location. The acting manager had submitted an application to the CQC to register as manager and their fit person interview was arranged for a date prior to the resumed hearing. This registration was a substantial part of the company’s appeal and key to the issues in dispute. However, the CQC rearranged the fit person interview until after the resumed hearing, undermining the company’s position in their appeal and providing an unfair advantage to the CQC.

Prior to the resumed hearing, the CQC had also carried out a further inspection, however, they had only served additional evidence relating to this inspection immediately prior to the resumed hearing, without any prior notice or permission from the tribunal. The evidence contained the inspector’s findings from the new inspection, which had not been through the CQC’s internal quality assurance stages or factual accuracy process. Our lawyers therefore objected to this evidence being allowed in the appeal.

After considering lengthy submissions from both parties, the panel ordered that the hearing be adjourned to allow for the inspection report to be finalised and to afford the company an opportunity to submit further evidence in response to this inspection. The panel also requested that the fit person interview to take place and that this be undertaken by another registration inspector outside of the company’s region to avoid any perceived bias. The hearing was also re-listed for two months’ time.

However, prior to the next hearing, and after further negotiations and the submission of additional evidence by our specialist lawyers, the CQC issued their decision to register the acting manager and a further inspection of the location was undertaken by the CQC which noted further improvements. As a result of this, the CQC agreed to withdraw their opposition to the appeal and the appeal was allowed.

Appeal against notice of decision to cancel registration (stay of proceedings)

Our specialist lawyers represented a nursing home in an appeal against the CQC’s notice of decision to cancel their registration as a service provider to the first-tier tribunal (health, education and social care chamber).

The CQC alleged multiple breaches of the 2014 regulations. The service had received several overall ratings of ‘inadequate’ and the CQC was not satisfied that sufficient improvements had been made at the time of issuing their notice of decision.

The provider instructed a specialist care consultant and employed a new registered manager to assist them in implementing the necessary changes to achieve compliance. The provider also implemented better quality monitoring systems, provided greater training for staff and completed an overhaul of its care planning systems to ensure compliance in the future.

Following a further inspection after the appeal was lodged, our lawyers negotiated a three month extension to the CQC’s response to the appeal. This enabled the provider to implement the final, necessary improvements within the service before the CQC carried out a further inspection.

At the next inspection, the CQC found that the service had improved. Subsequently, the provider met with the CQC in order to discuss the findings of the inspection and to agree an action plan which addressed the areas of the service that still required improvement. The CQC therefore agreed to withdraw their notice of decision to cancel the provider’s registration.

Appeal against notice of decision to cancel registration (sale of a care home)

Our specialist lawyers represented a residential care home in an appeal against the CQC’s notice of decision to cancel its registration as a service provider to the first-tier tribunal (health, education and social care chamber).

The provider was in the process of selling the home when the CQC issued their notice of decision. As such, it was vital for the provider to maintain its registration in the interim to ensure that the home remained a viable business option to prospective buyers and that all residents were able to remain at the home in the meantime.

Our lawyers represented the provider at a ‘Telephone and Case Management Hearing’ (TCMH) with the judge in which a stay of proceedings with the CQC was granted, enabling the provider to finalise the sale of the service. On completion of the sale, our client withdrew their appeal and the CQC approved the buyer’s application for registration.

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CQC publishes final guidance on visiting and accompanying in care homes, hospitals, and hospices

The Care Quality Commission (CQC) published its final guidance for health and social care providers on 4 April 2024, which outlines what providers must do to make sure they respect the right of each person to receive visits and to be accompanied in care...

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Challenging an Ofsted inspection - what is the process?

Ofsted previously announced that, following a three-month consultation, it was to make changes to the post-inspection and complaints-handling process to ensure that concerns about inspections are dealt with quickly and robustly. This move followed...

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CQC staff reorder

  • Laura Hannah
  • Chloe Parish
  • Martin Haisley
  • Cameron Stubbs
  • Paul Loughlin
  • Katie Wilson
  • Molly McMurtry
  • Skye MacPhee
  • Martyn Jackson