CQC defence lawyers case studies

Criminal prosecutions

Allegations of providing personal care without registration

Stephensons 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 Care Quality Commission (CQC), the regulator invited our clients to attend an interview under caution under Section 91(2)(a) of the Health and Social Care Act (HSCA) 2008 as the “directors, managers” of the company and the persons “purporting to be acting in those capacities” under Section 91(2)(b) of the Act.

The CQC alleged that the agency had been providing the regulated activity ‘personal care’ without being registered with the CQC in respect of that regulated activity. It was alleged that the agency had therefore failed to comply with Section 10 of the HSCA 2008.

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

Allegations of carrying out surgical procedures without registration

Stephensons represented a doctor who was being investigated by the CQC as it was alleged that they were carrying out the regulated activity ‘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.

Enforcement action

Alleged breaches of Health and Social Care Act 2008

Stephensons represented a provider which provided residential accommodation for people with learning disabilities. The provider was issued with a Notice of Proposal to cancel its 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.

First-Tier Tribunal Appeals

Appeal against Notice of Decision to cancel registration

Stephensons 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, Stephensons negotiated a three month extension in which the CQC would respond to the provider’s appeal. This enabled the provider to implement the final, necessary improvements within the service before the CQC carried out a further visit to the service before the end of that period.

At the next inspection, the CQC's 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 agreed to withdraw their Notice of Proposal and also withdrew the decision to cancel the provider’s registration.

Appeal against Notice of Decision to cancel registration

Stephensons 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 service at the time that the CQC issued their final decision to cancel registration. As such, it was vital the provider to maintain its registration in the interim to ensure that the service remained a viable business option to prospective buyers and that all residents were able to remain at the service.

Stephensons’ lawyers were present at a ‘Telephone and Case Management Hearing’ (TCMH), before a judge of the First-Tier Tribunal, before it was agreed that a stay of proceedings with the CQC would be granted, enabling the provider to finalise the sale of the service.

On completion of the sale, the provider withdrew the appeal and the CQC approved the buyer’s application for registration.