Care Standards Tribunal, 2018-08-14 (Care Management Group Limited v Care Quality Commission)
| Jurisdiction | United Kingdom |
| Neutral Citation | [2018] UKFTT 0434 (HESC) |
| Registration Number | 2017/3163/EA |
| Date | 14 August 2018 |
| Court | Care Standards Tribunal |
[2018] UKFTT 0434 (HESC)
1
Care Standards
The Tribunal Procedure (First-tier Tribunal) (Health, Education and Social
Care) Rules 2008
Heard on 11, 12, 13, 14, 15, 18 June and 6 July 2018 [2017] 3163.EA
BEFORE
Ms Siobhan Goodrich (Judge)
Dr David Cochran (Specialist Member)
Mr Mike Flynn (Specialist Member)
B E T W E E N:
CARE MANAGEMENT GROUP LTD
Appellant
and
CARE QUALITY COMMISSION
Respondent
AMENDED DECISION AND REASONS
Representation:
The Appellant: Mr David Lawson, counsel, instructed by Bevan Brittan
The Respondent: Ms Zoe Leventhal, counsel, instructed by CQC Legal Services
The Appeal
1. This is an appeal by the Care Management Group Ltd (CMG) brought under section 32 of
the Health and Social Care Act 2008 (the Act) against the decision made by the Care
Quality Commission (CQC) on 2 October 2017.
2. The Appellant is registered as a provider of regulated activities at The Cherry Tree at 272
Wingletye Lane, Hornchurch, Essex, for the accommodation of persons who require
nursing or personal care. In short the CQC refused CMG’s application to vary a condition
of the Appellant’s existing registration so as to permit 3 further places at “The Cherry Tree”
(referred to hereafter Cherry Tree) so increasing the maximum number of service users
from 7 to 10.
Restricted Reporting Order
[2018] UKFTT 0434 (HESC)
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3. The tribunal makes a restricted reporting order under Rule 14(1) (a) and (b) of the 2008
Rules, prohibiting the disclosure or publication of any documents or matter likely to lead
members of the public to identify the service users in this case, so as to protect
confidentiality and privacy.
4. Consistent with this, the names of service users and their family members and some other
details have been anonymised in this decision.
The Background
5. The basic background is as follows. Cherry Tree is situated on a site known as Lilliputs.
Lilliputs was originally a farm. It was established as a home for children with learning
disabilities some years ago. The site was later adopted by CMG in 2002. Over the ensuing
years it has been converted to provide residential provision for adults with autism, learning
difficulties and behaviour that challenges. There is now one remaining service for children
(Gulliver’s) which is registered with Ofsted for 4 children. The other services are:
• The Farmhouse (registered by CQC for 7 service users)
• The Paddocks (registered by CQC for 8 service users).
• Cherry Tree (registered with CQC - originally for 5 services users and, from 2015,
for up to 7 adults.
Everyone currently supported at Lilliputs is funded for at least 1:1 support throughout their
waking hours, generally for 15 hours a day. Two people receive 2:1 funding during waking
hours. On top of that several people receive a limited amount of 2:1 funding to enable them
to access the community safely. Staff are available 24 hours a day just as they are in
any other residential care home.
6. Cherry Tree is bungalow accommodation to which there are two parts. The building as a
whole has, (and has always had), 10 bedrooms, and there are corresponding facilities in
each side such as the kitchen, lounge, bathroom and laundry facilities etc. There is a
resource centre on the Lilliputs site which provides a swimming pool, sensory rooms,
sports hall, an activity area, therapy rooms, a home entertainment room and an area for
learning (for example life skills and ASDAN courses). At present 26 people live within the
different services on the site. The site lies within 20 acres in the greenbelt on the edge of
Hornchurch, Essex i.e. with easy access to fields and woodland. There are bus stops
within a few hundred yards of the entrance to the Lilliputs site. It is possible to walk to
Emerson Park train station or Hornchurch and Upminster Bridge tube stations.
Hornchurch is relatively near the M25 orbital motorway so enabling access of family
members if placement is not local.
7. The chart re current service users shows the bodies who have commissioned/fund the
places for current service users at Lilliputs include: Havering (5), Bromley, Lambeth,
Surrey Downs/Spelthorne Borough Council, Kent County Council (3), Ealing, Redbridge,
Lewisham, Tower Hamlets, Wandsworth, Newham, Brent and Essex. In terms of the
distance from the family place of residence to Lilliputs the furthest away are Thornton
Heath in Croydon, Faversham in Kent, Northolt in Middlesex, Sittingbourne in Kent,
Sydenham in Lewisham, Whitstable in Kent, Morden in Surrey, Hunsdon in Hertfordshire
and Edgware in Barnet.
The Chronology
[2018] UKFTT 0434 (HESC)
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8. Cherry Tree was registered with CQC in November 2013. In 2015 CMG successfully
applied to vary the registration so that the maximum number of service users permitted
was 7. Later in 2015 CQC Inspectors considered that the service at Cherry Tree required
improvement. At the next inspection on 29 March 2017 the service at Cherry Tree was as
“Good” in all 5 domains (safe, effective, caring, responsive and well led) and “Good”
overall. Once CMG had received the draft inspection report it applied to vary the conditions
of registration so that the service at Cherry Tree could accommodate 10 people overall.
9. The main dates and events relevant to the application/decision process are as follows:
• 5 April 2017: Application to vary a condition.
• 10 May 2017: CQC assessment visit
• 11 July 2017: Notice of proposal
• 10 August 2017: Representations
• 2 October 2017 Notice of decision
The Notice of Proposal
10. In his letter Mr Lelliott, CQC Inspector, proposed to refuse the application for reasons
which included the following:
“C1.1 The evidence above demonstrates that Care Management Group Limited have
been unable to identify how they would provide a service in a manner that is compliant
with the Health and Social Care Act 2008 (Regulated Activity) Regulations 2014.Care
Management Group Limited have failed to evidence that they have taken into account all
pertinent service specific national recognised guidance when proposing to expand the
service user capacity at the location, including current best practice as stated in Supporting
people with a learning disability and / or autism who have a mental health condition or
display behaviour that challenges - Association of Directors of Adult Social Services
(ADASS), Local Government Association (LGA) and NHS England).
C1.2 Lilliput’s Farm is a secluded congregate setting with 3 other locations and a day
centre in addition to The Cherry Trees situated there. It is approximately 10-15 minutes’
walk from the nearest housing community and public transport stops. National guidance
states that new services should not be developed as part of a campus style development
or congregate setting. The geographically isolated location will present clear barriers to
person centred care / dignity and respect for residents of a care home.
C1.3 The Commission is not assured that the increase in capacity at Cherry Tree is in
accordance with nationally recognised good practice guidance. Strategic local
commissioners have confirmed they had no knowledge of the variation application prior to
being informed by Care Management Group Limited’s e-mail on 28 April 2017 that they
had applied to CQC for the variation. Evidence from the Havering Commissioning &
Programming Manager that the proposed increase is not due to demand for the service in
the local area and that Care Management Group Limited has not engaged in any provider
events and forums to hear Havering’s intentions or needs profile. Therefore, the variation
application has failed to evidence that the increase in numbers is required by and in
response to local need.
C1.4 Your lack of consultation around local need and failure to provide us with sufficient
evidence to demonstrate how the service meets the transforming care agenda, leads us
to believe that individuals would be admitted to the location regardless of their originating
locality, which is not in line with current best practice as stated in A national response to
Winterbourne View Hospital: Department of Health Review Final Report.
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