First-tier Tribunal rules in favour of CQC

August 9, 2019

A First-tier Tribunal has ruled in favour of the Care Quality Commission’s (CQC's) decision to refuse an application submitted by Lifeways Community Care to vary a condition of its registration.

Lifeways, a care provider for people with a learning disability, autism or mental health issue, was seeking to add another location to its portfolio to support people who require accommodation and personal care. The provider has been registered with CQC to provide accommodation for people requiring personal care since 2010.

In April 2018, Lifeways applied to add an additional care facility in the West Midlands. The new facility, which had previously been an NHS care home, would accommodate 10 people (later reduced to nine) and would be split up in to three units offering three en-suite bedrooms with shared kitchen and living room facilities and three self-contained flats.

The care home was situated on the same site as six supported living flats for people with learning disabilities and/or autism. The care home residents and the supported living residents shared some facilities, including a large garden and car park.

In April 2018, the CQC Registration team visited the location alongside an expert by experience. They found that the proposed care home had an institutional appearance and looked more like a hospital. The national guidance advocates small, domestic models of care and dispersed settings.

CQC informed Lifeways that they proposed to refuse the application, stating their view was that the care home proposal did not comply with Registering the Right Support. Additionally, it did not comply with the underpinning national guidance, which states that new services and variations to registrations for services should not be developed as a campus and/or congregate setting, as this not in the best interests of people with a learning disability and doesn't promote choice, independence or inclusion.

CQC confirmed with Lifeways in September that they would refuse the variation in registration, which Lifeways appealed against in October 2018.

The Tribunal panel’s unanimous view was that it 'was obvious the proposed care home had an institutional look to it and clearly had characteristics of a campus style setting which stood out and was apart from the surrounding neighbourhood' and that the Springside proposal was 'completely inappropriate' with reference to the national guidance and policy. The panel also felt that 'the proposed care home and the extent to which it departs from national policy and guidance creates unacceptable and serious risks to service users in the provision of care'.

Importantly, the First-tier Tribunal confirmed the importance of Registering the Right Support and the associated guidance in shaping care provision for people with learning disabilities and/or autism by concluding, 'The national policy and guidance is (and is supposed to be) aspirational. It seeks to transform existing care provision going forward. The panel accepts that the evidence establishes that the small domestic model of care promoted by the policy and guidance is (despite the challenges involved) realistic, workable and achievable.'

This is an important judgement as it further clarifies what is an acceptable care setting, says CQC. The appearance of the proposed service did not match with the residential area it was located within and was too big, as there was a supported living service on the same site. This did not promote integration with the local community.

Welcoming the decision, Joyce Frederick, Deputy Chief Inspector, Registration at CQC said, 'I am delighted the First-tier Tribunal has recognised that our decision to refuse this variation in registration was justified and in the best interests of those who would have potentially used this service.

'The panel agreed with the analysis of CQC witnesses that to allow registration in these circumstances would not promote the Transforming Care agenda and that "if we accept Good Enough we can’t transform the service and achieve the necessary change."

'This recognises the important role that the CQC has in making decisions about registration that protect and promote the health, safety and welfare of people with complex learning disabilities and/or autism.'

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