Tribunal rules in favour of CQC

August 24, 2018

A Tribunal has found the Care Quality Commission’s (CQC’s) decision to prevent a care provider from increasing its number of people with a learning disability 'fair, reasonable and proportionate.'

The First-tier Tribunal has ruled in favour of CQC's decision to refuse an application submitted by Care Management Group Limited (CMG) to change a condition of its registration and increase the number of people with a learning disability at one of its services.

CMG – a care provider running several specialist support provisions across the country for people with learning disabilities and/or autism – applied to CQC in April 2017 to increase the maximum number of people at its Cherry Tree service in Essex from seven to ten.

Situated on a congregate and campus site known as Lilliputs, the setting also includes two other registered services, a children’s home registered by Ofsted and a day centre. Altogether, CMG may accommodate up to 26 people across those services on the site.

CQC refused CMG’s application to increase this number on the basis that it did not demonstrate it would comply with Registering the Right Support – as well as the underpinning national guidance – that states new services and variations to registrations within a campus and congregate setting should not be developed due to this model of care not being in the best interests of people with a learning disability.

National guidance includes Building the Right Support (supporting people with a learning disability and/or autism) and the accompanying transforming care national service model, as developed by NHS England (NHSE), the Association of Directors of Adult Social Services (ADASS) and the Local Government Association (LGA).

CQC was also not assured that appropriate consultation had taken place with those who used the Lilliputs site, their families and advocates, or with local commissioners to identify local need.

CMG appealed CQC’s decision which was heard by the Care Standards Tribunal over seven days. This concluded on 6th July and the Tribunal’s judgement has now been published, upholding CQC’s decision of refusal, meaning the appeal is now dismissed.

Tribunal Judge, Siobhan Goodrich said, 'We have found that the decision was plainly in accordance with the law, including the regulations.

'We also consider that the decision was necessary in pursuit of a legitimate public interest, namely, the protection and promotion of the health and wellbeing of future service users, who, if this provision were to be extended would be placed there despite the national recognition that this model of care, in a campus and congregate setting, is not the appropriate model in terms of according adequate respect for the rights of those with autism to live as ordinary a life as any other citizen.'

Welcoming the decision, Andrea Sutcliffe CBE, Chief Inspector of Adult Social Care at CQC said, 'This recognises the important role CQC has in taking decisions about registration that protect and promote the health, safety and welfare of people with autism and learning disabilities – decisions that support and are informed by national and best-practice guidance.

'I am proud of CQC, and in particular the registration, advisory and legal teams who worked on this application, for standing up for the rights of people who use services and I am determined that we will continue to do so.'

Viv Cooper OBE, Chief Executive of The Challenging Behaviour Foundation has also commented, saying, 'People with learning disabilities have the same rights as everyone else to live in their local communities with the right support to enable them to lead fulfilling is right that CQC should robustly challenge the development of large, segregated that service providers and commissioners invest in a range of high quality, local and individualised services to meet individual need.'

Ray James, National Director for Learning Disability at NHS England, said, 'This judgement is welcome reinforcement of the importance of supporting people with a learning disability, autism or both to lead fulfilling lives in their communities. Consistent with national policy – as set out in Building the Right Support – it gives a clear message about the types of services that will be provided in the future to help ensure people get the very best care and support.'

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