Care Quality Commission
Tribunal upholds CQC decision to refuse registration to ‘campus style’ accommodation for people with learning disabilities and / or autism
A First-tier Tribunal has ruled in favour of the Care Quality Commission’s (CQC) decision to refuse an application submitted by Lifeways Community Care (Lifeways) to vary a condition of its registration. Lifeways had applied to add an additional location to look after people requiring accommodation and personal care.
This is an important judgement as it further clarifies what is an acceptable care setting. The appearance of the proposed service did not match with the residential area it was located within and was too big - there was a supported living service on the same site. This did not promote integration with the local community.
Lifeways is a care provider looking after people with complex care needs, including those with a learning disability, autism and mental health issues. Since 2010, it has been registered with CQC to provide accommodation for people requiring personal care.
In April 2018 Lifeways applied to add an additional care facility, the proposed location being Springside, Spring Lane, Walsall, West Midlands, WS4 1AZ. The new facility, which had previously been an NHS care home, would accommodate 10 people (later reduced to 9) 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.
On 13 April CQC Registration 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 and did not follow the national guidance which advocates small domestic models of care and dispersed settings.
On 25 May 2018 CQC informed Lifeways that they proposed to refuse the application, stating their view was that the care home proposal did not comply with their policy ‘Registering the Right Support’. Additionally, it did not comply with the underpinning national guidance – that states new services and variations to registrations for services should not be developed as a campus and/or congregate setting due to this not being in the best interests of people with a learning disability and not promoting their rights of choice, independence and inclusion.
On 21 September 2018, CQC confirmed with Lifeways that they would refuse the variation in registration. Lifeways submitted an appeal against CQC’s Decision on 19 October 2018.
As part of the appeal hearing the Tribunal panel carried out a site visit at the proposed care home; it was only after this visit that the panel heard oral evidence on behalf of both Lifeways and the CQC.
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 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”.
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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Notes to editors
- The Tribunal’s decision is subject to an appeal period of 28 days from the date of the decision.
- CQCs guidance, 'Registering the Right Support’ – as well as the underpinning national guidance, 'Building the Right Support' – states new services and variations to registrations for services for people with learning disabilities and/or autism should no longer be developed as a campus and/or congregate settings and principles of care should be followed which are good quality person-centred care in the community that enables greater independence, inclusion and choice, and the right to live an ‘ordinary’ life as any citizen.
- The definitions of ‘campus’ and ‘congregate’ care settings within CQC’s policy – ‘Registering the Right Support’ – on registration and variations to registration for providers supporting people with a learning disability and/or autism are:
- Campuses: Group homes clustered together on the same site and usually sharing staff and some facilities.
- Congregate settings: Separate from communities and without access to the options, choices, dignity and independence that most people take for granted in their lives.
About the Care Quality Commission
The Care Quality Commission (CQC) is the independent regulator of health and social care in England.
We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.
We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.
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