Automated Summary
Key Facts
Sonia Heway Care Agency Limited appealed the Care Quality Commission's (CQC) decision to cancel its registration for providing personal care. The CQC cited repeated regulatory breaches since 2015, including failures in safeguarding, staff management, and electronic care management (ECM) system oversight. Despite efforts to improve through external consultants and staff changes, the tribunal found ongoing non-compliance with Regulation 17 (good governance) and concluded the cancellation remained proportionate.
Issues
The central legal issue was whether the Care Quality Commission's decision to cancel Sonia Heway Care Agency Limited's registration for personal care services, based on its history of non-compliance with regulations (including breaches of Regulation 17 on good governance) and repeated inspection failures, remained proportionate and reasonable under sections 3, 4, and 17 of the Health and Social Care Act 2008. The Tribunal evaluated the evidence of systemic failures, lack of accountability, and insufficient improvements despite multiple inspections and enforcement actions.
Holdings
- Allegation 40 accepted by Mr Fawole: The service failed to resolve a complaint about a carer's conduct and missed visits, with no documented resolution.
- Allegation 38, 44, and 45 not proved: Improvements in recruitment, training, and training integrity were acknowledged, with no specific regulation breaches identified.
- Allegation 20 proved: A carer attended a service user's visit late despite a time change, leaving the user without food and fluids for an extended period.
- Allegation 62 proved: The festive period did not justify gaps in care, as service users require consistent support regardless of holidays.
- Allegation 21 proved: The ECM system was not effectively managed, leading to discrepancies in visit monitoring and no oversight during a three-day system outage in October 2020.
- The Tribunal dismissed the appeal, confirming the CQC's 22 October 2019 decision to cancel registration as proportionate and necessary due to persistent breaches of Regulation 17.
- Allegation 9(a) not proved: Insufficient evidence that staff consistently administered Lorazepam contrary to medical advice, though tablet recording practices were confusing.
- Allegation 12 proved: Service failed to report an ungradable pressure sore to the CQC despite awareness of the issue and local authority involvement.
- Allegation 25 proved: No records existed to show how negative feedback from service users L, BC, and BD was addressed.
- Allegation 57 proved: Information requested during the October 2020 inspection could not be provided, highlighting ongoing governance failures.
- The Tribunal found Ms Appah, Mr Scott, and Ms Reed's oral evidence credible and supported by documentation, indicating their professional and diligent approach during inspections.
- Allegation 50 proved: Ms Goncalves did not understand her obligation to report safeguarding incidents to the CQC without waiting for other investigations.
- Allegation 49 proved: Management structure lacked clear accountability, with Mr Fawole failing to verify information and relying on unproven claims from staff.
- Allegation 52 proved: The service lacked updated Covid-19 guidance during the July 2020 inspection, despite later corrections.
- Allegation 60 proved: The service's business continuity plan for the pandemic was incomplete, with Ms Goncalves unaware of its existence.
- Allegation 28 not proved: Supervision record creation date was explained as a PDF export, lacking conclusive evidence of fabrication.
- Allegation 58 proved: Carers did not follow proper risk assessment procedures for a service user with poor vision, leading to fall risks.
- The Tribunal concluded that the Respondent's decision to cancel registration remained proportionate after reviewing three inspections post-July 2019, including October 2020, and the service's ongoing breaches of Regulation 17.
- Allegation 6 was proved: Staff culture hindered improvements, with carers not following managerial requirements and a lack of functional teamwork observed during inspections.
Remedies
- The Respondent's decision of 22 October 2019 to cancel the registration of Sonia Heway Care Agency Limited is confirmed
- The appeal is dismissed
Legal Principles
The Tribunal applied the principle of proportionality under section 4 of the Health and Social Care Act 2008 to assess whether the Care Quality Commission's decision to cancel the Appellant's registration remained a proportionate and reasonable response to the service's ongoing regulatory breaches and governance failures.
Cited Statute
- Health and Social Care Act 2008
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
- CQC Registration Regulations 2009
- Tribunal Procedure (First-tier Tribunal) (Health, Education and Social Care) Rules 2008
Judge Name
- Ms Denise Forshaw
- Ms Lorna Jacobs
- Ms S Brownlee
Passage Text
- The Tribunal has considered all of the material extremely carefully, applying the principle of proportionality and it has concluded that the decision to cancel the registration of Sonia Heway Care Agency Limited to provide a regulated activity remains a proportionate decision which meets the requirements of section 4 of the 2008 Act.
- The Tribunal reminded itself that we are looking at matters afresh. We do that by taking into account all of the evidence in the hearing bundle, the supplementary documentary evidence and the oral evidence provided during the hearing, as well as applying the requirements in sections 3, 4 and 17 of the 2008 Act and the 2014 Regulations.
- We concluded that this evidence supports the conclusion that the structure and lines of accountability were simply not clear since the inspection of July 2019.