Seabrooke Manor Limited, R (on the application of) v The Care Quality Commission
[2024] EWHC 2203 (Admin)
Hexpress Healthcare Limited, R (on the application of) v The Care Quality Commission
6 March 2023
[2023] EWCA Civ 238
Court of Appeal
A healthcare company challenged a critical report from the government's health watchdog. The court said the watchdog followed fair procedures and could use information only from the date of its inspection, even if the company improved later.
Key Facts
- •Hexpress Healthcare Limited (Hexpress) appealed against Mostyn J's refusal to grant permission for judicial review of a Care Quality Commission (CQC) report.
- •The CQC report rated Hexpress's services as 'requires improvement', including 'inadequate' for safety.
- •Hexpress challenged the CQC's process, specifically the independent review of the draft report and the CQC's failure to consider post-inspection improvements.
- •The CQC inspected Hexpress, reviewing six patient records and raising concerns about five.
- •Hexpress submitted extensive factual accuracy comments (FAC) which were reviewed by both the lead inspector and an independent inspector.
- •The CQC published the report despite ongoing disputes over factual accuracy.
- •The appeal concerned two grounds: (1) insufficient independent review of FAC response; (2) undue weight given to irrelevant factors (pre-improvement status).
Legal Principles
Procedural fairness in administrative decision-making requires a balance between efficiency and fairness, dependent on the specific circumstances.
R v Secretary of State for the Home Department, ex parte Doody [1994] 1 AC 531; R(Osborn) v Parole Board [2013] UKSC 61
Statutory duties, such as the CQC's responsibility to report on inspections under section 61 of the 2008 Act, must be interpreted fairly, and this interpretation may involve implicit obligations of procedural fairness.
Health and Social Care Act 2008
The common law duty of fairness requires regulators to give a person subject to criticism a reasonable opportunity to respond to adverse findings. This typically involves providing the person with the findings and an opportunity to comment. However, this does not necessitate providing an opportunity to comment on every revision.
Pergamon Press [1971] Ch 388; Maxwell v Department of Trade and Industry [1974] QB 523; R(Shoesmith) v Ofsted [2011] EWCA Civ 642; SSP Health [2016] EWHC 2086 (Admin)
High degree of deference should be shown to specialist regulators' judgments and findings unless irrational.
Outcomes
Appeal dismissed.
The Court found that the CQC's process was procedurally fair. The CQC complied with statutory requirements and provided Hexpress with adequate opportunity to comment on the draft report. While the court acknowledged conflicting first-instance decisions on the required level of independent review, it held that Hexpress's interpretation of SSP Health was an overly statutory reading that didn't reflect the inherent flexibility in procedural fairness.
Permission to apply for judicial review refused on grounds 1 and 2.
Ground 1 (failure of independent review) was rejected because the CQC's process provided sufficient procedural fairness. Ground 2 (undue weight on irrelevant factors) was rejected because the CQC was entitled to base its rating on the inspection date. The CQC’s decision to report post-inspection improvements without altering the rating was rational and lawful.
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