Hexpress Healthcare Limited, R (on the application of) v The Care Quality Commission
[2023] EWCA Civ 238
Seabrooke Manor Limited, R (on the application of) v The Care Quality Commission
27 August 2024
[2024] EWHC 2203 (Admin)
High Court
A care home challenged the government's inspection agency (CQC) for giving them a bad rating. The court sided with the agency, saying their concerns about medication safety and record-keeping were justified, even though the care home tried to fix the issues later.
Key Facts
- •Seabrooke Manor Limited (Claimant) challenged the Care Quality Commission's (CQC) 'Requires Improvement' rating for their care home.
- •The CQC inspection found deficiencies in medication management, particularly concerning covert medication administration.
- •The Claimant argued the CQC's policy on covert medication record-keeping was overly stringent and irrational.
- •The CQC's rating was based on cumulative findings, not solely on covert medication issues.
- •The Claimant argued the CQC relied on ex post facto reasoning and lacked adequate reasons for its decision.
- •The CQC's internal review process involved multiple checks and expert opinions which supported the 'Requires Improvement' rating.
Legal Principles
Procedural fairness requires fair notice of proposed findings and a fair opportunity to respond.
R (Hexpress Healthcare Limited) v CQC [2023] EWCA Civ 238
A regulator's factual assessment and evaluative conclusions should be accorded deference, especially in areas concerning public safety.
Case Law (Implicit)
A decision is irrational and unlawful if a material finding is made without supporting evidence.
Case Law (Implicit)
The CQC cannot make adverse findings based solely on the absence of evidence without attempting to verify assertions made by the regulated body.
R (SSP Healthcare Limited) v CQC [2016] EWHC (Admin) 2086
Reasons for a public law decision must be intelligible and adequate, enabling understanding of the decision-making process.
South Bucks DC v Porter (No 2) [2004] UKHL 33
Wholesale amendment or reversal of stated reasons is inimical to the purpose of giving reasons.
R v City of Westminster ex p Ermakov (1995) 28 HLR
For a factual mistake to cause unfairness, it must be based on an uncontentious and objectively verifiable fact, the alleging party not responsible, and the mistake materially impacting the reasoning.
E v Secretary of State for the Home Department [2004] EWCA Civ 49
The CQC is entitled to judge the claimant on the basis of what was seen in place at the date of the inspection.
R (Hexpress Healthcare Limited) v CQC [2023] EWCA Civ 238
Outcomes
The Claimant's judicial review challenge was dismissed.
The court found the CQC's determinations were rational and evidence-based. The CQC's policy on covert medication was deemed sensible guidance, not an irrational or overly stringent requirement. The 'Requires Improvement' rating was supported by cumulative evidence of deficiencies in medication management and quality assurance systems.
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