Notice to cancel registration
We acted for a care home provider which received a Notice of Decision to cancel its registration. The local authority had also placed an embargo on the home. We drafted and submitted an appeal to the First Tier Tribunal and managed our Client’s case through the Tribunal procedure. A detailed analysis of the Notice showed it was fundamentally flawed and historical in nature. The appeal was successful and the embargo lifted.
Warning Notices
We acted for a provider who was served with a set of Warning Notices alleging various breaches of the Regulations and Essential Standards. We prepared detailed written representations on behalf of our client challenging the factual accuracy of the Warning Notices and raising technical legal issues about their validity and proportionality. The challenge was successful and CQC did not proceed further with the Warning Notices.
Safeguarding and suspension of placements
Our client’s care home had faced unfounded allegations by a disgruntled former member of staff. The adult protection team had adjourned meeting after meeting and had begun investigating matters that were outside the scope of the local safeguarding policy. The team also persuaded the home to voluntarily suspend admissions until the conclusion of the investigation. The home was barraged by a succession of visits by safeguarding and contract monitoring visits and no progress was being made on closing the initial investigations. At that point we were instructed. We notified the local authority that the home would lift its voluntary suspension of placements immediately if concerns were not particularised, investigated and resolved within two weeks. As is often our experience in such cases, the local authority approached its functions with greater care and speed once we were on board. After months of uncertainty and frustration, the local authority agreed to the suspension being lifted in the timescale we set.
Due Diligence Process (Divestment)
We were requested by a client to undertake a healthcare regulatory due diligence exercise of their specialist business and prepare a report of our findings. We sent the client an Information Request setting out the key documents we needed to see in order to determine compliance with the relevant regulations. This included registration certificates, inspection reports, care plans, staff records and commercial contracts. A site visit was undertaken and an analysis of documents completed. We compiled a comprehensive report detailing the findings from the documents disclosed. The report highlighted some concerns regarding compliance and possible regulatory action. Our client used our findings to address those concerns at the start of the divestment process which ensured that they did not impact on price further down the line.
Obstacles to Registration
We acted for a provider wishing to open an independent hospital for service users with learning disabilities and liable to be detained under the Mental Health Act 1983 but who were meeting opposition from CQC, including an aborted pre-registration inspection. We took control of the management of the registration process which included resolving outstanding issues and correcting incorrect statements being made by CQC which would prevent registration. We advised the client on what they were legally required to do in order to obtain registration, including advice on the content of documentation, the appropriate use of CCTV and whether the correct planning permission had been granted in the context of the Care Standards Act 2000. A new pre-registration inspection was arranged with a new team from CQC. Ridouts was present in order to answer any concerns of the inspector and protect the client’s position. Registration was achieved adding £10 million to the value of the business.
CQC conditions on NHS Trust
We acted for a NHS Foundation Trust which received Notices of Proposal from CQC to impose conditions on four of its Regulated Activities, which if adopted would have impacted on its Foundation Trust status. Ridouts drafted robust representations to those Notices and after consideration of those representations, CQC decided not to adopt the Notices.
NHS commissioning dispute
A new state of the art hospital was built by our client to provide mental health services in an area that has a shortage of provision. The local NHS commissioners refused to commission from the hospital on the grounds that their framework agreements had been finalised with potential providers and would last for four years. The commissioners refused to commission from providers outside the agreements until the four year period expired. We helped the provider complain to the Cooperation and Competition Panel (CCP), the body responsible for ensuring competition in the NHS. In a groundbreaking ruling the CCP agreed that the commissioners had acted anti-competitively in using exclusive framework agreements. The case also paved the way for closer scrutiny of commissioning in the NHS.
Local authority tries to remove residents
We acted for a care provider. The local authority had conducted a contract monitoring visit and on the back of its findings cancelled its contract with the home and began removing residents. The provider disputed the findings and the residents wanted to stay. We helped the residents to instruct their own solicitors on Legal Aid who obtained injunctions to prevent their removals. The residents stayed and in time we helped repair the relationship with the local authority which reinstated the contract.
Unilateral fee reduction
Our client, a significant operator of a number of care homes, received a letter from a local authority stating that residential care fees would be reduced by 20%. This amounted to reduction in annual fees for our client in excess of £250,000 - straight from bottom line. The potential knock on for business value was significant - £2 million taking an EBITDA multiple of 8. We advised (subsequently confirmed by the Court of Appeal in another case) that one party to a contract cannot unilaterally vary price without the agreement of the other party. We carefully reviewed the contracts. There were no provisions allowing a mechanism for price change. The local authority was advised that any reduction in fees would be unlawful and any shortfall would be the subject of legal action. The local authority retaliated by serving notice to terminate the contract. We countered by arguing that the notice periods were too short (unlawful) and that moving service users without consultation was unlawful. Service users were introduced to lawyers who could represent them with public legal assistance. The services users issued protective claims in the Court of Protection and for judicial review. In the meantime the local authority agreed to honour existing fee levels. The Service Users were successful. The potential moves were blocked by the court. Ridouts negotiated suitable proportionate fee increases.
Registration of primary dental service providers
We acted for a dentist who found himself newly within the scope of compulsory registration with CQC. The dentist came to us for advice on what the Health and Social Care Act 2008 (and its associated Regulations) meant for his business and for practical help in making his application for registration to CQC.
We were able to help the client draft his application based on what his service had to offer and advise him on what he had to do to ensure that his practice met the requirements set in CQC’s Essential Standards of Quality and Safety. Where the dentist fell short of the standards, we were able to advise on what steps should be taken to achieve compliance and what policies and procedures the dentist should implement to ensure that his application would be successful.