Bradbury v National Care Standards Commission [2003] EWCST 0178(NC) (1 October 2003)
Susan Ruth Bradbury v NCSC
[2003] 0178.NC
BEFORE
Andrea Rivers (chair)
Sally Derrick
Geraldine Matthison
October 1st 2003
1. This was an appeal against a decision by the NCSC to refuse Mrs
Bradbury's application to register as manager of the Chase Nursing
Home in Walsall, a home registered for 22.adults with enduring mental
health problems.
2. On her application form she asked the tribunal to direct that
the press and public be
excluded from the hearing. Regulation 19 of the Protection of Children
and Vulnerable Adults and Care Standards Tribunal Regulations 2002
states that hearings are to be in public unless privacy is necessary
to safeguard a child's or vulnerable adult's welfare, to protect
someone's private life or to avoid injustice in legal proceedings.
We found that none of these exceptions applied in this case and
accordingly we did not agree to her request.
3. We did, however, make an order under Regulation 18 prohibiting
the publication
(including by electronic means) in a written publication available
to the public, or inclusion in any programme for reception in England
and Wales, of any matter likely to lead members of the public to
identify any of the vulnerable adults resident at the Chase.
4. As well as reading the written material provided to us before the hearing we accepted additional evidence from the Respondent during the course of the hearing, namely two letters from Mrs Bradbury to the Respodent and one from the director of the home, Mr A. Gunputh, all dated 12th February 2003. At the hearing before us the applicant represented herself and brought no witnesses. The Respondent was represented by Mr N.A. Carter of Anthony Collins solicitors. He brought two witnesses, Joy Hoelzel, an NCSC inspector and Graham Martin, Area Manager for Wolverhampton NCSC.
The Law
5. Section 21 of the Care Standards Act deals with the powers of the Tribunal in appeals against decisions of a registration authority . Section 21(3) states that:
" the Tribunal may confirm the decision or direct that it shall not have effect."
Section 21(5) also gives the Tribunal power to vary, remove or impose any condition.
6. Section 11 imposes an obligation on anyone who manages a relevant establishment or agency to be registered.
7. Section 13 states that a registration authority shall grant
any application for registration,
provided it is satisfied that "the requirement of regulations
under section 22" and of any
other enactment "are being and will continue to be complied
with".
7. The Care Homes Regulations 2001 set out the requirements for a registered manager. Regulation 9 deals with the issue of the fitness of the registered manager. Regulation 9(2)(b)(i) states that:a person is not fit to manage a care home unless:
"he has the qualifications, skills and experience necessary for managing the care home".
The Respondent submitted that their refusal to register Mrs Bradbury relied on this regulation.
8 It was the responsibility of the Respondent to show, on balance of probability, that their decision to refuse registration was the right one.
The Facts
9. Mrs Bradbury has been the Care Manager at the Chase Nursing
Home since November
1999. She is an experienced Registered Mental Nurse, having qualified
in 1979. Initially
she worked with the elderly, becoming a Ward Sister and then a Senior
Sister and in 1992 she gained a teaching and assessing award. In
1993 she retired from the NHS and began
work in the private sector.
10. She applied to register as manager on 23rd April 2002 and on
13th November she was
interviewed by an inspector employed by the Respondent, Joy Hoelzel,
who was accompanied by a colleague, Chris Fuller. Ms Hoelzel took
notes of the interview on a
form designed for that purpose. Some weeks prior to the interview
Mrs Bradbury had also
been sent a self-assessment quetionnaire to complete and this was
returned to the
Respondent some time after the interview. The interview and the
questionnaire were both
designed to test Mrs Bradbury's knowledge and understanding of administrative,
procedural and legal issues related to the running of the home and
the care of residents. It
was a matter of some concern to the Respondent that Mrs Bradbury
was giving up an
NVQ course in management, even though a qualification of this sort
would be a
requirement by 2005.
11. On 20th November Joy Hoelzel and Chris Fuller, having considered
the results of the
interview and questionnaire, sent a report to Graham Martin, the
Area Manager, recommending that Mrs Bradbury's application for registration
be refused and setting out the reasons for their view.
12. On 6th February 2003 Mr Martin, the Area Manager for Wolverhampton, wrote to Mrs Bradbury informing her that the inspectors did not consider that she met the necessary criteria for registration and that he was therefore proposing that her application. be refused. His letter set out the reasons for his decision.
13. On 7th May 2003 Mr Fraher, Regional Director for the West Midlands, wrote to Mrs Bradbury to inform her that he had decided to adopt the proposal to refuse her application to register but that she had a right to appeal against his decision to this tribunal.
14 On 5th June 2003 Mrs Bradbury applied to the tribunal indicating
her wish to
appeal against the Respondent's decision. In her Grounds of Appeal
she said that she had
made efforts to rectify the problems identified by the Respondents
in their reasons for
refusing her application to register. In particular she had enrolled
on a new management
course in March, to be completed in May 2004.
15. On 4th August 2003 the President issued directions and this
appeal was set down for 1st
October 2003.
Decision
16. In their Response to Mrs Bradbury's appeal the Respondents
gave three reasons for their
refusal to register her. We carefully considered these reasons in
the light of all the evidence and make the following findings:
17. Reason 1
" that the Appellant had not been able to demonstrate an in depth knowledge of developing policies and procedures or the importance of staff training issues the Appellant's understanding of legal requirements with regard to the protection of vulnerable adults and equal opportunity policy was also limited."
We heard evidence from Mrs Bradbury that she had indeed had no input into developing policies and procedures. These had been put in place by the proprietors of the home. She also accepted that she did not yet feel that she had absorbed either the theoretical or the practical implications of these new procedures and said that she had not yet covered these matters in her course. For instance, she was not able adequately to explain how staff were appointed.
18. Although she had begun to address the issue of staff training
by drawing up lists with staff
members of what training they had done and what still needed to
be done she did not give any other indication that she understood
the importance of staff training. Mrs Hoelzel told us that at an
inspection of the home on June 17th she had been shown staff supervision
records but that appraisals and assessments of training needs had
not been completed.
19. She was not able to demonstrate an understanding of the legal
issues relating to vulnerable
adults or equal opportunity policy, although we have no reason to
doubt that the vulnerable adults in her care were well looked after
and indeed Mrs Hoelzel emphasised that Mrs Bradbury's nursing and
caring skills were not in issue.
20. Reason 2
"that the Appellant's pattern of working shifts was not conducive to her role as manager and furthermore that her general practice of not including service users in the planning of their care together with her limited response to care pracice issues were a concern."
21. We heard that Mrs Bradbury worked a 40 hour week with two long
days and three shorter
days. Only occasionally did she work a night shift to help out.
We did not consider that this pattern of working shifts was such
as to prevent her from carrying out her duties as manager.
22. She did, however, accept that it was not her practice to include
service users in the
planning of their care and did not appear to grasp the importance
of this issue.
22. Reason 3
"that the Appellant had indicated her intention to give up
her NVQ4 course in
management which would have the result in her not having the appropriate
level of
qualification that is required by 2005. Whilst the Appellant has
sought to address the issue
of her personal training
it still remains unclear whether she
will have the appropriate
level of qualification.
23. We heard evidence from Mr Martin that the course Mrs Bradbury
has now embarked upon
is recognised by the NCSC as suitable for managers applying to be
registered. However,
we were not able to establish what she had learned from it so far.
Her grasp of the issues
considered by the Respondent to have been inadequate at the time
of the interview last
November did not seem to show very much improvement, despite the
clear efforts she has
made.
24. We were impressed with the honesty and directness of Mrs Bradbury's answers to us as well as her evident concern for the residents she cares for and we took particular note of the fact that, with 22 residents in the home, only one vacancy occurred each year. Moreover, on the few occasions when residents had to be temporarily re-admitted to hospital, their bed was always available for them once they were well enough to return home.
25. Nevertheless, in the light of our findings above we consider
that Mrs Bradbury does not
meet the requirements of Regulation 9(2)(b)(i ), since we find that
she does not have the
qualifications and skills necessary to manage the home and accordingly
this appeal is
dismissed. This is the unanimous decision of the tribunal.
Andrea Rivers
Sally Derrick
Geraldine Matthison