Bradbury v National Care Standards Commission [2003] EWCST 0178(NC) (1 October 2003)

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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.

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.

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.

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:

"…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.

"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.

"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.

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	England and Wales Care Standards Tribunal
You are here: BAILII >> Databases >> England and Wales Care Standards Tribunal >> Bradbury v National Care Standards Commission [2003] EWCST 0178(NC) (1 October 2003) URL: http://www.bailii.org/ew/cases/EWCST/2003/0178(NC).html Cite as: [2003] EWCST 178(NC), [2003] EWCST 0178(NC)

England and Wales Care Standards Tribunal