CQC v Hillgreen Care Ltd  MHLO 50
Prosecution of care home provider (1) The care home provider charged with failing between 1/4/15 and 1/12/15 to comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 by failing to provide care and treatment in a safe way for service users (reg 12) and failing to put in place, and operate effectively, systems and processes to protect service users from abuse, including sexual abuse (reg 13). The provider had known since 2004 that its resident XX posed risk a of causing sexual abuse. Following an allegation of anal rape of a woman in 2008 his care plan stated that he "identifies with both male and female around his sexual orientation" and that he "needs to be supported at all times and not to be left alone unsupervised when around other service users and when in the community". XX admitted to having sex with two other residents, neither of whom had capacity to consent: a female resident AA in April 2015 and a male resident YY on 1/11/18. The provider had not followed the care plan and the district judge concluded that "[t]he incident with YY could not have happened had there been an extra member of staff on duty to watch XX and where he went." It was found guilty of both charges and was fined £300,000. (2) The judgement states that the CQC's inspection of the care home and seizure of documents took place on 27/7/17: this is the same day as a critical article in the Times (Andrew Norfolk, 'CQC covered up suspected rape in care home' (Times, 27/7/17)). Information about the chronology can be found in the CQC's subsequent report (CQC, 'CQC publishes independent investigation into its regulation of 14 Colne Road' (press release, 13/6/18)).
A care home provider has been fined £300,000 for allowing a man in its care with a history of sexual assaults the freedom to prey on vulnerable people.
The Care Quality Commission brought the case against Hillgreen Care Limited for not providing the constant, one-to-one supervision required for the man, who was described in court as XX.
CQC prosecuted Hillgreen Care Limited for failing in its duty to protect people in its care, exposing them to the risk of sexual abuse. District Judge Susan Williams also awarded CQC £141,000 in costs. The judge ruled that residents at the care home must not be identified.
She added: “There was a failure to provide appropriate care and a high level of culpability because the risks were well known to the company.” She said there was a “woefully inadequate system of care” in place.
The judge said that although Hillgreen was subject to insolvency proceedings, this should not affect the sentence and that the “fine would serve to mark society’s condemnation” of Hillgreen’s failure to protect vulnerable people in its care.
The CQC brought the case against Hillgreen Care Limited, for failing in its duty to protect people in its care, exposing them to the risk of sexual abuse. Hillgreen Care Limited was not present in court at any time during the proceedings.
Highbury Corner Magistrates’ Court was told that on 1 November 2015, an autistic man was assaulted at Hillgreen’s care home at Colne Road, in Enfield, north London. At the time there were only two care staff on duty to look after six people.
One of the residents, who was described as non-verbal, with limited mental capacity, was followed up to his room by XX, and, allegedly, raped. The incident was eventually reported to the police, but partly because of the alleged victim’s mental capacity and a lack of evidence, no prosecution ensued.
The alleged perpetrator had been under the care of Hillgreen Limited for 10 years. Mr Paul Greaney QC, representing CQC said that: “XX is a predatory and opportunistic sex offender” and was a risk to both sexes. Numerous allegations involving vulnerable adults and children had been made against XX dating back to his childhood.
The court heard from expert witness, Chartered Clinical Psychologist, Dr Neil Sinclair, who said that it should have been apparent to Hillgreen Care Limited that there was an extremely high risk of XX committing sexual offences. XX needed to be monitored at all times.
Dr Sinclair said that if that monitoring been carried out, the alleged attack would probably never have happened. Residents at Colne Road were exposed to potential and actual harm.
A number of care workers who had worked at Colne Road gave evidence - although nobody from the senior Hillgreen management team.
A support care worker, who said she had not been given any instructions about watching XX, said that she walked in on XX while he was assaulting another service user, described as YY, on 1 November 2015.
Following the alleged sexual assault Colne Road Home Manager, said that the home was no longer a place he wanted to work after the incident. He said that staffing levels were inadequate and that he had raised the matter with senior Hillgreen management, but that nothing had been done about it.
A statement was read out in court from YY’s mother in which she said she had no doubt that YY would have been incapable of providing informed consent to sexual activity, given the nature and extent of his disabilities.
Paul Greaney QC said: “YY plainly needed to be protected from abuse. One only needs to think for a moment about the situation that existed in that care home, a vulnerable man, in an environment in which a predatory sexual offender was largely free to roam, to realise that YY needed protection.”
CQC began the process to cancel the registration of the Colne Road service in February 2016. The registration of Hillgreen Care Ltd was cancelled altogether in September 2017.
Andrea Sutcliffe, CQC's Chief Inspector of Adult Social Care, welcomed the judgment and sentence: "As the judge has made clear, Hillgreen Care Limited utterly failed in their duty of care for the people they were responsible for supporting. YY should never have been exposed to the potential of sexual abuse from XX and the impact on him and his family is heartbreaking. My thoughts are with them today.
"It has taken a long time to bring this prosecution to a conclusion but the outcome proves that it has been worth the effort and dedication of CQC's inspection and legal teams. Providers should be clear that if people are exposed to harm through their failure of care we will take every step we can to hold them to account."
Transcript supplied by the CQC on request on 19/11/18.
- Rick Goodman, 'Care home failed to protect vulnerable pair from resident's "predatory" sex attacks' (Press Association article appearing on Care Appointments website, 16/11/18) — This article provides some more detail on the prosecution of Hillgreen Care Ltd.
- Andrew Norfolk, 'CQC covered up suspected rape in care home' (Times, 27/7/17) — This article related to a "cluster" of sex alerts at residential homes owned by Hillgreen Care, a private company that specialised in the care of young adults with learning disabilities. It was said that confidential documents revealed that: (a) the deputy manager of one home was a convicted sex offender working in Britain illegally; (b) concerns were raised at other homes over “sexual grooming” of residents, and staff having sex while on duty; (c) care workers were initially told not to inform police of a suspected rape in November 2015 of a severely autistic 23-year-old man who lacked capacity to consent to sexual relations; and (d) potential DNA evidence linked to the incident was destroyed. The CQC said it was "actively pursuing what criminal action can be taken in relation to the failings" at the Enfield home, and had not made any of the concerns public because its desire to be "open and transparent" needed to be balanced alongside a risk of "compromising ongoing investigations".
- Criticisms of CQC and care home. Andrew Norfolk, 'Sexual predator’s victim was failed at every turn' (The Times, 27/7/17) — (1) This article is critical of the CQC's response to sexual abuse in a care home: "It had the power to bring criminal charges against the company or the senior individuals responsible for its running. Instead, it chose a much quieter, less public course of action. The Enfield home no longer has any vulnerable adults in its care. It is one of four Hillgreen homes that have ceased to operate since November 2015 because the CQC identified, and publicised, lesser problems in their operation. In the case of the home where Tom was allegedly attacked, the commission’s website carries the report of a 2016 inspection that was published in October last year. It rated the facilities as inadequate and unsafe, but not because a high-risk sex offender was allowed unsupervised access to the bedroom of a defenceless, highly vulnerable resident. Instead, the report criticised the home for failings that included storing mops and buckets in the garden and having overflowing bins, scuffed skirting boards, loose handles on kitchen drawers and a broken dishwasher. The report noted the recent promotion of a senior care worker to deputy manager but chose not to reveal that the vacancy was created by the exposure of her predecessor as a convicted sex offender. ... No one has told the residents of those homes, or their families, what happened at the Enfield home in November 2015. It is almost a year since anyone spoke to Tom’s mother about the attack." (2) It is also critical of the care home management: "In written statements seen by The Times, three Hillgreen workers said that Ross Dady, the company’s regional manager, and Roger Goddard, its director of care, initially told them they should not contact police or any external authorities. ... [Tom's mother's] shock and dismay increased, she said, when the manager told her that Tom had not yet been taken to hospital and that JL had not been arrested because '[Tom] may have consented to it'. There is some disagreement as to how swiftly, and by what means, the various safeguarding authorities became aware of the incident but by the time the police were involved Tom’s underwear had already been put through the laundry." (3) After this article the CQC did prosecute: see CQC v Hillgreen Care Ltd  MHLO 50.
- CQC, 'Statement on CQC's actions in relation to Hillgreen Care Ltd' (27/7/17) — In this response to the Times article of the same date, the CQC's chief executive stated: "Today's coverage in the Times has rightfully challenged the action we have taken in respect of the care provided to the people who were resident at Colne Road. Whilst we did take action that led to the closure of this and two other services run by the Hillgreen Care Ltd, I believe that we could and should have taken action more speedily, both to ensure people were safe and in prosecuting this provider. Consequently, I am commissioning an independent investigation, which will report publicly to the CQC Board and identify what has happened, what we should have done differently and which will make recommendations to strengthen our future work."
- CQC, 'CQC publishes independent investigation into its regulation of 14 Colne Road' (press release, 13/6/18) — This relates to the publication of a CQC-commissioned report by Sir Paul Jenkins on the CQC's handling of the Hillgreen case.