A comprehensive inspection took place on 22 and 25 May 2018 and was unannounced.

Champion House - Care Home with Nursing Physical Disabilities, known to people, their relatives and staff as Champion House, is situated in Calverley, a rural area mid-way between Leeds and Bradford. It is part of the Leonard Cheshire Disability company. The care home accommodates 27 people in one adapted building and provides residential and respite care, over two floors. Rooms are singly occupied and provide necessary aids and adaptations to suit people’s individual requirements. There are well appointed communal areas and communal bath and shower rooms located on each floor. On both days of our inspection there were 25 people living at Champion House, providing care and support for people with a physical disability.

When we completed our previous inspection on 3 February 2017 we found the registered provider was not meeting the regulation relating to the management of medicines. We issued a requirement notice as systems in place did not ensure people received their medicines as prescribed. Following the last inspection, we asked the registered provider to complete an action plan to show what they would do and by when to improve the service.

The purpose of this inspection was to see if improvements had been made with management of medicine and to review the quality of the service currently being provided for people. We also wanted to look at recent concerns raised by a whistle-blower and information shared with CQC about the two incidents which indicated potential risks. ‘Whistleblowing’ is when a worker reports suspected wrong doing at work. At this inspection we found the service had met the requirement notice in regards to the management of medicines.

At the time of the inspection there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service told us they felt safe with the care they received and there were systems and processes in place to protect people from the risk of harm. Staff and the registered manager had a good understanding of safeguarding adults and knew what to do to keep people safe. A new medication management system had recently been introduced and staff were getting used to the recording of the administration medicines. We found the registered provider had appropriate arrangements currently in place to manage people’s medicines safely. We found people had access to healthcare services to make sure their health care needs were met.

We found people were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. Robust recruitment procedures were in place and staff completed an induction when they started working for the registered provider. Staff received the training which ensured people received appropriate care and support to meet their individual needs.

People told us they enjoyed the meals provided and their suggestions were incorporated into menus. We observed the dining experience was a pleasant occasion and people received appropriate support with their meal when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We found the home was well maintained, bedrooms had been personalised and communal areas were comfortably furnished. We saw throughout our inspection people were treated with sensitivity and kindness. Staff had a good rapport with people. People’s dignity and privacy was respected. Staff had a good knowledge and understanding of people’s needs and worked together as a team.

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This inspection took place on 3 and 8 February 2017 and was unannounced. At the last inspection in November 2015 we rated the service as requires improvement. We found the provider was breaching three regulations, which related to person centred care, governance and staffing. The provider sent us a report which told us what action they were going to take. At this inspection we found the provider had made improvements and addressed the issues identified at the last inspection.

Champion House provides care for up to 27 people who have a physical disability. The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We asked people who used the service if they felt safe; they told us they did. Staff also told us everyone was safe living and working at Champion House. People lived in a safe and pleasant environment. Systems were in place to manage risk to individuals, however, medicines were not managed consistently and safely. The provider took action to address the issues promptly when we raised this with them. During the inspection we observed people received support at appropriate times, which indicated there were enough staff to meet people’s needs. There was a better system in place which ensured people received agreed one to one staffing. Robust recruitment processes ensured staff suitability was checked before they were employed.

Staff were supported to do their job well. They received appropriate training and supervision which ensured they understood their role and responsibilities. Staff we spoke with had good knowledge around the Mental Capacity Act 2005 (MCA) and how to support people who did not have capacity to make some decisions. People were happy with the quality and variety of meals. Menus offered people choice including healthy options. Arrangements were in place to make sure people’s specialist dietary requirements were met and a range of other professionals were involved to help make sure people stayed healthy.

People were well cared for. Staff knew the people they were supporting well. This included people’s individual communication skills, likes, and preferences. Staff had attended training called ‘a day in my shoes’ which helped them understand people’s experience at Champion House. End of life care planning was being further developed to make sure people’s wishes were known. Information was displayed to help promote choice and keep people informed.

People’s needs had been assessed and care plans contained good information which guided staff around how care should be delivered. Care plans covered what was important to the person, what they wanted to achieve and what support they needed. People were enabled to carry out person centred activities. The service had recently received a new minibus which provided people with more opportunities to access the community. People who used the service were encouraged to share their views and attended monthly meetings where they discussed topics that were relevant to the home. Systems were in place to respond to concerns and complaints. The service had received compliments about the quality of care provided.

The provider had effective systems in place to monitor most areas of the service; however, auditing processes for management of medicines had not picked up issues identified at the inspection. People were regularly involved with the service and their feedback was positive about the way the service was managed. Staff we spoke with told us the registered manager led the service well and had driven improvement.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see the action we have told the

This inspection took place on 9 November 2015 and was unannounced. At the last inspection in November 2013 we found the provider was meeting the regulations we looked at.

Champion House provides nursing care for up to 27 people who have a physical disability. At the time of the inspection, the service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager started working at the home in September 2015. They told us they would be applying to register as a manager with CQC.

People we spoke with told us they enjoyed living at Champion House and were complimentary about the staff who supported them. They told us they felt safe, enjoyed the food and received good support with their health needs. People consented to care and had the freedom to make their own choices. People were relaxed in the company of staff. Staff interactions were friendly, respectful and caring. Visitors were happy with the standard of care and told us the service was well led.

There was a lack of consistency in how people’s care was assessed, planned and delivered. Guidance around care delivery was not easy to find because people’s care files contained lots of old information. Sometimes important information about people’s care and welfare was not recorded.

Staffing arrangements did not always meet the needs and circumstances of people using the service. Some people received funding for one to one staffing support but they did not always receive this. People sometimes sat for long periods with little stimulation.

Staff understood how to safeguard people and knew the people they were supporting very well. During the inspection staff assisted us to communicate with people. Staff clearly knew the people well and enabled communication. Medicines were managed consistently and safely.

People lived in a safe environment. Rooms were decorated to individual taste and people could choose what items to keep there. Some of the décor was dated; a refurbishment programme was under way to improve the environment.

Information to help inform people was displayed in the home, this included leaflets about people’s rights, standards people should expect and customer surveys results. People had access to advocacy services.

Staff we spoke with told us they were well supported by peers and management. However, they did not receive appropriate training, supervision and appraisal which places people at risk of being cared for by staff who do not have the right skills and knowledge.

Everyone we spoke with was complimentary about the new manager. Staff told us although the manager had only been in post a short time, they felt positive changes had already been introduced. People got opportunity to comment on the service and influence service delivery. However, systems to monitor the quality and safety of the service were not effective.

We found the home was in breach of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Some people who used the service had complex needs which meant that they were not able to tell us their experiences. Those who were told us they were happy with all aspects of service.

One person said “We were given information then we came and looked around before making a decision.” People spoke highly of the care staff. One person described them as ‘wonderful’; another person said “In my opinion people are very well cared for. The two relatives we spoke with told us that there was always sufficient staff on duty when they visited and that staff always appeared competent and well trained.

Some people who used the service had complex needs which meant that they were not able to tell us their experiences. Those who were told us they were happy with all aspects of the service. One person said, "I have no complaints" and another one said, "I go out when I want". People spoke highly of the care staff. One person described them as 'Marvellous'.

We observed medication being administered with a weekly audit taking place and full records were accessed.

The five relatives we spoke with told us that there was always sufficient staff on duty when they visited and that staff appeared competent and well trained.