This inspection took place on 24 and 27 July 2017 and was unannounced.

Belong Crewe care village provides accommodation for up to 66 people who require nursing or personal care. At this inspection 65 people were living there some of whom were living with dementia. There were six separate households over three floors. These households were named Britannia, Coronation, Duke, Jubilee, Patriot and Royal Scott. Individual households were named after famous trains which built on the links to the Crewe railway network.

Belong Crewe was previously rated as good following our inspection on 7 September 2015. This rating was displayed in the reception area and also on the provider’s website.

At this inspection we found the service was overall outstanding.

A registered manager was in post and present during our inspection. 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 received excellent care from a staff team which was highly skilled, trained and motivated. The provider supported staff champions within the service who actively supported people to ensure they experienced good healthcare outcomes in areas such as dementia. Staff members had individualised development plans which capitalised on their skills to provide effective care for people. Staff members were actively encouraged by the provider to develop their professional skills and knowledge.

People were supported with links with health and social care services which were excellent. Where people had complex and continued health needs staff sought to improve their care, treatment and support by identifying and implementing best practice. People benefited from receiving support in a place best suited to meet their physical and emotional needs. Belong Crewe had achieved recognised accreditation in a number of schemes including dementia and end of life.

People received support from staff who had an excellent understanding of their social and cultural diversity, values and beliefs that may have influenced their decisions on how they want to receive care, treatment and support.

People had positive and empowering relationships with those they lived with and those who supported them. People received emotional support and took strength from those around them. People were encouraged to further develop relationships that mattered and brought value to their lives.

Staff were excellent in enabling people to remain independent and had an in-depth appreciation of people’s individual needs around privacy and dignity.

People’s human rights were promoted by staff members who were aware of current guidance and legislation which directed their work. People were involved in decisions about their care and had information they needed in a way they understood.

People were supported to eat and drink sufficient amounts to maintain good health. People’s personal likes and preferences were known by the staff who supported them to make informed decisions regarding their diet.

People received support that was flexible and responsive to their individual needs and preferences. Staff and the management team sought creative ways to enable people to live as full a life as possible. People received person-centred care which achieved outstanding results. People took part in social activities, and where appropriate education and work, which was innovative and met people’s individual needs, likes and aspirations.

People were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People were supported by enough staff who were available to safely meet their needs.

People had individual assessments of risk associated with their care. Staff knew w

During our inspection we spoke with eight people who lived in the households. They were all very happy with the care and support that they received. One person told us; "The staff talk to me all the time and they listen to me. They are my family now." Another person said; "I only need to ask for something and they endeavour to get it for me."

We spoke with the general manager, the support manager, the practice development facilitator, a senior support worker and three support workers. They all told us that they liked working at Belong Crewe Care Village and that felt supported to do their jobs.

We looked at consent issues and found that we had concerns in this area as there were not suitable arrangements in place for obtaining and acting in accordance with the wishes of the people who used the service.

We looked at the safety and suitability of the building and we saw that it was maintained to a very high standard.

We looked at the systems in place for recruiting staff and found that the service followed all of their procedures.

We looked at the support arrangements in place and found that the staff were supported and offered regular training in order to do their jobs effectively.

Not all the people we spoke to living at Belong Crewe were able to use words to tell us if they were happy with the way the service was run, and the way they were supported. People gave us the thumbs up or could indicate with a few words if they were happy. We were able to speak to people and observe their care as well as interactions between them and staff. People told us they enjoyed living at Belong Crewe and that staff respected their routines and lifestyle.

One person living at Belong Crewe told us the importance of maintaining their independence was essential to them. They told us they were able to choose their own routines and lifestyles and these decisions were respected by staff. They said that staff supported them to maintain their independence but were quick to respond to their requests for assistance. They said, “The problem is my memory is getting worse. The staff keep me up to date and doesn’t mind how many times you ask them something. At home I was not taking my tablets, I was forgetting. Now the staff help me I am feeling the benefit”.

We saw that people’s health care needs were supported by staff who they commented were ‘polite’, ‘friendly’, ‘I absolutely love them’, ‘such fun’ and ‘everyone knows your name even if you have only met them once’. Staff told us they were well trained and supported. We saw they were respectful of the needs of people living at the home.

The inspection took place on 14 May 2015 and was unannounced.

Belong Crewe Care Village is a purpose built complex that provides modern accommodation for people who require nursing or personal care. The village is located in a residential area of Crewe. There are six separate households, each able to accommodate 10 or 12 people who require differing levels of care, support and treatment. For the purpose of this report we will refer to the accommodation as households.

The service has 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.

When Belong Crewe Care Village was last inspected in February 2014 it was found not to be meeting the regulatory requirements looked at and which applied to this kind of home. It was found that where people did not have the capacity to consent, the provider was not acting in accordance with legal requirements.

Following the previous inspection the registered manager sent us an action plan explaining how the service would address this and identifying the actions that would be taken and the timescales involved.

During this inspection we found that all of the issues had been addressed.

During our inspection we found that the provider took steps to make sure that staff were recruited safely and that they were provided with training so that they could do their job. The provider used value based recruitment with a view to selecting staff with the right skills and attitudes.

People who used the service were provided with activities they could participate in if they wished to do so and staff were deployed to ensure that activities were arranged and were suitable to meet the personal choices of everyone who lived in the care village.

The care and support provided in all six households met the needs of the people living there and the environment was clean and comfortable with plenty of signage to ensure people were able to safely move around the building.

The experiences of people who lived in the households were positive. People said they felt safe, enjoyed the food provided and staff were kind and caring.

The service had a range of policies and procedures which helped staff refer to good practice and included guidance on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This included the provision of pocket booklets for all staff which gave information about safeguarding, ‘If you see something, say something’.

There was a flexible menu in place which provided a good variety of food to the people using the service.

Staff members we spoke with were positive about their various roles and the level of support they were provided with. They told us that all staff worked together in a happy atmosphere and that the care village was very well run.

Belong Care Village had a complaints procedure in place to ensure that people could identify any areas of concern. We saw systems which identified that complaints were logged and appropriate actions taken to ensure the services were run in the best interests of the people who lived in the care village.