The inspection was unannounced and took place on 8 and 10 January 2019.

Belong Macclesfield Care Village is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The home is referred to throughout the report as ‘the village’, as this is their preferred name. The report also references ‘life plans’ as this is how Belong described care plans.

The village has accommodation for up to 72 people. Accommodation is provided in six separate households over three floors. The households varied between 11 and 13 single occupancy bedrooms and each room has an en-suite bathroom. Central to each household is a kitchen, dining area and lounge. The care village has a bistro, internet café, hairdressing salon, gym and the ‘Venue’ which doubled as a cinema room and events facility. These facilities are available to people living in the community as well as living in the village. At the time of our inspection, 72 people were living in the village.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained good, but one domain had improved to outstanding.

There were enough sufficiently qualified and trained staff to meet the needs of the people living in the village and they had been recruited safely. There were systems and processes in place which ensured that people who lived in the village were safeguarded from abuse and staff were aware of how to report any concerns. Risks to people were effectively recorded and subject to regular reviews and there were clear instructions for staff to try to minimise risks to people without unnecessary restrictions.

Staff received regular supervision and appraisals to support them in their roles. Staff were encouraged to develop and were supported to do so by the provider. Staff received training and opportunities to give them the skills and knowledge to meet the needs of the people.

People were supported to have maximum choice and control of their lives and staff enabled them in the least restrictive way possible; the policies and systems in the service supported this practice. However, we did find some recording issues in relation to this, which were resolved during our inspection. People had access to other health professionals and staff maintained very good relationships with other health professionals.

People and their relatives we spoke with were all extremely positive about the care they received and approach of the staff within the village. We observed that staff knew people very well and respected their dignity. Staff promoted independence as far as possible and everyone spoke very positively about the staff and manager.

Staff were extremely proud to work for Belong and were clearly motivated and compassionate to provide an exceptionally caring service to the people living in each household. They were committed to finding ways of continually improving people’s experience of living in the village and involving the community and relatives in fundraising to gain additional technology for the village.

People’s life plans were person centred and contained details about the person, their history, preferences and how they wanted to be supported. These were regularly reviewed and contained any necessary advice from other professionals. There was a complaints procedure in place and people were clear who to speak to if they wanted to raise any issues.

People, their relatives and staff spoke positi

The inspection was unannounced and took place on 15 and 20 June 2016.

This service was last inspected on 3 February 2014 where it was found to be compliant in all the areas we looked at.

Belong is a care village providing personal care and nursing care for up to 72 older people. CLS refer to the home as a village, therefore we have used this terminology throughout the report. The village opened in 2007 and is managed by CLS Care Services Limited, a not for profit organisation based in the North West of England. The village is situated on the outskirts of Macclesfield in a residential area. Local community amenities such as shops, a pub and a bus stop are within a short walking distance. The village consists of six households for either 11 or 13 people. Each household has a lounge, dining area and fully fitted kitchen. All bedrooms are single occupancy with en-suite shower and toilet. There are also communal facilities that are shared with adjoining sheltered housing apartments. These consist of a bistro, hairdressers, fitness suite, activities venue and internet room.

The village 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. At the time of our inspection there were 72 people living in the village.

We found that people were provided with care that was safe, person centred, sensitive and compassionate. The village was managed and staffed by a consistent team of support workers and nurses who were well trained and well supported.

We saw that the service had a safeguarding policy in place. This was designed to ensure that any safeguarding concerns that arose were dealt with openly and people were protected from possible harm. All the staff we spoke to confirmed that they were aware of the need to report any safeguarding concerns.

We looked at staff recruitment files to check that effective recruitment procedures had been completed. We found that appropriate checks had been made to ensure that they were suitable to work with vulnerable adults.

The provider had their own induction training programme that was designed to ensure any new staff members had the skills they needed to do their jobs effectively and competently. This resulted in staff having the skills and knowledge to carry out their jobs well and provide safe and effective care.

We asked staff members about training and they all confirmed that they received regular training throughout the year and that this was up to date and provided them with knowledge and skills to do their jobs effectively.

People had care plans which were personalised to their needs and wishes. Each care plan contained detailed information to assist support workers to provide care in a manner that respected the relevant person’s individual needs, promoting their personal preferences’. The care plans were holistic as they considered in detail people’s physical as well as mental health needs to maintain a good standard of well-being.

People living in the village told us that the standard of care they received was good. Comments included, “this is a lovely place, nice staff”, “it’s good here” and “we have no complaints at all here”.

Relatives spoken with praised the staff team for the quality of care provided. They told us that they had every confidence that their relatives were safe and protected from harm and enjoyed a good quality of life. One person told us, “we are delighted that he has settled in so well”.

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 meant that staff were able to help and support people who had difficulty

During our inspection at Belong, Macclesfield, we observed Life Plans for people using services and all were very individualised and reflected a person centred approach to care. We saw evidence that people and their representatives were involved in the planning of their care packages. Life Plans, where necessary, were present for all people using services and were reviewed every month along with any identified risk assessments which kept people safe at the care village. People were protected from the risk of infection because appropriate guidance had been followed which meant people using services were cared for in a clean, hygienic environment. We observed an external audit in 2013 and noted that 100% of people using services said `the home is clean and tidy.`

There were effective recruitment and selection processes in place which meant only suitably skilled and competent staff were employed at the care village. Appropriate checks were undertaken before staff members began work which ensured the safety of all people using services. There was an effective complaints system available which people were aware of. Any comments or complaints people made were taken seriously and responded to appropriately and within a stated and acceptable time-scale.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by a practising professional.

At the time of our visit 70 people lived in the home. We visited two of the households at the home; Holly House and Cedar House. We spoke with six people who lived in these households, four support workers, the head chef and the registered manager. Limited information was obtained from some of the people using the service due to their dementia care needs or communication difficulties. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

During our observations we saw staff were respectful, kind and patient when addressing people or offering assistance. For example, we saw staff knock before they entered rooms, introduce themselves and ask permission before assisting people with personal care. From the staff interactions we observed we felt that staff had a good understanding of people's individual needs and personal preferences. They spoke with people in an appropriate manner, explained what they were doing and did not rush them taking time to support them properly. The atmosphere was friendly and relaxed.

We also observed that people were given choices around their day to day routines. Their independence was promoted as much as possible. For example, we saw staff help encourage people to participate in meaningful activities. One person was asked if they wanted to help lay the table for lunch and they were very happy to do this

One person we spoke to said the home was; “Like being with friends.” Another said; “Everyone here is marvellous they look after me above and beyond what I would expect.”

We observed that people had choice about when and where they would like to eat and drink and could choose the food and drink they wanted. For example, people got up when they wanted and could have breakfast when they wanted. A variety of drinks was offered regularly throughout the day and people were always asked what drink they preferred. We saw people choose what they wanted for lunch from a menu that had a number of alternatives. One person chose to eat on a chair in the corridor and staff bought them a small table to enable this.

One person told us; “The meals are very good and you can say what you want and what you don’t want. "Another told us; “I never have soup as they know I don’t like that.” Another said; “I often go and eat at the bistro with my wife when she visits.”

People told us they were happy with the care provided and there were enough staff to meet their needs. One person said; “I have a buzzer and when I push that staff come. I usually don’t have to wait too long.” Another said; “There are usually enough staff and I have no concerns about my care and no complaints. If I had I would raise them.” Another said; “I feel safe.”

People living in the home said that they receive the care and treatment and support they need, that they have fun living at the home and the people around them seem happy and content. Health and social care professionals who visit the home to provide care and treatment also told us that they saw care needs being met and that staffing levels are adequate when they have visited the home.