This inspection took place on 10 and 11 December 2018 and the first day was unannounced. The service was last inspected in 2016 and rated ‘Good’. At this inspection three breaches of the Regulations of the Health and Social Care Act (2008) were found so the overall rating is now ‘Requires Improvement”.

Belong Warrington 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. CQC regulates the premises and the care provided, both were looked at during this inspection.

Belong Warrington Care Village is a purpose-built care home close to local amenities. It can accommodate up to 72 people across six households on three floors. Each household has separate adapted facilities. At the time of our inspection there were 68 people living there. Each household had a mix of people who required nursing or residential care.

Within the care village there is a bistro which is also open to the community, The Venue which is used for activities and social gatherings, a hair salon, a wellness centre and gym. The gym is available to everyone who lives at the service as well as the community, it is staffed by a qualified fitness instructor.

There was a registered manager in post who worked alongside a general manager and clinical lead. 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.

Medicines were not always managed safely. We found a missed medication and failure to follow up a prescription request from four weeks previously. We found medication keys were not always kept safely on the designated person but were left out on one of the households. This was a breach of Regulation 12, Safe Care and Treatment.

Staff were not always recruited safely. The provider failed to explore staff’s employment history. This was a breach of Regulation 19, Fit and Proper Persons Employed.

The registered manager did not have complete oversight of medication audits, household audits, safeguarding or accident and incident logs. This was a breach of Regulation 17, Good Governance.

People told us they felt safe and happy living at the service. Relatives of people who lived there told us they were happy with the care their relative received.

Risk assessments were completed and regularly reviewed and updated to protect people from the risk of avoidable harm.

There were enough staff to keep people safe and provide companionship. Staff had time to spend with people and many examples of kind, caring, meaningful interactions were seen during the inspection.

The households were warm, welcoming and homely. There were communal areas on each household and people were able to visit the bistro and the Venue as and when they wished.

Food and fluid monitoring was not always effective, and procedures required improvement. This was highlighted during the inspection and the registered manager informed us this was already underway.

People were empowered to retain their independence, people who were able to, controlled their own medications and were given a key fob so they could come and go as they pleased.

There were varied activities on offer six days a week. There were social gatherings and activity areas for people to enjoy at any time.

Safe infection prevention and control procedures were in place. All staff used appropriate personal protective equipment and the service was clean and tidy with no malodours.

The service employed two practice development facilitators who conducted on site face to face training and reviewed staff techniques through a supervision process. Extra training was offered, and outside companies were commissioned to deliver this.

The inspection took place on 24 February 2016 and was unannounced. This was the first inspection undertaken by the Care Quality Commission since the service opened on 18 August 2014. There were 72 people living in the premises at the time of our inspection.

Belong Warrington Community Village is situated in the Stockton Heath area of Warrington. It is a purpose built dementia designed building providing dementia and nursing care. The Village offers ‘household’ living across six households, each household providing a home to 12 residents. Each household has 12 en-suite bedrooms which surround a shared living space with a lounge and dining area and kitchen facilities. The open plan layout of the households enables staff to observe each individual’s wellbeing closely but naturally. For the purpose of this report we will refer to the accommodation as households.

The home 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.

The manager was available throughout the inspection and engaged positively with the inspection process. The manager was friendly and approachable; he operated an open door policy for people using the service, staff and visitors.

We found that care was provided by a consistent staff group in an environment which was friendly and homely.

People told us they felt safe at Belong Village. They told us it was like living in a family environment and we saw that people were settled, relaxed and comfortable living there. The relationships we saw were caring, respectful and dignified and the atmosphere was one of calm and comfort.

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. People's consent was gained before any care was provided and the requirements of the Mental Capacity Act were met. People’s capacity to make decisions was kept under review and the registered manager was aware of actions that would need to be taken where people had reduced capacity.

Staff were aware of their duty to safeguard vulnerable people and were provided with pocket booklets which gave information about safeguarding ‘If you see something, say something’. Staff understood their responsibilities with regard to safeguarding people, and people were supported by sufficient numbers of staff. The staff team had become established which helped people to receive consistent care from people who knew them well.

Staff members had developed good relationships with people living at the home and care plans clearly identified people’s needs, which ensured people received the care they wanted in the way they preferred.

People told us they liked the food and had a good choice available to them. People told us that they had been involved in choosing the meals and they were encouraged to make healthy choices.

Medicines were stored and administered safely. Staff had received training in the medicines they were giving to people and the systems were regularly audited to make sure safe practice was maintained.

Each person had a care plan which detailed their choices and preferences in relation to their care. Plans reflected people’s wishes, skills and aspirations as well as areas in which they needed support. People followed an active programme of individual and community activities.

Staff told us they worked well as a team and there were clear lines of authority within the management structure. Staff said the registered manager “knew his stuff” and was very supportive and cared deeply for the staff and the people who lived in the households.

The complaints policy was clearly visible within each h