This inspection took place on the 08 August 2018 and was unannounced. Ulysses House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Ulysses House is registered for six people with learning difficulties and Autism. On the day of our inspection, five people were living at the service.

At the last inspection on 27 November 2015 this service was rated good in all five key questions, and before that the home has a sustained a history of compliance with legal requirements.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. People living at Ulysses House could live a life as fully as they were able in a homely environment that had been created to meet their needs.

On the day of our inspection visit 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 was run.

Information about people’s care was provided in format that they found accessible and they could understand. The service was extremely well led. There was a strong person-centred ethos which meant that people were empowered to have choice and control over their lives. The registered manager provided strong and stable leadership and clear direction to the staff team. Staff felt supported and valued.

There were effective systems to monitor the quality and safety of the service provided that placed an emphasis on the quality of people’s lives. These systems were used to continue to drive improvements in the service and the care people received.

The service provided at Ulysses House was extremely person-centred and the staff were passionate about caring for people. We saw that without exception people at the service and relatives were treated with kindness by a staff team that were passionate about providing care to people who they considered to be like family members. Staff supported people with respect and dignity, and had developed some extremely positive relationships with people that were based on respect and trust.

People could maintain relationships with people who were important to them. Relatives we spoke with felt their views and opinions about their loved one’s care were always listened to so that they felt involved in their loved one’s care.

People received care that met their individual needs, people’s views and preferences were sought and staff made exceptional efforts to provide a service that empowered people to develop and live a life that they enjoyed. Staff understood people’s unique methods of communications so that they could meet their needs and involve them in all aspects of their care.

Staff sought consent from people before caring for them and they clearly understood and followed the principles of the Mental Capacity Act, 2005 (MCA). Where people were deprived of their liberty, processes had been followed to ensure that this was done lawfully. Staff understood people’s unique communication styles and ensured that the views of people with communication difficulties were captured and acted upon.

People were protected from the risk of harm because there were robust processes to ensure their safety. Staff all knew and understood their responsibilities in relation to protecting people from abuse and had had received the training they needed to do this. The registered m

During our unannounced inspection we met all six of the men currently living at Ulysses House. We spoke with three of them. Amongst their comments were: "I have more freedom here, I can talk with any staff. They are good to work with" and "It is good here." Some people were not able to express their views and one person did not want to talk with us.

There were four health professionals visiting the home during our visit. Amongst their comments were: "The manager and staff are energetic and have insight. They do a great job in not the easiest environment," "They give us information and they are open and welcoming" and "I have visited at the weekend. Staff are welcoming and there is a well-controlled atmosphere." We saw good interactions between the people that lived in the home and the staff and manager when issues arose during the day.

People had individual care plans and where possible signed these plans to say they agreed with their content. Risks were identified and plans were put in place to keep people as safe as possible. Risk assessments were updated when incidents occurred so that known risks could be appropriately managed.

There were enough staff on duty to ensure that people had opportunities to attend activities as well as meeting their other needs. Staff told us they were well trained and felt supported.

We saw that people that lived in the home had a good relationship with staff. There were appropriate systems in place to identify when people were unhappy and to try and resolve their concerns.

We had visited Ulysses House in May 2012 when we found that the home had undertaken refurbishment work but that redecoration and repair in all areas of the home needed to be completed.

At this visit we found all areas of the home had been redecorated and repairs had been attended to. A contract had been put in place with a local firm to ensure that repairs could be attended to in a timely manner.

Although people living in the home were not at the home at the time of our visit we saw that each person's bedroom had an individual style and evidence of their interests. All communal areas of the home looked appropriately decorated and comfortable.

We visited Ulysses House on 9 May 2012. They did not know we were visiting. We spoke with four out of the six people that lived in the service. Some people living in the home had difficulties with verbal communication and one person spent most of their day out of the home. We observed how support workers assisted people in the home. We spoke to three support workers, the deputy manager and the registered manager.

People living in the home said or indicated that they were happy living in the home. Two people living in the home said staff were "alright." A completed survey from a relative said: "(My relative) calls Ulysses House home and he is always happy to come back."

People said or showed us that their beds were comfortable. They showed us that they had belongings important to them in their bedrooms. Some people had lots of belongings and equipment in their rooms, other people were not able to tolerate a lot of belongings.

People agreed that they had a choice of food and activities. We saw three people choosing and preparing their lunch. Each person chose and prepared something different. We saw that people had different activities planned for the day.

We saw how support workers and managers spoke with people living in the home. People were treated with respect and kindness. People were reminded gently of agreed plans and appropriate respectful behaviour. People were able to have jokes with all staff in the home.

We saw people being encouraged to do their own laundry, keep their room clean and manage their own personal care. A relative wrote on a survey: "(My relative's) skills have improved he can now dress himself, he is happy and settled."

We carried out an unannounced inspection of this home on 27 & 30 November 2015. We had previously inspected the home on 13 November 2013 when we found that the home was compliant with all the regulations we looked at.

This home can provide accommodation and personal care for up to six people with learning disabilities and autistic spectrum disorders. Between our inspection visits the number of people living in the home increased from four to five people.

The home had a manager registered with us. 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 were kept safe from the risk of harm. Staff knew how to recognise signs of abuse and who to raise concerns with. Staff felt confident that the appropriate action would be taken if they raised any concerns with the managers or through the provider’s whistle–blowing arrangements. People had assessments which identified actions staff needed to take to protect people from risks associated with their specific conditions and challenges to themselves and others. Medicines were managed appropriately and this helped to keep people well.

People were supported by enough staff to keep people safe and to give support when each person requested support. Where possible people were involved in the recruitment of staff. Induction processes were in place to ensure new members of staff were suitable to support the people who were living in the home. People were happy with how staff supported them. Relatives and professionals from health and social care stated that staff demonstrated skills and knowledge to ensure people were supported effectively and safely.

The care manager and staff we spoke with were knowledgeable of the requirements of the Mental Capacity Act 2005. Appropriate Deprivation of Liberty Safeguards (DoLS) applications had been made where people needed when people’s rights were being restricted. Arrangements were in place to limit the effect of deprivations as staff worked in a person centred way. Staff sought consent from people before providing support and at times this meant respecting a person’s refusal of personal care support that would help them but continuing to try to gain consent in different ways. People’s rights were protected as they had control over their lives unless action had been taken to legally restrict their liberty.

People were supported to have the choice of meals that they liked. Efforts were made to provide healthier options of people’s favourite foods and where people needed to support to maintain a healthy weight, appropriate professionals were consulted. People had access to health professionals to keep people physically and mentally as well as possible.

People we spoke with were happy with the staff who supported them. We saw good interactions with between staff and people during both days of the inspection. Staff knew how to communicate with individual people and spoke about people in a warm and kind way. Staff responded quickly and appropriately to any choices that people made.

Relatives and professionals from health and social care told us that the home had taken exceptional care to ensure that new placements went well. People’s needs were assessed prior to admission and action was taken to make the transition as smooth as possible. Considerations were made of the needs of existing people living in the home, how care was to be provided and how the environment needed to be adapted.

Arrangements were in place to listen to people’s views in regular meetings, through surveys and via daily checks on how their planned care had worked. Action was taken where an individual’s care plan could be improved. All care plans were individualised to the person. People were able to undertake interests and hobbies both in a planned way and when they wished to change their plan.

Relatives felt confident that they could speak with the management about any concerns and appropriate systems were in place to respond to complaints.

The manager of the home was seen to be fair, calm and understanding. Staff, relatives and professionals from health and social care said that the management responded to any recommendations and issues raised in a positive way. We found that if we raised any issue or requested information that the manager responded very quickly. Systems were in place for an independent quality assessment of the service two or three times a year. This indicated that the service was well-led.