The CQC has published an update on how all registered health and social care providers must ensure they receive training in learning disability and autism.
This must include how to interact appropriately with autistic people and people who have a learning disability. This should be at a level appropriate to their role.
This new legal requirement was introduced by the Health and Care Act 2022. It applies to:
- All services and all settings, not just specialist services for people with a learning disability and autistic people, and not just the places where people live
- All health and care staff as well as ancillary staff who may have contact with people with a learning disability and autistic people, such as administrative staff
The CQC states that all registered health and social care providers need to meet the requirements of Regulation 18. This means employees must have the appropriate support, training, professional development, supervision and appraisal to enable them to carry out their duties.
CQC statutory guidance introduced 2 specific points about the new requirement:
- Providers must ensure that all staff receive training in how to interact appropriately with people with a learning disability and autistic people, at a level appropriate to their role
- Staff must receive appropriate supervision in their role to ensure they demonstrate and maintain competence in understanding the needs of people with a learning disability and autistic people, including knowing how to support them in the best way
How this affects your service
The CQC states that providers should be able to meet the needs of anybody using their service. The requirement also includes people who are not directly using your service, but whom your staff may have contact with.
It expects all providers in all health and care sectors to review what training and support they provide to staff in various roles, to ensure they are meeting their legal responsibilities.
It applies to all staff who have contact with, or may potentially have contact with, an autistic person or a person with a learning disability, whether that person is using the service themselves or if they are accompanying somebody. It also includes ancillary staff, for example, receptionists, security guards, cooks and kitchen staff, or cleaners.
CQC approach
When assessing quality, the CQC will check that staff are competent to deliver care and treatment to all people using services – including those with a learning disability and autistic people.
The regulator will not tell you specifically how to meet legal requirements in relation to training. Providers are responsible for ensuring their staff are appropriately trained to meet the requirements of the regulations.
But it adds, to ensure that staff are competent to interact with autistic people or people with a learning disability, providers should:
- Consider all the guidance available and all relevant circumstances
- Decide the most appropriate training to choose
If providers decide that a member of staff does not need such training, the CQC expects providers to be able to show how that decision was made if asked about it.
What the CQC will look at
The focus, it says, will be on ‘whether your service and your staff are delivering safe, person-centred care and treatment that safeguards people using services from abuse and improper treatment.’
It may not look at staff training in every assessment. The CQC may only look at Regulation 18 if there are areas of concern. If the concern is in relation to a person with a learning disability or an autistic person, it will check certain areas, for example:
- How you make sure you get people’s consent to care and treatment, or the consent of a person authorised to speak on their behalf
- Whether people’s care and treatment are appropriate, and that care meets their needs and reflects their preferences
- Whether care and treatment are being delivered safely
- Whether staff are treating people with dignity and respect
- Whether you protect people from abuse and improper treatment
- The training provided to staff and training records
If staff have not yet received training appropriate to their role, it will check what action you have taken to mitigate any potential risks to people using services. Where staff have been trained, it will look at how you make sure they are competent and are putting what they have learned into practice.
What if you breach Regulation 18?
The CQC follows its enforcement policy when deciding to take action.
If staff have not specifically received training appropriate to their role to support people with a learning disability and autistic people, it may amount to a breach of Regulation 18 and the CQC will decide what action to take.
The new legal requirement does not specify a training package or course for staff.
However, in 2021 the Department of Health and Social Care, NHS England, Health Education England and Skills for Care developed and trialled the Oliver McGowan Mandatory Training package on learning disability and autism.
Work is ongoing to finalise the standardised training packages for staff. Updates will be available from Health Education England.
The Government is expected to publish a Code of Practice to set out what must be included in training to meet the legal requirement. The Government must carry out a public consultation on the Code of Practice.
Further Information
See Health Education England’s information on the Oliver McGowan Mandatory Training in Learning Disability and Autism
