Brief guide: Mandatory training requirement on learning disability and autism

Page last updated: 8 September 2025

This guide explains the mandatory training requirement on learning disability and autism, and what we expect from providers.

The Health and Care Act 2022 introduced the need for all CQC-registered service providers to make sure their staff have training on learning disability and autism, at a level appropriate to the role of the individual member of staff. This training must include how to interact with autistic people and people with a learning disability.

Reports from LeDeR reviews (Learning from lives and deaths – people with a learning disability and autistic people) show that, compared with the general population, people with learning disability and autistic people:

die earlier than they should
have poorer physical and mental health
experience inequalities in the quality of their care and barriers in accessing care.

Introducing a legal requirement for training on learning disability and autism was an important step to improve the knowledge, skills, and culture of staff in health and care services.

The government prefers and recommends the Oliver McGowan Mandatory Training on Learning Disability and Autism for health and social care staff. This training was developed in response to a recommendation from the second annual LeDeR report.

The Oliver McGowan Code of Practice

From 6 September 2025, the Oliver McGowan Code of Practice aims to further support implementation of the legislation. It sets out the standards that training needs to meet, in terms of both its content and how to deliver it.

The Code of Practice is required by the Health and Care Act 2022. It explains how a registered provider should use the Code and what would happen if they do not comply with it.

The Code of Practice was developed by consulting with autistic people and people with a learning disability, their families and carers, charities, health and social care stakeholders and CQC.

How CQC has responded

In July 2022, we updated our statutory guidance for providers on complying with Regulation 18(2)(a) of the Health and Social Care Act 2008, which relates to staffing. Our guidance added requirements that 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.”

And that 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.”

This legal requirement applies to:

all services and all settings, not just specialist services for learning disability and autism, and not just the places where people live
all health and care staff, and ancillary staff, who may have contact with autistic people and people with a learning disability (such as administrative staff).

Regulation 18: Staffing in the Health and Social Care Act does not state which training packages providers should use or what training must include. This means that we can’t promote, endorse, or require providers to undertake any named training programme. Because of this, we will refer to the training as ‘mandatory training requirement on learning disabilities and autism’. This includes references in our assessment reports.

What we expect from providers

We expect providers to be responsible for making sure their staff are appropriately trained to meet the requirements of the regulations. The Oliver McGowan Code of Practice sets out how providers can meet the training requirement. It has a strong foundation in the capability frameworks for learning disability and autism.

CQC will consider the Code of Practice when assessing whether providers have provided their staff with learning disability and autism training that is appropriate to their role and that meets the standards of the Code.

When we look at training as part of an assessment, we expect providers to have assessed all the training needs and abilities of their staff. Providers should be satisfied that the care and/or treatment being delivered as part of the regulated activity is safe for all people. It should meet everyone’s individual needs, including those with a learning disability or autistic people.

How we assess this training requirement

As part of a full assessment, we expect our operational teams to check whether staff have received training in learning disability and autism. During a responsive assessment, checking for this training will depend on the reason for the assessment, and the focus of the quality statements assessed.

Our focus will be on whether providers and staff are delivering safe, person-centred care and treatment, that safeguards people using services from abuse and improper treatment.

We may ask to see:

records of assessments of training needs
training plans
schedules of booked training, or evidence of training already delivered.

We will then confirm these in interviews with staff as needed. When assessing this topic, we will follow these principles:

If previous training on learning disability and autism has been provided, we expect providers to review this training against the specific requirement of Regulation 18 using the Code of Practice. This includes staff who work with those who deliver care directly. For example, administrators and other on/off-site staff who come into contact with people with autistic people and people a learning disability. Providers should check whether previous training is compliant, due to the added requirement combined with the Oliver McGowan Code of Practice.
If staff in a service might have contact with people with autistic people and people with a learning disability, we expect the provider to have carried out an assessment. The assessment is to identify what level of training individual members of staff need and what steps have been taken to arrange it. For example, an action plan setting out when and how training will be delivered.

Quality statements we use

We usually consider a provider’s learning disability and autism training under these quality statements:

Safe and effective staffing (safe key question)
Governance, management and sustainability (well-led key question)

If we have concerns

If a provider’s training is assessed and/or there are concerns about the quality and safety of the service, we will do the following to help us judge whether they are meeting the regulation’s requirements:

check what action has been taken to meet the training requirements
focus on the type of training that has been found, booked, and provided for staff
review how staff are supervised to make sure they maintain competence
check against the Oliver McGown Code of Practice standards.

If there are concerns about how autistic people and people with a learning disability are being supported, inspectors will check whether there has been a breach of other regulations. This should happen before they decide on whether enforcement action is needed, and can be regulations other than Regulation 18: Staffing, for example:

This may provide stronger grounds for taking action if it can be demonstrated that the standard of care being delivered is not high enough.

If the requirement isn’t being met

If there is evidence that providers are not following the mandatory training requirement, inspectors will need to decide whether to take regulatory or enforcement action against them. Our enforcement policy applies as usual when making a decision about breaches of regulation.

If the provider decides that a member of staff does not need the mandatory training on learning disability and autism, they must be able to show us a record of how they reached that decision if asked. However, all staff involved in delivering a regulated activity fall under the requirements of the regulation. It is important we repeat that the training requirement applies to all CQC regulated services and direct them to the regulations.

If there is no plan for the provider to take suitable action, or there is no/weak evidence to show they will, we will consider the impact on people using the service on a case-by-case basis.