The requirement
Since 1 July 2022, all CQC registered health and social care providers have been required to provide training for their staff in learning disability and autism, including how to interact appropriately with autistic people and people with a learning disability. This should be at a level appropriate to their role.
The 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.
You still need to meet the requirements of Regulation 18. This requires you to provide employees with appropriate support, training, professional development, supervision and appraisal to enable them to carry out their duties.
We updated our statutory guidance on Regulation 18 in July 2022 to include 2 specific points about the new requirement:
- You 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.
You need to be aware of this when reviewing your induction, training and supervision plans for all staff.
How this affects your service
You should be able to meet the needs of anybody using your service. The requirement also applies to people who are not directly using your service, but who your staff may have contact with. Autistic people and people with a learning disability are as likely as any person to use any regulated health or care service. Training your staff appropriately will help to improve the experience and outcomes for all people who use services.
We expect 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.
This requirement means many more members of your staff will need to have some form of training that is appropriate to their role.
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.
You need to decide how to meet the requirement for these roles by assessing each member of staff, making sure that no one is left out.
For example, you might decide that a member of reception staff needs some awareness training as they may come into occasional contact with an autistic person or a person with a learning disability. In comparison, a healthcare professional would usually need a higher level of training.
Some staff may already have received training, but you should consider reviewing the suitability of any existing training and monitor its effectiveness, as well as how you support all staff in relation to the new requirement.
Our approach
When assessing the quality of care provided by a service, we 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.
We do not tell you specifically how to meet your legal requirements in relation to training. You are responsible for ensuring your staff are appropriately trained to meet the requirements of the regulations.
To ensure that staff are competent to interact with autistic people or people with a learning disability you should:
- consider all the guidance available and all relevant circumstances
- decide for yourselves the most appropriate training to choose.
The Oliver McGowan Code of Practice
The 2022 Act sets out a requirement for CQC registered providers to ensure their staff receive learning disability and autism training that is ‘appropriate to the person’s role’. The Act also introduces a requirement for the Secretary of State for Health and Social Care to issue a code of practice about compliance with this requirement. The Oliver McGowan Code of Practice commenced on 6 September 2025. The purpose of the code is to explain what is meant by training that is ‘appropriate to the person’s role’ and to provide guidance on how to ensure all staff receive such training.
Compliance with the standards is expected to ensure that every person receives high quality learning disability and autism training that meets their learning needs and is appropriate to their role. This means that CQC registered providers must ensure that they provide each member of staff with training that meets the standards set out below in order to deliver the best possible outcomes.
Standard 1
All staff receive training that covers a minimum curriculum of capabilities from the Core capabilities framework for supporting people with a learning disability and the Core capabilities framework for supporting autistic people.
Standard 2
All staff receive training that enables them to explore how they will put their learning into practice.
Standard 3
All staff receive a minimum amount of live and interactive training that is co-produced and co-delivered by people with a learning disability and autistic people.
Standard 4
All staff receive training that is based on evidence and is quality-assured through trialling, ongoing evaluation and accreditation. People with a learning disability and autistic people must be meaningfully involved in these processes.
All health and social care staff must receive training that meets the 4 standards set out in the code.
If you decide that a member of staff does not need such training, we expect you to be able to show us a record of how you've reached that decision if we ask.
What we will look at
Our main focus is 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 and meets their individual needs.
CQC will use the Oliver McGowan Code of Practice when considering whether providers are meeting the requirements of the regulation. We will take a risk-based approach to this and will look closely at your staff training and compliance with Regulation 18. Where your staff have been trained, we will look at how you make sure that they are competent and are putting what they have learned into practice. If we see that staff have not yet received training appropriate to their role, we will check what action you have taken to mitigate any potential risks for people using services and seek to understand your plans to address this.
When we are considering the care and treatment of a person with a learning disability or an autistic person, we 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.
Action we may take
We will always act where there is evidence of poor care or treatment. Our enforcement policy enables us to take into account a provider's specific circumstances when deciding whether it is necessary and proportionate to take any enforcement action.
If your staff have not specifically received training appropriate to their role to support people with a learning disability and autistic people, you may be in breach of Regulation 18. If this happens, we will decide whether we need to take regulatory action.
Further information
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 with over 8,000 people. This training is named after Oliver McGowan, whose tragic death in 2016 highlighted the need for better training for health and social care staff when interacting with autistic people and people with a learning disability.
The Oliver McGowan Mandatory Training on Learning Disability and Autism (Oliver’s Training) is the government's preferred and recommended training for health and social care staff to undertake to enable providers to meet the requirements of this regulation. The training package is co-designed and co-delivered with people who have lived experience. It will be divided into tiers depending on the needs of staff and levels of skills required. Initial e-learning is also freely available for staff of registered health and care services on Health Education England’s e-learning for healthcare website. Further updates on available training will be available from Health Education England.
In October 2024, the Department of Health and Social Care launched the Quality Assured Care Learning Service (QACLS). This service is delivered by Skills for Care. As part of the QACLS training providers who deliver Oliver’s Training are quality assured against a bespoke quality framework which has been coproduced with experts by lived experience.