CQC guidance for supporting autistic patients and patients with a learning disability

All registered health and social care providers must ensure that their staff receive training in learning disability and autism

CREDIT: This is an edited version of an article that originally appeared on CQC

Health and social care staff should have training on how to interact appropriately with autistic people and people who have a learning disability. This new legal requirement was introduced by the Health and Care Act 2022, and 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 also still need to meet the requirements of Regulation 18 which requires you to provide employees with appropriate support, training, professional development, supervision and appraisal to enable them to carry out their duties. CQC statutory guidance introduced two 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 roles 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 includes people who are not directly using your service who your staff may have contact with. People with a learning disability, and autistic people, 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 using services.

The CQC expects all providers in all health and care sectors to review what training and support they provide to staff in various roles, in order to ensure they are meeting their legal responsibilities. The new requirement means many more members of your staff will need to have some form of training 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 are accompanying somebody. It also includes ancillary staff – for example, receptionists, security guards, cooks and kitchen staff, and cleaners. You need to decide how to meet the new requirement for these roles by assessing each member of staff, making sure that no-one is left out.

Some staff may already have received training, but you should consider reviewing the suitability of any existing training, monitor its effectiveness, and how you support all staff in relation to the new requirement.

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 CQC does 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.

If you decide that a member of staff does not need such training, the CQC expects you to be able to show a record of how you’ve reached that decision, if asked.

What will be looked at

The main focus 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.

The CQC may not look at staff training in every assessment; they 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, they 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 is 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 your staff have not yet received training appropriate to their role, they will check what action you have taken to mitigate any potential risks to people using services.
• Where staff have been trained, they will look at how you make sure they are competent and are putting what they have learned into practice.

The CQC will always act where there is evidence of poor care or treatment; its enforcement policy enables it to take into account a provider’s specific circumstances before deciding whether it is necessary and proportionate to take any enforcement action.

If staff have not specifically received training appropriate to their role to support people with a learning disability and autistic people, a practice may be in breach of Regulation 18. If this happens, the CQC will decide whether regulatory action needs to be taken. They will act proportionately and consider each individual case.