This briefing note provides a comprehensive synthesis of the joint The Care Provider Alliance (CPA) and Care Quality Commission (CQC) webinar on the Oliver McGowan Code of Practice. The Code, which is now in effect, serves as official guidance for the mandatory training requirement on learning disability and autism, a legal obligation for all CQC-registered providers since July 2022 under an amendment to the Health and Social Care Act 2008, specifically impacting Regulation 18 (Staffing).

The CQC will use the Code as a foundational framework to assess whether providers are meeting the regulation, providing a shared understanding of what compliance entails. However, the Code itself is not a regulation. The core responsibility lies with providers to select appropriate training, determine the correct level (tier) of training for each staff role, and ensure that staff are competent in applying their learning. The CQC will not prescribe specific training packages or dictate training tiers.

The CQC’s regulatory focus is on outcomes, whether people using services receive safe, person-centred care that meets their individual needs. Assessments will be risk-based and proportional, taking into account a provider’s rationale, action plans, and mitigation strategies, particularly where full compliance has not yet been achieved. A proactive, organisational culture that can demonstrate its decision-making process is paramount. Crucially, matters concerning the funding and availability of training fall outside the CQC’s remit and are the responsibility of the Department of Health and Social Care (DHSC), Skills for Care, and local Integrated Care Boards (ICBs).

The Legal and Regulatory Framework

The Core Requirement: Regulation 18 (Staffing)

Since July 2022, all health and social care providers registered with the CQC are legally required to provide staff with training on learning disability and autism. This requirement stems from a change in the Health and Social Care Act 2008 and is integrated into CQC Regulation 18. While this regulation has always mandated that staff be appropriately trained, the update specifically requires training that enables staff to:

• Interact appropriately with autistic people and people with a learning disability.
• Receive appropriate supervision to demonstrate and maintain competence in supporting these individuals.

The Role of the Oliver McGowan Code of Practice

The distinction between the regulation and the Code of Practice is critical for providers to understand.

• The Regulation: This is the mandatory legal standard that registered providers and managers must meet. It is the enforceable law.
• The Code of Practice: Issued by the Secretary of State, the Code is official guidance designed to support the implementation of the regulation. It is not a regulation itself and is not directly enforced.

The CQC will use the Code to inform its assessments and gain a shared understanding with providers on what constitutes compliance. A key operational change since the Code’s commencement is that CQC inspectors are now able to quote the Code directly in their inspection reports, providing a clear framework for their findings.

Scope and Applicability

The training requirement is comprehensive and applies to:

• All Services and Settings: The mandate is not limited to specialist services. It applies across all regulated settings, including general hospitals and dementia care homes.
• All Staff: Any staff member who may have contact with an autistic person or a person with a learning disability must receive training. This includes ancillary staff, such as administrative and domestic workers.
• Training Level: The training must be provided at a level appropriate to each individual’s role. It is the provider’s responsibility to determine this level.

CQC’s Approach to Regulation and Assessment

Focus on Outcomes and Organisational Culture

The CQC’s primary focus remains on whether services deliver safe, person-centred care that meets individual needs and safeguards people from abuse. The Code of Practice provides a tool to assess this more deeply. It allows the CQC to move beyond a simple training matrix and understand:

• How training translates into staff competency and improved outcomes for people.
• The overall culture of an organisation. A provider that can demonstrate a clear rationale for its decisions, explain its mitigation plans for any gaps, and show a commitment to getting things right will be viewed more favourably than one that is passive or unaware of the requirements.

A Risk-Based and Proportional Approach

The CQC’s regulatory actions will be proportional and based on a thorough assessment of risk.

• If staff are not yet trained, inspectors will seek to understand the provider’s action plan and what mitigations are in place to manage potential risks to people using the service.
• The CQC will use its enforcement powers if there are concerns about poor care, people’s needs not being met, or a risk of harm.
• The training requirement has been in effect since 2022. Therefore, assessments are not a matter of “leniency” but a focus on whether regulations are being met.

The Provider’s Responsibility for Assurance

A central theme of the CQC’s approach is that providers must be assured of their own compliance. The onus is on the provider to demonstrate to the CQC how they have reached a state of assurance that their staff are trained, skilled, and competent. CQC representatives stated: “it’s for you to be assured and to be able to demonstrate to us how you’ve got to that place of assurance.”

Provider Responsibilities and Decision-Making

Selecting Training Packages

Providers have the flexibility to choose the training that best suits their service and staff.

• The Oliver McGowan Mandatory Training: This is considered a “good practice example” and the government’s preferred package. If procured and implemented correctly, it should ensure compliance.
• Other Training Options: It is not the only training that meets the requirement. Providers may choose other packages but must ensure they meet the standards set out in the Code of Practice. CQC reports will refer to “the training requirement on learning disability and autism” rather than naming specific training brands.

Determining Training Tiers

A frequently asked question concerns which tier of training is required for various roles. The CQC’s position is unequivocal: it is for the provider to decide.

• The CQC will not prescribe what tier of training a support worker, administrator, or manager should undertake, as roles can vary significantly between services.
• Providers are best placed to understand the specific functions of their staff and must be able to justify their decisions on training levels.

Utilising the Core Capabilities Frameworks

To support decision-making around training tiers, the CQC strongly recommends that providers familiarise themselves with the Core Capabilities Frameworks for learning disability and for autism. These frameworks, which have been in place for several years, provide a robust mechanism for mapping staff roles to required competencies and are heavily referenced within the Code of Practice.

Demonstrating Competency Beyond Attendance

Simply having a record of staff attending a training course is insufficient. The Code and Regulation 18 require that providers demonstrate staff competency. This means showing how learning is put into practice, which can be evidenced through:

• Regular supervision sessions.
• Continuing Professional Development (CPD) plans.
• Competency assessments and observations of practice.

Key Questions and Clarifications

The webinar addressed several common queries from providers. The following table summarises the CQC’s position on these key issues.

Is the Oliver McGowan training the only accepted package?

No. It is a good practice example, but other training can meet the requirement if it aligns with the standards in the Code of Practice.

Will CQC tell us which training tier our staff need?

No. This is the provider’s responsibility. Providers must make this decision and be prepared to justify it, using resources like the Core Capabilities Frameworks.

Is there a requirement for a Tier 3 trained person at each location?

No. The CQC does not have such a prescriptive expectation.

How often must training be refreshed?

The regulations do not specify a time frame. The provider must be assured that staff knowledge remains relevant and that they are competent to perform their roles.

Is there a CQC-approved template for evidencing compliance?

No. Providers should use whatever system works best for them to demonstrate their assurance processes.

What about funding and availability of training?

This is outside the CQC’s remit. These are commissioning conversations to be had with local ICBs, DHSC, and Skills for Care. The CQC’s focus is on the impact on people using services.

Internal CQC Preparations and Provider Feedback

Ensuring a Consistent Regulatory Approach

To ensure its staff regulate this requirement effectively and consistently, the CQC has undertaken several internal actions:

• A program of upskilling sessions for all CQC staff.
• Development of internal tools and a publicly available “brief guide.”
• An extensive internal communications campaign.
• The availability of a team of senior specialists to provide expert advice to operational colleagues.

Channels for Provider Feedback

The CQC acknowledges that as a human-led organisation, it may not always get its approach right. Providers who have feedback or concerns about the CQC’s regulation of this requirement are encouraged to share it through official channels, such as the national customer service centre or the complaints process. This is distinct from the factual accuracy check process for individual inspection reports.

Key Resources and Next Steps

Providers seeking further information should consult the following resources:

• CQC Website: The provider guidance sections were updated on September 8th and include the aforementioned “brief guide.”
• Skills for Care: Has published an FAQ document with information on funding and training availability.
• DHSC and Skills for Care Webinar: A specific webinar to address questions on funding and training is scheduled for November 13th.
• CPA Website: The recording of this webinar, along with the slide deck and an accessible version, is available on the Care Provider Alliance website.