Mandatory training about learning disability and autism for health and social care provider staff

• From 1 July 2022, health and social care providers registered with CQC (Care Quality Commission) must ensure that their staff receive training on learning disabilities and autism appropriate to their role.
• This new legal requirement follows Baroness Sheila Hollins' successful amendment to the Health and Care Act 2022 in the Lords
• On July 1, the Care Quality Commission issued guidance and updated regulations on compliance with this requirement for providers.

• DHSC (Department of Health and Social Care) will be consulting on and publishing a Code of Practice for the sector which may take twelve months to develop.

• The act does not specify the Oliver McGowan Mandatory Training in learning disability and autism which has been developed and will become available soon, however national partners would recommend this as the best way to cover some of the critical learning outcomes staff will need. 

Background and further information

• This amendment follows the evaluation of the pilot Oliver McGowan Mandatory Training (OMMT) that Government previously commissioned.
• The trial of this training which led to this regulation is named after Oliver McGowan, a young autistic man who died after being given anti-psychotic medication in hospital against his and his families wishes.
• Following Oliver’s death, aged just 19, his mother Paula McGowan (OBE) led a campaign for more training for health and social care staff to provide them with the confidence and skills to understand the needs of people with learning disabilities and/or autistic people in their care.
• In 2019, the Government set out its commitment to mandatory training in their consultation response in 'Right to be heard’. In this, they announced funding to develop and test a learning disability and autism training package which can be rolled out widely. This document also made it clear that such training should:
  • be based on two core capability frameworks, one about autism and one about learning disabilities
  • include people with lived experience as trainers
  • allow learners to explore how their learning can be applied to their role in practice.
  • As work on the OMMT and the mandatory training evolves, these three points remain constant and should guide employers in the training their staff receive.
• The training was piloted various approaches throughout 2021. The National Development Team for Inclusion (NDTi)  conducted an independent evaluation to understand what worked well.
• The NDTi Evaluation Report of trial confirmed that there will be a level of training (currently called tier one) which all staff with contact with people using any services will need. This completely covers tier one of both the core capability frameworks. The other level (currently called tier 2) covers some carefully selected learning outcomes from tier 2 of both frameworks focusing particularly on communication, health inequalities, rights, and the law. 
• A code of practice for the mandatory training will be developed over the coming year by DHSC. This will outline the detail of the content, delivery and ongoing monitoring and evaluation of the mandatory training which will take account of the recommendations from the report of the evaluation of the Oliver McGowan Mandatory Training trial. 
• In the meantime The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 18 has been updated by CQC.
• This now says: "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."
• Providers will want to prepare for their next CQC inspection to evidence compliance with this new requirement in relation to the competency of the workforce. Many staff should already meet the required capability however it will be important for all CQC registered providers to consider how they will meet this new requirement. Some providers will need to start putting their staff through training to meet the CQC requirements now, whilst others will already be meeting these requirements and will need to provide much more extensive training in due course.
• Until the DHSC guidance is developed providers and councils should take account of the existing capability frameworks for both autism and learning disability that CQC registered services should already be using as a guide when commissioning training and wider workforce planning and development.  
• This Health and Care Act requirement covers health and social care providers registered by CQC in England.
• It is anticipated that this requirement may be extended to broader groups of staff at a later date. At this stage however it does not apply to Ofsted registered providers or social care staff working in unregulated providers. However, it is good practice to ensure these staff are appropriately trained.
• An FAQ about the new Health and Care Act requirement for mandatory training in learning disability and autism has now been published.  This is regularly updated, and further questions can be submitted to [email protected].

Next steps for councils

• Ensure commissioners, providers (both in-house and commissioned), quality monitoring staff, safeguarding leads and workforce leads are aware of this new mandatory training requirement, and the regulation updated by CQC: Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and are using both the relevant core capability frameworks to underpin all workforce development.
• The Workforce Development Fund via Skills for Care, once reopened, is likely to be a primary route for social care providers to draw down funding for training of the workforce. We understand that this is due to re-open soon. Until the OMMT guidance is available, OMMT specifically will not be funded this year, however Skills for Care Workforce Development Fund information below provides details of current autism and learning disability qualifications that are expected to be eligible for funding. It is also anticipated that employers providing Positive Behaviour Support (PBS) training related to people with a learning disability, using a training provider that is part of the PBS training peer review system, will also be eligible to claim for funding. 
• Councils may wish to amend commissioning specifications and contracts for CQC regulated services to state the requirement to adhere to the Code of Practice once published and the updated CQC statutory regulations from the 1 July 2022.
• In preparing for Adult Social Care assurance councils will want to consider and maintain sight of the DHSC guidance about the mandatory training as it develops. In particular:
  • councils could consider introducing the requirement for adult social care commissioned services not regulated by CQC, such as supported living where personal care is not being provided or day opportunities, to demonstrate that appropriate training is in place.
  • councils can lead by example by ensuring that all in-house services that are CQC registered have training to meet the regulation and capability frameworks and that social workers, OTs, and assessors that are working in adult social care, but not in a service regulated by CQC, have had up to date training that meets the regulation and capability frameworks.
  • During 22 / 23, Health Education England and NHS England will be supporting Integrated Care Boards to act locally to build up capacity with local training providers, especially focusing on people with lived experience. Local authorities and social care providers, self-advocacy groups and disabled people’s organisations may find it useful to explore with their local ICB (Integrated Care Board) how they can contribute to this. 

LGA comments – new burdens

The LGA is working with the government to identify any new financial burdens that may result from the new training requirement.