Oliver McGowan Long-awaited Code of Practice.

As a result of the unnecessary and premature death of Oliver McGowan in 2016, an amendment was made to the Health and Social Care Act 2008, now the Health and Care Act 2022, which requires service providers to ensure that each person working for the purpose of the regulated activities carried on by them receives training on learning disability and autism which is appropriate to the person’s role.

The Department of Health and Social Care (DHSC) has recently published the Oliver McGowan training code of practice, which sets out that care providers have to ensure their staff receive learning disability and autism training suitable for their role and exactly what that means. For some providers, the code is also clear that their staff:

• may require further training in addition to The Oliver McGowan Mandatory Training in order to meet all of their learning requirements.

This code came into force on 6 September 2025 and so providers need to take account of it now as they reassess their care provision.

Why have mandatory training?

One of the questions providers of services which do not include care for people living with a learning disability and autistic people ask me is “why are we asked to undertake this training?” Quite simply, even providers like this may provide care for people living with a learning disability and autistic people whose primary need for care does not arise as a result of this condition. This simple means every social care worker should be able to recognise and respond effectively to the needs of people living with a learning disability and autistic people.

The 2023 Learning from Lives and Deaths: People with a Learning Disability and Autistic People (LeDeR) report identifies that people with a learning disability die 19.5 years sooner that the general population, with half dead before the age of 63. While the number of avoidable deaths in people living with a learning disability and autistic people has dropped since 2021 it is still running at 38.8% compared to 21.6% for the general population.

People living with a learning disability and/or autism also often receive care which does not meet their needs which can be greater and more complex than many health and social care professionals are used to delivering.

The Code

The code covers not only what training different groups of care staff need; it also identifies how the Care Quality Commission (CQC) intend taking it into account at inspections. This means looking for evidence the training has taken place and that its learning is embedded in the culture of the organisation, e.g. in staff knowledge and attitudes towards people living with learning disability and / or autism, as well as any reasonable adjustments made to accommodate their additional needs within the service: https://www.gov.uk/government/publications/oliver-mcgowan-code-of-practice/the-oliver-mcgowan-draft-code-of-practice-on-statutory-learning-disability-and-autism-training

The code also identifies that while the Oliver McGowan mandatory training is the recommended and preferred training, some staff will need additional training in order to fulfil the needs of their role.

The Standards

The Code is expressed as four standards:

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’ on the Skills for Health Supporting autistic people and/or people with a learning disability page. Further training beyond this minimum curriculum is proportionate and tailored to the requirements of staff at different levels and in different roles, taking into account the tiers and capabilities set out in the core capabilities frameworks. The training must explore how staff in a setting might put the training into practice.

2. All staff receive training that enables them to explore how they will put their learning into practice. Examples include the provision of augmented materials and learning tools to help staff understand how to apply their learning to their specific work setting and the people they work with.

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. For staff who require a general awareness of learning disability and autism, this is a minimum of one hour of live and interactive training with a person with a learning disability and an autistic person. For staff with responsibility for providing care and support for a person or people with a learning disability or autistic people and for staff with a higher level of autonomy, who manage complex care or lead on learning disability and autism services, this is a minimum of one day of in-person training. This is in addition to a compulsory e-learning module of at least 90 minutes covering the tier 1 capabilities set out in Standard 1 which all staff must complete.

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.

Each standard has an explanation including what this means for the content of the training.

Notably standard three requires an element of live training and perhaps goes beyond that expected previously and is on top of the at least 90 minute training required in standard one. The guidance for standard three states:

For providers who are not specialist in providing care for people living with a learning disability or autistic people: The one-hour training can be delivered online, but both the trainees and the trainers must attend in person for the one-day training…. Registered providers must provide training that is co-designed and co-delivered by people with a learning disability and autistic people when procuring training for their staff. Ideally, a wide range of people would be involved in the co-production of training, to ensure that diverse voices are reflected in the training. Family members and carers are also valuable in co-production and co-delivery and may be able to represent people with profound and multiple learning disabilities and people who have difficulty communicating. However, family members and carers cannot take the place of a person with a learning disability or autistic person.

This introduces an absolute requirement that the production and delivery of training includes people living with a learning disability or autistic people and as such seeks to explore the lived experiences of these groups pf people in what is a profound step for health and social care training in the UK.

The role of the Care Quality Commission (CQC)

Nominated individuals and registered managers reading this post will justifiably be concerned about what this means for inspections and the role of the CQC in regulating and overseeing compliance with this code of practice.

The code is clear that all registered providers must ensure staff receive training appropriate to their role and that the training must meet the code of practice standards. The code also states that the CQC will consider the extent to which providers comply with the code and that the CQC has the power to take civil action against providers who do not follow the code.

Of note the CQC on their website identify that the requirements of the code apply to more staff than previously and includes, for example all staff who have contact with, or may potentially have contact with, an autistic person or a person with a learning disability… including… ancillary staff, for example receptionists, security guards, cooks and kitchen staff, or cleaners. Such training should be proportionate to the role and the likelihood and level of contact the staff member will have with people living with a learning disability or autistic people.

It is worth noting that providers will also need to review the training staff have had to date because if it does not meet the requirements of the new code of practice, then it may need to be done again or at the very least topped up.

The CQC do not prescribe what providers must do in the way of training, nor which staff should undertake it, rather they expect providers to read and understand the code and make informed decisions for themselves. The CQC place the code firmly within the scope of what they will check when looking assessing the care and treatment of people living with a learning disability and autistic people, this means:

• 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.

Summary

In this blog we have taken a look at the requirement of The Oliver McGowan Code of Practice which is now in force. We have sent that it has four standards to which all health and social care providers in England must work. We have identified that providers will need to assess which members of staff need training and to what level. We have sent how providers must be prepared to justify their decisions to the CQC.

At Bettal we warmly welcome the code of practice which is long overdue. We do have some concerns about its all embracing nature and what it might mean for professionals already working and highly experienced in this area of care provision whose expertise is neither recognised nor accounted for in the ‘catch all’ requirements of the code. There is also no guidance about how often such training should be repeated – managers and providers are advised to watch the skills for care website for updates on this.

Bettal Quality Consultancy has policies, procedures and risk assessments, including those required for the care of people living with learning disability and / or autism, to support registered managers and their teams in the provision of CQC compliant care.

If you would like to know more, browse our website or get in touch:

Email: info@bettal.co.uk
Telephone: 01697741411

Peter Ellis MA MSc BSc(Hons) RN
Consultant
Bettal Quality Consultancy

Image credit: Gov.uk