The Department of Health and Social Care has published its draft code of practice on statutory learning disability and autism training. It came into force on 6th September following a consultation, and care providers are expected to ensure that staff receive the relevant training accordingly. With some providers seemingly not being at standard industry practice according to feedback from our clients, this could have a significant impact on businesses, operating costs and inspection readiness.
Background to the Oliver McGowan Code of Practice
The Oliver McGowan Code of Practice on statutory learning disability and autism training is named after the 18-year-old who tragically died in November 2016. His mother, Paula McGowan, believes doctors misunderstood his normal autistic behaviour, prescribing medication usually given to patients with psychosis or a mental illness. This set in motion a deterioration in his physical health, eventually resulting in his death.
Paula has since campaigned for health and care staff to receive mandatory training on autism and learning disability. Under the Health and Care Act 2022, the Government introduced a requirement for service providers registered with the CQC to ensure employees receive training as appropriate to their role.
New standards for autism and learning disability training
However, it is only via the code of practice, published in June this year, that provisions about the nature of training are definitively set out to comply with the legislation. These replace previous guidance by mandating standards for content, delivery and ongoing evaluation of training across three tiers – general awareness (tier 1), direct support and care (tier 2), and complex care and leadership (tier 3).
In progressing through these tiers, training should deepen knowledge of everything from service design and reasonable adjustments through to communication strategies and clinical decision-making. Under previous guidance, tier 1 e-learning training – providing a basic understanding of learning disability and autism, and quicker and cheaper than face-to-face tier 2 and 3 training – would have been sufficient for most care home staff.
Tier 2 training was required only when a care home accepted placements at very short notice or planned to welcome a resident with a learning disability or who was autistic.
The new code, however, says care home staff will likely require tier 2 capabilities to make their service accessible to current and potential residents and visitors, who are autistic or have a learning disability. Staff who do not interact with the public may only need tier 1 training. In our experience, few care home providers currently deliver tier 2 training.
Challenges faced by care providers
Anecdotally, we have already heard about the CQC referencing the draft code during one care home inspection by stipulating its staff all require tier 2 training. Other clients told us that even staff who are not directly employed in caring roles still interact with residents and may be caught by these expanded requirements.
There are also concerns on costs and capacity among training providers. A provider with more than 1,000 care staff was quoted hundreds of pounds per person to deliver tier 2 training, while some have reported the relevant development programmes are booked up for months.
Most tier 2 training appears to be designed for staff in services for working-age adults and may not be suitable for staff in the later living sector. Funding for training may be available, although providers should be aware of total funding caps and other conditions. It may be more difficult for providers to recover costs of designing and delivering training internally.
Those requiring tier 3 skillsets within specialist services may be in a better position for compliance as they may not need to make substantial changes to existing specialist training programmes. However, leadership teams and registered managers should be prepared for questions from CQC inspectors referencing the new terminology and be able to explain how existing training equates.
We recommend that all care providers ensure they are aware of the new training requirements so they can review current delivery, plan in changes before a potential surge in demand and explain to inspectors how they are complying with the new code of practice.
How has your organisation responded to the code of practice coming into force? leave a comment on this column or join the conversation to share your thoughts.
Carl May-Smith is a partner and barrister at Browne Jacobson.  Email: [email protected] LinkedIn: @Carl-May-Smith