Choice Support is a charitable Community Benefit Society working across much of England to provide the best possible support to autistic people, people with learning disabilities and/or mental health needs. As the Learning and Development Lead at Choice Support, I was sceptical about the need for the Oliver McGowan Mandatory Training in social care settings. Like many other large providers, I had the belief that what we were providing already met our needs. However, from the moment I attended the lead trainer course run by Mencap and the National Autistic Society I began to think differently.
Understanding the need
We began our roll out of Tier Two in April 2023. The Oliver McGowan Programme has co-production at its centre. Through working with co-trainers with lived experience, I have had to challenge my previous views and review my approach to the learning and development of social care staff. With 25 years’ experience in the social care sector, and as a carer for autistic relatives, I believed I was somewhat knowledgeable in this area. However, it has been my privilege to train and work alongside some exceptional autistic co-trainers and co-trainers with learning disabilities who have challenged my way of thinking. I would say there are barriers to overcome; in a sector already struggling to recruit and retain staff, an additional training requirement with no extra funds is a challenge.
Although if our current approaches were enough, then the average life expectancy of people with learning disabilities and those who are autistic would be the same as the general population. Research1 has shown that people with learning disabilities and those who are autistic do not receive the same quality of care as those without a learning disability or people who are not autistic. During training sessions at Choice Support, the co-trainers have sadly shared experiences that highlight how society remains inaccessible. However, people with learning disabilities and those who are autistic know which simple reasonable adjustment would have the most positive impact for them. We just need to listen to them!
So far, all co-trainers I have worked with highlighted the need for similar training for education, police and retail staff. Therefore, training for health and social care staff should just be the beginning.
Time for action
I know many health and social care providers are waiting for the Code of Practice to be finalised. This suggests that they will not implement the training unless mandated. However, the Oliver McGowan Programme is a co-produced, tested, evaluated programme that is available now and can improve the quality of life for everyone. My call to action is that as a sector we should be lobbying the Government for the funds to roll out the Oliver McGowan Mandatory Training Programme rather than debating whether it is needed at all.
Choice Support approach
At Choice Support we have trained 11 facilitators and 24 co-trainers with lived experience. We have added the eLearning to our learning management system and assigned this to all staff. We have begun the roll out of the face-to-face Tier Two training across the whole organisation with events scheduled every month at our main offices. We are prioritising new staff and intend to have trained all staff within 18 months.
We have assumed that funding will not be made available to us and have therefore budgeted accordingly to enable all our staff to attend training. We have also set aside funds to pay the salaries of co-trainers. The feedback to having co-trainers has been extremely positive, with delegates commenting on the fresh perspective. We intend to extend the use of co-trainers to other courses we deliver.
Overcoming obstacles
Having enough co-trainers is the biggest challenge to overcome. Initially I was surprised that we had spaces on our ‘Train the Trainer’ courses. However, fears of how benefits may be impacted has prevented some potential co-trainers coming forward. For example, several of the co-trainers have highlighted that they would like to deliver more sessions but the rule around their benefits and pay prevents this. I have also heard large NHS Trusts plan to recruit full-time co-trainers. This reflects a lack of awareness of the needs of autistic people and those with learning disabilities, including the risk of burnout. At Choice Support we have looked to have several co-trainers in each geographical area.
The lack of previous work experience from co-trainers has impacted on the confidence of potential candidates to apply. To overcome this, we have marketed the ‘Train the Trainer’ course as taster sessions with no requirement to take up employment at the end. Even with the taster session approach, we have needed more co-trainers than internal applicants. We have worked with local colleges, autism support groups and family members of our current workforce to find additional candidates. We don’t expect people to come to the taster events for free because three days is a big commitment. Therefore, we offer a voucher for those who complete. This has led to about 80% of attendees choosing to progress to a contract at Choice Support.
For those who wish to be employed, another barrier is the need for identification to meet the DBS requirements and proof of right to work in the UK. Many people with learning disabilities or autistic people do not have passports or driving licences. Furthermore, some have appointees so do not have letters addressed to themselves.
Reasonable adjustments
A main feature of the course is understanding what reasonable adjustments are needed and ensuring these happen in healthcare settings. It is essential that we demonstrate this good practice and meet the needs of our co-trainers and our delegates. This includes having fidget toys available, being able to reduce the sensory stimulation such as turning lights off and having spaces for people to go to if they become overwhelmed. Another reasonable adjustment is the need for some co-trainers to have support to travel to the training. All co-trainers train with a facilitator; however, some co-trainers need additional support from their regular support team. These all come at an additional cost so need to be factored into a roll-out plan.
Co-trainer perspectives
Mark Rawlings, a co-trainer, shared his perspective on delivering the training. He said, ‘I am an autistic young man. I work as admin support at a Choice Support employment service. My manager put me forward for the co-trainer role. I took part in a three-day Train the Trainer course in April 2023. Since then, I have co-trained eight facilitators and nine co-trainers. Those trainings were a huge success! All of the facilitators expressed that the training was incredibly valuable and how they were able to gain so much more insight into autism having been trained by an autistic person, as opposed to being trained by someone who does not have autism. All eight facilitators couldn’t wait to start training and they all wanted to have me as their autistic co-trainer.
‘Another staff member who has worked as a learning disabilities nurse for more than 40 years said, “I have learned more about autism in these three days of training than in the whole of my career” and said how it even helped her to support a family member to support their autistic child.
‘The training is incredibly inclusive for everyone; especially for me as an autistic co-trainer, not needing to mask is really important. For example, I bring my own fidget toys and feel comfortable to use them throughout the training. Other co-trainers also don’t feel like they need to apologise for needing reasonable adjustments such as: wearing sunglasses because the lights or the sun is too bright; needing to walk out and have some space, because hearing Oliver’s story for the first time can be distressing; and needing to put some headphones in because of feeling overwhelmed.
‘I think that an opportunity like this is extremely important; it not only provides training to health and social care professionals but also enables autistic people, of which only 29% are currently in paid employment, the opportunity to make a living. It also enables those with a learning disability, of which only 6% are currently in paid employment, that same opportunity. I would love to see more opportunities like this, because this training will enable health and social care professionals to better understand how to help autistic people and those with a learning disability. To ensure that the professionals on the training learn from the people who experience these conditions on a daily basis, so that they can adapt their practices to ensure that the tragic story of Oliver McGowan is not repeated, rather than just reading from some textbook and not learning how to put that information into practice.’
Achieving good outcomes
I strongly encourage social care providers to do their due diligence and investigate how to successfully deliver the Oliver McGowan Mandatory Training in social care settings. Given the great uncertainty on funding from this Government and of the next Government to take office, it is our duty and task as facilitators to take action and call on the Government to ensure the best possible care and outcomes for people with learning disabilities and autism.
Visit the NHS England website to stay up to date with the latest development relating to the Oliver McGowan Training. Visit
www.hee.nhs.uk/our-work/learning-disability/current-projects/oliver-mcgowan-mandatory-training-learning-disability-autism