Inside CQC: Models of care

Debbie Ivanova, Deputy Chief Inspector for people with learning disabilities and autistic people at the CQC, explains the importance of reviewing your model of care to ensure it meets the needs of people with learning disabilities and autism.

I want to start by saying thank you to our social care colleagues who have worked tirelessly throughout the pandemic amidst the challenges within our sector. The work that I’m leading to improve regulation of services for people with a learning disability and autistic people has shown me how important it is to have people with the right values and approach leading and working in our services.

I know from experience that working in social care provides an exciting and rewarding career. From my first job working with children with learning disabilities, I knew I wanted this career with its variety, the ability to make a difference and the fantastic people you can support to lead lives of their choosing. It’s so important that everyone across the system supports people to have good careers in social care.

I’m enjoying taking part in the Oliver McGowan training being piloted by BILD and funded by Health Education England. Oliver’s story shows us the importance of people having the right training and skills to deliver good-quality care for the people they support. This training makes sure we all understand the specific needs of people with a learning disability and autistic people, which should result in better services and improved outcomes for people across health and social care. It also involves learning from people with lived experience, which has been extremely powerful to listen to and learn from.

We recently published our annual State of Care report, which is our assessment of health and social care in England. We highlighted challenges in social care to reflect what we’ve heard from colleagues working on the front line of care services and the organisations that support them, including the need for increased funding support, improved infrastructure across the sector and improved professional support that reflects the range of skills and capabilities care staff gain throughout their careers.

Essential to delivering good care and high-quality support is recognising that different skills are sometimes needed to meet the needs of different groups of people. I welcome Department of Health and Social Care’s recruitment campaign Made with Care – its emphasis is on how a career in social care has such an impact on the people you’re supporting, as well as the emotional rewards. I encourage recruiting managers and leaders to engage with the campaign to help grow your workforces.

Recently, I’ve seen cases of providers starting to take on care for people with learning disabilities; while it’s fantastic that more providers want to offer this service, it isn’t something you can just do overnight. Firstly, you need to measure up your service against Right Support, Right Care, Right Culture and, secondly, you need to make sure you have the right workforce to deliver personalised and specialised care that matches the needs of people with a learning disability and autistic people. In our guidance on service user bands, we explain why it’s important to think about the specific needs of the people you are supporting.

If you’re thinking of extending your service to provide care or support to people with a learning disability and autistic people, please contact us. People with a learning disability and autistic people have the right to high-quality care that meets their needs and supports their ambitions, and that enables them to live the life they choose in the setting of their choice. The model of care needs to be right and people can’t just fit into any existing service. You will need to recruit staff with the right skills, values and experience, offering the training, development and support to retain those skills.

We need to change the way people think about working in care and get people to think about it as a career with a range of opportunities and fields to specialise in, as you learn more about how to support people based on their individual needs, background and experiences in or between settings.


Debbie Ivanova is the Deputy Chief Inspector for people with learning disabilities and autistic people at the CQC.

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