The Care Quality Commission (CQC) has released new guidance, Right support, right care, right culture, as a revision to its Registering the right support guidance. The aim is to make it clearer for providers who support autistic people and/or people with a learning disability.
Following feedback from people who use services, CQC has updated its guidance so it has a stronger focus on outcomes for people including the quality of life people are able to experience and the care they receive.
Now called Right support, right care, right culture, the guidance outlines three key factors that CQC expects providers to consider if they are caring for, or want to care for, autistic people and/or people with a learning disability:
- Right support: The model of care and setting should maximise people’s choice, control and independence.
- Right care: Care should be person-centred and promote people’s dignity, privacy and human rights.
- Right culture: The ethos, values, attitudes and behaviours of leaders and care staff should ensure people using services lead confident, inclusive and empowered lives.
Kate Terroni, Chief Inspector of Adult Social Care commented on the new Right support, right care, right culture guidance, saying, 'Autistic people and people with a learning disability are as entitled to live an ordinary life as any other citizen. We expect health and social care providers to ensure autistic people and people with a learning disability have the choices, dignity, independence and good access to local communities that many people take for granted.
'Our revised guidance makes clear that safeguarding people’s human rights must be at the heart of all care provided for autistic people and/or people with a learning disability.
'We will only register and give a positive rating to those services that can demonstrate high quality, person-centred care.'
CQC will be using the Right support, right care, right culture guidance in their assessments and judgements and providers are encouraged to directly discuss their proposals or development ideas before submitting an application or making changes to services. This can help providers make an informed decision about whether plans are likely to comply with this guidance.
This guidance has always been set alongside other standards in health and social care - this includes NICE guidance (CG142) on the definition of ‘small’ services for autistic people with mental health conditions and/or behaviour that challenges. This states that residential care 'should usually be provided in small, local community-based units (of no more than six people and with well-supported single person accommodation).'
While CQC uses NICE guidance in describing what ‘small’ means for how it applies its approach, this is not the same as having an absolute upper limit for the size of services. CQC clarifies that it has never applied a six-bed limit in registration or inspection assessments and will continue to register based on care that is person-centred and promotes choice, inclusion, control and independence.