The Care Quality Commission (CQC), the independent regulator of all social care services in England, has published a new report which sets out their expectations for what good care looks like for autistic people or people who have a learning disability, as well as how they inspect services which provide this care.

The report, entitled ‘Right support, right care, right culture’ looks at the care health and social care services should provide to all autistic people and people with a learning disability and how the CQC will regulate them. This report sets out how future regulation will check that providers support autistic people to live with the choices, dignity, independence and good access to the local communities most people take for granted.
Social care providers, both existing and future, will be expected to understand the CQC’s recommendations and develop and run services accordingly. 

Summary of recommendations

The CQC’s main objective is to protect and promote people’s health, safety and welfare. This means that autistic people have the same rights to live an ordinary life as any other person and are free to make choices about their own care where they can. To make these choices, people should be empowered with all the information they need and also be supported by the right number of staff with the right skills.

People should be able to get out and about and enjoy their local community as much as possible, including shops, groups, clubs and cinemas where they want to.

The CQC says that care must be person-centred. This means that the individual needs of a person must always considered, rather than applying a one-size-fits-all approach.

On the size of residential services, the CQC refers explicitly to NICE (National Institute for Health and Care Excellence) guidance which defines ‘small’ services for autistic people as “no more than six people.” 

What services need to do

Providers must demonstrate how they meet, or will meet, the CQC’s ratings for ‘good’ services, the CQC’s regulations, people’s expectations, and the CQC’s recommendations that people have access to the community and that the care model is in line with best practice. Best practice guidelines include:

• Building the right support, a national plan for developing services
• Building the right home, which helps to ensure some people can live in their own home.

Providers must meet four specific criteria:

1. There is a clear need for the service and it has been agreed by commissioners. This means that there is a local need for the service and that people’s care and support is planned to ensure they have a good quality of life. Providers must also prove in writing that their care has been asked for or agreed with local health and social care organisations. These organisations should also have been involved in developing the service, along with people who use services and their advocates.
2. The size, setting and design of the service meet people’s expectations and align with current best practice. This means that people who use services, their families and representatives, are involved in the design of the service and how it is right for them. Providers will need to explain how they have considered their preferences. The size and design also shouldn’t threaten people’s quality of care, safety or their human rights, and should always allow for person-centred care. Once using a service, people should be free to make choices about where they go and what they do where possible.
3. People have access to the community. Services must be in a location where people can participate in the local community where they want to, and also have access to local health services. Even if a provider offers in-house activities and services, people should still be able to take part in the same activities and services in the community.
4. The model of care, policies and procedures are in line with current best practice. This means that the service should operate a care model which is all about people’s strengths, including what they can do instead of what they can’t do. Decisions about their behaviour should be planned and shouldn’t use restraint or seclusion.

Further information

• Read the CQC’s story on the Right support, right care, right culture report.
• Please sign our letter to the Chancellor calling for investment in support and services for autistic people.
• For confidential support and advice, visit the Help and Support section of our website.
• To find out more about local and national services for autistic people and their families, visit our Autism Services Directory.