Regulation 18 – Staff training in Health and Social Care services has changed
As of 1 July 2022 new law has been introduced that will impact all health and social care providers registered with the CQC. The Health and Social Care Act 2022 now requires that all providers ensure that their staff have received training in how to interact appropriately with people with a learning disability and autistic people, at a level appropriate to their role.
This is now a requirement, irrespective of the type of service the provider runs.
The CQC has now updated its statutory guidance on compliance with Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (the regulation related to staff training), indicating that it will be reviewing this requirement as part of its inspection process.
It is vital that providers are clear on what the CQC expects of them.
Two new points have been added to the CQC’s guidance in relation to this change in the law. As mentioned above, as a component of Regulation 18 (2) (a) providers must now:
- “Ensure that all staff receive training in how to interact appropriately with people with a learning disability and autistic people, at a level appropriate to their role”.
In addition, Provides must ensure that:
- “Staff……receive appropriate supervision in their role to ensure they demonstrate and maintain competence in understanding the needs of people with a learning disability and autistic people, including knowing how to support them in the best way”.
Providers of health and social care services will be aware that the CQC will always review training and supervision as part of any comprehensive inspection. Analysis of training records, conversations with staff and observation of skills will form part of the inspector’s judgement in this area.
It has always been vitally important for providers to keep clear records of training. This will include an up to date and clear training matrix, as well as certificates of completion kept in staff files.
Supervisions on skills should be conducted regularly, in line with the service’s individual training and supervision policy. The supervisions should be evidenced by notes and an acknowledgement from the staff member that they have participated in that meeting.
The CQC regularly approaches staff during an inspection and asks them if they have received training in specific areas. One can assume that going forward, this new requirement will be a “hot topic” for the CQC and so we should expect staff to be questioned on this issue. It is important that providers prepare staff for an approach by the CQC and that they feel comfortable describing the training and understanding why it is important.
Ridouts has seen, on many occasions, draft inspection reports that state that staff did not fully understand something when questioned by the CQC inspector. The service is then deemed to be non-compliant in this area because it has not been proved that staff are competent in their understanding of a particular issue. When a draft is received that makes such a statement a service will challenge the CQC and say that there are policies or training in place that are clear on the matter in question however, if the CQC has questioned a staff member who has felt uncomfortable or lacks confidence in their own knowledge and ability, then it will be concluded that the staff member simply did not know the answer or that they have not understood their training. This is obviously unfair but can be easily avoided, thus limiting the impact on a service’s overall rating.
After any new training has been received, services might consider challenging staff, periodically, to demonstrate (in an ad-hoc way) the skills they have learned from training. All of this is preparatory work that will not only ready them for an inspection but also improve their skills generally.
Reducing the “shock” of an unannounced inspection is vital in empowering staff to relax and do themselves justice when an inspector calls. Care staff work extremely hard but probably are not familiar with the intense levels of scrutiny that can be associated with a CQC inspection. They will feel exposed, at risk and responsible for the overall success of the day. Managerial support and assurance given on an ongoing basis should help staff to be able to show the CQC just how talented they are and that the people in their care are treated safely and with dignity.
The new training requirement will ensure that staff are able to interact with service users in a meaningful way, in a way that is tailored to their needs. The requirement is another way that providers can demonstrate that they are delivering care in a person centred way and that this will help to achieve the best outcomes for service users.
Many providers may feel that they are already developing staff in this way through their standard, mandatory training, however, the CQC will be looking for evidence which demonstrates that the training comprehensively addresses how staff interact with service users with learning disabilities and autism. Providers should therefore seek out specialist training and incorporate this into their mandatory training programme.
Any failure to do this could be considered a regulatory breach which has the potential to lead to an adverse inspection and decreased ratings. If the training is consistently not provided and staff are found not to be able to communicate effectively with service users with autism and learning disabilities then this could contribute to a decision by the CQC to take enforcement action.