Regulation 18 and the Oliver McGowan Training: The Training Duty Providers Get Wrong
Regulation 18 and the Oliver McGowan Code: the training duty most providers still get wrong
There is a statutory training requirement sitting inside Regulation 18 that a surprising number of providers treat as optional, or as satisfied by an e-learning module somebody bought in 2022.
It is not optional, and since September 2025 there has been a published standard against which your compliance is judged.
Let me set out what the law actually says, because this comes up constantly and the confusion is understandable.
The legal position
Section 181 of the Health and Care Act 2022 inserted a requirement into Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. From 1 July 2022, providers registered with CQC must ensure their staff receive training on learning disability and autism appropriate to their role.
Note the two important words. Must, and all staff.
CQC's statutory guidance on Regulation 18 requires 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.
This applies whether or not you currently support anyone with a learning disability or an autistic person. It is a requirement of registration, not a requirement triggered by your client group. That is the single most common misunderstanding I encounter, usually phrased as "we don't do LD."
What changed in September 2025
The Health and Care Act 2022 said training must happen. It did not say what the training had to contain or how it had to be delivered.
The Oliver McGowan Code of Practice fills that gap. It became final on 6 September 2025 and sets out the standards training must meet, in terms of both content and delivery.
That matters because the Code now forms the benchmark against which CQC assesses whether you have met the Regulation 18 requirement. Before the Code, "we do some autism awareness training" was a defensible position. Now there is a published standard, and your training either meets it or it does not.
Tier 1 and Tier 2
The training is structured in two tiers.
Tier 1 is for staff who need a general awareness of the support that people with a learning disability and autistic people may need.
Tier 2 is for staff who may need to provide care and support for people with a learning disability and autistic people.
Tier 2 includes the Tier 1 material. So an individual only needs one package — whichever is appropriate to their role. You do not put Tier 2 staff through Tier 1 first.
The practical question for you is not "which tier do we buy." It is "which of my staff sit in which tier, and can I show why." That is a role-by-role judgement, and it needs to be written down.
The five things I see going wrong
Treating it as a one-off. Training completed once in 2022 and never revisited is not a live training position. Staff turn over. Roles change. New starters arrive. Your training matrix needs to show current coverage, not historical delivery.
Tiering by job title instead of by role. A kitchen assistant in a service supporting autistic people may well need Tier 2, because they interact with people daily. An office administrator in a service that has no contact with people using services may sit at Tier 1. Tier by what someone actually does.
Buying training that does not meet the Code.There is a lot of learning disability and autism training on the market. Some of it predates the Code. Some of it is generic awareness content relabelled. Ask your provider directly whether their training is delivered in line with the Oliver McGowan Code of Practice, and get the answer in writing.
Forgetting bank and agency staff. They are your staff for the purposes of the regulation while they are working in your service. If your agency cannot evidence the training, you have a gap, and it will be your gap at inspection.
Having no record of who is where. I have sat with providers who have genuinely trained everybody and cannot demonstrate it, because the evidence is spread across three systems and a filing cabinet. Under the new assessment framework, that is not a technicality — an inspector reading your evidence will conclude what your evidence shows.
What good looks like
A single training matrix. Every member of staff on it, including bank and agency. Their tier, with a note explaining why they sit at that tier. Date completed. Renewal position. Gaps visible and being worked through with dates.
Then, separately, evidence that the training changed something. Under the new assessment framework, with rating characteristics replacing numerical scoring, the question is increasingly what your service looks like rather than what you have completed. A training record shows attendance. Supervision notes, observed practice and care records show whether it landed.
Why I keep pushing on this one
Oliver McGowan was 18. He was autistic, he had a learning disability, and he died in 2016 after being given antipsychotic medication his family had warned would harm him. His parents campaigned for years to get this training into law.
That is why the requirement exists.
There is also a straightforwardly practical reason to take it seriously. Staff who understand how autistic people communicate, who understand sensory needs, who understand why someone might be distressed — those staff prevent incidents. Fewer incidents means fewer safeguarding referrals, fewer notifications, less restrictive practice, and a service that runs better. The training is not a compliance cost. It is one of the few interventions that pays for itself.
And it connects directly to other things landing right now. The Mental Health Act 2025 will move more autistic people and people with a learning disability out of hospital and into community services. The Supreme Court's June 2026 judgment on deprivation of liberty asks staff to assess whether a person is objecting to their arrangements — which requires understanding how that person communicates. Both of those depend on a workforce that has had proper training.
If you are unsure whether your current training meets the Code, or you want your training matrix looked over before an inspection, get in touch. It is usually a quick piece of work with a disproportionate benefit.
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*Tiffany Nelson supports adult social care providers in England with CQC registration and inspection preparation, with a particular focus on learning disability and autism services. [tiffanynelsonconsulting.co.uk](https://www.tiffanynelsonconsulting.co.uk) | [Connect with me on LinkedIn](https://www.linkedin.com/in/tiffany-nelson-177784281)*
**Sources:** Health and Care Act 2022, section 181; Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 18; DHSC, *The Oliver McGowan Code of Practice on statutory learning disability and autism training* (final 6 September 2025); CQC guidance on training staff to support autistic people and people with a learning disability.