Registering a Learning Disability and Autism Residential Service with CQC

Why LD and autism residential services have different requirements

While all CQC registrations require the same core documentation and governance, registrations for services supporting people with learning disabilities and/or autism have several additional requirements that go beyond the standard checklist. Understanding these from the outset will save significant time and prevent delays in your application.

Positive Behaviour Support (PBS)

CQC expects any service supporting people with learning disabilities or autism that involves behaviour that challenges to have a clear commitment to the PBS framework. This means having a PBS policy, access to PBS-competent staff or consultants, and an approach to support planning that uses functional behaviour assessment to understand the communicative function of behaviour and build proactive support strategies.

STOMP (Stopping the Over-Medication of People with a learning disability, autism or both) is also expected — CQC will ask how you work with GPs and psychiatry to regularly review and where appropriate reduce psychotropic medicines for the people you support.

Ligature risk assessment

A full ligature risk assessment is mandatory for any service where residents may be at risk of self-harm. This means a room-by-room assessment identifying all potential ligature points, a clear mitigation plan, the installation of anti-ligature fixtures where risk is identified, and critically — ligature cutters accessible in all areas (not locked away) with all staff knowing their exact location.

This is one of the most common areas of non-compliance found in CQC inspections of LD and autism services. Do not overlook it.

Communication and accessibility

People with learning disabilities and/or autism may use alternative communication methods — Makaton, Picture Exchange Communication System (PECS), Augmentative and Alternative Communication (AAC), or communication passports. CQC expects your service to have the knowledge and tools to communicate in ways that work for each individual, and for this to be reflected in your care planning and staff training.

Epilepsy management

A significant proportion of people with learning disabilities have epilepsy. If any of the people you support have epilepsy, your service must have an epilepsy management policy, staff trained in seizure recognition and first aid, and protocols for rescue medication (such as buccal midazolam) including who is trained to administer it, when to call 999, and post-seizure monitoring.