If your service supports autistic people or people with a learning disability, CQC assesses you against Right support, right care, right culture from the day you apply. Most refused applications in this sector fail its tests without the provider ever realising they were being applied.
Right support, right care, right culture is CQC’s statutory guidance for services supporting autistic people and people with a learning disability. It grew out of the failures at Winterbourne View and Whorlton Hall and the long national effort to move people out of institutional settings and into ordinary lives in the community.
The practical point for providers is this: the guidance is not an inspection extra. CQC uses it when deciding whether to register you at all. A supported living or residential application for this group that ignores it is, in effect, answering the wrong exam paper. This guide breaks down what each of the three elements means, what CQC checks, and how to evidence them at registration and beyond.
Right support: the model of care
Right support is about whether the design of your service maximises choice, control and independence. The questions behind it are structural, and they are asked before anyone looks at your care plans:
- Is the setting small and domestic in character, close to community facilities people can actually use?
- Do people choose who they live with, or does the provider fill vacancies to suit the business?
- Does the model promote independence, with support that adapts and reduces as skills grow, or does it create dependency?
- In supported living, are housing and care genuinely separate, so a person can change provider without losing their home?
Large services, campus-style developments and settings that group many people with complex needs together face a steep uphill argument. If your business plan depends on scale, expect CQC to challenge it, and prepare a serious answer about how the model still delivers individualised support. Our guide to supported living and domiciliary care registration covers the housing separation in more detail.
Right care: the support itself
Right care means care that is person-centred, promotes dignity, privacy and human rights, and reflects what matters to each individual. In evidence terms, CQC looks for:
- Support plans built around the person’s own goals, communication style and preferences, not around a standard template with the name changed
- Positive behaviour support done properly: understanding what behaviour communicates, with restrictive practices used only as a last resort, recorded, reviewed and reduced over time
- Consent and capacity handled in line with the Mental Capacity Act, with decision-specific assessments rather than blanket judgements
- Health needs taken seriously, including annual health checks and access to mainstream services, because the health inequalities faced by this group are well documented and inspectors know it
Right culture: the hardest one to fake
Culture is the element that closed services score worst on, and it is the one inspectors probe through conversation rather than paperwork. They talk to staff and ask what the service values. They watch how support workers speak to and about the people they support. They look at whether managers know people as individuals or as risk profiles.
For a new registration, culture is evidenced through your recruitment values, your training plan, your management arrangements and, above all, your registered manager’s answers at interview. A manager who talks about people’s lives, aspirations and relationships lands very differently from one who talks only about incidents, ratios and compliance.
How the guidance bites at registration
CQC has used this guidance to refuse registrations, to restrict conditions, and to require changes to proposed models before granting them. Applications commonly run into trouble when:
- The proposed setting is larger than the needs of the people it will serve can justify
- The Statement of Purpose describes person-centred values while the staffing model and rota tell a different story
- The provider cannot explain how people will be involved in choosing where and with whom they live
- Policies are generic, with no positive behaviour support, communication or restrictive practice content specific to the people supported
- The registered manager has no direct experience of supporting this group and no credible development plan
None of these is fatal if you address it before applying. All of them are difficult to argue away afterwards.
The evidence pack that answers the guidance
It helps to translate the three elements into the concrete documents and artefacts an assessor can actually look at. A registration application, or an existing service preparing for assessment, should be able to put its hands on:
- For right support: the service model description in the Statement of Purpose, floor plans or setting descriptions showing scale and ordinariness, the tenancy and care separation paperwork where relevant, admission and matching criteria showing how compatibility and choice are handled, and a commissioning statement of who the service is for and, just as importantly, who it is not for.
- For right care: a sample support plan built around one person’s goals and communication, a positive behaviour support plan showing functional understanding rather than management of behaviour, restraint and restriction records with reduction over time, capacity assessments that are decision-specific, and evidence of health action plans and annual health check uptake.
- For right culture: values-based recruitment materials and interview questions, induction and training records covering learning disability and autism content, supervision notes that discuss people’s lives and not only incidents, minutes showing people who use the service influencing decisions, and staff survey or exit interview themes with what changed as a result.
Two habits make this pack persuasive rather than performative. First, keep it live: an evidence folder assembled the week before an assessment reads exactly like an evidence folder assembled the week before an assessment. Second, let people speak in it: quotes, photos of real activities chosen by the person, communication passports and outcomes described in the person’s own terms carry more weight with inspectors than any amount of provider prose, because they are the point of the guidance.
What to do now
- Read the guidance itself, then read your business plan next to it and note every point of tension honestly.
- Write into your Statement of Purpose how your service delivers each of the three elements, in concrete terms rather than values statements.
- Check your policy set covers positive behaviour support, restrictive practice reduction, communication and MCA compliance for this specific group.
- Build your training plan around the needs of the people you will support, including the mandatory learning disability and autism training requirements for staff.
- Prepare your registered manager to answer culture questions with real examples, because they will be asked.
How Cura Compliance can help
We build registration applications for learning disability and autism services around this guidance from the start, through our CQC registration support service. Our CuraFlow policy libraries include supported living content written for this sector, covering positive behaviour support, restrictive practices and MCA compliance. And if you already hold a registration and want to know how your service measures up before CQC tells you, our mock inspection service assesses you against the same guidance inspectors use.
A final point on tone. Providers sometimes treat this guidance as a hurdle to argue past, and it shows in applications written defensively. The services that register smoothly treat it as a description of the sector’s direction of travel, because that is what it is: commissioners, families and case law are all moving the same way. Building your model around it is not regulatory compliance so much as market fit.
Frequently asked questions
What is Right support, right care, right culture?
It is CQC’s statutory guidance for providers of services for autistic people and people with a learning disability. It sets out expectations for the model of care, the quality of support and the culture of the service, and CQC applies it both when assessing registered services and when deciding new registration applications.
Does Right support, right care, right culture apply to supported living?
Yes. It applies to any registered service model supporting autistic people or people with a learning disability, including supported living, residential care and community services.
Can CQC refuse a registration because of this guidance?
Yes. Applications for services whose scale, setting or model conflicts with the guidance have been refused or granted only with conditions. Addressing the guidance explicitly in your application is considerably easier than appealing a refusal.
What size should a learning disability service be?
The guidance does not set a fixed maximum, but it strongly favours small, domestic settings within local communities. The larger the proposed service, the stronger your justification needs to be that people will still receive individualised support and a real choice about how they live.
What training do staff need in learning disability and autism services?
All staff in CQC-regulated services are required to have training in learning disability and autism appropriate to their role. For services dedicated to this group, expect scrutiny of induction, positive behaviour support training and how competence is assessed in practice.
How do I evidence culture in a new service with no track record?
Through the choices you can already show: who you hired and why, the values questions in your interview records, the training you have booked before opening, the way your Statement of Purpose describes people rather than beds, and your manager’s own history of working in this way. Assessors accept that a new service has no outcomes yet. They do not accept that it has no evidence of intent.
Sources
- CQC: services for autistic people and people with a learning disability, including Right support, right care, right culture (cqc.org.uk, accessed September 2026)
- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (legislation.gov.uk, accessed September 2026)