Right Support, Right Care, Right Culture: CQC’s Framework Explained

CQC assesses services supporting autistic people and people with a learning disability against a specific framework, distinct from the standard inspection approach used elsewhere. "Right support, right care, right culture" sets out what good looks like in this part of the sector, and providers who don't understand its three themes can find themselves genuinely surprised by an inspection outcome, even when they believe they're delivering good, compassionate care.

Why this sector gets its own framework

The guidance emerged from a recognition that services supporting autistic people and people with a learning disability have historically been assessed using criteria that didn't fully capture what matters most for this group — namely, whether someone's life looks and feels like an ordinary life, with real choice, independence, and community connection, rather than simply being safe and well cared for in an institutional sense. CQC's guidance applies to all providers in this space, both existing services and anyone registering a new one, and explicitly discourages the development of new campus-style or congregate settings, reflecting a clear policy direction towards smaller, more individualised models of support.

The three themes explained

"Right support" is about the model of care and the setting itself — does it maximise the person's choice, control and independence, rather than requiring them to fit into a fixed routine or environment designed around staff convenience? "Right care" is about how care is actually delivered day to day — is it person-centred, and does it protect the person's dignity, privacy, and human rights in practice, not just on paper? "Right culture" looks at the underlying ethos, values, attitudes and behaviours of leaders and staff — does the culture of the service genuinely support people to lead confident, inclusive, empowered lives, or does it default to risk-aversion and control because that's easier to manage?

What providers need to demonstrate

Providers are expected to show, in practice rather than in policy documents, that they maintain a person's dignity and privacy while actively supporting choice and independence, that their approach reflects current best practice guidance including relevant NICE standards, and that services aren't structured as large campus or congregate settings that concentrate people with similar needs together in a way that limits genuine community life. For providers already running an existing campus-style service registered before this guidance took effect, the size of the setting alone won't automatically cap the rating they can achieve — but CQC does expect a clear, credible plan showing how the service is moving towards the framework's principles over time, not simply maintaining the status quo indefinitely.

How this connects to existing training

This framework sits closely alongside training staff may already be familiar with, particularly Oliver McGowan mandatory training on learning disability and autism and positive behaviour support. Where Oliver McGowan training builds staff knowledge and understanding, and positive behaviour support gives staff practical tools for de-escalation and reducing restrictive practice, "right support, right care, right culture" is the regulatory lens CQC uses to judge whether that knowledge and those tools are actually translating into a genuinely person-centred service, rather than staying at the level of good intentions.

What inspectors are actually looking for

In practice, inspectors assessing against this framework look beyond whether a service is safe and clean, and ask harder questions: does this person have real choices about their daily routine, their relationships, and their environment? Can staff explain, specifically, how they support this person's independence rather than simply managing their behaviour? Is there evidence that restrictive practices are genuinely a last resort, reviewed regularly, and reducing over time rather than becoming embedded as routine? CQC states clearly that it will take regulatory action where people's needs aren't being met or where a provider can't demonstrate person-centred, rights-promoting care, regardless of how well-organised the service otherwise appears. This means the quality of a service's policies and paperwork will not compensate for staff who cannot describe, in their own words, how a specific person they support is exercising real choice and control in their day-to-day life.

Frequently asked questions

Does this framework apply to all care homes, or only specialist learning disability services? It applies specifically to services registered to support autistic people and people with a learning disability, which can include some general care homes providing this type of support alongside other services.

Is a campus-style setting automatically rated lower? Not automatically — CQC assesses the quality of care delivered within the setting, but expects a credible plan for moving towards the framework's principles over time.

How does this framework affect staff training priorities? It reinforces the importance of practical, person-centred skills — genuine choice-making support, reducing restrictive practice, and understanding human rights in daily care — over purely procedural or safety-focused training alone.

Understanding this framework helps providers move beyond compliance-as-checklist thinking towards the kind of genuinely person-centred culture CQC is now actively looking for during inspection.