Supported Living and CQC: The Separation Test, Right Support Right Care Right Culture, and the Training Duties

Supported living is regulated differently from a care home, and the difference is not about the building. It turns on a legal test about how care and accommodation are sold. Get that test wrong and you are registered for the wrong regulated activity; get the training duties wrong and you are in breach of Regulation 18 regardless of how good the support is.

This guide sets out the distinction, the guidance the CQC applies, and what the staffing and training requirements actually say.

The separation test

The Care Quality Commission’s guidance for providers of supported living and extra care housing, published in October 2015, states the test plainly: there is a real separation between the care a person receives and their accommodation.

In practice that means personal care and accommodation are covered by separate legal agreements and are not sold as a single package. A provider can only register for the regulated activity of personal care where that separation exists. A care home, by contrast, is where a provider offers residential accommodation as a single package that includes nursing or personal care.

So the regulated activities differ. Supported living registers for personal care — supporting people in their homes, or where they are living at the time, with washing, bathing, dressing and using the toilet. A care home registers instead for accommodation for persons who require nursing or personal care, and does not require registration for personal care. A provider doing both registers for both.

On occupancy, the CQC expects occupancy terms to be in a lawful agreement, and for extra care housing to be based on a tenancy, long lease or freehold.

Why your registered location is your office

This catches new providers out. For the regulated activity of personal care, the registered location is the premises from which the service is organised — not the homes where people receive care.

That single rule explains a lot about how supported living is inspected. It is assessed as a community service organised from one location rather than premises by premises, which is why there is no building to walk round and why the evidence an inspector asks for is about systems, records, staffing and outcomes across a dispersed service.

The CQC’s service type codes distinguish supported living services, where a person lives in their own home and receives care or support to promote their independence, from extra care housing services, which are purpose-built accommodation with varying amounts of care and support and some shared services and facilities.

Right support, right care, right culture

For services supporting autistic people or people with a learning disability, the CQC applies its guidance Right support, right care, right culture at both registration and inspection. It is statutory guidance under section 23 of the Health and Social Care Act 2008, and it replaced the earlier Registering the right support, published after consultation in 2017. The rename and revision were announced in October 2020.

• Right support — the care model and setting should maximise people’s choice, control and independence.
• Right care — care should be person-centred and promote dignity, privacy and human rights.
• Right culture — leaders’ and staff’s ethos, values, attitudes and behaviours should help people lead confident, inclusive and empowered lives.

The CQC says it will register only services that can show high-quality, person-centred care, and encourages providers to discuss proposals before applying or changing a service.

On size, there is a persistent myth worth killing. The CQC uses NICE clinical guideline CG142’s description of "small" — usually no more than six people — but it has never applied a six-bed limit. NICE guideline NG93 recommends small-scale shared housing and the option to live alone. The easy read version of the CQC guidance sets out four things it looks for: a clear need for the service; its size, design and location; access to the local community; and how care is organised, including that behavioural needs are met through planned approaches avoiding restraint and seclusion, and that people are supported by the right number of staff with the right skills.

The CQC’s current assessment framework retains the five key questions and the four-point ratings scale, with quality statements having replaced the former key lines of enquiry, prompts and ratings characteristics. Evidence is grouped into six evidence categories that differ by sector group, a scoring system produces the rating, and providers can challenge the factual accuracy of a draft report. The duty to be open when things go wrong runs alongside it — see our guide to duty of candour under Regulation 20.

Regulation 18: the staffing and training duty

The training obligations for supported living staff are the same as for any regulated activity, and they sit in Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. It requires that sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed, and that staff:

• receive such appropriate support, training, professional development, supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform;
• are enabled where appropriate to obtain further qualifications appropriate to the work they perform; and
• where registered with a health or social care regulator, are enabled to provide evidence that they continue to meet the professional standards.

The CQC’s guidance under the first of those is where the learning disability and autism duty lives: providers must ensure 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, and staff must receive appropriate supervision to demonstrate and maintain competence in understanding those needs.

The guidance also expects structured staffing and skills planning, induction, a training-needs assessment at the start of employment reviewed regularly, support for statutory, mandatory and role-specific training including first aid, prompt action when training is overdue, supervision until competent, and regular appraisal by a suitably skilled person. Regulation 19, on fit and proper persons employed, and Regulation 7, on the fitness of the registered manager, sit alongside it.

The funding route for much of this training changed in 2025 — see our guide to Skills for Care and the Learning and Development Support Scheme.

The Oliver McGowan training requirement

The statutory learning disability and autism training requirement comes from section 181 of the Health and Care Act 2022, which amended the Health and Social Care Act 2008 and Regulation 18. The requirement has applied since 1 July 2022, and the Oliver McGowan Code of Practice became final on 6 September 2025, having been laid before Parliament as a draft in June 2025.

All CQC-registered health and adult social care providers in England must ensure their staff receive training on learning disability and autism appropriate to their role. Providers that are not CQC-registered should use the code.

The structure is two tiers. Tier 1 is general awareness: 90 minutes of e-learning plus a one-hour online interactive session. Tier 2 is for staff with responsibility for direct treatment, care or support, and for professionals with high autonomy: 90 minutes of e-learning plus a one-day face-to-face session. The government recommends all staff take Tier 1 or Tier 2, and Annex A of the Code maps roles to tiers. Tier 3 capabilities are for intensive and leadership roles and are delivered through other routes such as apprenticeships. Refresher training is at least every three years, or more often where a member of staff needs it. Part 2 of both tiers requires three approved trainers: a lead trainer, an autistic trainer, and a trainer with a learning disability.

One precision point that providers should not get wrong. Skills for Care states that the CQC does not specify a preference for any specific training package; the CQC recognises Oliver McGowan training as a good practice example, but it is up to providers to show that their training meets the regulation. Completing the named programme is strong evidence, not an automatic discharge of Regulation 18. Our guide to Oliver McGowan mandatory training covers the delivery detail.

Restrictive practice: the published policy position

The Department of Health’s policy guidance Positive and Proactive Care: reducing the need for restrictive interventions, published in April 2014, is the document to know. Its scope covers adult health and social care commissioned or delivered by the NHS or local authorities in England and expressly includes care delivered in an individual’s own home, and homes where individuals employ their own support staff — so it reaches supported living, even though supported living is not named in it.

Its requirements include that a person likely to need restrictive interventions must have an individualised behaviour support plan; that care should follow positive behaviour support principles for people known to show behaviour that challenges, with programmes reviewed at least annually; and that all services where restrictive interventions may be used must have restrictive intervention reduction programmes in place. On training, it states that staff who may use restrictive interventions must have high quality, specialised training, with at least annual refresher training, and that training on a human-rights-based, non-aversive approach should precede training in physical techniques. Boards must maintain and be accountable for overarching reduction programmes, with a named executive lead for each service.

A note of caution about the training standards in this area. The Restraint Reduction Network training standards were created in 2019, commissioned by Health Education England and coproduced with people with lived experience of restraint, and certification is operated by Bild ACT under licence. Those standards are mandated under the statutory guidance to the Mental Health Units (Use of Force) Act 2018, for the settings that Act covers — which does not include supported living. For other settings, including social care, providers can choose to use certified training. Anything stronger than that should be checked with your own clinical and legal advisers before it goes into a policy, and physical intervention training is not something to commission from a general compliance catalogue.

Frequently asked questions

What makes a service supported living rather than a care home?

A real separation between care and accommodation, covered by separate legal agreements and not sold as a single package. Supported living registers for personal care; a care home registers for accommodation for persons who require nursing or personal care.

Do we register each supported living house?

No. For personal care the registered location is the premises from which the service is organised, not the homes where people receive care.

Is there a six-bed limit?

No. The CQC uses NICE CG142’s description of small as usually no more than six people, but has never applied a six-bed limit.

Which guidance applies to learning disability and autism services?

Right support, right care, right culture — statutory guidance under section 23 of the Health and Social Care Act 2008, which replaced Registering the right support.

Does Oliver McGowan training satisfy Regulation 18?

It is recognised by the CQC as good practice, but the CQC specifies no preferred package and it remains for the provider to show that its training meets the regulation.

How often is Oliver McGowan refresher training needed?

At least every three years, or more often where a member of staff requires it.

Evidencing it

Supported living is inspected as a system rather than a building, which makes records the whole of the evidence. The training-needs assessment at the start of employment, the review cycle, the supervision until competent, the prompt action when training lapses — those are the artefacts an inspector asks for. Learnsignal builds compliance and CPD training for care providers with completion reporting built for that purpose, covering the statutory and mandatory topics in our guide to mandatory training for healthcare workers, the induction expectations in our healthcare assistant induction guide, and infection prevention and control. If an assessment is coming, start with our mock CQC inspection guide. To see the catalogue, explore our CPD courses or see pricing for teams.