Adults with a learning disability usually live in small registered care homes, supported living or shared lives rather than traditional older people’s homes. CQC expects every such service to follow “right support, right care, right culture”: choice and independence, person-centred care that protects dignity and rights, and staff whose values help people lead confident, inclusive lives.
At a glance
- CQC’s care directory (4 November 2026) shows 5,015 of 14,902 care home locations in England listing learning disabilities.
- CQC found 80% of small homes (up to 10 beds) for autistic people and people with a learning disability were good (75%) or outstanding (5%).
- A care home is one option. Supported living and shared lives are the other main registered models.
- People have the right to a Care Act assessment, an independent advocate where needed, and a say in where they live.
- The Oliver McGowan code of practice sets the standards for statutory learning disability and autism training for CQC-registered providers.
What types of home and support are there?
The Care Act treats care homes, shared lives and supported living as the main types of “specified accommodation” for people whose needs are best met in a particular setting. The differences matter for rights, funding and how much control the person has.
| Option | How it works |
|---|---|
| Residential care home | Accommodation and personal care provided together by one registered provider, usually in a small shared home |
| Supported living | The person has their own home, often with a tenancy, and care is arranged separately; a direct payment usually covers the care, not the accommodation |
| Shared lives | A person lives with or regularly stays with an approved household, in family-style support |
| Own home with support | Help at home arranged by the council or by direct payments; see learning disability support at home |
In the same CQC file, 5,073 locations carry a supported living service type, although that figure covers all adult groups, not only people with a learning disability. For many people, supported living gives more control than a care home does. The right choice depends on the person’s needs, their wishes, and what is available locally.
What does “right support, right care, right culture” mean?
CQC’s statutory guidance sets out how it regulates services for autistic people and people with a learning disability. In short:
- Right support: the model of care and the setting maximise people’s choice, control and independence.
- Right care: care is person-centred and promotes dignity, privacy and human rights.
- Right culture: the values and behaviour of leaders and staff help people lead confident, inclusive and empowered lives.
CQC says it will not register new campus or congregate settings, and that it is unlikely to register services that are not run like ordinary residential accommodation. It points to NICE guidance (NG93), which recommends offering people the option of living alone with support, or in small shared housing with a domestic feel. CQC notes that NICE’s definition of “small” is no more than six people for some groups, but that it has never applied a six-bed limit when registering services. Older, larger services registered before the guidance should have plans to develop in line with good practice.
How good are these homes?
CQC’s State of Care 2025/26 analysed nearly 700 small care homes (10 beds or fewer) registered for autistic people or people with a learning disability and assessed since January 2024. It found 80% were good (75%) or outstanding (5%), which is 9 percentage points better than the overall figure for all care homes assessed under the current framework. CQC said small homes may be able to operate more flexibly and use local community resources.
That is an average, not a promise, so read the individual inspection report. See how to read a CQC inspection report and CQC ratings explained.
What rights do people have?
People with a learning disability have the same rights as anyone else under the Care Act 2014, plus protections for those who need extra help to take part.
- Assessment and choice. The council must assess needs and, if it arranges a care home, the person can choose between suitable providers, within their personal budget. See the Care Act 2014 and your rights.
- Advocacy. If a person has substantial difficulty taking part and no suitable person can support them, the council must arrange an independent advocate. See what is advocacy in social care.
- Capacity. Capacity is decision-specific. Where someone lacks capacity to decide where to live, the council acts on the choices put forward by their advocate, carer or legal guardian unless that would be against their best interests. See mental capacity assessment.
- Health. The NHS says everyone aged 14 or over on a GP practice’s learning disability register can have a free annual health check, and surgeries can make reasonable adjustments.
- Trained staff. The Oliver McGowan code of practice, published by the Department of Health and Social Care in June 2025, sets standards for statutory learning disability and autism training for CQC-registered providers and their staff.
Where a council places someone in a home in another area, it generally stays responsible, including for people who lack capacity to choose where they live. See moving to a care home in a different area.
Who pays?
Adults with a learning disability go through the same Care Act financial assessment as other adults, so the capital limits of £23,250 and £14,250 apply in a care home. For supported living or support at home they are minimum limits, and some councils set higher ones, so ask your council. Income such as PIP or DLA is considered under the charging rules, so ask the council what it takes into account. Direct payments cannot currently be used for long-term care home placements, though they can fund supported living care. Where someone was detained under the Mental Health Act, section 117 aftercare may be free.
Read our guides to DLA for adults, PIP rates and eligibility and learning disability support funding.
What should I ask when choosing a service?
- How are people involved in choosing who they live with, what they eat and how they spend their day?
- How do staff communicate with people who use words, signs, symbols or other methods?
- What training do staff have in learning disability and autism, and how is it kept current?
- How does the service avoid restrictive practices and respond when someone is distressed?
- How easy is it to get to local shops, work, college and friends?
- How does the service support access to GPs, dentists and annual health checks?
- How are families kept involved, and how do people raise concerns?
Visit at different times of day and talk to people who live there, as well as the manager. The questions in questions to ask when visiting a care home apply here too.
Frequently asked questions
Is a care home the best option for an adult with a learning disability?
Not always. Supported living, shared lives or help in the person’s own home may give more independence. The best choice follows an assessment of needs and the person’s own wishes, with a council-supported advocate if they need one.
How many care homes in England cater for learning disabilities?
In CQC’s care directory dated 4 November 2026, 5,015 care home locations list learning disabilities as a specialism. The listing shows what a home says it supports, so check its inspection report and ask about the staff.
Who pays for a care home for a person with a learning disability?
The council pays if it arranges the place and the person’s finances fall below the means-test limits, with the person contributing from income. Higher savings mean paying the full fee. NHS funding or free section 117 aftercare may apply in some cases.
Can a person choose their care home?
Yes, if the council arranges the place. The person can choose between suitable homes within their personal budget. If they lack capacity, the council acts on the choices of their advocate, carer or legal guardian unless that would not be in their best interests.
Does everyone with a learning disability get an annual health check?
Anyone aged 14 or over on their GP practice’s learning disability register can have a free yearly check. The NHS says practices do not have to offer it, so ask, and if refused contact the local community learning disability team.
Where to get help next
Ask the council for a needs assessment and ask your GP whether the person is on the learning disability register. Our funding checker shows likely support, and Find care lists homes by area. If you manage money for someone who lacks capacity, see Court of Protection deputyship.
Sources
- CQC: Services for autistic people and people with a learning disability (right support, right care, right culture)
- CQC: State of Care 2025/26, consolidation of the care home market
- GOV.UK: Care and Support Statutory Guidance
- NHS: Learning disabilities, annual health checks
- GOV.UK: Oliver McGowan code of practice
Find learning disability care near you
- Learning disability care in Richmond upon Thames 23
- Learning disability care in Plymouth 21
- Learning disability care in Leeds 19
- Learning disability care in Hounslow 19
- Learning disability care in Gloucester 18
- Learning disability care in Hastings 30
- Learning disability care in Streatham 26
- Learning disability care in Smethwick 24
All care homes in England by town → · Search by postcode
Highly rated care homes for learning disability care in England
- Avondale House Outstanding · Westgate On Sea
- Collegiate House Outstanding · Sheffield
- Hatzfeld House Outstanding · Mansfield
- Lang Riggs House Outstanding · Manchester
Rated by CQC in the last three years. Nobody pays to appear here.
Care homes by county
- Wirral
- Oxfordshire
- Bath and North East Somerset
- South Gloucestershire
- Solihull
- Calderdale
- Sheffield
- Nottinghamshire
- Peterborough
- Newcastle upon Tyne
- Bury
- Rochdale
Related guides
Free download
Choosing a care home: the 40-point checklist
Take it on every visit and compare up to three homes side by side: CQC checks, staffing, daily life, the room, fees and the contract.
Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.