Guide
STOMP and CQC: what your policies cover for learning disability and autism
If you’re registering a home care or supported living service that will support autistic people or people with a learning disability, STOMP will come up. It appears in CQC’s medicines policy guidance, it sits behind CQC’s guidance on psychotropic medicines, and it connects to the behaviour support and restraint policies CQC asks specialist services to send.
This article pulls those CQC pages together in one place, so you can see where STOMP shows up in a registration application and what each page asks for.
What STOMP is
CQC’s page on psychotropic medicines in adult social care defines it: “STOMP stands for stopping over medication of people with a learning disability and autistic people. STOMP is a national project to reduce prescribing and administration of psychotropic medicines. It is about helping people to stay well and have a good quality of life.”
The same page explains that psychotropic medicines “work in the brain” and affect behaviour, mood, consciousness, thoughts or perception. Examples it gives include antipsychotics, antidepressants, mood stabilisers, anxiolytics, sedatives and anti-epileptics. It says these medicines are “sometimes used to control how a person behaves or to restrain them”, and that this “could be because staff do not know how to communicate with a person or meet their needs”.
The CQC quality statement it quotes is: “People’s behaviour is not inappropriately controlled by medicines.”
STAMP is the children’s equivalent: supporting treatment and appropriate medication in paediatrics.
Where STOMP appears in your application
Your medicines management policy
Every provider sends a medicines policy. CQC’s medicines management guidance lists what all providers cover, then adds a line specifically for home care (domiciliary care) agencies: “your approach to STOMP (Stopping over-medication of people with a learning disability and autistic people) and STAMP (supporting treatment and appropriate medication in paediatrics) where applicable”.
So for a home care agency, STOMP is named on the face of CQC’s guidance, with the qualifier “where applicable”.
Your restraint policy (specialist services)
If you plan to be a specialist service for autistic people and people with a learning disability, CQC’s home care and supported living lists ask for a restraint policy and a positive behaviour support policy.
CQC’s restraint policy guidance asks providers to define the types of restraint, including chemical restraint, and to set out restraint as a last resort and the least restrictive option.
This links back to the law. Regulation 13 of the 2014 Regulations says a person controls or restrains a service user if they restrict “the service user’s liberty of movement, whether or not the service user resists, including by use of physical, mechanical or chemical means”. CQC’s guidance on Regulation 13 says improper treatment includes “unlawful restraint” and lists “unnecessary or disproportionate restraint”.
Your positive behaviour support policy (specialist services)
CQC’s PBS policy guidance asks you to show how you “focus on proactive strategies rather than reactive or punitive measures” and “understand behaviour as a form of communication”. It asks for your approach to functional behaviour assessments, individual PBS plans and how often they’re reviewed, staff training, data on behaviours and interventions, and your commitment to “reducing and eliminating restrictive practices”. It also asks you to link the policy to your safeguarding and complaints policies, and says your documents “should be consistent and not contradict each other”.
What CQC lists for providers on psychotropic medicines
CQC’s psychotropic medicines page is written for services already running, but it is the clearest statement of what CQC looks for. Citing NICE guideline NG11, it says to only consider psychotropic medicines if psychological or other interventions have not helped the person’s quality of life, or the risk of harm is severe.
Its “considerations for providers” include:
- assessing people’s capacity to make decisions about their medicines, following the Mental Capacity Act 2005 where necessary
- including when medicines might be used in person-centred behavioural care planning
- keeping clear records of behaviour that staff find difficult to manage, and identifying themes and triggers
- putting environmental and psychological support in place to reduce distress
- using medicines only as the least restrictive option
- providing accessible medicines information that explains risks and benefits
- clear, person-centred guidance for staff on “when required” (PRN) medicines, and recording the outcome each time one is given
- staff knowledge of psychotropic medicines and their side effects
- supporting people to access medicines reviews and physical health checks
- reporting the number of people whose behaviour has been controlled or restrained by medicines through the provider information return
CQC’s page on “when required” medicines adds that for homecare, the care plan describes how staff will manage PRN medicines outside visit times. It also says overuse or inappropriate use of medicines to control people’s behaviour “may need to be reported as a safeguarding incident”.
The wider CQC guidance: Right support, right care, right culture
CQC’s guidance Right support, right care, right culture is statutory guidance under section 23 of the Health and Social Care Act 2008. CQC’s before you apply page says “You must read this guidance before you apply”, and invites providers to send a pre-registration questionnaire and discuss proposals with a registration specialist early in their planning.
The guidance also explains its language. NICE guidelines use “behaviour that challenges”; CQC refers to people “who are communicating a need, expressing their feelings or an emotional reaction”, to focus on understanding the person’s experiences.
About NICE NG11
NG11 covers support for people with a learning disability whose behaviour challenges, including a section on medication. NICE’s own guideline page says it is “not mandatory to apply the recommendations”, while professionals are “expected to take this guideline fully into account”. CQC’s restraint and PBS guidance both list NG11 among related guidance.
FAQ
Does STOMP apply to a home care agency that isn’t a specialist LD/autism service? CQC’s medicines guidance asks home care agencies for their approach to STOMP and STAMP “where applicable” (source). CQC doesn’t define “where applicable” on that page.
Who decides whether someone takes a psychotropic medicine? CQC’s PRN guidance speaks to prescribers (“Only prescribe these medicines where there is a clinical need”) and asks providers to work with prescribers so these medicines are reviewed regularly, and to contact the prescriber if there are concerns about overuse.
Is STOMP a law? CQC describes it as a “national project”. The legal hook is Regulation 13, which counts chemical means as a form of control or restraint.
Do I send the PBS and restraint policies with my application? CQC asks for them if you plan to be a specialist service for autistic people and people with a learning disability, with an additional form (source).
Where OrCore fits
The OrCore policy pack interview asks every client about STOMP, whether or not they plan a specialist service, and uses the answers in your draft policies. It also has a module for services supporting autistic people and people with a learning disability. You check, edit and sign off every policy. Start the policy pack interview.
About us. OrCore Compliance is independent of CQC. We are not part of CQC and CQC has not endorsed us. We’re also new, so we don’t have a track record or success figures to show you yet, and we won’t invent any. We use AI to help draft and check our master policy templates. Your answers fill them in, and you confirm every policy matches how your service really works before you use it. The interview on our site uses fixed questions and fixed answers written by the OrCore team. No AI reads or replies to what you type there.
This article gives general information from CQC, NICE and UK law, with a link for each point. It isn’t advice about your own service: CQC makes every registration decision, and for advice on your situation speak to your own specialist. OrCore offers registration support only, with no guarantee of outcome.