Download STANDARD THREE COMMUNICATE EFFECTIVELY

Standard Three – Communicate Effectively
STANDARD THREE
COMMUNICATE EFFECTIVELY
Main topics:

Importance of effective communication in the work setting

Meeting the communication and language needs, wishes and preferences of
individuals

Overcoming difficulties in promoting communication

Understanding principles and practices relating to confidentiality
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Standard Three – Communicate Effectively
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STANDARD THREE
Communicate Effectively
Different reasons why people communicate
Basic physical needs:
People will do whatever is necessary to meet their basic physical needs and these are ranked as
the most important when people are placed under threat. The majority of people are able to take
these basic needs for granted but if deprived of them will go to great lengths to satisfy those
needs. For example, if a person is starving then their overriding priority is to find food. All the
other needs fade into insignificance when compared to needs like hunger, warmth and shelter.
Safety and security needs:
When people have their basic needs met then they will look for safety and security. Most people
will look for safety from physical danger, and will try to create an environment which is free from
fear and anxiety.
Love and emotional needs:
The need to form relationships with other human beings only becomes important after basic
needs, safety and security needs have been achieved. People need to reach out and form
relationships with other people. They need to express affection, to care for others and to feel
cared for and nurtured in return. We need to form close relationships, as well as having contact
with other people e.g. friends, colleagues, neighbours, cooperating and working alongside other
people. People dislike feeling like outsiders or not being accepted by a group.
Self-esteem needs:
Self esteem is about the way people feel about themselves. It is important that people feel that
they have a valuable contribution to make to society such as in their local community, workplace
or own family. Feeling good about yourself has a great deal to do with your own experience
throughout your life and the kind of confidence that you were given as you grew up.
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Standard Three – Communicate Effectively
Self-actualisation needs:
This is about everyone’s need to reach their maximum potential. This might be through setting
out to achieve new goals or meeting new challenges or through developing existing talents.
Abraham Maslow suggested that if our other needs have not been met (from the most basic up
to self-esteem needs) then this need will never be met, because people will need to continue to
try to achieve the needs lower down the hierarchy and will never attempt self-fulfilment and will
never try and reach their potential. No-one will ever reach their full potential but always be
striving towards it.
Understand how positive communication affects relationships in the work setting
Effective listening
Effective listening is important when communicating with people it is part of a two way process.
Speech is the highest form of human communication and is influenced by non-verbal
communication, i.e. body language, which gives particular messages to the listener, as follows:

Eye-contact and use of eyes and eyebrows, wide-eyed, raised eyebrows – surprise

The voice – volume, emphasis, pitch

Facial expressions – approachability, frustration, disbelief, impatience

Position and use of head – nodding etc

Use of shoulders – shrugging

Use of mouth – smiling

Posture and position – open posture signifies interest and listening

Gestures – can be helpful if not excessive

Use of touch – depends on situation and individual, it may not be appropriate but can
convey support and reassurance

Dress – could tell the service user something about your role

Utterances – mmm; aah (often used with head movement)
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To demonstrate effective listening the worker should:

Establish a rapport with the speaker

Use body-language which communicates that they are listening clarify where necessary

Be aware of cultural factors, e.g. avoiding gaze as a mark of respect

Focus on content, avoid distractions

Be patient – enable the speaker to finish without interruptions

Do not try to pursue your own agenda

Give encouragement and positive feedback, ask open questions

Use a variety of styles of communication – sometimes humour is helpful

Be able to pick out the main themes and summarise these when need be

Being able to help the speaker to determine the key concerns and the aims and strategies
to deal with them
Alternatively the ineffective listener tends to display the following:

‘switches off’ and is easily distracted

Looks pre-occupied and bored

Does not listen to the whole message only the main facts

May get emotionally involved in the issues therefore clouding their judgement

Does not give feedback

Uses only closed questions

Allows personal feelings about the speaker to interfere with ‘the message’

May take over telling the person what to do, bullying

May have a superior attitude or dispute things the speaker says

May be impatient and hurry the speaker
Communication needs and preferences
Try to imagine what it would feel like if:

You were unable to read these words

You were unable to talk about what you have read

You couldn’t find the right words to say what you felt
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Standard Three – Communicate Effectively
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You couldn’t hear what was being said

You couldn’t understand what someone was saying to you

People don’t listen to what you say

You couldn’t express yourself in writing
How can you establish if someone has particular communication needs?
Ideas might include:

Difficulty in understanding, shown by facial expression, mood, inability to reply

Difficulty in seeing / hearing, shown by body language, asking for repetition, using touch
to gain attention

Lack of confidence, shown by body language, lack of verbal expression

Poor reading / writing skills, shown by reluctance to read / write
Verbal and non-verbal communication
Verbal communication:

The actual words being said
Non-verbal communication, i.e. body language

Hand movements to emphasise what you are saying – hands can also replace verbal
speech such as in Makaton, British sign language, finger spelling

Eye contact – demonstrates if you are listening and understand what is being said

Use of touch – can be reassuring, but there is a need for sensitivity so that it cannot be
misinterpreted

Proximity / personal space – often indicates the relationship between two people.
Personal space varies and what invades the personal space of one person will not do so
for another

Tone of voice – this often indicates if the person is relaxed, angry, sad, etc

Facial expressions – gives you feedback if the person likes or dislikes something

Posture – is the person standing tall or slouching?

If the person has their arms folded – these can act as a barrier to other people
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Alternative and Augmentative Communication Aids
This means communication using signs, symbols, pictures, writing, objects of reference, human
and technical aids. These are alternatives to verbal communication, or can be used to add to
(augment) verbal communication. There are many ways we can replace or support verbal
communication. These include:
Signs - The idea of signs is familiar to most people, and examples are commonly used for
communicating in many ways, such as road signs. The same ideas can be used for other
communication.
Symbols - A symbol is a way of representing something using a line drawing. There are many
systems such as Makaton symbols.
Pictures - Pictures can be drawn or photographs used.
Writing - The person may prefer to receive communication in written form, or to reply in writing.
Objects of reference - An object of reference is something that refers to the concept, like a mug
for ‘drink’ or a model of a bed for ‘sleep’
Human aid - A human aid would typically assist the person to communicate by translating or
representing their communications, or by assisting them to use another system
Technical aids - There are many types of technical aids, including switches and talk boxes. A
talk box will enable the person to type or choose signs or symbols and will then ‘speak’ for the
person
Other examples include telephone systems for hearing impairment, adapted keyboards and
large screens for computers - And many more
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Standard Three – Communicate Effectively
Main barriers to communication
Some of the main barriers to communicating effectively with service users / patients are as
follows:

Inappropriate use of vocabulary including the use of jargon, abbreviations and long
complicated words which only act to confuse people

The length and construction of sentences

Inappropriate use of personal space, posture and facial expressions

Environmental factors such as space, background noise, light and positioning of lighting,
temperature of room, i.e. too hot / cold

Relationship between service user / patient and worker. Are service users / patients
enabled to express their own views / wishes – there is an imbalance in the relationship
which needs to be addressed?

Talking down to people – as if the service user / patient were a child

Not considering the service user / patient’s concentration and memory span e.g.
becoming tired
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The person’s level of literacy

Inappropriate responses to culture and ethnicity

Inappropriate responses to gender

Feeling ill or upset
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If the worker uses some words which act as a ‘red rag to a bull’ which prevent the real
message from getting across

Is the service user / patient you are talking to, able to hear, see and understand what is
being said?

Not using / knowing the appropriate communication methods, e.g. British sign language,
their own language, Makaton, Braille, communication board, pictures / photographs etc

The worker’s negative feelings towards the service user / patient, i.e. if the service user /
patient had demonstrated challenging behaviour this might affect the worker’s ability to
work with that particular person
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Reducing barriers to effective communication
People who are partially sighted or blind

Do not surprise the person, make sure they know you are near

Talk to the service user / patient stating their name and who you are as you approach

Check that the lighting is good enough
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Use the tone of your voice to express interest and concern
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Speak clearly and do not shout
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Describe objects and events if need be

Use touch to convey concern / positive regard, if appropriate

Explain where you or other people are leaving

Be prepared to use audio tapes, large print, magnifying aids and possibly Braille to assist
with communication
People with Speech Difficulties (Dysarthria)

Be patient and listen carefully to what the service user / patient is saying

Use a variety of methods of communication, for example, pictures, gestures, writing –
keep a pen and paper nearby
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Do not say too much at once, give service users / patients time to absorb and respond to
what you have said

Consider referral to speech therapist
People with dementia

Find out the history of the service user / patient: this may give you an insight and
understanding of their behaviour

Use short, simple sentences
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Talk about one thing at a time
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Try to re-confirm your intentions, e.g. “it is time for your bath, shall we get the things ready
for your bath” (find similar ways of saying things or repeat if necessary)

Make sure aids are correctly fitted / working, e.g. dentures, hearing aid
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Standard Three – Communicate Effectively
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Use cue cards, colourful pictures to provide everyday information (objects and pictures
can help those who are confused)

Do not directly contradict a service user / patient; this can be embarrassing for him / her
People with learning disabilities

Try to create a positive environment and atmosphere

Let the service user / patient know that what they have said is valued

Support people in expressing themselves

Use gestures, pictures and other aids to communication

Do not butt in – be patient and listen
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Adjust your conversation / communication to the required level of understanding

Do not hurry to do things for the service users / patients before they have had a chance to
explain what they want you to do

Consider the use of an advocacy service if need be
People who are deaf or have a hearing impairment

Gain the service user’s / patient’s attention

Do not approach people from behind, you will surprise them
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Identify their best ear and sit close

The service user / patient may be able to lip read: make sure the light is good and you
are in the best position for them to read your lips

Do not cover your mouth: look at the person and speak in sentences

Suggest adjusting the hearing-aid if necessary

Use other means if necessary, e.g. writing, sign language, Makaton or British Sign
Language: you may need an interpreter or signer

Do not rush the conversation, be patient. Use different words if necessary
People whose first language is not English

Make sure that you pronounce people’s names correctly

Speak clearly: do not raise your voice
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Standard Three – Communicate Effectively

Speak slowly, but not in ‘pidgin’ English

Pictures may be helpful

Simple sentences are best – use a clear, logical order

Focus on one thing at a time

Be aware of cultural differences in communication, e.g. body language or eye-to-eye
contact (averting gaze for example)

Do not use expressions only used in English e.g. ‘’spend a penny’

Consider using an interpreter
People with Challenging or Aggressive Behaviour

Keep calm and do not raise your voice or argue back

Try to defuse the situation with empathy and understanding
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Use your listening skills, look for a trigger event
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Inform your supervisor
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Seek help to escort the service user / patient to a quiet area

Remain with the service user / patient until they are more settled
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Divert the service user’s / patient’s attention if possible and appropriately
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When convenient, enable them to express their views on the situation

Reassure others nearby and make sure that you document events / concerns
Finally, remember what creates good communication

Having an equality between people
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Being honest about thoughts and feelings
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Being willing to actively listen to others
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Accepting that someone has the right to their own viewpoint
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Making time for someone

Being interested in others and what they have to say

You do not always have to be right
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What confidentiality means in my work role
Tick the sentences that you think should be treated as confidential in your work setting.

Miss Cornwall’s close friend has just died

Stephen needs a particular medication when he has constipation

Miss George has a private bank account that her family are not aware of

Some things make Sanna very angry

Susan likes to have her hair washed in a particular way

Mr Taylor has an estranged sister who has no part in his everyday life

Freda does not like a fuss to be made on her birthday

Mrs Johnson has been married three times

Paula had a miscarriage fifteen years ago

James is afraid of dogs

Tom is HIV positive

Mr Nelson is a Schedule 1 Offender (has abused children in the past)

Fred used to be a traveller

Mr George used to be a millionaire and has lost all his money

Sarah has a gambling addiction
Would effective work practice be possible if you did not share some of this information?
Keeping it safe!
What you have found out will be particular to your workplace. Good practice in storing
information will usually mean that personal information written on paper is stored in locked metal
filing cabinets in a reasonably private part of the building, e.g. an office.
Written records that are in daily use (e.g. report book, shift record, care plan notes) need special
attention to make sure the people who need them can see them easily, but other people cannot.
Again, a private lockable office area is the usual solution. Incoming letters and faxes will need to
be promptly sorted and left in an agreed secure place for individual colleagues.
Outgoing faxes need to be clearly marked as confidential and addressed to an individual rather
than a location.
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Points to remember!

Never leave papers on a window sill!

Do not forget to remove the originals when you have finished with the photocopier!

Personal information held on computer can be accessed only by using correct passwords
(the electronic equivalent of a key)

The password system should include e-mail access

Computer screens can easily be seen by passers-by while they are in use, so it is worth
checking that screens are directed away from areas where people may pass

Are any steps taken in your workplace to let the patients / service users you support have
access to their own records?
Scenario – Vincent
What is the worker’s role in the following case study?
Vincent lives in a small group home where you are his key worker. He has a part-time job at the
local supermarket. Vincent has recently started going to the pub with a group of young men he
has met through work. He has never been one to go out much, and this new pattern is doing a
lot to make him more self-confident. The way he talks about the men shows that he feels like
‘one of the lads’ because he’s included in their social life. Today Vincent has told you that he
needs to get out extra money from the bank because he will be buying drinks again tonight. As
you help him work out how much he will need, you talk to him about how many drinks he buys
and how often. It slowly becomes clear to you that Vincent is buying just about all the drinks for
the group, every evening they go out. When you ask Vincent about this, he agrees that this is
what happens and that it is not fair. But he does not want to say anything in case the men say
he cannot go out with them any more. He also tells you that you’re not to tell anyone else about
what’s going on
1.
What are the things you need to consider in this case?
2.
What are the risks of ‘telling’ or ‘not telling’?
3.
Who is at risk in each case?
4.
How would you respond to the situation?
5.
Who or what could you go to for help and advice?
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Scenario – Vincent – main issues
The main issues here are:
1. Vincent’s new drinking partners are taking advantage of him. They are in effect stealing
from him – this is ‘financial abuse’
2. Vincent is aware of his situation (though perhaps not how serious it is) but considers it
money well spent because he gets the reward of being included in the group, having a
social life, building better self-esteem as a man
3. If these nights are disrupted, Vincent’s social and emotional life will suffer
4. Vincent has expressly asked you not to say anything, he has made a choice about this
this choice may or may not be an ‘informed’ choice
5. Trust is an important part of your working relationship with Vincent
6. You have a ‘duty of care’ for Vincent that includes protecting him from abuse
7. The men’s behaviour is damaging the image of someone with a disability – they seem to
think he deserves no consideration or respect
8. Sorting these in terms of the ‘balance of risks’ will have helped you try to decide what
action to take. But you probably also came up against the difficulty of how important each
factor is – how much it ‘weighs’ against other factors.
Confidentiality in my workplace
If you have concerns relating to confidentiality within your work role use the following information
to guide your decisions. Remember discussions relating to confidentiality, whether relating to
workers or service users, should take place in private.
Written procedures relating to confidentiality are kept in the:
The person responsible for maintaining these procedures is:
If I am unsure about issues of confidentiality the first person I would ask is:
If I was still unsure I would speak to:
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Standard Three – Communicate Effectively
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STANDARD THREE – Communicate Effectively
Q1
Give three reasons why people communicate:
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
Q2
Provide examples on how you can promote positive communication when supporting
service users:
____________________________________________________________________________
____________________________________________________________________________
Q3
List three things that could stop your message being received positively:
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
Q4
What can a service user’s non-verbal communication indicate?
__________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Q5
Where will you find written information about the communication and language needs of
the people you support? Guidance: talk to your manager to help you with this question.
____________________________________________________________________________
Q6
Provide three examples of alternative communication aids that you could utilise when
supporting service users in your work setting.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Standard Three – Communicate Effectively
Q7
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Make a list of six barriers to communication. Highlight those relating to your work setting.
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
Q8
Make a list of eight different ways to reduce barriers to effective communication.
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
Q9
What support services can be accessed to assist service users to communicate more
effectively?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Q10
How can you maintain confidentiality in your work place?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Standard Three – Communicate Effectively
Q11
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When might confidential information need to be passed on?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Care Worker Signature:
____________________ Date: __________
Managers Signature:
____________________ Date: __________
Congratulations you have completed standard three
Communicate Effectively
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