Download Health and Social Care Level 2 Introduction to Communication in

Health and Social Care Level 2
Introduction to Communication in HSC
Reasons for communication
Humans communicate for a wide range of reasons and purposes.
Greeting - We establish who we are and introduce ourselves on first and subsequent meetings.
Satisfying needs - In order to get what we want we have to let others know or ask for something,
express our desires.
Controlling people in the environment – This can be by giving instructions or in some case orders.
Social interaction - A major purpose of communication. We express a wide range of emotions; we
interact with others to fulfil a basic human need to socialise.
Self-expression - We define our individuality, beliefs, values, wishes and our personality.
Seeking information - We seek out information in order to learn and explore life.
Informing others - We exchange information to increase understanding.
Imagining - We imagine as a way of expressing creativity, being innovative and sometimes day
dreaming and escaping from reality.
Reasoning - This enables us to solve problems and make sense of happenings.
Active listening
Active listening is an effective communication technique. It is a technique that encourages the
‘listener’ to focus on what they are hearing without the many distractions that can occur in our
everyday work life. We may be thinking of other things or thinking about what we are going to say
next – this is particularly what happens in conflict situations.
Active listening is about noticing and reacting to all aspects of communication; not just the words
they speak, but the way they say them, their body language and facial expressions.
If you are listening in an active way you will notice when one aspect of the communication does not
match another. An example might be when someone says they are not worried or unhappy, but
their body language suggests that they are concerned.
Active listening is:
•
a structured way of listening and responding to others
•
focusing the listener’s attention onto the speaker
•
not speaking until the speaker has finished their sentence or statement
•
the listener feeding back by restating or ‘paraphrasing’ the important issues and points – to
let the speaker know that they have been heard.
Six-point plan for active listening
1.
Give the individual your full attention.
2.
Listen not only to the words being said but the feelings/message behind the words.
3.
You need to be genuinely interested in what the person is saying.
4.
Restate what the person has said to clarify your understanding.
5.
You may need to ask occasional questions to clarify you have understood what is being said
– but only occasionally.
6.
Be aware of your own feelings and opinions – do not interrupt the speaker if you can
possibly help it.
Remember we have two ears but only one mouth for a reason – listen more, speak less.
Confidentiality
People entrust us with, or allow us to gather, sensitive information relating to their health and social
care.
They do so in confidence and they have the legitimate expectation that health and social care
workers will respect their privacy and act appropriately.
It is essential, if the legal requirements are to be met and the trust of individuals is to be retained,
that health and social care providers give a confidential service.
Maintaining confidentiality:
•
gives control to the individual
•
preserves the person’s rights
•
protects the individual
•
promotes respect and a feeling of security
•
encourages autonomy
•
gives the person the confidence to disclose information.
Confidentiality does not, however, mean that we never pass on any information to others. Some
details have to be shared in order to:
•
ensure continuity of care
•
ensure safety of the individual and others
•
reduce the need for repetition.
Confidentiality is about:
•
ensuring the safety of an individual
•
care
ensuring the privacy and dignity of an individual is maintained within the context of their
•
taking every precaution to protect sensitive information
•
knowing what can be shared and in what way
•
respecting choices and decisions made by individuals.
The communication process
Encoding is ‘the process of organising ideas into a series of symbols such as words and gestures
designed to communicate with the receiver’.
Decoding is where ‘the receiver interprets the message and translates it into meaningful
information. Decoding is the process of understanding a message’. (A J Dubrin 1996)
If communication is effective the process results in ‘action’.
In order to decode the message the receiver must gain information from the sender to assist in the
process.
Information can be gained by:
•
observing the position of the body (body language)
•
observing facial expression
•
observing eye contact
•
observing gestures made
•
observing head movements – nodding or shaking head
•
observing appearance – state and choice of clothing
•
listening to the tone and pitch of voice used
•
listening to the emphasis on certain words.
Essential Standards
In March 2010 the Care Quality Commission produced a set of Essential Standards which explain
how providers of health and social care can comply with the requirements of the Health and Social
Care Act 2008.
Outcome 1 of the Guidance states:
Respecting and involving service users
17.–(1) The registered person must, so far as reasonably practicable,
make suitable arrangements to ensure—
(a)
the dignity, privacy and independence of service users; and
(b)
that service users are enabled to make, or participate in making,
decisions relating to their care or treatment.
(2)
For the purposes of paragraph (1), the registered person must—
(a)
treat service users with consideration and respect;
(b)
provide service users with appropriate information and support in relation to their care or
treatment;
(c)
encourage service users, or those acting on their behalf, to—
(i)
understand the care or treatment choices available to the service user, and discuss with an
appropriate health care professional, or other appropriate person, the balance of risks and benefits
involved in any particular course of care or treatment, and
(ii)
express their views as to what is important to them in relation to the care or treatment;
(d)
where necessary, assist service users, or those acting on their behalf, to
express the views referred to in sub-paragraph (c)(ii) and, so far as
appropriate and reasonably practicable, accommodate those views;
(e)
where appropriate, provide opportunities for service users to manage their
own care or treatment;
(f)
where appropriate, involve service users in decisions relating to the way in
which the regulated activity is carried on in so far as it relates to their care
or treatment;
(g)
provide appropriate opportunities, encouragement and support to service
users in relation to promoting their autonomy, independence and
community involvement; and
(h)
take care to ensure that care and treatment is provided to service users
with due regard to their age, sex, religious persuasion, sexual orientation,
racial origin, cultural and linguistic background and any disability they may
have.
If health and social care workers are to comply with these regulations it is important to ensure they
have established how individuals prefer to communicate, and how they wish to be involved in
assessing, arranging and reviewing their own care needs.
The person-centred approach to care will not work without effective communication and time spent
establishing communication preferences is time well spent.
Modifying communication for different individuals – some examples
An individual with moderate learning disabilities:
Begin the conversation as with any other adult and find out at what level the individual prefers to
communicate. Language may have to be simple and not include jargon or technical terms. You may
have to find out from a carer/advocate if the person uses Makaton, BLISS, or a specific form of
signing. Check thoroughly that you are understood. There may be informative literature using more
pictures and symbols than text which could be useful as the person may or may not be able to read.
An individual who speaks a different language to you:
Explain what you need in simple terms. Make sure you keep eye contact with and talk to the person
involved. Enlist the help of a family member/carer/interpreter if necessary but still address yourself
to the individual. Do not shout. Use positive non-verbal communication techniques and access
literature in the person’s own language, if possible. Check understanding.
An individual who is profoundly deaf:
Speak to the individual and find out if the person can lip-read. Communicate in a well-lit area so that
light falls on your face to help lip-reading. Use positive non-verbal communication. You may need to
contact a BSL signer, write questions down and provide literature to enhance your communication.
Do not shout but speak clearly.
An individual with a visual impairment:
Communication here will be mainly verbal with perhaps access being made to Braille or very large
print literature, if available. Professional touch may be used to attract the individual’s attention but
remember to speak first or you may startle the individual. You will need to read out any documents
which need to be signed by the individual.
A young child:
Physically come down to their level. Be approachable and friendly; think of the tone and pitch of
your voice. Explain what you are doing in simple terms without patronising the child. Don’t use
jargon or technical terms. Invite questions and keep checking understanding. Allow time for the child
to discuss things with the parent/guardian/adult. Use child friendly literature if available.
Factors affecting communication
A number of different factors can affect communication with the people you care for.
Examples:
Hearing impairment: The individual may be unable to clearly hear what is being said. Ensure where
hearing aids are used they are worn and in good working order. Ensure the individual can see your
face. Communicate in a well-lit room. Use British sign language or seek the help of an interpreter.
Speak clearly and do not place your hand over your mouth.
Speaking different language: The individual may be unable or have some difficulty understanding
what is being said to them, and unable to make themselves understood. Use pictures and gestures
and access an interpreter. Do not shout.
Visual impairment: The individual may be unable or will have difficulty reading non-verbal
communication. The person may not be aware that someone is trying to communicate with them.
They may have difficulty or be unable to read written communication. Use touch and tone of voice
to convey meaning. Use more verbal communication. Avoid written communication where possible;
provide someone to read written communication. Access Braille information if appropriate.
Stroke (CVA): The individual may have difficulty in forming words (dysphasia) and possible
difficulties in finding the right words to use. They may have no speech (aphasia). Give the individual
time to express themselves, understand their frustration, use a notepad if able to, or flashcards.
Make sentences short and to the point. Refer to speech and language therapist for advice and
guidance.
Parkinson’s disease: Parkinson’s disease creates changes in facial muscles and rigidity in the throat
making verbal communication difficult. Give the individual time to communicate, listen carefully.
Refer to speech and language therapist for advice and guidance.
Cerebral palsy: The individual understands what is being said to them but there are difficulties in
verbally responding. Allow time for the individual to respond, take time to become familiar with the
individual’s speech pattern and sounds. Refer to speech and language therapist for advice and
guidance.
Dementia: The individual may gradually lose the ability to remember how to construct conversation.
Short-term memory loss means the content of the conversation is forgotten. It is important to
repeat information, where necessary flash cards or pictures maybe helpful. Sentences need to be
short and to the point. Give the individual time and remain patient. Not all barriers to
communication are linked to difference or impairments.
Think about:
Attitudes: Are you interested in the individual and what they have to say? Does your body language
convey an interest and eagerness to communicate? It is important to demonstrate a willingness to
communicate and to show you are interested and listening.
Environment: Choose an environment that supports communication. Is the area well-lit? Is it free
from noise? Is it comfortable? Is it a familiar place for the individual? Can anyone overhear the
conversation?
Time: Choose the right time to communicate. If you know that an individual is tired in the evenings
or does not like early mornings, then don’t try to have some discussions with them at these times.
Feelings: If you are trying to communicate about sensitive or painful subjects, be aware of how the
individual might react. They may not want to express themselves openly, especially in front of other
people. Be sensitive and respect their dignity.
How to keep information secure – top tips
Keeping information safe and secure is an important responsibility for health and social care
workers.
In some settings this is easier than others. For example, if you work in a group living setting any
written information will be kept in an office. If you are a support worker who visits people in their
own homes, the written information may be left in the person’s home and could be read by anyone
who visits the individual.
There are some simple rules to follow which can help to ensure confidential information remains so.
Top tips
1.
Where possible lock written records in a secure cabinet or office.
2.
Use passwords to protect electronic information.
3.
Try not to share information with others in an area where someone may overhear the
conversation.
4.
Be careful what you write in records. Make sure it is factual, evidence-based and respectful.
5.
Don’t disclose information over the phone or by email unless you are certain of the identity
of the person receiving the details.
6.
Double check any email address.
7.
If sending information through the post, mark as confidential and use a secure postal
method.
Can you think of any other top tips?
Finding out about an individual’s communication needs
Before we can work effectively with the individuals we care for, we need to know how they
communicate.
This means knowing about a wide range of factors that can impact on the way an individual is able to
or chooses to interact with others.
Language: This refers to the language that an individual may use to communicate, and also to the
words they may use to describe things. You need to ensure you understand all the words used by
the people you care for and what they mean by them.
Vocalisation: Some individuals use sounds rather than words to express themselves. These sounds
usually have meaning and it is essential to ensure you know what the individual may be conveying by
the sound they are making.
Individual preferences: Some individuals have particular preferences for the way they
communicate. An example might be that someone prefers not to talk much while they are watching
a TV programme, others like to comment on what they are seeing.
Behaviour: Behaviour is an important form of communication. Individuals can express a wide range
of emotions, reactions and express their needs through their behaviour.
Touch: Touch is an important form of communication and can demonstrate care, anger, irritation,
love etc. Touch should be used effectively and with care to avoid allegations of abuse, and to avoid
invasion of privacy.
Body language: This includes facial expressions and positioning of the body as well as body
movements. Some people match their body language to the words they are saying, and others use
body language to show they are joking or mean something different. Make sure you understand how
the individuals you care for express themselves through their body language.
Augmentative: There has in recent years been a growth in the communication range of aids and
adaptations available to support effective communication. These may be aided or unaided (using
equipment or not). It is important to be familiar with any aids, adaptations or techniques that the
individual uses.
Beliefs and culture: How an individual communicates with others is affected by their upbringing and
their values and beliefs. It may be that they feel it is respectful to always refer to people with their
full name, or it is disrespectful to look someone in the eye. Health and social care workers need to
find out about the individuals they care for and recognise any communication differences based on
heritage.
Think about how you can find out more about the way that an individual communicates. How
effective do you think the following methods might be?
•
Ask the individual.
•
Ask their family or carer.
•
Ask a colleague who knows the individual.
•
Read relevant records.
•
Try different methods and observe the response.
Can you think of any other ways of finding out about the way an individual communicates?
This sample scheme of work covers learning for Unit 201. It is based on 1.5 hours per session for four
sessions. It is an example only of a possible scheme of work, and can be amended to suit all learning
facilities with the necessary adjustments to meet individual learners’ needs.
Unit 201 is a mandatory unit and should be used in conjunction with the standards set for the
qualification to ensure full coverage of the learning requirements.
You can use the sample scheme of work as it is, adjust it or extract content to create a scheme of
work to suit your delivery needs. It can also be adjusted by adding theory and practical workshops to
support learners who have/need additional learning time.
Reference is made within the scheme of work to worksheets and handouts that are available on
SmartScreen.co.uk for tutors to use with learners. Any other resources listed are not provided on
SmartScreen but provide guidance for the tutor as to others they may produce. Delivery timings are
given; however, these can be amended to suit the group. The content of presentations, discussions,
explanations etc are left to the professionalism of the course tutor.
Centres should also incorporate the following themes, where appropriate, as strands running
through each of the sections within the qualification. Although they may not be specifically referred
to in the section content section, City & Guilds regards these as essential in the teaching of the
qualification:
•
health and safety considerations, in particular the need to impress upon learners the fact
that they must preserve the health and safety of others as well as themselves
•
Functional Skills (mathematics, English and ICT)
•
extension tasks and differentiation, inclusion, entitlement and equality issues
•
personal learning and thinking skills (PLTS)
•
use of information learning technology (ILT).