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Unit 1 Developing effective communication in health and social care OBJECTIVES: to re-cap on last weeks session on forms of communication to outline forms of interpersonal interaction to understand language needs and preferences TASK COMPLETE THE SHEETS PROVIDED ON THE TABLES Recap last weeks session Written Communication • In all Health and Social Care settings written communication must be VERY accurate. Communication • If a mistake is made in a formal record a client could have the wrong treatment or be given incorrect information. • This could lead to complaints and someone being taken to court!!! Written Communication • When writing down information it needs to be: • Clear; • Accurate; • Legible (easy to read) Written Communication • Communicating in writing can be a means of: • Giving information; • Obtaining information; • Exchanging ideas. Giving Information • When giving information to people you need to be very clear on the information that you give, to ensure that the correct message gets across Snowball • Using your post-it note, write down when you might ‘give information’ in a Health and Social Care setting Exchanging ideas • Much of the work within Health, Social care and Early Years services requires information to be exchanged between: • Workers and service users, • Workers and workers • Workers and their organisations • Organisation to organisation Exchanging Ideas • Why do companies exchange ideas? Written Communication • In many Health and Social Care settings there will be a policy stating that all written communication must be shown to a manager before it is sent. • Copies of written communication should always be kept in case they are needed for future reference. Written communication • There are lots of types of written communication: • Care plans – these describe what needs a client has and how they can be met. • Care records – these keep a record of appointments, problems etc. Written communication • Memos – to give information to someone at work. • Reports – a detailed description on an issue and how it is being resolved. For example a report on a child who is being bullied and what is being done about it. Written communication • Posters – giving information about events etc. • Minutes of meetings – a detailed account of what is discussed and decided. • Emails – about anything! Written communication • And finally… • Letters! Factors that influence oral communication INTERPERSONAL INTERACTION • Speech • Language – first language? Dialect, Slang, Jargon • Nonverbal – posture, facial expression, touch, silence, proximity, reflective listening Communication and language NEEDS Individuals may have preferred methods of communication e.g. • • • • • • • • Type of language Sign language Makaton Pictures Writing Objects Finger Spelling Technological aids Why is communication important between service users ad care providers? • In pairs come up with at least three reasons why communication is important between services users and care providers ? • You have 5 minutes Lighting • In a counselling session shining a bright light on a service user would make them less likely to talk. But when a doctor is diagnosing a patient a dim light would also be wrong. • Lighting can influence the way service users respond and what they say. Noise • If there is too much noise around us when talking with others, all those involved will have to strain to hear what is being said. • If there is total silence in a room people may feel too embarrassed to talk. • Noise levels must be appropriate for the conversation taking place. Ventilation and heating • Good air circulation is essential in all care settings. If a room is too hot service users and care workers will begin to feel drowsy and lose interest in the conversation. • A room that is too cold can also have a negative affect on service users as they may concentrate more on being cold than on the conversation. Think • How are you feeling in this room at the moment? Space, seating arrangements and proximity • Being in a room that is too small does not enhance communication as those participating will feel squashed in. • Whatever the type of communication all those involved should have enough personal space to be comfortable. Space, seating arrangements and proximity • If a group of service users are planning an activity they may prefer to sit around a table. • But if a service user is receiving information on a one-to-one basis, having two chairs opposite one another so that eye contact can be made may be more suitable. Relationships • If we are talking to a person we like we will have a positive attitude and this will be clear in our tone of voice. We are more likely to share information with someone we like and trust. • What we have to say to the person will influence the relationship we have with them. If a care worker moves someone's stuff without asking them the service user may speak negatively to them. Physical Influences • If someone is unwell their condition may influence the conversation they have. They may lack energy or be unable to concentrate. • Care workers need to notice the changes in behaviour of people in their care. Body Language • Body language is also very important in order to have effective communication between service users and care providers. • A care provider who seems not bothered, unmotivated, and reluctant to help will make it harder for service users to communicate with him/her. Barriers that prevent oral communication • So far we have discussed WHY we communicate with our service users and also factors that could influence verbal (oral) communication. Lastly for today we will look at different types of barriers to communication. • A barrier is something that can stop something from happening. Barriers Tiredness Patronising language having a negative attitude importing own experience invasion of personal space boredom inappropriate body language inappropriate use of language distress 1) Open questions: - These questions require an extended answer from a client. - Examples may include : How? Where? Why? When do you think open questions are best used? Closed Questions • A closed question simply receives a short answer. • Examples include; ‘yes’, ‘no’ or an age for instance Too many of these questions prevent effective oral communication to take place. Why? Task • Think of an example of either 1 An Open Question 2. A Closed Question These examples need to be for a Health and Social care setting Pace • Pace - Speed at which somebody speaks. This can be a very important factor when communicating with someone. - How fast do you speak? - Why could this be an issue? Tone • Tone - The pitch at which you speak. High or low pitch can make a big difference when speaking to different types of service user. - You would use a high voice when you are praising people. - A low voice may be used when you need to get a sensitive point across to a service user. Empathy • Identifying with and understanding of another’s situation and feelings. • Why do you think that empathy is a skill needed for communication? Who is it benefiting? Role Play • Working in your groups you need to comprise a role play to demonstrate the skill that you have been given. You have 15 minutes to complete this task Evaluate the Role play • As you are watching the role play, you need to evaluate the skill. Paraphrasing • Paraphrasing is the repeating of what the service user has said. It communicates to the service user that the care worker has taken on board and acknowledged what they have said. Summarising • Summarising is similar to paraphrasing in that it lets the service user know that they have been listened to. By summarising what the service user has just said, the care worker is showing interest and enthusiasm towards the service user. • Why is this important? Communications Unit The importance of body language in communication and barriers to communications Body language 42 • We have so far looked at verbal communication but can we communicate without using words ? • A large part of communication is actually carried out without speaking, this is what we call non verbal communication or body language • In all care settings this type of communication is Task 43 • How many types of non verbal communication can you think of ? • In pairs think of at least three example of non verbal communication. • Relate each example to a care setting of your choice. (nursery, hospital, care home, etc.) Types of verbal communication 1. Facial expressions, 2. Smiling, 3. Eye contact, 4. Positive positioning 5. Gesture, 6. Touch, 44 7. Makaton. Facial Expressions 45 • Our faces communicate complex and very subtle messages for example: • A smiling and alert face strongly attracts, • A sad and grumpy face arouses sympathy and concern. Smiling and Eye Contact • 46 Smiling is one of the most significant sign of warmth and openness, it also helps with positive interaction. • Eye contact is one of the most direct way to communicate. • You mustn't stare but it is necessary to look at the person you communicating Task Which facial expression do you see ? 47 Positive positioning • We all require personal space, the amount of space is party determined by culture as well as personal preference • The amount of personal space used in an interaction is important in relation to intimacy and dominance. 48 • The closer a person gets, the more Task Using the post it notes, write down a gesture which you use and stick it on the whiteboard. 49 Gestures • We use hand gestures whilst communicating a lot. • Hand gesture can be universally recognised however, their meaning differs between cultures. • For example : 50 Touch • Touch is very tricky aspect of non verbal communication, • A hand on someones shoulder or arm can be very reassuring, or even giving a hug to a distressed child can be very spontaneous response after a bad fall, • However, you must be aware that 51 physical touch can be deemed Task Can you think of : 1. 1 type of physical contact which can be appropriate 2. 1 type of physical contact which can be deemed inappropriate 3. 1 care setting in which it might occur. 52 Makaton • Makaton is a method of communication mostly used with service users with a learning disability, • Many signs in the Makaton are used in the British Sign Language. • Speech is also used with the signs. 53 Makaton • Makaton is a method of communication mostly used with service users with a learning disability, • Many signs in the Makaton are used in the British Sign Language. • Speech is also used with the signs. 54 Recap So what have we learned today ? 55 Empowerment Aims • Identify what empowerment is and be able to apply to care setting within Health and Social Care Recap • • • • • • • • • To give information To obtain information To exchange ideas To meet IES needs Noise Lighting Ventilaton Heating space • Seating arrangements • Proximity of others • Relationships Empowerment • Working in pairs write down what you think empowerment is • Now work with the pair next to you and as a four decide what you all think empowerment is • Once you have decided write in on the paper provided Empowerment • Empowerment in a care setting means allowing service users to take control of their own lives. This means presenting them with all the relevant information and allowing them to make choices and decisions Empowerment • Service users who feel that their views and decisions are valued respond positively when communicating Task – Discussion Point • What can care workers actually do in their day to day tasks to empower service users Task • • • • Children’s home Old peoples home Day care centre Nursery Aims • Identify what empowerment is and be able to apply to care setting within Health and Social Care Empowerment • Service users need to feel that they are equal to others and not people for whom things are done or arranged Empowerment • The target for effective communication is to form a good working relationship or partnership where each contributor is valued. Empowerment This means: • Respecting service users’ rights • Maintaining confidentiality • Respecting individual people’s beliefs and cultural views and opinions. • Allowing service users to express their views and opinions • Tolerating diversity when service users do not have the same opinions or ways of doing things as us. Empowerment • Effective communication and empowerment enables service users to retain their own identity and does not involve care workers imposing their identity on them. Starter Can you think of three things we talked about last lesson? Communication in a Care Setting Lesson Objectives: • Think abut the skills we need when communicating within a care setting. • Tone and pace, eye contact Active Listening •Focusing on the individual • Appropriate body language • Maintaining eye contact • Appropriate facial expressions Active Listening •Allowing sufficient time • Making encouraging sounds • Allowing pauses • Allowing silence • Reflecting back What is active listening? • A good listener hears the content of what the speaker says • Listening actively is the intention to complete a conversation by giving a response. Active listening • By listening actively the listener is conscious of what the speaker is saying and can aid the process by doing lots of things. • These ‘things’ are what we are going to discuss today. Help give appropriate care What is going on here ? How would you approach this child? How would you approach this man? How is this meeting going? Maintaining eye contact Maintaining Eye Contact • Eye contact is an essential part of communication. Without it the other party will feel remote from you and are unlikely to relate to you in a meaningful way. Maintaining Eye Contact • It is important to be aware of how sensitive people are to it. Eye contact should be a positive form of body language communication, but if it is not used correctly it can easily become negative. Maintaining Eye Contact • http://www.youtube.com/watch?v=OUQAe GkhsoY • http://www.youtube.com/watch?v=2V9aNc MLOEE&feature=related • http://www.youtube.com/watch?v=pc42W NcmXSU&feature=related • http://www.youtube.com/watch?v=z6yrcvPq10&feature=related Appropriate eye contact • It the UK, it is appropriate to look at someone when they are talking for about 75% of the time. • This action lets others know you are listening and paying attention. • This can help the clients feel you are interested in them which makes them feel valued Effect • Looking at people appropriately help build positive relationships because you are showing empathy to them. Poor eye contact is not looking at someone ( less than 75%) • How do you feel if someone does not look at you? Bored/disinterested –”they bore you” • Effect-Makes clients feel devalued, angry, not cared for Too much eye contact • Looking at someone over 75% of the time can come across either as you are in love or as aggressive? • Effect-frighten service users may feel their carer is angry or annoyed Eye movements When we look at others we pick up small changes in the face especially around the eye area - you face may be making a negative judgement of the client even if you are saying the right thing Rolling eyes Indicates to us how the client may be feeling Also following someone's eyes lets you know if you are getting through to them Confused- not understanding the message Blank look – depressed, not paying attention. Focusing on the individual • When communicating with services users the care need to be focused to their needs. • This is when a care plan would be used Focusing on the individual • Everyone has different needs and this needs to be taken into account when care is provided. • In your tables thing of an example when care needs to be individual • http://www.youtube.com/watch?v=2NiO63 9g4HY • http://www.youtube.com/watch?v=jP8_NlD 6S_E&feature=related Appropriate facial expressions • Look at these faces and say what they mean to you Appropriate facial expressions • Skills that help us to interact with other people. To have effective communication skills is vital in the health and social care industry because: – Develop care relationships – Understand and meet the needs of others – Provide information – Receive information – Report on work they do with clients. Allowing sufficient time http://www.youtube.com/watch?v=ZDpPQGk uWo0 Allowing sufficient time • It is important that you allow enough time to be able to complete the task and it’s important to think about how you are communicating with clients Allowing sufficient time • It is important that when caring for people that you are not trying to do other things at the same time. Reflecting back • What is meant by reflecting back? • How might you reflect back during a conversation? Reflecting Back Body language is culturally related. e.g. hand up =stop in UK, in Greece=you are dirt! You need to find out what clients are comfortable with and that you do not cause offence Allowing silence • There is a time when it is ok to have a short silence. • In your groups think when it is appropriate to allow silence within a care setting Answers the Questions Allowing pauses • What is meant by allowing pauses • How do pauses aid active listening? Task • Have a go at the puzzle in your pair Allowing Pauses • Pauses are a very important part of communicating, it allows people time to think and understand what is going on Newspaper Task • Have a go at the task Appropriate Body Language • Lets have a go at this quiz and see what you think about people’s body language http://www.youramazingbrain.org/testyours elf/default.htm# Making encouraging sounds • What are encouraging sounds? • Can there be a problem with constantly giving encouraging sounds? Why? Tone is very important part of the communication process 7% What you say 55% 38% Tone:how you say it Non-verbal communication The Care Value Base What is the care value base? The care value base is a range of standards for health and social care. It is designed to guide the practice of professionals working in this area. The aim of the standards is to improve clients' quality of life, by ensuring that each person gets the care that is most appropriate for them as an individual. What is the care value base? • The care value base offers guidance, and sets standards, in three main areas of health and social care: • Fostering equality and diversity • Fostering people's rights and responsibilities • Maintaining confidentiality of information 1. Fostering equality and diversity This means recognising and supporting people's individual needs. Fostering equality and diversity It involves: • Giving everyone the same quality of care and support This does not mean treating everyone in the same way • Respecting and supporting the diversity of people's experiences, lifestyles and backgrounds • As a carer you should ensure that a client's background or circumstances do not affect the quality of care they receive. Fostering equality and diversity • This does not mean that treating everyone in the same way. It means treating each person as an individual, taking into account their beliefs, abilities, likes and dislikes. This is known as client-centred care. 2. Fostering rights and responsibilities Discrimination is the result of stereotyping and prejudice. It means providing different care (better or worse) to some people because they are of a particular group, like Asian people, lesbians and gays, or older people Fostering rights and responsibilities Rights and responsibilities go hand in hand • You must support the right of a client to choose their own lifestyle AND help them to accept their responsibilities. Fostering rights and responsibilities • Your client has the right to eat unhealthy food, but you need to tell them about the health risks so they can take responsibility for their choice. Fostering rights and responsibilities • Your client has the right to smoke, but they must accept their responsibilities to other people who do not wish to be affected by passive smoking Fostering rights and responsibilities • • • • Clients have a responsibility to: Not discriminate against others Respect the confidentiality of others Do no harm to others 3. Confidentiality of information This means that any information clients give you must be private and confidential, whether it is: • Verbal • Written • Electronic (on a computer) You need to be aware of what you say to other carers and clients and also who has access to client files. In Summary • The care value base was developed to improve clients' quality of life by setting standards and guiding professional practice in health and social care. In Summary • Fostering equality and diversity means recognising that each person has their own individual needs. It also means working to meet those needs. In Summary • Fostering rights and responsibilities recognises people's rights, but also stresses that we all have responsibilities towards others. In Summary • The need to maintain confidentiality of client information protect the client's right to have personal information kept private. TASKS • The slides that are about to follow all deal with issues of Confidentiality • In pairs, decide what should be done in each of the case studies Darren • Darren has an appointment with the school nurse for a BCG booster injection. He is worried about it making him ill. He says that he has just taken some ecstasy and pleads with the nurse not to tell anyone. Yasmin • Yasmin tells her new Health Visitor that her new boyfriend is violent and is beating her. She asks the Health Visitor not to say anything as she is frightened of what might happen. Yasmin and her boyfriend have a three month old baby. Eileen • Eileen has terminal cancer. She tells her District Nurse that she has had enough of living and is going to end her own life tomorrow. She says that it is her choice and asks the District Nurse not to interfere. Jennifer • Jennifer goes to her GP for contraceptive pills. She asks her GP not to tell her parents. She is 14 years old. Stabbed man • A man with a stab wound arrives at the Hospital Casualty Department. He won’t give his name and asks the nurse not to phone the Police. He says that he will leave if the nurse does. He is bleeding heavily. Lee • Lee turns up at a Hostel for the homeless. He says that he has runaway because his father has been beating him. He asks the Social Worker not to contact his family. He is 16 years old. Evaluating your Communication Skills Communication Skills • We have looked at how effective we communicate. • We have looked at lots of different areas that can affect communication What areas have we looked at? • In pairs, list as many areas of communication that we have covered • There will be a prize for the pair with the most • So keep your answers covered Looking at your own communication skills • When evaluating how effective your communication skills are, you must have some ways of measuring them Task • Working in pairs, your task is to listen to the description that your partner is given and write down what words they are trying to say Listening • Listening is a very good way of finding out how effective you are at communicating You can evaluate your own communication by monitoring: • The quality of your contribution How much effort do you put in? • Working in groups of 4 have a debate on the following areas • X factor • Eastenders So how did you do ????? • Write down how you think you did in the debate. • Did you join in ? • Did you have points to say ? • Did you show an interest in your topic ? How do other people think you did??? • Ask the person next to you to tell you how they think you did • Did they say the same as you? • Did you agree with what they said ? Improvement from previous occasions • Over the course of this unit have your communication skills improved? • How ? • Why? • Detail please Your knowledge and understanding • Get some paper and a pen out we are going to have a quiz!!!!!!!! • Prize for the winner How We Evaluate? • This monitoring should be done using a variety of methods: • Verbal Feedback- this can be gained from the person you are talking to you • Written Feedback – is best obtained from a independent person, who may rate you on criteria. (e.g. how many closed questions did you use) How We Evaluate? • Self-reflection – It is very important to record your own experience • Video observation – this can be used to analyse your own behaviour and may show you things that you missed Aspect of Communication • Purpose – Did the skills used enable the purpose of the communication to be achieved? Aspect of Communication • Reason for use – What were the reasons for using the skills chosen? Were there other skills that would have been more suitable? Aspect of Communication • Effectiveness – Did the skills enable both the care worker and the service user to understand and have a meaningful exchange of information Aspect of Communication • Achievement of outcomes – Did the skills allow the outcomes to be achieved? Could the service user have benefited if something had been done differently? Task • Look at this for 20 seconds • Now draw it Task • Look at this for 20 seconds • Now draw it Did you do better the second time?????? Planning For Improvement • It is important that everyone thinks about how they can improve the things that they do. Planning For Improvement • When planning for such improvements they need to think about: • What needs improving • The order in which the improvements should take place • The timescales