Download Health and Social Care Level 3 Promote communication in Health

Health and Social Care Level 3
Promote communication in Health and Social Care
Reasons for communication
People communicate with others for many reasons. Read the following and see if you can think of
any other reasons for communication
Greeting
Expressing needs
and preferences
Passing on
information
Social interaction
Self-expression
Seeking information
Imagining
Reasoning
Saying who we are and asking about the other person. Acknowledging
another person.
Letting others know what we need and what we would prefer to happen.
Telling others about things that they need to be aware of, or may be
interested in.
Socialising and interacting with others for pleasure or work.
We define our individuality, beliefs, values, wishes and our personality.
Finding out about things that we need to be aware of or may be interested
in.
We can communicate our ideas and thoughts.
Solving problems or dealing with difficulties.
Communication and relationships
Health and social care workers need to develop effective communication skills in order to carry out
their responsibilities to the individuals they care for.
Good communication can support best practice by:
Helping to establish trust - Clear communication can help to build up a trusting relationship with the
individual/s you care for and your colleagues.
Ensuring continuity of care - Passing on information clearly helps to ensure that the correct actions
are taken by others and the individual does not have to repeat themselves.
Person-centred - Clear communication supports a person-centred approach to care by
demonstrating that you are listening to the individual’s own view of their needs and preferences.
Professionalism Clear communication with other practitioners, carers and colleagues shows you have
adopted a professional approach to your work.
When communication in the work setting is poor, it can show a lack of respect for others, a
breakdown in working relationships and may lead to harm or abuse of the individual/s
It is worth noting that every inquiry into failures in care mentions poor communication as a key
feature.
Listening skills
Listening skills can be broken down into THREE skills clusters:
•
attending skills
•
following skills
•
reflecting skills.
Attending skills
These can be used to describe the non-verbal communication which shows that you are paying close
attention to the speaker.
Attending skills include:
•
leaning forward
•
Appropriate body movements
•
head nodding
•
Eye contact (depending on culture).
And all signify the listener is paying attention.
Following skills
It is important for the listener to follow what the speaker is saying.
•
Do not try to lead or direct the conversation (depending on circumstances).
•
Encouragement in the form of paralanguage – ‘mm’, ‘really’, ‘aha’ – shows
you are listening.
•
Use open questions and allow people to think by respecting silences which both contribute
to successful communication.
Reflecting skills
Summarising what has been said shows that you have understood and helps to identify any areas of
confusion.
These involve:
•
repeating and confirming to people what they have said
•
Not giving your own opinion
•
Checking out your impression of how people are feeling, e.g. ‘you sound sad about that’.
Communication considerations
Health and social care workers must learn how to communicate effectively
with a range of people. It is important, therefore that they become aware of
the different factors which affect our interactions with others.
Consider the following points in relation to your own work.
 What is the information to pass on? - Is it sensitive? Will it be easy for the individual to
understand? Might it affect their mood or behaviour?
 Where is the best place to do this? - Does it need to be passed on in a private location? Can I
find somewhere suitable? Do we need a room which is quiet or brightly lit?
 What is the best method of - Should it be face to face? Would conveying the message? It is
better in writing or both written and faces to face?
 Can the individual understand me? - Do we speak the same language?
 Can I make myself understood? Will the individual understand me?
 Do I know the individual’s Do they use adaptive technology?
 Communication needs Do I know how to use it? Do they and preferences? Communicate
through their behaviour? Do I understand it? Do we have a shared understanding of words
and phrases?
 Will we need support? Does the individual need an interpreter or advocate? Do I need
materials to help me communicate?
Communication methods
People communicate in many different ways, and as health and social care workers we have to
understand and be able to communicate using the whole range of methods.
Think about the following points in relation to your own work
Verbal communication
The words and phrases
The tone of voice
The pitch
Facial expression
Could they be misunderstood? Do they have more
than one meaning?
Does the tone match the words spoken? Is it
sarcastic or demonstrate a lack of respect or belief?
is it loud or quiet? Does it match the words
spoken?
Does it match the meaning of the message? Are
you reacting appropriately?
Non-Verbal
Communication
Body language
Touch
Behaviour
is it appropriate to the meaning of the message?
Are you reacting to the body language of the
individual?
Is it appropriate to use touch? How can it support
the message without being intrusive or a show of
power? Are you responding to touch correctly?
Is the individual communicating through their
actions? What might they be trying to convey? Are
you assuming you understand without checking?
Augmentative and adaptive technology
There are a number of tools which can support effective communication.
Unaided communication
These are methods of communication which do not require additional equipment.
Examples include:
•
British sign language: this is the language used by many individuals who are deaf. It consists
of signs, body language and facial expressions.
•
Makaton: this is a signing method developed for people with learning disabilities. It uses
British sign language signs, speech, facial expressions and body language. Makaton also has symbols.
•
Following agreed methods of communication formulated by a multi-disciplinary team (which
may include the individual and their family)
Aided communication
These are methods of communication which may use additional low-tech or high-tech equipment.
Low-tech examples include:
•
Symbols, such as those used in Makaton, picture exchange communication or Easy Write
•
Objects of reference, which may represent an activity or action
•
Braille, which is used by people who are visually impaired.
High-tech examples include:
•
Voice output communication aids, which are electronic systems that can express
communication in words
•
Computer software designed to be easy to use by people with limited movement.
Intensive interaction and dementia mapping
Intensive Interaction is a technique used for developing communication with individuals who have
little or no speech and struggle to communicate effectively with others.
It was devised primarily as a way of enhancing communication with people who have an autistic
spectrum disorder.
The technique focuses on:
•
Paying close attention to another person without interruption for a period of time
•
Understanding and using eye contact, gestures, facial expressions and body language
•
Taking turns in communication
•
Using vocalisation as a means of communication
•
Responding in a way that mirrors the individual.
Dementia mapping is a way of establishing how an individual with dementia is communicating
through their behaviour.
The technique focuses on:
•
Close observation of an individual over a period of time
•
Detailed recording of their actions, responses and the environment
•
How they interact with others and their environment
•
What appears to make them anxious, or happy?
Note: both of these techniques require specific skills and knowledge and should not be attempted
without suitable training.
Find out more from:
http://www.intensiveinteraction.co.uk
http://www.dementiauk.org
Do we understand each other?
Have you ever had a conversation with someone and later realised that you had not truly
understood each other?
One of the reasons why this happens is because, depending on our background, culture and
education, we use language and non-verbal signals differently.
Some words, for example, have a different meaning depending on your age, first language or
background.
Make a list of words or phrases that might have more than one meaning.
Here are two to start you off:
•
Wicked
•
Gay
Health and social care workers need to be aware of how the individual/s they work with use
communication. It is important to avoid assumptions based on limited or incomplete information.
Mrs Ho’s support worker had been giving her a drink containing sugar for several weeks and was
concerned that Mrs Ho rarely drank it.
Eventually Mrs Ho’s daughter told the support worker that her mother did not like sugar. The
support worker said she had asked Mr Ho if she had sugar when they first met and she had said
‘yes’. Her daughter explained that this had meant ‘Yes I understand you, and I do have sugar in
my home’.
Recognise that people who are different to you may communicate in ways you do not fully
understand and may in turn misunderstand you.
If you are aware of potential differences you can ask the right questions to make sure your
communication is effective.
What can you do to ensure you understand and are understood?
Discuss the following with your colleagues or assessor and think about how effective they may be in
clarifying misunderstandings.
1.
Summarise your understanding of what the other person has said. Use phrases such as: ‘My
understanding of what you have said is ... Is that correct?’
2.
Encourage the other/s you are communicating with to summarise their understanding of
what you have said.
3.
If working with an interpreter ask them to explain any cultural or linguistic confusion that
may arise.
4.
Ask the individual for clarification.
5.
Observe the reactions to your communication.
6.
Observe the responses to any actions you take following communication.
7.
Don’t make assumptions.
8.
Avoid jargon, phrases or initials that may be misunderstood. For example, does ABC refer to
Airway, Breathing and Circulation or Antecedents, Behaviour and Consequences? The answer will
depend on your area of practice.
9.
Use Easy Write or clear written format for information. Avoid ‘text speak’. For example does
lol mean ‘lots of love’ or ‘laugh out loud’?
Make a list of organisations or people who can help you develop your skills and knowledge about
communicating with the individual/s you care for.
Confidentiality
The Oxford English Dictionary defines ‘confidential’ as:
‘Spoken or written in confidence; entrusted or charged with secrets’
In health and social care, however, it has a slightly broader meaning.
Whilst it is not acceptable to share details about the individual/s you care for with the general
public, or your own family and friends, health and social care workers must be prepared to pass on
information to their colleagues, other practitioners and, in certain circumstances, the family of the
individual or other organisations.
Confidentiality does not mean that you agree to keep secrets or never pass on details.
The Data Protection Act 1998 requires us to keep sensitive information in a secure location, and to
limit the number of people who have access to it. This has been used by health and social care
workers as a reason to refuse requests for information about the people they care for.
Partnership working, however, means that details have to be available to all those who have contact
with the individual to ensure continuity of care and to reduce the need for repetition.
So how do you decide what to pass on, when, how and to whom?
Think about the following points. Discuss them with your colleagues or assessor.
1. Some workers say they will pass on information only
on a ‘need to know’ basis. This is not very helpful
since it does not give guidance on what information
needs to be known by others. Why do you think the
principle of ‘need to know’ might not be a good
guide?
2. Should every detail be shared with your colleagues
or are there any matters which you would not pass
on?
3. If the individual is at risk of harm or abuse should
you pass on details to the correct authority even if
the person asks you not to?