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WJEC GCE Health and Social Care
Unit 1: Promoting Quality Care and Communication
1.4 Communication
Candidates should have knowledge and understanding of the different types of
communication and their importance in contributing to quality care of individuals as well as
the effective working of others within the care team. Candidates need to understand and be
able to evaluate the factors that govern the effectiveness of verbal and non-verbal
communication.
Communication can be:
 formal
 informal
and can take place:
 one-to-one
 in groups
Different types of communication
There are different types of communication, these include:
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written
verbal
non-verbal
graphical
alternative
Written communication
Written communication involves the use of written words or information we wish to convey. It
can be used in both formal and informal situations, such as:
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letters
reports
memos/notes
e-mail/text messaging
records
Discuss: When and how is
written communication likely to
be used within health and social
care settings?
Verbal communication – speaking, singing, active listening.
There is a well known saying: ‘it’s not WHAT you say but HOW you say it’.
There are a number of paralinguistic skills that can make all the difference to what is being
said and can therefore help, or hinder, communication. These include:
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volume (how loud or quiet)
tone (the quality of someone’s voice)
pitch (high or low)
pace (fast or slow)
Discuss: How do paralinguistic
affect communication between
individuals?
It is important that attention is paid to these aspects of verbal communication to prevent poor
communication.
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WJEC GCE Health and Social Care
Unit 1: Promoting Quality Care and Communication
Non-verbal communication
Including: body language, gestures, mime and drama, music, art and craft.
People can sometimes say a lot without uttering a single word.
Non-verbal communication involves the use of:
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Facial expressions (e.g. a smile, frown, grimace, raised eyebrow)
Hand gestures (e.g. thumbs up, pointing, waving, beckoning)
Body language (e.g. leaning forward, hands on hips, folded arms, slouching)
Eye contact (direct, staring, looking away)
Discuss: What is the effect of non-verbal communication on communication
between individuals?
Graphical communication – posters, signs, symbols and diagrams
Graphical communication uses visual materials (text and images) to convey information, e.g.
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drawing/illustration
cartoon
photograph
map
sign/symbol
text
diagram/chart
Discuss: Where or when are
these are likely to be used in
Health and Social Care settings?
Alternative methods of communication – British Sign Language, Makaton, Braille, Widget
Alternative methods of communication are used when other methods of communication are
not possible, e.g:
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signs and gestures (e.g. British Sign Language)
Morse code (telegraphic code of short and long sounds)
symbolic (e.g. Braille, Makaton, tactile systems, picture boards, widgets)
Find out: What the different types of communication are, how they work and who
is most likely to benefit from them.
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WJEC GCE Health and Social Care
Unit 1: Promoting Quality Care and Communication
Factors affecting the effectiveness of communication:
Communication is something we all do every day of our lives so you might think it should be
easy. Often, though, problems arise and misunderstanding occurs. This is because
something gets in the way and makes communication difficult, or even impossible. This is a
BARRIER to communication, which may arise because of:
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emotional factors
environmental factors
physical or intellectual disabilities
cultural influences
stereotyping and labelling
time constraints and pressures
use of technical terminology or colloquialisms
appropriate use of speed, clarity and loudness
use of eye contact, facial expressions and body language
legibility and accuracy
lack of resources
Emotional factors – personality clashes, stress and anxiety, empathy, worry and mood,
Emotions can affect the ability to communicate with others. These include:
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Personality clashes: tension, conflict, avoidance, resentment
Stress or anxiety: arguments, blaming, distracted, physical symptoms
Fear: afraid to speak up
Sadness: may not feel like talking and want to be left alone
Low mood: e.g. depression – may be disinterested/not feel like talking
Happiness: high spirits can make it difficult to say what we mean
Excitement: not listening, too talkative, unable to concentrate
Empathy: feel you are understood, more willing to talk/share
Environmental factors – personal appearance, proximity, seating arrangements,
background noise, lighting, comfort and warmth.
Environmental factors are features around us in day-to-day life which we often do not think
of as being a help or hindrance to communication. These include:
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Personal appearance: clean/dirty, tidy/dishevelled, smart/scruffy, pretty/ugly
Proximity: too close or too far apart
Seating arrangements: configuration, cramped, inadequate
Background noise: hard to hear people/be heard, concentration
Lighting: too dim/too bright
Comfort/warmth: too hot/cold/draughty
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WJEC GCE Health and Social Care
Unit 1: Promoting Quality Care and Communication
Physical or intellectual disabilities
Physical disabilities
This includes visual, hearing and speech impairments as well as disabilities that affect the
motor abilities of an individual, e.g. a wheelchair user. Factors include:
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Use of speech or need for alternative methods
Equipment, e.g. hearing aid, amplifiers, computer, etc
Special suppor,t e.g. signers
Use of non-verbal communication
Height at which you speak to people
Intellectual disabilities
Intellectual disabilities such as IQ differences, limited speech ability or impediment, can
make communication difficult due to lack of understanding but, with patience and
willingness, both parties can make themselves understood by:
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using simple language/no jargon
having support from another person (family, friend, carer)
Cultural influences
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Eye contact is considered respectful in western culture and shows that a person is
interested but some cultures believe that looking away is a mark of respect.
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Non-verbal communications: not all gestures are universally acceptable, e.g. thumbs
up or showing the soles of your feet can cause offence in some cultures.
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Humour differs between cultures, e.g. subjects such as death, religion, politics are
sometimes joked about in the UK but this can offend other cultures.
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Gender roles: men and women communicate differently, e.g. women may not be
comfortable talking to a man who is not a close relative.
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Language differences: can create clear difficulties but even where a common language
is spoken, accent, dialogue, slang can pose problems.
Stereotyping and labelling – making assumptions about others
Stereotyping
A stereotype is “ … a fixed, over-generalised belief about a particular group or class of
people.” (Cardwell, 1996)
By stereotyping, we infer that someone has all the characteristics and abilities that we
assume all members of that group have, e.g. all blondes are dumb, all women are bad
drivers. Clearly that isn’t true!
Negative stereotyping can lead to social categorisation, one of the reasons for prejudice and
discrimination.
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WJEC GCE Health and Social Care
Unit 1: Promoting Quality Care and Communication
Labelling
Labelling is defining or describing a person in terms of his or her behaviour, e.g. describing
someone who has broken the law as a ‘criminal’. It can be the same as ‘pigeon-holing’, e.g.
all sufferers of schizophrenia are violent and dangerous. Not true, by the way!
Once labelled, an individual may take on the characteristics associated with the label and
become what they have been labelled … a self-fulfilling prophecy.
Discuss: How does stereotyping and labelling cause a barrier to communication?
Time constraints and pressures
Time constraints and pressures can affect communication, e.g. high workload/staff
shortages, causing:
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less time during interactions – poor listening
rushed interactions – lack of clarity can lead to misunderstanding
poor record-keeping – misinformation, errors, omissions
low morale
Use of technical terminology or colloquialisms
Technical terminology
Sometimes called jargon, this is a special language for use by a group or profession, e.g.
doctors, nurses, social workers. This could include the use of specialist terms to describe
parts of the body, medical procedures, specialist equipment or the use of acronyms which
the patient may not understand.
Technical terminology should only be used during communication with those who are
familiar with it, e.g. ‘DNR’ is a term sometimes used in nursing/medicine. A doctor would
understand it to mean ‘DO NOT RESUSCITATE’, while a cleaner within the hospital might
interpret the initials in a completely different way. This could easily cause confusion which
might lead to all sorts of unexpected outcomes.
Colloquialisms
A colloquialism is an informal expression that is more often used in casual conversation than
in formal speech or writing. It may be a word, phrase or saying that is often understood in
specific geographical areas, e.g:
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to be pleased with something – chuffed
to be drunk – ratted, wasted, trollied
Use of technical terminology, jargon or colloquialisms can:
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be misinterpreted
cause confusion/lead to misunderstanding
lead to individuals feeling excluded
speed up communication when used appropriately
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WJEC GCE Health and Social Care
Unit 1: Promoting Quality Care and Communication
Appropriate use of speed, clarity and loudness
This is linked with ‘paralinguistic skills’ associated with verbal communication. These skills
can both help and hinder communication.
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Speed:
Too fast – hard to understand and follow conversation
Too slow – hard to follow; may feel you are talking down to them
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Clarity:
Be clear – say exactly what you mean and avoid vagueness
Speak clearly – mumbling, muttering, not facing the person makes it hard to hear or
understand what is being said
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Loudness (volume):
Too quiet - hard to hear what is being said
Too loud - distracting, viewed as disrespectful, even threatening
Use of eye contact, facial expressions, body language
These are also ‘paralinguistic skills’ which can help or hinder communication.
Eye contact
You can tell a lot from just looking at someone’s eyes as they often reveal what someone is
thinking/feeling, e.g. happiness, sadness, shock, suspicion, boredom.
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Shows someone is listening, paying attention
Some cultures show respect whilst talking by looking away/down
Staring can be off-putting; can indicate aggression
Facial expressions
Provide a form of feedback alongside the words involved in communication that adds to the
interpretation of what is being said, e.g.
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smiling
frowning
grimacing
raising eyebrows
all add to the interpretation of what is being said.
Body language
So much can be said without ever opening our mouths, e.g.
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hand gestures – pointing, beckoning, thumbs up/down
head – nodding/shaking head, inclined to one side
body posture – leaning back/forward, crossed arms/legs, shrugging
other gestures – winking, rolling the eyes, pursing the lips
NB: non-verbal communication must match what is said verbally. If this isn’t the case, there
is a risk of sending ‘mixed messages’ which hinder communication.
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WJEC GCE Health and Social Care
Unit 1: Promoting Quality Care and Communication
Consider … an elderly patient asks for help to visit the bathroom. The care worker agrees
but, as she goes to help her, she pulls a face and rolls her eyes at a fellow care-worker.
What message is sent to the elderly lady? How do you think she would feel?
Legibility and accuracy – written documentation
Legibility: being clear enough to read and understand, e.g. handwriting, notes, files.
Accuracy: being free from mistakes and relaying the truth.
Both these factors are important in written, computerised and electronic methods of
communication.
All records, notes, letters, memos, etc MUST be legible. Attention to detail, spelling,
grammar and relevance of information is important and information must be recorded with
care.
Good written communication can be easily understood at a later date without raising
questions or uncertainty.
Example: A telephone caller leaves a message for a manager who is unavailable. He
wants the manager to call him back as soon as possible. What information would you ask
the caller for and record to later pass on to the manager concerned?
Lack of resources
This could mean anything that is of limited availability. Lack of resources that can affect
communication could include:
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technology, e.g. computers, telephones, fax machines
recording materials, e.g. paper, pens, books, files
faulty equipment, e.g. broken PC, TV, telephone, no internet service
personnel, e.g. signers, care workers, nurses, social workers
time, e.g. staff training, meetings, client activities
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