Principles of communication in adult and social care settings
Ai Identify four different reasons why people communicate
Making and developing relationships
People communicate to make new relationships. The way I first speak and listen to a newcomer can make them feel welcome or overlooked. As I speak or comment, listen and watch, take an interest, smile and nod, whether to a service user, a member of their family, a colleague or a visiting practitioner I am building and developing my relationship with them. Communication will continue to be the main way I nurture and develop my relationships at work.
Giving and receiving information
At work I will be expected to give and receive different types of information. Perhaps a service user confides in me, or a member of their family asks me a question. A colleague could give me instructions a visiting practitioner might make an observation. The information I give, receive and pass on will help me to carry out my work effectively.
Expressing needs and feelings
Expressing needs and feelings is part of being human and these are communicated through behaviour as well as speech. Most people need to share needs and feelings with each other and in this way build up a sense of trust with the person they confide in.
Sharing thoughts and ideas
Human process many of their thoughts by discussing them. If I have ideas, questions and opinions about my work, sharing them with colleagues helps to clarify, develop and even change the way I think and act. The way in which I respond to the thought processes of service users could encourage or discourage their sharing with me.
Affirming one another
Affirmation is about acknowledging and encouraging each other and reassuring individuals of their worth and value. Affirmation is communicated through positive words, praise and gestures. Some care settings use support groups, staff meetings and appraisals as ways of affirming practitioners about their work performance.
Aii Describe two ways how communication can affect relationships in an adult social care setting between individuals using the service, their carers, colleagues and other practitioners.
The ability to communicate well is a key skill that enables me to work effectively with others. Communication process is much about listening and receiving messages as it is about talking and giving messages. As a care worker I need to be skilled in both aspects. My communication skills will develop and become more effective as I gain experience in my work role, learning from observing more experienced colleagues. Learning from others, seeking for advice and using support are all part of this process. During my work with service users there will be specific situations where good communication skills are particularly necessary.
In a care setting it is vital that information is shared appropriately between workers to enable each member of team to carry out his or her role effectively. I will also need to share information with service users and their relatives. Sometimes the information might be of a sensitive nature, such as when breaking bad news or dealing with private information, and I will need to be especially sensitive. In the course of my work I will need to find out information, pass on information and listen information.
Communication is the main way in which I continue to sustain relationships and build this up. As a health and social care worker I will need to offer support to service users and their families and this is enabled through both verbal and nonverbal communication. I will need to listen, as much as I speak and the use of appropriate and non intrusive touch can add to sense of being supportive.
Aiii Using the table below, identify three ways of finding out the communication and language needs of an individual. For each method, describe how effective it is at establishing the needs of the individual.
Asking/Observing the Individual. Asking/Observing is probably the best way of establishing the individual’s communication and language needs as this would immediately allow me to establish their usual language, if they are visually or hearing impaired etc.
Check the Care plan for the individuals communication needs. The Care plan can be a good source of information on the needs of the resident, but if documented incorrectly due to human error this method becomes ineffective.
If the first two don’t provide me with the needed information I could ask resident’s family, friends, doctor or other professionals who have worked with the individual. This is another effective method, only to be used if the first two fail.
Aiv Describe three factors to consider when promoting effective communication
Physical distance: the better you know a person the closer I am likely to be physically. Closeness can encourage sharing. Positioning chairs at an angle rather than side by side makes it physically easier to talk to another person. Sitting directly opposite is more formal and can feel confrontational. Sometimes a table between me helps a person feel protected. Yelling from one room to another doesn’t aid communication.
Body position: leaning forward can communicate that you are interested, but too close might invade “body space”. Turning away can show lack of interest , but standing directly opposite a person can be too direct, where being at an angle can provide a helpful space.
Behaviour: folded arms can look defensive and discourage communication. Friends and family without realising, often mirror the other person’s posture during conversation, which is thought to increase a sense of familiarity. Standing over a person who is seated might feel patronising or threatening.
Av Describe three verbal and three non verbal communication methods and styles that a social care worker may use in an adult care setting.
Communication is a complex process made up of many different elements to do with verbal and non verbal language. These are reflected in a range of communication styles and methods. Communication is also a two-way process that must take into consideration the reactions of others and respond appropriately. To be a skilled communicator and interpreter of communication I must pay close attention to my words and actions, as well as the words and actions of others.
Verbal communication. It’s about the choice of words being spoken, but also the way the words are said.
Vocabulary. Choosing words that are appropriate to the service user’s level of understanding is important. Perhaps English is not their first language, or they have communication difficulties associated with a physical condition. At the same time, I need to be aware of not being too simplistic and coming across as patronising.
Tone of voice. Tone of voice concerns the emotional message being conveyed alongside the spoken words. When these don’t match, people can become aware of my emotions and will pick up whether I am irritated or anxious, for example.
Pitch of voice. Pitch of voice concerns how low or high my voice sounds.
Speaking in a low voice can be calming and soothing, but too low and I can sound boring. In contrast, a high pitch can sound shrill and be unpleasant to listen to.
Non verbal communication
Non-verbal communication is a form of communication that take place almost subconsciously, that is, without being aware of thinking. It provides clues about the meaning of spoken language.
Body language. Body language relates to the way my body reflects my thoughts and feelings. This can add emphasis to my words, but if I don’t really mean what I am saying it can also reveal a truer and contradictory message beneath my words. For example, exclaiming, “how fascinating” might sound as though I am interested, but body language of tapping fingers, poor eye contact and stifled yawns betrays I am actually bored.
Gestures. Gestures are signs made with the hands and arms to illustrate or emphasise my words or to stand in place of words. People often gesticulate during conversations without really thinking about it. I might see someone gesticulating while talking on the phone, even though the person receiving the call cannot see their gestures. Some gestures are understood across many different countries of the world, such as thumbs up, meaning “good news”, but not all the gesture are universal and instead of clarifying a message, could create a confusion.
Eye contact. Eye contact is very important and sometimes it is difficult to know if a person is telling the truth unless I can look into their eyes. Holding someone gaze is a sign of intimacy, but to do so with a person I don’t know well can feel uncomfortable, even threatening. During most conversations it is normal for my gaze to flit to and from another’s face. When working with service users who have communication difficulties it can help to exaggerate elements of non-verbal communication to provide more clues about my spoken message.
Avi Explain why it is important to respond to an individual’s reactions during communication.
The following qualities will help to respond appropriately to the communication of others. Awareness of how my communication is being received. Look for nonverbal cues that indicates the recipient’s interest and understanding and equally those that indicate misunderstanding or boredom.
Sensitivity to tune into my recipient’s emotional responses to my words. Flexibility to change the way I am saying something in order to clarify my meaning and increase understanding.
Communication techniques. Some communication techniques assist with the process of responding to the reactions of others.
Echoing. Echoing is a technique where I repeat back what a person has said in a way that both checks my understanding of their words and also affirms the underlying feeling being expressed. For example, if a distressed resident of a care home tells me she thinks someone has stolen items from her room, I might say, “It must be upsetting for you to think someone has been interfering with your personal belongings.”
Mirroring. Mirroring is a communication technique used to improve rapport with another person. In many cases it happens naturally, where one person reflects the other person’s physical positions and mannerisms, their tone of voice, word use and communication style.
Asking questions. If I want a person to express their ideas and feelings I am best to ask open questions which invite broader responses. ‘How are you feeling today’ Is and example, where a service user is free to respond in a way they choose. If I ask a closed question the answer is usually reduced to one word, for example ‘Are you feeling better today?’ Invites a ‘yes’ or a ‘no’
Avii Explain how an individual’s background can influence the way they communicate.
Communication is all about sharing with one another and yet each person communicates slightly differently according to their different background and experience.
The impact of differences. Diversity is something to be celebrated and enjoyed, but our differences can also lead to misunderstanding and different interpretations of the same communication
Cultural background. Cultural differences refer to a variety of different influences, such as family background, peer group, religion, and ethnicity. These all play a part in shaping the way a person views the world and spin dot it. Cultural differences are revealed by particulars attitudes, values and practices, all of which have bearing on how a person communicates and understands the communication of others. For example, if an individual comes from a family where it is usual to make decisions through noisy and heated discussions, this person might find it difficult to accept an order without question.
Individual personality. Although individuals share personality traits in common with others, the unique make-up of these and the way they operate together is individual to that person. One individual might be quiet and reserved, another enthusiastic and bubbly and this will affect the way each communicates and responds to communication.
Levels of confidence. All communication requires a certain amount of confidence to speak up, make a statement, or share with others through spoken or written words. Sometimes a person has had their confidence undermined by a previous experience of communication, such as being misunderstood, or laughed at for mispronouncing a word, or perhaps an experience from childhood, such as failing their English exams. Confidence builds up over time but can be knocked down in seconds by a thoughtless or unkind response.
Competence in communication skills
Literacy skills refer to a person’s competence in reading, writing and speaking in a particular language. The service users I work with may be a different levels of competence in literacy and need to be communicated with a level they can cope with. Some adults struggle with literacy and may feel embarrassed by their difficulties. As well as literacy skills, some individuals will have better access to and be more competent using information and computer technology (ICT) than others. I should not assume that everyone I have dealings with at work has access to the internet and email, or mobile phones, or that they are competent in using such technology.
Aviii Identify three examples of barriers to communication and explain how you could overcome each barrier.
Barrier: sender speaks different language. Overcome: to have a translator or a dictionary Barrier: poor or incomplete information selection. Overcome: to give as many details possible Barrier: hearing difficulties, visual difficulties. Overcome: to seek for medical advice and find a way of communication Barrier: sender cannot express message clearly, I speech or writing. Overcome: to use body language and sign language Barrier: distraction. Overcome: to change the environment, to focus
Aix Describe two strategies that you could use to clarify misunderstanding
Communication is a complex process and Health and social care is a complex area, so it is inevitable that misunderstandings will arise from time to time. When a. Is understanding happens it is important to have a range if methods to clarify the situation and improve communication.
Adapt my message: Sometimes the message needs to be said or written in a different way. Perhaps the tone need to change, or the message style. The language I have used might need to be simplified. Maybe a phone conversation has been unsatisfactory in some way, but a face to face meeting would help establish better communication.
Change the environment: It might be necessary to make changes to the environment to enable better communication. For example, if I am conducting a meeting in an office where people are constantly coming in and out, or the phone keeps ringing, I will need to find a quieter place to speak.
Ask for feedback: In most situations it is acceptable to stop the flow of conversation with the person I am speaking with to check that I have understood correctly what is being spoken about. Equally, I can check that the person I am communicating with can hear me or understand me.
Ax A social care worker wants to enable more effective communication with individuals using the service. Explain how they could access extra support or service that they may be helpful.
There is a range of support available to enable effective communication with the service users I work with and members of their family. Importantly, individuals need to be informed about these services and be able to access them. For example: – support available via local authorities and services, such as NHS and adult social services departments. Help is also available from national charities, such as ICAN, for speech and language needs and the national Autistic society for those with autism. – The Citizens Advice Bureau (CAB) is another source for advice and assistance on advocacy, translation and interpretation. – in addition there may be projects operating in local areas and these are likely to be advertised at a local library or community centre, or in a health centre. Communication support tends to include these categories:
– speech and language services
– translation and interpreting services
– language service professionals (LSP)
– advocacy services.
Task B case study
You are a social worker and a service user, Hannah, tells you she is unhappy taking her medication. She thinks she does not need it and so she is throwing it away. You know from her care plan that Hannah does not need to take the medication regularly and gets confused. Hannah begs you to keep this confidential and not to tell anyone especially her daughter, who she sees regularly, as her daughter will be very angry.
Bi How would you explain the term ‘confidentiality to Hannah’
I would say to Hannah that confidentiality refers to the need to handle personal information in ways that are appropriate, safe and professional and meet legal requirements. And it is my duty of care to look after her and to inform the appropriate people about possible situations when she might be at risk. In this case, not taking medication could be a risk for her mental health and I need to report to my managers in first instance and to seek for medical advice or other professional advice if need it and to explain all this to Hannah. And also that might need to involve family if necessary or if it specified in Care plan.
Bii Describe the possible tensions that may arise between telling others or Hannah’s decisions and keeping this information totally confidential.
The relationship I built with service users and their families are central to my care role. If I share their personal information with others who have no need or right to know I risk breaking their trust in me. Hannah also needs to know thee are secure systems and procedures operating in the care stating to protect confidential information. Some information must be kept confidential for safety reasons. For example, some service users as categorised as vulnerable adults, such as a person with special needs whose wearer outs might need to be protected from a relative who abused them in some way in the past.
Biii Describe ways to maintain confidentiality in day to day communication
A great deal of information will pass around at my work placement through conversations, hand-over reports, letters, written reports and emails. Some of it will be confidential and I need to know how to manage this appropriately in a care setting. If I am unsure whether information is confidential, ask a senior member of staff.
Spoken information: Oral information can be transferred via face to face conversations, or over the phone. These might take place during meetings, or in less formal settings. If I need to discuss a confidential matter with a service user, family member, or with a colleague or visiting practitioner, I have to make sure I find somewhere private where I will not be interrupted or overheard. In care settings it is not generally the policy to discuss confidential matters over the telephone, unless I can verify the person is who they claim to be. Never leave confidential messages on an answering machine. Do not at any time be tempted to gossip about confidential work matters.
Paper information: Personal records including notes, reports and letters concerning individual service and their families should be kept together in a file which is locked in a safe place. A lockable filing cabinet is inky safe if keys are not left lying around. Equally, rooms with keypads are not secure if the door has been propped open. To be aware of leaving documents around such as diaries, telephone messages and faxes if these contains confidential information. Many organisations have a policy that personal records must not be removed from their workplace, because could be lost, seen by others, damaged, or the information could be taken and used wrongly.
Electronic information: These days great deal of information is stored and transferred electronically, via computer. Computer files should be protected using passwords which are only shared with authorised individuals. Care must be taken to close private documents after use, to prevent individuals who are passing from catching sight of the screen. To be vigilant when transporting information between computers via memory pens or discs. To make sure the memory pen doesn’t get lost and that the information doesn’t remain on the hard drive of the computer it was played on.
Biv Explain when and how a social care worker should get advice about confidentiality
Anytime need it.
We can always ask our superiors for advice, read policies and procedures and talk with appropriate bodies. When we are not sure about a situation or a person we should always double check first with our manager and to go to their files or documents and find out more information. We can always ask HR department as well.