Communication in Care Settings

Introduction

This unit investigates the different types of communication skills used in care settings and their purpose. I will give an in-depth description of the different types of communication used in care settings and their purposes. The description will clearly show how people are valued and supported by the different types of communication. These include; written, oral, computerised and special methods. Also, I will show my understanding of how the application of the values of care by practitioners when communicating with people who use services can be supportive. These values of care include; promoting equality and diversity, maintaining confidentiality and promoting individual rights and beliefs. For example, confidentiality is a key value in health and social care and that may be faced by confidentiality dilemmas and in such cases what to do if information is given and is felt this should be shared. I will show a high level of understanding of how communication can be supported and inhibited by factors, which can influence communication which includes the use of the values of care. The factors include; positioning (for example, space, height), emotional (for example, fear happiness, self-esteem, trust, empathy, responsiveness, attentiveness, respect) environmental conditions (for example, space, noise, lighting, ventilation) and special needs (for example, using appropriate vocabulary, sign language). A wide-range of examples will be given. Furthermore, I will also show my understanding of the importance of the content that is being communicated.

Within health and social care settings communication is key to communicate with other practitioners, people who use these services and relatives. I will consider the different types of interaction, their purposes, the people involved and how to build a professional partnership with people who use services. There are a variety of skills used within care settings when communicating with others and these influence the effectiveness of the communication. I will give a detailed and comprehensive explanation of four communication skills used by practitioners in one care setting and how skills may affect interaction, how they can minimise communication barriers and help value individuals. Examples of skills include; tone of voice, pace of voice, eye contact, facial expression, clarifying, posture, paraphrasing and empathising. Detailed reasons for using each skill will be given. Also, I will show a high level of understanding of how people who use the service are valued and supported by the application of values of care and appropriate use of communication skills. A wide range of appropriate examples will be included.

I will demonstrate the ability to select and use appropriate information from a wide range of sources, for example, books and the internet, for at least two theories of communication. I will give an in depth explanation, showing a high level of understanding of how these theories can be used as a strategy to enhance and prevent barriers to communication and to provide guidance about how to effectively communicate with people who use the service/practitioners. I will include theories relating to; group structures, the communication cycle, the structure of interactions, SOLER and theories of formation.

I will provide comprehensive records of one interaction with a person who uses services/practitioners or a small group of people who use services/practitioners. These will be supported by records that show how the interaction was planned and conducted, the aims and objectives and the skills used for the interaction. The information considers, at a comprehensive level, the skills used the factors that supported and/or inhibited the interaction and information which shows a high level of understanding of how the values of care were applied. I will produce a comprehensive evaluation of the interaction which shows evidence of reflection, analysis and conclusions; I will consider the interaction from their own and the person/people who use services/practitioner(s) perspective. I will include a witness statement. Lastly, I will describe in detail realistic improvements that could be made.

Different Types of Commutation used in Care Settings

There are many circumstances in a care setting, where is it vital to exchange information. Communication enables the building of appropriate relationships and meeting the physical, intellectual, emotional and social needs of service users. The quality of communication will form the value of relationships and the ability of carers to meet service user’s needs.

Types of communication include; oral, written, computerised and special methods.

Oral Communication

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Having a conversation with someone consists of the development of skills and social coordination. This means; showing an interest, being interesting and having the ability to start conversations and end them. When communicating orally with others within a care setting may have different intentions. These may include; giving information (for example, service providers within a GP may state what and where services are available), obtaining information (for example, when a child begins nursery contact information will be given to early years staff and is used if contact with any child’s parents is necessary) or even to exchange ideas (for example, within a care home elderly individuals may share present or past experiences with others)

Giving and obtaining information is essential because the content must be accurate. If incorrect ‘facts’ are given, the individual who needs the information will be misled and this may result in serious consequences. An effective approach of ‘making a connection’ is by putting people at their ease by taking an honest interest in them. This should apply whether you are giving the information to an individual or even if you are receiving the information. In addition, if an individual is from a different culture, it is vital as this shows the value of diversity. Also, being open about what individuals are aiming to accomplish and inspiring the others to do the same is also needed when giving, obtaining information or exchanging ideas.

When talking to people, non-verbal signals, such as gestures or smiles are regularly used. This is reffered to as ‘body language’ and is also a method of giving messages to individuals with whom we are talking to: for example, smiling will express friendliness.

When individuals communicate with each other they send messages and unveiling information. When communicating verbally, messages are encoded by a sender and decoded by a receiver.

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Communication in different settings is likely to be of a complex nature; therefore this means it may have a number of intensions. For example, care workers will need to be conscious that each individual will have their personal way of understanding messages. Effective communication refers to more than just passing on information and consists of involving or engaging with another person.

Tearesa Thompson (1986) argues that communication is significant for two main explanations. Primarily, communication allows individuals to share information. Also communication allows relationships between people. Thompson states ‘communication is the relationship’. Therefore, speaking or signing is essential to creating relationships between people, and care workers must have highly developed social skills, to ensure their ability to work with the variety of emotional needs that service users will have.

Examples of tasks, where verbal/oral communication is vital;

• Asking for information
• Explaining issues, policies and procedures
• Building an understanding of another person’s life
• Clarifying issues
• Problem solving
• Exchanging ideas/learning new ideas
• Carrying out interviews and assessments
• Building a sense of trust
• Establishing professional relationships
• Providing emotional support
• Calming people who are experiencing strong emotions
• Welcoming people

Written Communication

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The written word is used extensively and is the most frequently recognised method of communication. The rules that administer writing are different from those that are accompanied for spoken language. Within many settings accuracy of the written word is particularly essential. For example, if inaccuracies take place with keeping of formal records within a GP; an individual might have the incorrect treatment or be given improper information with possible severe consequences. Essentially this could result to a complaint being put forward or even court proceedings being taken against the organisation.

When writing information down it must be; clear, accurate and legible. Inaccurate, written records could result in; inappropriate actions, failure to act or complaints and litigation (legal action).

In many settings, written information is used to record personal history. For example in early years settings communicating in writing helps care workers to keep in contact with parents, friends of the organisation and other professionals. The intentions may be on giving or obtaining information or exchanging ideas. In many settings the communication policy will lay down that all written communication needs be shown to the manager before it is passed on. It recommended that copies of written communication should be kept in case they are essential for future reference.

Types of written communication may include;

• Letters– Appointments, information about meeting, visits, tests results
• Accident slips– To inform of minor injury to children
• Care plans– A plan of the care an individual is to receive
• Menus– The choices available at meal times
• Monitoring medical records– Temperature, pulse or, in early years, the progress that is being made
• Newsletters– Giving information about events
• Notice boards – These can be reminders or information about group meetings
• Personal history– Individuals details about past and current experience

Computerised Communication

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In recent years the development of email has grown to be a frequently used method of communication. Emails can be both formal and informal depending on their intension. An advantage of emails is that it is a fast technique of communicating with another individual or organisation as answers can be received in a matter of minutes, rather than having to wait for a number of days. Care must be taken to make sure that confidentiality is maintained and only shared on a ‘need to know basis’ only.

In addition, the internet is too increasingly being used as a source of information for various types of purposes. Computers use the written word, as their main function, but they are also used to show information in graphics and sounds.

Electronic forms of communication such as mobile devises are currently the most used technology in the many individuals everyday life. In many settings computers may be used for interacting between one organisation and another. For example, a GP surgery could use the computer to send information about a patient to a consultant at a hospital, to send a prescription to a pharmacy or even to send essential information to an individual’s home address. Moreover, this is similar as an internal network system can also be in place to ensure that employees within one setting can be linked with others to share information. For example, within school organisations, teachers can be sent key information via email.

With electronic records it is important to;

• Keep a ‘back up cop’ increase the system crashes
• Use a password security check to make sure that only certain staff have access
• Find out about the policy on the printing of details so that hard copies do not get lost, or even seen by others
• Know the policy on who is authorised to update or change records. The recording system must prevent information being altered or lost by accident
• Print out fixed documents in an appropriate confidential area and keep the documents in a safe system to prevent unauthorised people having access to confidential material

In all situations care needs to be taken to guarantee that the requirements of the data protection act are followed when using the computer. The act: generated new obligations for those keeping personal information, entails that a service user can be given a copy of any information that is kept about them (this is known as your ‘right of access’), requires that any incorrect information about a person is modified or deleted, gives an individual the right to complain to the data protection commissioner if they think someone is keeping data and is not conforming with the act, permits individuals to declare compensation through the courts if they suffer damage through mishandling information about themselves, enable an individual who uses services to find out from any person or organisation whether information is being kept about them and if they do to be told the type of information kept and the purposes for which it is kept.

People keeping personal information should give individuals access to their personal information and can correct or delete any information found to be inaccurate. Settings must: get personal information fairly and openly, use it only in ways compatible with the intension for which it was given in the first place, secure it against unauthorised access or loss and make sure that it is accurate and kept up to date.

Special Methods

All health, social care and early years’ settings must be ready to offer individuals with special needs where communication is concerned. Special needs may include the following: hearing impairment or deafness, poor eyesight or blindness, language difficulty (including English not being first/preferred language). Therefore, there are a number of organisations that can provide support with such needs for example, Makaton, Braille, Sign Language and Interpreters.

• Makaton

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Makaton is a language programme using signs, speech and symbols to help people to communicate. Makaton aids individuals who have a hearing impairment or who may have a learning difficulty to communicate with others. It is designed to support spoken language and the signs and symbols are used with speech, in spoken word order. Makaton uses an established set of hand movements to convey meaning. Today over 100,000 children and adults, use Makaton symbols and signs.

With Makaton, children and adults can communicate straight away using this language programme. With young children it is usually as soon as it is recognised that they have a need. Some individuals then naturally stop using the signs or symbols at their own pace, as they develop speech. However for others this system is required throughout their lifetime.

For those who have experienced the frustration of being unable to communicate meaningfully or effectively, Makaton really can help. Makaton takes away that frustration and enables individuals to connect with other people and the world around them. This opens up all kinds of possibilities.

Makaton helps deliver extra clues about what someone is saying. Using signs can help people who have no speech or whose speech is unclear. Using symbols can help people who have limited speech and those who cannot, or prefer not to sign.

Makaton is extremely flexible as it can be adapted to meet an individual’s needs and used at a level appropriate for them. It can be used to:

• Share thoughts, choices and emotions
• Label real objects, pictures, photos and places
• Take part in games and songs
• Listen to, read and tell stories
• Create recipes, menus and shopping lists
• Write letters and messages
• Help people find their way around public buildings

Braille

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Braille is a system of raised dots that can be felt with fingers, for people who have limited vision or are blind, this system provides the opportunity for independent reading and writing as it is based on ‘touch’. Braille was introduced by a Frenchman blind person named Louis Braille in 1829.

Using the correct computer software, individuals can translate written material into Braille and print out using special printers. Braille can be very useful to individuals who use services who have poor eye sight as they are able to read leaflets and hand-outs that provide information regarding their treatment, as well as being able to read books and magazines and satisfy their personal intellectual needs.

• Sign Language

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Sign Language is a visual means of communicating using signals, facial expression, and body language. Sign Language is largely used by people who are deaf or have hearing impairments.

Within Britain the most common form of Sign Language is known as British Sign Language (BSL). British Sign Language has its individual grammatical structure and syntax, as a language it is not dependant nor is it associated to spoken English. British Sign Language is used amongst 50,000 – 70,000 people within the UK. The government officially recognised British sign language, in March 2003 as an official minority language, this lead to an increase in raising awareness of the BSL campaign.

British sign language has a phrase ‘make your fingers counts’ which appeals to children. British sign language can be taught at any age, for example even children are intrigued about BSL. It is a language that has developed over hundreds of years and enables interaction between people who otherwise might experience difficulty.

• Interpreters

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Interpreters can be used to support communication with service users for whom English is not their ideal or first language. In the past usually service users have brought along translators which have been people who are members of their own family. However this has currently been decreasing as it was considered by many individuals that using family members was not beneficial, as service users became aware that the information may not necessarily be kept confidential even by using family members. For example, a daughter (family member) who is translating for her mother (service user) can discover that her mother has a terminal illness, in this case a mother would rather have someone who is not a member of the family to ensure nay health problems are kept confidential and shared only on a ‘need to know basis’.

Within a lot of health, social care and early years’ services, there are leaflets available which cover a variety of health topics or health facilities and are produced in a number of other languages (including English). Therefore many service users within our multi-cultural society have full access to the information needed, rather than having to use a translator.