Health and Social Care

PCWS 31

Task 1

People communicate to extent out to another person, to reach them and make them understand what they want to tell them. We communicate to pass on information, whether it is to chat with a friend, pass on information to a college or engage a service user through their given form of communication.

In a social care setting communication with a service user is an integral part of their care. If a service user does not understand what is being said to them or vice versa it can lead to misunderstandings and serious problems. It will also affect the wellbeing of the service user and can lead to challenging behaviour.

TASK 2

When you meet someone for the first time and you engage in conversation you not only speak but your whole body communicates with facial expression, body language and eye contact. When you meet a new service user for the first time a basic care plan will be in place which will include information on how the individual best communicates. This information is collected from the service users parents, carers, social worker, doctors, speech therapist and the service user themselves before they start their first session.

Factors to consider are heating and lighting in your surroundings, if it is too cold a service user may just retreat into themselves, rather than communicate and if it is too hot can cause health problems and challenging behaviour.
If it is too dark or bright the same can happen.
If the venue they are at is too noisy they may not be able to hear properly or if it is too busy and they use sign language they may not be seen properly.
Also sometimes service users do not get along with everybody which is part of life and this can lead to people becoming withdrawn.
They also may not feel very well or if they suffer from a condition it may be that that is making them withdrawn.
Another factor which must not be forgotten is abuse, which can cause a person behave differently and their manner of communication. They can become withdrawn but also they can also become more extrovert.

For good communication you need to have: in position facing the person do not invade their personal space have relaxed none tense body language relaxed facial expression eye contact (unless using sign language) listen carefully wait until the person has stopped talking – do no try to finish their sentences for them if using sign language always say the word as well as signing if using PEK cards always get the person to follow the words with their finger as they are being spoken. Always speak the words you are communicating to the person as well as following them with your finger.

When communicating with a service user you can visually monitor their reactions to your communication. By their reactions you can see if they have understood what you have just communicated to them. It is important that we get it right provide a safe and diverse environment for the service users to engage in and enjoy. Without correct communication methods the service user will feel isolated and alone and this can lead to challenging behaviour and dangerous situations.

TASK 3

Individuals from different backgrounds or cultures often use different languages or dialects. Also different words or phrases have different meanings and also body language and gestures are received differently. These must all be investigated and identified before a new service user joins the service and procedures adopted to prevent any miscommunication.

Barriers to effective communication and how to overcome them are:

Physical – Hearing, visual, mobility and physical disabilities and if the person is unwell or in pain.
Ensure your person is in a comfortable position for their wellbeing, the noise level is low enough for them to hear and they have their glass on if they wear them and they are clean and the lighting is correct. Check for signs of fatigue, pain, episodes from their condition/syndrome (if they have one) and general unwellness.

Mental Health – Due to the nature of their illness they may feel isolated and are reluctant to communicate. They also can feel detached due to their illness and live in their own “world”. Also mental health has its own prejudices and often people believe there is a stigma attached to mental health. This can also lead families not communicating facts as issues of mental health are not spoken about outside of the family as they believe it will bring shame to the family.
A concise in-depth care plans must be observed and updated regularly. Doctors, social workers, family, care workers, key workers and the service user themselves must be involved in the planning of their service and care. This will give an open and honest view of the best way to support the person without any misunderstandings. Also working together gives everyone a chance to understand the service users anxieties and the world they live in.

Cultural Barriers – Different languages, dialects, meanings of words and phrases can cause confusion if not addressed correctly before the service user starts their new centre. Also body language and gestures are different in certain cultures but all of this must be explored to assemble a concise care plan for the individual. Short simple sentences can be understood much easier. None verbal communication (PEK) may be useful for non-English speaking individuals.
Also, regular meetings planned to discuss any cultural differences which may happen unintentionally. This is to prevent offence and possible prejudice accusations.

Environmental Barriers – These are noise, heat/cold, light/dark, interruptions, being uncomfortable, odours, cleanliness, unattractive surroundings (decor etc.) and lack of privacy.
Check the venue before you use it to ensure it is suitable for your person to use. If you have no choice and have to use a venue which isn’t entirely suitable unsure you have a backup plan i.e. fans if it is too hot, etc.

Personal – A person may be very quiet or shy which can be incapacitating when trying to communicate with them. Also if a person is the other extreme, very loud, rude, abrupt and impatient and also have violent challenging behaviour this can make communication difficult.
Firstly take time to gather as much information about this person as possible, ensure you are up to date with all triggers if the person has challenging behaviour and how to correctly care for them if they reach crisis point. Take your time and be patient with them especially if they are shy or quiet

Other Barriers – these can be through stereo typing from relatives, care workers and sometimes from society. Also people (relatives, carers) who are close to the service user can generate an obstacle to communication by either speaking for the person and not giving them a chance to communicate or giving false information about their persons condition through ignorance, shame or neglect.
These types of barriers can only be overcome by good reporting and record keeping. Regular meetings with doctors, social workers, specialists, nurses, therapists, key workers and the service user, their family and carers. This way stereo typing can be stamped out and the real person can emerge and be allowed to blossom.

If a misunderstanding occurs and it is a minor one, talk it through with the service user, say you are sorry and work together to correct it. Afterwards relay the information to your senior staff and communicate it to everyone else who is involved with that service user. Also relay to home if necessary.
If it is a major misunderstanding and it triggers a serious behaviour ensure you alert a senior member of staff for support. Ensure everyone in the area is safe and keep the service user who has misunderstood the communication is safe from themselves but also ensuring you are safe too. A behaviour strategy will be in place to deal with this behaviour and a ‘time out’ or empty room period of time may be needed to help re-establish calm back to the service user. Everything will be recorded in a communication, behaviour sheet and if it is the first time this behaviour has been displayed reported to their key worker so it can be added to their care plan. The incident will be relayed to home to ensure the continued care of the service user.
After any misunderstanding the service user will have a meeting with their key worker and senior staff to communicate and work through the behaviour and find out how they feel. For serious behaviour their family, social workers and medical team may be involved to identify the triggers and how best to deal with them.

Regular key worker meetings with the service user, review meetings with their care team help to keep up to date with any changes in their care.
Regular staff training on sign language and PEK card use and individual service users conditions/syndromes, keeping up to date with service user’s care plans and files, good communication documents relayed after an event will help to provide good communication for everyone.

Everyone is different and everyone communicates through different methods. It is just a matter of ensuring you are precise in what you say and how you say it (speech, sign & speech or PEK & speech), your body language, eye contact and the environment. You do not invade the person’s personal space unless you are invited and it is appropriate to do so and you then in turn listen with not only your ears but your eyes and your senses. However everyone can change through unforseen circumstances and we can sometimes get it wrong, therefore we must try to identify any these and adapt and change before it causes a misunderstanding.

TASK 4

Confidentiality

Is the respect of a person’s dignity and privacy including information, documents, files and photographs.

All staff and volunteers must sign a confidentiality statement during their induction process.

You do not discuss sensitive information in places where other people can hear your conversation. All sensitive information to be held in locked cupboards and are not for public access. All staff must have a CRB before they can access the service users files. Only key workers can speak to their service users family/carers over the phone unless permission is granted through a senior member of staff. All other phone calls are to be taken by senior staff.
You do not discuss service users sensitive information around other service users. All meetings to be held behind closed doors and any service users in the building to be in a separate room with that door closed also.
You do not chat about service users to other staff, you respect and maintain their dignity and privacy at all times.

The service users like to chat to you about their lives and everyday things. Sometimes they talk about things that are not appropriate and you have to decide whether it is best to just ask them to stop, change the subject before it goes any further or challenge them as to what they mean by their communication (is it just to make you uncomfortable). However this is not always the case and sometimes a service user may disclose serious information about a crime or worse a form of abuse. This cannot be kept confidential and you must let the service user know that some things you cannot keep secret and tell them you must fetch a senior member of staff into the conversation.

Everything must be recorded and taken to your safeguarding officer with your senior member of staff.

You seek advice on confidentiality when you are unsure about a situation or information you have heard, seen or been communicated.