NVQ 3 UNIT 4222 301

Promote communication in health, social care or children’s and young people’s settings (SCH31)

Outcome 1 – Understand why effective communication is important in the work setting

1.1 – Identify the different reasons people communicate.

People communicate in quite a few different ways and not just talking to one another. Each person is different and you will find that depending on the person’s ability to communicate depends on how they communicate.

The main reason for communication is to transfer messages from one person to another person. Another reason is so you find information on just about anything you want, so in the care setting communication is very important because you would be able to find the information you need about the service users in your care.

Communication is a great way to start and build on a friendly relationship weather it is a personal one or a professional one. This can be done in many ways like through written letters, computer, telephone and talking.
Other ways of communication is through your body language, facial expressions and or touch.
Communication is a great way to express yourself especially with facial expression as people would be able to see if you are happy or sad, if you are in pain, not very well or have a problem with may need help.

Communication is also a great way that you can learn about different people especially in the care setting. You will find that using your communication skills you will be able to build a good relationship with the service users and the other staff in the organisation you work for and over time the service users and staff will begin to trust you as well.

1.2 – Explain how communication affects relationships in the work setting.

Communication is very important in the work setting and how you communicate can affect your relationship with work colleges and or service users and their families.

Building a good relationship with your service user can help in their care. You can then build on the trust which in turn will help you be able to understand the service user.

With your work colleges having a good communication skill will also help in building trust between you and the team. If you work as a team, work would become easier as you would learn from one another. If you have found any problems at work, being able to communicate with colleges and management would help to resolve the problem.
Also you will be able to build a good professional relationship with your supervisor and manager. Your will be able to ask questions if needed and also having a good working relationship with colleges makes a happy home for the service users.

With service users in your care you need to be able to build a good relationship through communication as you can learn a lot about the individual. You will be able to find out about the service users past, what they like and dislike, if they are sad or happy and if they are in pain or not.

When you have built a relationship with the service user the service user in turn will start to feel more confident and relaxed about them.

Outcome 2 – Be able to meet the communication and language needs, wishes and preferences of individuals

2.2 – Describe the factors to consider when promoting effective communication

There are different ways in which we can communicate. You may think that talking is at the top of the list but you will find that facial expressions are at the top.
Research has been conducted over a period of time and with facial expressions and the tome of your voice people will pay far more attention than if you just spoke words to them.
The research has shown that only 7% of works contributed to whether or not someone was liked. 38% was the tone of voice and 55% was the facial expression. You will also find the individual can pick up of weather there is a contradiction between the carer’s facial expression and works. The individual is probably going to believe the carers facial expression that their words.

You can tell a lot of things when looking at the face. Usually we look at the eyes first because the eyes can tell you a lot about the individual.
Below are a few facial expressions that you will come across.

With the facial expressions and the eyes you can pick up on the thoughts and feelings of the individual. When looking at the individuals eyes if the black circle in the middle of the eye has become dilated (bigger) it could mean that the individual is happy or interested in what is going on. If the individual is just staring at you it could give you the message that the individual could be angry. If you find that the individual is getting fidgety and keeps looking around this could mean that they are fed up or board of the conversation.
It could also mean that the individual is not telling you the truth. If the individual is trying not to make eye contact this could mean that they are shy.
People often use the comic faces through the computer of text messaging through mobile phones. Below are some examples of the smiley face that is used:-

When you want to talk to someone you can tell by their face how they are feeling (emotional state). The things to look for are if they are sad they might be looking down at the floor. Their mouth may also be closed and they may show tension in their face and neck.
If the individual is angry they would tense their facial muscles and they would frown. You may see fixed lines around the mouth and the individuals face is a little red (flushed).
If the individual is happy their mouth is smiling and their eyes are wide. They will also make eye contact with you.

With our voices it can also show emotions. If you are angry you tone of voice with be fixed. If your voice is slow and calming it can let you know that you are friendly. If you add facial expressions it can show you a range of different emotions like concern, interested, boredom and other emotions.

Another way we can communicate is through our body language. The way we walk, move, stand and sitting.

1.) If we are standing or sitting with our arms crossed this could mean that we are disgusted or we are not taking any notice of what is happening.
2.) If we are sat up straight or we are leaning to one side could sent the message that we are relaxed or bored.
3.) If we are sat and have crossed legs could mean that we are tired, happy sad or bored.
4.) Leaning forward could show that you are interested in the conversation and depending of what is being said you may be showing concern or giving sympathy.
5.) Whether we are standing or sitting face to face3 could show that we could be angry or being formal.
6.) If you tilt your body or head to a slight angle can show that you are more relaxed and will show that you are transmitting a friendly feeling.

We use a lot of muscles in our body especially the face to make a facial expression. They say we use a total of 17 muscles in our face to make a smile and 43 muscles to frown.
If you are tense your mouth is firmly closed and your lips and jaw are tightly closed. You may also breathe very quickly and become hot and flustered. But if you are relaxed and happy you relax your muscles but when you are upset you tense your muscles.

Other ways to communicate is through gestures. But you will find that in some religions or customs gestures may be considered rude or repulsive. So before you start you need to find out what religion or customs the service user follows. In some religions or customs if you show the soles of your feet it is considered very rude in come cultures also if you give the thumbs up sign to say it’s ok or great can also be very rude to some people.

You will find that in a group of people only a certain present of individuals will use gesture movements when they talk. The carer will also notice that when an individual is excited they would move their hands and or arms when they are talking to you.

It is said that we don’t learn how to do gestures that it is more to do with our speech development when we are young. So 1998 two researchers called Jana m Iverson and Susan Goldin-meadow decided to gather information on why we use hand gestures when we talk. They gathered a number of young individual together. Half of the individuals were blind and the other half could see. They found that gesturers were similar in both groups of individuals.

Touch is also another way that is used in communication. The only thing with touch is you need to check with the individual first as some don’t like the thought of you giving then a hug or holding their hand for comfort. You must never make assumptions that the individual is happy for you to hold their hand or give them a hug. In all occupations you must be very careful in using touch as it cou8ld mean that the individual feels you have power over them or you have sexual interests.

The best thing is to ask the service user if they would like a hug or if you could hold their hand especially if they are feeling low or upset. The individual will also feel that their rights are not being invaded.

Some individuals like to have personal space and there are four zones that can let you know.

1.) Intimate (touching) close family
2.) Personal (less than 1M ) friends
3.) Social ( between 1M and 2M) acquaintances
4.) Public ( between 2M +) strangers

You will be able to see when looking at a group of people what spaces they have between then weather it is intimate or public.
Different cultures can have a different view on how close people should be when talking. You will also find that different cultures could be more inclined to touch than others.

You need to respect an individual’s personal space especially when you are working. If you don’t it is disrespectful and the individual may feel uncomfortable.

Outcome 3 – Be able to overcome barriers to communication

3.1 – Explain how people from different backgrounds may use and/or interpret communication methods in different ways.

Everyone in the world is different. From the colour of their skin, language they speak the culture they live in and how they were brought up.
But the best way to learn and the individuals you care for is to observe what they do. By observing an individual you can find out if they are happy or sad, if they can hear what people are saying. Do they wear a hearing aid? If so is it either ears or just one ear? Do they wear glassing all the time or only to read? Can they speak? If so what language they are using. Are they speaking in a foreign language or are they using sign language or can they lip read?
You will also be able to see if the individual has any disabilities. Are they using any walking aids like a walking stick, a walking frame or are they sat in a wheel chair.
You will also be able to find information about the individual by reading their care plans if they have one.
Finding out this information can help you discover what and how would be the best way to communicate with the individual and for the individual to communicate with you.
If you are new to the job and you have never meet the individual before you meet them it would be a good start to find information about the individual either from their care plan or from talking to the care staff who look after the individual.
When you have found out the best way to communicate with the individual the best person to find information you need is talking to the individual themselves.
There are also other people that you can talk to about the individual who would be willing to help you are the individuals family or friends as they know them best. If you need to know any medical information a doctor or social worker would be best to talk to if you have permission from the individual. The doctor and social worker would be able to tell you more about any disabilities or illness the individual may have. If you want to find out more information about disabilities or illnesses looking on the internet can explain what you may need.
When you have found out the best way to communicate with the individual you can start to build a great relationship and trust with the individual.

3.2 - Identify barriers to effective communication.

You will find that in today’s society that there are quite a few difficulties a person will come up against. It is important especially in the care settings that care staff learn how to see if any difficulties the individuals they care for have and learn how they can encourage the individuals to overcome any obstacles

There are quite a few communication barriers we all will come across in our life time.
Listed below are a few difficulties we may come across:-

1. Sensory impairment
2. Physical illness
3. Disability
4. Learning disability
5. Foreign language
6. Cultural differences
7. Different styles of speech
8. Distress.

3.5 – explain how to access extra support or services to enable individuals to communicate effectively.

Sometimes you may need help with the individual in being able to communicate. Also beginning able to communicate depends on the circumstances. You should be able to access the information you need from other staff, family members, management and social workers. They may have more information on the individual than you know or you may be able to have access to different resources on the internet. In some cases you may need extra support from specialist organisations.

If when you are trying to help an individual and you find that they have just lost a loved one you may need extra support on how to help the individual with the loss they are suffering. You might have to call a doctor or social worker if you find that the individual is starting to suffer with depression.

In some circumstances you must not try to offer counselling even in some situations you must not attempt to solve them yourself. You must seek help from organisations that deal with the situation you need to solve. The only time you can offer help is if you have been correctly trained to deal with the type of counselling or situation the individual is suffering with. Even then you may need to get extra help. If it is a situation that you can deal with having good communication skills and person centred care will be a great help to you and the individual.
You will begin to understand what is going on in the individual’s life. You need to start to understand, relate to or imaging the depth of the individuals emotional state or situation,
You need empathy with is learnt over time but it must not be mistaken for sympathy. It is a skill that is learnt through listening to the individual and having a caring attitude.

Building on a good relationship with the individual can give you good communication skills with that you can try to get the individual to open up to you and be able to tell you how they are feeling. With the individual feels relaxed with you they may be able to tell you of any problems that they have, whether they are feeling low, worried or distressed.
You should make sure first that you can. If you need to contact any family or friends for information you must remember to ask the individual first if they give you consent to talk to their family or friends.

Some situations can be sorted out and problems can be halved if the individual knows that they have someone they can trust and who is very understanding. As the saying goes “a problem shared is a problem halved”. Even holding the individuals hand or giving them a hug can make the individual feel much better. But if any problem is more that you can handle it is best to assess support or refer the individual to someone who can help.

Sometimes it may not only be the individual that needs help and understanding. The care worker themselves may need help, especially if they have had something very upsetting to deal with. The carer is best to talk to their manager who would then be able to arrange for someone else to care for the individual while you get help. If you need extra help you should also be able to assess it through work or your doctor.
Whilst looking on the internet for different versions of what empathy means I found this:-

Outcome 4 – be able to apply principles and practices relating to confidentiality

4.1 – explain the meaning of the term confidentiality

In a care setting confidentiality is very important and policies and procedures of the company concerning confidentiality must be followed. In a care home confidentiality consists of keeping all information about each service user safe. The care assistant should only pass on information that is a need to know bases. Any person files should not be left around for other people to read

There are laws which have been introduces to protect person records from any one reading every body’s personal information. The law is Data Protection Act 1998.

If the service user’s personal information is shared with everyone the service user would not feel that they could trust their carers and it could make them feel unsafe with can lead them to losing their self-esteem.

All professional services must keep private information about everybody that they deal with confidential.

The care home provider has the responsibility of keeping all their service users and employees details safe and secure. Whether it’s in paper form it is computerised. With the computer passwords are put in place to that only the selected few can assess the information. You will also find that antivirus software would have been up in place so no one on the outside can get any information about the people working and the service users of the organisation.

The carer must also never take any information about the service users outside of their place or work as it could get lost and the information could also get into the wrong hands,

The service user also has the rights to say who can look at their personal records. So if any family members want to know about any certain issues regarding their relation if the service users says they cannot look the family cannot look or be told of any issues. The organisation has the duty to not share the information.

Any information that the carer writes down about the service user is confidential and it is written clearly and factual.

In the care home that I work for we have certain books for certain information like the mar sheets which is for medication. Listed below are other records that we use:-

1. Daily occupational records – written by all staff about the daily activities the service user has done through the day,
2. Medical records – information that has been recorded when a DR, dentist, CPN etc. have been to see the service user,
3. Fluid chart – to record what fluids the service user has had through the day
4. Food chart – to record what food the service user has had through the day
5. Accident records – anyone having an accident in the home
6. Service users own files – any information that is about the services user is in this book.

So if you require any information about the services user you can find it either in the daily occupational records or the service users own file.

So recording all information about an individual would give anyone reading the file a most accurate and up-to-date picture of the service user also it can help trace if there is a problem with the services user.
e.g. if the service user had a fall on Monday and she was wearing slippers then on Tuesday she was ok she was wearing shoes but on Wednesday she fell and again was wearing slippers. This would tell you that there was something wrong with the service user’s slippers. You could then talk to your manager to see if there was anything that could be done to rectify the problem of the service user’s slippers. Another reason for making sure that the information you write down is clear and factual is because other agencies like the doctors may need to read what has been written.

There is a good way to remember what you write and it is called ACES:-

A is for Accurate
C is for Clear
E is for Easy to read
S is for Shareable

All information that is recorded about people whether written or on the computer is coved by the rules laid down in the Date Protection Act 1998 which covers all medical records, social services records, credit information and criminal records etc.

There are eight enforceable principles of good practice regarding the Data Protection Act
They are:-

Fairly and lawful processed
Processed for limited purposes
Adequate, relevant and not excessive
Accurate
Not kept for longer than necessary
Processed in accordance with the data subjects rights
Kept secure
Not transferred to countries without adequate protection.

In the United Kingdom there are 4 organisations that are responsible for making sure that everyone in social care follows the standard about how confidentiality is maintained.
The organisations are:-

The inspecting organisations and the regulatory bodies will make sure that everyone is recording and storing information correctly they will also make sure that you comply with regulations that have seen set. Weather you work in a large company or you work for a single employer you will be bound by the codes of practice of the regulatory bodies for your area.

It is important to keep records correct and uptodaye because it helps in the checking of the individuals careplan.

When it is the first time an individual comes into the care setting it good to get as much information about the individual as you can. You can ask the family and friends also you need to know who to contact if there are any problems. Also you need to know their who their doctor is and any other information that they can give you. All this information will be recorded in the individuals care plan. Any other professionals that will be involved in the care of the individual will also need to know any information about the individual.
In most care homes you will find that they do hand overs which is when a shift is finishing and a shift is starting every thing that has happened on the shift will be written down so that the nexed shift can continue with the care of the service users. The hand over sheet can help in the planning of the best care for the individual

If the service users information is not recorded correctly it can cause quite a few problems. Like incorrect medication given to the service user as they may be elergic to an ingreadent in the medication. This could result in the service user feeling unwell, it could also cause death.
So you must record correctly.

Years ago people could not see what was written about them selves, but in 1987 parliament passed an act with allowed you to see your own personal files. The act is called Access to Personal Files Act 1987. Also since then a few more Acts have been passed they are:-

1. - Data Protection Act 1998
2. - Freedom of information Act 2000

These Acts have given you the permission to look an your own files from general information from the NHS and the public and local authorities. The main thing is that no one can ask to see your information. That is still private.

4.3 – describe the potential tension between maintaining an individual’s confidentiality and disclosing concerns.

In some circumstances you may have a reason to break the confidentially of an individual. But you have to balance the rights of the individual and the rights of others.
Sometimes that you have been told by an individual in confidence may need further assistance like you need to get a doctor to see the individual. It could mean that if you keep the information to yourself it could result in the individual being harmed even more. It could also harm you as it could be happening to someone else as well. You must take care of the individual you are supporting.
In certain circumstances when you are employed as a carer to your employer you may have to pass any information onto the social services, the police even the doctor.
It can be a very difficult decision to make, so you need to be as accurate and as clear as possible that the decision you are about to make is in the individual’s best interest. The decision could be made because the individual is too ill or confused to report the incident themselves. The may also be very afraid of the consequences. You must only do this if you are one hundred per cent sure that the individual is at risk of serious harm.

It can be very hard to make the decision to breaking confidentiality. You need to balance the risks. You also need to know if breaking confidentiality will stress the individual more than the risk of the individual’s health and wellbeing.

Also you know that breaking the confidently of the individual can damage the friendship and trust that you have built over time. If you are worried about what to do you need to be able to discuss what is happening with your manage.

Anything that you have been told about anyone should stay between you and the person who has told you unless they have said that you can tell others.
The exceptions to the rule are when the information you have has to be passed to others on a need to know bases. The person you should talk to is your manager who will then make a decision which could affect the individual. You are not the only person working with the service user other people who may need to know are the doctor or district nurse who need to be kept up to date with the service user.
Any information that needs to be shared should have the consent of the individual but if the information that you have been given from the individual can cause a risk then you must tell you manager. This information should be treated as confidential and a need to know.

In the care system you also must make sure that the person you are sharing the information with is who they say they are. If you do not recognise the person you need to ask for identification.

It is good communication skills when you can ask the service user if you could let other care staff that are also looking after the service user know of certain things about them like where they were born, where did they live, what they like to eat etc. because you need permission from the service user because if you did not you would be breaking the confidentiality of the person. You need to let other people know about the service user because if you don’t you could have a situation like –
The service user is a Jehovah’s Witness and you turn up with a birthday cake to celebrate the service user would not be very happy because they don’t celebrate birthday and you would find yourself in a lot of trouble. In 1985 a mother named Victoria Gillick went to court so that she could view her daughter’s medical records because she wanted to know if the doctor had prescribed the contraceptive pill. The doctor refused to tell her because of the confidentiality between the doctor and his patient. Mrs Gillick was not happy with the decision so she when to the House of Lords to see if she could change the ruling. The House of Lords refused to let her see her daughter’s medical records. The same law still remains today. Any relatives even close ones cannot assess confidential information about their parent unless the individual has agreed.

It can be very hard for the carer if they are faced with angry or distressed relations that want to know about their mother or father. If they have not got permission to see their relative’s files you must not let them. The best thing to do is to get the manager to speak the them. Most often it is when a son or daughter thinks that they have the authority to see their parents files especially if there is a medical problem. You have to be careful because sometime family members would like to find out about i.e. where their brother of sister is and the only one that knows is their parent. It is up to the parent to tell them.

You must be very clear and that you understand but you cannot discuss any information about the services user unless they agree. You can be very polite and say that “if you would like to leave you phone number you will pass the information on”.

So do not give out any personal information about any service users unless you have permission.
You may find that in their care plan that they have signed a form to give you permission but until you have checked don’t.