UNIT 501

Karen Snook
Unit 501
Use and develop systems that promote communication
1. Be able to address the range of communication requirements in own role.
1.1 Review the range of groups and individuals whose communication needs must be addressed in own job role
Who
Why
How
Barriers
Staff
Give information, supervisions, appraisals, disciplinary,
Face to face, Staff meetings, communication books, emails, text, care docs
Cultural differences, not wanting to listen
Clients
Give them information, reassurance, discuss any changes or needs
Face to face, written, picture
Unable to understand, deaf, unable to read, disability i.e dementia, mental illness
Families
Give information on the client, inform about appointments, needs, changes, family meetings
Face to face, telephone, written
Not wanting to listen, language barriers
Other professionals: GP’s, social workers, Phlebotomists, Dentists, Psychiatrists, district nurses
Multi- disciplinary meetings, discuss clients any needs or changes
Telephone, Emails, written, face to face
Not receiving messages,

1.2 Explain how to support effective communication within own job role
An example of a communication model is:
Shannon and Weaver Model of Communication
In 1948, Shannon was an American mathematician, Electronic engineer and Weaver was an American scientist both of them join together to write an article in “Bell System Technical Journal” called “A Mathematical Theory of Communication” and also called as “Shannon-Weaver model of communication”.
This model is specially designed to develop the effective communication between sender and receiver. Also they find factors which affecting the communication process called “Noise”. At first the model was developed to improve the Technical communication. Later it’s widely applied in the field of Communication.
The model deals with various concepts like Information source, transmitter, Noise, channel, message, receiver, channel, information destination, encode and decode.

Sender: The originator of message or the information source selects desire message
Encoder: The transmitter which converts the message into signals
Note: The sender’s messages converted into signals like waves or Binary data which is compactable to transmit the messages through cables or satellites. For example: In telephone the voice is converted into wave signals and it transmits through cables
Decode: The reception place of the signal which converts signals into message. A reverse process of encode
Note: The receiver converts those binary data or waves into message which is comfortable and understandable for receiver. Otherwise receiver can’t receive the exact message and it will affect the effective communication between sender and receiver
Receiver: The destination of the message from sender
Note: Based on the decoded message the receiver gives their feed back to sender. If the message distracted by noise it will affect the communication flow between sender and receiver
Noise: The messages are transferred from encoder to decoder through channel. During this process the messages may distracted or affected by physical noise like horn sounds, thunder and crowd noise or encoded signals may distract in the channel during the transmission process which affect the communication flow or the receiver may not receive the correct message
Note: The model is clearly deals with external noises only which affect the messages or signals from external sources. For example: If there is any problems occur in network which directly affect the mobile phone communication or distract the messages
Criticism of Shannon-Weaver model of communication:
1. One of the simplest model and its general applied in various communication theories
2. The model which attracts both academics of Human communication and Information theorist to leads their further research in communication
3. It’s more effective in person-to-person communication than group or mass audience
4. The model based on “Sender and Receiver”. Here sender plays the primary role and receiver plays the secondary role (receive the information or passive)
5. Communication is not a one way process. If it’s behaved like that, it will lose its strength. For example: Audience or receiver who listening a radio, reading the books or watching television is a one way communication because absence of feedback
6. Understanding Noise will helps to solve the various problems in communication communicationtheory.org/shannon-and-weaver-model-of-communication Effective communication is essential within our health care setting especially when working with people who are elderly, enduring mental health and dementia. You need to be a good listener and be able to interpret what is being said to you either through active listening or by a person’s body language. Good communication skills are essential for developing a good relationship with our staff, clients, client’s families and other professionals that we come into contact with on a daily basis. Regular interactions with our clients are essential for building their trust enabling them to be able to talk to us about anything. It will also help us to understand their fears, anxieties and communication needs. Also regular contact with families builds up trust and a good rapport so that we can speak openly and honestly with each other about their loved ones.
1.3 Analyse the barriers and challenges to communication within own job role.
There are many barriers that can challenge communication. These can be cultural differences and language barriers with staff and clients. What as one meaning in one culture could have a completely different meaning in another culture. Even different dialects can create barriers and challenges with communication. Barriers and challenges with communication within my job role vary depending on who I am communicating with. Communicating with a client diagnosed with dementia and depending on what stage they are at would depend on how I would communicate with them. Someone with early onset dementia I could possible talk at a normal pace and tone, asking the client if they understand what is being said to them if needed. If I was talking to a client with advanced dementia my pace would be a lot slower, maybe using a couple of words at a time due to them not being able to cope with too many words all at once. I may have to use pictures to explain what I was saying to them or make hand gestures. When communicating with staff who are from different cultures I may have to think about my accent or the terminology that I use, my pace and tone and also how I say something. In some cultures people can come across as being rude but that is there way of talking.
Physiological barriers could be hearing difficulties or sight impairment. If a person is ill or tired could cause problems with communication. A loss of concentration can be caused by psychological barriers. This could be a client or member of staff with depression, worries or personal problems. Physical barriers could be being in the wrong environment, it could be too noisy, the room could be too cold or too hot.
1.4 Implement a strategy to overcome communication barriers
Completing an initial assessment with our clients will enable me to determine their communication needs and highlight any barriers that there may be. If any communication barriers are identified I can implement a strategy to help with this. This could include training for staff such as communication training which could include how to use communication aids, Makaton or sign language so that the client’s needs can be met. Working with other professionals like Speech and Language, Speech therapists, Opticians or audiologists could also help overcome communication barriers with our clients. Also making sure that staff speak clearly and slowly and are up to date with client care plans so that they are aware of all client needs.

2 Be able to improve communication systems and practices that support positive outcomes for individuals.
2.1 Monitor the effectiveness of communication systems and practices
Communication is very important to us at WIllowbrook. Our aim is to exchange information effectively and build on relationships with staff, other professionals, clients and their families.
We use various communication systems. These include a communication book that all staff have access to, memo’s that staff read then sign and date to say they have read the information, e-mails through our computer system called care docs which every member of staff has access to. Handovers that happen at the start and end of each shift, they must be clear and as informative as possible, this then enables us to maintain effective communication between changes of staff and shifts. Also Person Centered planning for all of our clients so that we can gather as much information on our clients.
In our reception there is a message book that the receptionist can fill in to record any important information from telephone calls or messages from other professionals or families if the member of staff is not available.
During our handover in the morning relevant information is delivered to the shift that is taking over. All staff are required to have a note book and take down all relevant information. There is also a handover book where staff can record anything that as happened on that shift and that needs to be given to the next team coming on shift.
When making phone calls staff should make sure that they put a message in the communication book letting other staff know the name of the person contacted, time and reason for call. This should also be done when receiving phone calls and if these calls are to do with clients a note should be made on their notes for future reference.
A suggestion box is available for clients, staff and families to use, this ensures that they all have the opportunity to express their thoughts and needs. Also quality assurance questionnaires are posted out every year to clients, families, other professionals and other services that come into our home. There is a complaints procedure within our care home and all staff receive regular feedback on their performance. Supervisions are carried out every three months on all staff within our care home and appraisals happen yearly.
2.2 Evaluate the effectiveness of existing communication systems and practices
Our communication book is there for all staff to write in and read. This is not always done and sometimes important information can be missed from this. Nursing staff will tend to read the communication book but care staff tend not to and wait for nursing staff to pass on information to them. Care Doc’s tends to be the best and easiest communication system in place. Once logged onto this system the first thing that you will see are your emails. Again some staff do not read their emails and if questioned about this will say “I did not see it”. Our handover book is only a good communication system if the relevant information is documented. This is not always the case. There are times when you are unaware that another professional has been in or something has happened because it is only documented in the notes on care docs and not in the communication book where if it was in the communication book I feel it would be easier to know that something had happened or had been actioned.
Our suggestion box and questionnaires can be an effective way for staff, families and other professionals to communicate with us if used in the correct way. They can sometimes be use incorrectly and have no relevance for the purpose they were intended for. Sometimes families will use the questionnaires to make a complaint or have a moan indirectly, because they are all unidentified questionnaires with no names on.
We also actively encourage clients and families to communicate their preferences and needs so that we can ensure that a person centred approach is used at all times. This can only be effective if all of the correct and relevant information is collated by the staff. Sometimes the families do not want to provide all information. This can sometimes be because they feel embarrassed about some of the things their loved ones have done in the past.
Our existing communication systems and practices are fairly effective but I would say there is always room for improvement.

2.3 Propose improvements to communication systems and practices to address any shortcomings.
Improvements to communication systems and practices that could address any shortcomings could be at hand over the communication book can be read out by the person conducting the handover, this will then ensure that all staff are receiving all of the information needed. Our care docs emails do not show if staff have read their emails talking to the supplier of this system may be an option to see if they can implement this. Normal emails that senior staff have access to do show that a request was delivered. Staff meetings will always start off with issues raised from the previous meeting and all actions will be discussed individually, staff are then asked if they need anything repeated or if they are unsure about anything.

3 Be able to improve communication systems to support partnership working
3.1 Use communication systems to promote partnership working.
Communication systems that we have set up to promote partnership working with others are Care docs, emailing, phoning, meetings, reviews and face to face.
Pros and cons for these are Care docs is our own Willowbrook system which can only be accessed on the premises. Emailing is a good way of communicating if you have the correct address to start off with. Phoning can be good for quickness but can delay communication if you can’t get hold of the person. When other agencies and professionals talk to us face to face, have meetings or reviews we will get them to write in the clients records.
3.2 Compare the effectiveness of different communications systems for partnership working
Within my role as Deputy Manager I believe that my communication systems and practices are very positive. I communicate with my Director, Manager, Clinical lead nurses, staff nurses, team leaders, Care Workers, clients, families, Social Workers, District Nurses, Psychiatrist and GPs on a daily/weekly basis. Formal discussions can take place by email, team meetings, reviews, supervisions and family meetings. Examples of communication would be for the following reasons – to discuss/review clients and obtain advice and support, discuss complaints which have made, discuss new referrals and discuss any problems as they arise.
3.3 Propose improvements to communication systems for partnership working.
Collecting information is essential in monitoring the effectiveness of our communication systems. We can collect information by observing, getting feedback from others and recording information. We need to work with others to identify ways to support the continued development of communication. Complaints procedure and questionnaires are also forms of data to inspect before proposing improvements
We can communicate with colleagues and other professionals in many ways every day by emails, letters, verbal, telephone calls and written. Effective communication requires personal and professional respect for others, verbal and listening skills.
Care professionals may communicate formally and informally with colleagues, clients, families and other professionals.

4 Be able to use systems for effective information management
4.1 Explain legal and ethical tensions between maintaining confidentiality and sharing information
Ethical decision making model
The model as outlined below requires you to work through the following steps:
1. Identify the dilemma. Firstly you need to look at the dilemma and gather as much information as you can to clarify the problem. For example consider if there are any legal aspects to the issue or if the situation can be defined as an ethical dilemma. It might help to consult with a work supervisor or colleague about it.
2. Apply the code of conduct or code of ethics. Once you have a clearer picture of the nature of the problem you need to consult the code of ethics for your profession to see if there are clear guidelines on how the issue should be addressed. Sometimes further exploration is required. There may also be a code of conduct in your agency’s policy and procedures manual. Read this.
3. Determine the nature and dimensions of the dilemma and seek consultation. In this step you will need to ask yourself questions such as: ‘What actions will have the least chance of bringing harm to the client?’ ‘What decisions will safeguard the well-being of the client?’ ‘How can I best promote self-determination?’
Sometimes the dilemma may involve other agencies or other professionals. This is a situation where you must consult with your supervisor or director. Do not try to manage on your own! At times the dilemma may involve your director or supervisor. If this occurs, it would be important to raise your concerns with them directly. If you are unable to do this, it would be appropriate to speak to someone outside the agency, such as a management committee member, a superior from head office, a worker from an outside body or in extreme cases, the police. Appropriate people are usually at least one level up from the person concerned and perhaps two levels up if you feel that your immediate supervisor may be biased. It is therefore useful to know who people within the service are and the organisation’s relevant reporting system.
Be careful to protect the identity of the client in these situations unless they have given you permission to release their personal information.
4. Generate possible actions. Brainstorm (with colleagues if you can) possible solutions to the problem/dilemma.
5. Consider the possible consequences of all options and determine a course of action. This stage involves looking at all the options and the consequences of actions for all relevant parties, clients, colleagues, agency, profession etc.
6. Consider the rights and responsibilities of all people involved. It is critical to consider the balance between rights and responsibilities of workers and clients. It is possible that as a worker you may consider that a client’s actions may be putting them at risk of injury. The dilemma arises out of the responsibilities of workers to maintain a safe environment for all clients while at the same time maintaining the rights of clients to make informed choices which may have an element of risk to attached to them.
This is called ‘dignity of risk’. It is important to consider this balance and choose alternatives which uphold the rights of clients and allow them to accept personal responsibility for their choices and actions.
7. Evaluate the selected course of action. Review your selected course of action. Be careful that the action chosen doesn’t raise any new dilemmas!
8. Implement the course of action. You have worked through a process and should be able to justify your actions and responses. It is always useful to reflect on the effectiveness of your choices, once again with a supervisor or colleague if possible.
There is also a common law responsibility of a duty of care towards clients. This duty exists and is owed at all times by all staff catering for the needs of others. Ethical issues do arise from time to time and it is up to you to be able to recognise it to then to be able to discuss the issue with an appropriate person. https://sielearning.tafensw.edu.au/MCS/CHCAOD402A/

WIllowbrook as its own policies and procedures for maintaining confidentiality and sharing information. The policy has been written to meet the requirements of The Data Protection Act 1998, The Human Rights Act 1998, The Computer Misuse Act 1990 and Crime and Disorder Act 1998. There is scope, statement of responsibilities and procedures which include:
Confidentiality of Information, General principles of confidentiality, Sharing information, Sharing information without consent, Telephone enquiries, Providing information to relatives, Requests for information by the police and media, Carelessness, Use of internal and external post, Faxing information, Storage of confidential information, Disposal of confidential information, Confidentiality of passwords, Emailing confidential information, Use of social networking sites, Working in the community and Working at home.
Willowbook staff sign a contract to state that they will maintain confidentiality and that any breach of confidentiality will be subject to a disciplinary hearing and most likely an end of their contract.
All confidential information is stored in a locked filing cabinet in the main reception office and only senior members of staff have access to the key.
As a qualified nurse I am also governed by the Nursing Midwifery Council which underpins all of my actions as a nurse.
4.2 Analyse the essential features of information sharing agreements within and between organisations
Willowbrooks policies say that information needs to be shared in multi-disciplinary care team and the immediate care team on a ‘need to know’ basis. This essential sharing of information is needed to provide safe and effective care for service users. If information could not be shared with care teams on a ‘need to know’ basis, service user and staff could be at serious risk. Service users must therefore be made aware of the need to share relevant information about them.
Sometimes it may be essential to share information without consent if a client threatened to harm others or themselves. If this was to happen I would inform the client that I was doing this in their best interest.