The Care Certificate Framework For Adult Social Care Workers & Healthcare Support Workers

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1 The Care Certificate Framework For Adult Social Care Workers & Healthcare Support Workers Standard 6 Name of Learner: Role: Organisation: Mentor: Assessor: Date started: Page 1 of 23

2 The Care Certificate Framework Communication Standard 6 Main areas: I will understand the importance of effective communication at work I will understand how to meet the communication and language needs, wishes and preferences of individuals I will understand how to promote effective communication I will understand the principles and practices relating to confidentiality I will use appropriate verbal and non-verbal communication I will be able to support the use of appropriate communication aids / technologies Links Code of Conduct: Standard 4 & 5 Compassion in Practice (6 C s) Care, Compassion, Competence, Communication, Courage and Commitment Page 2 of 23

3 Standard 6 This standard explores the importance of effective communication in your work setting, how we meet the communication needs of individuals, how to promote effective communication using verbal and non-verbal and communication aids and also understanding the principles of confidentiality. Communication can be defined as the giving and receiving of information, it is a two way process and for it to be effective, it needs to be done in a manner where both parties can understand the meaning of it. Communication is now recognised as an essential part of health care delivery, and therefore, it is seen that if communication is poor or inadequate, the quality of service will suffer as a result. Ensuring good and effective communication is a fundamental component of providing high quality services. It is not a luxury or an optional extra. We all need to communicate with each other, and as a care worker you will need to be aware of the different ways communication can take place. Individuals communicate through a range of different methods and these can be either verbal or non-verbal and can include: Verbal Volume Intonation Rate Fluency Tone Non-verbal Objects of Reference Photos Pictures Symbols Written word Body language Facial expression and eye contact Page 3 of 23

4 Pointing Gestures Touch British Sign language (BSL), Makaton, braille Proximity and position Silence, is also a very powerful tool, when communicating with someone, but is often a skills that we find hard, as we feel that we should be saying or doing something. It gives that person the time to reflect on their thoughts and ideas, without us rushing on to the next thing; we feel that they should be talking about. We also need to be aware, that often the non-verbal communication tells us far more than the verbal communication does, and therefore it is imperative that you are observing and are receptive to the individual s reactions when communicating with them. Take for example you are talking to a client asking them if they are alright, they may confirm in words that they are, but their eyes may be filling with tears. This may be for a number of reasons, including that they are trying to deny how they are really feeling, they are scared to admit why they are upset, they don t want to talk about it at that time, or you may be the wrong person for them to talk to about it. As we can see from Professor Albert Mehrabian s model, only 7% of our communication is via words. 7% meaning in the words that are spoken = 7% 55% 38% meaning is paralinguistic (the way that the words are said) = 38% meaning is in facial expression = 55% Fig 1 - Professor Albert Mehrabian's communications model Individuals communicate for a variety of reasons and these can include: Page 4 of 23

5 Physical day to day needs (food, drink, warmth, identification of risks in risk assessments) Safety and security - to be reassured physically and emotionally Social to form positive relationships (socialising, involvement in activity, community involvement) Emotional to be loved and accepted (finding out how they feel) Meeting personal potential self actualisation To give information (instructions, taking medication) To obtain information (life history) To exchange ideas (discussion of care plan) Within a work setting, you will be communicating with many different people, this could include clients, their families and friends, colleagues, other members of the multidisciplinary team, emergency service staff (e.g. paramedics) to name a few. How you communicate with these people will depend on who they are and the situation you are in at that time. You will also need to consider that you may need to have different approaches to communicate the same message to different people. Take for example a client has died, how you tell your colleagues and the doctor will be very different to how you tell the family. When using verbal communication, you should speak at the service users level of understanding and in a manner that shows respect. You need to understand that individuals may need to be spoken to and communicated with in different ways, and you begin by finding out what the individual s preferred way of being addressed is. It is therefore really important that you establish that particular individual s communications and language needs, wishes and preferences and this can be done in a number of ways including:- Asking them Talking to their family (and friends where appropriate, taking into account confidentiality) Talking to colleagues Speaking to other members of the multi-disciplinary team Reading their care / support plan or notes Page 5 of 23

6 Individuals do have a wide range of communication needs and this involves consideration of many aspects, including: Physical ability Sensory ability Culture Language Confidence and self esteem Level of cognitive ability The important thing to remember is that we need to be able to communicate with that individual and therefore we need to adapt our communication to meet their needs as we are often in a situation where they can t adapt. As we explored earlier, there are many different communication methods and it is normal that we use a combination of them throughout all communication. We are at times faced with barriers, to communication and we then need to overcome these. The important thing is to ensure that person feels comfortable and is not made to feel different or excluded as they don t communicate in the way that you or others do. It is therefore far better to be aware of how that person communicates before you speak to them, as then you can be prepared for it, as opposed to being stood there and not knowing what to do. Some of the barriers are listed below, along with methods of overcoming them: - Communication barrier Visual impairment Possible ways to overcome Use of touch where appropriate Increased use of tone of voice as opposed to facial expression Ensure all that is normally visually communicated is transferred to a method that can be heard Use of braille Use of tapes / computer programmes such as Jaws Page 6 of 23

7 Hearing impairment Speak slowly and clearly Remove any other distractions that may cause a noise Consider your position so that you face the client Allow the clients to lip read if they are able to Make sure any hearing aids worn are fully functioning Use sign language if appropriate and if so ensure the topic is communicated first Ensure all adaptive equipment is functional Use of flashcards etc Consider the use of electronic note taker if appropriate Physical disabilities Depending on the nature of the disability this will have to be titrated according to the individual s problems, but consider: - Speaking clearly and slowly using closed questions Do not patronise Only ask one question at a time Consider picture cards allowing them to point to answers Use of specialised equipment e.g. light-writers Learning disabilities Initially assess the level of understanding Speak at an appropriate level without using jargon or medical terminology Allow time to respond and if necessary repeat Use closed questions Use picture cards Language differences Use of gestures, pointing to various objects Use of pictures / flashcards Relevant language dictionary Ask the family to design an appropriate scrapbook in alphabetical order with relevant pictures Through an interpreter (care needs to be taken if using the family for this due to confidentiality reasons) Dementia / Confusion Observe their non verbal communication Page 7 of 23

8 Comprehension Cultural differences Eliminate all distractions Allow them time to communicate Discuss only one item per sentence and keep it simple Do not challenge confused statements Continually show respect Use pictures and items of reference This could include; inability to comprehend, lack of knowledge about the subject, anxiety, worry, high emotions, attitude and personal values, confusion between verbal and non verbal cues. This will need to be titrated on an individual basis according to reason for this issue. Explore their culture so you have an understanding of it Accept that they may well have a different way of expressing themselves Try to reach a compromise as to what is acceptable Transmission This could include areas such as: inability to articulate properly, due to sore throat, paralysis, strong accent, level of attention span, terminology used. Method to overcome this will have to be titrated according to individual issue. Environmental This could include factors such as: noise, cold, poor lighting, lack of privacy, distractions and unfamiliar surroundings. This could also link to not having enough time, so they feel rushed. Method to overcome this, will have to be titrated according to individual issue Personal / sensitivity This could include factors such as incompatible communication styles use of jargon, differing cultures, low self esteem / value, age, gender, work role, dress code, stereotyping, negative body language, negative attitude of staff to client etc Method to overcome this will have to be titrated according to individual issue. When communicating with someone, it is imperative that you check to establish if the message that you have been trying to convey has actually been understood. There is Page 8 of 23

9 no point in you communicating with someone if that message is not being received. Checking that it has been understood is a vital part of the process. One skill that is useful, is paraphrasing what has been said, so you repeat back and summarise with that person, as it will allow them to correct you where needed. At times it is also appropriate to use open questions, where they have to give you a reply which consist of more than a yes / no type answer, and also at times it is appropriate to ask closed questions depending on what you are needing to establish. It is important that you demonstrate really good active listening skills when you are communicating with your clients. There will be times when you are talking to them whilst assisting them with their care for example, but there will also be times when you are sat having a conversation with them, which at times can be quite emotive for them. In these types of situations, it is important that you work to the principles of SOLER. S Sitting squarely and opposite the individual O Having an open posture, with no physical barriers between you L Leaning forward, slightly towards the individual, but not too close E Eye contact, but don t stare R Relax and show that you are listening When communicating with the client it is also important that you: Do not interrupt even if they are struggling to get their words out, as it can feel very patronising Allow them the time they need to express what they need to tell you Do not give advice Do not dismiss fears, worries as whilst they may appear trivial to you, they are real and of importance to that person Acknowledge that their behaviour is a form of communication, and we see this in particular if they are unable to express themselves in other ways, may be due to learning disabilities or dementia for example. It may include some Page 9 of 23

10 of the following types of behaviours: swearing, repetitive rocking to and fro, self harm, walking or running away, not talking or responding, yelling or shouting and sarcasm. Some individuals also use communication aids e.g. hearing aids, light-writers, other speaking aids, IT software, it is important that if they are using them, they are clean, working correctly, switched on (where needed) and in good state of general repair. If you find that one is not working correctly, it is your responsibility to report it, as without it, at times that individual is therefore unable to communicate. When you are communicating in writing, it is also important to ensure that the same principles are applied, as clients can at times read their notes and therefore read what you have recorded about them. Also, any records that you complete are legal documents and so can be used in a court situation. Sometimes, even when you have good communication skills, you still feel that your communication is not as effective as it could be with your clients. It is at this point that you may want to seek some additional support and this could be via a range of sources including: - Your senior / line manager Reading the care plan again Speaking to the family Finding out more about their condition and therefore having a better understanding of it Speaking to specialists (in the relative condition) Contacting condition specific organisations (e.g. Stroke association, Alzheimer s Society, Motor Neurone Disease Association) Confidentiality means not sharing information about someone without their knowledge and agreement, and this applies to all methods of communication - be it spoken or written, as we are often dealing with sensitive, personal information. It is important as you are working in a position of trust, the clients need to feel that they can trust you and if you are talking about them, this may result in them losing some of their self esteem and dignity. Page 10 of 23

11 Confidentiality is governed by the following policies / codes of practice and legislation: - Organisational policy Skills for Care / Skills for Health Code of Conduct standard 5 Data Protection Act 1998 Freedom of Information Act 2005 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and The Fundamental Standards You may only disclose information to those with direct need for information (such as health care professionals, care managers and your manager). Relatives, neighbours and family friends are not necessarily entitled to receive confidential information. Sharing information from individual s care / health records must be on a needs to know basis only, so for example you may need to discuss with the GP about a health complaint, but if they started to ask re their financial situation, then this would be totally inappropriate and should not be shared with them. Depending on the environment you work in will dictate to some degree what might need to be shared. Take for example you are in a hospital, and are looking at discharge, then it may be very appropriate for the doctor to be asking about the home that the client lives in, to establish whether discharge back there is appropriate or not. However, there may be times, when it will be necessary to breach client confidentiality, and these could include if:- It can be justified to protect the client or another from a significant risk or harm. If there is suspected abuse It is required by law or by the order of the court. To maintain confidentiality you need to consider where and when you discuss clients i.e. not when you are on the train going home or in the pub in the evening or in a public place. Within a residential care setting (e.g. care home, nursing home, hospice, hospital), it is also important what you do with the clients records, so that they are not left in a public place for all to read, you will need to check your own individual organisations policy on the management of this. Page 11 of 23

12 Within the client s own home, do not leave their documentation in a place where an unauthorised person could gain access to it and also if you need to talk to the office or other health professional, consideration needs to be taken as to where you make that phone call. Likewise, if you are in the client s garden with them, be aware of neighbours, who may be able to hear that conversation. If you have any concerns re confidentiality, and whether you should pass information on or not, this should be discussed with your line manager who will advise you as to the best course of action. You will also have a policy and procedure relating to this within your workplace, which would be helpful for you to read. Page 12 of 23

13 Standard 6 Workbook Communication Standard 6 Main areas: I will understand the importance of effective communication at work I will understand how to meet the communication and language needs, wishes and preferences of individuals I will understand how to promote effective communication I will understand the principles and practices relating to confidentiality I will use appropriate verbal and non-verbal communication I will be able to support the use of appropriate communication aids / technologies Links Code of Conduct: Standard 4, 5 Compassion in Practice (6 C s) Care, Compassion, Competence, Communication, Courage and Commitment Page 13 of 23

14 Standard 6.1 Understand the importance of effective communication at work 6.1a Describe 5 different ways that people communicate b Describe how communication affects relationships at work 6.1c Describe why it is important to observe and be receptive to an individual s reactions when communicating with them Page 14 of 23

15 Standard 6.2 Understand how to meet the communication and language needs, wishes and preferences of individuals 6.2a Describe how to establish an individual s communication and language needs, wishes and preferences 6.2b List a range of communication methods and styles that could help meet an individual s communication needs, wishes and preferences Page 15 of 23

16 Standard 6.3 Understand how to promote effective communication 6.3a & 6.3b List 5 barriers to effective communication and ways to reduce these barriers Barrier to communication Ways to reduce barriers to effective communication c Describe how to check if you have been understood when talking to the clients Page 16 of 23

17 6.3d Describe where to find information and support for services, to help you communicate more effectively Standard 6.4 Understand the principles and practices relating to confidentiality 6.4a Describe what confidentiality means 6.4b List legislation and agreed ways of working to maintain confidentiality in day to day communication Page 17 of 23

18 6.4c Describe situations where information, normally considered to be confidential, might need to be passed on Situation when confidential information may need to be shared Reason for sharing d Describe who to ask for advice and support about confidentiality Page 18 of 23

19 Standard 6 Observation Communication Standard 6 Main areas: I will understand the importance of effective communication at work I will understand how to meet the communication and language needs, wishes and preferences of individuals I will understand how to promote effective communication I will understand the principles and practices relating to confidentiality I will use appropriate verbal and non-verbal communication I will be able to support the use of appropriate communication aids / technologies Links Code of Conduct: Standard 4, 5 Compassion in Practice (6 C s) Care, Compassion, Competence, Communication, Courage and Commitment Page 19 of 23

20 Standard Observation Signature & Date of observation 6.5a Demonstrate the use of appropriate verbal and non verbal communication Verbal (tone, volume) Non verbal (position, eye contact, body language, touch, signs, symbols and pictures, writing, objects of reference, human and technical aids) Communication may take place face to face, by telephone or text, by , internet or social networks, by written reports or letters 6.6a Check that communication aids / technologies are: - Clean - Work properly - In good repair 6.6b Report any concerns about the communication aid / technology to the appropriate person This could include: - Senior member of staff - Carer - Family member Standard 6 Observation / simulation (please indicate) Page 20 of 23

21 Outcome To meet this standard Assessment Evidence Date signed off 6.1 Understand the importance of effective communicati on at work 6.1a Describe the different ways that people communicate Assessed by any of the following methods: - 1:1 discussion 6.2 Understand how to meet the communicati on and language needs, wishes and preferences of individuals 6.3 Understand how to promote effective communicati on 6.4 Understand the principles and practices relating to confidentialit 6.1b Describe how communication affects relationships at work 6.1c Describe why it is important to observe and be receptive to an individual s reactions when communicating with them 6.2a Describe how to establish an individual s communication and language needs, wishes and preferences 6.2b List a range of communication methods and styles that could help meet an individual s communication needs, wishes and preferences 6.3a List barriers to effective communication Assessed by any of the following methods: - 1:1 discussion Assessed by any of the following methods: - 1:1 discussion Assessed by any of the following methods: - 1:1 discussion Assessed by any of the following methods: - 1:1 discussion Assessed by any of the following methods: - 1:1 discussion 6.3b Describe ways to Assessed by any of the reduce barriers to effective following methods: communication - 1:1 discussion 6.3c Describe how to check Assessed by any of the whether they have been following methods: understood - 1:1 discussion 6.3d Describe where to find Assessed by any of the information and support or following methods: services, to help them - 1:1 discussion communicate more effectively 6.4a Describe what Assessed by any of the confidentiality means in following methods: relation to their role - 1:1 discussion 6.4b List any legislation and Assessed by any of the Page 21 of 23

22 y 6.5 Use appropriate verbal and non-verbal communicati on 6.6 Support the use of appropriate communicati on aids/ technologies agreed ways of working to maintain confidentiality in day-to-day communication 6.4c Describe situations where information, normally considered to be confidential, might need to be passed on 6.4d Describe who to ask for advice and support about confidentiality 6.5a Demonstrate the use appropriate verbal and nonverbal communication: Verbal: Tone Volume Non-verbal: Position/ proximity Eye contact Body language Touch Signs Symbols and pictures Writing Objects of reference Human and technical aids Communication may take place: face to face by telephone or text by , internet or social networks by written reports or letters 6.6a Check that communication aids / technologies are: Clean Work properly In good repair 6.6b Report any concerns about the communication aid / technology to the appropriate person. following methods: - 1:1 discussion Assessed by any of the following methods: - 1:1 discussion Assessed by any of the following methods: - 1:1 discussion The assessment must be observed in the workplace as part of the normal work duties The assessment must be observed in the workplace as part of the normal work duties The assessment must be observed in the workplace as part of the normal work duties. Page 22 of 23

23 This could include: Senior member of staff Carer Family member The opportunity to demonstrate this during the induction period may not arise. Therefore the use of simulation / role play using scenarios is permitted I am satisfied with the evidence of learning that it meets all the required standards. Assessor s Name: Signature: Learner s Signature: Assessor s Position: Date: Date: Page 23 of 23

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