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  7. 301: Promote communication in health, social care or...

301: Promote communication in health, social care or children’s and young people’s settings (SHC 31)

Explain when and how a social care worker should get advice about confidentiality.

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You are a social care worker and a service user, Hannah, tells you that she is unhappy taking her new medication.  She thinks she does not need it and so she is throwing it away. You know from her care plan that Hannah does need to take the take the medication regularly and gets confused. Hannah begs you to keep this confidential and not tell anyone especially her daughter, who she sees regularly, as her daughter will be very angry.

A social care worker may need to get advice about confidentiality if a situation arises that they are unsure about. For example, somebody may ask for an individual’s personal information but the worker may not know if they are authorised to be given it.

Social care workers should, in the first instance, get advice about confidentiality from their line managers and company policies. Up-to-date training can also help keep them informed.

Further information can be obtained from the local authority or current legislation (e.g. The Care Act 2014, Data Protection Act 1998).

Describe ways to maintain confidentiality in day to day communication.

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Confidentiality

Day-to-day, confidentiality can be maintained by being mindful of how personal information is stored and discussed. Social care workers should also be familiar with current legislation; the UK’s Data Protection Act and the EU’s General Data Protection Regulation.

Personal records and documentation should be kept in a secure place where it can’t be accessed by the public or non-permitted individuals.

Discussions about individuals should only be done in private, where there is no risk of being overheard by others. Personal information should only be discussed with others on a need-to-know basis.

Personal information that is stored in digital format should only be on secure, password-protected devices and, again, only people that have authorisation should have access to it.

Envelopes and letters should be marked as Private & Confidential.

Documentation and records should be disposed of securely (e.g. shredded).

Any non-compliance or breaches in confidentiality should be reported immediately.

You are a social care worker and a service user, Hannah, tells you that she is unhappy taking her new medication.  She thinks she does not need it and so she is throwing it away. You know from her care plan that Hannah does need to take the take the medication regularly and gets confused. Hannah begs you to keep this confidential and not tell anyone especially her daughter, who she sees regularly, as her daughter will be very angry.

In this case, I would explain to Hannah that her medication is necessary for her health and I have a duty of care to ensure that she takes it or contact relevant people if she doesn’t. I would discuss the reasons for her not taking the medication and explain that I could contact her GP to look at the possibility of changing the medication. Whether I tell her daughter or not would depend on the circumstances. If her daughter is her main carer, advocate or power of attorney I would explain that she has a right to know.

Describe the possible tensions that may arise between telling others of Hannah’s decision and keeping this information totally confidential.

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You are a social care worker and a service user, Hannah, tells you that she is unhappy taking her new medication.  She thinks she does not need it and so she is throwing it away. You know from her care plan that Hannah does need to take the take the medication regularly and gets confused. Hannah begs you to keep this confidential and not tell anyone especially her daughter, who she sees regularly, as her daughter will be very angry.

Hannah may be upset with me for breaking confidentiality, resulting in her being less open or friendly with me in future. If Hannah’s daughter was to find out that Hannah hasn’t been taking her medication, she may get angry which could cause tension between mother and daughter. Hannah may also blame me for this.

If I kept this information totally confidentiality, it would result in tensions between myself, my managers and my co-workers as they would, quite rightly, assume I cannot do my job properly and cannot be trusted. I would also expect to receive a disciplinary at the very least. If Hannah’s health were to deteriorate as a result of not taking her medication, her family and friends would not be happy with me. I could also be charged by the police for neglect.

How would you explain the term ‘confidentiality’ to Hannah?

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You are a social care worker and a service user, Hannah, tells you that she is unhappy taking her new medication.  She thinks she does not need it and so she is throwing it away. You know from her care plan that Hannah does need to take the take the medication regularly and gets confused. Hannah begs you to keep this confidential and not tell anyone especially her daughter, who she sees regularly, as her daughter will be very angry.

As an individual, Hannah has the right to choose whether or not she takes her medication but because her care plan states she needs to take the medication regularly, I would explain to her that I have a duty-of-care to disclose the fact that she has not been taking it. I would explain that if she were to get ill from not taking the medication, I would feel awful and could get in trouble for not telling anybody.

I would continue by saying that I respect her privacy and would reassure her that I would only tell the people that need-to-know (my manager, her G.P etc.) and would not tell her daughter directly if she didn’t want me to.

A social care worker wants to enable more effective communication with individuals using the service. Explain how they could access extra support or services that may be helpful.

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Firstly, the social care worker should make a list of all the preferred methods of communication for the individuals using the service by referring to their Care Plans and consulting them individually. Then they can use this information to research what services are available.

Some professional services they may need to look into include translators that translate different languages, interpreters that translate sign language, speech and language therapists that work with individuals to create a tailor-made plan to help improve their communication.

Extra communication support can  be found from local or national charities and organisations as well as technology firms (for example, a visually impaired individually may need screen-reader software to be able to use a laptop).

Some individuals may also need to use an Advocacy Service if they are unable to put their views across themselves. An advocate is somebody who represents an individual’s point of view and communicates on behalf of them.

Describe two stratergies that you could use to clarify misunderstandings.

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A misunderstanding can be clarified by actively listening to what an individual is saying and then verifying their main points. This is done by repeating it back to them in your own words and asking if what you have said is correct.

Another method that can be employed is to ask somebody else to mediate. They may be able to better understand the individual as well as explain it to you in a different way.

Identify three examples of barriers to communication and explain how you could overcome each barrier

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Individuals either side of a wall that represents a barrier to communication

A good social care worker knows that effective communication is a very important part of the job and understands that methods of communication used should be tailored to the individual. The table below lists three examples of barriers to communication and how they may be overcome.

BarrierHow it can be overcome
1. LanguageIf two individual’s do not share a common language, communication can be difficult as they will not be able to understand one another. A rudimentary form of communication can be utilised by using signs, gestures and/or pictures, however a better solution would be to employ the services of a translator or interpreter who is conversant in both languages. Over the long term, one or both individuals could learn the other’s language.
2. Stress/AgitationIt can be difficult to communicate with an individual if they are feeling stressed or upset. In a heightened state of mind it is difficult for anyone to concentrate or hold a conversation, so the primary objective will be to help them return to their baseline. This can be done in a number of ways dependent on the individual. Examples include giving them time and space to calm down on their own, showing them empathy and compassion or offering solutions to their problem. Once the individual is in a calm state, the barrier will be lifted and communication can continue.
3. Sensory Impairment (e.g. deaf, blind, non-verbal)If an individual has a sensory impairment, communication difficulties can be overcome in a variety of ways. Deaf people may use a hearing aid to hear, use sign language or be able to lip read. It is also important to try to avoid an unnecessary background noise. Blind people are still able to speak and listen and can read using Braille. Non-verbal individuals may use writing, pictures, signs and/or gestures to communicate.

This is not a definitive list. Other barriers to communication might include:

  • Shyness: A shy individual may be very anxious about talking to other people, especially those they do not know well. This could be overcome by ensuring the individual is in a comfortable and (ideally) familiar environment, having people with them that they know and trust and working with the individual over the long-term to build trust.
  • Vocabulary: Use of long words or technical jargon may confuse individuals who are not familiar with the vocabulary. This can be overcome by using plain simple language and keeping sentences short.
  • Location: Perhaps the most obvious barrier of communication is the location of the two parties. There may be a long distance that makes meeting face-to-face impractical. Technology such as telephones and the Internet may be used to overcome this.

Explain how an individual’s background can influence the way they communicate

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The background of an individual will have a big influence on how they communicate.

In some cultures, eye contact is viewed as impolite or disrespectful in certain situations, such as between a father and daughter or a professor and student. Similarly, some cultures display emotion and feeling in their communication whilst others are more subdued.

An individual who has been brought up in a close, loving family with lots of affectionate touching may naturally hug everyone they meet, even when it would be considered socially inappropriate, whilst an individual that has been abused in the past may be timid or cower away from people in close proximity to them.

Education (or a lack thereof) can limit an individual’s ability to communicate. They may not be able to read or write and may have a limited vocabulary with which to express themselves.

If an individual is from a different country, their knowledge of the English language could be limited, making it difficult for them to communicate their needs.

Explain why it is important to respond to an individual’s reactions during communication

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During the process of a conversation, an individual may react in a plethora of ways. It is important to observe and respond to these reactions to show that you are listening, keep the conversation going and prevent misunderstandings.

For example, if the individual is nodding whilst you are speaking, and clarifying what you say, it probably means that they are listening and attentive and you should carry on. If the individual looks confused, it may indicate that they do not understand and you may need to re-explain what you are saying in different words. If they are avoiding eye contact and looking in the opposite direction it may mean that they don’t like what you are saying or aren’t interested, so you may need to try a different approach or try again later.

Describe three verbal and three non-verbal communication methods and styles that a social care worker may use in an adult care setting

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VerbalNon verbal
Speaking – The most obvious form of verbal communication is by speaking in a language that both parties are familiar with. It is also important to ensure that the vocabulary used is appropriate for the individual and situation.Touch – Touch can be used to express different feelings to an individual. For example, a pat on the back when they have done something good can make them feel proud and happy or holding their hand when they are having an injection can display compassion and empathy.
Voice Tone – Tone of voice can have a massive influence on how something is communicated. For example, if you gently ask an individual “What’s the problem?”, it will convey that you are interested in the situation and want to offer assistance, whereas if you yell “WHAT’S THE PROBLEM!?” at an individual it would be conveyed as confrontational and aggressive.Gestures – A gesture is a movement of a part of the body to express and idea or meaning and can be used instead of or in addition to verbal communication. For example, holding your thumb up can be used to say ‘yes’ or that something is ‘okay’ and a wave of the hand could mean ‘hello’ or ‘goodbye’.
Written – Verbal communication can also take the form of writing. In an adult care setting , there are many documents and records that need to be kept up to date including Daily Records, Medication Administration Records and Finances. Written records must always be accurate and legible.Facial expressions – Facial expressions is a great way of ascertaining an individual’s mood. Smiling often means an individual is happy and frowns usually mean the individual is sad about something. If an individual has a confused look on their face when you are explaining something, it probably means you need to explain it again or if they are grimacing, it may mean that they are in pain.

Describe three factors to consider when promoting effective communication

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There are a myriad of factors that should be considered when promoting effective communication.

The most obvious is the method used to communicate. This could be verbal, sign language, makaton, pictorial aids or others but should be in line with an individual’s personal preferences.

The environment is another factor  to consider as an improper environment could make an individual feel uncomfortable. Are they too hot or too cold? Is the lighting too dim or too bright? Are there any distractions (e.g. T.V, radio, other people)? Does the individual feel safe? Adjusting these environmental factors could have a positive or negative affect on an individual’s ability to communicate effectively. By understanding and learning about an individual’s personal environmental preferences, it is possible to create the optimum conditions to communicate with them.

Demonstrating active listening is another factor that helps to promote effective communication. Active listening involves focusing attention on the person doing the speaking, listening to what they say and then repeating back to them in your own words what you think they have just said. This ensures that the listener fully comprehends what the speaker is saying and can prevent misunderstandings. It is also a great tool to encourage an individual to open up more as they will be aware that you are listening to what they have to say.

Describe two ways how effective communication can affect relationships in an adult social care setting between individuals using the service, their carers, colleagues and other practitioners.

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Effective communication is very important in an adult social care setting and can have a positive affect on relationships.

For example, communicating empathy when an individual is upset can make them feel cared for and understood, resulting in a deeper connection. Ultimately this builds trust between individuals, creating a more open, transparent and honest relationship.

Accurate and legible record-keeping is another very important form of communication in this setting as it ensures that everyone involved in the care of an individual is well-informed and up-to-date with the individual’s current and changing needs. When everybody is working in the same way, it creates a harmonious and stable atmosphere where an individual, their carers and other professionals can feel happy, confident and satisfied with their day-to-day tasks.