Use and Develop Systems That Promote Communication Essay

Within my role as Team Leader, I communicate with a variety of people for various different ways. This would involve speaking to resident’s families and social workers (this could be in the form of a face –to –face service review which could also include the resident). Additionally, I converse with other healthcare professionals such as a GP. This could be done over the phone to arrange a visit to a resident or to speak regarding medication. Additionally, contacting District nurses for resident intervention is normally done by faxing requests to them.

These are generally the appropriate forms of communication for these healthcare professionals. These requests or instructions are then recorded in a care-plan for an individual. In some cases written down and locked away, in other cases they would be password protected on a secure computer system. Dealing on a daily basis instructing colleagues with their daily duties are also part of my role, as is reporting concerns/giving updates to senior manager. Colleagues would be given written information and concerns from a previous shift, arming them with the information they needed to be effective care givers for the day. In this case, paperwork would immediately be locked away, as would resident care-plans. Information regarding residents may be securely emailed to a regional manager, such as weekly or monthly reports. Primarily, it is the residents themselves that I communicate with the most.

1.2 – Explain how to support effective communication within own job role: Within my role, I feel that it is essential to maintain good relationships with staff, peers and healthcare professionals and this is assisted by good communication. As previously explained, working with a range of multidisciplinary organisations (social services, GPs, hospitals etc.) and resident’s families means that on a daily basis, information is relayed and shared in order to promote the best service for the individual. This is also true in dealing with managers, who need to know specific information in order to effectively run the core care principals of the organisation.

Effective communication becomes commonplace and a core principal needed for continuity of care.

1.3 Analyse the barriers and challenges to communication within own job role As I work within Dementia units, verbal communication is not always the effective way. Some individuals have had a stroke and are unable to speak. Some have high needs Dementia and do not recognise simple verbal instructions. In this case, perhaps the person can write their needs or respond to written instructions or indeed using pictorial imaging as a form of communication. Other’s cannot speak or appear to communicate by reading their facial expressions (generally with carers that know the resident well, or by family intervention). 1.4 – Implement a strategy to overcome communication barriers When dealing with people in the care environment, there may be barriers when communicating.

This could be differences of opinions, language barriers or the understanding of the person you are trying to communicate with. A strategy to overcome barriers could include the use of simple, jargon-free language. Additionally, reducing noise levels when communicating with people would also be of benefit. To show the individual that you are actually listening and processing what they are trying to say and not over-complicating the person with too much information. Also, the emotional state of people is a big factor when communicating. Little is gained when people are engaged in a highly emotional state. Being flexible with targets set, if at all possible and offering constructive feedback to a carer who perhaps might be having an annual appraisal.

1.5 Use different means of communication to meet different needs To meet the needs of relaying information to several people at once, it could be possible to present and communicate this information in the form of a presentation. When dealing with mentally impaired individuals, it would be beneficial to use uncomplicated language or even pictured ‘flash-cards’ (i.e these would illustrate pictures of food, a toilet, a drink, emotional faces to help ascertain what the individual may want). 2 – Be able to improve communication systems and practices that support positive…

2.1 – Monitor the effectiveness of communication systems and practices In July 2012, I helped train members of staff in a new on-line care-planning

system called Abyliss. The initial piece of work was to transfer all paper care plans and risk assessments for all residents onto the computer system. A proposed improvement was the keeping of a small paper file that held a copy of care-plans, medical information and relative’s contact details (along with DNR forms), as a ‘grab-sheet’. This became very effective, as initially there were system failures and a back-up of essential information were needed to hand. 2.2 – Evaluate the effectiveness of existing communication systems and practices In my role, I feel there are systems of communications that are effective and others that are no. A hand-over with night staff, with my day care team is an essential verbal tool, which give staff an update of any concerns that they have. 2.3 – Propose improvements to communication systems and practices to address any shortcomings

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I feel that the current environment has issues regarding communication. I am trying to implement into my new role, a weekly GP round which they had at my previous place of employment. Previously staff would record concerns (not-life threatening) in a GP book. The GP would then come and walk around the units with a Senior Carer and address these concerns. This was opposed to continuously calling out a GP for a non-emergency. This is something I feel needs bringing into my new organisation, as communications with healthcare professionals are essential in maintain up to date care practices.

2.4 – Lead the implementation of revised communication systems and practices. To review previous hand-over sheets that communicates between staff from shift, to shift. It was felt that a simple hand-over book, in the form or a diary would not necessarily be sufficient for capturing all the care needs of the individual. A new one was devised by myself that had a list of names of residents and space to record comments about them in it (i.e. not drinking, loose bowels, challenging behaviour etc.). Additionally, added boxes were made for hospital admissions, GP visits and other healthcare appointments/reviews by healthcare professionals 3 – Be able to improve communication systems to support partnership working

3.1 – Use communication systems to promote partnership working

Communication systems to promote partner working include faxing a pharmacy with a medication change, phoning a social worker to arrange a review of a residents changing health needs or visiting a resident who may be in hospital and liaising face to face with nurses and Doctors, in order to gain current information regarding the person involved.

3.2 – Compare the effectiveness of different communications systems for partnership working

I feel that as I have to fax medication changes to the pharmacy, it is always beneficial to ring and make sure that have received written instructions. I feel that this works well but the pharmacy will also take verbal instructions, based on the fact the prescription is there when they come to bring the new medications. District Nurses will only receive faxed instructions and should there be any reason there is a fax error, it is incredibly difficult to gain intervention from them from verbal communication. Verbal communication works best with a GP, as it is generally an emergency and staff will want to know that they have spoken to someone regarding a resident and action is imminent.

3.3 – Propose improvements to communication systems for partnership working

I feel that verbal instructions backed up with written documentation would be more beneficial to making a service run optimally. An email system linked to partners would be more beneficial, as would limited access to medical records for an individual in care, that may come from hospital with no specific details. 4 – Be able to use systems for effective information management

4.1 – Explain legal and ethical tensions between maintaining confidentiality and sharing information

In the event of a family member phoning and asking for details of perhaps a GP visit that took place earlier, I would need to ensure that this person is who they say they are. This could involve taking a phone number of the person before speaking either directly to the service user (or next of kin) and explaining who has rung and would they be happy to share this information. Taking into consideration that a person’s confidential information is protected under the Data Protection Act and Access to Records policy. The individual may not be able to make decisions for themselves and may have been assessed under the Mental Capacity Act. However, the CQC’s regulations state under the Health and Social Care Act that information may be disclosed when required by law or when it is done to protect and maintain the welfare of the individual.

4.2 – Analyse the essential features of information sharing agreements within and between organisations

Residents (or next of kin where they are not able) are asked to sign a ‘Consent to Share Information’ from. This gives the home permission to share information ‘in the best interest’ of the person, with GPs, social workers, District Nurses, Geriatricians, Occupational Therapists. Additionally, an access to information form is signed by a healthcare professional, before they are allowed to view confidential information. All information and communication is recorded on a person’s daily notes.

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4.3 – Demonstrate use of information management systems that meet legal and ethical requirements

Information management systems that meet legal and ethical requirements involve the storing of sensitive material relating to an individual’s care needs. Generally in the form of a care plan, this would involve material stored on an encrypted computer system (pass worded with a set log-out time so others cannot see information, should a person be called away from their desk) or a paper file which would be stored in a lockable cupboard and the keys kept on a named responsible person. These requirements would be in-line

with the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. Additionally, section 60 of the Health and Social Care Act 2001 deals with confidentiality and states that ‘ patient‐identifiable data should not be provided to third parties’.

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Use and Develop Systems That Promote Communication Essay

Review the range of groups and individuals whose communication needs must be addressed in your own work job role. As an early years practitioner communication within the role is an essential skill required in any setting and is the foundation in which we are able to find out information needed for different purposes. Having an excellent communication scheme allows for a great team and a successful setting, there are many different means to communicate with others, some of these are:

Verbal

Body language/Non-verbal

Sign

Pictorial

Written

Assisted

Personal

Organisational

Formal

Informal

Public

Communication affects everyone within a nursery setting and therefore is a crucial part of managing a nursery. There are many groups of people that we interact with while carrying out our day-to-day duties. All members of staff such directors, managers, teachers, teaching assistants, cleaning staff rely on many different forms of communication to assist with their individual job roles. All job roles come with different responsibilities and without clear and constant communication between them; tasks and team moral will be affected. As a manager there are many techniques and approaches we can apply to ensure that all members of staff are involved and communicated with in the appropriate manner. For example; 5-minute communication meetings each morning, weekly meetings with line managers, team building days, email accounts etc. Children within the nursery, are an essential part of our daily routine and communication with them is of an equal value, however involves a different approach.

There are many important factors to be taken into consideration when communicating with children; firstly, it should always be age appropriate, taking into account the language we chose and the level of the class. Secondly, what are we trying to achieve from our lesson, and finally, how do we respond to the children trying to communicate to us. These factors or techniques should always be considered throughout our day with the children, with some key examples being; circle time, stories, singing, role-play, messy play etc. Parents of children who com to the nursery, play a huge part within a nursery setting and clear communication with them is vital at all times to development a good partnership. Different techniques and approaches within a nursery setting should be applied to ensure that all parents gain clear and concise communication in the correct way.

When dealing with parents on a day to day basis, communicate allows teachers and management to build a good relationship between the children’s nursery and home life, therefore allowing us to put them at ease and help them to understand and be apart of the nursery’s vision and ethos. It is very important to understand that communication does not just involve talking to someone, but about making them feel comfortable to approach a member of staff with any questions, queries or complaints. As management within a nursery it is a requirement to discuss and work closely with all members of staff, parents and children.

Therefore it is crucial to have excellent communication skill in order to deal with situations that may involve individuals from outside your nursery. This will assist with the day-to-day running of the nursery, allowing everyone to keep up the high standards. There are many different external personnel groups that a setting will interact with and as a manager ensuring strong communication with them is key. There are various ways of communicating with these groups and again finding the correct approach is paramount. For example; contacting them by telephone, e-mails, setting up meetings within the nursery or at their organisations, reports, recording books etc.

1.2

Explain how to support effective communication within your own job role. While managing a nursery, it is essential that the management build good positive working relationships with everyone they communicate with, having the ability to be able to talk openly, honestly and clearly, creating an atmosphere of trust and respecting the needs of others while interacting with them. Within a nursery the management will take on a vast amount of roles and responsibilities throughout their daily routine, and so should adjust their approach to communicate in different circumstances if and when needed. Changing communication approaches when developing these relationships with others should help deliver the message effectively. Here are some examples of roles which management will undertake: advising, instructing, welcoming, observing, informing etc.

Management use a variety of different communication methods (shown above in 1.1) to help with the multiple roles they contend with on a daily basis. There are many reasons to be an effective communicator within a nursery, as this will allow the manager to delegate tasks to others, conduct meetings, deliver presentations, supervise, manage appraisals, report, build a team, negotiate and interview etc. Bearing in mind that being a good and effective communicator is being able to adapt their style to the situation and being able to respond in sensitive and empathetic ways to those who they are communicating with. As well as supporting others to become an effective communicator, they should role model effectively and reflect daily on their own communication skills.

1.3

Analyse the barriers and challenges to communication within own job role. Effective communication is paramount to running a successful nursery and the management team should always build strong and positive relationships with the people they may communicate with. If these relationships are not built, communication may become limited and will not be communicated on a meaning full level with the group or individual delivering or receiving the message, which may begin to create conflict between them. It is vital that the group or individual shows respect for one another while being communicated to as this will help keep in the effectiveness of communication. There are several barriers, which may affect clear and effective communication between a group and an individual making communicate ineffective. Ensuring these barriers are solved the management need to find the correct approach to overcome them.

Some of the barriers that a nursery may be faced with are listed below. Firstly, the difference in culture, values and language is a major barrier within applying effective communication as this could block any important information getting through to the appropriate person, and therefore affecting the purpose involved. Communicating with the correct language Being aware and knowing the importance of respecting the cultural differences could help the manager, group or individual deliver or receive highly effective communication.

‘By developing a respectful curiosity about the beliefs and practices within all service users’ lives, we are able to communicate in more meaningful ways.’ (Miller 2006). Secondly, negative feeling towards others has a big impact on the way communication is delivered or received. As a human being, liking and getting along with everyone is not expected and during a working nursery environment interacting with this barrier is incredibly common.

Part of negative feelings can also be affected by body language when communicating with others, as it can be shown easily through actions without speaking. ‘Non-verbal communication can have up to five times the impact on a person’s understanding compared to words. (Argyle 1978). For example, the attitude, appearance and behaviour of the individual show clear signs of negativity. However, working alongside others is a top priority of the managers daily roles and keeping things professional is a major plus when dealing with different situations and is vital to ensure that speech and body language match in order to deliver the message. Finally, a barrier that could challenge effective communication is an inappropriate environment that is being used, could lead to others not understanding the message.

Occasionally, the message could be distorted when the environment is too noisy, to hot or cold and crowded etc. Distractions could have another giant impact in the environment as some people may be easily unfocused on the communication given and so could present to the manager poor work. Therefore, ensuring that the nature of environment is appropriate for the communication being delivered or received is an essential part of effective communicate and a successful nursery. For example, staff meetings are in a large enough area for the number of staff with appropriate seating, temperatures in the area are correct, mobile phones turned off in meetings, quiet area to ensure effective communication etc.

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1.4

Implement a strategy to overcome communication barriers.

Evaluating and reflecting on previous communication with others supports the management to improve and change their communication strategies if needed, allowing them to identify and take adequate action. For example, within my class, I communicated with a teaching assistant (who is of a different culture) explaining prep work I will need for the following week. She did not understand the content of the things I was asking and so I changed my communication method, writing and drawings examples on paper. In respect to cultural, values and language barriers, (an external barrier) staff training should be given, specifically on all types of communication and different strategies they could use in regards to different situations. Some examples that we use in my nursery are; staff training on using home-school communication books with parents, using their nursery e-mail accounts and checking them daily, having parent teacher meetings, using there teaching assistants effectively- having a meeting with them weekly and communicating with them using written communication if verbal has not been successful.

Also training to raise awareness of cultural and religious differences within a nursery. The internal barrier is the body language used when communicating with others; here managers need to be aware of how they present themselves to parents, other members of staff and external services. Reflecting on this each time they are in different situations will allow room to improve in the following situation. ‘Through the development of your self-awareness you can resolve past and current issues and, by doing so, you can improve on your skills in the role of manager’. (Geldard and Geldard 2003). A technique to improve body language as a manager is through ‘SOLER’ (Egan).

Use different means of communication to meet different needs. There are a vast amount of communication methods, which need to meet many individual needs, a range of these are verbal, non-verbal, sign, pictorial, written, electronic, assisted, personal, organisational, formal, informal and public. Some of these methods are listed in more detail below. Verbal Communication- During nursery routines verbal communication is used daily, as most staff discover important information this way. However, this is sometimes not enough as verbal communication can also become complicated due to the meaning of words used and how they are perceived between cultures, leading to a possible ineffective form of communication.

‘The words we use alter depending on the situation and the people involved and, because of this, we can never be sure that a word has the same meaning for two people’. (Porritt, 1990). The words managers use are very important and are as equally important as the tone of voice, pitch, volume, rhythm and timing that are included within the conversation as it can affect the way the message is delivered. For example, talking to an adult like they were a child and receiving tuts and sighing back, shows signs that the individual does not feel comfortable with the way they are being spoken to. This is called paralinguistic communication, which allows us to see signs through the individuals sounds that they may reply, for example, sighing, coughing, tutting, yawning etc.

Non-Verbal Communication- This form of communication uses different factors that we can see without using any kind of speech or sounds. Below is a table containing examples of the different factors individuals may come across when using non-verbal communication.

Facial Expression

Our facial expression communicates emotions unless we train ourselves to mask our feelings. Burnard (1996) argues that it is important to be congruent- if you say you are angry while smiling, it gives a confusing mixed message.

Eye contact and gaze

The way we look into another person’s eyes during conversation is what is known as eye contact. If somebody can hold eye contact through a conversation, it can communicate a level of confidence and willingness to communicate fully. Some of the people we communicate with will have a very low level of eye contact, which might communicate a lack of ease with the conversation or a lack of confidence. It is a good idea to reduce the level of our eye contact to reflect theirs, otherwise it can feel threatening. The appropriateness of maintaining eye contact differs according to culture.

Gestures

Gestures are movements of your arms and hands that accompany speech. Gestures can help communication, for example, pointing at the direction a person needs to go in can add emphasis to the communication. However too much gesturing can be distracting. Body position, posture and movement.

The body position of a client can tell you a lot about how they are feeling- if they are hunched over, with arms and legs crossed, they are probably feeling quite anxious. Rogers (1980) recommends that we relax and it is important not to appear too formal and distant. However if we are too laid back in pour posture, we could appear disinterested. Sitting with our arms and legs can appear closed off and defensive. However, in some circumstances, it may be a good idea to mirror the body posture of the person we are with.

Personal space and proximity

Two to three feet distance between the chairs is about right for me; however I have noticed that some client’s push their chairs back as soon as they sit down in the prearranged chairs. I assume that space does not feel comfortable to them. People seem to have their own invisible boundaries which change according to who they are interacting with and how comfortable they feel. Porritt (1990) calls it a bubble that surrounds us.

Clothes

The clothes we choose to wear say a lot about us. Dressing too informally and too formally can alienate us from our clients. Therapeutic touch Touch can be a contentious subject. On the one hand there is evidence of touch having therapeutic benefits; on the other it can be misinterpreted and seen as an invasion of a person’s personal space. Bonham (2004) suggests it may be appropriate and supportive for staff to touch when clients are distressed as it may validate the degree of their suffering. He suggests that appropriate places to touch in this situation are hands, forearms, upper arms and shoulders. (Tina Tilmouth, T. et al., 2011).

Sign- Using this form of communication is key to those who have hearing impairments and is made up of many gestures, using mainly hands and arms in different signals to communicate. There are different methods of using sign for communicating these are British sign language (BSL), makaton, which helps support speech and baby sign language, which helps communicate with babies and toddlers who have not yet developed their language skills. Pictorial- With this method, communication is primarily through pictures and drawings to communicate effective messages to others. Pictures and drawings are easy to understand and remember, which is why children are shown them from an early age allowing them to understand different instructions.

Written- Within a nursery setting, written communication is used a numerous amount of times throughout daily routines. These can be written reports, notes, and e-mails etc. Written communication allows us to be accurate and keep information up to date, while maintaining clear and effective communication. ‘Written communication should be accurate, in detail, up-to-date non-judgemental and legible so that others are able to read it. We also need to comply with confidentiality guidelines and, as such, all forms of written communication must be kept safely.’ (Donnelly and Neville 2008). Electronic- Several methods of electronic communication that could be used within a nursery setting bearing in mind confidentiality are e-mails, telephone calls, text messaging, web pages, social networking sites, forums and video chats. Some explanations of these methods placed below.

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1. E-mails are the most quick and convenient method of electronic communication within a setting as messages can be sent to an address immediately, alerting the receiver that they have a new message waiting. The receiver can then reply as soon as possible therefore a shorter amount of time for response is predicted. Adding attachments and links may also be included in the mail, showing various images, videos, notices, letters etc. As e-mails are passed back and forth to individuals or groups the conversation between them will preferably be saved, therefore information needed in the future can always be received as long as it has not been eased.

2. Telephone calls and text messages are another electronic communication method and can are used vastly within a setting. Telephone calls along with e-mails are one of the biggest communication methods used in any organisation, and can be used both formally and informally. Telephone calls can have disadvantages, however others could be overheard, also the individuals cannot pick up on non-verbal signs shown by the other person. Text messages are easy and informal and can immediately be delivered to one phone or a group of mobile phones, they can also be quicker than a telephone call.

A text message could be used instead of a telephone call as it can stop a conversation being overheard. 3. Within a nursery setting, promoting high standards is essential and creating a website could help communicate how excellent the setting is to others. Therefore, another electronic communication method is web pages. Creating a web page for a nursery can help provide others seek information needed about the setting. Web pages can contain different information allowing others to view, for example, text, multi-media files including images, sounds, games etc. Web pages can store this information for a good period of time.

4. Social networking sites have become a main electronic communication method over the last 10 years and are a very popular way to communicate with others. A social networking site is made up of individuals that create a profile and build connections with others by a particular type of interest, such as, ideas, values, trades, fashion etc. A nursery setting may become part of an online social networking site creating a page about the nursery to maintain effective communication with parents, bearing in mind confidentiality at all times.

4.1

Explain the legal and ethical tensions between maintaining confidentiality and information sharing. Confidentiality and sharing information is information shared from one individual to another or even to a small group, this information is not to be shared with others and is of the up most importance when dealing with staff, parents and children within a nursery setting. Confidentiality permits parents to have a sense of trust in members of the nursery staff. Polices are set out for staff to respect and obey daily throughout there routines however, staff only have the right to know relevant information not all, and if this is breeched serious action could be taken.

To ensure all staff members understand the policy on confidentiality, training and appropriate guidance and support should be given when needed. (Beauchamp and Childress 1994), defined ‘Confidentiality as ‘keeping secret’ information given to a person by another. Infringement occurs when that information is disclosed to someone else without the giver’s consent’. Within a nursery setting, all confidential files are kept within a locked cabinet and staff are obliged to keep parent and child information confidential at all times, however confidentiality can be broken when a crime has been committed or when the member of staff believes it is about to, malpractice has occurred, child abuse is suspected, to help prevent suicide, or misconduct has occurred, and only sharing the information to the professionals who need to know. If by law, confidentiality is breeched, then the manager has the right to take disciplinary and/or legal action.

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Use and Develop Systems That Promote Communication Essay

Learning outcome 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.

Common groups and individuals that are present in the workplace that may have communication support needs could include: Resident’s with DEMENTIA – Dementia is a progressive illness that over time will affect a person’s ability to remember and understand basic everyday facts, such as names, dates and places. Dementia will gradually affect the way the person communicates. Their ability to present rational ideas and to reason clearly will change. Resident’s suffered from STROKE – A stroke is an injury to the brain. The brain controls everything we do including everything we interpret and understand. A stroke can cause problems with communicating if there is damage to the parts of the brain responsible for language. These functions are controlled by the left side of the brain in most people.

As the brain controls the opposite side of our body, many people who have communication problems after stroke also have weakness or paralysis on the right side of their body. Stroke can also cause communication problems if muscles of the face, tongue or throat are affected. It may result into communication problems like aphasia/dysphasia (difficulty in speaking), dysarthria (happens when a stroke causes weakness of the muscles you use to speak), and dyspraxia (condition that affects movement and co-ordination. Dyspraxia of speech happens when you cannot move muscles in the correct order and sequence to make the sounds needed for clear speech).

1.2 Explain how to support effective communication within own job role. To the staff:

Ask people how they prefer to be addressed and respect their wishes. Give people information about the service in advance and in a suitable format Don’t assume you know what people want because of their culture, ability or any other factor – always ask. Ensure people are offered ‘time to talk’, and a chance to voice any concerns or simply have a chat. If a person using the service does not speak English, translation services should be provided in the short term and culturally appropriate services provided in the long term. Staff should have acceptable levels of both spoken and written English. Overseas staff should understand the cultural needs and communication requirements of the people they are caring for.

Staff should be properly trained to communicate with people who have cognitive or communication difficulties. Schedules should include enough time for staff to properly hand over information between shifts. Involve people in the production of information resources to ensure the information is clear and answers the right questions Provide information material in an accessible format (in large print or on DVD, for example) and wherever possible, provide it in advance. Find ways to get the views of people using the service (for example, through residentsʼ meetings) and respect individuals’ contributions by acting on their ideas and suggestions.

1.3 Analyse the barriers and challenges to communication within own job role.

Barriers in effective communication can become the hurdle in progress of professional life as well as in the personal life. There are various points where the message is misinterpreted in which some are as follows: Material or Physical Barrier: This is the main hurdle or barrier in effective communication at workplace. This barrier in the company comprises large working area which is physically estranged from each other. Other things due to which physical barrier rises may be the organizational environment or noise coming from back. Various things can be included in physical barrier like large working place or working in one section which is physically separate from each other, closed office doors, separate place for people of different rank etc.

These points can be concluded in physical barriers to effective communication: Environmental cause: Too much humidity in atmosphere, light in excess, lofty temperature or bad ventilation are some of the environmental barriers in effective communication. Challenging Stimulus: If there is loud music or noise in the background and there is distance between sender and receiver then it becomes very difficult to send the correct message by the sender to the receiver. Subjective strain: Due to bad health, too much mental stress, lack of proper sleep or consumption of medicines, the receiver can never understand the message appropriately.

Linguistic Barrier: Different language and vocabulary is another barrier in communication. Language is vague in nature and its words are symbols which hardly represent only one meaning. The meanings of these symbols or words are understood by the sender and receiver in their own way which can result in misinterpretation. If communicator uses difficult or inappropriate words or if message is not explained in proper manner then it can result in misinterpretation. It is the language only that plays vital role in every field so it should be kept in mind that proper language and words are used. In today’s world if you send your message to another person in his language then it will be more effective and in this way the communication can be made effectively.

Cultural Barrier: You will find diverse culture barrier to effective communication in this world. This communication barrier arise when two people of any organization belongs to different culture, place or religion. There are many other factors of cultural barrier like age, social position, mental difference or thinking behavior, economic status, political views, values and rules, ethics or standards, motives and priorities. The communication done without mixing any culture will not miss its meaning, but once a culture is mixed up with the communication then it may lose its exact meaning. Emotional barrier: Every person takes the situations and affair in his own way as everyone differs from each other. Many times thoughts of the person become strong base for communication. There are many emotions which can be the cause of effective communication barrier. Examples include anger, fear, or hostility.

Apart from these some barriers to effective communication are mentioned below: Sudden reactions: Many times while communicating, a listener makes comment or criticizes the message sender without waiting for the sentence to be completed. So it’s very necessary to be keep patience and speak once the communicator completes his speech. Unfair assumptions: Never make wrong assumptions of the message as it creates great confusion. For example, you incorrectly assumed that your subordinate have understood the thing you have explained regarding any issue. Terror: This emotion makes the person to think slowly. He becomes narrow minded.

This makes the negative impact on effective communication skill. Person becomes defensive: Man who cannot communicate effectively just tries to justify himself every time because he thinks that accepting the mistake means degradation. This kind of attitude is a great obstacle in the effective communication. Being overconfident about self-knowledge: There are number of persons existing in this world that are overconfident about themselves that they have enough knowledge about any subject. But when you talk to such people, you will discover that they don’t have enough knowledge nor such people accept that they can be wrong. This is another hurdle in effective communication.

1.4 Implement a strategy to overcome communication barriers. In our care practice we have a significant number of service users who have communication difficulties due to dementia and post-stroke. The following strategies are identified in order to have an effective communication and be able to understand and meet their needs.

1. Residents with dementia.

speaking clearly and slowly, using short sentences making eye contact with the person when they’re talking, asking questions or having other conversations giving them time to respond, because they may feel pressured if you try to speed up their answers encouraging them to join in conversations with others where possible letting them speak for themselves during discussions about their welfare or health issues, as they may not speak up for themselves in other situations trying not patronise them, or ridiculing what they say

acknowledging what they have said, even if they don’t answer your question, or what they say seems out of context – show that you’ve heard them and encourage them to say more about their answer giving them simple choices – avoid creating complicated choices for them using other ways to communicate – such as rephrasing questions because they can’t answer in the way they used to 2. Residents suffered from stroke with communication problems. Keep your own language clear and simple.

Speak in a normal tone of voice.

Don’t rush the conversation. Give the person time to take in what you say and to respond. Assume the person can hear and understand well, in spite of any difficulties responding, unless you learn otherwise. Stick to one topic at a time using short sentences. For example, instead of saying, “Your wife called and she will be here at 4pm to pick you up and take you home”, say: “Your wife called.” (pause) “She will be here at 4pm.” (pause) “You can go home then.” Use all forms of communication to help reinforce what you are saying, such as clear gestures, drawing, communication aids. Use adult language and don’t “talk down” to the person with aphasia. Even if someone understands little or nothing, remember they are not a child. Don’t interrupt them. Watch out for when they are finished, or when they are looking for help. Ask if your help is needed before giving it. If it helps them to remember things, make use of a diary, calendar or photos.

Lists of words or options to select from can help. If they can’t think of a word, ask how it is spelt. Write down the first letter or syllable as a prompt. Write down key words with a marker pen. Write clearly in lower case and don’t underline. Keep the lists of words to refer back to. If they prefer, guess the word they can’t find and ask if it’s correct. If they are keen to find the right word, give them more time to respond, or guess their meaning and check out if you’re correct. Otherwise, if they prefer and you’ve understood the message, just carry on the conversation. If easier for them, establish the general topic of their message by asking careful questions that only require a ‘Yes’ or ‘No’ answer. Give them plenty of time to respond. Don’t ask too many questions too quickly, as they may feel overwhelmed and become frustrated.

1.5 Use different means of communication to meet different needs. Members of the health care staff use different ways of communication in order to meet the needs and preferences of the service users. Staff should be familiar with the difficulties of communication that a certain resident may have in consideration to their medical condition. They used verbal and non-verbal communication that varies depending on the individual’s needs and difficulties. Below are examples of different ways of communication to meet the different needs of clients. Verbal communication uses words to present ideas, thoughts and feelings. Good verbal communication is the ability to both explain and present your ideas clearly through the spoken word, and to listen carefully to other people.

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This will involve using a variety of approaches and styles appropriate to the client you are addressing. Non-verbal communication – This refers to the messages we send out to express ideas and opinions without talking. This might be through the use of body language, facial expressions, gestures, tone of voice, touch or contact, signs, symbols, pictures, objects and other visual aids. It is very important to be able to recognise what a person’s body language is saying, especially when as a health or social care worker you are dealing with someone who is in pain, worried or upset. You must also be able to understand the messages you send with your own body when working with other people.

Written communication -This is central to the work of any person providing a service in a health and social care environment when keeping records and in writing reports. Different types of communication need different styles of writing but all require literacy skills. A more formal style of writing is needed when recording information about a patient. Technological aids- Technology is moving so quickly now that we have many electronic aids to help us communicate. For example, we have computers on which we can record, store and communicate information very quickly and efficiently over long distances.

Learning outcome 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. To the staff – Two monthly supervisions are being practice in our workplace in order to address the needs and concerns of the members of the health care staff. Work schedules, preferences, relationship with other staff and continuing professional development (trainings, study days, etc) are some of the topics being discussed during supervisions. Meeting are also held on a regular basis. To the service users – Part of the care plan of each client is their communication needs.

Changes or difficulties in communication are being monitored or evaluated monthly. This file is accessible to members of the health care staff to familiarize themselves to the mode of communication effective to a particular resident. To families of service users – regular meetings with families of residents is being practiced. Management of the health care staff are approachable to address their needs or concerns with regards to the care being provided to their family member. 2.2 Evaluate the effectiveness of existing communication systems and practices 2.3 Propose improvements to communication systems and practices to address any shortcomings

Evaluation of existing communication system is very important in order to meet the needs of the service users, maintain the high morale of the staff and satisfy the relatives of the residents. The following are the existing communication systems and practices in my workplace. Communication System Scores: 1-5 (1=very poor; 2=poor; 3=adequate; 4=good; 5=very good) Staff Handover (4) – Staff should be provided with adequate information to changes happened to a particular resident in a particular shift. Staff Supervision (4) – Management should not take it personally when providing constructive criticisms.

Care plan recording (4) – staff should ensure that files are updated on a regular basis. All staff should be familiarise to the different needs of each resident. Complaints Procedure (4) – Ensure that all service users and family members are aware of the procedure in making a complaint. Call Bell System (4) – Service users to differentiate the normal call button from the emergency button. Telephone Log (4) – Staff should be trained in confidentiality regarding sharing of patient’s information. 2.4 Lead the implementation of revised communication systems and practices

Learning outcome 3: Be able to improve communication systems to support partnership working. 3.1 Use communication systems to promote partnership working. 3.2 Compare the effectiveness of different communication systems for partnership working. 3.3 Propose improvements to communication systems for partnership working.

In a Nursing Home you communicate with different agencies and departments of the health care in order to meet the optimum level of care that the services users deserved. Liaise with GP’s, dietician, Occupational Therapist, Pharmacist, Clinics and other members of the health care setting contributes in the effectiveness of communication for partnership working. These are the list of problems that are identified with the current system and proposed improvements in order for partnership working to be effective. GP Visits – Doctors should trust the decision making of healthcare staff because they are more familiar with the behaviour and changes of service users. Medication Ordering – Pharmacists should delete the medications that were stopped from the repeat prescriptions in order to prevent medication errors. Electronic ordering should be considered to Nursing Homes in order to save time and effort.

Referral to dieticians, podiatrist, SALT and OT – Preferably nurses should directly refer to these departments in order to save time and decrease the actual waiting time for visits of service users. Learning outcome 4: Be able to use systems for effective information management 4.1 Explain legal and ethical tensions between maintaining confidentiality and sharing information. Confidentiality is an important value within the healthcare setting for clients, their families and employees. Important confidentiality issues are trust and client safety. Personal and private information such as health diagnosis, feelings, emotions and financial status must be restricted to people who have an accepted need to know. NMC [online] 2002 confirms that confidentiality is the respect for the privacy of any information about a client/patient. The Value Base ( a system of values to guide the care profession) states that confidentiality of records and information should be discussed with clients if possible, however some information can be kept from a client if it were to cause them to self-harm (physically or mentally).

If clients/patients know that personal details and conversations are private it will enable them to feel safe and that trust is present. Clients/patients should be told that other health professionals involved in the care of them have a need to know of some confidential issues to enable better recovery for themselves. It sets rules for and applies to personal information, paper records and computer held records. It covers data held in the respect of any individual including financial and credit information, membership of organisation, medical, health and social services records. Nolan Y, (2001). Good record keeping helps to protect patients and clients by promoting: – High standards of clinical care and continuity of care – Better communication between health care professionals regarding information of clients/patients. – An accurate account of treatment, care planning and delivery. Confidentiality arises when service uses keep information about themselves off the record and determine how recorded information about themselves is shared and used.

Users of services can control information about themselves by refusing to disclose it at all and this is the most obvious way to do so. Whatever service it is, there will be always a minimum amount of information which the client has to disclose as a condition for receiving the service, hence would- be users of services don’t have a real choice about keeping information. However confidentiality policies are important in carework. Most records in health and care are made with a view to the information being shared.

This is so that continuity of care is not vulnerable to individual practitioners becoming sick, going on holiday or changing their jobs. Records are an important facility for co-ordinating care. However sharing the information in records raises issues about whom the information should be shared with, what they may or may not do with, and what rights clients have to know how and with whom information about themselves is likely to be shared. The code: Standards of conduct, performance and ethics for nurses and midwives’ (2008) states: “You must respect people’s right to confidentiality.”

“You must ensure people are informed about how and why information is shared by those who will be providing their care.” “You must disclose information if you believe someone may be at risk of harm, in line with the law of the country in which you are practising.” Confidentiality is a duty of confidence arises when one person discloses information to another in circumstances where it is reasonable to expect that the information will be held in confidence. This duty of confidence is derived from:

common law – the decisions of the Courts

statute law which is passed by Parliament.

Confidentiality is a fundamental part of professional practice that protects human rights. This is identified in Article 8 (Right to respect for private and family life) of the European Convention of Human Rights which states: Everyone has the right to respect for his private and family life, his home and his correspondence. There shall be no interference by a public authority with the exercise of this right except such as is in accordance with the law and is necessary in a democratic society in the interests of national security, public safety or the economic well-being of the country, for the prevention of disorder or crime, for the protection of health or morals, or for the protection of the rights and freedoms of others.

The common law of confidentiality reflects that people have a right to expect that information given to a nurse or midwife is only used for the purpose for which it was given and will not be disclosed without permission. This covers situations where information is disclosed directly to the nurse or midwife and also to information that the nurse or midwife obtains from others. One aspect of privacy is that individuals have the right to control access to their own personal health information. It is not acceptable for nurses and midwives to:

discuss matters related to the people in their care outside the clinical setting discuss a case with colleagues in public where they may be overheard leave records unattended where they may be read by unauthorised persons.

Legislation

All nurses and midwives need to be aware of the following pieces of legislation relating to confidentiality: The Data Protection Act 1998 – This Act governs the processing of information that identifies living individuals. Processing includes holding, obtaining, recording, using and disclosing of information and the Act applies to all forms of media, including paper and electronic. The Human Fertilisation and Embryology Act 1990 – Regulates the provision of new reproductive technology services and places a statutory ban upon the disclosure of information concerning gamete donors and people receiving treatment under the Act. Unauthorised disclosure of such information by healthcare professionals and others has been made a criminal offence. The National Health Service Venereal Disease Regulations (SI 1974 No.29) – This states that health authorities should take all necessary steps to ensure that identifiable information relating to persons being treated for sexually transmitted diseases should not be disclosed.

The Mental Capacity Act (2005) – This provides a legal framework to empower and protect people who may lack capacity to make some decisions for themselves. The assessor of an “individual’s capacity to make a decision will usually be the person who is directly concerned with the individual at the time the decision needs to be made” this means that different health and social care workers will be involved in different capacity decisions at different times. The Freedom of Information Act 2000 and Freedom of Information (Scotland) Act 2002 – These Acts grant people rights of access to information that is not covered by the Data Protection Act 1998, e.g. information which does not contain a person’s identifiable details. The Computer Misuse Act 1990 – This Act secures computer programmes and data against unauthorised access or alteration. Authorised users have permission to use certain programmes and data. If the users go beyond what is permitted, this is a criminal offence.

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Disclosure

Disclosure means the giving of information. Disclosure is only lawful and ethical if the individual has given consent to the information being passed on. Such consent must be freely and fully given. Consent to disclosure of confidential information may be: Explicit consent is obtained when the person in the care of a nurse or midwife agrees to disclosure having been informed of the reason for that disclosure and with whom the information may or will be shared. Explicit consent can be written or spoken. Implied consent is obtained when it is assumed that the person in the care of a nurse or midwife understands that their information may be shared within the healthcare team. Nurses and midwives should make the people in their care aware of this routine sharing of information, and clearly record any objections.

Disclosure without consent – The term ‘public interest’ describes the exceptional circumstances that justify overruling the right of an individual to confidentiality in order to serve a broader social concern. Under common law, staff are permitted to disclose personal information in order to prevent and support detection, investigation and punishment of serious crime and/or to prevent abuse or serious harm to others. Each case must be judged on its merits. Examples could include disclosing information in relation to crimes against the person e.g. rape, child abuse, murder, kidnapping, or as a result of injuries sustained from knife or gun shot wounds. These decisions are complex and must take account of both the public interest in ensuring confidentiality against the public interest in disclosure. Disclosures should be proportionate and limited to relevant details.Nurses and midwives should be aware that it may be necessary to justify disclosures to the courts or to the Nursing & Midwifery Council and must keep a clear record of the decision making process and advice sought.

Courts tend to require disclosure in the public interest where the information concerns misconduct, illegality and gross immorality. Disclosure to third parties – This is where information is shared with other people and/or organisations not directly involved in a person’s care. Nurses and midwives must ensure that the people in their care are aware that information about them may be disclosed to third parties involved in their care. People in the care of a nurse or midwife generally have a right to object to the use and disclosure of confidential information. They need to be made aware of this right and understand its implications. Information that can identify individual people in the care of a nurse or midwife must not be used or disclosed for purposes other than healthcare without the individuals’ explicit consent, some other legal basis, or where there is a wider public interest.

Information Sharing Protocols – These are documented rules and procedures for the disclosure and use of patient information between two or more organisations or agencies, in relation to security, confidentiality and data destruction. All organisations should have these in place and nurses and midwives should follow any established information sharing protocols. Confidentiality after death – The duty of confidentiality does continue after death of an individual to whom that duty is owed. Information disclosure to the police – In English law there is no obligation placed upon any citizen to answer questions put to them by the police. However, there are some exceptional situations in which disclosure is required by statute. These include: the duty to report notifiable diseases in accordance with the Public Health Act 1984 duty to inform the Police, when asked, of the name and address of drivers who are allegedly guilty of an offence contrary to the Road Traffic Act 1998 the duty not to withhold information relating to the commission of acts of terrorism contrary to the Terrorism Act 2000 the duty to report relevant infectious diseases in accordance with the Public Health (Infectious Diseases) Regulations 1998.

The Police and Criminal Evidence Act (1984) – This Act allows nurses and midwives to pass on information to the police if they believe that someone may be seriously harmed or death may occur if the police are not informed. Before any disclosure is made nurses and midwives should always discuss the matter fully with other professional colleagues and, if appropriate consult the NMC or their professional body or trade union. It is important that nurses and midwives are aware of their organisational policies and how to implement them. Wherever possible the issue of disclosure should be discussed with the individual concerned and consent sought. If disclosure takes place without the person’s consent they should be told of the decision to disclose and a clear record of the discussion and decision should be made as stated above. 4.2 Analyse the essential features of information-sharing agreements within the and between organisations.

These are the usual subjects that are applicable in sharing information within and between organizations: Complaint Procedure – Service users and relatives are informed regarding the proper procedure in filing a complaint. This guideline is posted and accessible in the nursing home. Infectious Disease – The care home should produce a written policy that details the roles and responsibilities of the staff during an outbreak of communicable disease or episode of infection. The plan should include details of the roles and responsibilities of senior personnel as follows. The owner of a home is responsible under health and safety legislation for maintaining an environment which is safe for residents, visitors and staff alike. Suitable arrangements and procedures for control of infection would form part of the health and safety requirements.

The registered manager should have 24-hour access to advice on infection prevention and control from a suitably qualified and competent individual. It is good practice for the registered manager to produce an annual report on the systems in place for the prevention and control of infection and how these are monitored. The report should contain information on incidents and outbreaks of infection, risk assessment, training and education of staff, and infection control audit and the actions that have been taken to rectify any problems. The person in charge should ensure that appropriate infection control policies and procedures exist, are readily available, are understood by all members of staff and are used within the home. Health and Safety – We complete all of the necessary risk assessments and procedures (Fire, COSHH, Premises, Administration of Medicines, Clinical Waste Disposal & Handling, Food-Personal Hygiene, Infection Control, Use of Stairs, Use of Wheelchairs, Use of Bathrooms, Maintenance of Showers, Lone Working, Manual Handling, Expectant Mother, Office Safety, Passenger Lifts and many more).

We write Health and Safety policies, review and provide staff training (Specialist Training and Safety Training). Medical Records – The Health Insurance Portability and Accountability Act produced the Standards for Privacy of Individually Identifiable Health Information rule which requires health care providers to make reasonable efforts to use, disclose, and request only the minimum amount of protected health information needed to accomplish the intended purpose for which the information is being used, disclosed, or requested. This means the authorized entity requesting the information may not use, disclose, or request the entire medical record for a particular reason unless it can justify the whole record as the amount of information reasonably needed for that purpose. 4.3 Demonstrate use of information management systems that meet legal and ethical requirements.

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Use and Develop Systems That Promote Communication Essay

1. Be able to address the range of communication requirements in own role.

1:2 – Explain how to support effective communication within own job role.

Everyone in a managerial role is responsible for establishing the communication needs of the service users, providing appropriate support and ensuring any equipment needed to communicate is available. The Managerial role is to empower and promote the rights of every person taking into account individual needs, wants and rights.

Before any support can be given, the individual’s ability, needs and most importantly preferences should be considered and taken into account. When an individual enters any care setting they should have their needs and preferences assessed and a base line established with regard to communication abilities. Effective methods of communication should be established. This is the initial assessment.

Every organisation will have their own forms where these details should be recorded. Establishing a baseline by observing ways in which the individual communicates and the method they use is essential. Everyone, regardless of whether they have a Learning Difficulty or health need has the right to communicate using their chosen method and their choice should be acknowledged and respected. During an initial assessment, an individual’s ability and communication methods will be established. Everyone involved in the care of the individual should be made aware of their baseline, needs and preferences regarding communication and any changes that are recognised during reviews. This information should be recorded and shared with the team to ensure the individual’s needs are met.

Within any job role communication is initiated with a variety of people including Service Users, relatives and carers, employees and colleagues, Health Care Professionals (i.e. GP, Consultants, Community mental Health Team), Social Services and Safeguarding Teams. Effective communication is vital.

Key people that should be included in partnership working are listed below. These people should be included in the initial assessments and any reviews in order to access information and support and to ensure you get the best from an individual’s communication abilities.

Family and friends – are important to the individual. The individual must be supported to communicate with their loved ones using the appropriate method. Sometimes close family members do what they think is best for the individual rather than asking what the individual wants. The family may need to be educated and supported to ensure they allow the individual to make choices and use their preferred method of communication. Speech Therapists – assess and support the individual’s speech development. They may work with individuals who have difficulty in swallowing which will have an effect on an individual’s communication needs. The therapist works closely with other professionals and the family of the individual to ensure the communication methods are used correctly to maximise effectiveness.

GP’s are consulted to ensure there are no unknown health needs that could affect communication and to access important information. Psychologists – are involved in assessing patterns of behaviour associated with certain conditions. These could include depressions or anxiety. Psychologists also offer support to carers in the best ways of working with individuals to ensure the highest rate of success and therefore the best results for the individual. Psychiatrists – assess and treat people with mental health problems, learning disabilities, behaviour disorders, dementia and epilepsy. They can be informative in supporting the individual’s communication needs.

Occupational Therapists – support the individual to develop fine motor skills. Some methods of communication require the use of fine motor skills, including the use of keyboards (e.g. the lightwriter). Care staff are often the first port of call for Health Care Professionals and usually spend the greatest amount of time with the individual if they are in long-term residential care or need a high level of support in their own home. Often the care staff will know an individual extremely well and can recognise and interpret the intricacies of the individuals communication. Behavioural Support Service Workers – work with individuals and their carers in developing appropriate methods for the individual to express themself in non-challenging ways.

Through regular staff, relative/carer and Service User meetings and/or reviews, information can be shared, efficient and effective health care and support given and decisions reached regarding assessed needs and outcomes/achieved outcomes. Effective communication means that the Individual is at the centre of every decision.

When planning such meetings the use of a planned agenda which is distributed to the relevant parties and requests for suggestions and additions to the agenda are beneficial in opening the lines of communication. When planning review,s the last review should be researched and any outcomes achieved should be noted and shared at the meeting. Any changes to the review information should be checked and changes made accordingly. Minutes of meetings should be taken and distributed to relevant parties following the meeting. This is also a valid way to communicate with parties who could not attend. Those who attended the meeting will be reassured to have written testimony of what was covered in the meeting and an accurate and factual account for future reference.

Informal communication in the form of one to one chats with both staff and service users is also vital in maintaining the line of communication. When in a managerial role it is necessary to make yourself available to staff and Service Users in order to build relationships and maintain an open line of communication.

The use of handover sheets, daily diaries, care plans, supervisions and appraisals are all forms of communication used within the Day Care setting.

The use of an electronic diary system is also invaluable as a quick and efficient way of sharing information with colleagues This enables one to one interviews, meetings, reviews and supervisions to be pre-booked and others to have access to this information. This communication system is used very effectively within our management team; all members have an electronic diary in place via a central server and share information with others allowing the smooth running of diary entries.

One of the most important and valuable forms of effective communication is an ‘open door policy’, ensuring that staff, relatives/carers and Service Users are aware that you are available to discuss matters at their convenience. This form of communication instils confidence in the day care setting ensuring that everyone feels ‘listened to’ and that communication is paramount in the day to day running of the centre.

Effective communication improves the quality of life of people. It is essential that efforts are made to enhance communication, time is made to listen and to understand. In a managerial role best practice is essential. This includes ensuring that:

Staff are aware of the different communication needs of different individuals including taking account of any hearing or visual problems or where English is a second language. Staff are trained to understand the importance of verbal and non-verbal communication ad barriers to effective communication. A multi-disciplinary approach is used to implement communication strategies Staff are able to access specialist advice and information

Advocacy services are utilised

1:3 – Analyse the barriers and challenges to communication within own job role.

Communication is a fundamental relationship-building skill in the workplace. If people don’t communicate well they limit their ability to connect on any meaningful level and in extreme cases this can create conflict. Depending on your position and role within your workplace, others will have expectations of how you should communicate. It is important that respect is shown to those you work with.

The General Social Care Council’s Code of Practice states that communication should be conducted in an appropriate, open, accurate and straightforward way. By communicating in this manner others will have trust and confidence in you and your abilities. Workplace relationships become a lot stronger when people can clearly and effectively communicate what they need and allow others to do the same.

There are many barriers to effective communication. Anything which blocks the meaning of a communication is a barrier. The first barriers to check out are those that you could be creating. You may think that you are doing everything possible to assist communication, but be sure that you are not making it difficult for people to understand what you say for instance using acronyms another person does not understand. Avoid professional jargon and terminology. Not listening effectively is another barrier that could affect communication, both when making requests and receiving them. Noise is a constant barrier to communication in the care environment. Sharing an office with other people, telephone conversations, background noise or people talking and playing music.

Physical barriers – these are due to the nature of the environment where you are trying to communicate. It could be that there are distractions and/or noise, such as the TV on, an inappropriate temperature, making the room too hot or cold. Is the room light enough? Are you positioned so that you are close enough to be heard but not invading the individual’s personal space?

Physiological barriers – personal problems and worries can lead to lack of concentration. Memory loss (dementia) can also create significant issues with communication. Distress – When someone is distressed, they might find it hard to communicate. They may not listen properly and not understand what is being said and may also be tearful or have difficulty speaking Emotional Difficulties – can cause the individual to be unable to listen to what is being said and can lead to misunderstandings. When someone is feeling ill, they may not be able to communicate as effectively as when they are feeling well. .

Language differences – this could be due to the choice of words used. Others linguistic abilities may differ from your own, leading to poor explanations and misunderstandings. Do they speak the same language as you?

Lack of subject knowledge – leading to poor explanations or answers to questions.

Stereotyping – When an individual has a preconception about another individual, to makes it difficult for the individual not to view the other individuals communication with prejudice.

Sensory Loss – When someone has an impairment to one or more of their senses, most commonly a visual or a hearing disability, they may have a problem receiving, retaining or passing on information.

One of the main barriers in communication that are faced within my job role is that of clinical barriers. Many of the Service Users who attend the centre have a diagnosis of a learning difficulty and/or cognitive impairment. The use of body language, gestures and pictures are often used as alternative forms of effective communication when supporting this client group. Other individuals may be non-verbal, have a loss of speech or impairments in speech, sight or hearing, all having an effect on communication and making effective communication more challenging.

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Equipment such as picture boards (PECS) can be a useful tool in minimising these barriers along with touch and written word and Etran boards or computer systems such as Eye Gaze. In my experience emotional barriers are often detrimental in the line of communication between staff and relatives. It can be very distressing for relatives to witness their loved ones either contract a long-term or life altering illness from disease or accident especially if this results in altered behaviour or through a learning difficulty or altered diagnosis if a physical/learning difficult deteriorates over time. Ensuring relatives have sufficient time to understand information or supplying them with information leaflets gives time to take the information away with them, to their own environment, which may help them understand what you are trying to communicate.

Giving relatives/carers clear contact details is beneficial ensuring that they are confident with communication links between them and the centre/carer. Giving links to other lines of communication and help, such as voluntary organisations or support groups can also be effective. These strategies can help overcome emotional barriers to communication they may be facing. Different means of communication are used to meet differing needs. Care Plans, handover sheets, notice boards and staff meetings are used to ensure staff are kept updated.

2. Be able to improve communication systems and practices that support positive outcomes as individuals.

2:2 – Evaluate the effectiveness of existing communication systems and practices.

Once you have established and agreed the methods of communication and support which you are to provide the individual with, it is important that you evaluate the effectiveness of that support. The agreed method of communication and support are only effective for as long as the individual’s communication skills remain the same. If their skills change then so do their support needs.

As a manager you will be expected to recognise and act on changes to the individual’s communication skills. This can be done by monitoring feedback from staff, the individual, the individual’s family and other professionals involved in the individual’s care and by observing the individual when they are communicating with you, carers, friends and relatives. In this way you are able to evaluate if the communication method is working and also recognise any changes as they occur. The most obvious changes are when an individual is not able to of what they used to do. For example you notice that you are having to repeat things more often or they request that their TV/radio is louder than before.

As well as the individuals communication skills becoming worse, an individual’s circumstances and abilities could improve. This could be in the case of an individual who had suffered a stroke. With therapy and encouragement their speech could improve so that they are able to gradually express their needs through speech. These changes need to be collated, discussed and available to everyone in the acre team so all are aware and can add their views and opinions.

With regards evaluation of the effectiveness of existing communication systems and practices between individuals, staff and management, it is important that you have established a system in the workplace where regular meeting take place and everyone’s view and opinions are discussed and valued. Other communication methods in the workplace could include:

Staff communication books – daily notes which are not confidential Staff notice boards – details off personal development, training opportunities, staff rotas Staff handover – discuss recent events re individuals

Complaints procedure – everyone should be aware of the process and how to complain Care plan records – confidential daily records

Supervision – staff can discuss any issues.

2:3 –Propose improvements to communication systems and practices to address any shortcomings

It is important that everyone involved in care of the individual works as part of a team to establish the best support for that person. This is known as multidisciplinary working.

When changes occur it is important that the correct help and support is obtained immediately so that the individual does not feel frustrated or isolated by being unable to communicate effectively. You will need to access appropriate support and have access to sources of information and resources in able to do this. It is therefore important to immediately deal with any changes to the individuals communication skills. Encouraging carers, family and friends to monitor an individual for change will lead to positive outcomes. If changes are identified, carers should record this stating the date, with a factual entry of what was observed or how you identified the change followed by a signature and status. These should then be formally reported to you as the manager and any required actions taken immediately.

Significant changes in an individual’s ability to communicate should be referred to the speech therapist or GP involved in the individual care for professional investigation and monitoring. If no changes have been reported, reassessment should be undertaken on a yearly basis and should involve both the individual and key people in their lives, including their family, friends, partner, speech therapist, GP, psychologist, psychiatrist, occupational therapists, care staff and any other significant person involved in the individual’s life. This is known as a multidisciplinary review. This ensures the continued development of the individual’s communication.

With regards staff communication systems and practice it is important to evaluate these on a regular basis in order to address any shortcomings. To avoid any shortcomings;

All staff should attend training regarding completion of communication records and confidentiality and should be aware of the workplace policies and procedures regarding these areas. All staff should be aware of the complaints procedure in the workplace and have the knowledge of who/where they should complain for themselves and also on behalf of an individual. All staff should have regular supervision where they are able to voice their concerns Regular hand over and team meetings where everyone can discuss concerns and feedback on all areas of problem.

3. Be able to improve communication systems to support partnership working.

3;2 – Compare the effectiveness of different communication systems

Effective communication between partners is essential to good partnership working. Without effective communications staff can feel very isolated. Interaction needs to be on-going and partners needed to be mindful of the need to reduce jargon to promote clarity of understanding. Inclusion of the views of service users and their carer are also important to the communication process, both as a means of helping staff to look at things in new ways and to bring diversity and creativity to the process.

There are many different communication systems which can be used in partnership working. Computerised systems with shared records and access for example hospitals and GP’s now share some computerised information and medical records. This ensures continuity of care and service with immediate access to records. It avoids the need for paper records which increases the need to secure storage and accurate filing systems. This also allows for faster retrieval of information and an increased frequency with which information is collected and shared. It also ensures a standardised system across the partnership working. Any system used has to be available, effective and efficient in order to benefit all partners involved.

3:3 – Propose improvements to communication systems for partnership working.

If you feel there is room for improvement to communication systems for internal partnership working this could be proposed by calling a meeting in your workplace and discussing your proposals or, proposals could be made through written communication. By liaising with external partners at regular meetings and discussing, listening and hearing ideas and problems, solutions will be able to be found to any communication improvements which need to be made. Sometimes this may mean reaching compromises or it may just involve alleviating the anxieties of others in the partnership.

The use of effective communication systems with our partners is essential in ensuring a close link is maintained. Our communication needs to take into account the differing relationships we have with these partners. The needs of the partnership we have with relatives will be very different from that of our regulators. However, there are also many similarities. All communication should be accurate, timely and courteous. It is merely the way in which we communicate that may vary. Most communication with family may be informal, day to day nature with all parties keeping each other informed. Care reviews and relatives meetings also play a vital part in the effective communication between the two.

4. Be able to use systems for effective information management.

4:1 – Explain legal and ethical; tensions between maintaining confidentiality and sharing information.

The Data Protection Act 1988 – governs the storage and use of information collected but your organisation. In order to keep personal records the organisation must be registered with the Data Protection Register. Some of the relevant aspects of the Act are: The information should only be used for the purposes explained when it was collected The information should not be disclosed to anyone who has no right to see it The information collected should be relevant and contain no more than is necessary for its purpose The information should be accurate when collected and where necessary kept up to date Individuals should have access to the data held about them

Appropriate security measures should be taken to prevent unauthorised access to data

Caldicott principles

1. Justify the purpose for which the information is needed. 2. Only use personally identifiable information when absolutely necessary. 3. Use the minimum personal identifiable information possible – if possible use an identifier number rather than a name. 4. Access to the information should be on a strict need to know basis. 5. Everyone should be aware of his/her responsibilities to respect client confidentiality. 6. Understand and comply with the law. The most relevant legislation is the Data Protection Act 1988, the Police and Criminal evidence Act 1984 and the human Rights Act 1988.

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Essential standards for quality and safety Complance Criteria

5. You can expect you care provider to constantly check the quality of its services.

Your care provider will continuously monitor the quality of its service to make sure you are safe. If you or someone acting on your behalf makes a complaint, you will be listened to and it will be acted upon properly. Your personal records, including medical records will be accurate and kept safe and confidential.

The Human Rights Act 1988 – Article 8 stated “The right to respect for private and family life, home and correspondence”

Public Interest Disclosure Act (1999) – This act, sometimes called the “whistle blowing act” is not solely for people working in the caring professions but for any employee in any sector of employment. It has its place in considering other perspectives of confidentiality and relates more to corporate consideration than perhaps individual or personal confidences shared. It allows people at work to raise genuine concerns about crime, negligence, miscarriages of justice, dangers to health and safety and applies whether the information is confidential or not. The Act seeks to protect “Whistleblowers” from dismissal and victimisation and thus promotes the public interest and potential extra protection for vulnerable people in society.

Generally confidential information can only be disclosed if it is in the Individual’s best interests, for the protection of others, in their interest of public health, during an official or legal investigation, or if there has been or there is a risk of a serious crime committed. Individuals using care services need to feel that their personal information is kept confidential, even from family members. This builds trust between you and the individual. In formal relationships such as in a carer/service user, trust is based on the assumption that because the carer is in a professional role they are governed by laws and legislations, ethics and principles which protect their confidentiality. These laws, ethics and principles give individuals the confidence to give confidential information to others in the knowledge that if that information was to be divulged to another, they would face serious consequences.

Sharing information is kept to effective communication but this should be balanced alongside the need to maintain a service users rights to confidentiality. This is often complex relationship. Service users should be involved in decisions as to whether sensitive information can be shared with the wider network of care providers and staff should reflect on balance whether sharing the information will benefit the client and whether the benefits out-weigh the risks of sharing the information. Supervision should be used to support staff in reaching these decisions.

In certain circumstances you may be faced with ethical issues regarding the disclosure of confidential information to a third party. Any professional has a “duty of care” which means as previously stated a confidence can only be broken if it is in the Individual’s best interests, for the protection of others, in the interest of public health, during an official or legal investigation or if there has been or there is a risk of serious crime committed. This can place the individual in a dilemma between the law and their professions and personal ethics.

4:2 – Analyse the essential features of information sharing agreements whitin and between organisations.

Certain information will need to be shared within your workplace and also between your and other organisation. As discussed in the last outcome information can only be disclose if it in the individuals best interests, for the protection of others, in the interest of public health, during an official or legal investigation or if there has been or there is a risk of a serious crime committed. Information should only ever be shared on a need to know basis. For example, if a service used had a fall, you may need to pass on details of the individuals medication to the paramedics as this would be in the individuals best interest but you would not need to pass them details regarding the individuals financial affairs as this is not relevant and the paramedics do not have a “need to know”.

Other examples could include an outbreak of an infection disease in your workplace which by law has to be reported (RIDDOR). You should also consider your workplace “Whistleblowing policy” which allows people at work to raise concerns and report areas such as negligence, dangers to health and safety or crimes whilst being protected from dismissal or victimisation. Your workplace will have policies and procedures in place for the sharing of information with others. In order to analyse your workplace agreements regarding the sharing of information you will need to look at the circumstance you are allowed to divulge information and who to and analyse why this is acceptable in certain circumstances.

Establishing clear boundaries around confidentiality in our service is vital. Confidentiality enables people who receive care services to have a sense of trust in professionals and a sense of control over their life and the service they receive. The data protection act 1998 concerns the recording of personal and sensitive information. It also covers confidentiality and access to records. It is important that we consider the principles that the data protection act sets out, these include, ensuring the information that we record is used fairly and lawfully, that it is used for a particular and lawful reason, that it is not excessive , that it is accurate and up to date, it is kept no longer than necessary, that it is used in line with the rights of the individuals, that it is kept securely and information must not be transferred between countries which do not have adequate protection for personal information. The act also gives people the right to access all information held about them, this includes all care records and incident forms.

We should, as professionals. Be aware of this at all time when recording sensitive information about our Service Users. It is easy for information to be misinterpreted especially by someone with limited medical knowledge or someone who is emotionally involved with issues surrounding the information being documented. Records should always be non-judgemental, factual, clear, concise, legible and objective. Not only does the individual have the rights to see care records but, we also have to share Service User’s information with other organisations such as Safeguarding and CQC. In this instance, it is ideal if Service Users can consent to this information being shared, however this is not always possible.

All parties need to be clear on the purpose of information sharing and that only necessary information about the individual is shared. In my role it is essential that I act as a role model for my staff ensuring that I emphasise care recording as an essential part of our service and ensure policies and procedures are established and that I instil confidentiality into the culture of our service. I do this by taking immediate action if staff breach confidentiality. In dealing with confidentiality issues as they arise I hope to instil the correct culture in the work place. Having an open and honest approach and discussing issues at staff meetings and in supervision ensures staff fully understand the importance of confidentially for Service Users.

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