Surrey Skills Academy with support from Health Education Kent Surrey Sussex

The Care Certificate Framework For

Adult Social Care Workers &

Healthcare Support Workers

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Mentor: Click here to enter text.

Assessor: Click here to enter text.

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Standard 6

Surrey Skills Academy with support from Health Education Kent Surrey Sussex

The Care Certificate Framework

Communication

Standard 6 Main areas:

I will understand the importance of effective communication at work

I will understand how to meet the communication and language needs, wishes

and preferences of individuals

I will understand how to promote effective communication

I will understand the principles and practices relating to confidentiality

I will use appropriate verbal and non-verbal communication

I will be able to support the use of appropriate communication aids / technologies

Links Code of Conduct: Standard 4 & 5

Compassion in Practice (6 C’s) Care, Compassion, Competence, Communication, Courage and Commitment

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Surrey Skills Academy with support from Health Education Kent Surrey Sussex

Standard 6

This standard explores the importance of effective communication in your work setting, how we meet the communication needs of individuals, how to promote effective communication using verbal and non-verbal and communication aids and also understanding the principles of confidentiality.

Communication can be defined as the “giving and receiving of information”, it is a two-

way process and for it to be effective, it needs to be done in a manner where both

parties can understand the meaning of it. Communication is now recognised as an

essential part of health care delivery, and therefore, it is seen that if communication is

poor or inadequate, the quality of service will suffer as a result. Ensuring “good” and

“effective” communication is a fundamental component of providing high quality

services. It is not a luxury or an optional extra.

We all need to communicate with each other, and as a care worker you will need to be

aware of the different ways communication can take place. Individuals communicate

through a range of different methods and these can be either verbal or non-verbal and

can include:

Verbal

Volume

Intonation

Rate

Fluency

Tone

Non-verbal

Objects of Reference

Photos

Pictures

Symbols

Written word

Body language

Facial expression and eye contact

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7%

38%55%

meaning in the words that are spoken = 7%

meaning is paralinguistic (the way that the words are said) = 38%

meaning is in facial expression = 55%

Surrey Skills Academy with support from Health Education Kent Surrey Sussex

Pointing

Gestures

Touch

British Sign language (BSL), Makaton, braille

Proximity and position

Silence, is also a very powerful tool, when communicating with someone, but is often a

skill that we find hard, as we feel that we should be saying or doing something. It gives

that person the time to reflect on their thoughts and ideas, without us rushing on to the

next thing; we feel that they should be talking about.

We also need to be aware, that often the non-verbal communication tells us far more

than the verbal communication does, and therefore it is imperative that you are

observing and are receptive to the individual’s reactions when communicating with

them. Take for example you are talking to a client asking them if they are alright, they

may confirm in words that they are, but their eyes may be filling with tears. This may be

for a number of reasons, including that they are trying to deny how they are really

feeling, they are scared to admit why they are upset, they don’t want to talk about it at

that time, or you may be the wrong person for them to talk to about it.

As we can see from Professor Albert Mehrabian’s model, only 7% of our communication

is via words.

Fig 1 - Professor Albert Mehrabian's communications model

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Individuals communicate for a variety of reasons and these can include:

Physical – day to day needs (food, drink, warmth, identification of risks in risk

assessments)

Safety and security - to be reassured physically and emotionally

Social – to form positive relationships (socialising, involvement in activity,

community involvement)

Emotional – to be loved and accepted (finding out how they feel)

Meeting personal potential – self actualisation

To give information (instructions, taking medication)

To obtain information (life history)

To exchange ideas (discussion of care plan)

Within a work setting, you will be communicating with many different people, this could

include clients, their families and friends, colleagues, other members of the multi-

disciplinary team, emergency service staff (e.g. paramedics) to name a few. How you

communicate with these people will depend on who they are and the situation you are in

at that time. You will also need to consider that you may need to have different

approaches to communicate the same message to different people. Take for example a

client has died, how you tell your colleagues and the doctor will be very different to how

you tell the family.

When using verbal communication, you should speak at the service users’ level of

understanding and in a manner, that shows respect. You need to understand that

individuals may need to be spoken to and communicated with in different ways, and you

begin by finding out what the individual’s preferred way of being addressed is. It is

therefore really important that you establish that particular individual’s communications

and language needs, wishes and preferences and this can be done in a number of ways

including: -

Asking them

Talking to their family (and friends where appropriate, taking into account

confidentiality)

Talking to colleagues

Speaking to other members of the multi-disciplinary team

Reading their care / support plan or notes

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Individuals do have a wide range of communication needs and this involves

consideration of many aspects, including:

Physical ability

Sensory ability

Culture

Language

Confidence and self esteem

Level of cognitive ability

The important thing to remember is that we need to be able to communicate with that

individual and therefore we need to adapt our communication to meet their needs as we

are often in a situation where they can’t adapt. As we explored earlier, there are many

different communication methods and it is normal that we use a combination of them

throughout all communication.

We are at times faced with barriers, to communication and we then need to overcome

these. The important thing is to ensure that person feels comfortable and is not made to

feel “different” or “excluded” as they don’t communicate in the way that you or others do.

It is therefore far better to be aware of how that person communicates before you speak

to them, as then you can be prepared for it, as opposed to being stood there and not

knowing what to do. Some of the barriers are listed below, along with methods of

overcoming them: -

Communication

barrier

Possible ways to overcome

Visual impairment Use of touch – where appropriate

Increased use of tone of voice as opposed to facial expression

Ensure all that is normally visually communicated is transferred

to a method that can be heard

Use of braille

Use of tapes / computer programmes such as Jaws

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Hearing impairment Speak slowly and clearly

Remove any other distractions that may cause a noise

Consider your position so that you face the client

Allow the clients to lip read if they are able to

Make sure any hearing aids worn are fully functioning

Use sign language if appropriate and if so ensure the topic is

communicated first

Ensure all adaptive equipment is functional

Use of flashcards etc

Consider the use of electronic note taker if appropriate

Physical disabilities Depending on the nature of the disability this will have to be

titrated according to the individual’s problems, but consider: -

Speaking clearly and slowly using closed questions

Do not patronise

Only ask one question at a time

Consider picture cards allowing them to point to answers

Use of specialised equipment – e.g. light-writers

Learning disabilities Initially assess the level of understanding

Speak at an appropriate level without using jargon or medical

terminology

Allow time to respond and if necessary repeat

Use closed questions

Use picture cards

Language differences Use of gestures, pointing to various objects

Use of pictures / flashcards

Relevant language dictionary

Ask the family to design an appropriate scrapbook in

alphabetical order with relevant pictures

Through an interpreter (care needs to be taken if using the

family for this due to confidentiality reasons)

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Dementia / Confusion

Observe their non-verbal communication

Eliminate all distractions

Allow them time to communicate

Discuss only one item per sentence and keep it simple

Do not challenge confused statements

Continually show respect

Use pictures and items of reference

Comprehension This could include; inability to comprehend, lack of knowledge

about the subject, anxiety, worry, high emotions, attitude and

personal values, confusion between verbal and non-verbal cues.

This will need to be titrated on an individual basis according to

reason for this issue.

Cultural differences Explore their culture so you have an understanding of it

Accept that they may well have a different way of expressing

themselves

Try to reach a compromise as to what is acceptable

Transmission This could include areas such as: inability to articulate properly,

due to sore throat, paralysis, strong accent, level of attention

span, terminology used.

Method to overcome this will have to be titrated according to

individual issue.

Environmental This could include factors such as: noise, cold, poor lighting,

lack of privacy, distractions and unfamiliar surroundings. This

could also link to not having enough time, so they feel rushed.

Method to overcome this, will have to be titrated according to

individual issue

Personal / sensitivity This could include factors such as incompatible communication

styles – use of jargon, differing cultures, low self esteem / value,

age, gender, work role, dress code, stereotyping, negative body

language, negative attitude of staff to client etc

Method to overcome this will have to be titrated according to

individual issue.

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When communicating with someone, it is imperative that you check to establish if the

message that you have been trying to convey has actually been understood. There is

no point in you communicating with someone if that message is not being received.

Checking that it has been understood is a vital part of the process. One skill that is

useful, is paraphrasing what has been said, so you repeat back and summarise with

that person, as it will allow them to correct you where needed. At times, it is also

appropriate to use open questions, where they have to give you a reply which consist of

more than a “yes / no” type answer, and also at times it is appropriate to ask closed

questions – depending on what you are needing to establish.

It is important that you demonstrate really good “active listening skills” when you are

communicating with your clients. There will be times when you are talking to them whilst

assisting them with their care for example, but there will also be times when you are sat

having a conversation with them, which at times can be quite emotive for them. In these

types of situations, it is important that you work to the principles of SOLER.

S – Sitting squarely and opposite the individual

O – Having an open posture, with no physical barriers between you

L – Leaning forward, slightly towards the individual, but not too close

E – Eye contact, but don’t stare

R – Relax and show that you are listening

When communicating with the client it is also important that you:

Do not interrupt – even if they are struggling to get their words out, as it can

feel very patronising

Allow them the time they need to express what they need to tell you

Do not give advice

Do not dismiss fears, worries – as whilst they may appear trivial to you, they

are real and of importance to that person

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Acknowledge that their behaviour is a form of communication, and we see

this in particular if they are unable to express themselves in other ways, may

be due to learning disabilities or dementia for example. It may include some

of the following types of behaviours: swearing, repetitive rocking to and fro,

self harm, walking or running away, not talking or responding, yelling or

shouting and sarcasm.

Some individuals also use communication aids e.g. hearing aids, light-writers, other

speaking aids, IT software, it is important that if they are using them, they are clean,

working correctly, switched on (where needed) and in good state of general repair. If

you find that one is not working correctly, it is your responsibility to report it, as without

it, at times that individual is therefore unable to communicate.

When you are communicating in writing, it is also important to ensure that the same

principles are applied, as clients can at times read their notes and therefore read what

you have recorded about them. Also, any records that you complete are legal

documents and so can be used in a court situation.

Sometimes, even when you have good communication skills, you still feel that your

communication is not as effective as it could be with your clients. It is at this point that

you may want to seek some additional support and this could be via a range of sources

including: -

Your senior / line manager

Reading the care plan again

Speaking to the family

Finding out more about their condition and therefore having a better

understanding of it

Speaking to specialists (in the relative condition)

Contacting condition specific organisations (e.g. Stroke association,

Alzheimer’s Society, Motor Neurone Disease Association)

Confidentiality means not sharing information about someone without their knowledge

and agreement, and this applies to all methods of communication - be it spoken or

written, as we are often dealing with sensitive, personal information. It is important as

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you are working in a position of trust, the clients need to feel that they can trust you and

if you are talking about them, this may result in them losing some of their self esteem

and dignity.

Confidentiality is governed by the following policies / codes of practice and legislation: -

Organisational policy

Skills for Care / Skills for Health Code of Conduct – standard 5

Data Protection Act 1998

Freedom of Information Act 2005

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and

The Fundamental Standards

You may only disclose information to those with direct need for information (such as

health care professionals, care managers and your manager). Relatives, neighbours

and family friends are not necessarily entitled to receive confidential information.

Sharing information from individual’s care / health records must be on a “needs to know”

basis only, so for example you may need to discuss with the GP about a health

complaint, but if they started to ask re their financial situation, then this would be totally

inappropriate and should not be shared with them. Depending on the environment you

work in will dictate to some degree what might need to be shared. Take for example you

are in a hospital, and are looking at discharge, then it may be very appropriate for the

doctor to be asking about the home that the client lives in, to establish whether

discharge back there is appropriate or not.

However, there may be times, when it will be necessary to breach client confidentiality,

and these could include if: -

It can be justified to protect the client or another from a significant risk or

harm.

If there is suspected abuse

It is required by law or by the order of the court.

To maintain confidentiality, you need to consider where and when you discuss clients –

i.e. not when you are on the train going home or in the pub in the evening or in a public

place. Within a residential care setting (e.g. care home, nursing home, hospice,

hospital), it is also important what you do with the client’s records, so that they are not

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left in a public place for all to read, you will need to check your own individual

organisations policy on the management of this.

Within the client’s own home, do not leave their documentation in a place where an

unauthorised person could gain access to it and also if you need to talk to the office or

other health professional, consideration needs to be taken as to where you make that

phone call. Likewise, if you are in the client’s garden with them, be aware of neighbours,

who may be able to hear that conversation.

If you have any concerns re confidentiality, and whether you should pass information on

or not, this should be discussed with your line manager who will advise you as to the

best course of action. You will also have a policy and procedure relating to this within

your workplace, which would be helpful for you to read.

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Surrey Skills Academy with support from Health Education Kent Surrey Sussex

Standard 6Workbook

Communication

Standard 6 Main areas:

I will understand the importance of effective communication at work

I will understand how to meet the communication and language needs, wishes

and preferences of individuals

I will understand how to promote effective communication

I will understand the principles and practices relating to confidentiality

I will use appropriate verbal and non-verbal communication

I will be able to support the use of appropriate communication aids / technologies

Links Code of Conduct: Standard 4, 5

Compassion in Practice (6 C’s) Care, Compassion, Competence, Communication, Courage and Commitment

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Standard 6.1 – Understand the importance of effective communication at work

6.1a Describe 5 different ways that people communicate 1. Click here to enter text.

2. Click here to enter text.

3. Click here to enter text.

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5. Click here to enter text.

6.1b Describe how communication affects relationships at work

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6.1c Describe why it is important to observe and be receptive to an individual’s

reactions when communicating with them

Click here to enter text.

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Surrey Skills Academy with support from Health Education Kent Surrey Sussex

Standard 6.2 – Understand how to meet the communication and language needs, wishes and preferences of individuals

6.2a Describe how to establish an individual’s communication and language needs,

wishes and preferences

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6.2b List a range of communication methods and styles that could help meet an

individual’s communication needs, wishes and preferences

Click here to enter text.

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Standard 6.3 – Understand how to promote effective communication

6.3a & 6.3b List 4 barriers to effective communication and ways to reduce these barriers

Barrier to communication

Ways to reduce barriers to effective communication

1.

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2.

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3.

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4.

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6.3c Describe how to check if you have been understood when talking to the clients

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6.3d Describe where to find information and support for services, to help you

communicate more effectively

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Standard 6.4 – Understand the principles and practices relating to confidentiality

6.4a Describe what confidentiality means

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6.4b List legislation and agreed ways of working to maintain confidentiality in day to day

communication

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3. Click here to enter text.

4. Click here to enter text.

5. Click here to enter text.Page 17 of 24

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6.4c Describe situations where information, normally considered to be confidential,

might need to be passed on

Situation when confidential information may need to be shared

Reason for sharing

1. Click here to enter text. Click here to enter text.

2. Click here to enter text. Click here to enter text.

3. Click here to enter text. Click here to enter text.

6.4d Describe who to ask for advice and support about confidentiality

Click here to enter text.

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Standard 6Observation

Communication

Standard 6 Main areas:

I will understand the importance of effective communication at work

I will understand how to meet the communication and language needs, wishes

and preferences of individuals

I will understand how to promote effective communication

I will understand the principles and practices relating to confidentiality

I will use appropriate verbal and non-verbal communication

I will be able to support the use of appropriate communication aids / technologies

Links Code of Conduct: Standard 4, 5

Compassion in Practice (6 C’s) Care, Compassion, Competence, Communication, Courage and Commitment

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Standard Observation Signature & Date of observation

6.5a Demonstrate the use of appropriate verbal and non-verbal communication

Verbal (tone, volume)Click here to enter text.

Non-verbal (position, eye contact, body language, touch, signs, symbols and pictures, writing, objects of reference, human and technical aids)Click here to enter text.

Communication may take place – face to face, by telephone or text, by email, internet or social networks, by written reports or lettersClick here to enter text.

Click here to enter text.

Click here to enter a date.

6.6a Check that communication aids / technologies are:- Clean - Work properly- In good repair

Click here to enter text. Click here to enter text.

Click here to enter a date.

6.6b Report any concerns about the communication aid / technology to the appropriate personThis could include:- Senior member

of staff- Carer- Family member

Observation / simulation (please indicate)Click here to enter text.

Click here to enter text.

Click here to enter a date.

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Standard 6

Outcome To meet this standard Assessment Evidence Date signed off

6.1 Understand the importance of effective communication at work

6.1a Describe the different ways that people communicate

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

Choose an item.

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6.1b Describe how communication affects relationships at work

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

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6.1c Describe why it is important to observe and be receptive to an individual’s reactions when communicating with them

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

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6.2 Understand how to meet the communication and language needs, wishes and preferences of individuals

6.2a Describe how to establish an individual’s communication and language needs, wishes and preferences

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

Choose an item.

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6.2b List a range of communication methods and styles that could help meet an individual’s communication needs, wishes and preferences

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

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6.3 Understand how to promote effective communication

6.3a List barriers to effective communication

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

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6.3b Describe ways to reduce barriers to effective communication

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

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6.3c Describe how to check whether they have been understood

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

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6.3d Describe where to find information and support or services, to help them communicate more effectively

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

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a date.6.4 Understand the principles and practices relating to confidentiality

6.4a Describe what confidentiality means in relation to their role

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

Choose an item.

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6.4b List any legislation and agreed ways of working to maintain confidentiality in day-to-day communication

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

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6.4c Describe situations where information, normally considered to be confidential, might need to be passed on

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

Choose an item.

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6.4d Describe who to ask for advice and support about confidentiality

Assessed by any of the following methods: - 1:1 discussion - Group work- Written

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6.5 Use appropriate verbal and non-verbal communication

6.5a Demonstrate the use appropriate verbal and non-verbal communication: Verbal: Tone Volume

Non-verbal: Position/ proximity Eye contact Body language Touch Signs Symbols and

pictures Writing Objects of reference Human and

technical aids

Communication may take place: face to face by telephone or text by email, internet or

social networks by written reports or

letters

The assessment must be observed in the workplace as part of the normal work duties

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6.6 Support the use of appropriate communication aids/ technologies

6.6a Check that communication aids / technologies are: Clean Work properly In good repair

The assessment must be observed in the workplace as part of the normal work duties

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6.6b Report any concerns about the communication aid / technology to the appropriate person. This could include: Senior member of

staff Carer Family member

The assessment must be observed in the workplace as part of the normal work duties. The opportunity to demonstrate this during the induction period may not arise. Therefore, the use of simulation / role play using scenarios is permitted

Choose an item.

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I am satisfied with the evidence of learning that it meets all the required standards.

Assessor’s Name:Click here to enter text.

Assessor’s Position: Click here to enter text.

Signature:Click here to enter text.

Date:Click here to enter a date.

Learner’s Signature: Click here to enter text.

Date:Click here to enter a date.

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