Communicating Effectively
Scope of this chapter
Effective communication is more than just exchanging information with another person:
- When providing information, it involves the conscious use of both verbal and non-verbal techniques to convey the information in the way that it was intended, and in a way that the other person will understand;
- When receiving information, it means listening in a way that gains the full meaning of what is being said, and that makes the person conveying the message feel heard and understood.
Being able to communicate effectively is a vital skill that everyone in the service must already have or be committed to developing. Because of this, it is a core principle and value. This means it applies to everyone and is always relevant when planning for or providing care and support.
Relevant Regulations
Related Chapters and Guidance
- Choice and Control
- Consent
- Culturally Appropriate Care and Support
- Good Recording
- Participation and Advocacy
- Partnership Working
- Preventing Abuse and Neglect
- Supporting People with Complex Needs and Specific Conditions
Amendment
In November 2024, a new Section 7, Communicating with families was added. A link to the new Good Recording Procedure was also added to the related chapters and guidance.
Verbal communication is ‘the use of words and sounds’.
Words are used to communicate something specific. If selected well, the words that you use can help someone to understand exactly what you are trying to say. If used poorly, words can cause confusion or an emotional response such as anger or distress.
Top tips
Use the person’s name at the start of a conversation so they know you are talking to them
Don’t use more words than you need to
Use words people are likely to understand
Don’t use words to infantilise the person (language normally used to talk to children)
Don’t use slang
Don’t use jargon
Don’t use abbreviations
Don’t swear or use language others may find offensive
Don’t use inflammatory words (that you know will cause a negative or volatile reaction)
Don’t use provocative words
Don’t use words that lead someone into responding a certain way, including questions that can only be answered with a ‘yes’ or ‘no’.
Sounds refer to the tone (volume), pitch (highness or lowness) and pace (speed) in which you deliver the words that you use. It also refers to any sounds that you may use that are not words. For example, grunts, humming, sighs etc.
Tips
Don’t shout
Don’t speak too loudly or too quietly
Don’t mumble
Don’t speak quickly
Don’t use a high pitch to talk about something sad. People may think you do not care
Don’t use a low pitch to talk about something another person is excited about-they may think you disagree that their news is good
Vary your pitch - using a single pitch (monotone) can be hard to engage with
Be aware of any emotions coming through your voice - speak calmly even if you are not
Be aware of any authoritarian tones - these can create a power imbalance
Don’t use sounds that are not words - these can be felt as boredom, disapproval etc.
When we communicate, we do not just use the spoken word. In fact, most of what we communicate is done through other means. This is called non-verbal communication.
Eye contact (or lack of eye contact) is important because it can indicate feelings.
Long, unbroken eye contact (but not staring), can show that you are interested in what the other person is saying. It can help build rapport.
Short or broken eye contact, on the other hand, can be interpreted as nerves, mistrust or distraction. If someone senses these feelings from our eye contact, they may decide to disengage from communication.
Facial expressions are very powerful, as they communicate fairly openly how both parties are feeling about what is being said.
- Smiling usually means happiness;
- Frowning can mean someone is unhappy;
- Wide eyes can show interest or excitement;
- Looking away shows distraction or boredom;
- A scrunched-up face can mean someone is confused;
- A tense expression can mean someone is worried;
- Yawning usually means someone is tired or disinterested.
Posture is the way we sit or stand.
- Leaning towards someone can show interest in what they are saying;
- Being restless can show nervousness;
- Crossed arms can mean someone is bored, angry or disinterested;
- Standing at a slight angle can show you are relaxed and friendly.
Proximity is how physically close we are to someone during communication.
What is the right amount of proximity will vary from person to person, some people like being close and others do not. For some people, proximity will also have a cultural connotation.
It’s always best to ask a person ‘Do you mind if I sit here?’ or ‘Where would you like me to sit?’
Being too close to someone invades personal space and can make them feel worried and threatened.
However, being too far away can make them feel isolated.
Be particularly aware of anyone that may have experienced abuse or neglect in the past, as they may not like close staff proximity at all.
Hand gestures can be both helpful and unhelpful when communicating.
Too many hand gestures can be distracting, even irritating to others.
If someone fiddles with their hands, they could be nervous or worried.
Large movements should normally be avoided, such as waving an arm. These can appear aggressive.
Many hand gestures also have different meanings in different cultures.
Although the environment isn’t a form of communication it can have a huge impact on the effectiveness of communication.
- Try to reduce distractions e.g., noise, the TV, music, other people;
- Provide privacy-a lack of privacy can cause people not to communicate honestly;
- Make sure rooms are well lit, so that facial expressions can be seen;
- Position furniture in a way that facilitates communication e.g. chairs facing towards each other rather than next to each other;
- Make sure people are comfortable and have what they need e.g., a drink.
Haley has asked to speak to her support worker in private. They go into a side room where nobody else is. The support worker opens the curtains as it is gloomy in the room. She asks Haley if she would like a drink as Haley is fiddling with her hands and looks a little nervous. Haley accepts a drink then sits down at one end of the table. The support worker asks Haley if it is OK to sit down next to her. Haley says it is and pulls out a chair for the support worker. The support worker sits down and leans in towards Haley as she talks. The support worker makes good eye contact with Haley and Haley feels able to confide about something she is not happy about. The support worker asks Haley what she would like to do about the problem and tells her some of the options. Haley asks for more information about one of the options and then makes a decision about what to do.
Ethan is at a social event in the community. He has become a little agitated and his support worker needs to try to find out what is wrong. The support worker approaches Ethan slowly and asks him if he is OK. Ethan tries to talk but it is very noisy. The support worker uses a gentle hand gesture to signal that he cannot hear Ethan and point to the door, suggesting that they should maybe go outside to talk. Ethan nods his head and the two of them go outside. Ethan is still agitated but being in a less noisy environment is helping. His support worker remains very calm and speaks in a soft tone. He recognises that Ethan isn’t feeling very happy and asks him what has happened. Ethan explains that someone inside stood on his coat. His support worker volunteers to look at the coat and check whether it is OK. They take a good look over the coat together. Ethan is satisfied it is not damaged. His support worker asks what he would like to do and explains that he can go back inside if he wants to, but that he doesn’t have to.
Derek lives in a flat and has support three times each day. When a new support worker is there, he decides that he wants to ask them how to prepare his evening meal. It is a new one that he hasn’t cooked before and he is looking forward to trying it. The support worker checks her watch before responding. She agrees to take a look at the instructions on the packaging. Derek gets it from the fridge. When he returns the support worker is filling out some paperwork. She tells Derek ‘just a minute’ and finishes what she is doing. She looks at the instructions and reads them out loud to Derek exactly as they have been written on the packaging. Derek looks confused. She reads them out again. Derek still looks confused. The support worker asks Derek which bit he doesn’t understand. Derek doesn’t want to say that he doesn’t understand any of what she is saying. Normally a support worker would write down simple instructions for him, and he feels silly having to ask. Derek says not to worry, and that he will figure it out.
Sally has told her support worker that another resident, Tom, has hit her. The support worker is shocked by the news as Tom is normally very quiet. She asks Sally if she is sure and raises her eyebrows. Sally says that she is sure. She frowns in anger at the support worker, who responds by telling Sally not to pull faces at her and that she is "only trying to help". Sally becomes upset by the support worker's tone. The support worker goes over to her and puts her hand on Sally’s shoulder, trying to reassure her. Sally pulls back and clearly doesn’t like the physical contact. The support worker asks Sally if she would like to raise a safeguarding concern about Tom. Sally says she doesn’t know what this is. The support worker says that it is a way of getting Tom into trouble for what he did. Sally doesn’t want Tom to get into trouble so does nothing more about it.
Complex communication needs happen when there is a difference between the way that we communicate and the way that a person being supported communicates. It requires us to gain a deeper understanding of how they communicate, so that we can adapt our own techniques to maximise their participation, choice and control.
Information and guidance about supporting someone with complex communication needs is found in a different chapter of this Handbook:
See: Supporting People with Complex Needs and Specific Conditions
Effective communication with each other and with professionals is just as important as effective communication with the people that we support and their families.
If you do not understand anything, it is important to tell someone or ask the other person to explain it differently, or to show you what they mean etc.
There is nothing wrong in saying that you do not understand something.
In all cases, you should never do something without having understood it. The consequences could be dire. For example, if you were to use a piece of moving and handling equipment without having properly understood how to do so safely.
Families and friends are often an important part of the life of people we support and communicating effectively with them is essential to providing person-centred support.
The Working with families, friends and carers framework from Skills for Care sets out some good practice guidelines about what staff need to know and do to work effectively with families, friends and carers. This includes the following list of ‘things to know’ and ‘things to do’ to maintain appropriate communication with families:
| Things to know | Things to do |
|---|---|
| How to build rapport and communicate well with families. | If a person is being visited by family members, offer support to make them feel welcome. |
| Respond to requests and messages from family members promptly and in a way that works for them. | |
| Take family member’s concerns seriously and be mindful not to take them personally. | |
| Do what you say you will do, in the agreed timescales, or keep family members updated and informed if this isn’t possible. | |
| When and how to provide information to families. | Find an appropriate and agreed balance between the person’s right to privacy, and their choice to share information with family members. |
| Agree with the person what information you’ll share with their family members and help them to communicate this to those family members. | |
| Respect the rights of the person in regard to information that they do not want to share with family members. | |
| Understand the principles of the Mental Capacity Act 2005 and best interest decisions as they relate to people and their family members (see 7.2 below). | |
| Discuss with the person about occasions when you might have to share personal information with a family member. | |
| Interact with family members in a way that respects their individual experience, culture and expertise. | |
| Explore and address your own unconscious bias when working with and supporting families. | |
| Adapt your attitude and behaviours, as needed, to support families. | |
| How to address concerns, dilemmas and conflicts that may arise when working with families. | Ensure that everyone puts the person at the focus of any conversation. |
| Listen carefully to the person’s and their family member’s concerns, grievances and complaints. Ensure that they feel heard and decide together, what actions will be taken. | |
| Understand that what one family member sees and identifies as ‘normal’ may not be the same for others. | |
| Be open to explaining how and why you’re providing care and support in the way that you are and invite family members to suggest ways that they think works best. | |
| If needed, explain the importance of choice, involvement and mental capacity assessment of the person, to their families - they might need learning and development to aid this understanding. | |
| Be confident in your own skills and knowledge about how and when to challenge decisions. | |
| How to involve families when planning for the future. | Understand the wishes of the person and their family members to plan for the future, including their needs and aspirations. |
| Follow the service’s policies and procedures for documenting future planning. | |
| The organisational and legal requirements for recording information. | Understand and comply with the service’s policies and procedures around recording and sharing information, including General Data Protection Regulations (GDPR) and confidentiality policy. |
| Discuss confidentiality and privacy with the person and their family members from the start. | |
| The agreed process for reviewing how you work with families. | Get feedback from families about how staff work with them and express your workplace values. Use this to shape, change and improve the quality of support. |
| Offer family members suggestions or comments in a way that preserves your relationship with the family. |
To read the framework in full, see Working with families, friends and carers: a framework for adult social care employers.
Wherever possible, unless the person has asked us not to do so, close relatives, friends or other individuals who take an interest in their welfare should be consulted as part of any best interest decision making process. This includes anyone who is acting as a Lasting Power of Attorney (LPA) or Deputy. The views of those consulted should be recorded and considered as part of the decision making process.
In circumstances where a decision needs to be made urgently and someone who it would normally be appropriate to consult with is not contactable, the registered person (or a line manager) can decide that it can be made without consulting them. Unsuccessful attempts at contact and the rationale for proceeding to make the decision should both be recorded.
The decision in question may be one that a Lasting Power of Attorney or Deputy has the legal authority to make. If this is the case, they must be notified and asked to make the decision. When made, the service should treat the decision in the same manner as they would had it been made by the person themself.
Further information about the Mental Capacity Act 2005, including the process of making a best interest decision, see:
Each year, the Local Government Ombudsman for Health and Social Care (LGO) receives a large number of complaints about charging. Most of these arise because insufficient or inadequate information has been provided to the person and/or the family member who manages their finances.
Unless all costs are being met by the commissioning organisation, the service should be clear and transparent about all its fees and charges. This should include the cost of the service itself and any other expenses that it intends to charge the person (for example, staff activity expenses in a supported living service).
Where the service contracts directly with the person (or a family member), notice periods and any costs associated with contract termination should also be highlighted.
Any changes to fees and charges should be communicated in a timely way.
Last Updated: October 26, 2024
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