These skills include:
Respecting for other people’s beliefs and views – we all has different ideas about how we conduct our lives. It is predictable that a care worker will come across many people with vastly different backgrounds, beliefs and outlooks on life. Regardless of your own views, you should always respect the views of others. This involves:
- Not passing judgment on the way other people live
- Avoiding stereotyping people on the basis of age, sex or ethnicity
- Not trying to impose your views onto others
Establishing boundaries – all organisations operate within some set of boundaries or limits, which determines the extents of their willingness and the ability to respond.
Establishing boundaries within care settings might include:
- An explanation of policies and practices
- How long a interview or meeting is to last
- Arrangements for the future meetings
Showing interest in the individual - it is important to try and show a bond with clients and patient. This can be achieved by:
- Being patient
- Listening carefully to them
- Trying to remember their names, hobbies, interest, likes and dislikes
- Not changing the subject
- Asking relevant questions
- Using effective body language
- Sharing personal information
Using appropriate body language – you should make sure how you should sit and how you should use gestures because using good gestures and sitting in a good way will show that you are interesting and that you are aware of what message you are conveying by your body language.
Active listening – research has shown that we all are poor listeners and that we only listen when we are interested in something and not listening to the things that we are not in. But in health and social care active listening requires lot of concentration and the following skills are essential to active listening:
- Eye contact – must have a good eye contact when having a conversation. The person talking will look to see that the other person is listening and then will look away and will keep on doing this. But the listener’s eye contact tends to be stronger.
- Postures – the listener should keep the body and the hands neat and relaxed.
Conveying warmth – in health and social care for example the client may have personal and painful information to share but may decide not to because of the care worker being rejecting or cold. But warmth maybe conveyed none verbally by:
- A warm smile
- Open welcoming gestures
- A friendly tone of voice
- A confident manner
- Offering help – physical e.g. helping an elderly to stand up
- The general appearance of the care worker
- Calm and relaxed movements
Conveying understanding – a care worker conveys understanding through empathy, acceptance and non-judgemental attitudes, So that the client has a great relief at being able to tell the truth without getting an emotional reaction from someone else.
Conveying sincerity – is also conveyed by:
- Setting boundaries for example the care worker will clearly state how long the interview should last
- Reassurances about confidentiality
- Clear assessment at the end of the interview
Conveying the positive value of others – a psychologist Carl Rogers developed a theory that all human beings need:
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The need for self-actualisation – basically we are born with a tendency to be healthy as possible, physically and mentally.
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The need for positive regards – it is when effective communication should take place, we all need good relationships, which provide us with love, affection and respect from others.
Such positive regards could be unconditional: it does not matter how badly we behave, we are still loved for being ourselves. Roger argues that if we receive unconditional positive regards then we will also give our self the unconditional regards. Also if our parents love us conditionally, when we do something good at school at a job then we will constantly seek approval from others as we grow into adults.
Using non-verbal signals such as may do conveying positive value of others; smiling, calm movements, listening skills, eye contact, open gestures.
The positive value of others may be shown through; empathy, freedom from any type of stereotyping or discrimination, conveying warmth, respect for individual etc.
Seeking feedback, paraphrasing and reflection – the care worker must try and imagine how it would be like as a client. This understanding is demonstrated to the client by means of feedback – showing that they have understood what it is like to be in the client’s position.
The techniques that are used are:
In paraphrasing – the care worker will summaries what the client has said, demonstrating that it has been fully understood. In this way the care worker can check that they have really understood in what the client has said.
SPECIAL NEEDS & COMMUNICATION
Communication between professional and clients in health and social care settings may need specialist resources in for example sign language, Makaton, signalong, a foreign language etc. or they may need special resources or equipment.
Sign languages –
Dactylographic or finger spelling – when people have a dual sensory impairment, this is when they are both deaf and blind. Their needs are to find a way to communicate which are purposeful and fulfilling. Children who attend schools for those who are deaf and blind are often taught by means of dactylography. This would only be a little use for the children if they only had a little idea about the world and objects which the come across.
The one method how children are taught who is both deaf and blind is:
- Are given a model of pig to handle
- Then they go to a farm and handle one
- When they come back they use modelling material to make a model of a pig
- Then the children learn finger spelling for pig.
British sign language (BSL) –
This is another name given for the sign language for deaf people. It evolved as a natural language and the signs do not necessary translate to spoken English.
Makaton - this is a unique language programme which teaches sign language to deaf adults who also had learning difficulties. It is also used with children.
(Symbols from Google)
Structuring a conversation - when we talk to people we have to start the conversation off. We usually start with a greeting or we ask how someone is. Conversations have a beginning, middle and an end. The most important thing is that we all have to create the right kind of atmosphere for a conversation at the beginning. When ending the conversation we have to leave the other person with the right feelings about what we have said.
The conversation sandwich illustrates this:
A boundary is a line that should not be crossed. In care work the metaphor of a boundary means that there are limits to the degree of emotional involvement and commitment within a relationship. Although the professionals care about what happens to the service users, professionals do not form an emotional bond in the way that parents and children do.
Here is a diagram of the three main ways in which communication becomes blocked:
BARRIERS TO EFFECTIVE COMMUNICATION
When communications are difficult it is often because of barriers. The first step to overcoming these barriers is to identify them
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Physical environment – the designs of a building, lack of access for people who use wheelchairs, noise and lack of privacy are all factors, which can inhabit effective communication.
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Disability and impairment – care workers need to be trained to recognise the influence of hearing impairment, limited mobility, visual and verbal impairment and cognitive differences such as memory loss and learning disability.
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Attitudes – if care workers are unaware of the stereotyping and prejudice them hold in their minds, these will unconsciously act as a barrier to communication. Examples of such attitudes include; deferential attitudes, stereotyped thinking, a self-fulfilling prophecy, labelling, differences and emotions and feelings.
Further inhabits communication between individuals include:
Distractions
An interaction between two people will be inhibited far more by interruptions. Suppose a client was telling personal information to the care worker and the phone rang or someone knocked on the door. The care worker takes their attention from the client and talks for some minutes to the person on the phone or on the door. The client will feel that their communication is unimportant and therefore they are unimportant too.
Dominating the conversation
Care workers are there to listen and should put their feelings to one side.
However that may perhaps accidentally dominate the conversation in any three ways:
- Making the clients story their own – so e.g. the same thing happened to my relative
- By assuming responsibility for working out the problem and solving it for the client and giving them a minor role - for e.g. planning out the clients care plan them selves.
- By trying to take over every areas of the client’s life.
Manipulation
The care worker or client can be manipulative if either one of them has a hidden agenda in the interaction.
There are also specific ways in which each side may manipulate the other:
Care worker – this maybe direct or indirect. Care workers can manipulate clients by manoeuvring them to choose of action that accords with the care worker’s judgement – in such a way that the clients are not aware of the process.
The client – this can happen when the client goes to several agencies for help and complains at new agency about the lack of help received at the last agency.
Blocking the others contribution
In one to one, face-to-face interaction, one participant in a number of ways, verbal or non-verbal, can block communication. The care worker may block the communication of the client in many non-verbal ways for e.g.
- Look for boredom
- A yawn
- A smile at the wrong time
- The slightest expression of disgust
- Withdrawal of eye contact
- Drumming the fingers
Communication barriers can damage a person’s quality of life
The Maslow’s Hierarchical of Needs:
Self-actualisation -leading a fulfilled adult life depends on a secure sense of who you are and positive self esteem.
Self-esteem – communication barriers can prevent you from feeling valued by others.
Love & belonging - communication barriers can create a sense of isolation and exclusion.
Safety needs – if others will not listen to you and you cannot make your needs understood you are likely to feel physically and emotionally threatened.
Physical needs – physical health can suffer if a person is stressed. Poor and in appropriate communication can create stress.
HOW TO OVERCOME THESE BARRIERS
Emotional barriers to communication – service users often have a serious amount of emotional needs. They maybe scared or depressed because of the stresses they are experiencing. Sometimes service users may lack self-awareness or appear to be shy or aggressive. Sometimes carers may not listen to service users to avoid unpleasant feelings.
Emotion can create barriers because care workers:
- Are tired – because listening takes mental energy
- Don’t have time to communicate
- Are emotionally stressed
- React with negative emotions
- Make assumptions about others
COMMUNICATION SKILLS IN GROUPS
Types of groups:
In health and social care settings there are many group formations. But the two major types are:
Multidisciplinary groups – e.g. doctor, police officer, teacher, social worker, ward sister, nurse.
Groups of people in similar situations – for example groups of people with similar diseases or disabilities or people who are waiting for their foster children.
The stages of group formation:
A group develops through certain stages. Theorists have named these stages and have agreed on what happens on each stage. Tuckman and brown (1979) called these stages of group formation:
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Forming stage – in this stage member of the group move from finding out information about the group in a parallel communication directed at the leader, to increased communication with each other. The group and the leader are tested by each other to see if trust can be established.
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Storming stage – this is the stage where the group members argue about how they see the group’s function and structure. People reveal their differences and their personalities; some may be overbearing and disruptive.
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Norming stage – when this stage has been reached it means that group cohesion has been established. Intimate and personal opinions maybe expressed by members to each other and people start to look for affection.
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Performing stage - when performing occurs, the group is working together to solve problems. It is no longer dependent on the leader, who moves into the background.
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Mourning stage – this is the ending stage that follows achievement of a task. Or groups have to end some time, or they may cease productive. Members will feel a sense of loss, but often a sense of achievement.
Planning and managing a group activity
Managing communication in a group maybe a way to:
- Develop an awareness of others
- Develop skills in a co operative behaviour
- Promote independence and to develop individual potential
The tasks involved in planning and managing group work include the following:
- Identify and keep in mind the individual communication skills of each group member
- Observe and interpret what is going on
- Find ways to support and develop communication skills in the group
- Shape the way the group works so that it is facilitative to communication
SKILLS IN GROUP WORK
All groups within the health and social care settings need a common identity so that group members feel belong. Everyone involved in a group work will be contributing with some sorts of skills. The skills in the groups work include:
- Listening
- Accounting
- Supporting and communicating
Assertiveness – makes communication at team meetings more effective, and it should not be confused with passiveness, loudness or aggressive behaviour.
Those who behave submissively or (passively):
- Allow others to make decisions for them
- Feel helpless, powerless, inhabited, nervous or anxious
- Rarely express feelings
- Little self confidence
- Do best when following others
- Are fearful of taking the initiative
Those who behave aggressively are:
- Very expressive to the point of humiliating others
- Obnoxious, vicious and egocentric
- They are able to make others feel devastated by an encounter with them
If you are assertive in your behaviour, you:
- You are expressive with your feelings, without being unpleasant
- You are able to state your views and wishes directly
- You can respect the feelings and rights of other people
- You are true to yourself
- You are able to say, whether its positive or negative, while also leaving the other person’s integrity intact
Most people are assertive at sometimes with some people, but it is possible to learn to be assertive in situations, which cause stress.
Turn taking – it involves complicated non-verbal behaviour:
- Eye contact
- Looking for everybody in the group for signals
- Hand gestures – out
- Lifting and nodding of head
- Failing of mesh – both people talking
- Leader will often conduct – will make sure that the meshing takes place.
Group values – for a group to perform effectively, members will need to share a common system of beliefs or values, which are relevant to the purpose of the group.
When running a group activity it is very important to identify the extent to which the groups share values.
Group maintenances:
- Warms, laughter, friendless would encourage
- Be honest and sincere
- Show respect – that you value them
- Makes sure that turn takes place
- Solution findings for disagreements
(Barriers) - Constraints to successful group work
Distractions - which would interrupt the development of the group, might be:
- Outside intermittent noises
- Constant interruptions
- Group members coming and going
- One group member leaning out the window
- One group member distracting others
Irrelevant topics – sometimes a group may discuss a topic that seems irrelevant to the task in hand. But the leader will be able to see the real meaning of the irrelevant topic and explain to the group how that topic links to the main one.
Dominating – one member of the group may be aggressive and out spoken, whilst the rest hide their true feelings so as not to be different or unpopular. But the leader has to make sure that they handle the dominant person because other members of the group may start to lose their tempers or may even leave the group.
Pairing – in all groups, their maybe previous friendship or pairing to take in account. Occasionally, such pairings of individuals will be benefit to the group. But sometimes such pairings can adversely effect the functioning of the group.
Blocking – if someone is allowed to dominate the group, this could prevent others with useful things to say from contributing.
Blockers – these people may not get involved because:
- Not knowing the purpose or value of the group.
- Feeling threatened from leader
- Might feel different in a group
- Not feeling confident about communicating
- Feeling of lack of power
Inappropriate talking - all groups need to have opportunities to talk among themselves about topics unrelated to the task in hand. However such talk is indulged in during a group discussion, it can have an effect of undermining group cohesion and may actually cause conflict.
Ignoring and changing the subject – some people will have their own hidden agenda; for example a group which is meeting to discuss proposed changes to procedure will need to have a clear attempt to agenda of its own. When someone attempts to ignore the task then it’s the leader’s role to remind the group of its objectives.
CARE VALUE BASE
WHAT ARE VALUES?
Values are beliefs that identify “something that is valued” or “valuable” in a situation. Beliefs and values can influence what people do and the choices and the decision that they make.
VALUE BASE PRINCIPLES & MORAL RIGHTS
The table below gives key value base principles that might also be considered to be service user’s moral rights, together with other rights that are specified within the GSCC code of practice (summary of the GSCC code of practice for employees)
Equality and respecting for differences –
In the UK there has been major tension between different social groups, such as religious groups. The one idea for reducing conflict is the concept of ‘tolerance’. This word was used two centuries ago to argue that different religious groups could co exist without the needing to fight each other. Diversity involves being interested in and willing to learn about other cultures and belief systems. Anti discrimination involves providing the same quality of service for everyone. But equality is about everybody getting the same quality of service - not the same service!
Anti – discriminatory practice –
Some groups of people that are at risk of being discriminated against at listed below:
Direct & indirect discrimination – direct discrimination is where the discrimination is open and obvious. For example advertising a job and stating no Asians people are allowed to apply for this job role. Such offensive and obvious discrimination is direct.
Indirect discrimination may do equal harm but it is less clear. For example an employer produced an advert stating that applicants for the job must live in certain local areas. At first this sounds all right, but it became obvious that the area was chosen to avoid black and Asian people.
Stereotyping & labelling - sometimes people try to save mental energy and just make the assumption that groups of people are” all the same”. Perhaps a younger person meets an 80 year old who has a problem with their memory. Perhaps they have seen someone else who also has a bad memory and then it will be easy then to say that all old people are forgetful. This would be stereotyping. Stereotyping is a fixed way of thinking.
Confidentiality -
This is an important right to all service users. Confidentiality is important because:
- Service user may not trust a carer if the carer does not keep information to him or herself
- Service users may not feel valued or able to keep their self esteem if their private details are shared with others
- Service users safety may be put at risk if their property and habits are shared publicly
- A professional service which maintains respect for individuals must keep private information confidential
- There are legal requirements to keep personal records confidential
Advocacy –
This can be defined as ‘pleading the cause of another or a ‘means of transferring the power back to the service user, to enable him or her to control there own affairs.
There are different forms of advocacy such as:
- Peer advocacy
- Citizen advocacy
- Self advocacy
The requirements for a safe and secure working environment, which values the rights of service users and care workers, are:
Equal Opportunities Legislation
The main acts of parliament covering discrimination in the UK are:
The Equal Pay Act 1970 - this act made it unlawful for employers to discriminate between men and women in terms of their pay and the conditions of work.
The Sex Discrimination Act 1975 – this act made it unlawful to discriminate between men and women in respect of employment, goods and facilities. It also made it illegal to discriminate on the grounds of material status. The act identified two forms of discrimination; direct and indirect discrimination. The act tries to provide an equal opportunity for both men and women to get jobs and promotion.
The Race Relation Act 1976 – (amended 2000) – this act makes it unlawful to discriminate n racial grounds in employment, housing or services. Racial grounds means according to colour, race, nationality, ethnicity or national origins. This also in direct and indirect discrimination is made unlawful.
The Disability Discrimination Act 1995 – this act is designed to prevent discrimination against people with disabilities, covering employment, access to education and transport, housing and obtaining goods and services. Employers and landlords must not treat the disabled person different to a non-disabled person.
Legislation to Protect Confidentiality
Data Protection Act 1984 - this act protects information about living individuals held on computer and has been fully in force since 1987. The act aims to ensure that all computerised personal data:
- Is accurate and up to date
- Has been obtained fairly and lawfully
- Is used for specified and lawful purpose
- Is kept confidential
- Is available for scrutiny
Why is confidentiality an ethical issue?
From one (utilitarian) point of view, without patients or clients being willing to disclose personal and sometimes very intimate and embarrassing information, health and social care professional would not be able to do their job of advising and assisting clients and patients. Therefore it is a matter of prudence to maintain confidentiality.
Codes of practice charters and policies
Health and social care workers such as nurses follow a code of professional conduct published by the nursing and midwifery council. This code has similar principles to the GSCC code for social care. Here is a summary of the key principles: in caring patients and clients you must:
- Respect each service user -individually
- Obtain consent before any treatment is given
- Protect confidential information
- Co operate with others in a team
- Maintain your professional knowledge and competence
- Be trustworthy
- Act to identify and minimise risk to patients and clients
Empowerment - half a century ago, expert professionals held the power and made decisions about what kind of treatment the service user should have. The service user had no say at all and no power. But now the theory of empowerment is that health and care staff should not make any decisions and take control of the service user lives. The care staff should communicate their knowledge to service users so that they can make the decisions and choices about what treatment they would like. Empowering communication is communication that aims to give the service users choice and control.
TRANSMISSION OF VALUES
AWARENESS OF NEEDS: - Maslow’s hierarchical of needs
1. Personal growth often depends on sharing ideas and interaction with other people
2. A sense of self-esteem is developed in the context of other people’s reactions towards us.
3. Communication enables people to show affection and build attachment to others
4. Communication helps to reduce feelings of threat
5. Communication about needs for assistant, pain is all-important in care work.
Here are some ideas of transmitting care values:
ASSESSMENT OBJECTIVE
The nursery that I went to have a learning centre - this area was for older children up to the age of five years old. The children here enjoy a variety of dance and drama as well as messy play, construction and creative sessions. Also at this stage children receive a gentle introduction to other subjects such as science, maths, English and IT.
This is where I carried out my interactions with the children. But before I could carry out any interactions I had to get permission from the manager of this nursery. I also can’t use any of the children’s names in this unit because of protection. So the children are called; child 1, child 2, child 3 and child 4.
INTERACTION 1
There were four children that I did my interactions with. I spoke to them using Basic English words so that they could understand me and use their listening skills. In this group we read a book, which was “animals in the zoo”. This book had basic words, I read the book to them and then I asked them what they thought about the book and what the book was about. They all discussed in a group what the book was about. It was found that the children were able to recall what has happened in the beginning of the book and the end. But they weren’t able to recall what happened in the middle of the story.
INTERACTION 2
Using the same group of children I used flash cards, which contained pictures of the zoo animals in their habitat. Each child was given an opportunity to state what they could see and what was going on in the pictures. It was noted that the children were more responsive and had greater depth to there description of the animals. It was also found that all of the children participated with a lot more confidence.
INTERACTION 3
In this interaction I decided to use visual and touch, communication skills. I along with the help of assistant put together models of zoo animals each in there own habitat. The same group of children were then asked to describe and discuss what they saw in each habitat. It was established that the description the children gave of the zoo animals and the environment was again very detailed and further more enhanced because they were able to use touch and visual communication skills, this enabled the respondents to give detailed description of the animals i.e., texture of their skin, the shape of their body. Also they gave detailed descriptions of their habitats i.e. living in mud, straw, fields and amongst trees.
TRANSMISSION OF CARE VALUES
From the class I asked four volunteers to assist me in my research, Thus giving freedom of choice and valuing the diversity and inequality. I had decided to choose two males and two female respondents, therefore preventing gender discrimination. Because it was a group of children from one particular class there was no discrimination against age or individuals ability within the class, as they were all from the same age group and of same ability.
All respondents’ personal details were kept confidential. The respondent were given a choice of what story they wanted to choose and where they wanted to sit and read it therefore respecting individuals rights to making choices and creating a positive learning environment. This also empowered the respondents to be independent and showing awareness of their preference and needs.
BARRIERS TO COMMUNICTION
From the discussion it was noticed that some group members were able to express their thoughts and ideas more than others therefore the information collected could have been just from one or two group members therefore not given a complete overview of the research topic. In order to prevent this I gave equal amount of time and asked the same questions from each respondent to end
To ensure reliability of data collected.
Another barrier to communication was the environment that the responded were in this was overcome by giving the respondents a choice to what environment they wanted to be in, i.e. did they wanted to go outside or remain in class or any other place to create a positive learning environment.
CONCLUSION
Through these interactions I was able to show knowledge and understanding of communication values and transmission of values from the children. Each of the three interactions undertaken – a group interaction with the children in different setting areas and with different things – has demonstrated the need to apply knowledge and understanding of communication, values in care settings and the transmission of these values in the process of communication.
Also in this report I have chosen the barriers to communication in the interactions and how I overcame these barriers in the nursery care setting. I have also shown the different ways of communication skills that took place in the three interactions. I have also shown the need to respect confidentiality of the respondents.
All of these points add to the need for knowledge and skills in communicating and transmitting values. Also there needs to be a good understanding of the value base of care so that in all communication in the care areas are positively promoted. This would not be possible without knowledge, understanding and skills.
EVALUATION OF REPORT
From my three interactions, which I carried out, I was able to conclude that interaction three was the most enhanced out of all. This was because the children were able to use their visual and touch senses to take in information and then communicate back in greater detail. This interaction shows that the children were able to describe and communicate what they saw because it was available to them in object form and they could touch it. The other interactions were just as plausible but limited to this particular age group. This showed that certain communication techniques weren’t suited to younger age groups and the need to expand the delivery of information using other tools is necessary, as shown in interaction two and three.
Not all the different types of communication were used here such as cultural variations, electronic technology etc because they were not relevant in these interactions. But some communication and the skills involved were discussed in the interactions and used. Barriers to communication were shown and also were overcome in the interactions above. But again cultural, language differences, beliefs and etc were not relevant to the interactions above; they could have been if I was to choose the respondents my self for the interactions. I have also shown understanding and knowledge of the value base of care in all of the interactions and the transmission of values.
Due to lack of time and resources available I was not able carry out research in other areas of communication. If further studies were to be undertaken I would recommend a larger group to research and also use different communication skills.
I believe that this portfolio could have been more detailed and extended with other information. If I had more time I would of carried individual interactions and more group interactions by using other communication skills and using different age group respondents and then comparing the communication techniques and level of understanding to see what results I could get.