Dignity factors - Communication: Ideas you could use
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Use advice posters to remind staff about better communicationOpen
Produce posters with advice to staff on how best to communicate with people. You can include reminders on good telephone manners, tips on how to communicate well face to face, and factors to bear in mind when speaking or writing to someone who has a communication difficulty, whether through a disability or because of a language barrier.
This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Southampton University Hospital NHS Trust’s Essence of Care Group – for further information contact Julie Dawes, Associate Director of Nursing, Tel 02380 798435. Email julie.dawes@suht.swest.nhs.uk
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Create a team of people to provide a multi-racial outlookOpen
Either recruit people with expertise in diversity or identify people to train and develop expertise, so your organisation has people who can bring a multi-racial perspective to the care provided.
This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Birmingham and Solihull Mental Health Trust, where a diversity department advises and supports staff, facilitates training and has Race Champions. Staff also have access to interpreters for all languages who will come in and see patients and carers and assist with assessments, consultations and ward rounds. In addition a Black and minority ethnic team offers support to patients and staff in providing cultural awareness training. There are information leaflets on wards available in a range of languages.
For further information contact Linda Playford. Email Linda.Playford@bsmht.nhs.uk
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Ask people for their opinions when making changes to your serviceOpen
If you are thinking of making a change to the physical layout of your premises, or to the way you go about doing things, involve people who use services and carers in your discussions right from the start – they offer a perspective that can give you valuable insight.
This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Luton and Dunstable Hospital: when they redesigned one of their clinics they involved patients and carers, who highlighted ways that the old layout was adding to patients’ anxiety. As a result, the clinic has been redesigned with the patients’ needs first.
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Use the right equipment to meet people’s communication needsOpen
Where possible, use appropriate equipment to make it easier for people to communicate – for example RNID crystal loop listeners, wipe-clean A4 boards and speech amplifiers.
This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Ashford and St Peter’s NHS Trust. The trust’s Communication Group looks at how the communication needs of patients can be met and highlights any areas of concern or best practice in regard to patients’ communication. It is currently building up a supply of equipment within the trust to facilitate more effective and dignified communication.
For further information contact Harriet Stephens, Lead Nurse, Practice Development. Tel 01784 884940. Email harriet.stephens@asph.nhs.uk.
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Provide menus in different formatsOpen
Introduce a range of menus in different formats to help people who cannot communicate what they would like to eat. You could include a multi-cultural pictorial menu to suit Halal, Afro Caribbean and Kosher diets, for example, as well as braille menus.
This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by County Durham and Darlington NHS Foundation Trust. As well as using different formats for menus, the Trust employs a chef who is a qualified signer and able to assist deaf patients in making their choices.
For further information contact Alison McCree, Associate Director of Facilities & Performance. Tel 01325 743070 Email alison.mccree@cddft.nhs.uk.
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Develop a card or booklet to help communicate people’s needsOpen
Where people have difficulties communicating, develop a way of recording their needs in a booklet or a card that contains essential details, such as whether support is needed with personal care and the holder’s nutritional preferences. This can be referred to wherever necessary; for instance, to inform new members of staff or medical staff on hospital visits.
This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Barnet Learning Disabilities Service, who use it to help patients communicate their needs to hospital staff who may not be used to working with people who have learning disabilities. Their Health Information Card (PDF file) holds essential details of the person’s needs.
For further information contact Sarah Pope, Acute Liaison Nurse – NHS Barnet. Email sarah.pope@bcf.nhs.uk.
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Look below the surface when communication is a problemOpen
When communication is a problem, bear in mind that the reasons for a person's distress may not be as they first seem. It may be useful to use an advocacy service to bridge a communication gap.
This idea can be used in different settings - so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by the Isle of Wight Advocacy Trust. This is Tracy's story:
Tracy is 32 and has lived in the same residential home since she was 17. She has no relatives or friends on the Isle of Wight, and is funded by a mainland Authority. Tracy has very high support needs, and her behaviour is challenging. She chooses not to access day care services, and becomes extremely agitated when day care is suggested. Tracy was referred for an advocacy assessment following a review.
An experienced advocate spent time with Tracy creating pictures of her likes and dislikes. Tracy was able to communicate that being given regular injections, which were required for medical reasons, distressed her. These injections always followed her visits to the day centre and were, it seemed, related to her refusal to attend. The advocate met with staff, and it was agreed that another form of medication would be adopted; Tracy has since become far less aggressive towards staff.
It was evident that Tracy missed her family and the advocate requested that the care manager research residential homes closer to them on the mainland, two possible homes were found. It was agreed that Tracy may find the long journey stressful and so the advocate travelled with a video camera to film the possible new homes and members of Tracy's family.
The DVD enabled Tracy to be involved in the choice of new home; it worked well as a communication tool and this method can be used again in the future.
For further information contact Jan Gavin, Chief Executive, Isle of Wight Advocacy Trust, Quay House, The Quay, Newport, Isle of Wight PO30 2QR. Tel 01983 559299. Mobile 07734 448069. Website: www.iwadvocacytrust.org/.
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Use video or DVD to communicate people’s individualityOpen
Consider how you could use video or DVD to support the people who use your service. For example, a video of family and friends can be a comfort to people, and if it includes information about people’s likes and dislikes, this can be an excellent way of communicating a person’s individuality to care workers.
This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by the Isle of Wight Advocacy Trust in order to support Jane, a woman of 29 with severe learning disabilities.
In October of 2005, Jane’s father died unexpectedly and her mother was diagnosed with a terminal illness. Jane was moved into a residential home without the usual preparation, planning and transition.
Jane was withdrawn, frustrated and very anxious and. Having previously suffered mild and infrequent epileptic fits these became frequent and more severe. Staff had little knowledge of epilepsy, and the continuity of care was poor.
The Advocacy Trust met with Jane’s mother and the care manager and staff from the home and day care services to discuss how they could work together to support her. It was agreed that staff at Jane’s home would receive epilepsy training.
In addition, an experienced advocate was allocated to Jane and her mother to make a DVD diary. Consent for the filming was obtained from those involved. The diary is in two parts: 'Me and my mum’ and 'Where do I want to live?’ Jane is able to use this DVD at her day centre, or at home with the use of a laptop computer. When Jane becomes anxious and distressed, the DVD has an immediate calming effect on her. Within the DVD, Jane’s mother talks of Jane’s likes and dislikes. This is a useful source of information for care workers now and in the future.
For further information contact Jan Gavin, Chief Executive, Isle of Wight Advocacy Trust, Quay House, The Quay, Newport, Isle of Wight PO30 2QR. Tel 01983 559299. Mobile 07734 448069. Website www.iwadvocacytrust.org/.
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Use the single assessment process to deliver person-centred careOpen
Using the single assessment process, talk to people on admission about what they want to achieve and how they would like their care to be delivered. Gather personal details such as how the person likes to be addressed, how they wish their privacy to be respected and issues of consent for information sharing with other organisations and partnerships.
This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Leasowes Intermediate Care Centre in Smethwick. Leasowes is a bespoke 20-bed unit where people (predominantly older people) can be assessed and rehabilitated. Often, people come in with complex needs and multiple medical conditions that may have culminated in a fall and they may have had difficulty managing at home. By building strong relationships with colleagues in the community staff help to ensure that good quality, person-centred services continue after the person has been discharged.
For further information contact Marian Long, Email marian.long@nhs.net.
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Improve practice using the Essence of Care benchmarking toolOpen
The 'Essence of Care' benchmarking tool was designed to support hospitals to measure quality and improvement. The benchmarking process helps practitioners to take a structured approach to sharing and comparing practice, enabling them to identify the best and to develop action plans to remedy poor practice.
This idea can be used in different settings - so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Derbyshire Mental Health Services where they have used the benchmarking factors of privacy and dignity to measure practice in each clinical area. This includes how staff converse with patients and carers and what information is given; it also provides a check that information is in a format that the person is able to understand.
For further information contact Mark Ridge, Head of Patient Experience, Tel: 01332 362221. Ext.3771 Email mark.ridge@derbysmhservices.nhs.uk.
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Listen to and support carersOpen
Using a questionnaire to understanding their needs, develop care and support programmes tailored to each carer.
This idea can be used in different settings - so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Cambourne Redruth Community Hospital. The aim was to offer better levels of information and support during the admissions process, which can be an extremely frightening and confusing time for all concerned. Carers were asked to fill in feedback questionnaires and a support forum was set up; stronger links were also developed with existing carer support networks.
Engaging with carers has a beneficial effect on the people using the service giving a better understanding their individual needs and the needs of their families. The good feedback has also boosted staff morale.
For further information contact Alison Morris, alison.morris@ciospct.cornwall.nhs.uk
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Aid communication for hearing impaired people through textOpen
Introduce an emergency texting service for people with hearing or speech impairment. This will engage the emergency services and promote recognition of the needs of this group. This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Middlesborough Deaf Centre. A need for the emergency services to consider the needs of those with hearing and speech impairment was identified. Not having to rely on a third party to contact services on your behalf promotes empowerment. The emergency texting service is potentially life-changing, and life-saving. The idea was positively received and emergency services were key stakeholders in development. Experts from companies that specialised in texting services were brought together with the emergency services to develop the system.
This work encourages trial and use of a technology that is sometimes feared amongst people with hearing and speech impairments. Telecommunications systems are often perceived as alien and become barriers because of people’s reluctance to try something new. The work aims to promote independence and build confidence.
For further information Gill Marshall, gill_marshall@middlesborough.gov.uk
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Use a calendar to communicate vital informationOpen
Produce and distribute calendars to people receiving community care to ensure that visiting health professionals have access to vital health information to aid their decision-making. Once people have received their personal calendar, (with the person’s permission) insert next of kin details, contact numbers for people who could be called upon to stay with the person to avoid hospital admission and a list of current medication.
This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.
For example, this idea has been put into practice by Nuffield Road Medical Centre. They consulted on the design and sent out just under 1,000 calendars free of charge to people over 75 years old. Their calendar uses large print and has emergency telephone numbers and a wallet to keep hospital discharge or appointment letters. Each month the calendar gives public health information and tips e.g. about how to keep warm in winter.
For further information contact Greta Evans, greta.evans@nhs.net
