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Communication

Communication

Communication in home care has 2 main aspects:

  • communication with the person using home care (and their carer, family, or friends)

  • communication among professionals.

It refers to both written and non‑written communication. As with person‑centred care as a whole, effective communication is an ongoing process. As a person's needs or preferences change, so may their preferred forms of communication.

Key resource

National Voices and Think Local Act Personal (TLAP) have produced a series of 'I' statements in A narrative for person-centred coordinated care expressing what integration and coordination of care and support look like to people who use services. It considers the outcomes and experiences that are most important to them.

It can be confusing if many different professionals are involved in a person's care and support. Good communication is vital for keeping misunderstanding and distress to a minimum. Ideally communication will be face‑to‑face – but this is not always realistic. Effective communication methods, such as using clear and concise language and listening carefully, should always be used, no matter what the medium.

Case study

People with communication difficulties or sensory loss may feel an increased sense of social isolation if they are not supported to maintain contact with their family and friends. Social isolation has a negative impact on mental and physical wellbeing. The Debenham Project (featured by SCIE) offers local support to those living with dementia. Volunteers (with professional support) lead a comprehensive range of activities, supporting both the person with dementia and their carer.

Care diaries

Care diaries (recommendations 1.3.22–1.3.24) (sometimes known as 'care records') are detailed logs of all care and support provided. They highlight the person's needs, preferences and experiences. Care diaries enable practitioners to communicate effectively with the person, the carer, and with each other – especially if practitioners do not routinely speak in person. Every practitioner (including home care workers) should ensure that the diary is filled in on each visit, including details of any incidents or changes. It should be comprehensive enough to keep people, their carers and all professionals fully informed. Everyone involved in the person's care should always read new entries in the diary, adding information in, with the named care coordinator (recommendation 1.3.6) having overall responsibility for it. There is no set format for a care diary, but everyone involved in the person's care should find the format easy to use.

Case study

Mary A is her own care coordinator. She stores her care diary on her tablet device (including letters from her consultants, scan results and medication charts). Mary also has an app that helps her to monitor her vital signs and activities each day. Her care staff fill in a report on each visit, noting her health and wellbeing, her nutrition and hydration, her skin condition, and medicines. Mary gives home care staff copies of reports, but it is her information to control as she wishes.

Late or missed visits

As well as major risks to the person's health and wellbeing, late or missed home care visits (recommendations 1.4.10–1.4.15) can cause distress to the person expecting a call at a certain time. It can also break people's trust in the home care service. People who live alone, or lack capacity, may be particularly affected by changes to a usual visit. Any unexpected changes to a service should only occur in exceptional circumstances. They should be communicated immediately and in a way that is clear, meaningful and accessible to the person. Alternative arrangements for late or missed visit should be set out clearly. This may include making arrangements for a family member, carer, or neighbour to visit (and giving home care workers contact details for this person).

The United Kingdom Home Care Association (UKHCA) has analysed the findings of Not just a number: Review of home care services, an overview of CQC inspections of home care services, and made some recommendations for providers. These include the recommendation that providers should consider auditing the number of missed or late visits (and the reasons for these) occurring over a minimum period of 4 weeks. They should then review their practice to reduce them.

Telecare

Telecare (recommendations 1.4.16–1.4.20) uses technology to help people live independently at home. It may include personal alarm systems and sensors. In line with person-centred care principles, it should meet the person's needs and wishes and should not replace face‑to‑face contact (unless the person consents to this).

Good communication is important in telecare. It includes:

  • offering information about their telecare options

  • recording in the home care plan how the telecare equipment helps meet the person's needs (and ensure the person understands this)

  • regularly reviewing the use of telecare to ensure the person finds it useful and that it continues to meet their needs (which can change over time).

People, and their carers, should be helped to understand how the technology works and (if appropriate) should be trained to use it.


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