1.1 Identify the different reasons people communicateLots of communication takes place in a care setting between many different people for many different reasons, some of these include;• Expressing feelings, emotions, wishes, needs and preferences. As a carer you need to be able to find ways to encourage the service users that you support to feel confident in expressing their feelings, talking about how they wish to be treated and their likes and dislikes, and also talk about you own in supervisions for example. • Develop and maintain positive relationshipsEffective communication is essential to build and develop relationships with the people you support, their families and friends, GP’s, nurses and any other professionals involved in a person’s care, it also enables people to interact and relate to one another. • Socialising and building networks Carers should be encouraging and enabling service users to socialise whether its in the home, local community or maintaining family relationships. Staff should also be encouraged to socialise and build relationships within the local and wider community.• Sharing ideas, information and experiences This could be at meeting and/or handovers, discussing issues and problem solving as a team to be able to provide the best care for the service users. • Giving and receiving support Service users and their relatives often seek reassurance from carers or the senior team as a way of developing their self-confidence when in the home. In response, carers should use praise and touch, and give time and attention as a way of rewarding a person’s efforts and achievements and to reassure them. Some care settings also use support groups, staff meetings and appraisals as ways of providing carers with support and reassurance about their work performance.Recently I had to go and asses Mrs X at home with a view to her potentially moving into Swan house, Initially we received a written assessment of Mrs X’s care needs via email from her Care Manager, once this was received I then phoned Mrs X husband to arrange a day that was convenient for them for me to go and meet and asses Mrs X. Once that was arrange, I communicated that to the Care Team Leader and management team via the message book. On arriving at Mr and Mrs X’s house I made sure that I came across polite and kind by making sure that I introduced myself, was smiling, speaking clearly, and using my body language in the current manner. Throughout the assessment I ensured that both Mrs X and Mr X understood why I was needing to ask questions and what would happen with the information. After I had gathered all the information required, I informed them that I would need to go back to the home and discuss their case with the care team leader and that I would be in touch the next day. I then relayed the I formation I had gathered and recorded to the care team leader and a decision was made that we would be able to meet Mrs X’s care needs at Swan house and I could offer her a place. I phoned them the next day to inform them of the outcome of the decision and arranged a day convenient to them for Mrs X to move into Swan House. I then communicated this to the senior team via the message book and diary, and emailed Mrs X’s care manager to inform them of the outcome.Information gathered at Mrs X’s assessment was then used to begin building a care plan and relayed to the care staff via the unit message book, hand over book and verbally in handovers. This whole could not happen without effective communication. 1.2 Explain how communication affects relationships in the work setting Effective communication affects all aspects of work in a care setting, delivered in a clear concise way in such mediums as written in message books or verbally in handovers and team meetings it can build up teamwork, by increasing trust between staff members, enable negotiation, prevent or resolve conflict, raise moral, make sure that everyone has the required information enabling them to carry out their roles and responsibilities effectively, prevent misunderstanding that could potentially negatively affect work performance, enable staff to ensure that individuals needs and preferences are met, avoid demotivation with in the team and create a positive environment to work in. It also enables reflection leading to improvement and positive changes. Good effective communication is essential when building relationships with service users and their families, it aids understanding of individual’s needs and wishes. Effective, clear and concise communication is also essential with individuals GP, nurses, CPN, physio and any other health professional involved in an individual’s care to ensure that all parties involved have the information required so that they can all work to provide the best possible care for the individual and avoid misunderstandings or mistakes happening. As a senior care assistant, it is important that I understand and recognise some of the accepted theories related to one to one and group communication, doing so enables me to apply their concepts whilst promoting effective communication at work, one theory related to group development is Truckman’s theory. Dr Bruce Truckman researched the way that groups develop and operate. His theory focuses on the way a group tackles a task from the initial formation of the group through to the completion of the task, he suggests that when groups work together, they go through a series of stages progressively coming more effective. As the group moves through the stages the group leader/team leader/me would need to adjust the style of leadership to accommodate the groups progress towards effectiveness. ‘’ The stages that Tuckman identifies are as follows: • Forming – establishing the purpose of the group, the expected outcomes and the relationship of the group with the wider organisation. Individual roles and responsibilities are not yet clear and processes are often ignored as members work at getting to know each other. Very little progress is made towards the goal and the leader needs to be directive and prepared to answer questions as members test them out. • Storming – during this stage, members of the group compete with each other, and often with the leader, to establish their position. Sub-groups and factions may be present as power struggles persist. Decisions are hard to confirm because this requires compromise. Clear direction and purpose can be obscured. The leader should be coaching. • Norming – agreement begins to appear amongst team members. Roles and responsibilities are allocated and accepted, and big decisions are made collectively as the team establishes processes, working styles and methodologies. There may be some socialising and enjoyment of each other’s company. The leader facilitates and enables the group to work together. • Performing – the group finally begins to make progress towards achieving goals and objectives. There is a high degree of self-direction and autonomy and any disagreements are usually sorted out within the team. The leader needs to delegate tasks and projects, overseeing without interfering. • Adjourning – this is when the goals are achieved, tasks completed, and the group is ready to break up and move on. This stage can engender some sadness and feelings of loss if members have bonded successfully. However, they can feel good about their achievements’’ (Hodder Education, Btec Level 3 Health and Social care, 2013). 1.3 Explain ways to manage challenging situationsIf faced with a challenging situation, good communication skills are important to be able to positively manage them, and ultimately diffuse the situation. Recognising warning signs for when a situation has the potential to involve conflict can also be useful as it could mean that you can diffuse the situation before it escalates into a challenging situation. You should always try to remain calm, avoid crowing the individual and where possible take some time to assess the situation before acting. You should keep your body language neutral and you should speak clearly and slowly to try and ensure that you are understood.You should give the individual plenty of time to be able to process what you are saying, show compassion and empathy and try to show that you are non-judgmental. For individuals who have a cognitive impairment it is important to try and observe what they are trying to express through their behaviour. For example, an individual might be shouting but their body language and facial expressions may tell you that they are feeling frightened or unhappy. Recognising signs like this can help inform you of what may be contributing to or causing the behaviour enabling you to address it and allowing for more effective communications. I you have tried everything you can but the individual continues to behave in a challenging way it may be best to take some time away from the situation and leave the individual to calm down before approaching them again. After the situation has passed you should report and record it in line with Heritage Care’s policy. This means that I would inform the manager or deputy manager of the incident, write a factual incident statement or record the incident in the service users care plan. Where necessary and appropriate I would also pass on information to other staff members, the individual’s GP as they may require medical treatment/investigations or referral and inform the service users NOK if they wish. I would also reflect on the situation so that I can look after my own and other staff members well-being, this is important because I do not look after myself and/or other staff team members we may not be able to provide good quality care. ‘Heritage care group promotes positive behaviour support and expects staff to work with others to develop an individualised care plan that incorporates procedures to be employed to prevent and manage behaviours that present a challenge.’ (Heritage Care Group, Positive Behaviour Support, 2016). Within my job role I am expected to identify challenging behaviour, communicate with other staff members, managers, NOK, GP’s, advocates etc to help design and implement a person-centred behaviour management strategy to try and manage the challenging behaviour presented by an individual in the least restrictive way possible. I am expected to record this in their care plan and relevant forms e.g. Foreseeable challenging behaviour form, communicate it to all staff members via message books and handovers and support staff to implement the plan when necessary and asses its effectiveness. As a senior it is also with in my job role to support staff after incidents that they may find distressing and offer support as necessary. ‘’ 5.2 After incidents that staff find distressing Managers must assure the worker that distress is natural and consider offering support as necessary. This may include: • Providing support and offering access to other services, such as counselling. • Consideration of options to relieve the worker, such as: o Time out (while remaining on shift). o Taking some time off duty. o Temporary re-deployment to another service. o Strategies to re-integrate the worker to their workplace sensitively’’ (Heritage Care Group, Positive Behaviour Support Policy, 2016). 2.2 Describe the factors to consider when promoting effective communicationCommunication is about both the giving and receiving of messages, promoting effective communication require the consideration of both, the way the message is being given and the way the message is being received. There are several factors that must considered when promoting effective communication, they includeThe environment, communication can be difficult and ineffective if the environment is creating barriers. Things to consider include temperature, lighting, noise levels, seating and is the space appropriate for the communication that is required. E.g Conducting a supervision or an individual’s review in the lounge or communal space would not be appropriate because it is not a private space where communications cannot be over heard, the position of the chairs could also encourage of discourage communication if you are not facing the person or if there is an obstacle in the way. Personal space/proximity is the distance an individual keeps between them and others during social situations, everyone’s personal space differs base on gender, culture and personality differences. The study of Proxemics (personal space and its impact on communication) identifies four levels of personal space: Public- beyond 3.5 meters Social- 1.5-3.5 meters, an area for formal conversations and business transactionsPersonal- 30cm-1.5 meters, for friends and informal conversations Intimate- up to 30cm, reserved for close friends and family Research shows that people from different cultures have different personal space levels. Effective communication requires a message to be received in an effective way, Active listening is extremely important in letting people know that they are valued and ensuring that their choices and preferences are recognised. Active listening includes, allowing sufficient time, using ‘encouragers’ such as nodding to indicate that you are listening, being non-judgmental, reflecting or paraphrasing to show that you have understood and encouraging further communication by asking skilful questions. The individual’s condition, does the individual have a medical condition that impacts on the ability to communicate? For example, an individual living with Dementia could have difficulties in remembering and retaining information, following threads of conversation and finding the right words to say. Individual’s with a mental health disorder often experience difficulties in concentrating, anxieties and busy environments. Strokes usually cause damage to one side of the brain, if it causes damage to the left side then it can affect brain functions that are responsible for an individual’s ability to use language, potentially affecting an individual’s ability to speak, understand, read/write or their expression of what they wish to say, this condition is known as aphasia or dysphasia. If the stroke causes damage to the right side of the brain it could cause the individual to have difficulties in connecting information together such as being able to verbalise what they see or hear. Conditions such as arthritis can cause server pain and discomfort, if an individual is experiencing pain, they may appear disinterested or distracted.It is important to remember that everyone experiences illness and pain differently, so factors that could be considered will not necessarily be the same. Sensory loss, an individual who is unable to verbally communicate may have a difficulty expressing their needs and feelings unless some other form of communication can be established.This could include the use of signs, gestures, writing, pictures, noises or facial expressions. Visual aids such as pictorial cards could also be used or technology such as text-to-voice converters.An individual could be able to communicate verbally but not be able to hear what is being said, in this instance carers would need to ensure that they are facing then individual so that they can read their lips, or they may have to learn and use sign language.When communicating with individuals who are partially sighted/blind without hearing loss a carer would need to gain their attention first by speaking to them such as saying their name to make them aware that they are talking to them. In contrast when communicating with an individual who is blind and deaf a carer would need to initiate and communicate by touch e.g. gain their attention by placing a hand on the top of their arm Recreational drugs can include both legal and illegal substances such as tobacco, cannabis, cocaine, heroin, alcohol and controlled drugs such as sedatives or opiate pain relief. The use of these drugs can cause an individual to feel disorientated, confused or be unable to think and respond rationally to situations and interactions with other people.