There are a number of different forms of communication that are employed in a care organisation. The usual everyday methods of communicating such as speaking, reading, writing, and listening are employed. Crucially however, non verbal communication skills are also of paramount importance, especially when delivering care to older people living with dementia. Simple and effective communication skills are required on a daily basis to ensure vital messages are conveyed to all individuals in the care environment.
All communication needs to be in an appropriate manner in order to protect an individual’s confidentiality, but in the same breath be available to all those delivering care to that particular individual. Communication is a particularly fluid area within any organisation; breakdowns in communication occur particularly easily and can have particularly negative consequences. It is for this reason communication has to be proactively managed with some focus on positive outcomes for all concerned. In today’s electronic world much of the communication in my daily job takes place via email.
Email has become the primary method of communication for those working in management and administration, and increasingly is being relied upon to deliver messages to individuals everywhere including nursing and care staff. The use of email does have a number of significant advantages including the ability to convey the same message to a large number of individuals very quickly. The use of email leaves an audit trail to evidence the communicating of certain messages. It can therefore be very beneficial in this respect.
Over reliance on email has, however, become an increasing problem with individuals resorting to email as opposed to having a conversation. Communication that would have previously taken place via a face to face conversation or by use of the telephone has, in many cases, been replaced by the use of email. At Gibraltar House we have collected emails addresses for all those individuals with whom we have regular contact such as staff, residents families and social workers. Increasingly we are using email to stay in touch with all of these stake holders.
We are finding that use of this tool, in the right circumstances, enables us to keep all the stakeholders better informed of what is happening at the home. Individuals feel more involved and more part of a team. We are still mindful, however, that there are limitations to this type of communication and email cannot take the place of team meetings or one to one conversations. Whilst we are making use of modern communication techniques such as email, there can be no real replacement for face to face meetings.
In order to foster communication across the various teams and grades that work within the home, we operate a fairly complex meeting diary. This meeting diary incorporates meetings for teams that work in each geographic area of the building, as well as meetings for each grade of staff such a staff nurses or senior carers. Operating a range of meetings allows in depth discussion to resolve issues tht arise in a consultative manner. For example we may have an issue on the first floor of odour problem due to staff practices, but the second floor may have an issue of low morale due to repetitive staff sickness.
There may on the other hand be issues that all saff nurses need to be aware of such as a change in the policy for management of admissions. Holding a variety of staff meetings allows for the dissemination of messages that are relevant to each staff group. Each meeting is minuted and these minutes are shared by email. In this way we are able to combine different forms of communication. Through such combinations we are able to reinforce key messages. Another example of a combination of communication can be found in the form of shift handovers.
These are a critical method of communication in any care organisation. The residents in our care rely on the fact that those providing the care will be fully briefed in their care needs and know how to react in every situation. For example if someone has had a bad night they would not expect to be woken up first thing in the morning by staff bustling around. In order for staff to be mindful of these aspects, and hence provide appropriate care interventions, they need to have been provided this information through handover.
Handovers therefore need to be prepared by the nurse giving the handover carefully. The nurse had a set period of time to communicate all relevant information to the next shift. Communication must therefore be succinct but comprehensive at the same time. The nurse also has to provide information written information in the form of written entries in the daily notes. These written entries should be more comprehensive than the information passed over at handover. In this way the nurse has to ensure everything is recorded in the correct place and then summarised for handover on the handover sheet.
This in itself is a key skill; the ability to summarise information and effectively communicate the key points to another person. Failure to complete this process effectively can have real and significant effects for the residents in our care. All of the communication methods detailed above are used in conjunction with an extremely detailed care planning documentation system, which prompts for the timely and accurate recording of all aspects of a resident’s care.
The documentation system that we use at Gibraltar House is designed centrally via a working party made up of representatives from each PSP care home. Each resident has their own care planning file, which ensures that documentation for each resident is kept separately and increases the security of this information and reduces the risk of documentation being confused between residents or inappropriately disclosed to the wrong party. Care planning files are kept in secure cupboards at each nurse station and are generally accessed only by nursing and senior care staff.
In this way the medical information is kept secure and confidential. With the use of any care planning system the team has to ensure that the information is accurate and updated regularly. Monthly reviews of the care planning file are scheduled on the set day of each month in order to ensure that the information contained in the file is accurate and updated and that any changes in the needs of residents have been updated. Some data is held and communicated solely electronically via our specialised computer database called Coolcare.
This database holds resident and staff data that is updated by care home staff and then utilised by Head Office in the performance of their various functions. The data is stored on the servers at Head Office and is only accessible to registered users via secure web access. When updates are made to this information “flags” are set by the person inputting the update indicating to other users that the information has been updated. In this way information is exchanged between sites in a purely electronic fashion.
The electronic database holds a vast amount of information and therefore it is important to ensure its integrity and accuracy. We have found that the best way to ensure the accuracy of information is to ‘use’ the information. For example staff lists, resident lists, and equipment lists are all produced from this system. An example of such a list is the birthday list for residents. By running this from the system the data is used, and potential errors are picked up and corrected. The information is also reported on in weekly and monthly cycles.
For example the contracted hours report is produced at the end of each month to identify positions that we may need to recruit for due to changes in contract hours. The use of this report to drive recruitment efforts ensures that the data is queried and hence inaccuracies are picked up and corrected. Despite all of the various methods of communication in use within organisation, communication could always be improved upon. Recently there has been a drive to ’empower’ teams within PSP Healthcare. Individuals can only be empowered if they have they the relevant skills and knowledge with which to address issues and make decisions.