Supporting People With Communication Difficulties

1. @mcadorset #mcaconference10 Supporting People With Communication Difficulties • Kirsty Mayhew and Megan Williams • Speech and Language Therapists • Adult Learning Disability Services

2. Learning Outcomes • By the end of this session we hope you’ll be • able to… • List the kinds of communication difficulties that can impact on decision making. • Know what the MCA requires practitioners to do. • Describe how to find out about a person’s communication support needs. • Know some ways to support people with communication difficulties.

3. Assessing Capacity • Whether the person can… • Understand the relevant information about the decision to be made including… • What decision they need to make and why they need to make it. • The likely consequences of making, or not making, a decision. •  Retain the information. • Use or weigh up the information. • Communicate their decision.

4. Communication difficulties that can impact on decision making • These include… • Sensory impairment – eye sight, hearing • Attention – looking, listening • Understanding – verbal, non verbal • Memory and recall • Expression – needs, wants, feelings, preferences, wishes • Speech – intelligibility • Literacy • Relating to other people

5. Mental Capacity Act (2005) • Aims to protect people who lack capacity to make particular decisions, but also to maximise their ability to make decisions, or to participate in decision-making, as far as they are able to do so. • 2nd statutory principle: • A person is not to be treated as unable to make a • decision unless all practicable steps to help them • to do so have been taken without success.

6. Mental Capacity Act (2005) • Practitioners are required to do everything they • can to support a person’s communication when… • Assessing their capacity to make a decision. • Considering their participation if they lack capacity.

7. Things to find out… Understanding and experience of this decision ? Is it meaningful and motivating ? Understanding of timeframe ? a What are the best ways of communicating and giving information about this decision ? Means Reasons Decision to be made Opportunities Who’s best to support ? Where’s the best place ? When’s the best time ?

8. Sources of information and support • The person or other people who know them well. • Information recorded about the person’s • communication support needs… • Communication Passport or profile. • Accessible Information Standard. • If unsure, consider referral to SALT service for assessment of the person’s communication skills and abilities.

9. Accessible Information Standard The Accessible Information Standard says that people who have a disability or sensory loss should get information in a way they can access and understand. It also says that they should get support with communication if they need it. The law says that all organisations that provide NHS or adult social care have to do what the standard says. This is part of the Health and Social Care Act 2012.

10. Accessible Information Standard All organisations that provide NHS or adult social care must do 5 things… • Ask • How should we contact you ? • How should we give you information ? • Who might you need with you when you see us ? • What do we need to do when we see you ? • Record • Alert • Share • Act How does your organisation collect and record this information ?

11. Inclusive / Total Communication We are all responsible for communicating in ways that include everyone. We can include people by communicating in lots of different ways. This is called Inclusive / Total Communication.

12. Inclusive / Total Communication Is about building shared communication with another person by… • Using easier words. • Keeping sentences short. • Showing what we mean as we speak or write using • objects, photos, pictures, symbols, sign. • Slowing down. • Giving people time to understand and respond.

13. Symbolic Understanding Apple Symbol - something that represents or stands in for the real thing Written word Symbols These symbols are called symbols ! Line drawings Photos Objects The real thing Always check that people can understand the things you use.

14. Understanding – Verbal & Non Verbal • What information does the person use to make • sense of what’s happening or said ? • Be mindful of what your non-verbal communication • is saying… • Facial expression • Nodding / shaking head • Tone of voice • Verbal understanding - easier words, short sentences. • Checking understanding in a way that demonstrates understanding… • Recap • Multiple choice / forced alternatives • Selecting images You like it here, don’t you ? (smiling, nodding, sounding positive) Do you understand ?

15. Supporting Communication • What does the person need to know ? • What’s the best way to present the information / • support conversations ? • Easy read – Bournemouth People First Easy Read Checklist • Talking Mats – https://www.talkingmats.com/ • Take photos, video • Ensure the person has time and support to go over • the information at their pace. • If unsure, consider referral to SALT service for • advice on supporting communication.

16. Local SALT Service Contacts • Adult Learning Disability Services • Hillcrest, Bournemouth - 01202 636174 • Acland Road, Dorchester - 01305 751360 • Adult Community • Shelley Road, Bournemouth - 01202 443712 • Alderney Hospital - 01202 305719 • Blandford Hospital - 01258 394084 • Yeatman Hospital - 01305 361543 • Weymouth Hospital - 01305 762584

17. Any Questions?

18. Thank you for coming You will be emailed an online evaluation form Your certificate will be Emailed once this is completed Conclusion