Communication in Care Homes | Practical Staff Guide

Communication is at the heart of good care.

Every conversation, question, facial expression, handover and written record can influence a person’s experience of the support they receive.

For care workers, effective communication is about much more than speaking clearly. It involves listening, observing, understanding individual communication needs and giving people sufficient opportunity to express their wishes, feelings and concerns.

Good communication can help people feel respected, involved and understood. Poor communication, on the other hand, can contribute to distress, misunderstandings, medication errors, missed changes in health, complaints and potentially unsafe care.

This makes communication a fundamental professional skill for everyone working in residential care, nursing homes and other adult social care settings.

Why Is Communication So Important in Care?

People receiving care need to be able to express what matters to them.

This may include:

How they want to be supported
Whether they are in pain or discomfort
What they want to eat or drink
Their personal routines and preferences
Concerns about their care
How they are feeling
Whether they understand what is happening
Who they want involved in decisions
Their cultural or religious preferences
Whether they consent to particular care or support

Communication therefore affects virtually every aspect of care.

It is closely connected to dignity, consent, safety, safeguarding and person-centred care.

Communication Is Part of the Care Certificate

Communication is sufficiently important to have its own standard within the Care Certificate.

The 2025 Care Certificate Standard 6: Communication includes understanding different ways people communicate, identifying people’s communication and language needs, recognising barriers, using communication aids and assistive technologies, understanding behaviour as communication and maintaining confidentiality.

This reinforces an important principle:

Effective communication is a professional care skill — not simply the ability to have a conversation.

Start With the Individual

There is no single communication method that works for everybody.

One resident may enjoy conversation and communicate verbally with ease.

Another may have hearing loss.

Someone living with dementia may need additional processing time.

Another person may use British Sign Language, pictures, symbols or assistive technology.

Somebody recovering from a stroke may understand what is being said but experience difficulty expressing their response.

Care staff should therefore understand each person’s individual communication needs and preferences.

The person’s care plan may contain important information about:

Preferred name
Preferred language
Hearing or visual needs
Communication aids
Speech difficulties
Cognitive impairment
Cultural considerations
How the person expresses pain or distress
The best way to present information
Whether additional time is required

Staff should not assume that everyone communicates in the same way.

Listening Is as Important as Speaking

Effective communication requires active listening.

A care worker may technically hear someone’s words without genuinely listening to what they are saying.

Imagine a resident saying:

“I don’t want to go into the dining room today.”

A task-focused response might be:

“Come on, everyone is having lunch now.”

A more person-centred response would explore the reason.

Perhaps the resident:

Feels unwell
Is tired
Is upset with another resident
Finds the dining room noisy
Is embarrassed about difficulty eating
Simply wants some time alone

Listening creates an opportunity to understand the person rather than simply completing the task.

Give People Time to Respond

Silence does not necessarily mean someone has nothing to say.

Some people require additional time to:

Understand a question
Process information
Remember something
Formulate a response
Find the right words
Use a communication aid

Repeatedly asking the question or finishing someone’s sentence can make communication more difficult.

Where appropriate, ask clearly and then allow sufficient time for the person to respond.

Patience is an important communication skill.

Pay Attention to Non-Verbal Communication

Communication does not depend entirely on words.

People communicate through:

Facial expressions
Eye contact
Gestures
Posture
Movement
Tone of voice
Behaviour
Touch
Changes in usual behaviour

A resident saying “I’m fine” while appearing distressed may be communicating something very different through their body language.

Care staff should therefore consider verbal and non-verbal information together.

Behaviour Can Be Communication

This is particularly important when supporting people who have difficulty expressing themselves verbally.

Changes in behaviour may sometimes indicate an unmet need.

For example, a resident who becomes agitated might be:

In pain
Hungry
Thirsty
Frightened
Tired
Too hot or cold
Needing the toilet
Overwhelmed by noise
Confused about their surroundings
Missing someone
Unable to explain what is wrong

This does not mean staff should automatically assume the cause of someone’s behaviour.

Instead, behaviour should encourage professional curiosity.

Ask:

What might this person be trying to communicate?

Communicating With Someone Living With Dementia

Dementia can affect memory, understanding, language and the ability to process information.

Good communication may involve:

Approaching calmly
Introducing yourself where necessary
Using the person’s preferred name
Speaking clearly
Using straightforward sentences
Asking one question at a time
Reducing unnecessary background noise
Allowing additional response time
Paying attention to non-verbal communication
Avoiding unnecessary correction or confrontation

Most importantly, staff should communicate with the person rather than around them.

Someone living with dementia remains an individual with preferences, feelings and a right to be involved.

You can explore this further in our Dementia Awareness Training for Care Staff.

Supporting People With Hearing Loss

Hearing loss can easily create misunderstandings.

A person who appears not to understand may simply not have heard what was said.

Practical approaches may include:

Facing the person
Ensuring your face is visible
Reducing background noise where possible
Speaking clearly without shouting
Checking whether hearing equipment is being used appropriately
Avoiding speaking from another room
Checking understanding

Staff should follow the person’s communication plan and seek appropriate support if their hearing appears to have changed.

Supporting People With Visual Impairment

Visual impairment can also influence communication.

Care staff may need to:

Introduce themselves when approaching
Explain what they are doing
Avoid relying solely on gestures
Describe relevant surroundings
Ensure information is available in an appropriate format
Tell the person before leaving

Never assume that someone recognises who has entered the room simply because you recognise them.

Communication Aids and Accessible Information

Some people may benefit from additional communication support.

This could include:

Pictures
Symbols
Large print
Braille
Hearing loops
Communication boards
Electronic communication devices
Interpreters
Sign language
Advocacy

NICE guidance emphasises identifying and recording how people wish to communicate and providing appropriate support to help them express their views and participate in decisions.

Care staff should know where communication information is recorded and how to access appropriate support.

Avoid Jargon

Care professionals use terminology every day that may mean very little to residents or their relatives.

Terms such as:

MAR, SALT, IDDSI, PRN, safeguarding referral, capacity assessment

may be familiar to staff but unfamiliar to somebody receiving care.

Information should be explained in clear language appropriate to the individual.

NICE recommends using plain language and checking that people understand when complicated information or technical terminology is necessary.

Check Understanding

A person nodding does not necessarily mean they understood.

Staff should check understanding sensitively rather than simply asking:

“Do you understand?”

Depending on the circumstances, it may be more useful to ask the person to explain their understanding in their own words or use another appropriate communication method.

This is particularly important when information affects:

Consent
Medicines
Care decisions
Appointments
Risks
Treatment
Changes to routines

Communication and Mental Capacity

Difficulty communicating does not automatically mean someone lacks mental capacity.

The Mental Capacity Act requires appropriate support to help people make their own decisions wherever possible.

A person may require:

More time
Simpler information
Pictures
A quieter environment
Communication equipment
Support from someone who knows their communication style

Staff should not confuse difficulty expressing a decision with inability to make that decision.

Our Mental Capacity Act & DoLS Awareness guide explores this important area further.

Communication During Personal Care

Personal care requires particularly sensitive communication.

Before providing support, staff should explain what they are doing and involve the person as much as possible.

This helps protect:

Dignity
Privacy
Choice
Consent
Independence

Staff should not simply enter a room and begin providing care because the task appears on the care plan.

The person receiving support should remain at the centre of the interaction.

Communication With Relatives and Families

Families can provide valuable information about someone’s history, preferences and communication.

However, professional boundaries and confidentiality still apply.

Being a relative does not automatically mean someone is entitled to every piece of information about a resident.

Staff should understand:

What information can be shared
The person’s wishes
Consent
Mental capacity considerations
Organisational policies
When senior advice is required

When unsure, staff should seek appropriate guidance rather than guessing.

Communication and Confidentiality

Care workers regularly have access to private information.

Conversations about residents should not take place casually:

In corridors
In lifts
In communal areas
Around visitors
On social media
With friends or family outside work

Information should only be shared appropriately and for legitimate reasons.

However, confidentiality does not mean serious concerns should be kept secret.

If information indicates potential abuse, neglect or significant harm, staff should follow safeguarding and reporting procedures.

Our guide to Safeguarding Training for Care Staff provides further information.

Communication During Staff Handovers

Good handovers are essential for continuity of care.

NICE specifically highlights the importance of good handover arrangements when the same staff are not available.

Relevant information might include:

Changes in health
Changes in mobility
Food or fluid concerns
Medication issues
Behavioural changes
Falls
Skin concerns
Appointments
Emotional wellbeing
New professional instructions
Changes to a care plan

Handovers should be relevant, factual and respectful.

They should not become opportunities for gossip or judgemental comments about residents.

Written Communication Matters Too

Communication in care is not limited to conversation.

Care records are a form of professional communication.

Good records should be:

Accurate
Factual
Relevant
Timely
Clear
Respectful

For example:

“Resident was difficult and refused breakfast.”

provides limited useful information and contains judgemental language.

A more factual entry might state:

“Mr Jones declined breakfast when offered at 8:15am and again at 9:00am. He stated that he did not feel hungry. Drinks were offered and accepted. Senior carer informed.”

The second entry provides information another member of staff can actually use.

Poor Communication Can Become a Safety Issue

Communication failures can contribute to serious problems.

For example:

A care worker notices that a resident appears unusually drowsy but does not tell anyone.

A medication change is not communicated during handover.

A resident’s swallowing recommendations change but catering staff are not informed.

A person repeatedly reports pain but their concerns are not escalated.

A family communicates an important change but it is never documented.

In each example, communication is directly connected to safety.

This is why communication also forms part of professional Duty of Care.

Communicating With Catering and Other Departments

Care homes depend on communication across departments.

Care staff, nurses, catering teams, housekeeping, activities teams and management may all hold information relevant to a resident’s wellbeing.

For example, catering staff may need accurate information about:

Allergies
Texture-modified diets
Dietary requirements
Food preferences
Changes in eating ability

Care teams may need information about whether someone has eaten or drunk significantly less than usual.

Good communication prevents important information becoming trapped within one department.

Communicating Concerns

Care workers should feel able to raise concerns.

This could involve:

A change in someone’s health
Suspected abuse or neglect
Unsafe practice
Medication concerns
Environmental hazards
Changes in behaviour
Poor staffing practices
Errors or near misses

Staff should understand their organisation’s reporting and escalation procedures.

If an immediate manager does not appropriately address a serious concern, staff should know how to escalate it through the correct channels.

Complaints Are Communication Too

When somebody complains, the immediate reaction should not be defensiveness.

Complaints can reveal where someone’s expectations or needs have not been met.

Staff should:

Listen
Remain respectful
Avoid arguing
Take the concern seriously
Explain what they can and cannot do
Follow the organisation’s complaints procedure
Escalate appropriately

Even when a complaint appears minor, the person should feel that they have been heard.

Communication at the End of Life

Communication becomes particularly sensitive when someone is approaching the end of their life.

People and their families may experience fear, sadness, uncertainty and grief.

Care staff should communicate compassionately, respect individual preferences and remain within their professional role.

Staff should never speculate about prognosis or provide clinical information they are not qualified or authorised to give.

Our End of Life Care Awareness Training article explores this subject in greater detail.

Cultural Awareness and Communication

Communication is influenced by culture, language, beliefs and personal experience.

Staff should avoid assumptions based on someone’s:

Age
Ethnicity
Religion
Disability
Accent
Background
First language

If language creates a significant barrier, an appropriate interpreter may be required rather than relying automatically on relatives.

Person-centred communication means finding the method that works for that individual.

A Practical Communication Checklist for Care Staff

During everyday care, ask yourself:

Do I know how this person prefers to communicate?
Am I speaking directly to them?
Have I given them enough time to respond?
Am I actually listening?
Have I considered non-verbal communication?
Is the environment making communication difficult?
Does the person need an aid or additional support?
Have I checked their understanding?
Am I using plain language?
Am I respecting confidentiality?
Have I documented important information?
Have I communicated relevant changes to colleagues?
Am I avoiding assumptions?
Do I need to escalate a concern?

Small improvements in these areas can make a significant difference to people’s everyday experience of care.

Building a Positive Communication Culture

Excellent communication cannot depend on one particularly good care worker.

It needs to become part of the culture of the service.

Managers can support this by ensuring:

Communication needs are recorded
Care plans remain current
Staff receive appropriate training
Handovers are effective
Staff have time to listen
Communication aids are available
Concerns can be raised safely
Poor communication is addressed
Good practice is reinforced through supervision

NICE recommends that services create open communication channels and give practitioners time to build relationships with the people they support.

Communication Is at the Heart of Person-Centred Care

Good communication is not an optional extra.

It is fundamental to understanding what a person wants, recognising when something has changed and providing care that respects their individuality.

The strongest care workers do not simply talk to people.

They listen.

They observe.

They adapt.

They check understanding.

And they recognise that every person has the right to communicate in the way that works best for them.

When communication is effective, residents are better able to express choices, participate in decisions, raise concerns and maintain meaningful relationships.

That supports safer care — but it also supports something equally important:

being heard, respected and treated as an individual.

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Tagged Adult Social Care, Care Certificate, Care Staff Communication, Care Staff Training, Communication in Care Homes, Communication Needs, Dementia Communication, Effective Communication, Person-Centred Care

Communication in Care Homes: A Practical Guide for Care Staff