Communication in Care Homes: A Practical Guide for Care Staff
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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: Staff should not simply enter a room and begin providing care because the task appears on
Proven Duty of Care in Health and Social Care
Everyone working in health and social care has responsibilities towards the people they support. One of the most important principles underpinning those responsibilities is Duty of Care in Health and Social Care. Duty of Care in Health and Social Care guides everyday decisions in care. It covers following care plans, using equipment safely, reporting concerns, maintaining confidentiality, and responding appropriately when something goes wrong. However, Duty of Care in Health and Social Care does not mean removing every risk from someone’s life. It also does not imply automatically making decisions on their behalf. High-quality care requires staff to protect people from avoidable harm. This Duty of Care in Health and Social Care also respects their rights, choices, dignity and independence. This can sometimes create difficult situations. What happens when someone makes a choice that staff believe involves risk? What should a care worker do if they witness unsafe practice? When should concerns be escalated? And what happens when a genuine mistake occurs? In this guide, we explore what Duty of Care in Health and Social Care means for everyday practice. We also explain how care workers can apply it safely and professionally. What Is Duty of Care? Duty of Care in Health and Social Care sets the standard for protecting the safety and well-being of those supported. This obligation requires organisations and staff to act with due regard for the people you support. In practice, this means taking reasonable care to avoid actions — or failures to act — that could cause foreseeable harm. For a care worker, duty of care can influence almost every aspect of the working day. This may include: Duty of care is therefore not one individual task. It is a principle that should underpin everyday professional practice. Duty of Care and the Care Certificate Duty of care is included within the Care Certificate standards for people working in health and social care. It covers important areas including understanding how duty of care affects a person’s work role, recognising dilemmas between an individual’s rights and safety, responding appropriately to complaints, and dealing with incidents, errors and near misses. For new care workers, understanding duty of care provides an important foundation for safe and professional practice. For experienced staff, the principles remain equally important and should continue to be reinforced through supervision, reflective practice and ongoing training. What Does Duty of Care Look Like in Everyday Practice? Duty of care is often easiest to understand through ordinary situations. Imagine that a care worker notices water spilled on a corridor floor. Walking past it because cleaning is technically someone else’s responsibility would not be appropriate if the spill presents an immediate risk. A responsible response might involve making the area safe and following the organisation’s procedure for dealing with the hazard. Another example could involve noticing an unexplained bruise on a resident. The care worker should not simply assume that someone else will deal with it. They should follow the appropriate recording and reporting procedures. Duty of care often means recognising something that could affect another person’s well-being and taking appropriate action rather than ignoring it. Duty of Care Does Not Mean Removing All Risk This is one of the most important principles for care staff to understand. People receiving care retain rights, preferences and choices. A duty to protect someone from avoidable harm does not automatically give staff the right to prevent them from doing anything that carries an element of risk. Everyday life involves risk. Walking outdoors can involve a risk of falling. Cooking can involve heat and sharp objects. Choosing particular foods may involve nutritional considerations. Going into the community involves different environmental risks. Removing every possible risk could also remove independence, enjoyment, confidence and personal freedom. The aim should therefore be proportionate risk management, not eliminating every element of risk regardless of the person’s wishes. Our guide to person-centred care explains why individual choice, independence and dignity should remain central to care. Balancing Duty of Care With Individual Choice Care workers will sometimes encounter situations where their responsibility to promote safety appears to conflict with someone’s choices. Consider a resident who enjoys walking independently but has recently experienced a fall. A purely risk-averse response might be: “You can’t walk on your own anymore because you might fall.” A more person-centred approach would consider the wider situation. Questions might include: The objective is to manage risk appropriately without unnecessarily restricting someone’s life. Duty of Care and Mental Capacity Questions about risk and choice may also involve the Mental Capacity Act. Care workers should never assume that someone lacks capacity simply because they make a decision others consider unwise. Capacity is decision-specific. A person may require support with one complex decision while remaining perfectly capable of making many other decisions independently. Where there are genuine concerns about a person’s capacity to make a particular decision, staff should follow the appropriate procedures and work within the Mental Capacity Act framework. Our guide to Mental Capacity Act and DoLS awareness provides further information about capacity, individual rights and person-centred decision-making. Work Within Your Role and Competence An important part of duty of care is recognising the limits of your own role. Staff should not undertake tasks for which they have not received appropriate training or where they have not been assessed as competent when competency is required. If you are asked to do something you do not understand or do not feel competent to perform safely, the correct response is not to guess. You should seek support. Depending on the situation, this might mean speaking with: Knowing when to ask for help is a sign of responsible professional practice. Duty of Care and Safeguarding Duty of care is closely connected with safeguarding. Care workers may be among the first people to notice signs that someone could be experiencing abuse, neglect or improper treatment. Possible concerns might include: Staff should understand their organisation’s safeguarding procedures and know how concerns must be reported. Concerns should never be ignored because