Communication needs in the care plan

Also called Care plan communication section, Support plan communication, Communication care plan

If how a person communicates is not written into the care plan, a new carer on a Sunday night will not know it. Here is what to write and how to make it stick.

What it is

A care plan, or support plan, is the document a care provider works from: what the person needs, how it is to be done, by whom, and what the person wants. Every regulator in the UK expects it to record communication, and in England the Care Quality Commission will ask to see it and the Accessible Information Standard requires the need to be recorded and flagged. A council's care and support plan under the Care Act should carry the same information, and it should follow the person from one provider to the next.

The communication section is the part that decides whether every other part of the plan can happen, because nothing else in it can be done with the person if staff cannot understand them.

Who it can help

Anyone with care and support whose communication is not obvious to a stranger: people who use AAC, people with dementia, people with a learning disability, autistic people, Deaf people, people with aphasia. Also agency staff, night staff and new starters, who are the people the section is really written for.

A single line saying "communication difficulties" or "non-verbal" helps nobody and is worse than nothing, because it lets a reader stop looking. The section is only worth having if a stranger could use it in five minutes.

How it works

A usable communication section answers six questions. How does the person understand: speech, simple sentences, signs, symbols, objects, routine? How do they express: speech, a device, a book, signs, gestures, facial expression, behaviour? What do specific things mean: this sound, this movement, this word? What helps: wait time, one question at a time, a quiet room, a particular person? What harms: rushing, standing over them, finishing their sentences? What are the tools: which device or board, where it is kept, who charges it, what to do if it breaks?

The best way to write it is as a communication passport or communication dictionary attached to the plan, written with the person and the people who know them best, and reviewed at every care review. It should also travel: to hospital, to respite, to day services, at handover.

Getting started

Ask to see the communication section of the plan this week. If it is thin, write the six answers above with the person, on one or two pages, and ask the manager to attach it and to have every staff member sign that they have read it. Ask for it to be a standing item at handover for the first fortnight.

Add the practical line that is usually missing: the name of the app or board, the device it lives on, its passcode arrangement, where the charger is, and who to call if it stops working. If the person uses Fiducia Talk, note that it works offline in the browser and needs no account, so a replacement tablet can be set up in minutes. Then check at the next review that the section was used, not just filed: ask a new member of staff what it says.

Where to get help

SCIE has guidance on person-centred care planning. The Care Quality Commission explains what it expects in a plan. Mencap, Alzheimer's Society and Dementia UK all publish communication guidance for care staff. Communication Matters for AAC in care settings. See also communication in care standards and person-centred planning.