Handover between carers

Also called Communication handover, Shift handover, Passing on communication needs

How a person communicates must pass to every new carer, every shift, every change of staff. If it lives in one person's head it is already lost.

What it is

Handover is the passing of what a carer knows about a person to the next carer: at the end of a shift, when an agency worker arrives, when a person moves from school to respite, from home to hospital, from one service to another. For a person who does not speak, the crucial part of that knowledge is how they communicate: how they say yes, how they show pain, what the device is for, what the flapping means. If it is not handed over, the new carer starts from nothing and the person spends the shift unheard.

It is the most common failure in care of non-speaking people, and it is entirely fixable.

Who it can help

Anyone who relies on others to understand them, and everyone who supports them. It matters most where staff turnover is high, where agency staff are used, and at the boundaries between services, which is where information dies. Family carers need it too, for the day they are ill and somebody else steps in.

It is not a substitute for training. A handover tells a new carer what to do; it does not teach them to wait.

How it works

The tools already exist. A communication passport is the person's own document about how they communicate, written in the first person, and it is designed to be read in five minutes by a stranger. A one-page profile does the same in less space. A communication dictionary lists what the person does, what it means and what the partner should do in response, and is essential for people whose communication is behaviour and body language rather than words.

The handover itself needs those documents to be where the new carer will look, and it needs the communication section to be a fixed item in the verbal handover: "here is how she says no, here is her device, it is charged, here is where the paper backup is". Sixty seconds. The care plan's communication section says the same and is where the Care Quality Commission will look; see communication needs in the care plan.

Hospital admissions are the worst gap. The hospital passport is the handover document for that, and it goes in the bag before the ambulance arrives.

Getting started

This week, write the one-page profile if one does not exist: how I communicate, how I say yes and no, what helps, what to do if my device is not working. Put it on the wall of the person's room or the front of their file.

Ask the service to add "communication" as a standing item in every handover, and check it is happening by asking a new carer what they were told.

For families: write the same page for the relative or friend who steps in when you cannot, and put it with the device.

Where to get help

SCIE publishes guidance for care providers on handover and person-centred records. Care Quality Commission sets the standards and inspects against them. CALL Scotland publishes the original personal communication passport templates. Mencap provides hospital passport templates. Carers UK supports family carers planning for emergencies.