Staff in residential services recognise importance of setting communication goals to improve quality of life but lack consistent guidelines


BILD’s communication factsheet suggests that estimates of the proportion of people with learning disabilities who have difficulties with communication vary between 50% and 90%.

For many people with learning disabilities, this communication will be non-verbal, or working at a pre-lingual level, which mean the use of many means including gesture, facial expression, sign language, picture exchange etc.

For people living in services with support staff, those frontline staff will be major participants in everyday communication. The attitudes and responses of staff will therefore have a major impact on opportunities for communication for people they support.

The researchers in this study therefore set out to undertake a descriptive survey of front-line staff regarding their knowledge
of the availability and use of communication supports naturally occurring  in residential settings.

The authors were interested in understanding the level of knowledge and skills that staff had in communicating effectively with the people they supported. They were particularly interested to understand how staff ensured the rights of people living in services to communicate

What they did was asked 138 staff to complete a self-report questionnaire which asked a number of questions about the respondent, including
job title, area of work, gender, age, length of service in residential setting and training in nonverbal communication. There were also a number of questions about the people supported, including level of learning disability, gender,  age as well as the number of people supported who were verbal or  nonverbal.

In addition, respondents marked a scale consisting of ‘true’, ‘sometimes true’, ‘rarely true’ or ‘never true’ for 23 items, covering

  • Overall Organisational Supports For Communication
  • Assessment Practices Goal-setting Practice  and Programme Implementation
  • Team Competencies and team skills and experience

What they found was

  • 45.7% of respondents were staff nurses
  • 43.5% were care staff
  • 8% were clinical nurse managers
  • 2.9% were catergorised as ‘other’.

Nearly 90% of respondents stated that all people communicate in some way and almost the same proportion believed that setting appropriate communication goals could improve the quality of life for people they supported.

Nearly 45% said they were rarely involved in communication assessments of the people they supported.
In terms of the implementation of communication programmes just over 50% said that communication goals were consistently established within their services.

Nearly 60% stated that they recognised challenging behaviour as a form of communication and 56% said they had access to professional help to plan and monitor communication intervention programmes

The authors conclude that whilst staff in the study recognise the importance of communication supportsthese appear not to be supports consistently available for people in need of them.

They recommend the development of a co-ordinated to take into account operational constraints and the development of staff training to enable the introduction of best practice guidelines in the provision of communication supports.

Communication supports in residential services for people with an intellectual disability,Dalton, C & Sweeney, J in British Journal of Learning Disabilities, 41: 22–30

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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