2.3 Interpreting, Signing and Communication Needs

1. Introduction

Some adults with care and support needs, and their carers, may require reasonable adjustments to ensure they understand information and can participate fully in discussions about their care and support, and have the means to get their message across (expressive communication).  Reasonable adjustments may be needed as a result of hearing impairment, visual impairment, dual sensory loss or learning or physical disabilities for example.

In relation to hearing impairment, reasonable adjustments may be provided by a British Sign Language interpreter, a Sign Supported Communication trained worker or by another professional who has specific communication skills (for example a Speech and Language Therapist). Within Salford, our most commonly used Sign Supported Communication system is Signalong. This is taught across school, college and adult services. Some individuals may use an alternative system (e.g. Makaton, BSL signs in spoken word order) or signs they have produced themselves (idiosyncratic signing).

It is important to note the differences between British Sign Language (BSL) and Sign Supported Communication systems such as Signalong.

Reasonable adjustments can also be provided in the form of communication tools such as easy read information or visual tools such as photos, symbols, objects and objects of reference.

Communication is a basic need and a fundamental human right. It underpins all aspects of daily living.  Adults and carers with specific communication needs should be supported to ensure their needs are met (see Assessment chapter) wellbeing is promoted and their needs prevented, reduced or delayed (see Promoting Wellbeing and Preventing, Reducing or Delaying Needs chapters). They should receive the same level of service as those in the local population who do not have communication needs.

2. Principles of Communication Services

There are a number of main principles that should be considered when a person has communication needs:

• communication needs should be recorded on first contact, documented clearly, shared as appropriate and acted upon at each contact (See also, Accessible Information Standard);
• individual members of staff have a responsibility to ensure identified reasonable adjustments are in place;
• communication tools should be readily available to support understanding and expressive communication. This may include communication tools and/or specialist interpreters/communicators;
• family members should not be used as interpreters / communicators;
• neither should children (within the family or extended network) be used as interpreters / communicators;
• the person acting as the interpreter / communicator should be acceptable to both the adult / carer and the local authority;
• the adult / carer should be consulted in relation to any concerns they may have about a proposed interpreter or communicator, including issues of confidentiality and potential conflicts of interest;
• the interpreter / communicator should declare in advance of providing the service if they have any personal knowledge of the adult / carer;
• the interpreter / communicator should also be asked in advance about any needs they may have themselves, for example disability access, water and so on
• the importance of confidentiality should be discussed with the interpreter / communicator prior to them first meeting the adult / carer. They should be sourced from an agency who is already contracted with the local authority and where there is an existing confidentiality agreement. If this is not possible, they must sign a confidentiality agreement prior to undertaking any work;
• the role of the interpreter / communicator is to act solely in relation to issues of communication, not as a mediator between the adult / carer and the local authority;
• the interpreter / communicator should be briefed before the meeting. This may include preparing them for possible disclosure and discussion of sensitive or harrowing information. They should also be briefed if an advocate will also be present (see Independent Advocacy chapter).

Decisions about the way in which the interpreter / communicator will be used will depend on their skills and training, the needs of the adult / carer and the purpose of the meeting.

Staff working with interpreters / communicators should not use them to obtain information about racial, cultural, religious or language issues. This is not a proper use of an interpreter; also their views and life experiences may not necessarily reflect those of the adult / carer.

3. Further Reading

3.1 Relevant chapters

Assessment

Care and Support Planning

Independent Advocacy

3.2 Relevant information

Good Practice Guide for Social Workers in England and Wales Working with Adults with Acquired Hearing Loss (British Association of Social Workers)

Five good communication standards Reasonable adjustments to communication that individuals with learning disability and/or autism should expect in specialist hospital and residential settings (Royal College of Speech and Language Therapy)

All providers of NHS care or other publicly funded adult social care must meet the Accessible Information Standard.