Delighted to introduce you to ‘The Communication Game’ : a board game for staff to improve their communication skills.

How we  listen, talk and engage with people is fundamental to the quality and effectiveness of health and social care services. Although communication underpins everything we do in a work context, it can be a difficult topic for staff to talk easily about. Add to that the possibility of service users having an additional communication support need, through reasons like stroke, learning disability or dementia, then there is much potential for things to go awry and  unfortunately, they often do. ‘Poor communication’ is cited as the most common cause of frustration in complaints about services.

The Communication Game was developed by Focus Games, NHS Education for Scotland (NES) and Talking Mats. It is a learning tool to help staff working in the health & social care sector increase their knowledge and skills around communication.  The Communication Game is fun and easy to play. It can be played with or without a facilitator, and allows staff groups to have discussions and reflect on their communication skills. It allows them the chance to learn from each other. It will improve knowledge, but more importantly enable them to think about the small steps they can make to improve their interactions.

The project grew out of two previous projects funded by NES: Making Communication Even Better and Through a Different Door. In these projects, it was recognised that the experience of services for people with a communication support need is something of a lottery. For them, there was a considerable difference in the experience of interacting with a staff member who was empathetic and able adapt to their communication, to interacting with a member of staff who was struggling and unable to adapt their interaction. Training and understanding of inclusive communication practice is key. It has been a great privilege for Talking Mats to continue to support the work of the previous 2 projects and work with Focus Games Ltd to develop The Communication Game. Support during the development process from the Stroke Association Scotland, Capability Scotland, RCSLT, Scottish Care, Communication Forum, Queen Margaret University and NHS Ayrshire & Arran SLT Department have been invaluable, and we are very grateful; also to NHS Education for Scotland for their continued input and funding.

If you are working with staff in the health and social care sector, then this will be a great resource for you. You can get The Communication Game from the Focus Games online shop. It is guaranteed to promote laughter learning, and a touch of competitive team spirit. Most importantly, it will be a catalyst to help develop staff communication, making interactions better for people with communication support needs.

You can find out more about the game at www.communicationgame.co.uk

, and follow the game on Twitter on @Comm_Game.

Get your copy at www.focusgames.com.

Talking Mats considers both health and social aspects when it is used to include people in their care planning.  Lots of interesting comments are made by course participants on the forum in our online training course.  Annemarie, who works as an agency carer visiting clients in their own homes posted her thoughts about the social model of disability

 Remembering the person behind the condition

In my experience, society is fixated on the medical model, the ‘what’s wrong’ approach. Whilst the medical model is clearly a valuable and required tool, it often leads to labels that individuals are then lumbered with, such as, ‘she has dementia’, ‘she is visually impaired’, ‘he’s deaf’ or has a ‘leaning disability’. Taking this approach overlooks the person behind the ‘condition’ and so can restrict inclusion.  One example could be an individual with dementia being unable to make everyday choices about seemingly mundane issues such as what to wear that day. Using a medical model, a carer may be aware of the clients difficulties and make choices for them, whereas using the social model approach enables the carer to see beyond the condition and fully include the client, allowing them to be part of the decision making process for themselves. A second example could be a person with a communication disorder such as Asperger’s Syndrome. Access to work could be severely restricted using a medical model as the pragmatic manifestation of this condition may well exclude a person from seeking certain types of employment. Promoting the use of a social model would ensure work colleagues understood the possible limitations of the condition and ensure adequate support networks were in place. The social model attempts to embrace a person’s difference and raises awareness within society of individual needs that will facilitate inclusion into all aspects of life.

The WHO ICF -World Health Organisation International Classification Framework of Functioning, Disability and Health (2001, 2007b) aims to merge the medical and social model, encouraging professionals to think not only of the persons health condition and resulting impairment, but the impact this has on the persons participation and activities.  It captures the full complexity of people’s lives, including environmental and social factors and can be applied over different cultures

The Talking Mats Health and Well- being resource is based on the WHO ICF and supports a person to reflect and express their view on various aspects of their lives.  Using the Health and Well being  resource supports workers to remember the person behind the condition.

We are delighted to have received funding from Life Changes Trust to work with Patient Opinion to help improve the access to their website by developing a Talking Mats to enable people to tell their stories.

Like Talking Mats, Patient Opinion is a Social Enterprise and has an excellent independent website https://www.patientopinion.org.uk/  that enables people to share their experiences of UK health services, good or bad. They then pass the stories to the right people so that they can learn from them.

The project we are working on is focusing on people with dementia but in the long run we hope that lots of people will benefit.  It will bring our two innovative technologies together marrying the expertise of the Patient Opinion website with that of the Digital Talking Mats.

Our aim is that people affected by dementia can use their own voice to share their experiences and make real differences to relationships, services and culture, just as many others are already doing across health and care. We also hope that this work will empower others with communication or cognitive difficulties to share their experiences and be heard in an open and transparent way.

This ground breaking work is being funded and supported by Life Changes Trust, People Affected by Dementia programme. The Big Lottery funded programme is committed to working with people living with dementia and those who care for them, investing resources so that individuals are more able to face the challenges before them, and can exercise more choice and control in their own lives.

We expect the project to take 18 months to complete and have already run focus groups with people with dementia, family members and expert practitioners to plan the new symbols. We are now working with the technical experts to create the website interface which we will then pilot with people with dementia.

Watch this space for more updates…..

This is the second of Kristine Pedersen’s projects using Talking Mats as a tool to support people with dementia.

Care workers at two residential care homes in Denmark were taught how to use the Talking Mats framework and how to incorporate the method into planning daily activities for  people with dementia.

The care workers  gave positive feedback in regard to using Talking Mats:

• Using the Talking Mat framework provides important knowledge about communicative difficulties of the person with dementia
• Talking Mats helps people to understand their options and thereby motivates to social activities, eating, physical exercise, etc.
• Talking Mats increases the possibility of active participation in caregiving plans
• Talking Mats enhances the joy of work, when I know how I can give the right care
• The Talking Mats conversations support a closer relation between elderly and care giver

This project and the one described in the previous blog, gave the opportunity to explore the Talking Mat framework in use and how the framework can support the communication of people with dementia. Very importantly, due to the adoption of Talking Mats and its extension in Denmark, the projects gave  a lot of Danish examples. The projects also gave important information about how to implement the tool in care homes for people with dementia within a Danish setting.

‘We are very grateful to the Directors, Dr Joan Murphy and Lois Cameron and everyone on the team at the Talking Mats Centre who developed the framework and who continue to increase knowledge of Talking Mats through research and education. It is a very helpful tool for many people and supports and enables more people to have their views seen and heard’

And we are grateful to Kristine for sharing her projects with us.

Get your New Year’s resolution Talking Mat here!
Talking Mats is a social enterprise whose  vision is to improve the lives of people with communication difficulties. 2015 has been another exciting year for us. We have had great opportunities to work with a fantastic range of people and hear great stories: from wee ones in nurseries using Talking Mats to encourage active participation and decision making, to older people and their families through our dementia family training project. It is our core belief that good communication is fundamental to a quality service. Making sure there is space for active listening to views and concerns particularly, if individuals have difficulties communicating is central to effective interactions and individualised, person centered care. We are really grateful to all the people who have supported the work of Talking Mats; people with communication support needs, staff who work with them and organisations that we are privileged to work with on a consultancy basis.
It will not surprise you to know that as an organisation we like to set goals and then go for them so as our thank you to you all for your continued support , we have created our very own New Year’s resolution Talking Mats;
• What are you definitely going to go for ?
• What is in the maybe pile – or that could be for those things you are already doing and will continue
• What is not a goal for you in 2016 .
• Don’t forget to use the blanks to personalize it further!
• Plus take a photo so you can reflect back on where 2016 takes you and whether you achieved your goals .
So open and download it , cut it up and we hope you enjoy using the resolution Talking Mat with friends and family ! resolution pics
We wish you all every health and happiness from all in the Talking Mats team

Fika (coffee time)  in the Talking Mats office is always interesting.  Recently we got chatting about Christmas preparations and who had the longest ‘to do’ list.  There was a definite variation in enthusiasm for all things Christmas.  We needed to do a Talking Mat! This was done on our digital Talking Mats – it’s  easy to import your own images now and make a digital Talking Mat about any topic.

Eating , drinking and games and puzzles got the thumbs up!   (Lois is the games queen and was the most enthusiastic about that).

Holiday, partying and entertaining got consensus.

Extended family coming to stay? This moved around a bit, but was generally positive (say no more!)

Shopping was in the mid section-we all agreed.  Perhaps by now it would be less positive with last minute mayhem.

Gifts was added as a blank (how could the interviewer forget that) and not everyone was comfortable about the commercialisation of Christmas.

‘How do you feel about Juggling demands?’   We all agreed -not sure.  Again remember, Talking Mats is how a person feels at a certain point in time.  Ask us again on Christmas Eve?!

Christmas cleaning?  All agreed was a chore and some thought best not to get too bothered about it

Talking Mats supports a group conversation.  We all got our say

Merry Christmas one and all

We are grateful to Emma Atkiss, one of our accredited trainers for this interesting report.

The purpose of The Voice of the Child pilot project carried out by the Wigan Pathfinder team was to obtain pupil views using a viable tool.  The team selected Talking Mats as a framework to support pupils to express their views in decisions regarding their lives.  They were working on the principle that engaging with the young person and his/her family would lead to better outcomes

The project team considered that Talking Mats met the 5 criteria of Shier’s model of participation (2001)

1. Children are listened to.
2. Children are supported in expressing their views.
3. Children’s views are taken into account.
4. Children are involved in the decision-making processes.
5. Children share power and responsibility for decision-making.

Click on diagram to enlarge.

The pupils in the pilot ranged from 7 to 17 years with a range of disabilities.  During the pupil interviews the team found that the Talking Mats Health and Well being resource provided a practical framework for decision making and target setting

Talking mats provided :

• An objective, neutral space – a thinking tool- ‘Children and young people are able to consider their priorities when setting targets’.
• Opportunities for change – ‘Children and young people are able to make changes to their initial thoughts and have time to decide and reconsider options’.
• A truly person centred approach
• It was fun!

For example :   A seven year old child with Autistic Spectrum Disorder identified both her cognitive strengths and areas for development using the Learning and Thinking domain.  She provided feedback regarding her difficulty in attending when faced with too much information or choice and also her strength in planning skills.  Thinking skills targets and interventions can be developed using this information as a starting point.

Their report states that the information gained from Talking Mats can be used, as part of the Education Health and Care planning and review cycle, to inform both decision-making and goal setting for children and young people   i.e. It identifies strengths; It identifies areas to develop; It identifies the child / young person’s response to a range of experiences; It informs day-to-day decision-making ;  It informs both targets and interventions for Individual Education Plans and it supports transition planning.

Ref :  Engaging the voice of the child / young person at an individual level  – Emma Atkiss,Senior Educational Psychologist and  Caroline Gomez,     Educational Psychologist, Wigan council

Sophie Mitchell SLT describes how she supported her students to develop their EHC Plans with the Talking Mats app .

In September 2014 our  team and I were asked to facilitate the production of Education and Health Care plans for the Year 14 students at the Secondary Special School (for adolescents with complex, profound and multiple learning difficulties) where we  are based. As Speech and Language therapists we were asked to work with the students to gain their view on what they would like to be detailed in their plan and also what their aspirations were for their future. We wanted to ensure the production of these plans were as client centred as possible so therefore decided to use the Talking Mats App on the Ipad using the Health and Wellbeing resource.  This resource proved invaluable when working with our students. Not only were our students highly motivated to participate in the sessions due to the Ipad being used, talking mats empowered them to make meaningful decisions about their future, communicate any areas where they would like further support and discuss likes and dislikes. The impact on our students became clear when working with one 19 year old student. Although he did not have any spontaneous expressive language and would only echo things said by others, during a Talking Mats sessions when talking about his likes and dislikes, he appeared to be placing most items under ‘dislike’.  As the session went on the student started to appear agitated, then started pointing towards ‘like’ although no symbol was presented. Suddenly the student said ‘Garden’, still pointing towards the ‘like’. When presented with a gardening symbol he soon placed this under ‘like’. This information was then presented in his plan and his college were instructed to explore opportunities for this student to develop his gardening skills. For all students this information was then used to not only create their Education and Health Care plan but also expand and explore areas they were highly motivated by while still at School and also identify possible work placements for the future.  Furthermore the School invested in Talking mats training to ensure this approach is used throughout each academic year and school staff are skilled to use Talking Mats as each student starts their assessment for their Education and Health Care plan.

We would like to thank Sophie who is from Sandwell and West Birmingham NHS trust  for such a great example of how to use the app in EHC Planning . If you are interested in purchasing the digital Talking Mat then please phone the office 01786479511. We are just changing the purchasing model from subscription to one off sale so its temporarily removed from the web site.

What are social care outcomes and how do we measure them? The Adult Social Care Outcomes Toolkit (ASCOT) was developed over a number of years as a way of measuring user views on their social care. The ASCOT has been developed by researchers at PSSRU, University of Kent http://www.pssru.ac.uk/ascot/index.php

 There are eight domains of ‘social care-related quality of life’ included in the ASCOT. These include:

• Control over daily life
• Personal cleanliness and comfort
• Food and drink
• Personal safety
• Social participation and involvement
• Occupation
• Accommodation cleanliness and comfort
• Dignity

The measure has been tested with service users from different user groups and there are a number of different versions available, including an easy-read version.

Many people with who have communication difficulties are not able to provide views via interview alone.  Talking Mats is a communication tool that can be used with people who have communication difficulties. The mat consists of a set of symbols or pictures that are tailored to the subject you want to talk about.

The ASCOT Talking Mat: Tizard Centre’s Jill Bradshaw with Ann-Marie Towers and Nick Smith (both from PSSRU) have worked with the Talking Mats team at Stirling to develop three ASCOT Talking Mats.  These will enable people to give their views on:

• Where I Live.  This is a starter mat, designed to introduce people to the approach and for those people who might find more abstract concepts more challenging;
• My Care. People will be supported to give their views about whether aspects of their care are going well or not going well.
• Control over my Care. People will be given tools to think about how much choice they have over different aspects of their care.  The second and third mats have options for both basic and more abstract concepts.

The TM version of the ASCOT will enable researchers to investigate user views regarding social care outcomes.  By using this more inclusive methodology we will be able to engage with these seldom heard groups.  The use of symbols in combination with a structured approach will enable us to represent these participants’ own feelings/perspectives in the research, rather than us having to rely on the views of proxies.

Researchers at the University of Kent will be piloting the ASCOT Talking Mats with people with dementia and people with intellectual and developmental disabilities (learning disabilities).

Jill Bradshaw (Accredited trainer) Lecturer in Learning Disabilities, Tizard Centre, University of Kent

Ann-Marie Towers (Research Fellow) and Nick Smith (Research Officer). PSSRU, University of Kent

Background

Social workers are required to complete a detailed assessment of their client’s needs. It is recognised that it can be a challenge to ensure clients fully participate in the process if they have cognitive or communication difficulties. The City of Edinburgh Council were keen to explore if we could adapt their standardized assessment tool and make it into a Talking Mat framework. Several staff in the council are already skilled practitioners in Talking Mats so are familiar with the framework and use Talking Mats in their practice. They are enthusiastic about the benefits of using Talking Mats both in terms of how it increases participation of service users but also because in their view it makes interviews easier for staff to undertake.

Structuring Talking Mats assessment framework

In order to develop the bespoke Talking Mat we held a seminar to discuss the social work assessment tool and approach used. Six key staff attended the seminar, facilitated by two Talking Mats associates. The discussion at the seminar identified a structure that would enable us to construct a coherent visual conversation that would cover the issues required to complete the assessment, using mind mapping to support this process. It is also important to identify a top scale that matches the question you are asking and make sure the options you are including are neutral and not leading.

The structure that emerged from this discussion is a Talking Mat that enables people to explore their views on 3 topics

• their home
• their health and well being
• their community involvement

 Trialling the Talking Mats framework

Talking Mats then took the mind maps and developed these into symbol sets that were piloted by social work staff. At the end of the pilot a review was held and changes made which included alterations to

• the language used
• the symbols used
• the topic an option was included under
• making it clearer to staff when options were more abstract and required further explanation and or personalisation

Nicki Ewing from Edinburgh City Council who leads on the project says ‘ I am very excited that staff have a tool that can make assessment more meaningful for service users to participate in and makes it easier for staff to get good quality information’.

Next steps

We are thinking of holding a focus group for others that might be interested in using the framework for their practice if, you are interested please contact Lois  via the info@talkingmats.com email – call your email ‘social work focus group’.