⚕️Care Handbook

Teamwork & Communication

Effective teamwork and communication areessential for safe, high-quality care. Poor communication is a leading cause of adverse events in care settings, including medication errors, missed care, and safeguarding incidents. This section covers the key areas of teamwork and communication that every care worker needs to be competent in.

1

Effective Handover

Shift handover is the process of passing critical information from one team to the next. Poor handover is a leading cause of care failures, missed medication, and missed observations. A structured handover ensures continuity and safety.

Best practice:

  • Use a standardised handover template or proforma (see Handover Templates section)
  • Handovers should be face-to-face, not just written — verbal communication allows questions
  • Use a systematic approach: e.g. SBAR (Situation, Background, Assessment, Recommendation) or a resident-by-resident walkthrough
  • Cover: changes in condition, new admissions, discharges, medication changes, safeguarding concerns, upcoming appointments, and any tasks yet to be completed
  • Allow time for questions — the incoming shift should clarify anything they are unsure about
  • Do not rush or skip handover — it is a clinical safety process, not a formality
  • Written handover notes should be legible, factual, and signed by the author
  • Confidentiality: handover should take place in a private area, not in corridors or public spaces where it could be overheard
2

Multi-Disciplinary Working

Care homes work alongside many external professionals: GPs, district nurses, occupational therapists, physiotherapists, speech and language therapists, dietitians, chiropodists, social workers, and mental health teams. Effective multi-disciplinary working ensures residents receive coordinated, holistic care.

Best practice:

  • Know which professionals are involved in each resident's care and their roles
  • Attend and contribute to multi-disciplinary meetings when invited
  • Keep accurate records of all professional visits, assessments, and recommendations
  • Communicate changes in a resident's condition promptly to the relevant professional
  • Follow through on recommendations made by visiting professionals and record outcomes
  • If a professional's recommendation conflicts with your observations or the resident's wishes, raise this with your manager
  • Ensure all handover information includes updates from external professionals
  • Recognise that you are part of a wider team — you have valuable information to contribute and your input is essential
3

Conflict Resolution

Conflict in care teams can arise from differing opinions, workload pressures, personality clashes, or poor communication. Left unresolved, conflict affects morale, retention, and — most importantly — the quality of care provided to residents. Every care worker has a role in managing and resolving conflict constructively.

Best practice:

  • Address concerns early — do not let frustrations build up over time
  • Use 'I' statements rather than accusatory language: 'I feel concerned when...' rather than 'You always...'
  • Focus on the issue, not the person — describe the behaviour and its impact
  • Listen actively to the other person's perspective without interrupting
  • Seek to understand before seeking to be understood
  • If direct conversation does not resolve the issue, involve your manager or team leader
  • Use supervision to discuss ongoing interpersonal difficulties in a safe, structured setting
  • If conflict involves harassment, bullying, or discrimination, raise it formally through your employer's grievance or dignity at work policy
  • Remember: the primary concern is always the safety and wellbeing of the residents
4

Documentation Standards

Accurate, timely, and professional documentation is a legal requirement and a cornerstone of safe care. Poor documentation leads to poor continuity, increased risk, and may constitute a regulatory breach under CQC Regulation 17 (Good Governance).

Best practice:

  • All entries must be dated, timed, and signed with your full name and designation
  • Write in black ink (or as per organisational policy) — never in pencil or erasable ink
  • Be factual and objective — record what you observed and what the resident told you, not your personal opinion
  • Avoid jargon, abbreviations that could be misinterpreted, and subjective language
  • Record late entries as 'Late entry' with the actual time and date of the original event
  • Never alter, overwrite, or remove a previous entry — if a mistake is made, draw a single line through it, sign, date, and write the correct entry
  • Ensure records are stored securely and only accessed by authorised personnel
  • Record refusals of care, medication, or food — not just what was given, but also what was declined and why
  • Document conversations with relatives, GPs, and other professionals, including any advice or decisions made
  • If in doubt about whether to record something, record it — it is always better to have information documented than missing

SBAR Communication Framework

SBAR is a structured communication framework widely used in health and social care to ensure information is conveyed clearly and completely, particularly during handover or when escalating concerns to other professionals.

S — Situation

What is happening right now? Identify yourself, the resident, and the current problem clearly and concisely.

B — Background

What is the relevant background? Provide context: the resident's medical history, current care plan, recent changes, and any relevant information.

A — Assessment

What do you think is going on? Give your professional assessment of the situation, including any observations, vital signs, or changes in condition.

R — Recommendation

What do you want to happen? State what you think needs to be done — e.g. a GP review, a medication change, an urgent assessment. Be specific.

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