Contraception and Termination

Below you will find details of Ask, Listen, Do. 

Ask:

• Always communicate with the person first, even if you're not sure they are able to understand you.
• Ask what someone's preferred methods of communication are.
• Ask if there is a communication passport, hospital passport, care plan or other document that the person, or their support, has that you could see. This could help you understand the person's needs and how best to support them.
• Begin with open questions. If people struggle, then provide more support and move on to yes and no questions, if needed.
• You may need to repeat or rephrase things.
• Ask:
• "what would you like to happen?"
• "how would you like to be supported?"
• "what is the best way I can help you?"
• Ask if there is anyone else it would be helpful to talk to.
• Always consider the person's capacity to make decisions about sharing information with others. Only share information, or talk to other people, with the person's consent or (if they lack capacity) where it is in their best interests.
• If someone is struggling, do not ask, "what is wrong with you?" but instead, "what has happened to you?"

Listen:

• Listen to all the ways that somebody might communicate their thoughts, feelings and preferences.
• This includes body language, tone, behaviour and any other method they use to communicate.
• Don't jump in when someone is taking time to think. Allow time and listen carefully to the person's views and choices.
• People need more processing time. Be patient and persevere.
• Listen to the person's own language and understanding; use their words where it is helpful.
• In listening, check that the person has understood what you have said; get them to summarise in their own words.
• Check that the person is not simply repeating what you have said, or just agreeing with you. If you notice any response patterns, try asking questions in a different way to see if you get the same answers.
• Avoid making judgements or assumptions, which can be barriers to good listening.
• Consider involving an advocate if the person needs support in order for their voice to be heard.

Do:

• Empower people. Support to them to have choice and control in their own life. Make sure that you keep the person at the centre.
• Encourage people to ask questions and to tell you if they don't understand something. Never talk about the person as if they weren't there.
• Treat the person in an age-appropriate way, respecting their roles and experiences.
• Be respectful and take time to find out about the person's preferences and cultural needs.
• Don't assume that because the person has a learning disability they don't understand. Instead, make sure that things are explained in more simple language. This means avoiding jargon and long, complex sentences.
• Break things down into chunks or smaller steps.
• Make use of existing reports and care plans, which help you to understand someone's areas of strength and needs and how best to adapt your approach.
• Think holistically about the person and their life. Consider their broader needs, such as good supportive relationships, meaningful occupation, the right environment and meeting their mental and physical health needs, and the impact these may have.
• Promote independence and skills development in a way that is meaningful and accessible for the person.

• Introduce easy read format letters so they are accessible from the beginning.
• Consider arranging appointments when it is quieter.
• Extend appointment times to give more time during appointments.
• Explain what will happen at an appointment, giving patients the opportunity to ask questions beforehand.
• Provide clear explanations with no jargon or acronyms and use easy words, so people can make their own informed decisions.
• For people attending outpatient appointments, provide introductory visits and information packs including pictures ahead of appointments.
• If you can't make the necessary adjustments, consider a home visit or an alternative venue.

• Offer awareness training, for example the Oliver McGowan Mandatory training, to help your employees understand how to support people with learning disabilities and/or autism.
• Ask your employees to be more patient and take extra time to explain and help people with learning disabilities and/or autism.
• Promote the support that is available on your website and in communications with patients.
• Be willing to make appropriate adjustments if they are asked for to help people to feel more comfortable and to reduce the risk of sensory overload.
• Consider who else (if anybody) needs to be involved to support your interactions in order to make sure that the voice of the individual is heard?
• Consider if someone responds better to a particular gender of worker and how you could facilitate their appointments being with that person so the individual feels empowered to speak up in their appointments.

• Remember to introduce yourself and explain who you are.
• Remember to talk to the person the appointment is for and ask them about who they have brought with them, if there are carers present.
• Be clear and direct in the language that you use; talk in the "here and now"; avoid jargon, abbreviations and "figures of speech".
• Spoken language can be challenging for some people so consider other methods of communication.
• Ask companions such as family and paid staff how to best adapt communication and, if in a hospital setting, ask for a learning disability liaison nurse.
• Be aware of your tone and approach; there is a careful balance to be found between matching someone's communication needs and appearing to talk down to someone.
• Use silences and allow greater gaps in conversation to allow more time for information processing.
• Look at the person as you talk to you them so that you can look for signs that they are understanding you, but do not insist that they look at you.
• Consider the wording of any questions you ask; asking "Can you…" may result in a verbal response of "yes" or "no", as opposed to the person actually carrying out the desired action.
• Provide regular summaries throughout your interaction and check whether it would be helpful to share some of the key points in writing or other formats such as pictures.
• Listen carefully and patiently, and persevere, even if you don't understand the first or second time.

• Ensure floorplans and maps are readily available.
• Provide virtual tours of your facilities for people to watch online before their visit.
• Use easy read signage or include pictures on signs.
• Provide clear directions and instructions.

• Create quiet waiting rooms or separate spaces to wait before appointments and offer these to people rather than wait to be asked.
• Lower or soften the lighting in waiting rooms.
• Use a Starlight Distraction Box filled with toy items and resources to support people who are worried about a medical procedure.
• Ensure members of staff regularly update people who are waiting so they know what is happening.