How to Deal with Misunderstandings in Health and Social Care

A misunderstanding is when a message gets mixed up along the way. This can happen between staff, between staff and people who use services, or with families and other professionals. The message may not be received as the sender intended. This sometimes leads to mistakes, confusion, or even harm.

Common reasons include:

• Language differences
• Medical or care jargon
• Cultural backgrounds affecting how people communicate
• Sensory impairments, such as hearing or sight loss
• Written communication errors
• Staff stress or distractions

For example, suppose a care worker says “take your medication after your meal” but the person thinks they mean after breakfast only, not after lunch or dinner. This is a misunderstanding that could lead to missed doses.

Spotting the Signs of a Misunderstanding

Picking up on misunderstandings early prevents mistakes. Some signs are easy to see, but others may be subtle.

Look for these clues:

• A puzzled or unsure look
• Repeated questions about the same thing
• Tasks not done as expected
• Increased frustration or agitation
• Sudden change in behaviour
• Someone withdrawing or becoming quiet
• Disagreements about what was decided or said

Sometimes a misunderstanding is clear straight away, but sometimes it only comes out later, for example when someone misses a healthcare appointment or does not take their medicine.

How Misunderstandings Affect Care

When a message is not clear, the person may not get the right care or support. This can affect health, well-being and safety.

Some effects are:

• Medication errors, such as wrong doses or missed medicine
• Delays in getting help or accessing services
• Missed appointments or changes in treatment plans
• People not eating or drinking enough
• Falls or accidents due to not following instructions properly
• Emotional upset, distrust, or loss of confidence in the care team

Staff may feel blamed, and people using services may feel they can’t trust the information they receive.

Main Causes of Misunderstandings

Misunderstandings rarely happen for a single reason. Usually, several factors add up.

Common sources include:

• Language Barriers: Not everyone speaks English as a first language.
• Jargon: Terms like “PRN”, “OT”, or “DNAR” are not always understood.
• Cultural Values: Some topics or ways of speaking are uncomfortable to discuss.
• Sensory Impairment: Poor hearing or sight can block messages.
• Poor Written Notes: Illegible handwriting or unclear notes confuse readers.
• Distraction: Staff may feel rushed or tired and miss key details.
• Lack of Person-Centred Communication: Not checking how each person prefers to communicate.

Being aware of these issues helps prevent confusion before it starts.

Practical Steps to Prevent Misunderstandings

Avoiding confusion should be part of daily care. There are some tried and tested ways to do this.

• Use Short, Simple Sentences: Avoid long and complicated explanations.
• Explain Jargon: Use “medicine you can take when needed” instead of “PRN.”
• Check the Person’s Understanding: Ask, “Can you tell me what you think needs to happen next?”
• Reduce Distractions: Hold conversations in quiet areas where possible.
• Write Clearly: Use legible writing and double-check names, dates, and times.
• Repeat Key Information: This confirms it has been heard and sink in.
• Use Visual Aids: Show appointment cards, or use pictures to explain.
• Offer Written Instructions: Give a printed summary after important meetings or changes.
• Use Interpreters: For people who use different languages, always bring in a trained interpreter.
• Encourage Questions: Allow people to ask for clarification at any time.

Handling a Misunderstanding When It Happens

Not every misunderstanding can be prevented, but they can be sorted quickly and fairly.

Follow this approach:

• Stay Calm: Respond with patience and respect.
• Listen Carefully: Let the other person describe what they think and feel.
• Find Out What Was Missed: Repeat what was said and ask where it went wrong.
• Apologise if Needed: A genuine apology often calms the situation.
• Re-explain or Repeat: Put the information in other words.
• Use a Different Method: If words failed, try writing it down or show with objects.
• Agree Next Steps: Check everyone now has the same message.
• Make a Record: Write down what happened and what was done.

Involving Families and Advocates

Families or advocates often speak up for people using services, especially if someone finds it hard to communicate themselves.

Tips for keeping everyone informed:

• Hold regular meetings in person or by phone, where everyone can ask questions.
• Provide written notes afterwards, with contact details for further questions.
• Offer easy-read or translated materials.
• Check who the person trusts to help explain things and bring them into discussions.
• Record who has given consent to share information, and stick to those wishes.

A strong relationship with families reduces the impact of any mix-ups.

Supporting People with Communication Needs

Extra steps are needed for people with conditions like dementia, learning disabilities, or sensory loss.

These include:

• Using objects or pictures to support speech
• Speaking slowly and clearly, allowing extra time for a response
• Checking hearing aids and glasses are in place and working
• Using sign language or communication boards
• Working with speech and language therapists
• Offering familiar staff for continuity

Care plans should set out each person’s preferred communication style in detail.

Multi-Disciplinary Team Communication

In health and social care, many different professionals are often involved. If messages are not shared clearly, important details can be missed.

To keep communication clear between teams:

• Always confirm spoken agreements in writing, such as with email or a team message board.
• Use shared care records that everyone can access and update.
• Double-check that referrals or updates have been received and understood.
• Hold regular case meetings where different teams can discuss complex cases together.
• Use structured handover tools, like SBAR (Situation, Background, Assessment, Recommendation).

This protects people using services and keeps teams working together.

Resolving Misunderstandings in the Workplace

When staff disagree about what was said or who should do what, it creates tension and can harm service quality.

Tackle these issues promptly:

• Raise concerns calmly with the person involved, ideally in private.
• Stick to the facts and avoid assigning blame.
• Listen to your colleague’s point of view. They may have a valid reason for their actions.
• Agree changes for next time, such as better handover notes.
• Involve a line manager if the issue is not resolved.
• Train teams in communication skills, including cross-cultural awareness and active listening.

A workplace where staff feel comfortable discussing errors is safer for all.

Recording and Reporting Misunderstandings

Recording what went wrong helps the organisation learn and improve practices.

Records should include:

• What happened and who was involved
• When and where it happened
• The type of misunderstanding and its effects
• What was done to sort it out
• What could change to stop it happening again

This information helps management spot patterns and take action, such as extra training.

Care Quality Commission (CQC) inspections often ask for proof that communication issues have been dealt with and learned from.

Relevant Law and Guidance

There are rules in place to keep information clear, accessible, and fair.

Main requirements include:

• Equality Act 2010: says reasonable adjustments must be made for disabled people, including communication support.
• Accessible Information Standard: all organisations must provide information in the way that best suits people with a disability or sensory loss.
• Data Protection Act 2018: guides how and when information can be shared.
• Duty of Candour: requires openness and honesty when mistakes are made.

Breaking these rules can lead to complaints, inspections, or legal action.

Management Role in Preventing and Dealing with Misunderstandings

Leaders set the tone for how communication is handled.

Managers should:

• Provide clear induction and refresher training in communication skills for all staff.
• Model open, honest interactions and encourage questions.
• Support staff when errors happen, avoid blame, and offer solutions instead.
• Regularly review communication procedures and update them when needed.
• Ensure resources are in place, such as interpreters or communication aids.
• Share learning from incidents with the whole team.
• Encourage a workplace where feedback and complaints are welcomed.

This builds trust and reduces future misunderstandings.

Using Technology in Communication

New tools can ease information sharing, but they come with risks.

Points to keep in mind:

• Use secure, encrypted systems for sharing personal details.
• Train staff and people using services on electronic systems.
• Give information in more than one format – for example, both email and paper.
• Check that automatic messages, such as appointment reminders, have gone out correctly.
• Offer video or voice calls for people who cannot attend in person.

Technology can support good communication if used carefully and thoughtfully.

Learning and Improving from Misunderstandings

Each misunderstanding is an opportunity to make the service better.

After an incident:

• Hold a debrief with those involved.
• Reflect on what worked and what did not.
• Update policies if needs change.
• Arrange further training or support if patterns are spotted.
• Share learning with other staff teams.

A commitment to quality means always looking for ways to communicate better.

Encouraging Feedback from People Using Services

Regular feedback helps check whether your messages are getting through clearly.

Ways to gather feedback:

• Anonymous surveys
• Suggestion boxes
• Regular meetings with people using the service and relatives
• Follow-up calls after appointments or changes
• Staff asking “Is there anything we could have explained better?”

Respond to feedback and show what changes have been made as a result.

Creating a Safe Space for Open Communication

Everyone in a service – staff, people using the service, families – should feel safe to voice confusion or concerns. People must believe that raising a misunderstanding will not get them into trouble.

Leaders can help by:

• Having open-door policies for concerns
• Providing confidential ways to raise issues
• Protecting whistle-blowers
• Promoting a supportive, open culture

Psychological safety means people feel able to admit errors, speak up, and help improve services for all.

Final Thoughts

Misunderstandings are a common challenge in health and social care, but practical steps can limit their harm. Clear communication, good records, and a team approach make all the difference. Focusing on clear messages and respectful listening improves both safety and quality of care for everyone involved.