Updated: 5 days ago
As part of the National Lottery funded Communicate and Connect project, we have been working closely with services who provide support for adults with learning disabilities, particularly Persona Care and support Bury. Support workers can be overlooked as key to the success of communication with people with learning disabilities. Many are highly skilled, adapting their communication, altering their spoken language and using sign support. Our next blog was written by such a support worker from Persona Care and Support Bury.
We were approached by Coral after the training to say she had written something to support our next bid. We decided it would make a great blog so we could share her views from the perspective of support staff.
‘My name is Coral Mulligan and I am a support worker, supporting adults with learning disabilities at one of the many day centres run by Persona Care and Support. I am hoping to make a difference and advocate for those who do not have the capabilities to be able to voice their needs vocally. Within the day centres at Persona, we support a variety of lovely individuals who differ in terms of their level of support needs and ways of communication. As a member of staff my first priorities are to; deliver care and support that is person centred, safeguard the individuals and build positive relationships with them. Being able to communicate with who I support to learn more about them, ask questions and understand them is an essential part of my role. Those I support communicate with staff to express feelings, likes and dislikes and also concerns. This ensures the safety and positive well-being of all at the centre.
A part of my role is to undertake many forms of training which can be mandatory or voluntary. I recently put myself forward, as did other staff at Persona, to take part in a days training of Signalong with Alison and Helen from Total Communication Services CIC. This was a training session that was offered, however only a certain number of staff were able to participate in this, meaning a lot of staff did not get to experience this. During this training session we learned many essential signs that I have been using now myself in my work. The sessions were led by Alison and Helen from Total Communication Services CIC and students studying speech and language therapy at university and are currently focusing on connecting and communicating with others.
The knowledge, understanding and passion those people had have inspired me greatly. They made the training session fun, interactive and very memorable, providing very helpful books with basic signs I am going to need in everyday life. The books were to take home with us so we can further our own knowledge. Our staff knowledge was tested and put to practice when they visited our different day services to teach Signalong to the individuals we support. Again, this was a fun session which even more staff and the individuals gained a lot from. For the second time I was a witness to the passion, knowledge and thought put into the sessions that made who I support all feel included and learn new skills. At Persona we focus on the enablement of who we support. The training I have received will allow us to develop a way to confidently and competently use Signalong in our roles which will subsequently empower those who communicate non- verbally, which is a large amount of those I support.
Some of the people I support can face communication barriers daily and they are considered to be very vulnerable in their day-to-day lives. From this training I am confident I can communicate basic needs and wants with them. to ensure I am person centred. This consequently improves the relationships, and their safety and wellbeing by having a better understanding of one another. The people I support will now feel more included and a part of the community as Signalong is an inclusive form of communication.
The value and appreciation I have placed upon this training as well as Total Communication Services CIC for delivering this, is immense, and I am so glad that myself, my colleagues and people I support will benefit from this. I truly do believe other companies will benefit just as much and everyone learning Signalong will better the quality of lives of non-verbal people. As a company and staff team we ourselves face many barriers which include funding for the best resources, that are also accessible to who we support. To further develop what we have learnt we will need the best resources we can find, many of which I believe should come from Total Communication Services CIC due to the understanding they have of Signalong, the passion they exude and the connection they have secured with Persona. We have discussed many ideas that have been agreed on by other staff that will further benefit who I support.
Signalong is a great and necessary way of communicating that I wish more people know, understand and are taught. It is a vital way to communicate and connect with people. I hope Total Communication Services can receive more funding so they are able to share these training sessions, Signalong resource packs with many more people so thousands of other people can feel and notice the positive impact this will have in the work place, communities and one day the world. As one staff member in one company I feel the benefit of just two sessions. Imagine the wider impact they can have with the funding allowing them to reach more people and do more sessions with better resources to share.
The National Lottery Fund is a distinguished way to help those achieve inspirational ideas and Total Communication is absolutely a service that is more than deserving of some funding to benefit many people in terms of communication, connection and inclusion.’
Taking a Total Community Approach
Communication plays a vital role in how we learn, work, maintain relationships and participate within society. Around 90% of individuals with learning disability also experience communication difficulties. Some individuals have profound and multiple learning disabilities that may pose an extreme limitation to communication, spanning from language, facial expressions to eye contact and dexterity. Due to such variation in learning disabilities and other disabilities, communication is personal to the individual and therefore takes a person-centred approach. A Total Communication approach refers to adapting communication in the most accessible and effective way for the service user. Total Communication often requires a marriage of communication strategies including non-verbal, written, verbal and manual.
Signalong is one such strategy used by service users and their support staff. It is a keyword signing system and, unlike BSL, is not a language as it has no independent grammar or syntax. Instead, Signalong uses simplified keyword signs adapted from BSL to support people with communication difficulties. It has been found to be a useful alternative communication channel and a valuable addition to a communication toolkit, empowering service users to make choices about daily routines and communicate non-verbally, particularly during times of stress and frustration.
Within the social model of disability, it is thought that prejudice and exclusionary norms in society are the arbiters of who is disabled. Spoken language and understanding social cues is considered the standard form of communication within public services. Oftentimes, adults with learning disabilities benefit from a family member or a support worker assisting them in public spaces such as during hospital visits and on public transport. This is not because service users are not able to communicate, but because the world is not equipped to communicate in the style appropriate to the service user.
Support staff have a responsibility to respect people’s chosen forms of communication and use them themselves. In this sense, staff and carers have an important role for adults with learning disabilities, particularly in advocacy in public space. Despite this, constant support can place adults with learning disabilities vulnerable to forms of abuse and/or neglect. It is important that individuals are afforded ample opportunity to communicate and execute autonomy. To allow for appropriate communication, adults with learning disabilities require skilled communication partners. Individuals with intellectual and psychological differences are disabled by a world that was not built with them in mind. This is not just the way of life; this is not inevitable. Public service workers would benefit from communication training like Signalong, to increase accessibility to basic needs. Total Communication Services CIC is dedicated to social action. The non-profit organisation works with service users, carers and the wider community to enable people to understand and express decisions and opinions, access services, maintain health and wellbeing, and develop personalised services.
Collaborating with local day centres along with self-advocates from Bury and Rochdale People First, we have coproduced four films based on vocabulary relevant to service users. These topics included ‘daily living,’ ‘activities,’ ‘advocacy,’ and ‘fire prevention.’ The latter of the four was created in collaboration with Greater Manchester Fire and Rescue Service. During the placement, we participated in and facilitated staff workshops demonstrating signs related to these four topics. The reception from staff members was overwhelmingly positive. But this is only the beginning.
Fire Prevention and Education (2020)
In 2020, Total Communication Services CIC partnered with Greater Manchester Fire and Rescue Service (GMFRS) to develop a video simulating a rescue from a car accident. In the simulation a service user was ‘rescued’ by the fire service. During the rescue the firefighters communicated with the service user what they were doing to give a forewarning. The fire service used visual aids, (see below), and speech to communicate this.
The firefighters were enthusiastic and proactive during the simulation, providing scrap cars to provide a realistic experience and utilised the training exercise.
Unfortunately, due to external pressures on the service, we have not been able to continue our work with the Greater Manchester Fire and Rescue Service, as of yet.
In the meantime, we have been editing the simulation video and preparing our own Signalong resource for fire prevention vocabulary. We hope to continue working with GMFRS as we believe fire prevention and communication for adults with learning disabilities to be vital.
Public Transport Workshop (1998)
This approach to working with the community is not new, it has always been a fundamental part of a total communication approach. In 1998, Therapists from Total Communication Services CIC partnered with Greater Manchester Passenger Transport Executive (GMPTE) in preparation for Oldham’s new bus station. GMPTE requested advice for using symbols to signpost the bus station. Co-producing with local service users we developed a workshop to generate some feedback. Each participant and support worker were provided with an envelope containing three exercises: get 135 bus for one stop and return; find the toilets; look for stand for bus to Oldham. From completing these exercises, the participants provided some positive feedback and some constructive criticism:
Room for improvement:
o More symbols and clearer signs for directions
o Signs and information posters would be better on the ground – to help wheelchair users
o Crossing could be safer
o There were no seatbelts for wheelchair users
Positives:
o Automatic doors
o All on one level without steps
o Painted floor demonstrates the safest walkway
o Everything in the bus station is nearby
This workshop served great use for service users in Oldham and was well received by GMPTE. Consulting adults with learning disabilities is a vital step in improving accessibility of public services. This was a great step towards greater inclusion in public transport services. Accessible information is only one part of the puzzle.
During my time here at Total Communication Services CIC I have had the privilege to converse with advocates from Bury and Rochdale People First groups. One of the times I attended a self-advocate session, an advocate discussed feeling that bus drivers could perhaps benefit from learning some keyword signs in Signalong, to aid productive communication. The advocate reported feeling distressed on the bus and that he would have benefited from using Signalong with the bus driver. There are oftentimes we may need to alert bus drivers to something suspicious on the buses or ask for further accommodations. Not being able to express this would be extremely frustrating and even dangerous. This is a potential avenue for future training programmes, which would improve autonomy and decision-making.
The Royal Oldham Hospital (1999)
A further example of work with the community as part of a total communication approach can be seen with the innovative work with the Royal Oldham hospital. A multidisciplinary Symbols Group in Oldham worked with adults with learning disabilities, speech and language therapist, and hospital staff to improve access to public services through symbol-based communication. After identifying barriers caused by text-only signage at the Royal Oldham Hospital, the group designed and tested simple symbols to help navigate complex environments. Trials showed that symbols were effective through straightforward picture-matching, even for people unfamiliar with them. Following a successful pilot, the hospital committed to introducing symbol-based signage and involving departments in the design process. The project demonstrates how adapting public environments, rather than expecting individuals to adapt, is a practical and powerful step towards inclusive public services.
A similar approach could be taken for disseminating health information. Healthcare professionals must explain treatment plans and diagnoses to patients. It is important to be able to express oneself to receive appropriate care. Without skilled communication partners, adults with learning disabilities may not understand what is being asked of them. This is not to be confused with the mental capacity to make decisions about their own care but instead the information is not being communicated in an accessible manner. It is vital to not misconstrue communication difficulties for a lack of mental capacity to make decisions. To improve comprehension, a variety of methods should be used by healthcare professionals, tailored to the patient’s communication needs.
Final Notes
Accessible communication should not be viewed as an optional adjustment, but as a fundamental requirement of inclusive practice. Adults with learning disabilities are too often expected to adapt to systems that were never designed with them in mind. A Total Communication approach challenges this imbalance by placing responsibility on services, professionals, and communities to communicate better.
Training in strategies such as Signalong equips public service workers with practical tools to increase accessibility, reduce distress, and promote autonomy. Small changes in how we communicate can have profound effects on safety, dignity, and participation within society. Meaningful inclusion requires awareness but more importantly it requires action.
Total Communication Services CIC will continue to work alongside service users, carers, and professionals to develop accessible resources and promote communication equity. We encourage organisations, public services, and community groups to reflect on whose input is currently being excluded. Communication is a shared responsibility, and inclusion begins when we choose to listen differently.
Hello, my name is Archer Morgan and I am a speech and language therapy student from the University of Manchester on placement with Total Communication Services CIC working with adults with learning disabilities. I had Alison Matthews and Helen Newman as my placement leads, both of which are Speech and Language Therapists (SLTs).
SLTs have a vital role to play in supporting advocacy, providing guidance and support on the most appropriate method or style of communication and sharing theory about communication development.
This was seen throughout my placement with Total Communication Services CIC, when supporting Alison with this year’s project ‘Communication and Connect’. This was through a multitude of scenarios.
One of these scenarios was when I was supporting Alison with providing training to support staff, where she shared information on the stages of communication development and the stages of symbolic development. Despite the staff having some awareness of these concepts, they had not been exposed to the underpinning theory, they just adjusted their ways of communication, intuitively just knowing it works. Furthermore, the understanding of symbolic development helped staff to understand the best ways to show choices to their service users, such as showing them the actual object instead of a picture as they don’t understand them to be the same thing, promoting improved communication between staff and service users. It also gave them the tools to write in their case notes now best to support their service users, ensuring other professions take it into consideration when caring for them, advocating on behalf of their service users to make sure they are heard. Additionally, giving the staff training allows them to support training the service users and other members of staff at their places of work, making this information more available and normalised.
SLTs would embrace a broad range of communication approaches. However, this doesn’t mean purely teaching positive language. Recently, in teaching practice there has been discussion about idea of using the word naughty and therefore the sign for bad/naughty. People do not want to use negative language when describing someone (e.g, a child is naughty) despite this being very unfair to take a vital word away from people, as the word ‘bad’ has many other meanings than just describing someone, it could describe a behaviour or a food as ‘bad’ both of which it would be used to keep individuals safe as well as giving an understanding about right vs wrong.
I do understand the ideology of not wanting to associate someone with purely negative connotations, however you wouldn’t tell a child they can’t learn the word bad, so why stop someone signing it?
There is also a level of connection that S<s can have with service users, since we are there to help them to connect with others, which first potentially requires them to connect with us. We may also be a relief to them, being a way for them to finally be heard and understood without impatience and judgement as well as giving them the tools to interact with others.
This can be seen through the self-advocate group with Rochdale People First, where we were teaching them important signs you may not first think of. These are signs such as advocacy signs and fire safety signs, as well as day-to-day signs such as activities, daily living and food signs, all of which are on the Total Communication YouTube channel (https://m.youtube.com/@TotalCommunicationServicesCIC). This advocacy group was also an important part of the creation process, choosing the sign topics and giving us feedback on the signs we had chosen to make sure they were as clear as they could be. We then also had Gareth who has a learning disability, ADHD and autism and is the non-executive director of Total Communication, to help record some of the signs.
It is important for advocacy to not just have co-production but also co-delivery, since it promotes important topics such as accessibility and inclusion. Inclusion being especially important since it shows that the people they are talking about can and will speak up for themselves, breaking down stereotypes which can prevent them from doing activities that we take for granted such as being able to work. Since people with learning disabilities are less likely to find work, only 53.1% of disabled people were employed compared to 81.6% of non-disabled people in 2024 (GOV.UK, 2025), a significant gap that doesn’t need to be there but is due to discrimination and fear, since only 1 in 5 people with disability, health condition or impairment inform their employers about it (Quinn Roache, 2025).
SLTs will have a role in supporting people in having a voice when starting conversations at work and ensuring they fully understand how the conversation may go, how to best ask for reasonable adjustments and more. This could lead to a role for S< in supporting pupil voice enabling them to self-advocate for instance an EHCP plan.
This is not the only place that SLTs can help people find a voice, such as people with dementia, since as they progress they lose their ability to communicate as effectively as they once did. SLTs will find other ways that are easier for them to communicate, such as talking mats to understand what is important to them. SLTs can also help them choose if they like their accommodation or not and which ones may be better for them.
One final way that SLTs can help someone find their voice is through supporting self-advocacy groups, this can be seen again with Rochdale People first and my placement. The group had asked to learn some Signalong vocabulary, and they felt Signalong is very important for them but also for many other people with learning disabilities. It gives them a way to communicate using a simplified sign support system alongside speech. This is helpful for individuals where they may experience difficulties understanding and where they may struggle to use speech. Furthermore, it is the official signing support system of their area in that there is a policy to use Signalong in Rochdale, Bury and Oldham amongst other areas. Consistency of sign support systems is vital across services. The decision to opt for Signalong as the preferred method was made initially by self-advocates in Oldham back in the 1990s and ever since then some regions have respected their voice and used a consistent approach in school and in the local community services.
Another issue for support staff we encountered on the placement was that due to austerity cuts there is a lack of access to training and resources, which is similar for other forms of communication aids since most advocacy groups are non-for-profit. This has left the 3rd sector to fill the void left by the public sector. This is seen through the training Total Communication Services CIC provides to support staff, ensuring that none of the service users go through their lives unheard and staff come out more educated on Signalong but other important topics too, such as intensive interaction, communication with parents with learning disabilities and visual support for communication.
Overall, S<s play a massive role to play in supporting advocacy. Especially for people with learning disabilities, from supporting the individuals themselves to the staff that support them, leading to better communication between the two. Signing is just one approach and it may not work for everyone so it is important to have an S< to support them deciding the best communication approaches which give them the opportunities to speak for themselves.
This has purely positive implications for both, having ideas be effectively explained to their communication partner. This can prevent misconceptions between the staff and service users, which can mean they are more likely to agree to do what is asked of them because they understand as well as prevent panic, it can also prevent frustration from not being understood. We are in desperate need of third sector provisions to fill gaps that were left by the austerity cuts to allow support staff to continue to improve the ways people communicate and connect with their service users.
REFERENCES:
GOV.UK (2025) ‘The employment of disabled people’ Available at: https://www.gov.uk/government/statistics/the-employment-of-disabled-people-2024/the-employment-of-disabled-people-2024 (Accessed: 17th December 2025)
Quinn Roache (2025) ‘Bullying, harassment and discrimination of disabled people in the workplace’ Available at: https://www.tuc.org.uk/research-analysis/reports/bullying-harassment-and-discrimination-disabled-people-workplace (Accessed: 17th December 2025)
