Option 2 - Befriending

  1. Option description

1.1.Appointment of an assistant co-ordinator to develop the befriending service in Caithness.
1.2.Description of change
Proposalto mainstream funding for Befriending Caithness. Further capacity building of Befriending Caithness by appointing an assistantCo-ordinator in order to meet the demands of referrals and development of the quality of the service.
Since March 2013 we have received 67 referrals. 94% of these referrals are from NHS and other health related organisations. 6% of the referrals have come from families or self referrals. We can see this increasing in the next few years. We deliver a tailor made service to each Befriendee, therefore it is not a “first come first served” waiting list. We meet with the Befriendee and the Befriender separately in order to take information of their profile which enables them to make an informed decision, whether they would consider this person to be the right match or not. This time is extremely valuable especially in a small locality as Caithness. The need for an extra Co-ordinator is a necessity due to the time that this takes. During this first meeting information is given to the Befriendee and is the beginning of the building blocks of trust.
We currently have a waiting list of 14 Befriendees. This is due to various reasons for example a Befriender may not want to see someone with mental health problems such as dimentia or other physical problems, or their Disclosure has not come through as yet, this can take up to five weeks. Or it could be the right volunteer has not been identified for the Befriendee.
We currently have 39 Befrienders(plus two volunteers who do local fund raising) of which 13 are unmatched.The importance of recruiting and retaining volunteers can not be emphasised enough, especially whilst they are waiting to be matched. Time needs to be spent preparing and delivering the introduction/induction training. It is important that there is a timetable for individual regular supervisions for the Befrienders and also frequent reviews. At the same time Volunteer Befrienders need ongoing training to deal with the different scenarios that they will come across. Every two months the Befriender Volunteers meet to enable them to discuss any issues or exchange any news and activities that they are doing with their Befriendee.
1.3.Reasons for change
Befriending Caithness began as a pilot and has outstretched this definition. We were originally funded by The Change Fund, Robertson Trust and Co-op. The steering group consisted of Laurandy Centre, Caithness Voluntary Group and the Carers Forum. The service was developed to meet the local need of the increasing numbers of isolated older people. Gaps in service support were largely apparent when individuals had to face the challenges of growing old as well as having health issues to contend with.
We are now more aware that many of thoseindividuals have been diagnosed with dementia, recovering from strokes, suffering from mental health issues as well as combating the ongoing issues of loneliness.The services in place can only provide a proportion of the support required. This need continues to increase and puts pressure on services and our locally community. We continue to get referrals from stakeholders, family and members of the community.
Befriending Caithness meets with the aims of the Reshaping Care for Older People initiative through community capacity building with trained volunteers and thealternative available option for support to enhance health and well being by informal means. This meets with the criteria of shifting care towards anticipatory and prevention.
Our now well established Befriending Caithness scheme continues to develop and prepare for the ever increasing older population.
  1. Evidence

2.1.Access
It is evident that mental well being can be affected by isolation, loneliness and concerns regarding physical health. In the Joseph Rowntree foundation report (1) it states that, “There is a plethora of evidence to suggest that loneliness has a detrimental impact on the health and social well-being of individuals and communities. It can have a significant impact on mental health. Studies have shown that people who are lonely experience more stress, have lower self-esteem and are more likely to have sleep problems than people who have strong social support”. Befriending Caithness Volunteers are trained to fully understand the above and also to work alongside the family, the referrer, and the appropriate health practioners, in order to give a holistic approach and deal with the many impacts of isolation and loneliness.
Failing to develop Befriending Caithness would mean that there will be an increase in isolation, self esteem will be reduced, confidence will be reduced, the level of activity and independence will be reduced, and people will not have the opportunity to develop a trusting relationship. We have a good working relationship with our stakeholders and if Befriending Caithness does not continue it will mean one less service for the stakeholders to refer to.
The service template now in place can be continued to be rolled out to wherever volunteers can be recruited and this provides increased accessibility throughout areas of our local community.
2.2.Equity
The needs of the individual are unique to them. Each referral is individually considered for the most appropriate match of volunteer. Every individual will have health and well being issued to be assessed for the best outcomes. First and foremost the Befriendee is a person regardless of their illness whether that is dementia, stroke, or loneliness. Therefore the Befriendee has the right to have respect, unrushed communication, a chance to laugh and reminisce and pass on their experiences to their Befriender. Supporting choices is very important for both of the Befriendee and the Befriender.
2.3.Improved outcomes
Befriending Network Scotland (2)carried out a feasibility study for this service within Caithness. This 59 page document showed that the “majority of those working directly with older people in Caithness see value in the opportunity of developing befriending for older people to meet a specific need; namely that many older people can be lonely and isolated, lacking support from family and friends and sometimes only having limited contact with professional staff”. The following outcomes would be achieved:
  • Volunteers trained to a high level of knowledge. Extra co-ordinator would be able to give further training, and support to co-inside with the current programme.
  • Fully engaged volunteers who are supported through regular contact with the Co-ordinators who will monitor and evaluate the match and observe any change in circumstances.
  • There would be a greater capacity of the service delivered in a shorter time scale.
  • Befriending Caithness could apply for the Befriending Scotland Network Quality Mark as they would meet the ratio criteria.
  • Increased confidence of the Befriendee which in turn will increase social and emotional wellbeing.
  • Enhance quality of life and community participation
  • Increase capacity to use own resources
  • Increase level of activity and independence
  • Reduce Isolation
  • Provide information on other service and support available
  • Offer a chance to develop a trusting relationship
  • Help strengthen ability to continue living at home independently
  • Assist individuals who are currently socially excluded to take a more active part in their community by being part of the Befriendee Group.
  • If funding was mainstreamed the capacity of the service would be secure and community capacity would be increased.
  • We have seen in Caithness that organisations recognise the need to support older people who are isolated, and that it will affect their health mentally and physically.
We have been approached by the Redcross to accept referrals through short term Befriending, through a local pilot scheme that is being run in conjunction with the Redcross and the Ambulance Service in Wick which will complete a gap that is within their service, through befriending on a long term basis.
We are very supported by the Caithness General Hospital who would like us to be involved with visiting their elderly patients on a short term basis, by visiting those who have no or very few visitors. This in turn may lead on to a long term Befriending relationship.We currently discussing the future with the NHS Volunteer Co-ordinator who felt the project would help his position as he has a very wide area to serve.
We receive training and support from the Speech and Language Department of our local hospital to undertake referrals that we receive from them, as they believe that the time the Befriender can give can make a big difference to their patients through building up self confidence and self worth as well as stimulating the mind.
We receive referrals from the Social Service Department who have told us that we are an important part of their programme when dealing with the care package of people over 60. “Organisations such as Befriending Caithness are so important in the lives of many people in the area” – quote by a Social Worker
Many of our Befrienders do support the Befriendee by taking them to visit the GPs, hospital and other health appointments, supporting them through shopping trips, taking them to the hairdressers and visiting places of interest.
2.4.Effective practice
Mainstreaming funding for Befriending Caithness would have the following effect:
  • Capacity to meet the demands of the numbers of referral from, Social Services, Doctors, Occupational Therapists, Mental Health Team, Family, Home Carers, District Nurses, Shop Keepers, and Community Councillor’s.
  • Secure an additional 16 hour post to enhance the delivery of the service.
  • Decrease the waiting list in order to make first visits to the Befriendee. Increase capacity for further support and training of Volunteer Befrienders
  • Increase capacity for raising awareness
  • Increase support to the carers i.e. family members who are finding it difficult living with an older relative with ill health.

2.5.Sustainable
We have seen a growth in the need for Befriending Caithness since the pilot scheme began with 12 volunteers. We now have 39 Befrienders. We will continue to need more and more Befrienders due to the fact that referrals continue and the need for further dementia awareness trained volunteers is on the increase. Each Befriender needs to receive quality support and supervision due to the nature of the service, visiting vulnerable people in their own homes. Potential Befrienders need to go through the PVG system, have three referees to vouch for their character according to the role description. The Befrienders need to go through the Training/Induction and also further external training. Increasing the capacity with another Befriending Co-ordinator will enable the effective quality that is needed for this service.
Networking and support with other statutory services is becoming more common place when sign posting is anticipatory in the best interest of the individual. Our initial visits are usually alongside the organisation that has referred. Ongoing communication and update is crucial. We work closely with the Mental Health team, Speech and Language Therapist, District Nurses, Social Workers and various other statutory and non-statutory health disciplines. This is crucial to working in partnership in order to engage with the Befriendees well-being.
2.6.Culture and values
Befriending Caithness respects the value of people being in their homes. We have heard Befriendees say they don’t want to leave their home. “I do not want to go into a home, although I am partially blind I am very used to my surrounds at home, I know where everything is I will lose the ability of being independent if I am in a home, lose my self confidence this way if I have a Befriender I will feel independent again, able to make my own choices, whether that is to stay in bed longer or get up earlier, what food to buy and what programmes to watch.” Befriending Caithness firmly believe in respect and equality for the Befriender, discussing choice of where to visit or what activity to do. Our volunteers can support the realisation of potential. This increases self confidence and in turn develops good mental health.
  1. Risks

  • The main risk is, if we do not receive an assitant Co-ordinator, that there may be a decrease of the quality of support and supervision for the Befriender. Also the support and reviews of the Befriendees would be affected. Commitment to support volunteers is crucial. The importance of their development and recognition for their work can not be undervalued if we are to retain the volunteers. Volunteer’s need to be matched carefully and a clear understanding of their role and responsibilities need to be achieved to prevent volunteer “burnout”.
  • Difficulty recruiting volunteers – More capacity would mean more time to raise awareness of the service available.
  • Inability to meet the demand for the service – Control measures in place to record and monitor referrals and regular contact with partners will ensure understanding on both sides about capacity. This change would increase the capacity of delivering the service.

  1. Implications for others

  • Currently we receive referrals from statutory organisations to finalise the individual care plan. We aim to conduct our initial visits within 14 days this change would reduce the time scale.
  • Increase volunteer and recruitment campaign which would mean more capacity to deliver talks, talk on the radio, be involved with the schools to encourage intergenerational work.
  • Increase support for the individual Volunteers through supervisions, meetings, appraisals at the same time providing capacity for continued review with the Befriendee throughout the ongoing process of Befriending.
  • Increased capacity to organise the current Befriendee Group which takes place monthly.
  • Enable us to see more Befriendee’s and take more referrals from statutory organisations as the need for Befriending Caithness continues.
  • Increases the time to meet with statutory organisations to discuss the individual needs of the befriendees.

  1. Consultation

Evidence from current stakeholders, service users, external organisation, Older Redesign Group, GPs, District Nurses, OT, Mental Health, family members of our current users, Befrienders, and Befriendees.
  1. References

(1)Josepth Rowntree Foundation Report 2014– Can a Neighbourhood to Loneliness Contribute to People’s Well Being (Angela B Collins and Julie Wrigley)
(2)Loneliness in the UK 2014 – Befriending Network Scotland Briefing
  • Griffin, Jo (2010) ‘The Lonely Society?’ Mental Health Foundation Report
  • Social Care Institute for Excellence (2011) research briefing ‘Preventing Loneliness and Social Isolation: Interventions and Outcomes
  • Befriending Networks “Reaching Out: Befriending for Older People in Caithness”

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