An evidence review and research into the involvement of volunteers in the provision of social care for older people identifies clear benefits and several challenges. Fiona Liddell. WCVA Helpforce Cymru Manager, summarises the findings.
The pressures on our health and care system have been felt keenly by people being cared for in the community and in care homes. Yet volunteering in social care has not received the same policy and practice focus as volunteering within the NHS.
A literature review, Volunteering in Social Care conducted by the University of Kent on behalf of the Royal Voluntary Service (RVS) and related research report by RVS, Reimagining Social Care, suggest that volunteers have avital role to play, especially within care homes, in improving the working and living environment for both staff and residents.
A strikingly wide variety of volunteer roles, responsibilities, tasks and activities is reported; mostly in residential and day care settings and to a lesser extent in domiciliary or home care. Companionship and social/ cultural activities are the most common. Volunteers also give practical help such as with transport and shopping, navigating the health and care system and other wellbeing related support such as improving outdoor green spaces.
Personal care was generally seen as the responsibility of professionals. Where volunteers felt drawn into bureaucratic processes, this was seen as limiting their flexibility and autonomy.
Volunteer involvement generally aligns to one of three models. The underpinning research and the implications of the different models have been discussed in a previous blog ‘Learning from social care volunteering with older people’.
WHO VOLUNTEERS, AND WHY?
Whilst volunteering within domestic settings had more appeal to women over 50 years of age, volunteering in care homes had significant interest amongst younger people, many of whom were seeking employment related experience. Such experience is increasingly being encouraged by health and care related training providers. Volunteering within formal, coordinated contexts such as within NHS or social services was more appealing than informal local groups.
The RVS research found that motivation for 25% of care home volunteers (n=120) was connected with having a loved one in the care home. Around 40% declared a desire to make a difference by supporting staff and adding to the quality of care provided. One in three said they had skills and talents that could be of use. Most volunteers were interested in providing social and emotional support through one to one activity with residents.
WHAT DIFFERENCE CAN VOLUNTEERS MAKE?
There is strong evidence of the positive impact on care home residents – but whether this is due to programmes of activity delivered by volunteers or simply a result of the informal social interaction is not clear. The creation of meaningful relationships may be more significant than the type of activity. This, in turn, suggests that sustained involvement of a volunteer over time is preferable.
There is more limited evidence of the outcomes on volunteers themselves, but these include social and career benefits and the positive impact of altruistic behaviour.
Studies report a positive impact on staff, including on staff stress levels, although it is not necessarily the case the volunteers reduce staff workload – indeed involvement of volunteers may add to the workload! Nevertheless, volunteers are regarded by care home managers as invaluable providers of care, especially meeting recipients’ social and emotional needs.
The risk of volunteers becoming effectively a cheap alternative to paid and qualified staff can be a cause of tension between volunteers and staff. Similarly, the degree of professionalism that can be expected of volunteers is unclear. Proportionality in relation to recruitment, training and codes of conduct needs to be exercised, depending on the role undertaken.
The recruitment, training and ongoing support of volunteers in care homes is a challenge, requiring time and experience which are often lacking.. A partnership model in which volunteer coordinators within external voluntary sector agencies fulfil this function can be a successful approach.
Communication challenges include lack of clarity around roles and responsibilities and lack of appreciation of different cultural norms . For example, the public service preference for predictability and continuity can clash with the more informal approach of volunteers.
There is recognition that commissioners need to better reflect the contribution of volunteers in service, outcome and evidence frameworks and that volunteers should be involved in co-productive processes of design and decision making.
Financial support for volunteering is needed and the initial start-up costs are high, with positive financial returns being reported after 18 months in care homes. Evaluation of the social return needs to include benefits to volunteers, residents, staff and the wider society. This is difficult to measure.
Volunteers can enable stronger relationships between services and local communities. They can help to bring together services delivered by different providers, providing coordination and continuity of activity around the service user. Such claims, however, are hard to evidence.
The RVS research leads the authors to conclude that greater civic participation through volunteering can support a new care model that puts the wellbeing of staff and residents at the centre. There appears to be public appetite for volunteering in care homes. There is evidence that care home staff want to work with volunteers and that well-designed volunteer roles can have significant benefits for residents, family and staff. Volunteering can also be a gateway into a career or employment in health and social care.
The radical vision, articulated by RVS, is for a model of care that is more ‘relational’ than ‘transactional’, which is about more than meeting basic needs, but rather helps people to flourish and to enjoy life.
‘Volunteers bring new faces, experience and age groups into care homes, providing residents – particularly those without family or regular visitors – with even more opportunities to interact and engage with other people’ (Care home support staff member)
All of this is a positive basis on which to build.
ABOUT HELPFORCE CYMRU
Helpforce Cymru is working with Third Sector Support Wales (WCVA and 19 CVCs), Welsh Government and other partners to develop the potential of volunteering to support health and social care services in Wales.