Volunteering policy

1 Introduction

The Department of Health’s definition of a volunteer is,
“Someone who commits time and energy for the benefit of others, who does so freely, through personal choice and without expectation of financial reward, except for payment of actual out of pocket expenses.”

Volunteers can be excellent ambassadors, supporters, advocates and champions for the service users or patients and the trust.

Rotherham Doncaster and South Humber NHS Foundation Trust acknowledge the added value that volunteers bring to the organisation as a whole.

Volunteers are people who come of their own volition, in their own time and who do not receive any financial benefit.
Roles carried out by volunteers will complement the work of employees and will not be used as a substitute.
The trust recognises everyone has a contribution to make to society and a right to equal treatment. It will therefore aim to ensure the appointment of staff policy guides all its dealings with volunteers.

2 Purpose

To provide a framework for the procedure and guidance on which our involvement of volunteers will be based.

To ensure that volunteers and prospective volunteers are assured of a fair and consistent approach. Guidance on this must be taken from the appointment of staff policy.

To uphold the definition of volunteering, providing a cohesive and consistent approach to ensure that volunteers are fully supported during their volunteering role.

To provide a framework to promote volunteering within all care groups and services throughout the trust and further enhance opportunities through partnership working with external organisations.

3 Scope

This policy applies to all volunteers registered within the trust and prospective volunteers who wish to volunteer in the trust.

The volunteering service offers the opportunity for patients and service users, carers, family and friends, and members of the public to consider the benefits of being a volunteer with Rotherham, Doncaster and South Humber NHS Foundation Trust. This could be for several reasons including:

giving something back or contributing to our communities
bringing new and diverse perspectives, expertise and skills to our work
providing an added dimension to existing services
increasing patient and service user involvement
promoting another route to recovery
gaining confidence and self esteem
the option to gain skills, knowledge and experience to improve employment potential within a vocational pathway

Volunteers can contribute in a wide range of roles across the organisation; a current list of all volunteer opportunities within the trust is accessible from the voluntary services managers (VSM).

This policy does not apply to:

all pre-registration, professional, school, further education or any other ad hoc work experience placements, which are managed via the Learning and Development team
trust associate managers (TAMs) who sit on hospital managers’ panels under the Mental Health Act 1983. This role is managed through the Mental Health Act administration
any volunteers working within a service managed by another organisation, where such services are provided for the benefit of the trust’s patients or service users or carers (such as a café on trust premises operated by a voluntary sector organisation that recruits and manages its own volunteers)
any visits that have been arranged for individuals or groups who may attend for the benefit of trust patients, for example, trust choir, Pets as therapy visitors
trust governors managed via the Corporate Assurance team

All individuals volunteering direct to the trust are covered for public liability, professional indemnity and related risks by NHS resolution under the trust’s membership of the Liabilities to third parties scheme (LTPS).

3.1 Other voluntary services within or linked to RDaSH

There are some services within or linked to the trust whom recruit and manage their own volunteers independently. Not all of these teams are aligned with the terms of the volunteering policy, however, voluntary services do liaise with them regularly in order to share opportunities, embed good partnership working and keep processes consistent across the organisation.

3.1.1 St John’s Hospice

The hospice volunteers are recruited and managed by the service’s voluntary services manager and fundraising administrator.

For further information, please contact the service at 03000 214871 or visit their St John’s Hospice website (opens in new window).

This service is aligned with the volunteering policy except where specifically indicated.

3.1.2 Aspire drug and alcohol services

Volunteers at Aspire are recruited and managed by the service’s volunteer and mentor coordinator under their partner organisation, AD, the alcohol and drug service.

For further information, please contact the service on telephone 01302 730956 or 01302 303900, or visit the Aspire website (opens in new window) .

As volunteers are managed by an organisation separate to RDaSH, this service is not aligned with the volunteering policy.

3.1.3 Flourish enterprises

Flourish enterprises, a not-for-profit social enterprise and community interest company (CiC) which is a wholly owned subsidiary of the trust, also works with volunteers whom are recruited and managed by their community engagement officer or volunteer coordinator.

For further information, please contact the service on telephone 03000 212000 or visit the Flourish website (opens in new window).

As volunteers are managed by an organisation separate to RDaSH, this service is not aligned with the volunteering policy.

4 Responsibilities, accountabilities and duties

4.1 Executive director of nursing and allied health professionals

The executive director of nursing and allied health professionals has delegated responsibility for safeguarding (adults and children) and will bring to the attention of the board any risk that may affect patient safety, in respect of the deployment of volunteers within the trust’s services.

4.2 Executive director of people and organisational development

The executive director of people and organisational development has overall responsibility for processes, policies and procedures relating to people management and ensuring their effective implementation in the trust. These include, but are not limited to, recruitment processes; learning, development and education; personnel record keeping; occupational health; and grievance procedures.

4.3 Chief operating officer

The chief operating officer is responsible for overseeing the implementation of the policy throughout all the care groups and for having overall responsibility for decision making that might bar them from undertaking this role, notably in respect of past offences or safeguarding risks.

4.4 Care group directors

Care group directors receive delegated responsibility for the volunteer service supported by the care group nurse directors.

4.5 Deputy director of nursing

The deputy director of nursing will be accountable for the delivery of the trust patient experience and involvement plan, including the strategic approach to volunteers.

4.6 Deputy director for patient experience and involvement

The deputy director for patient experience and involvement, through direct engagement with the voluntary sector, patients and carers, will lead on the development and implementation of the trust patient experience and involvement plan, including the strategic approach to volunteering.

4.7 Patient experience manager

The patient experience manager provides direct line management support and guidance to the volunteer services manager and has responsibility for the operational management and development of the volunteer service.

4.8 Care group nurse directors

Care group nurse directors are responsible for ensuring that suitable placements are made available for volunteers within their services and that such placements do not replace established job roles within the services. They must ensure that each volunteer has a named responsible manager, to oversee the placement and provide operational support for the volunteer in their volunteering role, reporting any concerns to the manager.

4.9 The voluntary services manager (VSM)

The VSM has overall responsibility for all volunteers across the trust including recruitment of volunteers, in line with this policy. The trust has 2 further managers with responsibilities for separate service areas within the Doncaster care group (see 3.1).

The VSM will be directly responsible for the recruitment, training and induction of new volunteers into the trust, excluding the above-mentioned services. They will be familiar with the appointment of staff policy (which covers the recruitment of volunteers) and have completed the trust recruitment and selection training?

The VSM will invite prospective volunteers to attend an informal interview to determine their expectations of volunteering. The VSM provides an introduction to volunteering in the trust and the application process, as well as explaining the content of the volunteer agreement, (which includes the volunteer’s responsibility to provide the information necessary for recruitment to be carried out in line with the trust’s policy for the appointment of staff and the prospective role expectations).

Upon successful completion of this process, the VSM will make the necessary arrangements and introductions to designated departmental managers responsible for the volunteer opportunity.

The VSM is responsible for retaining accurate records for all trust volunteers in relation to volunteer names and addresses, personal details, pre volunteer checks and details of all training undertaken to match their volunteering role, to be stored on a central database. Any personal information collected by the trust from volunteers will comply with relevant general data protection regulations (GDPR) and legislation.

Documents to be held by the VSM include:

application form
references
occupational health clearance
confirmation of satisfactory DBS check (enhanced, where appropriate)
example of role description (appendix B)
volunteer agreement or code of conduct (appendix C)
signed Confidentiality agreement (appendix D)
information governance and GDPR principles (appendix E)
1st volunteering offer letter
final volunteering offer letter
correspondence
supervision or file notes

All documentation relating to unsuccessful applications for volunteer placements will be retained for a period of 12 months and then destroyed by the VSM.

4.10 Responsible managers (RM)

The RM can be any team leader or service manager within the trust who undertakes to be responsible for the placement opportunity and for the work of the volunteer whilst in that placement. The RM will have completed the recruitment and retention training.

It is the responsibility of the RM to ensure that there is a volunteer role description in place for any volunteering vacancies within their service. Should they wish to appoint a volunteer to this role the RM is to notify the VSM of the vacancy and work with them to complete the role description. The RM must consider any safeguarding risks presented by any new volunteering role and seek advice and guidance from the trust’s Safeguarding team where necessary.

It is the responsibility of the RM to ensure that all potential volunteers in their area are referred to the VSM, in order that all necessary pre-volunteer checks are undertaken prior to the commencement of the volunteer role. Potential volunteers will be interviewed by the RM.

It is the joint responsibility of the RM and VSM to ensure that the application process registration and necessary pre volunteer checks are carried out. The RM should ensure that all volunteers and their pre volunteer checks are registered with the VSM.

The RM should notify the VSM if they would like to change the role description of any existing volunteer They will then work with the VSM and the volunteer to agree a new role description.

The RM will be responsible for ensuring local induction procedures are provided for all volunteers in their area, as well as carrying out any risk assessments including pregnancy risk assessment. They must then undertake risk assessment with the volunteer at least annually, and in accordance with any changes as required (for example, environmental changes)

The RM will also be responsible for holding the contact details for the registered volunteers working in their area of responsibility, including emergency contact details.

The RM must endeavour to make sure that the tasks carried out by volunteers are within the identified list of tasks to be undertaken in the volunteer role description, including considerations in respect of lone working, the VSM will help support this process.

Volunteer roles should have a description which clarifies expectations; these should allow for some flexibility whilst maintaining appropriate boundaries in terms of the tasks that are to be undertaken by the volunteer and those that are not, allowing adaptation to each volunteer’s skills and capabilities whilst reflecting the needs of the organisation

Volunteers are not to be placed in a role where the role has previously been filled by a paid member of staff. Volunteers should also not be placed in an essential role, for example, there should not be a disruption to a service if a volunteer is unable to attend without notice.

4.11 Supervisors

Each volunteer will be assigned a named supervisor who, under the direction of the RM, will provide day to day supervision of the work of the volunteer.

Depending on the nature of the volunteer role and the supervisory needs of the volunteer, the nature of the supervisory relationship may range from day-to-day oversight of the work, along with availability of the supervisor for advice, to some level of formal supervision, with a written record of each supervisory session.

Volunteers are to be supervised at all times within clinical areas. They should not have access to treatment or bathroom areas or observe any intimate care.

4.12 The volunteer

It is the responsibility of the volunteer to:

agree to a commitment that reflects the investment made by the trust in offering the volunteering opportunity and providing the volunteer with training against this role
agree to the boundaries of the volunteer role as outlined in the volunteer role description
agree, sign and comply with the volunteer agreement or code of conduct
agree, sign and comply with the confidentiality agreement
not undertake any activities outside of the approved list within their volunteer role description
engage with support and supervision arrangements, induction arrangements and appropriate training
wear their trust name badge at all times
adhere to all trust policies and procedures the Responsible Manager agrees are relevant, including safeguarding procedures for children and adults at risk

4.13 All employees

All members of staff who have contact with trust volunteers should have an understanding of the involvement of volunteers in service delivery and the value they bring in complementing the work they do.

Employees need to work alongside and support volunteers and assist in the development and implementation of new volunteer roles and adhere to this policy.

5 Procedure or implementation

5.1 Recruitment, selection and placement procedure

Enquiries from prospective volunteers will be received by the RM or VSM, from services such as the trust website, telephone or email contacts and links with departmental managers and organisations. The recruitment procedure will only commence should volunteer placements be available within the trust (appendix A). Each RM is asked to complete a role description clearly outlining the nature of the volunteer role within their service area and the responsibilities expected of the volunteer (appendix C)

5.2 Current service users

In the case of current service users within mental health services who wish to become a volunteer, a multi-disciplinary team meeting needs to be held prior to application to determine the following:

is the service user well enough to take on a volunteer role?
what would be a suitable placement area in which the patient could volunteer?
is there appropriate staff support or supervision for the volunteer in the placement area?

5.3 Recruitment process

Prospective volunteers will complete an application via the Trac online recruitment system, and subsequently attend an informal interview with the VSM and RM. Where an applicant may be unable to apply via the Trac system, suitable alternatives will be considered and they will be supported by the VSM and RM to complete their application. In relation to St John’s Hospice, applicants will be interviewed by the hospice manager and the hospice volunteer service manager.

The trust has an expectation that volunteers will agree to a commitment commensurate with the investment made by the trust in offering this opportunity and supporting the volunteer through training and preparation for the placement.

All individual volunteers must be registered with the VSM for reasons of insurance, security, health and safety. This process is facilitated by the VSM, following an appropriate disclosure and barring service (DBS) check and occupational health clearance. Volunteering must not commence until the registration process has been fully completed.

The interviews will be undertaken using criteria which will assess the individual’s skills and abilities in line with the trust’s policy relating to equal opportunities and diversity in employment. All applicants will be informed of the outcome of the volunteering interview process either by face-to-face at the end of their volunteering interview or by telephone, or alternatively in writing. All applicants will be given the opportunity to discuss their interview performance.

Although it is acknowledged that volunteers are not employees, reference checks and any other necessary pre-placement checks will be carried out in line with the trust’s appointment of staff policy. Prospective chaplaincy volunteers will be asked to provide a personal reference and a reference from a recognised leader of their faith tradition.

Once all the necessary checks have been undertaken, an offer of volunteer placement will be confirmed verbally and in writing. Following this, arrangements are put in place for local induction and appropriate training requirements by the VSM and the RM.

The trust encourages people with disabilities to participate in volunteering and will make reasonable adjustments to enable and support this.

5.4 Disclosure and barring service (DBS) check

All volunteers must consent to the appropriate level of DBS check. This is in line with the Protection of Freedoms Act 2012 which states that volunteers must meet the criteria for a standard or enhanced DBS check if they are volunteering with children or vulnerable adults in a ‘regulated activity’.

Within RDaSH, this includes (but is not limited to) volunteers within the following roles or services:

all volunteers working with the children’s care group
peer mentors within aspire drug and alcohol service
counsellors within St John’s Hospice
all volunteer drivers

In relation to volunteer drivers, there is a specific section within the guidance for the Act which identifies that:

“Any drivers and any assistants who transport an adult because of their age, illness or disability to or from places where they have received or will be receiving health care, relevant personal, care or relevant social work, are in regulated activity. The driver does, or the person assists in such conveying on behalf of an organisation and for the purpose of enabling the adult to receive services”.

In order to maintain consistent recruitment procedures within specific clinical service areas and care groups, local policy adaptations will be adhered to, for example, 0 to 19 services in Doncaster and North Lincolnshire children’s care group. Staff enhanced DBS checks are undertaken on a 3 yearly basis and therefore any volunteers within these services will also have a 3 yearly DBS check. The responsibility for monitoring the checks will be the appropriate service manager within the care group.

The DBS clearance process may also involve checking against the children’s or adults’ barred list if this is applicable to the volunteer role. There is no cost to the volunteer for the DBS check.

All new volunteer roles within the trust will be checked to see if they meet the criteria of a regulated activity and appropriate DBS checks will be implemented. All DBS processes should be followed in line with the appointment of staff policy.

Should an applicant return a positive DBS check, a risk assessment will be undertaken by the VSM and the RM with appropriate advice from HR and the trust Safeguarding team.

The following issues should be taken into consideration (this list is not exhaustive):

the seriousness of the offence, for example, GBH, murder, sexual offences would all be contraindications to volunteering within RDaSH
the timeframe for when the offences were committed and whether there has been any recognised training programme completed by the applicant in respect of the offences
whether the offences may be related to drug and alcohol misuse

The care group director will then discuss the outcome with the chief operating officer for final approval or acceptance.

5.5 Induction and training

On the commencement of their placement, all volunteers are required to complete trust local induction according to their level of capacity and competency. The RM will be responsible for helping the volunteer to complete the local induction processes, including a welcome and introduction to the trust and its values, and providing information on where to access or reference both trust and service specific policies and procedures.

Volunteers are required to complete a programme of core MAST training broadly aligned with the Level 1 MAST standards for staff. As part of this requirement, all volunteers at RDaSH are supported to achieve the national volunteer certificate (NVC) (opens in new window). This is a standardised package of volunteer learning courses offered by Health Education England (HEE) and co-produced by volunteers from around the UK.

The volunteer learning programme meets the six core standards required to achieve the NVC, also known as the national volunteer standards. These in turn are mapped against the outcomes of the national care certificate, which is used in the preparation of support workers in health and care settings, providing our volunteers with evidence of the skills and knowledge needed to pursue a career in care.

The training will include the following courses or core content:

The volunteer learning programme is offered exclusively via e-learning. Where a volunteer may be unable to complete the programme in this way, suitable alternatives will be considered and they will be supported by the VSM or RM with the training through to completion. When volunteers have completed the programme, they must provide the VSM with proof or confirmation of completion, and the VSM will duly update their records on the volunteer database.

Volunteers must complete all 11 courses of core training and subsequently evidence either:

30 hours of volunteering to achieve the in-house volunteer certificate
60 hours of volunteering to achieve the fully accredited national volunteer certificate

Some voluntary roles require additional role-specific or relevant training before a placement may commence. This will be completed in agreement with the RM and VSM, and courses include (but are not limited to):

food hygiene, for all volunteers in catering areas
driving assessment, for all volunteer driver roles
disengagement training, for all ward-based volunteers

These courses are all offered by the trust Learning and Development (L and D) team, and they will be responsible for confirming to the VSM when the volunteer has completed this training.

Other optional training courses will be recommended or offered to all volunteers at periodic intervals. These may be offered by the trust or by HEE or other national providers.

5.6 Level 1 safeguarding children and adults at risk

Safeguarding children and adults at risk is everybody’s business. All NHS services have statutory responsibilities for protecting children and adults at risk, and have a duty to take all reasonable measures to minimise risk of harm to the welfare of children and adults and take appropriate action when there are child and adult protection concerns by working to agreed local policies and procedures, in full partnership with other agencies. All staff and volunteers working within the organisation have a responsibility to safeguard children and adults at risk in accordance with the trust safeguarding children manual and safeguarding adults manual.

5.7 Accidents and incidents

If an incident occurs whilst carrying out voluntary duties, the volunteer should notify a senior member of staff in the area where they are carrying out their duties immediately. The senior member of staff will ensure the incident is recorded on the appropriate documentation or system.

5.8 Security

The VSM will hold a record of the names and addresses of all registered volunteers for purposes of security and health and safety.

To aid recognition by staff, patients and visitors, all registered volunteers will be issued with a lanyard and name badge, including a photograph. Volunteers must wear this at all times. Volunteers must also wear the clothing provided in the areas where it is appropriate.

5.9 Volunteer drivers

5.9.1 Drivers who drive their own vehicle

Any volunteer who offers their services as a volunteer driver must provide the following original documents on commencement of driving duties and annually thereafter:

current driving licence
motor insurance
MOT certificate
vehicle log book (V5C)

All volunteer drivers must inform their insurance company of this use of their vehicle and provide written proof from the insurance company that their voluntary activity is included in their motor policy.

Volunteer drivers are eligible for reimbursement of expenses incurred through use of their car in the service of the trust. Reimbursement will be at an agreed mileage rate applicable to trust volunteers.

Each volunteer who makes a reimbursement of expenses claim is personally responsible for declaring any consequent profits to the inland revenue.

5.9.2 Drivers who drive trust vehicles

Volunteer drivers who drive a trust vehicle will be required to undertake a driving competence test with the trust Examiner on appointment and every 3 years thereafter.

5.9.3 Driver responsibilities and safety

All volunteer drivers should familiarise themselves with the trust driver’s handbook.

Volunteer drivers must not transport, unaccompanied, a child or adult assessed as being at risk as defined by safeguarding adult policy.

If concerns are raised regarding the capability of a volunteer driver, this will be investigated by the voluntary services manager and RM. If it is felt necessary, the volunteer may be required to withdraw their services as a driver.

The volunteer driver is also responsible for immediately updating the RM or VSM should their driving status change or the status of their vehicle has changed.

Further information can be found in the trust safer driving at work policy.

5.10 Volunteer counsellors, hospice

Any volunteer who offers their services as a volunteer counsellor are supporting a professionally qualified role which complements the work of the paid counsellors of the trust.

Volunteer counsellors must provide evidence of an appropriate professional qualification, with an advanced diploma in therapeutic counselling as a minimum qualification requirement. Volunteer counsellors must also provide evidence of registration with their professional body, The British Association for Counselling and Psychotherapy, and adhere to their professional code of conduct at all times.

When considering giving their time as a volunteer, volunteer counsellors are asked to consider the needs of clients who may require weekly sessions at the start of their therapy.

Full details of requirements to be a volunteer counsellor can be found in the role description.

5.11 Redeployment

Existing volunteers may be redeployed to a different role within the trust under certain circumstances. These include, but are not limited to:

where a volunteer wishes to leave their existing role
where a service may wish to cease using a volunteer
where it is no longer appropriate for a placement to continue

Where a volunteer may be sought after for their specific skills or experience, for example, volunteer drivers.

Volunteers may be considered for redeployment provided that they have not violated the terms of the volunteer agreement, or that they are unsuitable for further placement due to reasons of conduct or capability.

Wherever redeployment is considered, the VSM will work with the volunteer, their existing service and any potential new service to facilitate as smooth and simple a transition as possible into a new placement. The VSM will ensure that the volunteer’s records are updated to reflect the change in a timely and accurate manner.

The VSM may work with the other voluntary services within or linked to RDaSH (see 3.1) to facilitate redeployment across those services where needed. In those cases, the VSM should agree terms of redeployment with their counterpart in the service, the new service and the volunteer.

5.12 Pass porting from outside the trust

Volunteers working in other or external organisations can be pass ported into the trust without having to undergo mandatory training and pre-placement checks, provided they are able to supply appropriate evidence and, or assurance that meets our standard requirements.

In terms of mandatory training, a copy of the National Volunteer Certificate (NVC) would be sufficient to proceed with pass porting. If candidates cannot offer a copy of this certificate, the trust will consider evidence of prior volunteer training that meets the six core National Learning Standards as set out by HEE. If the evidence supplied does not meet those standards, we would expect candidates to undertake the volunteer learning programme as a new applicant.

Any volunteer coming into the trust from another organisation will require a new ID or DBS check at the appropriate level for the role (as per 5.4). In the case of non-NHS or partner organisations, the trust may accept assurance that training and basic checks have been completed for the volunteer on our behalf by the partner organisation. This would normally be set out within the terms of a formal contract and, or information sharing agreement, any proposed exception to this must first be raised with the VSM.

5.13 Expenses

Trust volunteers are entitled to reimbursement of travelling expenses incurred travelling to and from home and the trust in their capacity as volunteers. Claims for home to trust mileage will only usually be paid for journeys up to 20 miles but claims for higher mileages may be agreed between the VSM and RM in exceptional circumstances. This may either be the direct cost of public transport by producing bus tickets or, if a private vehicle is used, the agreed mileage rate applicable to trust volunteers. Appropriate expense forms can be obtained from the VSM or RM.

Volunteers will be entitled to a hot meal voucher if they provide more than 3 consecutive hours commitment to the trust in any one day, or a hot or cold drink voucher if they volunteer for 2 consecutive hours. On the Doncaster site, volunteers can access the food and drink café or the WellBean coffee lounge, which are open Monday to Friday. A meal voucher to the value of £4.50 will be issued by the RM to all volunteers where applicable.

Volunteers assigned to areas where there are no trust catering facilities should discuss alternative subsistence arrangements with the VSM.

5.14 Withdrawal of an individual’s service

The VSM or RM has authority, at any time, to ask a volunteer to withdraw their service. A meeting will be arranged by the VSM or RM to discuss the reasons for the withdrawal of their services. If this is due to reasons of conduct or capability, the trust will investigate and may take action, for example, inform the police or independent safeguarding authority (if applicable).

The volunteer also maintains the right to withdraw their service at any time, either verbally or in writing.

On withdrawal of service, volunteers are required to return their tabard or overall, ID badge etc., together with any other trust property, to the VSM.

All documentation in relation to the recruitment of the volunteer and their time spent with the trust will be retained by the VSM for a period of 6 years (policy ref, records management policy).

All volunteers withdrawing their service will be asked to complete an exit questionnaire. An interview with the VSM may alternatively be requested and given to discuss their placement and experiences.

5.15 Recognition of volunteers

Volunteers are awarded with an appreciation certificate annually and there may also be other events (for example, lunches) held to recognise their contribution, as well as an award category of ‘volunteer of the year’ at the trust’s annual awards ceremony.

Long service awards are also given to volunteers whom have spent up to 5, 10 or 15 years volunteering with the trust.

5.16 Problems or complaints

If a volunteer has any concern about an employee or another volunteer, they should wherever possible discuss this in the first instance with the RM in the relevant area, who will take steps to resolve the problem as soon as possible.

If an acceptable resolution cannot be reached, the problem will be referred to the VSM.

If a staff member has any concerns about a volunteer, they should first discuss this with the senior member of staff in that department. Steps will be taken to resolve the problem as soon as possible. Any concerns should be logged with the RM or VSM so they can identify whether there is a pattern.

If an acceptable resolution cannot be reached, the problem will be referred to the VSM.

If a complaint is made about a volunteer or their work, whether by another volunteer, an employee, patient or member of the public, it will initially be discussed between the volunteer and the VSM or RM in the relevant area. This discussion will focus on the basis for the complaint and any changes that may be required, for example, additional training or support. If the complaint is regarding unacceptable behaviour or conduct, the volunteer may have their voluntary placement terminated.

The volunteer can ask for the decision of the VSM to be reviewed by the Patient Experience Manager, but there is no further right of appeal against any resolution process.

5.17 Referral to the independent safeguarding authority

Where a volunteer leaves trust service, either voluntarily or by request, following an incident where it is thought that, on the balance of probabilities, they have caused harm to or placed at risk of harm a child or vulnerable adult, the VSM will make a referral to the independent safeguarding authority (ISA), who will make a decision as to whether the individual should be added to the children’s or adults’ barred list.

6 Training implications

6.1 Voluntary services manager

How often should this be undertaken: Once then update of any policy changes.
Length of training: As required.
Delivery method: As part of local induction.
Training delivered by whom: Line manager.
Where are the records of attendance held: Electronic staff record system (ESR) personal file.

6.2 Responsible managers

How often should this be undertaken: Once then update of any policy changes.
Length of training: As required.
Delivery method: As part of local induction.
Training delivered by whom: Line manager.
Where are the records of attendance held: Electronic staff record. system (ESR) personal file.

6.3 Volunteers

How often should this be undertaken: Once then update of any policy changes.
Length of training: As required.
Delivery method: As part of local induction.
Training delivered by whom: Line manager.
Where are the records of attendance held: Electronic staff record. system (ESR) personal file.

7 Monitoring arrangements

7.1 Quality assurance

How: Reports for senior management meetings.
Who by: Patient experience manager.
Reported to: Safety and quality operational group, quality committee.
Frequency: Monthly and quarterly.

7.2 Compliance with documentation requirements

How: Auditing of volunteers files recruited within the year.
Who by: Patient experience manager.
Reported to: Deputy director for patient experience and involvement.
Frequency: Annually.

8 Equality impact assessment screening

The completed equality impact assessment for this policy has been published on this policy’s webpage on the trust policy library or archive website. Link to overarching EIA.

8.1 Privacy, dignity and respect

The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, ‘not just clinically but in terms of dignity and respect’.

As a consequence the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity and respect, (when appropriate this should also include how same sex accommodation is provided).

8.1.1 How this will be met

No issues have been identified in relation to this policy.

8.2 Mental Capacity Act 2005

Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individuals capacity to participate in the decision making process. Consequently, no intervention should be carried out without either the individual’s informed consent, or the powers included in a legal framework, or by order of the court.

Therefore, the trust is required to make sure that all staff working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005)to ensure that the rights of individual are protected and they are supported to make their own decisions where possible and that any decisions made on their behalf when they lack capacity are made in their best interests and least restrictive of their rights and freedoms.

8.2.1 How this will be met

All individuals involved in the implementation of this policy should do so in accordance with the principles of the Mental Capacity Act 2005.

9 Links to any other associated documents

10 References

Disclosure and barring service (DBS).
Volunteering England website.

11 Appendices

11.1 Appendix A Recruitment flow chart

Appendix A Recruitment flow chart, detailed below.

11.1.1 Potential volunteer placement identified by trust service

Role description agreed with responsible manager.
Vacancy advertised online.
Move to step 11.1.3.

11.1.2 Potential volunteer or peer mentor identified

Initial telephone call or face to face meeting:
- unable to identify placement
- signpost to other voluntary organisation, end process
Identify potential placement and signpost to online application
Move to step 11.1.3.

11.1.3 Completed application received

Application unsuccessful:
- signpost to other voluntary organisation, end process
Application successful.
invite volunteer and responsible manager to informal interview:
interview unsuccessful
signpost to other voluntary organisation, end process
Interview successful.
Initiate DBS and final checking process:
- DBS positive, risk assessment undertaken alongside recruiting manager and HR:
  - approval granted, commence placement and induction or training, end process
  - approval denied, applicant to be contacted and informed, end process.
- DBS clear, commence placement and induction or training, end process.

11.5 Appendix E Volunteer role description

Role title, volunteer.
When, to be agreed with the supervisor of the service area, minimum commitment of X hours (X session(s) per week).
Tasks to be undertaken, the volunteer is required to work within the list of tasks identified as follows.
Skills, attitudes and experience needed:
- to be punctual and reliable
- good listening skills with a warm, friendly and professional approach
- to adhere to the dress code for the area in which they volunteer.
- to aid recognition by staff, patients, service users and visitors you must wear your ID badge at all times
- be able to work as a member of a team
- to behave professionally and treat others with dignity and respect at all times and adhere to the principles of the trusts equality and diversity policy
Training, trust induction and annual mandatory and statutory training, training specific to the role (for example, food safety and awareness training)
Risk assessment, service to undertake the volunteer risk assessment at least annually, and in accordance with any changes as required (for example, environmental changes)
Support or supervision:
- day to day supervisor, title, depending on the nature of the volunteer role and the supervisory needs of the volunteer, the nature of the supervisory relationship may range from day to day oversight of the work, along with availability of the supervisor for advice, to some level of formal supervision
- responsible manager of service area: title, team leader or title service manager
- peer supervision: to be provided on request via volunteer coordinator
Expenses and recognition:
- reimburse the cost of travelling expenses to and from the volunteer role area
- volunteers are entitled to 1 hot meal and 1 hot or cold beverage if they work for more than 3 consecutive hours in any one day
- annual volunteers celebration
How to apply and what happens next, Information to be completed by the responsible manager and agreed with the volunteer coordinator.
Created, by whom:
- day to day supervisor: title.
- responsible manager: title
- volunteers coordinator
- date:

11.4 Appendix F Recruitment of volunteers checklist

Recruitment of volunteers checklist

Document control

Version: 8.1.
Unique reference number: 35.
approved by: Corporate policy approval group.
Date approved: 25 January 2024.
Name of originator or author: Patient experience manager and volunteer coordinator.
Name of responsible individual: Corporate policy approval group.
Date issued: 30 January 2024.
Review date: 28 February 2026.
Target audience: Volunteers and prospective volunteers, voluntary services manager, voluntary, community sector and enterprise (VCSE) organisations, managers and day-to-day supervisors with responsibility for volunteers, all trust staff.

Page last reviewed: April 15, 2024
Next review due: April 15, 2025

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