Final Project Report Befriending Pilot - · PDF filePhoto: Matt and Neil ... Appendix 8: The...

Final Project Report Befriending Pilot

Author: Titos Florides 2012 2

Acknowledgements.................................................................................................................................................4 Executive Summary ................................................................................................................................................5

Aims/objectives of Project ............................................................................................................................................................ 5 Overall approach ........................................................................................................................................................................... 6 Project findings.............................................................................................................................................................................. 7 Achievements ................................................................................................................................................................................ 8 Conclusions ................................................................................................................................................................................... 9

Photo: Katy and Clare .............................................................................................................................................................. 10 Background...........................................................................................................................................................11

The nature of the consortium ..................................................................................................................................................... 11 The need for the project .............................................................................................................................................................. 12 Potential Impact ........................................................................................................................................................................... 14

Aims and objectives ..............................................................................................................................................17 Aims .............................................................................................................................................................................................. 17 Objectives .................................................................................................................................................................................... 18 How the objectives changed in the course of the project........................................................................................................ 18

Methodology & Implementation.............................................................................................................................22 Eligibility and Referral Process .................................................................................................................................................. 22 Recruitment, Selection and Training ......................................................................................................................................... 23 Matching process ........................................................................................................................................................................ 24 Relationship timeline................................................................................................................................................................... 24 Reviewing relationship................................................................................................................................................................ 24 Supervision .................................................................................................................................................................................. 25 Evaluation Process...................................................................................................................................................................... 25 Reporting Protocols .................................................................................................................................................................... 25

Inputs, Outputs and Results..................................................................................................................................27 Resources .................................................................................................................................................................................... 27 Workshop materials .................................................................................................................................................................... 27 Training Materials ........................................................................................................................................................................ 29 Assessment Tools ....................................................................................................................................................................... 29 Reports ......................................................................................................................................................................................... 29 Presentations ............................................................................................................................................................................... 29 Findings........................................................................................................................................................................................ 30

Outcomes..............................................................................................................................................................32


Broad outcomes .......................................................................................................................................................................... 32 Service User related outcomes .................................................................................................................................................. 32 Community based outcomes...................................................................................................................................................... 32 Circle Support Services Outcomes ............................................................................................................................................ 33

Detailed outcomes by objectives ............................................................................................................................................... 33 Conclusions ..........................................................................................................................................................37 Implications ...........................................................................................................................................................39 Recommendations ................................................................................................................................................39

Photo: Matt and Neil ................................................................................................................................................................ 40 Case Study Example ............................................................................................................................................41 References............................................................................................................................................................42 Appendices ...........................................................................................................................................................43

Appendix 1: YOU Ladder Appraisal ........................................................................................................................................... 43 Appendix 2: Spidergram ............................................................................................................................................................. 48 Appendix 3: Evaluation Tree....................................................................................................................................................... 49 Appendix 4: Role Description..................................................................................................................................................... 50 Appendix 5: Assessment Sheets ............................................................................................................................................... 51 Appendix 6: Training schedule................................................................................................................................................... 54 Appendix 7: Hobbies and Interests Form .................................................................................................................................. 58 Appendix 8: The Befriending/Mentoring Spectrum .................................................................................................................. 59 Appendix 9: Demystifying Learning Disabilities – Samaritans Workshop ............................................................................. 60 Appendix 10: Individual Relationship Reports.......................................................................................................................... 61 Appendix 11: Summary of Other Findings ................................................................................................................................ 91


Acknowledgements This project was conducted with the support of the Circle Support Volunteer Service. The project team is most grateful to the following persons and organisations for their valued contributions during the project or in writing this report:

Circle Anglia Foundation and The Baily Thomas Charitable Fund Circle Support Volunteering Service: Fiammetta Schofield, Theresa Nkundo Circle Support: Sonia Powell, Susan Wilson, Tunji Tiamiyu, Rita Ferris-Taylor, Resident volunteers: Catherine Keogh, Pauline Robertson, Ron Barrow The Samaritans Steering group: Samaritans representatives, Neil Willington, Shenay Ismael, Maria Kalathaki, Nathan More, Diana Avlasenok (Circle Support reps)


Executive Summary Aims/objectives of Project

To provide a Befriending Service for individuals supported by Circle Support’s Learning Disabilities Division. To recruit and train 20 Befrienders to engage in relationships with Service Users who have been referred to the service. Support a befriending relationship to increase the Service User’s levels of social interaction and inclusion, self-esteem,

confidence and independence. Support the Befrienders to improve their self-confidence, increase employability, engage in meaningful employment and

achieve a level of personal satisfaction. Provide workshops and training courses for potential volunteer befrienders and in doing so increase the delegate’s

understanding and awareness of learning disabilities and the impact this diagnosis could have on an individual.


Overall approach A project manager with a background in working with adults with learning disabilities was recruited to design, implement and manage all components of the befriending service. The ethos adopted for the service was the belief that positive change can occur through a person centred relationship built on the core conditions (Rogers, 1967). These conditions are empathy, acceptance and genuineness. An assumption was maintained that if a person-centred relationship was achieved then a Befriendee’s sense of isolation would decrease automatically and provide the conditions for personal growth. An evaluation was conducted called the YOU Ladder appraisal (appendix 1) to ascertain Service User eligibility. The aim of this appraisal was to try and establish individual service user’s experiences of isolation and confidence and use this information as an indicator of need. The YOU Ladder appraisal’s secondary purpose was to operate as a 3rd party or self referral tool. To increase the YOU Ladder’s and befriending service’s potential impact, individual presentations were delivered to staff at every project in the learning disability service. This presentation included an introduction to befriending, the aims of the service, a guideline to support service users in completing the YOU Ladder appraisal and an opportunity to distribute the appraisals to each service user. Successful applicants were invited to a befriending workshop designed to screen potential applicants and assess their suitability. The workshops were structured to give vital information regarding befriending, the volunteer service, benefits and to answer any queries that candidates might have had. Successful candidates were invited to the befriending training programme. The training schedule consisted of three half day courses designed and delivered by the project manager. This programme focused on developing skills to build effective relationships, self awareness, an introduction to the core conditions and an insight into and demystification of learning disabilities. Evaluation and monitoring are considered to be integral aspects to the Befriending Services potential success. Data was gathered from the YOU Ladder appraisal at referral and towards the end of the relationship. Where possible this tool was completed by the service user, but support was available through staff at the project. Initial and final assessments conducted by the project manager gathered data regarding several factors concerning the wellbeing of service users. The Spidergram (appendix 2) was utilised to record this information and the perspectives of support staff, project manager and service user were collaborated in order to ascertain reliable figures. These two methods were used in an attempt to gather subjective and objective opinions concerning a service user’s wellbeing in order to report reliable outcomes or changes. In conjunction to the latter, reviews were conducted with service users in order to identify satisfaction levels and highlight any areas of concern or development.


Project findings That a befriending relationship supports and nurtures both parties self awareness and development. By promoting a person-centred relationship dramatic improvements in both parties sense of achievement and wellbeing are possible. The integral aspect of the relationship is the interaction between two people just ‘being with each other’ and the accomplishment of the relationship becoming involved in various community based activities is valuable but secondary in importance. It was noted how ‘being with’ often developed the relationship to the extent that Service Users became more motivated to attend activities in the community. Using a pedagogical1 and hermeneutic2 approach to supporting volunteers, enhances their understanding of complex issues, because they are directly involved in the process. Volunteers felt valued by the commitment shown to them and benefitted from the information and training provided to them to be an effective Befriender. This approach also encouraged and facilitated self-exploration due to the participant’s involvement in experiential learning. Providing training, supervision and on-going support has a positive impact on the volunteer’s experience. This support heightens the volunteer’s sense of worth and directly effects how the volunteer performs in his/her role. The workshop and training programme highlighted the delegate’s lack of awareness surrounding learning disabilities and how an open exploration of the facts can enhance understanding.

1 Pedagogical Theories postulate how things should be taught and/or how one can bring someone to learn. They often are based on learning theory that is interested in how we learn. A pedagogical approach will adapt the teaching methods to the need of those in training and demonstrate learning techniques through the examples set by the teacher. 2 Hermeneutics is based on the philosophy of interpretation. Instead of reducing the possibilities of what an action, feeling or idea could mean (reductionist approach), adopting a hermeneutic approach endeavours to open the possibilities of meaning in order to achieve greater clarity and truth.


Achievements The project has:

Demonstrated how person centred relationships can promote positive change. Improved the support and lives of Service Users directly involved in the service.

Reduced the sense of isolation and increased confidence of many service users directly involved in the service.

Documented and gathered evidence confirming the benefits of befriending adults with learning disabilities.

Provided volunteers with an opportunity to gain valuable experience and optimise this experience when applying for employment.

Improved the understanding Circle Support staff and volunteers and project partners volunteers possessed of the term learning disabilities across through internal presentations, workshops and internal/external training events.

Established need for Befriending Service to be expanded across older peoples services.

Developed a generic training programme suitable to provide foundation to volunteers who may befriend across diverse client groups.

Increased Circle Supports Volunteer Service exposure amongst staff and encouraged a team working environment for staff and volunteers respectively. This contributed to the increase in volunteer roles available Within LD Support, which in turn is hoped to have an impact on the quality of care experienced by Service Users.


Conclusions The achievements confirm that a befriending relationship can have a dramatic and positive influence on both parties’ lives. This pilot was not research based and therefore no control group was identified to validate the hypothesis that a person-centred relationship has greater efficacy than any other. However, the results imply that this type of relationship is effective and supports the decision to promote this approach to befriending. The decision was based upon well documented and reliable research conducted in the field of psychotherapy and counselling over the last 60 years (Dryden, 2007). Through various consultations with internal agencies, steering group members and Service Users, it was highlighted that other client groups would benefit from a befriending service. Confidence and isolation are universal feelings which are evident across a diverse group of service users. A relationship based on genuineness, acceptance and empathy can help reduce these feelings and in fact promote an individual to feel motivated and empower them to seek positive change. The support network and training available had a substantial impact on volunteers. Many volunteers expressed how the training, supervision and general support enhanced their experience and instilled a sense of self-belief. It is in the author’s opinion that this aspect of the pilot was integral to the overall success.


Photo: Katy and Clare were in a relationship for 7 months….

‘I liked the relationship. It was unbelievable how close we got. I would like another relationship. Nice knowing

Katy anyway. Nice girl and I wish her all the best.’


Background Through various consultations with Service Users supported by the Circle Support Learning Disability Service, it was established that a befriending service would be beneficial for this client group. Using the data gathered from these consultations funding applications were constructed and submitted to various charitable funds. We were granted funding by the following organisations: Circle Anglia Foundation – Is a registered charity that is funded from the surpluses generated by Circle Living. It was set up in 2008 to fund community development and help tackle issues prioritised in the Group’s Sustainable Community Strategy. The Baily Thomas Charitable Fund - Is a grant making registered charity which was established primarily to aid the research into learning disability and to aid the care and relief of those affected by learning disability by making grants to voluntary organisations working in this field. The nature of the consortium The project brought together internal and external partners that could have a direct influence on how the pilot developed. These included the Service Manager from Circle Support’s Learning Disabilities Team and Volunteers Service, a Service User representative, a representative from the Samaritans and the Project Manager. The Learning Disabilities Service Manager’s involvement enabled the group to explore the best strategy to engage with Service User’s. Safe-guarding, lone-working and accessibility tools were discussed and agreed upon. Advice was sought from the Volunteer Service Manager to ascertain best practice for recruitment, selection and methods of supporting volunteers in their roles. Both Service Managers directly influenced the approach and methodologies adopted by the pilot in order to successfully integrate both services into a productive partnership. In addition, the Samaritans representative offered an external perspective to proceedings and could contribute reliable knowledge and experience from their service that offers on-line, face-to-face and telephone based emotional support. Through steering group participation it was agreed that the Samaritans would deliver a one day training course on suicide awareness and active listening. To fulfil our commitment to this learning partnership the project manager agreed to deliver a one day training course on demystifying learning disabilities to Samaritan volunteers.


The partnership benefited from the experiences and insights offered by the Service User representative. Feedback was sought regarding assessment criteria, questionnaires and recruitment and amendments were implemented due to these valuable observations and comments.

The need for the project

1. Internal: service users/tenants inc. statistics and link with strategic objectives

The Circle Support Volunteer Service had already established that service users would welcome the idea of a befriending relationship. In a survey 26 out of our 71 service users gave the following results:

When asked who the people were who they spent most of their time with, 100% said paid staff, 73% said fellow service users and only 38% said ‘friends who like similar things to me’;

62% of our respondents reported that they often or sometimes feel lonely;

19% never, or hardly ever see their family;

85% would feel happier if they had more friends;

85% said they would like a Befriender.

Considering the above findings it was deemed necessary to conduct a further evaluation called the YOU Ladder appraisal (appendix 1). The aim of this appraisal was to try and establish individual service user’s experiences of isolation and confidence and use this information as an indicator of eligibility and need. The YOU Ladder appraisal’s secondary purpose was to operate as a 3rd party or self referral tool. A YOU Ladder appraisal was delivered to each Service User within the learning disabilities division. This amounted to 70 appraisals being distributed with 37 returned and completed, which is a 53% return rate. This indicates that just over half of all the Service


Users within Circle Support were interested in the befriending service or were at least willing to engage in other services that could improve or enhance their life chances.

2. External environment: local, regional, national context

The Department of Health white paper ‘Valuing People’ is the government’s plan for making the lives of people with learning disabilities, their families and carers better. It is based on people having: their rights as citizens; inclusion in local communities; choice in daily life; real chances to be independent. Local Authorities are under pressure to reduce costs and increasing people’s social networks can lead them to be less dependent upon paid staff, thus reducing costs to Local Authorities.

3. Other organisations providing this service and why there is a need to duplicate A number of other organisations and local authorities run befriending projects for people with LD (although the number running in London is surprisingly small). Projects like Interest Link Borders, a LD Befriending organisation in Scotland, identified that ‘the links between volunteers and service users provide opportunities for people with learning disabilities to engage in activities, sometimes within community settings in a way that is quite unique… The result is that people are able to be and feel more independent thereby gaining new skills and greater confidence about themselves and what they can do.’ It is a widely held perception that people with learning disabilities staying within residential settings can lack opportunities for social contact other than with professional staff and other residents. This is certainly backed up by the results gained from our Service User consultation discussed above. Befriending projects provide an independent means of social activity and a very different way of engaging with the community that most other adults would take for granted. Furthermore, befrienders can boost someone’s self esteem to the extent that they can often go on to be much more involved in local opportunities, thus increasing their opportunities to form other friendships.

4. Impact of not having this project on service users and wider community Many Service Users will continue to feel isolated and/or lonely, engage less with their local community and have less opportunity to develop their self-esteem, communication skills and social networks. The wider community will have fewer opportunities to engage with people with Learning Disabilities.

5. Evidence that project/approach works


There is very little longitudinal evidence that befriending works, however, anecdotal evidence overwhelmingly recognises that these types of intervention help people back into social networks, assist them in becoming economically active and support them in accessing services that are already there. As discussed above (pg.9) there is also evidence that suggest a person-centered relationship can empower an individual and promote personal growth. This evidence is based on research conducted in the fields of psychotherapy and counselling (REF) and should not be compared to a befriending relationship that is not within this field of expertise. However aspects of the person-centered approach can be integrated into befriending. Adopting a person-centered approach to befriending will aim to maximize the relationships efficacy. Rigorous monitoring will enable Circle to deliver evidence supporting this type of intervention’s efficacy.

Potential Impact

1. Internal: service users and volunteers Successful befriending relationships could improve the following areas:

Social Isolation Confidence The development and improvement of social skills. Reduce the risk of abuse.

The ethos adopted for the service was the belief that positive change can occur through a person-centred relationship built on the core conditions (Rogers, 1963). These conditions are empathy, acceptance and genuineness (see definition table, p.20). A befriending relationship that incorporates these conditions could act as a template or learning tool for the Befriendee and Befriender. The former could develop the capacity to form and maintain friendships independently by increasing their confidence in relating to others and in their own worth. The latter would realise the importance of adaptation when relating to individuals, gain experience of working with learning disabilities and increase their confidence in the skills sets they possess. An assumption was maintained that if a person-centred relationship was achieved than a befriendee’s sense of isolation would decrease automatically and provide the conditions for personal growth.

2. External environment: local, regional, national context.

Successful befriending relationships could improve an individual’s involvement in the community, increase their independence and improve their social networking ties. Although this pilot is small and its impact on Service Users is limited to those who are associated with Circle, potentially community awareness could improve regarding the meaning of learning disabilities, because Service Users will be more actively involved in their local community. The training provided to volunteers also aims to increase


awareness and demystify learning disabilities. Workshops based on demystifying learning disabilities were conducted for Samaritan volunteers at their head quarters in central London aiming to improve their skills in communicating with people who have learning disabilities. This workshop was videoed and uploaded onto their website for all Samaritan staff and volunteers to access. It is hoped that this partnership has enabled the befriending pilot to have an impact upon adults with learning disabilities nationally through the improved support and knowledge Samaritan volunteers could now provide to this service group.

3. Evidence that project/approach works Devising and implementing effective evaluating tools is essential in capturing the evidence required to prove that befriending relationships can be effective. The pilot aims to capture relevant evidence to validate the benefits of befriending and to support future funding applications. Evidence could enable Circle support to expand the befriending service to other client groups who are likely to experience isolation and low confidence.


Photo: Sam and Tony SamTony have been in a befriending relationship for 5 months and are still doing well.

“I enjoy spending time with Tony. I think he likes spending time with me too. It makes me feel so good seeing the

progress he has made”.


Aims and objectives Aims:

To recruit and train 20 Befrienders to engage in relationships with 20 Service Users who have been referred to the service via Circle Supports Learning Disability Service.

75% of relationships to last at least 6 months, with positive feedback from both parties

Devise 3rd party and self-referral process, including eligibility criteria and strategy to disseminate material to Service Users and

support staff across Learning Disability Division. To set up a steering group consisting of Service Managers, Service Users and external representative. External

representative would be experienced in providing a support/befriending service and would be open to building strategic partnership with Circle for future projects.

Support a befriending relationship to increase the Service User’s levels of social interaction and inclusion, self-esteem,

confidence and independence.

Support the Befrienders to improve their self-confidence, increase employability, engage in meaningful employment and

achieve a level of personal satisfaction. Provide workshops and training courses for potential volunteer befrienders and in doing so increase the delegate’s

understanding and awareness of learning disabilities and the impact this diagnosis could have on an individual.


Objectives:

1) Implement recruitment strategy that involved advertising using established protocols and resources. Applicants invited to Befriending Workshop for assessment and selection. Two stages of recruitment planned involving two workshops and training programmes.

2) Provide presentation and referral material to every Learning Disability scheme within Circle Support. 3) Consult with Learning Disability management team and Volunteer Service Manager to determine and nominate internal

members. Research and compile list of suitable external representatives and invite those identified to discuss proposal, establish interest and ascertain suitability. Discuss outcomes with Service Managers and inform prospective partners of decision.

4) Provide volunteers with on-going support in the form of supervision, telephone support and review meetings. Provide Service User’s an opportunity to discuss relationship at review meetings and at assessments in a one-to-one environment.

5) Deliver volunteers a befriending training programme. 6) To manage, report, evaluate and disseminate the project activities.

How the objectives changed in the course of the project The original concept and strategy of the project was to deliver the service to a potential pool of approximately 70 Service Users based across 9 schemes in Islington and Camden. However, in January 2011 the Learning Disability Service experienced an enforced restructuring due to the number of schemes under its care being reduced from 9 to 5. This had a huge impact on the number of Service Users who were eligible for the Befriending Service. The original approximate of 70 Service Users was reduced to an approximate of 27. Due to this event a new strategy was devised to ensure the service was as productive as possible, which is detailed below (p.17). Initially it was decided to proceed with two stages of recruitment. The first stage aimed to recruit 12 volunteer in May 2010 and the second stage to recruit 8 in November 2010. Unfortunately, due to lengthy delays in receiving CRB clearance or in some cases failing to be approved, a third round of recruitment was implemented in March 2011. Some volunteers were unable to continue due to their CRB being declined and others due to personal circumstances. This had a direct impact on the number of befrienders that were successfully matched with Service Users. Due to the time frame the Service was working with, it was deemed necessary to recruit, CRB and then train volunteers before we received CRB clearance. This enabled us to maximise the amount of time


Befrienders would be in a relationship with Service Users. However, the length of delays in receiving CRB clearances on some of the volunteers was not anticipated.

Summary of modifications to specific objectives:

1) Implement recruitment strategy that involved advertising using established protocols and resources. Applicants invited to Befriending Workshop for assessment and selection. Two stages of recruitment planned involving two workshops and training programmes.

Changes during the Project: Due to delays in CRB approval and some volunteers leaving the service a third round of recruitment was implemented in March 2011. A further training programme was also initialised to ensure training continuity and equal support for 3rd round recruits.

2) Provide presentation and referral material to every Learning Disability scheme within Circle Support. Changes during the Project: This objective was achieved, but further presentations were delivered to the Older People Services Management Team and Outreach Team in an effort to reach prospective Service Users within this service. This was seen as a necessary step due to the pool of LD Service Users being dramatically reduced. Only Service Users with a known learning disability were referred to the service. Established protocols were than adhered to with regards to assessment, but certain evaluation tools were modified/created to take in to account the diversity of the Service Users within these respective services.

3) Consult with Learning Disability management team and Volunteer Service Manager to determine and nominate

internal members. Research and compile list of suitable external representatives and invite those identified to discuss proposal, establish interest and ascertain suitability. Discuss outcomes with Service Managers and inform prospective partners of decision.

Changes during the Project: Key members of the Steering Group were unable to continue due to leaving the organisation and personal circumstances. The internal representative (LD Scheme Manager) was replaced with her replacement. The service user representative was replaced due to the original member being unable to commit to the role.


4) Provide volunteers with on-going support in the form of supervision, telephone support and review meetings. Provide Service User’s an opportunity to discuss relationship at review meetings and at assessments in a one-to-one environment.

Changes during the Project: Originally Befrienders were invited to check in/out on the telephone with their Supervisor before and after their first 8 visits. However, all volunteers agreed in group supervision that this support was unnecessary. Instead they suggested having the option to phone and would check in/out by texting. This new procedure was implemented immediately.

5) Deliver volunteers a befriending training programme.

Changes during the Project: A further training programme was initialised to ensure training continuity and equal support for 3rd round recruits. To save time the original training programme was condensed into two full days, in order to speed up the process and enable us to reach key milestones. In addition to this further training days were introduced for volunteers who missed previous training days.

6) To manage, report, evaluate and disseminate the project activities.

Changes during the Project: The YOU Ladder referral form was amended taking into account the Steering Groups constructive feedback. Further wellbeing questionnaires were created to accommodate the diverse group of Service Users within Older Peoples and Learning Disability services.


Photo: Robert and Arthur have been in a befriending relationship for 6 months and are still doing well.

“I like Robert I do, he is very nice.”


Methodology & Implementation The ethos adopted for the service was the belief that positive change can occur through a person centred relationship built on the core conditions (Rogers, 1963). These conditions are empathy, unconditional positive regard and genuineness. A befriending relationship that incorporates these conditions could act as a template or learning tool for the befriendee and befriender. The former could develop the capacity to form and maintain friendships independently by increasing their confidence in relating to others and in their own worth. The latter would realise the importance of adaptation when relating to individuals, gain experience of working with learning disabilities and increase their confidence in the skills sets they possess. An assumption was maintained that if a person centred relationship was achieved than a befriendee’s sense of isolation would decrease automatically and provide the conditions for personal growth.

The Core Conditions

Empathy The ability to understand how another person is feeling without

becoming too emotionally burden by the content. It is a personal quality that everyone has and can be further developed through practice.

Genuineness It is the degree to which we are able to relate to people in an honest, sincere and transparent manner.

Acceptance The ability to develop a warm caring for other people, which is not possessive and demands no personal gratification. It involves accepting other’s negative emotions and behaviours as well as their positive ones.

Eligibility and Referral Process As discussed above the YOU Ladder appraisal was established to determine individual service user’s experiences of isolation and confidence and use this information as an indicator of eligibility and need. The YOU Ladder appraisal’s secondary purpose was to operate as a 3rd party or self referral tool. To increase the YOU Ladder’s and befriending service potential impact, individual presentations were delivered to staff at every project in the learning disability service. This presentation included an introduction to befriending, the aims of the service, a guideline to support service users in completing the YOU Ladder appraisal and an


opportunity to distribute the appraisals to each service user. Service Users that indicated feelings from severe to moderate on either isolation or low confidence were given priority and an assessment was carried out in person by the project manager to determine suitability. At this assessment the Service User and their Keyworker were present to capture a realistic perspective of the Service Users present condition and needs. The Spidergram and Evaluation Tree (appendix 2 & 3) were utilised to record several wellbeing indicators taking in to account the Service User’s, Keyworker and assessors opinion. After this assessment, a decision was made whether or not the Service User would benefit from a befriending relationship and if so added to the waiting list of Service Users waiting to be matched to volunteer Befrienders. Those that were not deemed suitable were informed at the time of assessment. Schemes that were not suitable for supporting a befriending relationship, but through the assessment identified as needed voluntary support in some capacity were referred back to the Volunteer Service where volunteers were subsequently recruited to support Schemes under the role of Learning Disability Support Volunteer.

Recruitment, Selection and Training Running parallel to the presentation strategy was a recruitment drive that involved advertising the befriending role at Volunteer Centres across London, specifically targeting Camden and Islington boroughs. The role was advertised (appendix 4) using online volunteer services including Do-it.org, Prospects and The Careers Group. Project Manager attended volunteer fairs held at Goldsmiths College, UCL and Queen Mary University to attract potential candidates to volunteer service. Selected potential candidates from Volunteers Service’s existing applicants database targeting those who expressed an interest in working with adults who have learning disabilities.

Potential candidates were informed of the benefits of volunteering as a befriender, which included re-imbursement of travel and lunch (£3 towards refreshments) expenses, regular supervision and automatic enrolment in the befriending training programme. Candidates were asked to complete an application form, which enabled the project manager to assess their suitability depending upon their availability, time commitment, geographical location and their ability to demonstrate an open minded, empathic and non-judgemental attitude. Candidates were shortlisted and then interviewed on the telephone to further assess their skills and understanding of empathy, listening skills, and why they were interested in befriending. Successful candidates were then invited to a befriending workshop that would give them an opportunity to resolve any queries, inform them about what befriending means, and enable the project manager, staff and service users to make a final decision regarding the candidate’s suitability for the post. At the workshops candidates were split up into discussion groups consisting of a support worker and service user, with the project manager floating between each group. Discussing points were focused around statements concerning Learning disabilities and discrimination, competency based scenarios seeking solution based responses and exercises aimed at deciphering the candidates understanding and openness to diversity (refer to workshops materials, p.25). Each candidate was assessed on their communication skills, understanding and openness, and likeability and positivity using assessment sheets (appendix 5). After a


joint discussion with support staff, service users and the project manager candidates were selected and then offered the opportunity to accept the befriending role and attend the training programme. The training programme consisted of three half day courses designed and delivered by the project manager. This programme focused on developing skills to build effective relationships, self awareness, an introduction to the core conditions, an insight into and demystification of learning disabilities (appendix 6). Further training included courses on personal safety, communicating with adults who have learning disabilities and a course delivered by the Samaritans on active listening and suicide awareness. Relevant on-going training was available to volunteers, which could be accessed through Circle Support’s training diary. The extensive training programme was designed to provide a foundation for volunteers whose aim was to begin a befriending relationship. During training it was made explicit that although training was important for developing an understanding of complex issues it was by no means a substitute for experience. Delegates were encouraged to meet the service user as a unique individual and to try and suspend judgement values that can materialise when labelling an individual with a disability. Matching process Volunteers and befriendees were matched taking into consideration the information supplied by parties completing a hobbies and interests form (appendix 7). This form gathered information relating to the individuals general interests and hobbies, the television programmes they liked to watch and other activities they like to get involved in. The project manager also gained insight into the volunteers and befriendee’s character and personality by interacting and observing them on training days and initial suitability assessments respectively. Volunteer’s general experience or expertise and individual professional aims were also taken into account when matching them with a service user. Relationship timeline It was deemed necessary to have a structured framework to the befriending relationship to reduce levels of dependency and to ensure support was available to both parties. Befriender and Service User were informed that the relationship would last for 6 months, with each party able to end the relationship at any point. An extension period was available to extend the relationship past the agreed cut off, if both parties were in agreement. Endings are an integral part of any relationship and this aspect was explored and worked through in each befriending relationship. Support was available for Befriender and Service User at review meetings and assessments. Reviewing relationship Befriending relationships were reviewed with the service user and befriender respectively at two months, five months and at final assessment. This process was specifically implemented to give Service Users the opportunity to express their feelings,


expectations or concerns that they might have had about the relationship. Keyworkers and project managers were consulted at regular intervals to ascertain their perspective of the relationship, with subsequent feedback being cascaded to volunteers. Supervision

All volunteer befrienders were provided with individual and group supervision. Group supervision was facilitated in a similar manner to the training programme by adopting an open and honest approach to learning and development. Participants were encouraged to share experiences in an attempt to achieve pier-to-pier learning. One of the main tenets of the befriending and volunteer service is to invest in volunteers by providing on-going training and support. Regular reviews, supervision and an online training diary fulfil this obligation. We believe that volunteers who feel supported and trained will perform in their roles with a higher level of efficacy than those who are not invested in. Evaluation Process Evaluation and monitoring are considered to be integral aspects to the befriending services potential success. Data was gathered from the You Ladder appraisal at referral and towards the end of the relationship. Where possible this tool was completed by the service user, but support was available through staff at the project. Initial and final assessments conducted by the project manager gathered data regarding several factors concerning the wellbeing of service users. The Spidergram (appendix 2) was utilised to record this information and the perspectives of support staff, project manager and service user were collaborated in order to ascertain reliable figures. These two methods were used in an attempt to gather subjective and objective opinions concerning a service user’s wellbeing in order to report reliable outcomes or changes. In conjunction to the latter, reviews were conducted with service users in order to identify satisfaction levels and highlight any areas of concern or development.

Reporting Protocols

Each of the above components was discussed at quarterly steering group meetings. Recommendations for best practice were made and where appropriate amendments to procedures or processes were made.


Photo: Sarah and Rebecca have been in a relationship for 6 months.

‘Rebecca Rebecca helped me write letters to Nigel Havers. I like seeing Rebecca.’


Inputs, Outputs and Results Resources

The befriending service was delivered with the complete support of the Circle Support Volunteer Service. This included a designated desk, computer and telephone system. Access and use of all office resources including the use of meeting and training rooms, printers, fax machines, photocopiers, laminating machines and stationary. The Volunteer Service and Learning Disabilities Service worked closely to plan and deliver this project with support and guidance from Circle’s Involvement Service Manager. A dedicated Project Manager, managed by the Volunteer Service Manager, was responsible for devising strategy, planning, implementing all administrational tools, recruiting, training and supervising befrienders, as well as on-going monitoring and six-monthly reporting to the steering group. The Project Manager also liaised with relevant key workers and Care Project Managers to provide initial induction and on-going support to Service Users.

Workshop materials Befriending workshop PowerPoint presentation designed to help disseminate relevant information to applicants, Service Users

and staff at Swan Yard, Islington on 12th May 2010 and 10th November 2010. Agenda points and discussion topics included:

An introduction to volunteering with Circle Support. Discussion group to define befriending Introduction to befriending/mentoring spectrum (appendix 8) Discussion group to explore the qualities of a ‘good enough befriender’.

Befriending workshop group exercises facilitated by Support Workers, Service Users and Project Manager. Process supported by assessment sheets (see appendices) that scored candidates on various skills that were deemed essential for the role. Topics and scenarios included:

Scenario 1: A Service User wants to buy you dinner after you have supported them to a cinema. Discuss and provide solutions.

Topic 1: People with Learning Disabilities in our society are too often treated as second-class citizens or worse? Discuss.


Discrimination Exercise: 1) If you knew a woman who was pregnant, who had 8 kids already, three of whom were deaf, two were blind, one

mentally ill, and she had syphilis, would you recommend that she have an abortion? Discuss. If you said YES, you just killed Beethoven.

2) It is time to elect a new world leader, and only your vote counts. Here are the facts about the three candidates. o Candidate A:

Associates with crooked politicians, and consults with astrologists. He’s had two mistresses. He also chain smokes and drinks 8 to 10 Martinis a day.

o Candidate B: He was kicked out of office twice, sleeps until noon, used opium in College and drinks a quart of whiskey every evening.

o Candidate C: He is a decorated war hero. He’s a vegetarian, doesn’t smoke and drinks an occasional beer and has never committed adultery.

Which of these candidates would be our choice? Candidate A is Franklin D. Roosevelt. Candidate B is Winston Churchill. Candidate C is Adolph Hitler.

Demystifying Learning Disabilities Workshop (appendix 9) delivered to Samaritans Volunteers at Central London Samaritans,

Marshall Street, London on 14 July 2011. Workshop recorded and broadcast on Samaritans website for all 500 Samaritan volunteers to have access to. Agenda points and discussion topics included:

Defining learning disabilities. History and statistics. Cause and diagnostic criteria. The difference between learning disabilities and learning difficulties. The pitfalls of labelling individuals. What can Samaritans do to support individuals with learning disabilities?


Training Materials

Befriending handbook. Volunteer Policy Befriending/Mentoring scale Boundaries factsheet Confidentiality factsheet Tips on Dealing with Challenging Behaviour Tips on effective communication factsheet. Learning Disabilities factsheet

Assessment Tools YOU Ladder appraisal. Evaluation Tree Spidergram Final Relationship Report. End of relationship questionnaires (Service User, Staff and Volunteer versions)

Reports CAF Acceptance and Milestone report, November 2009 Quarterly CAF Reporting milestones and Expenditure. Quarterly Steering Group Project Progress reports + SU versions. End of Relationship reports (see appendix 10). Final report Final Report (SU version).

Presentations

10 presentations, delivered at all Circle Support Learning Disability Services to Support Staff, Managers and Service Users introducing them to the service, highlighting benefits and informing of process and procedures.

2 presentations delivered to Circle Supports Older People Services Team and Outreach Team, introducing them to the service, highlighting benefits, informing of process and procedures and to establish/identify Service Users within their services that could benefit from a Learning Disability Befriender.


Findings

Out of 24 volunteers recruited 14 started relationships with Service Users. 58% recruitment to relationship success rate. Recruitment target: 20, Actual: 24 = target excelled by 20%. Relationship target: 20, Actual: 15 = 75% success rate.

Reason for 10 not starting relationship: CRB complications 30% Personal reasons for the remaining 70%.

Out of 15 relationships, 13 lasted more than 3 months. Target: 75%, Actual: 87%. Out of 15 relationships, 11 lasted over 6 months or are still on-going: 73%. Relationship ending before agreed time 3/15 = 20%. Reason for relationship ending:

66% (2/3) Service User directed 33% (1/3) Befriender directed

9/15 (60%) relationships recorded positive change. No relationships reported a negative impact. Refer to individual reports in appendices for detailed indicator changes.

Percentage of Service Users in relationships reporting change in confidence levels: Increase- 40% (6/15) no change- 27%, (4/15) decrease- 0% unable to assess- 33% (5/15)

Percentage of Service Users in relationships reporting change in isolation levels: decrease – 53%, (8/15) no change – 13%, (2/15) Increase – 0% Unable to assess – 33% (5/15)

YOU Ladder response rate 37/70 = 53%. Out of the 15 volunteers who engaged in relationships 6 are now involved in meaningful employment. No. of voluntary roles available in LD services prior to Befriending pilot: 4. No. of voluntary roles available currently

(excluding befriending roles): 9, which equates to a 125% increase. Note: Summary of other findings can be found in appendix 11 (p.83)


Photo: Val and Ivy

‘On my birthday she phoned me up and it filled my heart.’


Outcomes Broad outcomes

Service User related outcomes

The Befriending Pilot has demonstrated the positive effects that a befriending relationship can have on adults who have learning disabilities. It has proved that a person-centred relationship can promote personal growth and empower an individual to make positive changes in their lives. These outcomes are not restricted to the Befriendee but also make an impact on the Befriender. Service Users have felt and continue to feel a positive difference to the levels of self-esteem, confidence and isolation felt. Service Users have stated that this relationship helped them believe that other people are interested in what they have to say and improved their skills in building relationships. Due to each scheme being assessed on suitability for the service, the project manager was able to recommend alternative roles to the Volunteer Service Manager. These recommendations were implemented and subsequently filled; enriching the lives of the Service Users cared for at these schemes.

Community based outcomes

The improved awareness of candidates, volunteers, and staff on the issues effecting adults with learning disabilities and what the label actually means will hopefully improve, although marginally, the perception that society holds of adults with learning disabilities. Workshops were held across internal and external partners in an effort to improve awareness. The Demystifying Learning Disability Workshops held at Central London Samaritans were recorded and were available to all their volunteers on-line, which would hopefully aid and inform the way they support callers from this client group. The befriending relationships increased the frequency and variation of activities that Service Users engaged with in their community, thus marginally increasing society’s experiences and understanding of learning disabilities.


Circle Support Services Outcomes

Volunteer roles available across the learning disability division have been increased by 125% as a direct result of the Befriending Service. Due to the project being directly supported and managed through the Volunteer Service, scheme managers were engaged with and supported by the Befriending Project Manager to developing volunteer roles at their schemes. Along with the volunteer Befrienders recruited, this increase impacted upon the quality of service available to Service Users. When volunteers were supporting Service Users, Support Staff were able to complete other duties for that particular Service User, Including administration, booking medical/social appointments or maintaining household chores. Support Staff were able to do this with a higher level of efficiency, because they knew the emotional needs of a Service User were being managed by a volunteer and they had more time to complete them. Support Staff have commented how volunteers improve morale and create a new dynamic within the team. Service Users are empowered to engage in activities without paid staff and feel privileged that the volunteer is visiting them out of choice not necessity.

Detailed outcomes by objectives

Objective 1. Implement recruitment strategy that involved advertising using established protocols and resources. Applicants invited to Befriending Workshop for assessment and selection. Two stages of recruitment planned involving two workshops and training programmes. Achievements:

a. Defined and streamlined successful recruitment procedure leading to high candidate turnout at Workshops. b. Successful workshops integrated the views of Service Users, Support Staff and volunteers allowing greater

understanding of befriending, commitment involved and issues effecting people who have learning disabilities. Successfully assessed and recruited volunteers. Increased exposure of Volunteer Service internally and encouraged active engagement between Service Users, staff and volunteers.

c. Successful training programme developed receiving positive feedback from participants. Level of flexibility achieved by providing catch up sessions for delegates and modifying training programme into half-day and full-day components.

Objective 2. Provide presentations and referral materials to every Learning Disability scheme within Circle Support. Achievements:

a. Presentations were delivered to each scheme enabling staff and Service User to ask questions and query protocols. This lead to a greater understanding of referral materials, which included the opportunity to receive valued feedback enabling amendments to be made to said materials and achieve greater clarity.


b. Hand delivering the YOU Ladder tool contributed to the high response rate and aided in capturing staff and Service User attention.

c. Increased the exposure of the Volunteer Service in general, which contributed to the increase in volunteer roles available Within LD Support, which in turn is hoped to have an impact on the quality of care experienced by Service Users.

Objective 3. Consult with Learning Disability management team and Volunteer Service Manager to determine and nominate internal members. Research and compile list of suitable external representatives and invite those identified to discuss proposal, establish interest and ascertain suitability. Discuss outcomes with Service Managers and inform prospective partners of decision. Achievements:

a. Steering Group proved to be robust and able to integrate diverse group of individuals, which culminated in its guidance and suggestions being extremely productive and insightful.

b. Productive learning relationship made with the Samaritans (external rep), which included provided workshops for each others volunteers, which enriched the skills base and perspective of volunteers involved.

Objective 4. Provide volunteers with on-going support in the form of supervision, telephone support and review meetings. Provide Service User’s an opportunity to discuss relationship at review meetings and at assessments in a one-to-one environment. Achievements:

a. Regular supervision was arranged for volunteers, which provided support and guidance to concerns they may have faced whilst in their role. On some occasions out-of-hours telephone supervision was offered for those who were unable to attend formal supervision due to work commitments. This support helped the volunteer sustain the commitment needed to be effective as a befriender and also gave the supervisor an opportunity to praise and value the work already achieved.

b. Updates from staff and assessments/reviews with Service User’s gave them opportunities to express how they felt about the relationship and enabled them to end the relationship if they wished to. This process also enabled the Service User and Befriender to work through any complications that arose.

Objective 5. Deliver volunteers a befriending training programme. Achievements:

a. Successfully delivered 3 training programmes to compliment the three stages of recruitment. Out of the 38 feedback questionnaires returned; 29 (76%) stated the training was excellent, 6 (16%) stated very good and the remaining 3 (8%) stated OK.

b. Successfully arranged additional training with internal partners (Training and Development Team) and external partners (Islington Borough Council & the Samaritans) to compliment programme.


Objective 6. To manage, report, evaluate and disseminate the project activities. Achievements:

a. Successfully organised and facilitated 6 steering group meetings. At each meeting a quarterly report was delivered and discussed. Reports included periodic developments with regards to strategy, development, recruitment, training, managing relationships and relationship outcomes.

b. Final report disseminated at Befriending Celebration Event to Staff, Funders, Volunteers and Service Users. PowerPoint presentation giving a summary of findings delivered at celebration event to compliment report. Report available in a version accessible to Service Users. Report available on-line on Cirano.


Photo: Joan and Anita

‘She was wonderful to work with and we did some good things together. I miss her a bit but I am looking forward

to other stuff’


Conclusions The Befriending Pilot has proved that a relationship based on person centred principles can have a positive impact on adults with learning disabilities. The findings indicate that Befriendees from this client group actively engage in relationships and can form secure attachments with their Befrienders. The feedback suggests that that both Befriendee and Befriender develop skills to relate and form relationships with individuals with greater efficacy. Befriendees have indicated that they feel empowered and motivated in the relationship. Feelings of Isolation are reduced and confidence levels improve marginally when contact is made. The findings suggest that the overall wellbeing of Service Users improved during the course of the befriending relationship. However, acknowledgement must be made to the work and support from Circle staff, Managers and external agencies that contributed to this improvement. The befriending relationship did have an impact but only as part of a wider support network. From consultations with other Services within Circle Support, the general consensus was that Service Users across all client groups could benefit from a befriending service. The findings indicate that a general befriending service open to all client groups, would achieve similar results to the pilot. A recent consultation across Circle Support’s Older Peoples Services reported the following:

45/80 residents (56%) stated that they often spend time on their own. 13/80 (16%) stated they had not left their home in the last month or more. 37/80 (45%) stated they often or sometimes feel lonely 40 (49%) stated that they would like a befriender and 11 (14%) stated maybe.

From these results we can conclude that a befriending service would be beneficial to Older People Services.


Photo: Nora and Jane have been in a befriending relationship for 4 months and are still doing well.

“I really enjoy going to art classes with Jane and we plan to go to the theatre soon”


Recommendations From the findings and feedback received during the course of the befriending pilot, we recommend expanding the service to all areas of Circle Support. This would include maintaining the existing service to Learning Disability Services and expanding into Older People Services, Mental Health, Young People and Families. The existing structure of the Befriending Service is adaptable and able to accommodate a diverse client base. The training implemented was designed with expansion in mind and is considered a generic programme for befrienders to feel comfortable to engage with a diverse client group. The current referral procedure will need to be modified to incorporate a larger client group from various backgrounds. Further consultations with Mental Health, Young People and Families will need to be implemented to ascertain service needs and assess service user suitability. Further workshops and presentations will need to be delivered to these services to ensure staff awareness and increase referral success.


Photo: Matt and Neil have been in a relationship for 3 months

‘I have to say I really like Matt. We are slowly beginning to trust each other.’


Case Study Example


References Dryden, W (2007). Dryden’s Handbook of Individual Therapy. London: Sage Rogers, C.R (1967). On Becoming a Person. London: Constable & Robinson Ltd.


Appendices Appendix 1: YOU Ladder Appraisal





Appendix 2: Spidergram Name: Date:


Appendix 3: Evaluation Tree Name: Date:

The Evaluation Tree


Appendix 4: Role Description

Circle Support1-7 Corsica StreetLondonN5 1JGTel: 020 7288 4000 Fax: 020 7359 4379www.circlesupport.org.uk

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