Submission to the Review of the Community Visitors Scheme

CPSA’s CVS employs one full time coordinator and is funded for 85 volunteers. The CVS delivers one-on-one services to clients receiving home care packages and both group and one-on-one services to clients who live in residential aged care. The CVS provides ‘mainstream’ services and does not specifically cater to any one special needs group, however the CVS coordinator considers the individual needs of clients when matching a volunteer. Specific details regarding CPSA’s CVS internal policies and procedures are noted in the Policy and Procedures Manual, which was developed to align with the Australian Government’s overarching CVS policy objectives [1]. CPSA’s CVS regularly reports to the Australian Government regarding the administration of the scheme as per the funding agreement.

CPSA’s CVS has been in operation for 25 years and a large part of its ongoing success can be attributed to experience. CPSA’s CVS is well known among aged care providers in the area, meaning there have been no issues obtaining referrals for clients. CPSA’s CVS accepts referrals from anyone, including the health sector. The CVS coordinator communicates regularly with staff of aged care providers to ensure that the scheme is operating smoothly to meet the needs of clients. This open and regular communication is a critical measure of the scheme’s success and ensures the CVS coordinator receives ongoing feedback regarding the operation and administration of the scheme.

CPSA’s CVS recruits volunteers by advertising in local newspapers and online. Many volunteers are attracted through word of mouth by existing volunteers. Prospective volunteers are interviewed in person to ensure their suitability for the scheme and are provided with initial training and orientation as well as ongoing training opportunities. In addition to regular phone and email contact between volunteers and the CVS coordinator, volunteers receive regular newsletter updates and are able to attend support groups, which are run four times a year in three different geographical locations. Volunteers receive counselling around potential and actual adverse events that may arise and ongoing support is always available.

Well established channels of communication between the CVS Coordinator, volunteers and aged care providers help to ensure that any issues are identified and dealt with quickly. Volunteers who have difficulty establishing relationships may be referred to a more appropriate volunteer organisation or re-matched to another client where appropriate. Conflict between volunteers and clients is very rare and ongoing support is always available to volunteers. Where conflict does arise, the CVS Coordinator communicates with the client and the aged care provider to reassess the requirements of the client. A community visitor is the client’s choice and they may choose either to terminate their participation in the scheme or, if appropriate, to be matched with a different volunteer. The success of the scheme depends on clients exercising choice and control, otherwise a relationship would not be developed and maintained. The most common issue faced by CPSA’s CVS is that many clients would like more contact with volunteers, but this is not possible either due to a shortage of funding for volunteers, or the time constraints of individual volunteers.

CPSA’s CVS is unable to meet the demand from clients for visitors, with the number of clients referred to the scheme far outstripping the number of volunteers required to meet their needs. CPSA’s CVS has a good reputation among aged care providers, volunteers and clients, much of which can be attributed to the scheme’s commitment to open and ongoing communication and the extensive support offered. The CVS program is a low cost way to provide social support to older Australians, which is in turn critical to their wellbeing. Expansion of the CVS at a national level should build on the existing networks of current CVS auspices to ensure that the current wealth of experience and knowledge is retained. The successful delivery of CVS services

A major strength of the CVS at a national level is its clear focus on the provision of social support by means of facilitating a relationship between clients and volunteers. Since the extension of the CVS to people being cared for at home, CPSA’s CVS has ensured that when a client transitions from home care to residential care they are able to continue receiving visits from their volunteer, assuming that it is geographically suitable do to so. While this level of continuity in relationship is desirable for many CVS clients and volunteers, the Australian Government should be wary of imposing additional expectations on volunteers, particularly around the provision of information and explicit consumer support. The CVS is successful because it does not place overly onerous expectations on volunteers or clients, with success dependent on both volunteers and clients freely choosing to establish and maintain a relationship.

The simplicity and flexibility of the CVS is one of the key factors attracting volunteers to participate in the scheme. While some volunteers do already provide information to clients on an ad-hoc basis, making the provision of information a part of the role is likely to diminish the desire of people to volunteer. It is critical that CVS auspices across Australia are able to attract a sufficient number of volunteers and expanding the function of the CVS risks undermining the sustainability of the scheme by reducing the capacity to retain volunteers. The likelihood of volunteer attrition must be a central consideration if any changes are to be made to the current CVS policy objectives set out by the Australian Government.

Expanding the function of the CVS to include the provision of information and consumer support would require a substantial increase in funding to ensure that volunteers are both sufficiently trained to provide consumer support and across all relevant information. Volunteers would require comprehensive training initially as well as regular follow up sessions for the dissemination of up-to-date-information. The collection and dissemination of relevant information to volunteers is in itself a huge undertaking due to the sheer volume of information pertaining to the aged care sector, the highly contingent nature of this information and the constant change stemming from ongoing reform to the sector. Very clear guidelines detailing the type, level and frequency of information volunteers would be expected to deliver would need to be developed.

Further clarification regarding what exactly constitutes ‘consumer support’ mentioned in the discussion paper is required. The provision of both information and consumer support to recipients of aged care requires extensive knowledge and experience. There are a number of established organisations that have a wealth of experience in the provision of information and consumer support to older Australians and in particular to those involved in the aged care system. These organisations operate under the national Older Persons Advocacy Network (OPAN) [2] and provide legal advocacy and education as well as information and consumer support. OPAN organisations employ professional case workers, solicitors and legal experts to provide both one-on-one and group support. These organisations have a well established reputation among the community, aged care providers and other stakeholders as the go-to for information and consumer support, which they have been providing for many years. An attempt to shift the services offered by aged care advocacy organisations away from highly skilled, paid professionals and onto volunteers participating in the CVS would be at best unrealistic and at worst downright dangerous.

CPSA’s CVS has found that volunteers are generally willing to visit clients in their homes, but that some prefer the more supported environment provided by a residential aged care setting. A number of volunteers are retired residential aged care workers and sometimes prefer the home setting. It is critical that volunteers who visit clients in their homes are well equipped to be left unsupervised with vulnerable people. Accordingly, the CVS coordinator tends to place more mature volunteers into clients’ homes, who have the life experience necessary to deal with any issues that may arise. These volunteers generally find it easier to relate to the client and establish a relationship. As volunteers only visit clients who are receiving a home care package, a comprehensive risk assessment has generally already been carried out by the home care provider. The CVS coordinator also carries out a visual inspection of the client’s home to identify any risks.
CCPSA’s CVS has found that volunteers are generally willing to visit clients in their homes, but that some prefer the more supported environment provided by a residential aged care setting. A number of volunteers are retired residential aged care workers and sometimes prefer the home setting. It is critical that volunteers who visit clients in their homes are well equipped to be left unsupervised with vulnerable people. Accordingly, the CVS coordinator tends to place more mature volunteers into clients’ homes, who have the life experience necessary to deal with any issues that may arise. These volunteers generally find it easier to relate to the client and establish a relationship. As volunteers only visit clients who are receiving a home care package, a comprehensive risk assessment has generally already been carried out by the home care provider. The CVS coordinator also carries out a visual inspection of the client’s home to identify any risks.

CPSA’s CVS has found that due to the increased isolation of clients in the home compared to those living in residential care, the value of volunteers is often greater as these clients would otherwise go without companionship and support. Clients have contacted the CVS coordinator directly to express their gratitude for the services provided by volunteers. However, awareness of the CVS program among home care providers is relatively low and this means that many prospective clients are missing out on the services available. CPSA’s CVS initiated contact with home care providers in the area, providing them with in-depth information regarding the scheme. A number of providers were initially hesitant about the scheme, but following open communication with the CVS coordinator and experience with the scheme there have been no problems. There is a need to promote awareness of the CVS to home care providers, Aged Care Assessment Teams (ACATs), Regional Assessment Teams (RASs) and via My Aged Care.
PSA’s CVS has found that due to the increased isolation of clients in the home compared to those living in residential care, the value of volunteers is often greater as these clients would otherwise go without companionship and support. Clients have contacted the CVS coordinator directly to express their gratitude for the services provided by volunteers. However, awareness of the CVS program among home care providers is relatively low and this means that many prospective clients are missing out on the services available. CPSA’s CVS initiated contact with home care providers in the area, providing them with in-depth information regarding the scheme. A number of providers were initially hesitant about the scheme, but following open communication with the CVS coordinator and experience with the scheme there have been no problems. There is a need to promote awareness of the CVS to home care providers, Aged Care Assessment Teams (ACATs), Regional Assessment Teams (RASs) and via My Aged Care.

Volunteers are assessed for their ability to relate to particular special needs groups if they wish to be assessed in this way. This is relatively more straightforward where volunteers are of a culturally and linguistically diverse (CALD) background and speak a language or languages other than English. In many cases clients and volunteers may not openly identify as belonging to a particular special needs group and may have previously experienced abuse, discrimination or harassment as a result of their identity. Some groups, such as the LGBTI community and Aboriginal and Torres Strait Islander peoples continue to face discrimination. As a result, many people who belong to a special needs group do not wish to be identified and disclosure would require a much greater level of trust. Given that equal rights are not afforded to all, it is unreasonable to expect those who identify as a member of a special needs group as stipulated in the Aged Care Act 1997 to disclose this information. Accordingly, the CVS coordinator takes an open and inclusive approach to matching clients and volunteers, recognising that special needs may be met without the need for both parties to explicitly identify with a particular group.

The CVS provides an invaluable service to people receiving care in their home or in a residential aged care setting. CPSA’s CVS works in an efficient manner to provide volunteers to as many clients as possible. However, demand for volunteers far outstrips the number available. An increase in funding would allow a greater number of clients to participate in the CVS and reap the benefits of companionship, while alleviating isolation.
Awareness of the CVS among aged care providers, in particular home care providers, could be improved through the provision of regular updates, to ensure that all aged care workers are aware of the CVS. The Australian Government Department of Health should provide the necessary resources to ensure that all aged care providers are aware of the CVS.

1. Department of Health (2014) ‘Community Visitors Scheme (CVS) POLICY GUIDE 2013-2016’ Available: https://agedcare.health.gov.au/sites/g/files/net1426/f/documents/12_2014/attachment_001_cvs_policy_guide_2013-2016_final_pdf.pdf
2. See the Older Persons Advocacy Network website for more information: http://opan.org.au/