Thursday 21 November 2013

LAY VISITOR -- Worked Example of Program Audit

Sorry for the delay in posting this audit: The original formatting of the audit sample didn’t work well on the Blog, so I had to change it. The related Position Audit of the Lay Visitor will be posted shortly. LS

WORKED EXAMPLE OF A PROGRAM AUDIT
Lay Visitor Program

NOTES:
(1) A copy of this sample audit (with some additional notes and tips) will also be posted to the diocesan website’s SafeR Church page. You will be able to download, print, etc., it from there.
(2) Check out the sample Position Audit for Lay Visitor (to be posted in the next day) and the Program and Position Audits for Pastoral Visiting when they are posted. There is considerable overlap between them, and ideas generated in one may be helpful to you in relation to the others.
(3) Remember that what follows is NOT a description of what a Lay Visitor Program “should” be or do or look like: You may do this differently; your parish’s visitors may do some things outlined here, but not others, or they may do things that are not mentioned here, etc. In addition, you may come up with different answers in your identification and assessment of risks and SafeR Church Measures for your parish. Use this as a starting point, and work from there. Your final audit and identification of SafeR Church Measures must be accurate and complete and shaped to fit the realities of your parish.
(4) Thanks to Susan Naylor and to the participants at a workshop for NSOM clergy earlier this year, who worked through an audit of the position of Lay Visitor. Much of what follows here was created through their discussions. It has been supplemented by information generated by audits of both Lay Visitor and Pastoral Visitor Programs undertaken at the risk management workshops for clergy last fall, as well as by other material.


1. Analyze and describe the Lay Visitor Program:
What? Who? Where? When? How? Why?  Etc.

WHAT? (i.e., what does a Lay Visitor do?)
- A layperson (or more than one) from your parish spends time visiting with someone—an individual, couple, family
- Could be a single visit at a particular time (e.g., post-surgery, on an important anniversary, some other special occasion, etc.)
- Could be a series of visits on some kind of regular, periodic, or irregular schedule, for a short time or a long time
- Visitor seeks to engage people in conversation, to provide support and encouragement, to encourage them to talk about themselves if they wish to do so, to bring people news from the parish and community
- Visitor pays attention to situation of the people being visited, is alert to indications of distress, that individual might need assistance of some kind
-Visits might include prayer, offering home communion*
(*lay visitor must be trained, authorized, licensed to offer home communion)


WHY does your parish have a lay visitor program?
- To live out Matthew 25:31-46—i.e., it is an extension of the ministry we all share—to visit and comfort those who are sick, alone, lonely, in need of companionship; because visiting one another is a “wholly holy” activity
- To remember and care for people and to help them know that they are cared for and remembered; this may be especially important in the case of people who were once part of the parish and now no longer participate
- To “bring the church to the people who can’t get there”; to bring community to those who are separate from the community
- To maintain personal contact with people (parishioners, former parishioners, people known to the parish, etc.), especially parishioners who no longer (or no longer can) come to worship services or participate in parish activities; to bring news, information, invitations to parish involvement
- To assist parish clergy, pastoral care team, to care for and support people, by doing  “reconnaissance”—i.e., helping clergy become or remain aware of special circumstances (or changing circumstances), pastoral needs, etc., of people being visited
- To provide support and encouragement to people, especially those who are isolated and/or alone: sometimes, visitors from the parish (lay, clergy, both) may be the only people that someone sees (or the only one other than caregivers, family, etc.)
- To help develop relationships with newcomers to the parish
- To build, rebuild, maintain, support, and nourish relationships among the people of God


WHO? Who do Lay Visitors visit?
- Any parishioner
- People who are shut-in, ill, isolated, dealing with a crisis, tragedy, joyful event, etc.
- Newcomers to the parish
- People who are ill, dying, people who are mourning a death
- Families with new babies
- Disaffected parishioners
- Former parishioners
- Anyone in the community who asks for visit


WHERE? Where do Lay Visitors visit people?
- In their homes (houses, apartments, rooms or apartments in places such as seniors’ apartments, residences, nursing homes)
- In hospitals
- In coffee shops, restaurants


WHEN? When do these visits take place?
- Visits are arranged by phone or e-mail (or both) ahead of time
- Daytime, evening
- Weekdays, weekends
- Visits approximately 1-2 hours long
- If person being visited is in a hospital or nursing home, time, duration of visits may be governed by their rules


HOW? How does this work? Where does this program fit into the parish? Who organizes it? Oversees it?
- Organized by and overseen by a committee of Parish Council (Pastoral Care, Outreach, Spiritual Development, etc.), so Parish Council is ultimately responsible for it. Committee reports to Council periodically (monthly? Quarterly?) about Lay Visitor Program.
- Visitors are supervised, report to Visit Co-ordinator? Chair of Committee? Rector? Other clergy? Etc.
- Visitors contact Visit Co-ordinator? Committee Chair? Rector? Other clergy? if they have urgent concerns, questions
- Visitors keep brief notes about each visit (e.g., date, time, who was there, how the visit went, any questions, concerns, etc.) and forward notes to designated person.
- Visitors receive initial orientation to visiting, as well as initial and periodic training and opportunities to reflect on their experiences, debrief, raise questions, concerns, and to identify resources, information, training that would help them (e.g., re issues of privacy and confidentiality, etc.)
- At each visit, Visitor leaves parish bulletin with person visited (a source of news as well as contact information)


2. Identify the inherent and foreseeable risks in the Lay Visitor Program.
The basic questions here are these:  Who (including the parish itself) might be harmed? How might they be harmed?

Special factors to consider:
(1) People being visited are often quite vulnerable (physically, socially emotionally, psychologically, spiritually, etc.)
- needy (emotionally, psychologically, financially, etc.)
- fearful
- isolated and/or alone (i.e., little or no family contact, small or no circle of friends, etc.)
- Person being visited may well be a “captive audience,” too frail or otherwise unable (or unwilling) to tell a visitor to leave, or that he/she doesn’t want visits

(2) There are increasing numbers of people with cognitive impairment, dementia, disabilities, etc., seeking or needing visits: These impairments, frailties put individuals at much higher risk—i.e., they may divulge personal information (e.g., re their finances, etc.), make requests that are inappropriate, etc.—and these frailties also put Visitors at higher risk

(3) The living conditions of person being visited may put him/her at risk and raise the question of the obligation of the Visitor to bring concerns to attention of designated person at parish: Visit Coordinator, Rector, etc.

(4) Seem to be more women than men who want (if not need) visits

(5) Often, the people being visited are long-time members of the parish; they may have long memories, preconceived notions about visitors generally, or about individuals specifically

nRisks to person being visited:
(1) Bodily Harm (physical injury)
- physical injury (e.g., person being visited is frail; Visitor doesn’t know how to help person stand or move, etc., and person is physically injured)
- physical abuse

(2) Personal Injury (non-physical harm)
- spiritual, psychological, emotional harm (e.g., person may become inappropriately attached to, or dependent on, Visitor; Visitor unclear about or unwilling to keep visits within appropriate boundaries, etc.)
- sexual abuse
- misunderstandings causing distress (exacerbated by cognitive impairments, physical disabilities (e.g., hearing loss), etc.)

(3) Financial Loss
- theft of property
- loss of assets (e.g., person is persuaded to invest money, change will, etc.)


nRisks to Visitors:
(1) Bodily Harm (physical injury)
- physical injury (e.g., Visitor helps person move, doesn’t know how, and is injured doing so, Visitor is physically assaulted, Visitor is in car accident on way to or home from visit, etc.)

(2) Personal Injury (non-physical harm)
- emotional harm (e.g., Visitor may become inappropriately attached to person being visited and/or may not know how to deal with inappropriate attachment on part of person being visited, etc.)
- misunderstandings causing distress (exacerbated by cognitive impairments, physical disabilities (e.g., hearing loss), etc.)
- loss of reputation, credibility (e.g., as result of misunderstanding with person being visited, his or her family, etc.)

(3) Financial Loss or Property Damage
- financial loss (e.g., Visitor is in car accident on way to or from visit; Visitor is injured and unable to work; car is damaged; etc.)

(4) Legal Liability
- visitor might be accused of wrongdoing or causing harm that results, might have to defend against criminal charges, lawsuit


nRisks to Parish:
(1) Loss of Reputation, Credibility, Support
- parish’s reputation and credibility are harmed as result of an injury to someone being visited and/or to Visitors

(2) Legal Liability and Financial Loss
- parish is potentially legally liable for the actions, inaction, wrong action of Visitors as they are acting on its behalf. Financial loss might ensue from being found legally liable.

3. Assess the risks. Prioritize them.
All the risks noted above were rated as medium-high, both inherent and foreseeable given the nature and purpose of the program, the needs and vulnerability of people being visited, and the fact that visits take place primarily in private homes.

Priority was assigned to the risks to the people being visited, because they are vulnerable and because the parish’s first obligation in this situation is to them.

NOTE: Remember that this rating is not a suggestion that any, some, most, or all people intend to do harm. It reflects the recognition that these risks are inherent and foreseeable in this kind of situation, that these kinds of harm have in fact taken place—i.e., people have been abused or assaulted, vulnerable people have been influenced to change their wills or make investments, etc.—and that people may inadvertently, accidentally, and completely unintentionally cause harm to another.


4 and 5. Identify SafeR Church Measures to address these risks. Prioritize the risks and measures:
Notes and Tips:
Many of the measures listed below are mentioned under more than one category, i.e., something that is a risk management measure that can protect the person being visited may also protect the visitors, and the parish. That’s a good thing—in general, the more risks that can be reduced by a single measure, the better.
Note that choosing SafeR Church Measures is not about choosing from a menu of options. Measures have to be chosen in answer to the question “What measure(s) will eliminate, prevent, avoid, transfer, or minimize this risk?” And you have to be able to answer these questions: “What risk does this Measure address? How? How will you know if this Measure is effective?”

Risks
SafeR Church Measures to Consider
nRisks to people being visited

(1) Bodily Harm (physical injury)
- physical injury (e.g., person being visited is frail; Visitor doesn’t know how to help person stand or move, etc., and person is physically injured)
- physical abuse

(2) Personal Injury (non-physical harm)
- spiritual, psychological, emotional harm (e.g., person may become inappropriately attached to, or dependent on, Visitor; Visitor unclear about or unwilling to keep visits within appropriate boundaries, etc.)
- sexual abuse
- misunderstandings causing distress (exacerbated by cognitive impairments, physical disabilities (e.g., hearing loss), etc.)

(3) Financial Loss
- theft of property
- loss of assets (e.g., person is persuaded to invest money, change will, etc.)
To reduce risk of harm to person visited:
- Visitors come in pairs, not alone
- Visits are arranged in advance; visitor doesn’t “drop in” without person’s prior consent to visit (Note: This is a good guideline, but it can’t be imposed absolutely: Obvious exceptions would be if the individuals are old friends, if this is something visitor has always done, if there has been some indication of urgent need, etc.)
- If person being visited has family, parish tries to contact family members to introduce them to visitor, help them understand visiting program, etc.
- Parish maintains regular, formal contact with individual being visited (e.g., someone is designated to call or visit the “visitee” monthly? Bi-monthly? to ask for feedback about the visits; record of contact maintained).
- Parish screens Visitors properly, pre- and post-selection, and provides proper initial training and continuing education to visitors about visiting people who are vulnerable, including obligation to report concerns of neglect or abuse, privacy and confidentiality issues, any discussion person being visited might raise about money such as asking visitor to do banking, telling visitors that someone is stealing from them, etc.)
- Visitor is introduced to person being visited by someone in authority in the parish
- Visitor sits in chair, not on couch with person being visited
- Visits are during day, not at night, especially in the winter
- Visitors keep brief set of notes about each visit, forwards notes to designated person (rector, secretary?) ASAP after the visit
- Visitor is given clear information about who to contact (and how) about any concern about the visit, or about the person being visited, especially anything that person being visited identifies as urgent or Visitor believes is urgent


Risks
SafeR Church Measures to Consider
nRisks to Visitors:
(1) Bodily Harm (physical injury)
- physical injury (e.g., Visitor helps person move, doesn’t know how, and is injured doing so, Visitor is physically assaulted, Visitor is in car accident on way to or home from visit, etc.)

(2) Personal Injury (non-physical harm)
- emotional harm (e.g., Visitor may become inappropriately attached to person being visited and/or may not know how to deal with inappropriate attachment on part of person being visited, etc.)
- misunderstandings causing distress
- loss of reputation, credibility (e.g., as result of misunderstanding with person being visited, his or her family, etc.)

(3) Financial Loss or Property Damage
- financial loss (e.g., Visitor is in car accident on way to or from visit; Visitor is injured and unable to work; car is damaged; etc.)

(4) Legal Liability
- Visitor might be accused of wrongdoing or causing harm that results, might have to defend against criminal charges, lawsuit

To reduce risk of harm to Visitors:
- People visit in pairs, teams, not alone
- Visitors are thoroughly screened, pre- and post-selection, based on the Bona Fide Occupational Requirements (BFORs) identified in Position Audit of Lay Visitor (as important for individuals to find out if they are suited for this position as it is for the parish to know)
- Visitors participate in initial orientation, training and continuing education about visiting people who are vulnerable, including re policies in operation, obligation to report concerns of neglect or abuse, privacy and confidentiality issues, any discussion person being visited might raise about money such as asking visitor to do banking, telling visitors that someone is stealing from them, etc.)
- Visitors have a support system—i.e., visitor knows he can always contact rector to discuss concerns, ask questions, etc.
- Visitors keep brief set of notes about each visit, forwards notes to designated person (rector, secretary?) ASAP after the visit
- Visitor is given clear information about who to contact (and how) about any concern about the visit, or about the person being visited, especially anything that person being visited identifies as urgent or Visitor believes is urgent
- Visitor leaves information about where he or she is going, when, when expected back, with family, with church (rector, secretary?) by phone message, e-mail, text, etc.
- Visitor takes cell phone
- Visits are during day, not at night, especially in the winter
- Visitor sits in chair, not on couch
- Visitors don’t accept refreshments, meals during visits
- Visitors do not do errands for person being visited (or perhaps groceries, but not banking?)
- Parish provides extra insurance protection for Visitors who drive to visits


Risks
SafeR Church Measures to Consider
nRisks to Parish:
(1) Loss of Reputation, Credibility, Support
- As result of harm coming to someone being visited and/or to Visitors

(2) Legal Liability and Financial Loss
- Parish is potentially legally liable for the actions, inaction, wrong action of Visitors as they are acting on its behalf. Financial loss might ensue from being found legally liable.

To reduce risk of harm to parish:
- Parish Council clearly identifies who (which individual(s) and/or groups (e.g., a committee) is/are responsible for overseeing Lay Visitor Program and communicates mandate.
- Parish maintains regular, formal contact with people being visited (monthly? quarterly?) to ask for feedback about the visits; feedback logged (i.e., record kept of who talked to whom, when, what was said, etc.) These conversations should be documented.
- Parish sets clear outlines of what a visit is and is not, ground rules made clear to Visitors, people being visited, family of people being visited
- If person being visited has family, parish contacts family members to alert them to plan to visit, keep them posted on visits and visitor, introduce them to visitor; contacts family member(s) periodically to follow up. These conversations should be documented.
- Parish thoroughly screens Visitors before they begin to visit and, especially, after and on ongoing basis, according to Bona Fide Occupational Requirements (BFORs) identified in Position Audit
- Parish provides proper initial orientation and training and continuing education to Visitors about visiting people who are vulnerable, including obligation to report concerns of neglect or abuse, privacy and confidentiality issues, any discussion person being visited might raise about money such as asking visitor to do banking, telling visitors that someone is stealing from them, etc.)
- Parish sets up support system for Visitors—i.e., visitor knows he or she can always contact rector or other designated person to discuss concerns, ask questions, etc.; some kind of periodic individual and/or group session set up so that Visitors can debrief, reflect, raise questions, concerns, offer feedback, etc.
- Parish requires that Visitors keep brief set of notes about each visit, forward notes to designated person (rector, secretary?) ASAP after the visit
- Parish secures insurance coverage for Lay Visiting Program, including, if possible, insurance against bodily harm, financial loss, etc., suffered by Visitor
- Parish policies explicitly require that
  - Visitor leaves information about where he or she is going, when, when expected back, with family, with church (rector, secretary?) by phone message, e-mail, text, etc.
   - Visitor takes cell phone
   - Visitor works as part of a pair, team, not alone
   - Visits are during day, not at night, especially in the winter
  - Visitor sits in chair, not on couch with person being visited
  - Visitors don’t accept refreshments, meals during visits
  - Visitors do not do errands for person being visited (or perhaps groceries, but not banking?)
  - Visitors notify parish (rector, secretary?) ASAP after the visit about any concern about the visit, or about the person being visited 
- Parish policies re lay visits are reinforced in training of visitors; communicated to visitors in writing (e.g., Guidelines for Visitors), discussed with people being visited (or discussed with them if they raise concern?)
- Formal report (quarterly? Semi-annually?) made to Parish Council by individual or group responsible for Lay Visitor Program for evaluation, changes, etc. SafeR Church Measures reviewed and modified, adapted, dropped, added, as required

Orientation, Training, Ongoing Education, and Support for Visitors
Issues/Topics:
- Visits are about sharing love; they are opportunities for mutual growth and benefit, but focus should primarily be on the person being visited
- Rapport builds over time
- Active listening
- Boundaries – establishing and maintaining them
- Recognizing when pastoral care is needed

Ways of providing this training and support:
- Initial orientation and training
- Ongoing support – informal (e.g., visitors encouraged to reflect as individuals on their experiences; visitors encouraged to call visit coordinator/rector if concerned about something) and/or formal (e.g., monthly, quarterly gatherings of visitors to check in, raise concerns, reflect as a group, etc.)