VOLUNTEER AGREEMENT (HR-F035) Notify Document Ref: HR-F035 (Volunteer Agreement & Boundary Declaration)Version: 1.0Confidentiality Level: HIGH (Restricted Access - HR/Recruitment)CQC Alignment: Safe (Safe Staffing) | Well-led (Governance)Statutory Framework: HSCA 2008 Reg 19 (Fit & Proper Persons) & Schedule 3 SECTION 1: Volunteer Details & Role AlignmentStaff Member NameStaff_IDDesignated Volunteer Role- Select -Befriending & CompanionshipDigital Inclusion ChampionCultural & Linguistic SupportCommunity Activity / Escort VolunteerPet Therapy / Animal CompanionAdministrative / Audit SupportResearch / Project AssistantDesignated Volunteer Coordinator / SupervisorAgreed Availability / Commitment- Select -1-2 hours per week (Flexible days)1-2 hours per week (Set specific days/times)3-5 hours per week (Part-time routine)Weekends OnlyAd-hoc / Event-based support onlyOperating Local Authority- Select -HaringeyIslingtonBarnetWaltham ForestCamdenHackneyBrentHarrowRedbridgeNewhamCity of LondonWestminsterTower HamletsBarking and DagenhamHaveringKensington and ChelseaHammersmith and FulhamEalingHillingdonHounslowSouthwarkLambethLewishamGreenwichWandsworthRichmond upon ThamesMertonKingston upon ThamesSuttonBexleyBromleyCroydonOtherSECTION 2: The Core Relationship (Legal Safeguard)Status Declaration- Select -I understand that I am a volunteer. This agreement is binding in honour only. It is not intended to be a legally binding contract of employment, and it may be cancelled at any time at the discretion of either party. I understand I will not receive payment for my time, other than the reimbursement of agreed out-of-pocket expenses.What Mutima Care Expects from You (The Boundaries)Values & ConductThe Clinical Boundary (Safe QS6)The Financial Boundary (Safe QS1)Safeguarding & Whistleblowing (Safe QS3)Reliability & CommunicationWhat You Can Expect from Mutima Care (Duty of Care)Induction & TrainingSupervision & SupportHealth & SafetyOut-of-Pocket ExpensesInsuranceConfidentiality Declaration- Select -During your time as a volunteer, you may hear, see, or read confidential information about service users, staff, or the business. I agree that I will not disclose any such information to anyone outside of Mutima Care, either during or after my time as a volunteer, unless it is a safeguarding concern reported to the management.Social Media Boundary- Select -I agree not to post any information, photos, or details identifying service users or their homes on any personal social media platforms.SECTION 3: Emergency Contact DetailsEmergency Contact NameRelationship to Volunteer- Select -Spouse / Civil PartnerParent / GuardianAdult ChildSiblingExtended Family MemberFriend / NeighborOtherEmergency Contact NumberVolunteer Declaration- Select -I have read, understood, and agree to adhere to this Volunteer Agreement and the boundaries set within itCoordinator/ Supervisor Declaration- Select -On behalf of HeartReach Group Ltd, I welcome this volunteer and commit to providing the support and induction detailed above.Next Review Date:Submit Form
