Meeting the Challenge heart of kent hospice Annual Review 2013-14 Making every day precious Making every day precious Page 1
Contents About Us... Page 3 About Us Our Care... Page 6 Education and Training... Page 12 Our People... Page 14 Our Supporters... Page 16 Our Finances... Page 18 Heart of Kent Hospice is an independent local charity. We are here to provide skilled, high quality care for all those facing the challenge of a life limiting illness. We work in Maidstone, Aylesford, Tonbridge and Malling and the surrounding villages. Our care is tailored and individualised for each patient and their family and is provided in their own home or in the Hospice to improve their quality of life. Our Thanks... Page 19 Our Services 10 bedded Inpatient Unit Day Therapy care (Magnolia Place) Drop-in Centre Care at home Physiotherapy Occupational therapy Complementary therapies Social work services Bereavement support Education and training Welfare advice Art therapy Chaplaincy Page 2 Annual Review 2013-14 Making every day precious Page 3
From the Chairman and Chief Executive A Gift to the Community Welcome to our Annual Review. We are delighted to be able to share with you a year in the life of the Hospice and the progress we have made in meeting the challenges presented to us. One such challenge was the unexpected departure of our Chief Executive following a serious accident. Following this sudden and unexpected event, the staff and volunteers responded magnificently to ensure the Hospice continued to function normally with minimal impact on our service delivery. As the story told in this review demonstrates, this was achieved admirably and our thanks and appreciation are expressed to all for their commitment, loyalty and hard work throughout the year. As ever, we have had the challenge of securing our income in a time of continued financial uncertainty. We are most grateful for the continued support from you, our local community, and to our local NHS Clinical Commissioning Group for maintaining their grant to us. The Hospice could not survive without these streams of income. Getting to know, and adapting to the style of, a new interim Chief Executive has also been a new challenge for staff and trustees. This has inevitably brought a different perspective and insight for the Hospice which has resulted in a variety of changes. Throughout this unsettling period we have stayed focused and continued to deliver the service expected of us a true testament to the quality of our staff and volunteers. We can all be entirely confident that in 2013-14 our most important challenge of staying true to our purpose has not only been met but surpassed. Providing exceptional care for people with a life limiting illness is at the very heart of what we do, and over the last 20 years we have built a strong reputation within the local community for the quality of our care. But we don t achieve this in isolation. It is through our many important relationships and partnerships that we have been, and continue to be, so successful at what we do. Professionally, the best interests of the patients are met through working well with all those involved in their care. This ensures that care is timely and reliable. Likewise we are keen to work with, and provide support, to those in our locality who have the responsibility for making funding decisions about end of life care. This is an unenviable task in the light of massive NHS change and reorganisation. But we remain committed to working constructively and creatively with all those who are striving to achieve high quality end of life care. Our Hospice partnerships are many and varied, reflecting the community we serve. We enjoy the business partnerships we are involved in, are pleased with the support of our local media and are delighted by the enthusiastic support from local schools. We are what we are because of you, and the feedback we receive from those in our care reflects the confidence and faith you have shown in us. It is with gratitude and satisfaction that we look back on this past year and it is with hope and confidence that we look to the next. Vicki Morrey Chief Executive Anthony Moffatt Chairman This year quite a number of new staff and volunteers have joined our workforce. Welcome! The team work, which is evident throughout the Hospice to keep it running efficiently, is to be commended. Patient care always being the first priority. This would not be possible, however, without our army of volunteers providing their gift of time both in our shops and in the Hospice. Improvements to the Hospice building are well in hand, made possible by a Department of Health grant of 370,000. I have been looking at the very first Hospice newsletter produced in 1991 and goodness, what a huge amount we have achieved since those early days, including massive improvements to the building and many more shops. As ever I wish to thank everyone, in whatever capacity for their care and time given to the Hospice. Marianna, Viscountess Monckton of Brenchley Patron Page 4 Annual Review 2013-14 Making every day precious Page 5
Our Care The Caring Challenge We look after patients and their families at their most vulnerable time; therefore it is important for them to remember and treasure those precious last days. Beverley Lebrette, Ward Manager We cared for 787 patients in their own homes in 2013-14 As soon as we arrived at the Hospice we were greeted with smiling, caring faces. Our Work in the Community Thank you for your help, encouragement and support, warmly given to me when the going got tough. I am privileged to have met such special people. 525 new patients were referred to our care at home service It can be a very stressful and emotional time for patients and their families living with a life limiting illness and at times can feel overwhelming. Our specialist teams not only provide skilled care, but they also support patients to make plans for the time remaining and help them to feel more positive about the journey that lies ahead. The majority of our patients have cancer, but we also care for patients with other life limiting conditions including heart failure, motor neurone disease, long term lung conditions, neurological conditions, renal failure and dementia. In 2013-14 we continued to provide the best possible care for people with a life limiting illness, with the emphasis on supporting them in the place of their choice, whether this is at home, in a care home or in the Hospice. To meet the challenge of caring for more patients with a range of complex needs, last year we focused on developing the expertise of our specialist teams in key disease areas through our education and training programmes. turned to us for their 968patients care in 2013-14 an increase of 83 on the previous year The majority of our patients will be cared for at home by one of our Clinical Nurse Specialists. They make it possible for people who wish to die at home to spend the last days of their life in a caring and familiar environment. Available seven days a week, our specialist nurses work to improve the patient s quality of life, helping to relieve any distressing symptoms and giving peace of mind. They also offer warm and caring support to their families during this challenging time. Keen to respond to the challenge of caring for more patients in their own homes, last year we invested in the recruitment of two additional Clinical Nurse Specialists to enhance the Community Team. We responded to 13,818 telephone calls, giving advice and assistance Page 6 Annual Review 2013-14 Making every day precious Page 7
Inpatient Care We provide expert care for 10 patients and their loved ones at any one time in our Inpatient Unit, 24 hours a day, every day. Within a warm and caring environment, patients can feel safe and comfortable, and their families can relax in the knowledge that those close to them are treated with compassion, dignity and respect. Patients receive expert medical and nursing care to control their symptoms, improve their quality of life and provide rehabilitation to enable them to return home if possible. Some of our patients choose to spend their last days in the Hospice under the compassionate care of our specialist staff. Building work began at the beginning of 2014 to convert a four bedded ward into three single en-suite rooms which will provide increased privacy and dignity for patients admitted to the unit. Despite having fewer beds available for patients during this time, with the challenge of managing admissions and discharge, we have seen a minimal impact on our waiting times. Staff in the Inpatient Unit have worked tirelessly to ensure that patient care was not compromised during this period of disruption. Day Therapy Care We 71 helped patients return home or to a care home, following the management of their symptoms The average length of stay in our Inpatient Unit was 12days for 2013-14 93 patients attended our Day Therapy care in 2013-14 Day Therapy Care provides patients and their families with access to a range of services including complementary therapies, which are provided by Hospice staff and volunteers. Here they can receive support to enable them to continue to lead an active and independent life. Work to extend the Day Therapy area began earlier this year as part of the Department of Health grant, and once completed will provide a light, spacious and welcoming environment for patients. During the building work we temporarily relocated Day Therapy to the Hospice garden room and coffee shop area, as it was important to continue to offer a limited day therapy service for our patients to enable them to access the support they need. Page 8 Annual Review 2013-14 Terry s Story Terry Davis was diagnosed with Motor Neurone Disease four years ago and regularly attends the Hospice for Day Therapy care. It s very positive and you get the chance to meet and make friends with people that you would not normally meet who have similar problems. The staff do a fantastic job and I particularly enjoy the massage sessions as it helps with my condition. Family Support Losing a loved one can be a very traumatic and distressing experience and that is why our specialist team is on hand to offer practical and emotional support, as well as spiritual care to families and friends. They are also able to help with practical issues including advice on benefits, housing or finance and can provide counselling and bereavement support to people of all ages. Many of our patients are unable to work due to ill health and this puts additional financial pressures on their families who are already facing a stressful and challenging time. As a result, we plan to recruit a Welfare Advisor to provide specialist advice to our patients and their families on benefits and other financial help. Following training in the therapeutic use of the arts, our Specialist Social Worker set up a group called Making your Mark which provides patients with the opportunity to share their experiences and feelings through the use of a variety of art mediums. 775 complementary therapies were enjoyed by patients and their carers 1,042 counselling sessions were offered to patients and their families in 2013-14 Making every day precious Page 9
Challenges met... Standards of Care Praised The Care Quality Commission (CQC) made an unannounced visit to the Hospice in December 2013 to carry out an inspection of our patient services. We are delighted to report that we met all the high standards of care required. This is a testament to the dedication, skill and expertise of our clinical staff and volunteers. Working in Partnership The recent NHS changes have presented real challenges for the Hospice and it is important that we are responsive to the new ways of working and make the most effective use of our resources. Earlier this year we conducted an online survey to gain feedback from local healthcare professionals about our services and this will help to inform our future strategic direction. Hospice User Group (HUGS) Our Hospice User Group meets regularly to provide valuable support and feedback on the work of the Hospice. This year members have been involved in the broader challenge of helping to raise public awareness about end of life care and took part in media interviews during Dying Matters Week. The Dementia Challenge We know that in future years there will be an increase in the number of patients diagnosed with dementia and this will have an impact on our existing services. To meet this challenge, earlier this year we created a new role of Dementia Nurse Specialist to provide specialist care and support to staff, patients and their families. Thanks to funding received from NHS West Kent Clinical Commissioning Group we launched a new dementia training programme for health and social care workers, carers and volunteers to improve the standards of care for people affected by dementia and their families. Designed and delivered by the Hospice s own specialist palliative care team, these workshops were launched in March 2014 with a further 11 workshops planned throughout 2014-15. Building a Hospice for the Future This year got off to an exciting start with the beginning of a 370,000 building programme to extend and improve the Hospice facilities, thanks to a successful grant application to the Department of Health. These improvements to the Hospice facilities will help us meet the growing demand for Hospice care in the future. The works include the conversion of the Inpatient four bedded room into three en-suite patient rooms and the extension of the Day Therapy area and we are looking forward to completion of the work in autumn 2014. Only 23% of our funding comes from the NHS Future Goals Reach more people who need our care Improve our therapy support enabling people to achieve their maximum potential and live as well as possible Create a dynamic, flexible day service in our newly refurbished Magnolia Place, providing rehabilitation, art and music therapy, welfare advice, counselling support, complementary therapy, carer support, dementia care and bereavement care Develop more volunteer-led services including a community rehabilitation service Expand the skills and develop the practice of our Inpatient nursing team enabling them to confidently care for the changing needs of our patient population Page 10 Annual Review 2013-14 Making every day precious Page 11
Education and Training The Learning Challenge At Heart of Kent Hospice we pride ourselves on being a centre of excellence for high quality end of life care. We believe it is important, therefore, to share the expertise we have gained with other health and social care professionals and support them in meeting the challenges they face to improve standards of care for patients at the end of their lives. That is why we offer a range of courses to the wider community on issues around palliative care which are delivered by our team of experts, or by experts from other organisations. We also provide specialised training for our own staff to share knowledge and develop best practice. Excellent course. The case studies prompted examples and discussion drawing on people s actual experiences. In 2013-14 we delivered 15 external courses to healthcare professionals A total of 109 people attended our courses from a range of local organisations Six Steps to Success Last year we successfully completed further training for staff working in local West Kent nursing and residential care homes on the Six Steps to Success programme in Palliative and End of Life Care. We were pleased to include a local care home for adults with a learning disability, following a call for help. As a consequence we will be launching a pilot bespoke training programme in partnership with the Community Learning Disability Nursing Team in the autumn 2014. Placements The Inpatient Unit continues to provide placements for external healthcare professionals to spend time at the Hospice and gain valuable knowledge and skills which they can take back to their own workplace. We have supported medical and nursing students at various stages of their training. In January, Richard Macintyre, Head of Care and Welfare at Avante Partnership joined us one day a week as part of a year s placement to update his practical nursing skills. He said: It has been one of the most fulfilling experiences I have had since qualifying as a Registered Nurse. I m learning about new approaches to life limiting illness and compassion in care, which I can take back to Avante. The course was very relevant to my work practice. Link Staff Programme We continue to develop our Link Staff programme within the Hospice to enhance specialism for patients in specific disease groups. All clinical areas now have staff members with a sub-specialism who act as a resource in their field and contribute to the Hospice s educational programme. Page 12 Annual Review 2013-14 Making every day precious Page 13
Our People The Resources Challenge Volunteers Volunteers continue to be the backbone of our organisation and over 600 part-time volunteers generously give their time to support the Hospice. They are involved in every aspect of the Hospice s work from making teas for patients on the ward, working in our shops, maintaining the Hospice garden, greeting visitors on reception, supporting our fundraising events, to counselling bereaved families. With new developments in services across the Hospice, including the opening of further shops, we are focused on meeting the challenge to recruit more volunteers in the different roles, especially outside our geographical area. We recruited 121 Valuing our Staff and Volunteers new volunteers to work across the Hospice teams in 2013-14 25 volunteers were recognised for their 20 years service to the Hospice Staff and volunteers from Heart of Kent Hospice were recognised for their service at a special awards ceremony held at Oakwood House on 4 th June 2013. The Lady Monckton Awards Ceremony is held every year during National Volunteers Week to celebrate the huge contribution staff and volunteers make in helping the Hospice to deliver vital care to its patients and their families. Our Staff In February 2014 we saw the departure of the Hospice s Chief Executive, Kate Bosley, who suffered traumatic brain injuries following a cycling accident, and we are grateful to Vicki Morrey for stepping into the role of Interim Chief Executive in June 2013, to provide continued leadership during a time of great change for the Hospice. We agreed last year that to meet the growing demands of our local community for Hospice care, we needed to invest in our services and recruit additional skilled staff. With the focus on raising our profile and increasing awareness of our services, we recruited a Communications Manager to work across the organisation. Three new appointments were made within the Fundraising team to take forward our donor development programme, improve our supporter database and increase our income through trusts and foundations. As part of the challenge to build on our community engagement and raise more funds for the Hospice, we actively recruited to the post of Director of Income Generation. Future Goals Ensure appropriate staffing levels and workloads through review and analysis Encourage feedback and engagement via staff and volunteer surveys and feedback Continue to hold staff meetings for information sharing and discussion Develop more opportunities for volunteer support Develop more volunteer-led services To care for more patients in their own homes, two additional Community Nurse Specialists were appointed. This is one of the most important functions within the Hospice as the Community Nurse Specialists are often the gateway for patients into the care of the Hospice. Knowing and understanding our patient activity is vital in assuring us that we are providing the optimum care for the optimum number of people. The decision to recruit an Information Officer was made to not only provide us with accurate information to plan and prioritise our work and resources, but to ensure we will have reliable data with which to negotiate with future funders and commissioners. We have introduced new payroll arrangements for staff, which has worked well and delivered efficiency savings. Plans were made to transfer the Hospice catering provision in-house and recruit a Head of Catering and Hospitality to increase our income streams and develop our hospitality function. Invest in training and developing our staff in order to equip them with the skills necessary for now and the future Ensure that staff feel valued and appreciated, learning from mistakes and responding to feedback Page 14 Annual Review 2013-14 Making every day precious Page 15
New Shops Our Supporters The Funding Challenge It is the role of the Income Generation team to make sure we raise enough funds year on year to help the Hospice meet the end of life needs of our local community. It costs over 4m a year to run our services. We currently receive an NHS grant of around 900,000 each year, which means we rely heavily on donations and fundraising from our local community to help us raise over 3m every year. It is due to the generosity of our supporters that we have been able to achieve so much in 2013-14. It is their stories that highlight the commitment, spirit and passion that make our supporters so very special thank you to each and every one of you. In 2013-14, we saw the ongoing success of our flagship events Bluebell Walk and Moonlit Walk and we introduced a new Cyclo Sportive event which raised 25k in its first year. 1,859 more players joined our Hospice Lottery in 2013-14. Our players benefit from the chance of winning a weekly prize of 1,000 whilst at the same time creating an important, regular income stream for the Hospice. We received over 740,000 in donations and Gifts in a Will in memory of someone who was cared for by the Hospice. These significant donations continue to play a vital role in ensuring we can provide the best care for people at the end of their life in the heart of Kent, not only today, but also in the future. Thanks to the generous donations of items from the local community, our enthusiastic volunteers and our loyal customers, our 13 Hospice shops raised over 1m in 2013-14. In July 2013 we opened a new shop in Coxheath which specialises in furniture, homeware and accessories. It is adjacent to our existing shop which is well supported by the local community. This additional space has enabled us to provide a greater selection of furniture and household items for our customers. Income from the Lottery increased by 56k on the previous year Shops turnover increased by 7% to just over Future Goals 1m Continue to expand the number of shops Seek to expand our successful Coffee Shop in King Street, Maidstone Invest in the infrastructure necessary to achieve maximum return Grow voluntary income by 19% in 2014-15 We claimed 36k in Retail Gift Aid in 2013-14 Open two new shops outside our catchment area Introduce a new, annual running event for the Hospice Reach our target of 7,000 Lottery players in 2014-15 Increase trust and statutory sources of income for the Hospice Page 16 Annual Review 2013-14 Making every day precious Page 17
Our Finances The Financial Challenge It costs Heart of Kent Hospice over 4m each year to deliver its services. Just over 23% of our income comes from the NHS which means we must raise over 3m each year to continue to deliver our patient and family services free of charge. This balance must be raised from grants, legacies, trusts, our community, local businesses and through our charity shops and lottery. Currently, the Charity s free reserves amount to 1,691,145 and represent just over five months running costs. The Hospice holds free reserves to improve both the financial security and the operational flexibility of the Hospice. Where our money came from 2014 Heart of Kent Hospice Consolidated Total Income 4,280,195 6.1% 262,776 Dept of Health Grants 23.1% 986,732 Grants and Recoveries 0.3% 13,183 Investment and other Income 30.7% 1,311,950 Voluntary and Fundraising Income 14.9% 637,976 Legacies and Trusts 24.9% 1,067,578 Charity Shops How we spent our money 2014 Heart of Kent Hospice Consolidated Spend 4,178,657 (Previous year %) 1.0% 42,231 Education Department 13.3% 557,722 Community Services 4.8% 199,711 Daycare and Support Therapies Our Thanks We would like to thank everyone who supported the Hospice this year. Your contribution, whatever size, makes a real difference to the patients we care for and their families, whether at home or in the Hospice. Thank you for your continued support. Trustees Tony Moffatt Chairman Vicky Stoodley Company Secretary Mike Startup Treasurer Peter Brice Tim Cathcart Karin Clement Charlie Hendry CBE Elizabeth Howe OBE 0.2% 6,933 Governance Costs 14.4% 603,050 Raising Funds and running the Lottery 20.7% 865,966 Charity Shops 45.5% 1,903,044 Inpatient Services Roger Sykes Jenny Thomas Dr Paul Unwin Nigel Wheeler Page 18 Annual Review 2013-14 Making every day precious Page 19
Making every day precious We serve a population of 220,000 people We care for nearly 1,000 patients and their families every year Our services are free It costs over 4m to run the Hospice Only 23% of our funding comes from the NHS We raise just over 3m from our local community each year At any one time we care for up to 350 patients and their families at home or in the Hospice Contact us Heart of Kent Hospice Preston Hall Aylesford Kent ME20 7PU 01622 792200 Fundraising 01622 790195 Stay in touch @heartofkenthosp www.hokh.org Registered Charity No. 298164 Page 20 Annual Review 2013-14