St. James s Place Foundation Grants 2015 Hospice Enabled Dementia Care Guidance for completing the application form You are strongly encouraged to read the information and criteria notes before completing all sections of the form. Some questions have a limit on the number of words so please be concise. As part of your application, we also require: a statement of support written and signed by the chief executive, clinical director or equivalent addressing the four bullet points in section five letters of support from any significant partner organisations. When completing this form, you may find it helpful to refer to the publication Hospice Enabled Dementia Care - the first steps. The document is available to download from Hospice UK s website. Section 1: contact and organisational details Provide contact details for the hospice and the person responsible for submitting this application, we may need to contact this person for further information. Section 2: project details 2.1 Project name (25 words maximum) 2.2 Project summary (75 words maximum) Provide a very short summary of your project, giving brief details of what you are going to do and why. If successful, this summary may be used to publicise your project. 2.3 Project description (200 words maximum) Describe your project. We are particularly interested in: your main aim and objectives. You may wish to show how the project builds on awareness of current national developments the activities you will undertake to achieve them. Please refer to the programme information and criteria for further details of what applications will be assessed against. Hospice UK, Hospice House, 34 44 Britannia Street, London WC1X 9JG Tel: 020 7520 8200 Fax: 020 7278 1021 Email: info@hospiceuk.org www.hospiceuk.org Company Limited by Guarantee, Registered in England and Wales No. 2751519, Charity registered in England and Wales No. 1014851 and in Scotland No. SC041112. VAT No. 731 304476, registered office as above.
2.4 Please give an estimate of how many beneficiaries during the lifetime of the grant your project will reach? Beneficiaries will be counted as people with dementia. 2.5 How will the proposed work improve the experience of people with dementia and their families? (100 words maximum) 2.6 Project need Tell us why there is a need for your project. For example: How did you identify the issue(s) you wish to tackle in your area? Who has been involved in the development of thinking about this proposal? Have service users, volunteers and other stakeholders had a say in this process? We are looking for specific references and strong evidence of need for your proposed work in your area. This could include consultations, mapping exercises, national strategies or any other research. 2.7 Please describe how your project would be nationally relevant. (100 words maximum) The Grants Committee will prioritise innovative projects they feel would most likely contribute to national learning. To support this, your application should demonstrate how your project would build on established practice and could be replicated nationally. 2.8 Outline how the proposed work would be part of the strategic commitment to dementia care by your organisation. This grant programme aims to support hospices as they try innovative approaches to further develop the care offered to those with dementia and their families. It is important that projects should have support from their own organisation and that the work fits within the organisations strategic thinking. 2.9 How will other organisations be involved in your proposed work? We expect to see evidence of partnership working, especially those that encourage seamless provision of care for patients with dementia, their families and carers. Identify the main organisations involved in the project, their role and their contribution, as well as the rationale for their involvement. You must send letters of support from any organisation with whom you propose a significant partnership. We will not consider your application without this.
2.10 What are the project activities and what do you propose to achieve over the 18- month grant period? Examples of what this might include: development of a new service or adapting existing model of care to meet the needs and preferences of people with dementia and their families building skills, knowledge and confidence of hospice staff including volunteers to care for people with dementia working in collaboration with dementia experts to increase reach to people dying with dementia and their families 2.11 Overall outcome of the project (200 words maximum) Briefly describe what will be the result of the project once it has been completed. Identify three outcomes you hope to achieve from your project and when you plan to achieve them. Outcomes are the changes or difference that your project can make in the longer term once it has been completed. They should be measurable and achievable. For example: the difference your project will make for the beneficiaries the amount of time it will take to see those differences the number of people with dementia that have benefitted from your project the findings of this project will be reported back to, and inform the development of, the hospice business plan/strategy. If successful, we will ask you to report on how you have progressed on meeting these outcomes, so it is best to be realistic. 2.12 How will you monitor and evaluate the difference your project has made? Describe how you will monitor and measure the effectiveness of your project in achieving your identified outcomes. This could include activities such as: data gathering to record numbers of users capturing the patient/carer experience observations from staff and volunteers 2.13 How will you sustain the work beyond the life of this grant? If it is a time limited project, explain why We are interested to know your initial thoughts on how the work might continue in the longer term, once the grant ends.
2.14 Have you identified any potential risks in the implementation of the proposed work? If so, what are they and how will they be addressed? We are keen to ensure the success of your proposed work, so encourage you to think about any potential risks and how you would address them. These could include: difficulties in establishing/maintaining partnerships recruiting staff delays in releasing the applicant from their duties to enable them to undertake the work 2.15 How do you propose to disseminate the lessons from your project? (100 words maximum) How would you disseminate the learning i.e. what you did and how you did it, in order for other hospices to replicate your model? Section 3: project costs Provide a detailed breakdown of the costs of the project showing how you determine the total cost. It should be clearly explained how any items budgeted for, particularly training and administration costs, are directly related to achieving the project outcomes. Your application will not be assessed without a detailed breakdown. You can apply for a major grant of up to 40,000. It is expected that the majority of the grant would go towards implementation costs for the new service. However, a range of different items should be budgeted for and all must be relevant to the project. You can apply for a maximum of: 1,000 for course/conference attendance 500 towards conferences to disseminate work 500 for IT equipment. Please note, if successful in your application, you will be required to attend a Project Lead Day in London. You should allow for the cost of travel for this as part of your budget. Please confirm that at least 5% of the project costs have been provided by your organisation. This can come from reserves or other sources of funding. If any other funding has been secured, please state how much it is and from where. State the number of months running costs that your hospice holds in free reserves. Please refer to your most recent audited accounts. Hospices free reserve levels may be taken into account when considering applications to the programme if there proves to be a high level of competition for funding. There is space on the form to provide additional information about your organisation s financial position if necessary.
For the purpose of this grant programme: free reserves are defined as all reserves with the exception of endowed or restricted funds and any reserves represented by property running costs are defined as total expenditure as per the most recent audited accounts. where the hospice operates one or more trading subsidiaries, the figures are to be based on the consolidated levels of reserves and expenditure for the group. Value for money will be taken into account when assessing applications. Please state whether you intend to appoint/second a new member of staff or backfill to release an existing member of staff and whether you will be undertaking the work full or part time and how much time per week you anticipate spending on your proposed work. Section 4: timetable and comments Please provide a simple timetable, highlighting significant stages in the delivery of your project. Please be realistic as this timetable will enable us to monitor your progress and so better support you in your work. We reserve the right to withdraw funding 18 months from the award date, so it is important that you keep us up to date with progress. Any other comments There is space for any additional information not already mentioned in the application form, which will enable us to fully consider your request for funding. Section 5: organisational support The lead applicant could need dedicated time to undertake the proposed work and full support from the organisation to execute necessary change to practice. Therefore, we ask you to state the name and contact details of the organisational support: the chief executive, clinical director or equivalent of the hospice. They also need to write and sign a statement of support on hospice headed paper, stating: what support will be provided to the applicant, such as resources, project management support and any arrangements for mentorship/supervision that 5% of the project costs will be funded by your organisation. This helps to re-affirm the commitment of the organisation to the project both financially and at a strategic level that this work will make a difference in practice and that the organisation will take responsibility to review the progress of the project to ensure that change is effected how the proposed work fits with the strategic direction and business plan of the organisation.
Submitting your application The application form can be submitted online. By submitting the form online, you confirm that you accept all of the terms and conditions of the grant as indicated in the grant application form. In addition, send by post or email (scanned copies) to the grants team: a signed statement of support from your organisation on headed paper signed letters of support from partner organisations any other supporting information. Deadline for submitting an application and supporting documentation is 15 May 2015. Timetable An outline timetable for the programme is given below. 27 March - Open programme 15 May Deadline for submission of applications Mid June (date TBC) Major Grants Committee meet to allocate funding (incl SJPF representatives) End June all applicants to be notified of decisions October (date TBC) Project Lead Day End December First progress report due from grantees