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it’s quite a story

Annual Report 2018/19 FOR THE YEAR ENDING 30 JUNE 2019 Annual Report 2018/19


caring. our touching


Elizabeth Knox Home and Hospital

Annual Report 2018/19 FOR THE YEAR ENDING 30 JUNE 2019

the story of 100 years


the eden alternative story


the short story of 2018/19 6 chairman’s report


ceo’s report






Annual Report 2018/19

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friendship. our enduring

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Elizabeth Knox Home and Hospital

Everyone has a story It starts before we’re born and we carry it through life adding details. Our stories continue right past our own lives and into the future. Needless to say, we think individual’s stories are important. They inform why we are all as we are. At Knox, they inform how we can understand and be of service to residents. Knowing our resident’s stories is one thing, but adding to them is even more meaningful for residents, their families and the Knox team. Life at Knox is an opportunity to do more. Possibly even more that residents may have been used to in the past. And then there’s the story of our founder Elizabeth Knox: She died 111 years ago, knowing there was more she could do with the wealth she and her husband had accumulated. Her generosity of heart and vision to leave a bequest to build and endow a hospital and home was an altruistic act with enduring benefits over more than a century. Since 1911 when the Knox Home Trust Board was formed, the not-for-profit Elizabeth Knox Home and Hospital has been caring for elders and disabled individuals. We proudly continue the valuable work that Elizabeth Knox started. That’s just part of our amazing story.

Annual Report 2018/19

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A story of transformation Much has changed since Knox began serving the community 108 years ago. The needs and expectations of residents and their families have advanced through the decades. Knox has continually matured and developed through these years too. Significantly though, in 2009 we adopted the Eden Alternative, a progressive philosophy of care dedicated to placing elders at the centre of all we do. The Ten Principles of the Eden Alternative uniquely guide us to transform the lives of our residents and team. We create an authentic caring home where our focus is combating loneliness, helplessness and boredom. Resident lives are enriched by promoting health, wellbeing and growth through meaningful activity. Companion animals, children and plants are also part of our daily lives. The Eden Alternative is perpetually central to the development of the Knox care model and influences all facets of Knox Home including future development. Knox is a lively and spirited place with evidence of more spontaneity, increased care and family engagement. Ours is a rewarding story of innovation and vision.

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Elizabeth Knox Home and Hospital

family. our secret

Annual Report 2018/19

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Merging of resident-focused teams The Lifestyle & Leisure, Community Partnerships and Volunteer teams merged to more easily collaborate and provide integration for meaningful activity, community engagement and the creation of an increasingly supportive environment for volunteers.

Resident activity grown The number of resident outings, activities and relationships formed in the wider community has increased substantially, reflecting the additional coordinated approach by our Lifestyle and Leisure team.

the short story of



Elizabeth Knox Home and Hospital

Strong training trend continued Investment in team and volunteer development remained a vital part of our continuing activity. 30 new Eden Associates have been trained. For volunteers there has been a wide range of personal and professional opportunities provided.

New Totara and Puka Homes plans finalised Plans were completed and building consents have been sought for the new 67-bed Totara Home which will be built on the site of the existing Totara and Puka Homes. Those residents currently in these spaces will be moved into the soon-to-be-built Puka Home which will be built on new ground between the main carpark and Griffin Avenue.

Plans for Occupation Right Agreements agreed Of the 21 rooms in Puriri Home, it is planned that there will be a mixture of 10 Occupation Right Agreements (ORA) on level 2 and 11 premium room arrangements. The ORA rooms will be subject to Retirement Villages Act requirements. The registration process was initiated.

Ongoing quality improvement initiatives

Puriri Home complete and open Construction of the new 23-bed home through the year was challenging with the Ranfurly Road access obstructed by a major year-long Watercare construction project. Featuring spacious and innovative living spaces, Puriri Home was officially opened in June to enthusiastic reviews.

Many quality advances across Knox have been made including reduced home sizes to 21-22 residents. This has increased the number of Registered Nurses with a noted reduction in resident falls. We’ve introduced a 10-Point Promise to Welcome New Residents and Staff and have rolled out VCare multidisciplinary team progress notes which all impact positively on resident care and wellbeing.

Annual Report 2018/19


chairman’s report

Dr Alastair MacCormick CHAIRMAN

While reviewing the past year, I have been struck by the extraordinary level of activity every day at Knox. Knox accompanies the highest quality of care for the health of our residents with a wide and vibrant range of activities and support, all designed as an antidote to the loneliness, helplessness and boredom which can plague elders. One of the keys to achieving this is the Knox volunteer programme. Each year many hundreds of friends, relatives and students spend time with our residents. There are so many we have a Volunteer Coordinator on the team, who trains them prior to starting, guides their activities and organises events to acknowledge the help given so generously. An innovation this year was a Volunteer Social committee, to plan events for the volunteers themselves. 8

Elizabeth Knox Home and Hospital

From something as simple as a chat, our volunteers do many of the little things that make a difference to everyday life. They also organise and lead events, such as regular concerts and musical occasions like a drumming session for more than 50 residents! Often students give after-school performances on the piano and other instruments that can be quite spontaneous. Knox residents are involved outside their Home. This year, weekend outings became well established, with visits to craft markets, opera and parks. Other outings included Operatunity, the Symphony Orchestra, Auckland Embroidery Guild, Cornwall Park, a vintage automobile display, Jazz in the Park, University of the Third Age, Parnell Rose Gardens, Christmas lights displays, Treaty of Waitangi Expo, the Pah Homestead, Ambury Farm Wetlands, tomato picking in Mangere, the Makaurau Marae in Mangere, beaches and a series of visits to Stardome for lectures and viewing the night sky. Residents themselves volunteer at the Epsom Library, helping migrants with English language acquisition and at the Epsom Kohia Terrace School, with additional reading tuition. Back at Knox, there are many clubs and activities such as Culture and Language, Te Reo Maori, Discussion facilitated by volunteers, Mah Jong, Community Claymaking with

artists and religious services. And residents keep their gardens going with a summer competition for sunflower growing. To coordinate all these activities together, the previously separate teams for Volunteering, Community Partnerships, and Leisure and Lifestyle were brought together to bring about collaboration and integration around meaningful activity, community engagement and creation of an increasingly supportive environment for volunteers. Another striking aspect of the Knox year is a clear focus on education and training for all staff and volunteers. There are regular sessions on the Knox Way for new and long-standing teammembers and on the Eden Alternative that guides care at Knox. In June, 25 Knox team members and two residents completed Eden Associate training. Nurses and Care Partners are also supported in further education and training to gain higher qualifications. Puriri Home was blessed and opened in May 2019. This added 23 high quality care beds in two homes on the corner of Market and Ranfurly Roads. The building established new standards for Knox, being designed with many improvements to combine excellent care with the feeling of being in comfortable, homely surroundings and living in a small community.

Bright, modern and generously proportioned, Puriri Home offers residents hospital-level care with atmosphere, comfort and independence.

The brilliant exterior design gives a strong street presence to Knox at a busy corner and thoroughfare. The next stage is to rebuild the Totara wings, with current residents of these areas being accommodated in a temporary building on Griffin Avenue that is fully approved for hospital care. The Trust’s financial statements, published on the New Zealand Charity Services register www.charities.govt.nz (Reg. No. CC20460), record another excellent year for Knox.

Knox Trustees give their time voluntarily. The Board has committees for Finance, Investment, Planning, and Quality and Risk, which meet bi-monthly. The Board meets monthly for lively discussion and decision. We record appreciation for the Trustees’ service to Knox, always given with enthusiasm and commitment to the ideals and mission of Elizabeth Knox’s trust.

The all-round quality of care for our residents is a tribute to CEO Jill Woodward and her outstanding team, who go beyond the call of duty to put the residents first. Knox has an amazing team of doctors, nurses and care partners, supported by allied health care professionals. Annual Report 2018/19


life. our inside

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Elizabeth Knox Home and Hospital

Annual Report 2018/19

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team. liz’s story Known to everyone at Knox, Liz has an enthusiastic sparkle and amazing smile. She grew up in Tonga, the youngest of 14 children. Her family relocated to New Zealand when she was 13. Then quiet and shy, she attended Manurewa High School. She began working with her church pastor Dad, at Farmers and then assembled cars for Nissan before leaving for a UK working holiday. Joining Knox as a Care Partner in 1997 was a turning point for her. Here she met future husband Robert who was visiting his cousin who worked in the Knox laundry. Liz left Knox after six years. She and Robert had four sons while Liz also cared for her unwell Mum. Liz returned to Knox in 2013, first as a Care Partner then for the last three years, a Lifestyle and Leisure Care Partner. Liz has reflected on her current role and her own growth during this time: She shares new experiences with residents, learns together with them and visits places she would otherwise, never have visited. This experience has changed her view on aging. She has witnessed the re-engagement of residents who themselves volunteer in the community. Liz makes a great contribution to the lives of residents in many ways and one most significant skill is her ability to set the bar high for residents by focusing on what residents can do, not what they can’t do.


Elizabeth Knox Home and Hospital

chief executive’s report A positive start to a busy year

Jill Woodward CEO

The Knox community started this financial year on a very positive note when we were again confirmed as ‘Master Gardeners’ following the Eden Alternative Community visit in June. These visits are great opportunities to see the community you know well, through the eyes of visitors. The positive feedback and helpful suggestions offer further strategies for growth of the Eden Alternative. The Eden Alternative community is a worldwide one and as such offers a resident-driven philosophy with a degree of rigor rarely seen in our sector.

Developing the Knox community In May, Puriri Home was finally completed at 2 Ranfurly Road and the blessing and official opening celebration took place the same month. The construction coincided with a large WaterCare infrastructure project which has resulted in a year-long road closure and much disruption to the neighbourhood. Puriri is a beautifully designed home with generous, light-filled rooms and shared living spaces, offering wonderful neighbourhood views for 23 new residents. This year we have also commenced the process to register as a

Retirement Village. The rooms in the upper level of Puriri Home, Ruru Home, are designated as Care Studios. These rooms are offered under the terms of Occupation Rights Agreements. They are certified by the District Health Board (DHB) to provide rest home and private hospital level of care to residents over 70 years of age having been assessed as requiring that level of care. Progress has faltered in the consenting process for the replacement building for Totara and Puka Homes. To date, Resource Consent has been achieved for the new Totara Home. However Building Consent has not. Planning and design of Puka Home, a temporary home to accommodate 37 residents from the existing home, has also been completed. However, Resource Consent and Building Consent have proved to be excessively complicated.

Improving and refining Further integration of technology into care has been a continued focus over the 2018/19 year. We successfully upgraded the Nurse Call system and integration across our communication systems has been trialed and implemented in Puriri and Nikau Homes. Migration to smart phones in place of pagers will further strengthen team communication. Annual Report 2018/19


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Elizabeth Knox Home and Hospital

aging. our growth

Annual Report 2017/18 2018/19

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Resident Rose and volunteer Francis preparing the Mahjong table for their weekly games.

A range of projects led by Margaret Brown have included the development of the utility of VCare, our electronic medical record, and MediMap, our electronic medication management system. Much improved quality and reporting systems including a reduction in manual systems, have been achieved. Our registration with the Auckland Primary Health Organisation (PHO) has been championed by Commercial Manager Dianne Lee and the introduction of MedTech for medical record keeping and communication has also been achieved. The Knox medical team have been central to the development of improved systems for the management of clinical information. Recruitment to the team has continued and later in 2019 we will farewell Dr Ron Hayden as he intends on taking a well deserved 16

Elizabeth Knox Home and Hospital

retirement. Ron has given incredible service to the Knox Community and he will be missed hugely by us.

Counting on the wider community Cultivate, our initiative to raise the visibility, decision-making and influence of Knox elders in the external community has itself become more visible and was the basis of the application for the Westpac Auckland Business Chamber’s Awards in which Knox is a 2019 finalist, results to be announced later in 2019.

Cultural diversity drawing us closer In 2016 we identified the need to develop a greater understanding of each other’s cultures. This focus continues to the present. Residents

and team continue with weekly in-house Te Reo Māori lessons and residents and team were hosted at a Pōwhiri at Makaurau Marae in Māngere. A range of other cultures have been celebrated over the year. And we have been most grateful for the committed involvement of the Epsom Chinese Association at Knox.

Eden Alternative… and a good life Knox commitment to the Eden Alternative has continued and deepened with our ‘Master Gardener’ status retained. The Eden Alternative philosophy underpins all we do and has been central to the development of the Knox care model and to the redevelopment of the site. I am saddened to report that the Knox community lost resident and Eden Associate Roy Johnson this year. Roy had a positive impact on many team members and residents through wise elder leadership, kindness, challenge and a wonderful sense of humour. In June 2019, another 29 Eden Associates were trained in-house including residents Beate and Brother Henry. New Eden Associates make a difference by giving encouragement to residents and guiding Care Partner leadership and decision-making. The Cultivate initiative continues to support the re-engagement of Knox elders in the wider community. This may be through volunteering in a variety of community settings or community-based organisations being involved in the life of Knox. This year, under the wise guidance of Tasha Mekesic, Cultivate and Community Partnerships continue to flourish. Last year we linked the Leisure and Lifestyle team with the Volunteering and Community Partnerships team with Tasha taking a key leadership role. These changes are now well embedded and support our approach to increased resident access to meaningful activities and the development of close

relationships both within Knox and the wider community. Knox continues to welcome New Zealand and International visitors. One example is our well established partnership with SOSU Nord, a vocational and training college for health and social workers in Denmark. The 5-6 weeks Danish volunteers spend with residents offer a rich experience for students and elders alike. We have maintained our focus on ensuring all our new and existing team members are very knowledgeable about the Eden Alternative as this supports the development of creativity, leadership, curiosity and positive action. To date we have trained over 350 past and present team members as Eden Associates. This focus also extends to the training of all volunteers. We have also continued to run free Eden Alternative sessions for the wider community. In addition, the ‘Knox Way’ training continues. It involves eight hours of immersion for all new team members in the way we do things at Knox, with a focus on the Eden Alternative, our history, values, team work and engagement in culture change projects. Weekly Eden Alternative sessions have continued for residents, family and team. Team members have participated in the facilitation of these sessions and we treasure the involvement of families at the twomonthly resident and family meetings which are held in the evening. The theme for the 2018 Annual Ball was ‘Blast from the Past’. The evening was a great success, as was the Children’s Christmas Party. Feedback from new residents and team members about their experience of coming to Knox encouraged us to find ways to honour the ‘New Resident Promise’ and the ‘New Team Member and Volunteer Promise’. Men’s lunches, welcome morning teas and a buddy system are just some of the ways the Knox community ensures everyone feels a sense of belonging.

Count us in As with past years, our team and our model of care continues to evolve. Early in 2019 we identified an opportunity to improve resident care by reducing the size of each home in the older parts of Knox. Puka Home was created, thus reducing the number of residents in each home to 20-22. The care model development is planned to continue over the next financial year to expand Care Partner leadership even further. Registered Nurses will be freed up to oversee and manage the clinical aspects of resident care and Care Partners recognised as the leads in the household.

Telling the story We continue to seek support of funders through telling the Knox story. As a not-for-profit with over 107 years’ service to the Auckland community, we hope to be viewed as a worthy recipient of support.

Volunteers amaze The volunteer team is an integral part of the life of Knox and we recognise the enormous contribution made by each volunteer. From July to June 2019 our volunteers gave a total of 13,625 hours. This represents a huge contribution to residents’ lives and in pure monetary terms has a value of approximately $240,082. The continued commitment of volunteers in the lives of residents is a source of great pride at Knox. Volunteers make a personal and meaningful contribution to companionship at Knox. We now have over 850 volunteers integrated across all areas of the Knox community. Volunteer Coordinator Louise Heijnen and Volunteer Support, Robson Chaves de Silva provide teaching, encouragement and leadership to the incredible volunteer team. Investment in the development of the team continues through the provision of extensive training opportunities for volunteers to Annual Report 2018/19


12% 11%

Fees Young OPERATING Disabled Care


Fees Rest Home Care



FOR THE PERIOD ENDING 30 JUNE 2019 Other income including Grants and Donations


Cleaning & Laundry


Net Operating Surplus




Fees Hospital Aged Care




Resident Care

12% 11%

Fees Young Disabled Care


Fees Rest Home Care



Other income including Grants and Donations


Cleaning & Laundry


Knox Home Trust received $99,588 of grants from: The Trusts Community Foundation for a part-time Volunteer Team Educator Murphy Trust for a mobile hoist


St Joans Trust for a mobile hoist

Resident Care

Lottery Grants Board for weekend Volunteer support Dragon Community Trust Ltd for CP & RN Guide roles ANZ Staff Foundation for training programmes Bluesky Community Trust for Lifestyle and Leisure Care Partners One Foundation Ltd for CP & RN Guide roles and Nurse Educator


Elizabeth Knox Home and Hospital

%are prepared for ensure they Net Operating Surplus future employment and gaining confidence in language and broader % skills. communication



Resident leadership


Resident’s involvement in % recruitment, gardening, residents Administration committee, weekly resident meetings and Food for Thought Group has gone from strength to strength. In addition, ESOL tutoring and other community volunteering are all wonderful examples of resident community engagement. %



Weekly resident’s meetings have continued and are well attended. Resident, family and friend evening meetings which happen twice a month, have also been well supported. I welcome family members and residents at these meetings as our discussions span a wide range of relevant topics

regarding future developments. Consultation with residents and families affected by the impending redevelopment of Totara and Puka Homes has been initiated. We seek many ways to communicate with residents and family. The quarterly KnoxLife newsletter continues and remains a superb vehicle for spreading the Knox message to families, community and neighbours. Speaking engagements across a variety of settings has also strengthened external knowledge of the Knox brand. Knox was promoted on radio, television, print media, in the local community and at conferences.

All things quality All Knox quality initiatives are underpinned by our commitment to the Eden Alternative. The Partial

Joy and Pam attend their regular Connect the Dots sessions with art teacher Lucy.

Provisional Audit carried out in May 2019, prior to opening Puriri Home, was very successful and provided superb feedback on areas of considerable achievement as well as areas of opportunity for further development. Knox continues to maintain its EQUIP6 Accreditation status and the mandatory Certification (mandatory compliance audit for all New Zealand Aged Residential Care Providers). We expect an unannounced audit visit in the latter half of 2019 which will be the mid-point in the three-year audit programme. The Accreditation Audit (EQUIP 6) which is a voluntary Australasian Audit, is due at the end of 2019. Considerable progress continues to be made by the Knox team in reducing the number of policies and documents we have. The Knox project to simplify, streamline and

speed up processes has proven effective to this end. The Knox focus on quality improvement has been further strengthened through the broad spread of team members involved in quality initiatives. Quality and Education continue to be a significant focus. Former educator Shradha Pratap now has the more encompassing role of Quality and Wellbeing Leader and also includes Health and Safety. Resident, family and team feedback increases in value through the wise stewardship of Health Consultant Carole McIntosh. In 2018, Carole reviewed how best to seek feedback and the past methods for undertaking surveys have been replaced with a mixture of short online surveys to measure a specific issue, in-depth one-onone interviews to understand the

experience of residents and more specific questionnaires to determine residents responses to change. This survey method has enabled evaluation to be made pre and post change. Our surveys are carried out in an ongoing way rather than in an episodic fashion which ensures feedback is related to recent, personal experience and helps with planning and change management. I wish to acknowledge the superb Knox team – Board, residents, family, team members and volunteers. The wonderful Knox community is a reflection of the care and commitment of all involved.

Annual Report 2018/19


governance of the Knox Home Trust

Dr Alastair MacCormick CHAIRMAN

Alastair has governance, executive and consulting experience in the business, government, notfor-profit, health and education sectors in Asia, Australia, New Zealand, the UK and the USA. He has held directorships in a diverse range of listed and private companies. Alastair was appointed to the Board in 1982 and in 2017 became Chairman.

Andrew Smith TRUSTEE

Warwick Peacock TRUSTEE

Warwick is a member of the New Zealand Institute of Chartered Accountants. He is now retired after being a principal in Chartered Accountancy practices for approximately 40 years. Warwick was appointed to the Board in 1994 and in 2017 stood down from his role as Chairman which he held since 1997.

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Elizabeth Knox Home and Hospital

Andrew has extensive business experience spanning 19 years with Smith & Smith Ltd, eventually becoming the Managing Director, and then 20 years with Metropolitan Glass which was sold in 2006. Since then, Andrew has become involved with Outward Bound NZ, and Outward Bound International, as well as the Auckland Art Gallery Foundation, the Museum Circle Foundation and the Mackelvie Trust Board Andrew was appointed to the Board in 1998.

Dr Bruce Foggo

Marika Eastwick-Field



Bruce is a Palliative Medicine Specialist and Medical Team Leader at Mercy Hospice Auckland and has more than 30 years of general and palliative medicine experience. Bruce was appointed to the Board in 2008.

Marika is a commercial litigation partner at Russell McVeagh. She joined the firm in 2008 from another Auckland law firm, and advises on a range of contentious and non-contentious matters including in relation to banking and financial markets, real estate and construction, and insurance. Marika was appointed to the Board in November 2016.

Bal Matheson TRUSTEE

Bal is a barrister specialising in resource management and local government, practising at Richmond Chambers. For the past 20+ years, he has been focussing on development projects across New Zealand, including many in the health care and rest home sectors. Bal was appointed to the Board in 2011.

directory Registered Office 10 Ranfurly Road Epsom, Auckland 1023 Charities Commission Registration CC20460 www.charities.govt.nz Auditors Hayes Knight Audit NZ Level 1, 1 Broadway Newmarket, Auckland 1023 Solicitors Russell McVeagh The Vero Centre 48 Shortland Street, Auckland 1010 Bankers Bank of New Zealand Annual Report 2018/19

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unique and loving it

10 Ranfurly Road, Epsom, Auckland 1023 PO Box 74060, Greenlane, Auckland 1546 Telephone 09 523 3119 info@knox.co.nz E Q uI P






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Elizabeth Knox Home and Hospital Annual Report 2018/2019  

Elizabeth Knox Home and Hospital Annual Report 2018/2019