St Richard's Hospice Annual Review 2018

Annual Review 2018

What we do St Richard’s Hospice is an independent charity offering specialist palliative and end of life care to patients with life-limiting illnesses and support for their loved ones.

We work with other health-care partners to prevent crisis intervention and hospital admissions where possible.

We care for patients in the South Worcestershire areas of Worcester, Droitwich, Pershore, Evesham, Malvern, Tewkesbury, Broadway, Martley and surrounding areas.

Last year we gave co-ordinated care and support to over 3,300 patients, loved ones and the bereaved.

We offer in-patient care for patients from the Wyre Forest, Kidderminster, Redditch and Bromsgrove areas.

We aim to improve patients’ quality of life, helping them to live as fully as they can to the end of their lives, however long that may be.

Everything we do is made possible thanks to the wonderful generosity of our donors, supporter and volunteers.

Our year in numbers We supported 3,310 patients, their loved ones and the bereaved 1,280 patients supported by our Community Nursing Teams

74,000 people visited our website

330 patients cared for in our In-patient Unit

655,000 items sold in our 18 shops

304 individuals supported by Day Services

2,006 individuals helped by the Family Support Team 2

£128,000 raised from Gift Aid in our shops

The care and support we offer

Day Services

Hospice at Home Service

Community Nursing Team

In-patient Unit for Specialist Palliative Care

Family Support Services Volunteer Services

Medical Services Education and Resources Centre

Spiritual Care

Outpatient facility for Consultantled clinics

Allied Healthcare Professionals

You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.

Dame Cicely Saunders

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Chairman’s reflection This review celebrates the many ways in which St Richard’s Hospice continues to care for and support our patients, their loved ones and carers, to meet the increasing needs of our local community for specialist palliative and end of life care.

We strive to be innovative to continuously improve our care which this year has seen the transformation of our Day Services, enabling and supporting people to ‘live well’ with their life-limiting illness.

Chairman John Bawden and Chief Executive June Patel at the launch of Build 2020

This approach has enabled people to gain confidence in managing their conditions supported by a range of self-care strategies tailored to their personal needs.

As well as our day to day care, we have embarked on an ambitious expansion and redevelopment project, Build 2020, so we can better support our current patients and reach the unmet need of thousands of local people in the future.

We continue our care with the fantastic support of our community who fund approximately three quarters of our work through donations and gifts in Wills.

We are forever grateful to our wider community and supporters who fundraise so tirelessly to pay for our services.

John Bawden Chairman

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Day Services Manager Claire Gijselhart celebrates progress on the build

“Laughter is a key ingredient” Terry Tromans was diagnosed with advanced prostate cancer in 2014 and was introduced to St Richard’s by his GP. “Conscious of a reaction to the word ‘hospice’, my GP was quick to point out that it was only a word and far removed from the stereotypical definitions that my parent’s generation may have had of it. As he so rightly pointed out, it was for living the life you have to the fullest and in the best possible manner. I liked the sound of this!

Reassured, I took up his offer and shortly after, I met my specialist nurse, Julie. She helped me to unravel the complexities of my illness, the processes which I was now being affected by and above all, someone with whom I could share my most intimate fears and thoughts with but still feel good about it.

It was she who introduced Men’s Space group to me. I joined a group of like-minded men each week who offer me companionship, laughter and encouragement, who pick me up when I’m feeling low and offer me a sounding-board when things are tough.

More importantly, the guys offer me the opportunity to share my innermost feelings in a safe and secure environment. Whether it’s tears or fears, they’re there to offer support.

The most valuable gift that the group gives me is the opportunity to discuss my illness, any aches or pains that may be bothering me or forthcoming procedures.

To be able to listen to someone who’s been there and are happy to share their experiences has been a most powerful tool in my armoury.”

Terry was cared for in the St Richard’s In-patient Unit before he died in 2018.

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Palliative care when and where it’s needed

Our nursing team in the community

The Gateway Service was set up in 2017 as our single point of access for all referrals.

Most of our patients tell us that they would prefer to spend their last days in their own homes.

This is where they feel safe and comfortable, and can spend precious time with their loved ones.

Patients who would like support from St Richard’s can be referred by their GP, Consultant at the hospital, District Nurse or other healthcare professional. Our Gateway team is also available should a patient, or person close to them wish to speak to them directly for information or advice.

Help is never more than a phone call away Specialist nursing advice is available 24 hours a day, every day. Our telephone advice service is available if circumstances change unexpectedly and support is needed before the next working day.

Our 2016 CQC inspection report gave us an overall rating of good.

Staff showed people mattered and they went the ‘extra mile’ to provide exceptional care which responded to people’s individual needs.

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Our highly experienced Nurse Specialists, supported by Senior Staff Nurses, use their skills and knowledge to help manage patients’ symptoms, support them and their families and carers in making informed choices and refer onto appropriate additional services.

How they are supported is determined by what the patient prefers: this can be through face to face meetings at the patient’s home, GP surgery or the hospice. Often there is a combination of face to face and telephone contact. The team works alongside other health care professionals, social service departments and other voluntary/charity organisations to ensure the patients have access to the services which may be needed to support their care.

We received 1,166 community referrals

Hospice at Home Our Hospice at Home service provides additional support which enables patients to remain in their own home at the end of their lives.

The service runs 24 hours a day, seven days a week and can provide urgent overnight or daytime periods of nursing care for patients at home.

The service is available as a short term package of care when patients are most in need – when they are very ill and in the final stages of their illness.

Day Services The Day Hospice has a team of multidisciplinary healthcare professionals. It runs three days each week, usually with a maximum of 20 patients per day.

From October 2017 due to building and redevelopment work, day services were temporarily relocated to a more limited space resulting in referrals for up to 12 patients a day.

A daily team meeting discusses goals set by patients, implements plans of care and clear discharge plans. All referrals are processed within one week. Patients who attend Day Hospice have an unstable or deteriorating disease that requires support with symptom control management and significant psychological and emotional support.

We welcome up to 30 patients one day a week to our Living Well services which empower patients to self-manage their condition and promote quality of life and independence.

Our Living Well courses offered: - Adapted Tai Chi (seated) - Adapted Tai Chi (standing)

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Relaxation Coping with illness Fatigue Management Managing your Breathlessness Art and Crafts Sharing Stories Spiritual Care

The courses are open to people living with a life-limiting condition such as cancer, heart failure, chronic obstructive pulmonary disease (COPD), chronic kidney disease, Parkinson’s disease and motor neurone disease.

With many courses participants will be encouraged to practice techniques to learn how to manage symptoms at home; to help gain the maximum benefit from the course and develop confidence to continue practising once the course has come to an end.

Out-patient Clinics St Richard’s works in partnership with the NHS in Worcestershire to offer patients with advanced non-malignant diseases (cardiac; renal; respiratory and Parkinson’s disease) the opportunity to attend specialist out-patient appointments at the hospice.

The clinics aim to improve quality of life for patients by proactively managing their illness, and helping them and their families to plan for the future.

129 people attended our clinics

The best thing was being able to discuss with others about illness.

Having people you can call on if you need help or guidance.

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The In-patient Unit The In-patient Unit continues to provide specialist, individualised palliative and end of life care that is totally focused around the needs of the patient and those who are important to them.

Our aim is to address and help with any issues or concerns that the patient or family may have – this could be problems regarding pain and other symptoms, physical difficulties or concerns of a spiritual, social or emotional nature.

nurses, chaplaincy, social workers, family support, physiotherapists, occupational therapists and complementary therapists.

The fantastic care and attention given to my wife by the nursing and medical staff, the dedication was unbelievable, even the volunteers were most helpful, to myself and my family.

This care and support is provided by a team that includes specialist doctors,

87% of patients are admitted within 24 hours of referral

F rom the moment we arrived it was evident that Dad’s needs were an absolute priority and every effort was made to ensure that this traumatic time was made more manageable. For him and us. We feel so fortunate that we were able to spend our last days at such a wonderful facility. We are hugely indebted to you all.

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Going the extra mile Hospice care is all about improving the quality of life and well being of those with a life-limiting illness.

Helping them live as fully as they can for the precious time they have left.

It’s also about supporting families, close friends and carers both during a person’s illness and afterwards.

Whether it’s organising weddings, throwing surprise parties or holding a patient’s hand through the night, we will be there.

We will always go the extra mile.

We were honoured to be part of a very special pre-wedding blessing in the beautiful hospice gardens where Jan

- who received care in our In-patient Unit - shared the joy of her daughter Sally, husband-to-be Oliver, family and friends.

At the time Sally said, “We couldn’t have made this happen on our own. It started as a gentle suggestion by a member of the hospice staff and chaplain Clare and the team rallied around to organise everything in three days.

Nothing was a problem and they just said, ‘we’re here to make every day as meaningful as possible’”.

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Supporting the family The Family Support Service provides a wide range of help to patients, their families and carers including counselling, bereavement support, social work, community volunteer support, citizen’s advice and group support. Bereavement Support South Worcestershire (BSSW) is hosted by St Richard’s Hospice and supports individuals and families who are bereaved unexpectedly.

Daily social work support is offered across all clinical hospice teams. Social

workers continue to attend all daily handovers, clinics and multi-disciplinary meetings in addition to providing the weekday open-door drop in service.

Other activities: -

Carers’ Tea Party Walking with Hawks event Bereavement walking group Teenagers, children and family activity days - Men’s Space group

1,803+ Family Support referrals 4,113 one to one support sessions 4,203 telephone contacts 201 group sessions 1,936 Family Support group attendees

The help I received impacted on my mental wellbeing in a very positive way, which therefore had an impact on my family.

The service is priceless and very much needed. Thank you.

Our bereavement cookery group learn new skills

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community. This also reflects that there are fewer services available within the community for our patients to call upon.

Guests enjoying the carers’ tea party.

Head of Family Support, Sarah Popplestone-Helm and Chief Executive June Patel celebrate the milestone.

Citizens Advice Referrals to the Citizens Advice Bureau Adviser can be complex. Our adviser gives an informed service to people when they are experiencing enormous challenge in their lives.

Over the twelve years that the CAB Advisers have been working with the hospice, they have raised in excess of one million pounds in benefits and trust fund grants for our patients and their families.

Community Volunteers There has been a significant shift in the type of support provided by the community volunteers.

This service is commissioned

by NHS South Worcestershire Clinical Commissioning Group.

Counselling, support for children and families, telephone support, a telephone helpline and group support are available for individuals and families who are bereaved through sudden and unexpected death.

I lost my only son to suicide and I will never be the same again. I’m so heartbroken and really struggling, but I must say my councillor was a great comfort to me.

More socially isolated people have been referred, reflecting the loneliness that people are experiencing within our

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The counselling team continue to work with patients and their families before and following the death of a loved one.

I miss him more than ever but with the fantastic coping strategies I have learned, can really manage my feelings. Please don’t go anywhere; your staff and service is far too precious.

Therapies Physiotherapy - Physiotherapy referrals continue to come predominantly from the In-patient Unit and Day Hospice. Physiotherapists also support a number of the Living Well courses.

Exercise classes take place every day in Day Hospice. These classes are run by a physiotherapist and also by volunteer therapists and other members of the team who have received training.

409 individuals were referred for physiotherapy Occupational Therapy - Our Occupational Therapists provide a home assessment service and provision of equipment to maintain a person’s independence at home; advice regarding home adaptations; assessing access to enable

patients to attend day hospice safely via volunteer transport and close liaison with the community Occupational Therapy teams.

The Occupational Therapists have provided support, with a greater focus on rehabilitation in palliative care and have been actively involved in running therapeutic groups and activities for the Living Well programme.

Complementary Therapies - These are used alongside standard health care and include various forms of relaxation and holistic massage such as aromatherapy, reflexology, Indian head massage and Shiatsu.

Creative Therapy - Creative Therapy is widely acknowledged as having particular benefit to patients with specialist palliative care needs.

These may include improved emotional and psychological wellbeing and/or the creation of treasured memories and memorabilia for family and friends.

Spiritual care and chaplaincy The Chaplaincy Team provides support to in-patients, day patients, families, staff and volunteers. In addition, the team reach a wider population through the many funeral services and community events they conduct.

The team has also conducted relationship blessings, marriages, baptisms and the distribution of silver leaves to families for the Tree of Life. The silver leaves are engraved with words in memory of loved ones who have died. The Chaplaincy Team was involved with Lights of Love and remembrance services, contributing to an estimated 3,500 people reached by community events. A Spirituality Course, “Finding Inner Peace,” is offered as part of the Living Well programme. It is designed to be suitable for people of all faiths and those without any faith.

Just a little note of thanks for allowing us to share with the other families in the Snowdrop Celebration. It was nice to again be part of the St Richard’s family and to feel the continued love and support.

The service was beautiful and gave us much comfort.

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Education developments St Richard’s Hospice is passionate about supporting palliative and end of life education and training for staff, volunteers and the health and social workforce in Worcestershire.

The team has a broad range of skills to enable the hospice to continue to deliver high quality education and learning opportunities both for staff internally and to benefit the wider health economy by sharing the specialist expertise of the hospice with generalist practitioners.

For example there is now a clinical skills facilitator who is a practicing intensive care unit nurse. She comes once a week to

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Staff and volunteer attendances at training sessions

teach and support staff on the In-patient Unit to develop and update their skills to enable them to meet the complex needs of patients who need specialist palliative care.

Thank you for an interesting experience! Changed my impression of hospices for the better. (medical student 2018)

270 External study days, courses and conferences.

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External staff given training

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Nine care homes supported through the Gold Standards Framework

Involving our community The Engagement Officer aims to widen and deepen the knowledge of St Richard’s services to increase access, awareness and involvement in end of life care.

During the year the Engagement Officer had face-to-face activity with more than 4,500 people. Six priority areas have been identified to focus the direction of community engagement – these are Asian and Eastern European Communities, geographical area of Evesham, lower income communities, 55+ and rural communities.

Activity included: • Before I Die board on Worcester and Evesham High Street, large supermarkets and Malvern Theatre to

promote Dying Matters Awareness Week and Hospice Care Week • E ngagement with local Eastern European community at Polish Heritage Day, Polish film screenings in Evesham, Catholic Churches and local mother and toddler group for Polish families • Two open afternoons at St Richard’s with over 200 attendees •C ontinuing to build relationship with local mosques, including new ladies’ mosque group • E xploring a volunteering role to support community engagement and widen our reach •R epresenting hospice at health and wellbeing, community and older people’s events •D elivering awareness talks to appropriate audiences

Thank you so much for your very interesting and inspirational talk this afternoon. Many of us thought the hospice was only cancer patients and hadn’t realised just how many services the hospice provided not only for patients but for the families as well.

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Our volunteers are superheroes!

Our volunteers are truly remarkable and we are privileged to have more than 900 donating their time in hundreds of roles around the county.

They give themselves freely, simply because they want to make a difference to the lives of others. We couldn’t continue to offer all our care without these fantastic individuals.

Volunteers contributed a total of 304,816 hours.

Volunteers involved in patient services worked for 23,563 hours While volunteers assist in a wide range of patient areas, their help with fundraising events; shops and commercial department and contribution within the administrative functions of the hospice are also essential.

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St Richard’s is a fantastic organisation doing a brilliant service for the local community and for me to contribute in some small way by giving some of my time is a privilege. The volunteers at the shop are like a family and it’s very satisfying to know that we are all assisting in providing a service to the community.

Fundraising The fundraising environment continues to be challenging with income from both the general public and statutory sources reduced.

Attracting voluntary income to sustain hospice contributions to the health and wellbeing of the individuals in the Worcestershire community is becoming increasingly essential.

A further consideration is the plethora of new charities in the community all seeking donor support.

During the current financial year St Richard’s has the challenge of raising more than £8.8million to fund the hospice services and plan for the future. A £5.3m capital appeal in support of our development work is underway and during the financial year 2017/18, thanks to the Trusts and grants organisations and individuals that have committed and pledged

to help us, we were able to secure funding in line with expectation. This support, along with good financial management of reserves and income from Gifts in Wills, has provided a stable foundation for the public appeal phase.

The hospice cannot do this without on-going support from the community and the involvement of many individuals, groups, clubs, schools, churches and local businesses.

We are indebted to everyone who supports us.

Commercial A challenging year on the high street nationally also has an impact on our charity shops with a decrease in footfall.

Despite this decrease our shops have still traded well with many up on last year.

Turnover rose to £2.6m from £2.4m last year with the net profit contribution to the hospice at £588,347.

Our Celebration Garden was one of many fundraising projects

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Financial review The increase in total income to £9.4m was driven by fundraising for our Build 2020 Project with Gifts in Wills, again, being a significant source of this income.

The surplus of £699k, after absorbing investment losses of £156k, yielded

a very worthwhile increase in our total funds of £543k. This places the hospice finances in a sound position to deliver its excellent patient and family care and continue its development to become a centre of expertise to meet future needs.

Richard Shaw Honorary Treasurer

Gifts In Wills £1.457 million Trading Company £2.611 million

TOTAL INCOME £9.396 million

Other £0.339 million

NHS £2.007 million

Voluntary Income £2.982 million

Other £0.300 million Trading Company £2.082 million

TOTAL SPEND £8.697 million

Fundraising £0.763 million

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Patient & Family Care £5.552 million

Year Ended 31st March 2018

INCOME £’000s Fundraising, grants, donations and events 2,982 Trading Company 2,611 Gifts in Wills 1,457 Education and Study Centre 62 NHS Contributions 2,007 Income from joint venture Lottery 105 Investment income 172 Total 9,396

EXPENDITURE Patient and family care 5,552 Education and study centre 253 Fundraising and publicity 763 Trading company 2,082 Cost of managing investments 47 Total 8,697

SURPLUS for year 699 Investment losses (156) Net increase in Assets 543

BALANCE SHEET (as at 31st March 2018) Year Ended 31st March 2018

INCOME £’000s Fixed Assets 11,806 Current Assets 3454 Current Liabilities -1210 Net Current Assets 2,244 Net Assets 14,050

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Please help us to do even more in 2019.

On behalf of our patients and families we would like to say a big Thank you to everyone who has supported our care.

To help us care for patients and their loved ones in the future, you can fundraise, volunteer or raise awareness of St Richard’s. For more information visit www.strichards.org.uk

St Richard’s Hospice Wildwood Drive, Worcester WR5 2QT | 01905 763963 Registered charity no. 515668. Registered company no. 01850502