2012
Future plans After a period of considerable turbulence, including major upheaval in the structure of the NHS, Cotswold Care Hospice enters 2012/13 in a stable financial position and with a positive view to the future.
With significant recent growth in our services, we will focus upon consolidating our position over the next 12 months. We will be paying particular attention to our internal structures and procedures, so that we ensure the quality of our care is maintained as we help increasing numbers of families. We do not expect the economic situation to improve quickly, so we
Impact Report
will redouble our efforts to generate sufficient income to deliver our specialist care services. The continued support of our many dedicated sponsors, supporter groups and volunteers will be fundamental to the ongoing work and success of the hospice. We trust that this Impact Report explains the important role that they play and how we steward the resources that they continue to provide.
Registered Charity No. 298627
Cotswold Care Hospice celebrating our 25th year in 2012 12 IMPACT REPORT
Introduction
Cotswold Care Hospice has helped more people in 2011/12 than ever before.
‘Fulfilling last wishes…’
We have expanded Hospice at Home significantly, providing 32% more care hours, so we now offer even greater support to people at home during the final stages of life.
Fundraising conditions are tough but we have maximised the fundraising opportunities of our 25th anniversary year. Facilities, Finance and HR all continued to play their unsung but essential support roles, as did the myriad of volunteers without whom the Hospice would be unable to operate.
When Liz Petch learned she had an inoperable brain tumour she decided she did not want to undergo any treatment.
Demand for Day Hospice continues to rise and we have focussed on helping those most in need to access the Hospice more quickly. Counselling and bereavement support activity remain high, as does client satisfaction. In countywide education, Cotswold Care Hospice has continued to deliver modules on bereavement and raised awareness of palliative and end of life care. We conduct regular internal audits to monitor our standards. A no-notice Care Quality Commission inspection in February found that the Hospice was meeting all the essential standards of quality and safety and no points for improvement were noted. Unsurprisingly, income generation has continued to be difficult, although retail performance has held up well. 2 IMPACT REPORT
OUR MISSION “As a specialist palliative care provider, our mission is to maximize the quality of life for those people in Gloucestershire patients and families - living with cancer and other life-limiting illnesses.”
Our Vision “Cotswold Care Hospice aims to be the leading independent provider of the full range of quality adult specialist palliative care services to meet the
needs of the people of Gloucestershire.” We are a local Charity based in Gloucestershire providing specialist care 7 days per week, 365 days a year. The Hospice offers a wide range of services which provide care for people living with or affected by a life-limiting illness. As an independent charity, in 2011/2012 we needed £2.4 million to deliver our services, however they are free of charge to all the people who use them. Hospice services support patients, families and carers from the point of diagnosis onwards. This includes day therapy, counselling, education and a range of outpatient services. Care at end of life is provided by our Hospice at Home service and continues after death through our bereavement support programme. Our future is driven by the needs of the people we support - Cotswold Care Hospice will continue to develop and deliver a full range of services tailored to local need. Jules Eaton, CEO
Instead she wanted to make the most of her time and spend it with her family. “We resolved to make the most of the time we had and make life as fulfilling and comfortable for Liz as we could,” said her widower Clive, near Stroud.
“With their support we were able to care for Liz at home”
Liz, who was a keen artist, first attended day hospice and as her illness worsened Cotswold Care Hospice at Home nurses supported the family. Clive, along with his children, Alice, Thomas, Alexander and Robbie all cared for Liz at home, taking turns staying with her, cooking and keeping things going. Clive moved a mattress into Liz’s room and slept on the floor. “The hospice helped us all the way. With their support we were able to care for Liz at home and ensure she spent her last days in the home she was born in, which meant such a great deal to all of us,” said Clive. Liz passed away at home in January 2012. She was 56.
“we resolved to make the most of the time we had and make life as fulfilling and comfortable for Liz as we could“
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How we help…
Cotswold Care Hospice can help from the moment of diagnosis onwards. We offer a range of services and these are tailored to suit the needs of the individual whether it is hospice at home care, day therapy, outpatient or bereavement services. Hospice at Home Hospice at Home really is our cornerstone service and has evolved and grown as a result of the response to the needs of people in Gloucestershire. Our Hospice at Home team support families to allow loved ones to die at home. The service is funded in part by the NHS and local Gloucestershire Primary Care Trust funding. In this year we know that 92% of our patients were enabled to die in their place of choice. Growth of our Hospice at Home service included the delivery of countywide education enabling our employees to become more specialised in the service they deliver.
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Our team provided more than 16,394 hours of care to patients in their own homes in 2011/12 which represented a huge increase of 4,008 hours more. Our team completed 4,462 visits to patients in their own homes. New developments in this year include: • Hosting a pulmonary rehabilitation programme on site, providing people with easier access to this service. • We also appointed a Clinical Nurse Specialist (CNS) who has advanced training in palliative care and who is part of the countywide Gloucestershire CNS team. • Another development was to host a ”Caring with confidence” programme in Autumn of 2012.
Day Hospice Our day therapy service is offered over three days per week and is free of charge. Following a life-limiting diagnosis, individuals can refer themselves to this service and will be
assigned a “key worker” who will help them to access the therapy that best meets their needs. The day therapy team includes specialist nurses, therapists, health care assistants, counsellors, creative therapist’s, a physiotherapist and several fully trained volunteers. 154 sessions/days were offered in day hospice this year 167 people were referred for 2011/2012 The consolidation of service this year has included continuation of our existing services.
Bereavement Care Providing bereavement care to those who have lost a loved one is an essential service that Cotswold Care Hospice provides. Bereavement support is offered to families and carers after the death of the people we have cared for. 385 bereavement support and bereavement counselling appointments were attended in the year 2011/2012. 248 telephone contact appointments were delivered in the same year. New developments in this year include: • A bereavement group which offers individuals the chance to talk with people who have experienced similar issues. The group is facilitated by a counsellor and bereavement Support Worker. • The hospice has also seen an increased number of bereavement follow-ups with the growth of activity in the Hospice at Home service.
Counselling The counselling service offered at Cotswold Care Hospice is available from the point of diagnosis onwards and is available to patients, their families and carers. In 2011/2012 we delivered 362 face-to-face counselling sessions, and 368 were delivered over the telephone. Here at Cotswold Care we practice Person-Centred Counselling and Cognitive Behavioural Therapy. Both these forms of therapy give the individual the opportunity to identify thoughts, feelings and behaviours that are distressing. The therapies allow appropriate coping strategies to be developed along with goals for future development. New developments in this year include: • A well being assessment which enables a holistic approach focusing on physiological needs that can address all aspects relating to a patient wellbeing. IMPACT REPORT 5
Outpatients The outpatients service we offer is important as it enables care closer to home in a supportive environment for people accessing our service. This service supports self care, monitoring and problem solving, and also allows access to specialist support and advice including; a palliative care consultant, lymphoedema, and heart failure clinics, counselling and bereavement services and a Clinical Nurse Specialist.
User Involvement We encourage feedback about our services including anonymous and face to face opportunities to help us monitor the standards of our services. User involvement this year included a bereavement focus group which supports the wider bereavement review.
Education New developments in this year include: • Hosting fifteen GP ‘personal development’ meetings, supported by Minchinhampton GP partners and the Stroud practice commissioning group.
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• The delivery of 20 educational training sessions for both Hospice and external staff & carers which have included Basic life-support workshops and an Introduction to palliative care for nurses course to name just a few. • The team have hosted four teambuilding days with employees from local companies such as Vertex, Zurich and Ecclestial Insurance. • Training for Hospice staff included four corporate induction days, Health & Safety Training Sessions and Practical manual handling training sessions. • We continue to host an “End of Life forum” on a monthly basis and have collaborated with South West hospices to deliver “train the trainer” programmes.
Meeting Facilities Our meeting facility occupies the lower ground floor of Cotswold Care Hospice and is accessed through its own entrance and car park. There are two training rooms available for hire which can accommodate up to 60 people. The Bistro/Books room
houses our library and is also used as a separate dining area or break out room. We continue to promote this facility to organisations and businesses throughout Gloucestershire.
‘Cotswold Care Hospice is a lifeline’ For Paul Stead Cotswold Care Hospice has been a lifeline. The 59 year old from Nailsworth has been coming to the hospice on and off for nine years. He was diagnosed with Multiple Sclerosis 20 years ago. “I used to come to the hospice for the MS support group. Then I could walk and do things on my own. Now I have this electric chair and can hardly do anything.” For Paul, the 12-week sessions at day hospice help him regain his peace of mind. “It’s brilliant. I spend so much time on my own and it gets so boring and I get so frustrated that I can’t do anything and it gets me down. Coming to the
hospice helps so much and means I can cope again for a while,” said the former inspection engineer. It was at the hospice that Paul discovered his artistic talent. “I had never touched a paintbrush apart from decorating. They kept saying ‘have a go’ and I would say ‘I can’t do that’. But I could.” The walls of his home are covered with landscape watercolours he has done. When he started to have limited use of his arms the art team at the hospice took a child’s soft play ball, big enough for Paul to grasp, cut a hole in it and used it as a brush holder. “The hospice isn’t a place to die. It’s a peaceful, relaxing place. I have had all sorts of treatment and help here, such as physiotherapy, - things I would never have tried before and had the access to.”
“Coming to the hospice helps so much and means I can cope again for a while.” IMPACT REPORT 7
Income Generation
In 2011/12 we needed 2.3 million to deliver our planned services
NHS Gloucestershire funding
ran a successful Christmas appeal which was combined with our Light up a Life events.
We currently have two funding streams which support our Hospice at Home service; The first is a grant from the Primary Care Trust commissioners and the second is from Continuing Healthcare Funding. We have had another successful year in a challenging economic climate with overwhelming support from our donors and supporters who help in so many ways. From those donating to and shopping in our ‘charity shops to those taking part in our events and signing up to our Charity Lottery.
Fundraising Events
Legacies Although legacy income had been reducing in 2011/12, a number of significant and generous legacies were received which boosted our legacy income to £424,823 which was an increase of more than £280,000 from the previous year.
Legacy income continues to be a vital source of hospice funding and we are very grateful to those who think of us who leave a gift, no matter how small, to the hospice in their will.
Trusts Trust funding has remained buoyant in 2011/2012 with continued funding received from the St. James’s Place Foundation, the Honey Trust and the Huggard Charitable Trust.
Retail Retail is an essential part of our income generation and in 2011/2012 generated 36% of our total income.
In 2011/12 we held two Midnight Walks – one took place in Gloucester and the second in Cirencester with more than 650 women walking and raising funds for the Hospice. The men followed on with our second Mens Walk starting and finishing at Gloucester Rugby Club and attracting 550 men to walk and enjoy a pie, pint and a game of live rugby and help raise more than £35,000. Our final event this year was a new event called the Wholehog Challenge. This is a cross country run across obstacles at Woodchester Mansion with 152 runners taking part in this gruelling challenge which ended with a hog roast.
Our new shop in Bishop’s Cleeve opened in April 2012 this is our 14th shop to open in Gloucestershire.
Regular support
Our generous donors also signed up for Gift Aid which this has risen by 10% in the year 2011/2012.
We continue to be supported by our regular donors without whom we could not provide the services we do. In 2011 we 8 IMPACT REPORT
All of our shops are now branded with new external signage which more effectively reflects our image. The new signage has been well received by shop managers, volunteers and customers. Our charity shops generated around 36% of the income received by the Hospice in 2011/2012.
“All of our shops are now branded with new external signage which more effectively reflects our image.” IMPACT REPORT 9
Financial Information
Volunteering
Total Income - £2,434,751
Total Costs - £2,250,309
How you helped us in 2011/2012
How we helped you in 2011/2012
0.1% Investment 0.7% Corporate Income Friends & Regular Giving Supporters Groups Gift Aid Rebates 1.5% General 2.7% IMO’s 0.8% Lottery 0.6% Other
4.8%
2.3%
Counselling
8.5% Education
4.7%
17% Hospice at Home service
5.6% General donations
17.4% Legacies
A full copy of our accounts can be found on our website www.cotswoldcare.org.uk
42% Retail total Merchandising & Commission 1% Retail 26% Retail Gift Aid 15%
Governance 4.5% 2%
14% Fundraising
36% Retail total
3.9% Trusts & Foundations
6.3% Hospice Events
18% Day care & outpatients 12.1% Primary Care Trust
“I started volunteering at Cotswold Care Hospice about a year ago on Reception - who would have guessed that so much goes on here: day therapy, complementary therapies, Hospice at Home admin, fundraising, specialist clinics, catering, education to name but a few. I’ve been surprised at how much the volunteers are valued and how the staff members make a point of saying hello and having a chat even though they must see many different faces on reception through the course of a week. The hospice feels like a lively and warm place so it is a pleasure to come to volunteer here.”
Jane Pilbeam, Reception & Bereavement Team Volunteer
“I’ve been surprised at how much the volunteers are valued and how the staff members make a point of saying hello.”
Jane has also extended her volunteering to the Bereavement Team and has had training to enable her to help with the vital follow up service which is offered to next of kin who have previously experienced the hospice services.
0.1% Education
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