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2021-03-31-accounts

St Nicholas Hospice (Suffolk)

Annual Report and Financial Statements

Year ended 31 March 2021

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Contents

4 Trustees’ Report

Annual Accounts 2020–21 3

Trustees’ Report for the year ended 31 March 2021

4

Trustees and advisors

Board of Trustees

Charles Simpson[ 1 4 5] Chairman Susan Hayter[ 3 4] Vice Chair Michelle Masson[ 1 4] Honorary Treasurer Marion Miles[ 2 4] Ann Langdon[ 2][4] Ian Morgan[ 1 ] Resigned 10 December 2020 Chris Minett[ 3] Karen Chandler-Smith[ 1] Anne Fisher[4] Appointed 10 December 2020 Donna Forster Appointed 10 December 2020 Neil Morgan Appointed 10 December 2020 Sam Turner[ 2] Appointed 29 April 2021

Secretary and registered/principal office

Fiona Heath, St Nicholas Way, Hardwick Lane, Bury St Edmunds, Suffolk, IP33 2QY

Chief Executive

Dr Barbara Gale MBE[5]

Directorate

Georgina Bissell – Fundraising and Marketing Director

Debra Garside – Clinical Services Director, Registered Manager, Accountable Officer to 30 September 2020

Gwyneth Tyler – Clinical Services Director from 7 September 2020

Rachel Spencer – Finance Director and Deputy Chief Executive, Company Secretary, SIRO to 21 April 2020

Data Protection Officer Sara Taylor Auditors RSM UK Audit LLP, Blenheim House, Newmarket Road, Bury St Edmunds, Suffolk, IP33 3SB Solicitors Ellisons Solicitors incorporating Gross & Co, 83-84 Guildhall Street, Bury St Edmunds, Suffolk, IP33 1LN Bankers Barclays Bank plc, 20/21 Cornhill, Bury St Edmunds IP33 1DY

Investment managers Rathbones Investment Management Limited, 159 New Bond Street, London, W1S 2UD Sarasin & Partners LLP, Juxon House, 100 St Paul’s Churchyard, London, EC4M 8BU Registered Charity number: 287773 Registered Charity name: St Nicholas Hospice (Suffolk) Other name used: St Nicholas Hospice Care Company number: 1748046

1 Finance and Income Generation Committee member 2 HR Committee member 3 Clinical Committee member

4 Organisation Change Committee member 5 Director of St Nicholas Hospice Trading Ltd

Annual Accounts 2020–21 5

Introduction from the Chief and Chairman Executive Officer

We are proud to present this year’s annual report, which details our achievements and our plans for the future.

This will be my last annual report as CEO, as I retire in December and welcome my successor, Linda McEnhill.

This year our teams continued to deal with the impact of the Covid-19 pandemic as it affected how we delivered clinical services and our ability to fundraise.

Like other clinical services across the country, Infection Prevention Guidance made a huge impact on hospice work, with visiting restrictions and the use of PPE and the loss of our capacity to be close to people in times of distress.

Fortunately, we did not need to use the increased beds capacity we had identified, as Covid-19 deaths remained relatively low. However, the Hospice did have to cope with Covid-19 outbreaks.

Many face to face services and activities were delivered online via Zoom or Team meetings and group meetings remained suspended as many staff worked from home in line with national guidance.

The Hospice clinical teams continued to work closely with West Suffolk Alliance colleagues to support demand in the community. Additional support was also provided to West Suffolk Hospital.

Although additional national and local funding helped offset some of the loss of income we continued with the plans agreed in September 2020 to implement organisational change to deliver a new clinical model and cost savings. A formal consultation with staff started in October which resulted in 8 compulsory redundancies.

Our plans will continue to be underpinned by a financial strategy, which ensures that we focus on financial sustainability over the longer term. This strategy will ensure that we:

Dr Barbara Gale MBE, Charles Simpson Chief Executive Officer Chair

St Nicholas Hospice Care

6

Annual Accounts 2021>21

Strategic Report

In 2020/21 we said we would:

By March 2021 we had:

Implement:

A locality-based model of support linked to local integrated neighbourhood teams and primary care networks encompassing:

Recruited Community Connectors. Plans for locality models were delayed because of the impact of the Covid-19 pandemic.

Provided community support to people in the community.

Ensure that a specialist multidisciplinary team delivers consultation and advice for people wherever they are

Delivered:

Ensure that:

Implemented an organisational restructure:

Rapid implementation of IT strategy and increased use of digital tools across the Hospice to support home working during the pandemic.

St Nicholas Hospice Care

8

The impact of Covid-19 on the Charity’s activities

Clinical Services

The onset of Covid-19 required the Hospice to work closely with local statutory services to support people facing dying, death and grief during the pandemic. These changes included:

Income generation activities

Covid-19 has changed the way we are fundraising dramatically. Our retail division was entirely shut during the first lockdown, and many of our usual fundraising events were cancelled or postponed. A large number of the Income Generation team were also furloughed.

We have focused, and continue to focus on, our Individual Giving programme. This includes our Friends of St Nic’s (a regular giving ask) and products such as our weekly lottery. We also delivered our first virtual event, Girls Night Out, which was very successful.

Income Generation continues to adapt the fundraising strategy to suit a post-Covid-19 environment and strive to develop products which focus on philanthropic donations rather than public events and traditional community giving.

Supporting our people

Also, numbers of staff and volunteers were required to shield, and some have adapted to home working. New online support and communication spaces were set up to support staff.

A Mutual Aid agreement with local statutory services facilitated some hospice staff working in the community with NHS colleagues and other external staff joining the Hospice team.

Annual Accounts 2020–21 9

Plans for future periods

This year our Hospice team will continue to move forward with plans to deliver our Equip Provide Strive strategy.

As a result of the impact Covid-19 has had on ourselves and our community, this year, we will be focusing on:

To meet our strategic aims to:

Equip everyone to live with dying, death and grief

Provide direct support

Strive for ‘something better’ through innovation

St Nicholas Hospice Care

10

In 2021/22 we will implement developments which will ensure:

That people:

We will do this through:

Implementing our equip approach in our communities by:

That:

Developing a specialist care model that works collaboratively alongside our colleagues in the wider healthcare system, ensuring equity across our community by:

The:

Focusing on:

Annual Accounts 2020–21 11

Financial review

The consolidated financial statements include the results of the Charity together with those of the trading company, a wholly owned subsidiary that donates under Gift Aid, the maximum available profits to the Charity.

The Hospice along with the rest of the sector, faced unprecedented financial challenges as a result of the pandemic. As a result, both our operating expenditure and operating income were significantly lower than the previous year. However, the non recurrent government funding in response to Covid-19, together with additional support from our local CCG, meant our total income for the year was in line with the previous year. This resulted in an operating deficit of approximately £0.67m, which was an improvement against the plan. Our investments recovered well during the year with a net gain of £0.70m which offset the operating deficit. Therefore, the Group, returned a small surplus of £0.03m and a net movement to reserves of £0.03m compared to a deficit of £1.78m in 2019/20.

The trading activity of St Nicholas Hospice Trading Limted (consolidated in the above figures) was also negatively impacted by the pandemic as house clearances and the café were unable to trade for several months, but once reopened, traded successfully and had a turnover of £0.22m and a profit of £0.04m (2020: £0.09m).

Income

Income has decreased by £0.11m from £6.20m to £6.09m (2%).

Income from charitable activities increased significantly from £1.28m in 2019/20 to £2.98m in 2020/21, as additional funding was received to support the Hospice during the pandemic. Our commitment to work in partnership with our local Clinical Commissioning Groups (CCGs) to continue to provide our services and reduce the overall burden on the NHS was clearly demonstrated during the pandemic. In response, we received an additional £0.479m from the West Suffolk CCG specifically to support the hospice’s services during the pandemic. This funding was in addition to the non recurrent contribution of £0.23m from West Suffolk CCG

which had been agreed previously to increase the grant value in the interim before the recurrent increases, agreed in the new four-year grant agreement for 2020/21-2023/2024, come in to effect. The new grant agreement will increase our funding so that by 2023/24, our CCG funding will be in line with the national average. The Hospice also received £1.04m non recurrent funding from the government via Hospice UK to make available bed capacity and community support during the pandemic.

Income generation activities across the Charity have suffered from the unprecedented impact of the pandemic. Most notably fundraising income was only a quarter of the income generated in the previous financial year, as many planned activities had to be cancelled or run virtually. Income from retail shops fell dramatically to half of that in the previous year, as the shops were closed for a total of six months due to the national restrictions imposed as a result of the pandemic. Legacy income was also approximately half of our fiveyear average. A fall in legacy income was not unexpected due to delays in probate and some legacy values proving difficult to quantify as a result of stalled property sales and fluctuations in the Stock Market creating delays in liquidating portfolios. All other income generation streams were also lower than in the previous year with the exception of ecommerce.

In addition to the financial support received directly from West Suffolk CCG, the Hospice received significant non recurrent income (£0.36m) from the various government funding schemes to support organisations through the pandemic, notably the Coronavirus Job Retention Scheme, so that overall our total income was in line with the previous year.

12 St Nicholas Hospice Care

Comparison of income for 2019-20 and 2020-21

Income sources 2020-21

Charitable activities - 24% Charitable activities (Covid-19) - 25% Other (Gov Covid-19) - 6% Donations - 15% Fundraising - 2% Legacies - 7% Lottery - 7% Shops - 11% Other - 3%

Annual Accounts 2020–21 13

Expenditure

Expenditure has decreased by £1.01m from £7.76m to £6.75m (13%).

Expenditure on charitable activities reduced across most departments. The reduction in costs is largely due to the implementation of the organisational wide restructure which included the closure of the day care unit, staffing vacancies due to the natural turnover of staff and the associated cost savings of the provision of some services on a virtual basis rather than face to face and remote working. Some significant recurrent savings came in to effect during the year, but the full year impact will be seen in future years.

Expenditure 2020-2021

Expenditure on income generation and trading also decreased reflecting the organisation-wide restructure and the associated cost savings of running fewer events and shop closures. There were no pay awards made in the year except for minimum wage adjustments where required, which contributed to lower expenditure than budgeted but pay will be reviewed in 2021/22.

Clinical Services - 63%

Grants, Donations and Legacies - 9%

Other Trading - 27%

Comparison of expenditure for 2019-20 and 2020-21

Investments - 1%

St Nicholas Hospice Care

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Investments

The Hospice has a diversified investment portfolio comprising of listed equities and unit trusts, fixed interest securities and cash and is managed by independent investment managers.

The investment portfolio is apportioned between and managed by two independent investment managers, Rathbones Investment Management Limited and Sarasin & Partners LLP, appointed by the Board of Trustees. The Trustees, through the Finance and Investment Committee, consult with the investment managers, to take advice on the management of the portfolios and to monitor their performance.

During the year, our investment funds increased in value, despite the liquidation of £0.40m which was used to support the operating deficit position and facilitate the operational cash flow. In addition, The Trustees, through the Finance and Investment Committee, agreed that £0.75m should be held in cash by the investment managers both to ensure the future availability of cash and increase the realised gains. Although there was considerable uncertainty in the markets, largely due to the pandemic, Brexit and the US election at the start of the financial year, the markets responded positively during the year to the respective outcomes of Brexit and the US election. As a consequence, our investments increased appreciably.

The Hospice investment policy remains unchanged. Over the long-term, we maintain and increase the real capital value of the investment funds to achieve returns from a diversified portfolio of equities, fixed interest securities and cash within a medium to low risk/reward profile as agreed by the Finance and Investment Committee. Where appropriate and within the investment objectives, the Trustees will attempt to invest in ethical and socially responsible organisations. The Finance and Investment Committee considered that the investment account had performed well given the market conditions.

The reserves policy, agreed by the Trustees, remains unchanged and requires that the Charity must hold a minimum level of reserves equivalent to approximately six-months’ worth of total running costs. Free reserves at the end of the year totalled £5.60m or the equivalent of approximately ten months’ worth of total running costs. This ensures that the organisation can continue to support beneficiaries in periods of a financial downturn, but also enables funds to be invested for future Hospice services and revenuegenerating projects.

As part of the Trustees’ review this year, no additional funds have been designated as the Trustees deem the current designations to be sufficient to support the development of our services and income streams.

Unrestricted funds comprise the following:

----- Start of picture text -----
Undesignated
SNHC Funds Designated – Designated - – Total
Not Free Free Reserves
as at 31 Free Reserves
March 2021 £000s
£000s £000s
£000s
Fixed
Asset Fund
2318 2318
(represented
by assets)
New building 2250 2250
Information
16 16
technology
Service
474 474
development
Income
399 399
generation
General
2464 2464
reserves
TOTAL 2318 3139 2464 7921
----- End of picture text -----

Reserves

Total reserves at the end of the year amounted to £8.03m (2020: £8.00m) of which £0.06m (2020: £0.06m) were restricted. The Charity also benefits from the Earl of Euston 2009 Endowment Fund of £47k. The attributed income (£431) from this fund was used in furtherance of the objects of the Hospice. The total value of designated funds is £5.46m.

Annual Accounts 2020–21 15

Building/Fixed Asset Fund

This is a designated fund representing the construction costs of the existing building to 31 March 2021 less depreciation charged thereon, together with funds transferred from the original foundation fund. During 2009/10 the balance on the capital appeal restricted fund (£511,529), which was held specifically for the purpose of the development and provision of accommodation for family bereavement and support services, was transferred into this fund. During 2019/20, the Trustees gave approval to reallocate the net book value of the fixed assets held within the restricted fund (£263,282) to the Building/Fixed Asset Fund, to realign the funds, subsequently a transfer to realign has been made during this year.

New Building and Maintenance Fund

This is a designated fund for the purposes of maintaining and updating the existing Hospice building and allocating funds for future building requirements. This fund has not been drawn on during 2020/21.

IT systems fund

The charity has a number of IT systems and hardware which require replacing or upgrading to develop greater reliance, functionality and efficiency to support the services we deliver and the way in which we work, now and in the future. During 2020/21, the CCG was able to support many IT priorities during the Covid-19 pandemic, including funding a VOIP project and supporting us with the loan of laptops to facilitate virtual working.

Therefore, the fund remains designated to support plans to upgrade our infrastructure in future years.

Service development fund

The purpose of this fund is to develop and test new service delivery models across our entire service offering in all settings. The fund will continue to support the ongoing development, testing and planning of services.

Income generation fund

The fund is to develop income generation through new and existing income streams that are sustainable and resilient to economic and social challenges. This fund has not been drawn on during 2020/21 but is expected to be used in future years to support a new strategy for sustainable income streams.

St Nicholas Hospice Care

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Community support for our clinical teams during the pandemic was dearly valued.

Many thanks to the 1st Acton and Waldingfield Scout Group whose creative talents have added some extra colour to our Sylvan Ward and the Hospice’s Garden. The pictures, one of which is a tree of thanks, have been put up on the wall with the decorated stones and slates surrounding a water feature in the garden.

Annual Accounts 2020–21

17

Trustees’ reportTrustees Report

The Board of Trustees presents their annual report on the affairs of the charity, together with the financial statements for the year ended 31 March 2021.

Background

St Nicholas Hospice Care has been supporting the people of West Suffolk and Thetford since 1984. This catchment area includes a population of approximately 270,000 (240,000 in West Suffolk and 30,000 in Thetford area).

Every year we support nearly 2,000 local people, delivering care to people in their own homes as well as in outpatient sessions, and

our inpatient ward. Services are not just for patients, but for their family and friends too, and include everything from specialist medical care to bereavement support and practical help. We also work with other community services that can help and provide a variety of training and education to local professionals and carers about palliative care and bereavement.

Our vision

For everyone to matter in life and death.

Our mission

For everyone to be informed, equipped and able to live with dying, death and grief.

St Nicholas Hospice Care

18

Our values

Compassion

From our people you can expect care, warmth, kindness and honesty.

Listen

We listen to what is important to you. What you tell us will be understood and not judged.

Team spirit

We work together with respect, friendship, trust and a touch of laughter.

Learn

We lead and develop, sharing knowledge and skills generously.

Resilience

Our attitude towards change and the future has the courage to move and grow with life’s changes.

19

Annual Accounts 2020–21

Objectives and Activities

Charitable activities

The Charity reviews its objectives and activities annually, identifying achievements and outcomes and ensuring that the activities relate to the aims and objectives set.

Hospice services

Our services are provided free to patients and their families and friends; however, some educational sessions do require payment. A clinical team led by the Clinical Services Director and Consultants in Palliative Medicine deliver the clinical services.

The Clinical Services Director is also the Registered Manager, Clinical Information Governance Lead and Accountable Officer (for Controlled Drugs). One of the Consultants in Palliative Medicine is the Caldicott Guardian. We have developed a flexible and experienced skill mix of people, ranging from employed staff such as palliative care clinicians, therapists and carers, to our broad mix of volunteers who provide support to all our services and organisational functions and work across all settings. This enables us to focus on proactive care planning and management, which aids effective people-centred decision-making.

Our services ensure that specialist support and advice is available to people wherever they are whether at home, in a care home, in a hospital or without a home. Some 88% of people receiving hospice care are at home.

However, we also support people in many different settings, from the Hospice itself in Bury St Edmunds, which has a 12 bedded inpatient unit, West Suffolk Hospital Foundation Trust to working in local communities.

In line with our Equip Provide Strive Strategy our services to those facing dying, death and grief are provided by:

• A specialist multidisciplinary team providing clinical consultation, advice and education including:

• A locality approach where our teams are connecting and working with:

• Education and training for people, families and professionals about caring and supporting people at the end of life and those bereaved, including:

20 St Nicholas Hospice Care

Bosmere Community Primary School in Needham Market added their support to our hearts and crosses innitiative.

Staff at the school knitted hearts, and the children of key workers who still attended school at the time drew colourful wishing hearts which were displayed in the Hospice’s reception.

Our services are provided free to patients and their families and friends; however, some educational sessions do require payment. A clinical team led by the Clinical Services Director and Consultants in Palliative Medicine deliver the clinical services.

The Clinical Services Director is also the Registered Manager, Clinical Information Governance Lead and Accountable Officer (for Controlled Drugs). One of the Consultants in Palliative Medicine is the Caldicott Guardian. We have developed a flexible and experienced skill mix of people, ranging from employed staff such as palliative care clinicians, therapists and carers, to our broad mix of volunteers who provide support to all our services and organisational functions and work across all settings. This enables us to focus on proactive care planning and management, which aids effective people-centred decision-making. Our services ensure that specialist support and advice is available to people wherever they are whether at home, in a care home, in a hospital or without a home. Some 88% of people receiving hospice care are at home.

However, we also support people in many different settings, from the Hospice itself in Bury St Edmunds, which has a 12 bedded inpatient unit, West Suffolk Hospital Foundation Trust to working in local communitieAnnual Account s . 2020–21 21

Who uses and benefits from the Hospice’s services?

Our purpose is to benefit

Our services are available to people living within the West Suffolk and Thetford areas (South Norfolk). Whenever possible, we will also help people outside our immediate catchment area if it is their wish to be supported by us.

As well as working with fellow healthcare professionals, we promote self-referral or contact from family or friends on behalf of others. We actively encourage people and their families to contact us early so we can help them live well and maintain their independence. Our services

are there to support anyone who needs us, sometimes from the point of diagnosis onwards, not just in the last year or months of life.

Additionally, the Hospice works with teenagers, young people, and their families. To promote continuity, Hospice staff collaborate with East Anglia’s Children’s Hospices to help meet the needs of young people transitioning from child to adult services.

The growing need in our community

----- Start of picture text -----
Brandon
Thetford
Lakenheath
Botesdale
Mildenhall
Stanton
Cavenham Ixworth
Newmarket Barrow Bury St Edmunds
Woolpit
Whepstead
Hawkedon Thorpe
Morieux
Haverhill Clare
Long Melford
Sudbury
----- End of picture text -----

Approximately 270,000 people live in our service area. The Suffolk Public Health Team has projected that West Suffolk CCG’s ageing population will grow; those aged 65 - 84 by 20.5% , and those 85+ by 45.3% by 2028.

Total annual deaths in West Suffolk Local Authority, 2011 - 2018 1,698

1,355

Since the last census in 2011, by 2018 the number of deaths in the West Suffolk local authority area had grown 25% . It can be estimated anywhere between 69% - 82% of deaths need palliative care. (Murtagh, 2014)

St Nicholas Hospice Care

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“Palliative care is required for a wide range of diseases. The majority of adults in need of palliative care have chronic diseases such as cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%). Many other conditions may require palliative care, including kidney failure, chronic liver disease, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, neurological disease, dementia, congenital anomalies and drug-resistant tuberculosis.”

World Health Organisation, 2020

The impact on dying during the Covid-19 pandemic

----- Start of picture text -----
Where people died People who died and
In respect to where people had died, those dying in a received Hospice support
community setting (usual place of residence or settings
such as nursing or care homes) increased significantly. In 2020/21, we saw an increase in the number
We believe this is due to the pandemic’s impact on of people who had died and received Hospice
healthcare services, people’s fears of being restricted services during their illness.
from visiting loved ones, and the virus’s overall effect on
the total number of deaths.
519
500
440 446
400 981
300
902
200
834
100
0
2018/19 2019/20 2020/21 2018/19 2019/20 2020/21
Unknown Community Hospice Hospital
----- End of picture text -----

Age frequency of the people we supported in the year 2020

The Hospice’s supports people from a range of ages but predominantly those in their older age.

----- Start of picture text -----
29%
30%
25% 23%
20%
17%
15%
12%
10%
7%
5% 3% 3%
2% 2%
1%
0%
0%
<5 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85-94 95-105
----- End of picture text -----

23

Annual Accounts 2020–21

29

EQUIP PROVIDE

STRIVE

Life’s Questions sessions held with a total of 549 attendees

20

Gravetalk sessions held with a total of 130 attendees

2,651 The total number of people who attended a Hospice education session

24 St Nicholas Hospice Care

EQUIP

The Hospice uses education, public awareness and community development approaches to support and build compassionate communities.

The Hospice equips local communities by growing links and relationships between Hospice teams, local people and organisations. We inspire local groups to ask ‘what they can do’ in their areas to support people who are experiencing dying, death and grief.

Resilient response

The pandemic disrupted our normal ways of working to equip the community. However, our teams found they could transfer education sessions and advice into digital formats establishing new ways to reach people.

The Education team successfully sustained expected reach levels, delivering virtual sessions to more than 2,500 delegates in 2020/21, benefiting healthcare professionals and the community.

Technological adaptation also supported those activities which equip people to talk about dying. Gravetalk grew attendees, 130 compared to 98 the previous year, in roughly the same amount of sessions, 20 compared to 22. Also, despite significant disruption to schools during the pandemic, we could still equip teachers and pupils to talk about dying, death and grief. We held 29 Lifes Questions sessions, facilitating 549 delegates compared to 33 sessions and 670 delegates the previous year. In addition, our Life’s Question’s lead has used the year to develop a manual to aid further coaching and equipping of others.

outcomes of its service design work of the last few years by recruiting our first Community Connectors. The team focuses on building relationships in the community to facilitate signposting to Hospice services and other sources of support in the community; this marks a development in our strategy to build resilience in communities and support them to access to our healthcare partners and community groups.

The Hospice also implemented one of the key

Annual Accounts 2020–21 25

EQUIP

Gravetalk adapts to online offer

GraveTalk is an opportunity for learning from one another in a safe environment where questions can be shared and discussed.

The team adapted to provide their sessions online via Zoom.

Held over the course of five sessions the group interact, listen and share thoughts. In essence, it is learning through exploring, experiences, thoughts and expectations. It is knowing how to enable, equip and encourage others to have difficult conversations.

The sessions look at Life, Death, Society, Funerals and Grief. In the final session we look at enabling others to have these conversations.

Good Grief festival – Life’s Questions workshop

Life’s Questions was highlighted at the Good Grief Festival.

Lisa Patterson held a workshop on the Life’s Questions initiative during the virtual Good Grief Festival in late October 2020.

“For many the current situation means that these topics are at the forefront of our minds, many of us may already be having these conversations.

“It is important that we not only have these conversations with those close to us but that we listen to our loved ones when they want to talk about death and grief.”

To aid conversations around dying, the Hospice, worked with colleagues in the NHS, to develop some guidance titled Talking Together About Dying.

The choices that people make around death and dying, however big or small, can give people a sense of control, the Hospice wanted the guidance to help people to talk about and record their wishes, and guide them to important advance care planning documents.

We all need to talk together about dying. At the moment people can become ill quickly. Before they do, we need to have a conversation about what is important to them.

Why is it important to talk about dying?

We all make choices throughout our lives and some of these are really important. This is another time when you will need to make some choices. The choices we make in death and dying give us a sense of control, however big or small.

before having the conversation

----- Start of picture text -----
It’s ok to have some of the following thoughts and feelings...
----- End of picture text -----

The Good Grief Festival aims to help people to talk, think and learn about grief. Lisa highlighted the important ways Life’s Questions helps children and young people across West Suffolk and Thetford.

Lisa said at the time: “The Good Grief Festival will give us a chance to showcase the work we are doing in our community, and give far reaching professionals from the children’s sector a taste of what a session is like. Equip them to have these possibly perceived taboo conversations and hopefully lead to them wishing to take on board the training manual we are developing.”

Dying Matters Awareness Week

The Hospice used the national awareness week to encourage families to have conversations around dying, death and grief, especially with the backdrop of the pandemic’s impact on the community and dying.

At the time, Barbara Gale, the Hospice’s Chief Executive, said: “Dying Matters Awareness Week is an important week as it puts these topics on the agenda.

----- Start of picture text -----
I don’t know what you would want if you I am worried about what
were really sick, how much treatment you want, or if you would want to might happen if I get
go to hospital. coronavirus.
If I talk to my
I don’t think loved one about I don’t I don’t
we’ve talked about a funeral, where your will is, or where your passwords are. the possibility they might die, will that jinx things and bring about their death? about this.worry you by talking want to want to leave you.
----- End of picture text -----

Having the conversation

----- Start of picture text -----
This might not be an everyday conversation but it is a
valuable one - so take a deep breath, and give it a go.
These are unusual times, and I’ve been
thinking about how important you are to me.
I’ve asked myself, if you became less well
during these times, would I know your wishes?
Can we have a conversation so I know what you would
want? We could write it down, so if I wasn’t with you
the doctors and/or nurses would know what you want.
What would you want to happen if your heart stops?
Have you talked about it with nurses and doctors?
If you were seriously ill, and might die,
what would you want to happen?
----- End of picture text -----

More information to support you

You may wish to use documents provided by your local healthcare system to help record your wishes:

----- Start of picture text -----
For people living St Nicholas Hospice For people living in
in Suffolk Care’s website north east essex
My Care Wishes for more links and support My Care Choices
available at www.stnicholashospice.org.uk/ available at
www.bit.ly/my-care-wishes talking-together-about-dying www.mycarechoices.online
----- End of picture text -----

----- Start of picture text -----
Produced by St Nicholas Hospice Care in conjunction with the NHS
----- End of picture text -----

St Nicholas Hospice Care

26

EQUIP

Introduced Community Connectors team

In spite of the challenges of the pandemic on developing services, the Hospice was able to implement a new team.

The newly formed team consists of a Lead Hospice Community Connector and three Hospice Community Connectors who will be collaboratively working within the West Suffolk and Thetford area.

They link internally within the Hospice and externally with local partnerships both statutory and voluntary sectors, to co-create compassionate communities through an ‘Asset Based Community Development’ model which makes visible and values the skills, knowledge, connections and potential in a community.

The team is focusing on the value of community groups and assets. We hope to offer support to enable people to build or rebuild friendships, community connections and a sense of belonging, as well as accessing existing services.

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Internet GPs
Schools Hospice
Churches Council
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inspired
How can I help? I knowlots of
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We have contribute
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share
I have
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the care
home
We have lots
I know my community of communitygroups
COUNCIL
Compassionate
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How does the
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Annual Accounts 2020–21 27

EQUIP

PROVIDE STRIVE

1,476 home visits were made

by the Clinical Community Team

165 ward admissions including re-admissions

425 people received 1-2-1 bereavement sessions

28 St Nicholas Hospice Care Measures from April 2020 – March 2021

PROVIDE

The Provide element of the Hospice’s model focuses on the specialist clinical expertise and care we are able to offer to those at the end of their lives, as well as support for their carers and those important to them.

Our clinical team, made up of consultants in palliative medicine, doctors, specialist nurses, therapists, healthcare assistants and advanced practitioners all provide highly skilled and complex advice and support for those who most need very complex intervention.

Service challenges

The pandemic significantly affected our specialist services and changed their delivery and where people wished to receive care.

The number of patients wanting to die at home had increased due to Covid-19 because of fears of infection in the hospital or hospice and worries about visiting restrictions. The clinical teams saw a 28% increase in patients dying at home, 457 versus 357 in the previous year. Ward admissions fell to 165 compared to 194 the previous year.

Clinical teams in all settings (psychological support, community and inpatient) worked with great care to follow infection prevention guidance to ensure patient safety while managing personal challenges, such as risks to their health and family, and coping with bereavement.

The need to relearn guidance was constant. The teams also faced difficulties providing the care they are well-known for whilst they contended with donning and doffing PPE and maintaining distance from patients and their colleagues.

In the face of the hardest of challenges, where staff could, they adapted and worked differently to ensure the Hospice could still reach people. While home visits were limited during lockdown periods and thus fell, 1,476 verses 2,563 the previous year, the teams were able to increase telephone contact by 12% compared to last year to ensure patients could access support.

Our psychological professionals successfully used virtual video calling to meet increased demand, supporting more individuals with 1-2-1 bereavement sessions, 425 people compared to 288 the previous year. They also were able to record and distribute advice online to whoever needed it, particularly concerning advice on compassion fatigue for healthcare professionals and child bereavement for schools.

The Hospice is proud of its teams for going above and beyond to ensure we sustained support. The total number of people we supported clinically was 1,898, including people receiving Hospice Neighbour visits. We believe this to be an incredible achievement, given the circumstances. We are indebted to their commitment and resilience.

A special mention of thanks goes to our Domestic, Maintenance and Catering teams, who were instrumental in keeping us safe and looked after during this time.

What next after the pandemic?

We have begun to observe how late diagnosis and delayed treatment have increased the demand for support with complex needs. To ensure our specialist support is available to those who need it, we must ensure our volunteer and Community Connector services continue to provide and enable access to light-touch support. We consider this to be an important strategic challenge going forward.

Annual Accounts 2020–21 29

PROVIDE

More support and advice provided digitally to the community

All our community-based groups were cancelled due to restrictions, also, the community needed access to information as general access to services in the local community became limited. The Hospice has launched multiple opportunities made available through online Zoom sessions such as,

Virtual Breathing Space - a monthly group that provides a mixture of education, exercise, peer support and relaxation to help those struggling with breathlessness to be able to cope with this very debilitating symptom.

Virtual Singing Group - aimed at encouraging everyone in the Hospice community to sing. It is increasingly well documented that regular singing has significant health and psychological benefits.

Adapting the use of volunteers with St Nic’s Next Door

St Nicholas Hospice Care’s Hospice Neighbours Team has adapted to the circumstance and strived to find new ways to offer compassionate support to those in our communities living with dying, caring and grief, while ensuring social distancing.

Our volunteers may have paused their face-toface visits, but they continued to offer kindness and practical support in inventive ways.

To complement our volunteer Hospice Neighbours, we offered St Nic’s Next Door. A resourceful and well connected team, who provided a warm response, supportive ideas and links to local community resources.

Virtual Mindful Movement Group - a gentle exercise and relaxation session that can be done in a group or on your own.

Living Positively – delivered over an 8-week block, the session provides a toolkit of strategies for the physical, emotional, practical and spiritual challenges of living with a palliative condition.

Virtual Bereavement Café – Support those coping with bereavement, loss and grief to share their experiences with others in similar positions facilitated by trained staff and volunteers.

“The coronavirus has changed the way we have been able to grieve, for those who have lost people during the pandemic funerals and celebrations of lives have been very different, family and friend groups haven’t been able to come together offer support.

“For those trying to find their way through a loss that may have happened some time ago, the support networks and social interactions that previously offered comfort may have stopped. Our virtual sessions may be different from our traditional bereavement cafés, but what hasn’t changed is that they are a place people can go for support, understanding and compassion.”

Our Adult Bereavement Co-ordinator on the impact of the pandemic on bereavement.

30 St Nicholas Hospice Care

Hospice hearts bring comfort and connect families

In April 2020, one of our fundraisers, Lizzie Cross, recognised the impact of wooden crosses that were given to people in our care; how they could give peace and offer comfort to those who held them.

Reflecting on this, we concluded that the cross might only appeal to those of faith and, conscious of being an inclusive organisation, a wooden heart was thought to be a sign acceptable to all. Here the “Hearts and Crosses” initiative began.

The wooden hearts and crosses were made in olive wood from the Holy Land, and a local group, The Bury Wood Turners, set to work, donating more than six hundred items for us to distribute.

supporting our attempts to offer spiritual care and a way of showing a presence, hope, strength, connection, peace and love to individuals separated at this difficult time.

People who were shielding or isolating who just wanted to make a difference to their fellow human beings, set their crochet or knitting needles to work. Parcels would be received at the Hospice with just the words ”the heart project” or anonymously dropped off outside the Hospice door.

In May 2020, after seeing a news report on people in care homes experiencing separation and isolation from their loved ones, we started to contact our local care/nursing homes. Building upon the relationships of our community team, 32 local care homes asked for some items. About 1,700 items (hearts and crosses) were delivered to the homes, enhancing community connections and starting conversations with our colleagues in care settings and the families they support.

Quickly after the initiative started, people began to provide knitted and crocheted hearts,

I lost my dad, Anthony, in May 2020. He battled cancer for two years but, during the lockdown, his health quickly declined. He went to West Suffolk Hospital and then St Nicholas Hospice for a short period. I wasn’t able to see dad for the last two months of his life because of lockdown. St Nicholas Hospice were always happy to talk on the phone, pass on messages to him from us, and were there as support when he passed away. The chaplain visited dad several times. She gave mum and dad a knitted heart, and she was with us after he passed away. This was such a personal touch to us as a family. We are grateful to the Hospice for making dad’s last weeks comfortable and for the support we were offered afterwards.

Annual Accounts 2020–21 31

STRIVE

STRIVE

As an organisation, the Hospice is committed to striving for improvement through innovation. This has been essential in developing a new Hospice model.

Experience-based service design has informed its contents, and innovative ideas have been generated and prototyped from across the Hospice teams. This will continue as the model evolves.

Development plans going forward

Before the pandemic, the Hospice had been working to develop its services to ensure its financial sustainability, and grow its reach in the community.

The disruption caused by Covid-19 resulted in the Hospice having to pause much of its development plans. However, the circumstances did propel the Hospice to move forward in important areas, for example, the adoption of technology to has proven how we can achieve further reach through different ways of working as described in the previous ‘equip’ and ‘provide’ sections.

This year, we wanted to use our ‘strive’ update to acknowledge, thank and celebrate our staff. This section of the report celebrates milestones and memorable moments during this unprecedented year.

Hospice Chaplain

becomes Honorary Canon

Sharon Connell, hospice chaplain, joined seven others at a special service at St Edmundsbury Cathedral when she was licenced as an Honorary Canon of the Cathedral.

Journal club established

A new staff Journal Club was set up by Caroline Jones from our Family Support Team.

It is intended that the club will create an opportunity for staff to debate current articles/ journals around a variety of topics for example, death literacy, holistic care and hospice care.

The staff at the Hospice came up with their own ideas to lift spirits. A Rainbow Tree was also created.

The event was live-streamed through the Cathedral’s Facebook page, and recognised Sharon’s dedicated service to the diocese.

Annual Accounts 2020–21 33

STRIVE

Life’s Questions wins Nursing Times Award

The Life’s Questions project scooped the top spot in the Children’s Services category, at the Nursing Times Award.

Judges said: “Given the significant impact bereavement and death can have on child health, wellbeing and life outcomes a public health approach to conversations about life, death, loss and grief in partnership with schools should be celebrated.

“Our winner has led the way in developing an informed and tested approach that is sensitive yet impactful. It will make a difference on many levels, and this work is particularly important in light of the global Covid-19 pandemic.”

The awards were held virtually, and Lisa was able to accept the accolade on everyone’s behalf.

Lisa said: “What an amazing accolade to have been given considering it all started in my kitchen as a test to see if a group of local teenagers thought it could be useful in their schools.

“I am super proud that the hospice and our local community have embraced this project and supported wholeheartedly.

“Our volunteers that we trained last year have made such a difference to the students they have talked with, and we see this in the post-it note responses after a session, and I’m looking forward to training more volunteers soon.

“Winning this award hopefully gives us the national (even international) reach to share with other hospices or schools to take on once training through our pending training manual.

“We already have interest from children’s services in London, community in Australia and a local teacher training school.”

Life’s Questions was also a finalist in the award’s HRH Integrated Approaches to Care category too.

To date, the Life’s Questions team have facilitated 85 sessions (14 during recent months through the online communication tool Zoom) to 1,618 children, young adults, parents, teachers, support staff, public and health and social professionals.

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Hospice staff provide advice digitally

The Hospice release videos to aid with symptoms such as Breathlessness.

The Hospice’s Family Support team has provided the resources below to help support children and young people in times of grief or bereavement.

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Annual Accounts 2020–21

Structure, governance and management

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Chief Execu
Barbar
Clinical Services Human Resources Head
Director Operations Manager Fina
Head of Education
and Outreach
Interim Head of
Head of Retail
Corporate Services
Care and Support
Operations
Manager
Catering
Head of Manager
Psychological
Services
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utive Officer
a Gale
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d of Consultants in Director of Fundraising
nce Palliative Medicine and Marketing (Deputy CEO)
Head of Head of
Facilities Manager
Marketing Fundraising
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Annual Accounts 2020–21

The Trustees confirm that they have given due consideration to the Charity Commission’s published guidance on the Public Benefit requirement under the Charities Act 2011.

1. Management and decision-making

St Nicholas Hospice (Suffolk) is a company limited by guarantee and is governed, under its Memorandum and Articles of Association, through a 62-strong membership association made up from persons from the community. The Association, in turn, appoints and monitors the performance of the Trustees. It delegates the effective Governance of the Charity to the Board of Trustees and receives reports at least once per annum. The full Board of Trustees meets quarterly to review performance and delivery of the strategic plan. Additional meetings are held to cover specific areas of focus, review strategy and direction, and the governance arrangements in place.

2. Register of members

The register of members is available for inspection free of charge, at the registered office of the charitable company.

3. Our workforce and management structure

The management and leadership of the Hospice is led by the Chief Executive who chairs a weekly Directorate meeting with the Clinical Services Director, Head of Finance, Fundraising and Marketing, and Human Resources Operations Manager. The Directorate meets regularly with the Operational Managers’ Forum to ensure good cross-organisation planning and management. The Chief Executive meets formally with the Chairman of the Board of Trustees and/or ViceChairman at least twice a month. On 31 March 2021, the Charity employed 175 staff, over half of whom were part-time (equating to 138 full-time equivalents), and 630 formal volunteers.

4. Board of Trustees committees

During the year, the Board has continued to operate four committees with specific terms of reference and functions delegated by the Board and with a Trustee as Chairman appointed by the Board - Clinical Committee, Finance and Income Generation Committee, the Human Resources Committee and the Organisational Change Committee. These committees include co- opted members with relevant experience from the Association and the majority of Trustees aside from the Chair serves on at least one Sub Committee. The meetings are attended by the Chief Executive and relevant Director or Head

of Department; other Directors attend when requested.

The Board is currently reviewing the terms of reference for the committees to ensure they continue to be fit for purpose. The committees review directorate KPIs, monitor risk, incidents, complaints, health and safety and managers’ recommendations for developments. The Chair of each committee reports back to the Board about matters discussed at each meeting.

  1. The Clinical Committee oversees all clinical matters with particular reference to palliative care and clinical standards and medicines management. It monitors performance and quality. The meetings are attended by the Chief Executive, the Clinical Services Director and the Consultant in Palliative Medicine.

  2. Finance and Income Generation Committee oversees all financial aspects and income generation and marketing aspects of the Charity’s activities. It reviews the budget and monitors performance against it. It also considers the appointment, resignation or dismissal of the external auditors and approves their annual fee. The meetings are attended by the Chief Executive, the Head of Finance and the Fundraising and Marketing Director. The committee reviews the:

  3. Charity’s investment strategy and monitors investment performance,

  4. Oversees the retail, fundraising and marketing strategy, policy and performance and reports its findings and recommendations to the Board.

  5. Audited financial statements of the Charity and recommends them to the Board, and

  6. Reports from the external auditors and monitors management actions to implement recommendations made in reports from the auditors.

  7. The Human Resources Committee reviews and monitors remuneration and employment policy and recommends to the Board of Trustees the annual employee percentage salary increase. The meetings are attended by the Chief Executive and the Human Resources Operations Manager.

  8. The Organisational Change Committee was setup to ensure procedures operate fairly and in a legally compliant way for all employees covered by SNHC Organisational

St Nicholas Hospice Care

38

Change Policy. The meetings are attended by the Human Resources Committee and 2 or 3 other members of the Board of Trustees, the Chief Executive, Deputy CEO and other staff or advisers as required.

The Board of Trustees fulfils their key role and function in overseeing and directing the affairs of the Charity, ensuring that it is well run and delivering the charitable outcomes for which it was established. The above committees are part of that process. The day-to-day running of the Hospice is entrusted to the Chief Executive who delegates that work through the Directorate and Management Team to the staff and volunteers deployed across the Charity’s services.

Trustee recruitment and induction

All current Board members have been appointed to the Board of Trustees based on their experience, expertise, and community involvement, and for their commitment to and passion for the work of St Nicholas Hospice Care and the hospice movement in general. All appointments to the Board are confirmed by the Association at its Annual General Meeting (AGM). The Board Chairman and Committee Chairs oversee the process of succession planning, recruitment and induction of Trustees and recruitment of Association Members serving on the Board Committees and will also meet with all prospective Trustees. Their work will include an ongoing skills audit and looking at different methods of recruitment.

As part of their induction, Trustees receive introductory information including planning and financial documents, national guidance about being a Trustee and information relevant to the Hospice. They see the work of the Charity first-hand and are given ample opportunities to engage with the Charity’s activities, services, staff and volunteers – and with service users as appropriate. Prospective Trustees will normally attend at least one Trustee meeting, before being asked to enter the formal processes of application and acceptance. Once approved new Trustees will usually identify particular areas of interest and will especially spend time in those areas.

Our Trustees

The Board of Trustees is made up of between no less than seven and no more than 12 Trustees.

Sam Turner joinedthe Board as a full Trustee after his appointment on 29 April 2021. Sam joined the Board last year as Young Shadow Trustee, which is part of a programme endorsed by Com-

munity Action Suffolk to develop young people as future charity leaders.

Risk and internal control

The Trustees have overall responsibility for ensuring that the Charity has an appropriate system of controls, financial and otherwise. Trustees are also responsible for safeguarding the assets of the Charity and for taking reasonable steps for the prevention and detection of fraud and other irregularities and to provide assurance that:

As part of the Charity’s risk management process the Trustees acknowledge their responsibility for the Charity’s system of internal control and reviewing its effectiveness. The Trustees recognise that such a system is designed to manage rather than eliminate the risk of failure to achieve the Charity’s objectives and can only provide reasonable, not absolute, reassurance against material misstatement or loss.

The Charity had undertaken a strategic review of our services and delivery models to ensure we continue to serve our local communities in the best possible way. St Nicholas Hospice Care operates in a highly regulated and complex environment. Clinical quality and safety is paramount for our patients and staff, as is ensuring we raise funds in an appropriate way and that care for people’s data correctly. These operational risks are managed through the Charity’s policies, staff training and development, and governance arrangements.

Strategically, the main risks for the Charity continue to be developing ensuring a robust leadership structure following the retirement of the current CEO and vacancies at directorate in 2021. Ensuring sufficient income to meet increasing costs as well as meeting the growing demand from our local population, some of which is in response to the Covid pandemic, continue to be risks which need managing. These risks are being managed by:

Annual Accounts 2020–21 39

mitigate risk include an operational plan, an annual budget and regular updated forecasts including cash flow.

Demand

The need for hospice support continues to grow due to demographic changes, the impact of Covid-19 and continuing pressure on public services. This year we continued with the plans to deliver a more sustainable clinical model of care and cost savings, the plans have also needed to accommodate the impact of Covid on clinical care.

Income Generation

The current economic climate continues to be uncertain, with macro-economic risks potentially affecting our investment portfolio and the possible negative impact of inflation on the economy.

We work closely with our local Clinical Commissioning Groups who continue to offer additional financial support to enable and extend provision of our services. This year we have received additional government funding to mitigate some of the impact of Covid on our income. In addition, the Trustees have ensured the Charity remains in a strong financial position by maintaining sufficient reserves. The income portfolio is diverse and we constantly seek new opportunities to improve income or find new sources of income, with a particular focus on transactional funding opportunities, such as the lottery and events.

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Our people

Recruitment

Recruitment was lower than average this year due to the pandemic with only 12 new appointments being made.

Average headcount figures for 2020/21 were 175 compared to 194 in 2019/20. The full-time equivalent (FTE) figures for the same periods are 138 (2020/21) and 156 (2019/20). This represents a decrease in FTE.

Total New Starters 2020/2021

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Income
9%
Generation
Support and
16%
Admin
Service
75%
Delivery
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Remuneration and benefits

Employee Costs were £5.27m compared to £5.68m last year.

Development of staff

The key focus areas for 2020/21 was to shift all mandatory and statutory training to an online provision to ensure continued learning and organisational compliance during the pandemic.

Organisational Restructure

The Hospice underwent an organisational restructure which involved a period of collective consultation and putting 24 roles across the Hospice at risk. 15 new roles were also created as part of the restructure. The CEO and HR Operations Manager led the consultation process, with the support of an external HR Consultant.

The collective consultation process lasted for 30 days, during which time Staff forum reps were kept informed and facilitated their views and counter proposals during regular meetings with the Senior Management team. In total, 3 counter proposals were received.

The consultation followed a defined timeline of activity, ensuring each key stage was completed thoroughly, legally compliant and in as much of a compassionate manner as possible.

As a result of the restructure:-

Some 33 employees are in the NHS pension scheme (principally clinical staff), and 116 employees in the Aegon Group Personal Pension Plan.

The employer’s contributions vary from 14.38% for those in the NHS scheme, and either 5% or 7% for those in the Group Personal Pensions Scheme.

9 roles were made compulsorily redundant 2 roles were not made redundant due to counter proposals

2 bank roles continued but at reduced hours

5 employees took voluntary redundancy 6 employees were re-deployed into alternative roles

1 consultation put on hold due to ill health

Impact of Covid-19

Employee wellbeing

An employee wellbeing strategy was developed, of which our mental health first aiders are a key element.

31 employees furloughed, mainly within Retail, Catering and Community Fundraising.

44 employees transitioned to working remotely, including all Support and Admin teams, Hospice Neighbours, Education and Family Support.

42 St Nicholas Hospice Care

During the pandemic, time was taken to thank volunteers who were also affected by the circumstances.

43

Annual Accounts 2020–21

Clinical quality and assurance

The structures in place to support clinical quality across the organisation provide assurance of patient safety. We aim to demonstrate a culture of transparency, learning and continuous improvement to deliver the Hospice strategy.

Quality assurance monitoring and reporting structure

Clinical Committee

Clinical Quality and Governance Group

Incidents, complaints, Hospice concerns, Clinical UK patient safeguarding Medicines guideline safety project and management monitoring benchmarking compliments and review monitoring and learning

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Audit Hospice
monitoring Advisory
and review Group
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Clinical incidents

Serious incidents 0 Safeguarding 8 General 15 Data Protection/ 0 GDPR Covid-19 3 Medication 43 Slips, trips and falls 22 Pressure ulcer 68 Total 159

Clinical complaints and concerns Concerns 13 Complaints 12 Total 25

Patient harm is viewed seriously and we constantly strive to deliver high quality care, the robust reporting and investigation of incidents, complaints and concerns allows us to understand our performance, how we could have performed better and essentially, if learning is achieved that this is shared with our teams.

Hospice UK benchmarking figures

Annual Accounts 2020–21 45

During 2020/21 the number of reported incidents reduced slightly, this included the number of slips/trips/falls (almost 50% reduction) and GDPR breaches. The number of pressure ulcers remained consistent and all other incidents increased, with medication errors being the most significant with an increase of 48%.

Covid-19 incidents involved 2 outbreaks of Covid-19 on Sylvan Ward; 1 involving patients and 1 involving staff. A further incident involved 2 community staff testing positive. (Outbreak defined as 2 or more confirmed Covid-19 cases). During this period frequent reporting was required to Public Health England, NHS England/ Improvement and Clinical Commissioning Group colleagues.

Process and practice changes evolved quickly during the early part of 2020 in response to learning achieved upon prompt review of outbreaks, which adopted a multi-agency approach, this response was supported by clinical and non clinical colleagues and involved enhanced testing of patients and staff, use of single patient rooms only, strict use of PPE, enhanced cleaning procedures, restricted access to clinical areas by staff and visitors and careful triage of patients prior to home visits.

against the 5 Key Lines of Enquiry used by CQC and alongside which we will be assessed as follows:

Audit

A focus on service delivery during the heightened pandemic period has resulted in a need to refocus on clinical audit to benchmark clinical quality. The need to review these and ensure that they remain good indicators of quality care is a priority during 20/21.

Safeguarding

We continued to raise awareness of the Suffolk Safeguarding Framework to underpin decision making and signposting to support decisions around safeguarding concerns. A total of 8 Safeguarding concerns were logged during 2020/21. A new Safeguarding Lead was appointed to guide this work during March 2021, who has further extended our links across the region and strengthened reporting systems and staff understanding/engagement still further.

CQC

preparation

Having submitted updated information to the Care Quality Commission (CQC) to support our previous Provider Information Request pack, we continue to expect an unannounced CQC inspection visit in due course.

As before, we benchmark our service provision

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Local company, Treatt gifted a selection of bird feeders and bags of food for use in the Hospice’s garden over the winter months.

Chloe Ludkin, personal assistant to Treatt’s Chief Executive Officer, said: “We’re delighted we could help St Nicholas Hospice Care in this small way, and hope that birds eating from the feeders may bring a smile to the face of a patient or a visitor.

“The Hospice is an important local charity and one that is close to the hearts of many of our staff and their families.”

Annual Accounts 2020–21

47

£ £ £ £6.1m £ £ £ total Hospice income in the financial year 2020/21 Donations, Legacies and Grants totalled £1.4m

The Hospice’s Lottery raised £[405k]

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St Nicholas Hospice Care
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Income generation

In 2020/21, several income streams were significantly affected by public health restrictions causing a drop in activity, particularly in community fundraising and retail.

Key support was needed from a financial package from the government to cover losses in income, also, additional funding for our adapted services to aid the NHS, and the commitment of determined supporters were vital in raising funds for the year. Here are just a few of the inspiring examples of fundraising which helped St Nic’s:

Virtual fundraising support

Hospice and supported-led activity used creativity to reimagine fundraising in a locked down world.

The Hospice digitally hosted some its traditional events such as Girls Night Out, Open Gardens and Light up a Life to ensure the community could engage with some of its much loved annual activities bringing entertainment, remembrance and challenges to supporter’s homes. Also, it introduced new events to encourage bringing people together to participate in lectures and sing-a-longs for when people were asked to stay home.

Some of our most enthusiastic supporter set themselves big challenges that they could take on in their own home, such as Matthew Crawley (picture right), who supported by his work colleagues from the Institute of Cemetery and Crematorium Management smashed their 1 million steps in May target and raised £950.

Annual Accounts 2020–21 49

Sewing skills makes a difference

Charlotte MacDonald made 185 fabric face masks and raised more than £900 for us.

Charlotte was spurred on to raise funds in memory of her dad, Anthony King, who was cared for on the Sylvan Ward for a short time before his death on May 25.

Charlotte said: “I started by making myself, my husband and mum one, then a few friends wanted one, so it spiralled from there.

“I wanted to raise money for St Nicholas Hospice and thought this could be a good way to put my skills to use and help others.

“As I was on furlough from work, I undertook this project during my baby’s nap time. I posted my progress on social media and I had a steady amount of orders.”

When the government announced it would become mandatory to wear either a face mask or covering in shops, Charlotte saw her orders soar with 40 placed in just one day.

Light up a Life provides digital way to remember loved ones who died

Last year our Light up a Life season of remembrance had to run differently.

Although the events could not take place in the traditional way, pre-recorded video services personalised for each community meant we were able to offer people a way to come together and remember loved ones.

Teams across from across the Hospice worked together to make the virtual services happen, and we hope all those who watched them felt comforted and supported.

Every year we receive donations from those who attend services, and in 2020, people’s generosity meant £23,804 was raised to support the Hospice’s work.

Team 365Motivate race to complete 365 Miles in 7 days.

Lucy Cronin said: “The Hospice is such a special place and an essential part of our community. Everyone in my 365 Team has had a family member or knows someone who has used the Hospice’s services.”

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Introduction of new Corporate Supporters Club

Sponsored by 1 Accounts Online, the new membership initiative enabled local businesses to show their support.

Paul Donno from 1 Accounts Online said at the time: “Continuing to support the Hospice through these difficult times is imperative as they need the funding more than ever.

“The team at the Hospice are doing a wonderful job and we will continue to support them for as long as we are able. Well done.”

Socially distanced skydive day

11 fundraisers took the plunge for the Hospice and raised an amazing more than £5k.

Facebook birthday fundraiser

Abbie and Elena Holloway are twins who celebrate their birthday every year by raising funds for the Hospice in memory of their mother Julie.

This year they’ve set up a Facebook birthday fundraiser page and have so far raised more than £400.

“St Nicholas Hospice is very close to our hearts. In April 2019, our mum Julie sadly passed away from battling brain cancer. She went to St Nicholas Hospice 4 days before she passed away.

“The care and support before and after mum had passed away was incredible. They let us have time to say goodbye and be with her till the very end.”

Annual Accounts 2020–21 51

Retail

The Hospice’s shops and retail operations, were significantly affected by the pandemic’s restrictions and this resulted in large amounts of lost income.

The retail staff and volunteers have been incredibly resilient during long periods of furlough, and reacting to changing guidance.

Guidance resulted in changes to daily operations, for example, the number of customers in shops were limited, and donations were quarantined to minimise the risk of spreading the virus.

Being able to welcome customers through the doors of our shops once again was fantastic, but could only be done thanks to the hard work and determination of the teams.

Staff and volunteers at the Haverhill hub were thrilled to welcome back customers.

Shop managers were instrumental in getting teams to embrace changes and keep customers safe.

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‘Treemendous’ crop

With the ongoing pandemic and changing situation, it was uncertain if the Xmas tree collection service would be able to run in 2021. However, following all government guidelines and with the help of Urban Forestry, the team were able to continue.

The take-up for the service this year was incredibly popular, and resulted in 1,850 trees being collected, the biggest standing at an impressive 17ft. The generosity of those making donations to use the service means a total of £7,280 has been raised, more than ever before.

Darren Devine, our house clearance and retail support manager, said: “We are so grateful to everyone who booked a tree collection with us and made a donation towards the charity’s work.

“The year 2020, and the start of 2021 have been extremely uncertain times for everyone, which made being able to run our Christmas Tree Recycling Service even more important for the team and the Hospice. The response we had from the public was fantastic, and I am so pleased that so many people supported us.”

Annual Accounts 2020–21 53

Fundraising Compliance Report

St Nicholas Hospice Care employs a core fundraising staff to develop, promote and run a range of fundraising campaigns, assisted by vital volunteers and taken up by our supporters. We steward our donors and promote our fundraising campaigns to them, and the wider community which we serve, through direct mail, e-mail contact, telephone and digitally. During the pandemic, we did not engage in any canvassing activity to promote our lottery.

We constantly monitor the cost and time which goes into each fundraising activity against the financial return to ensure we are making the most of every donation received. Many of our income streams were adversely effected by the Covid pandemic, but this loss was offset by income received through government grants in this exceptional year.

We are registered with the Fundraising Regulator and work in accordance with the Code of Fundraising Practice, and the best practice laid out by the Hospice Lotteries Association, Institute of Fundraising and Institute of Legacy Management. Our lottery and raffles are promoted in accordance with the Gambling Commission guidelines and we have checks in

place to monitor third parties who carry out work for us, or for whom we enter into contracts with. We appraise the commercial marketplace before entering into contracts with others and ensure our supporters enter into written agreements with us when promoting or selling products or activities which raise funds for us. Our staff are encouraged to be actively involved with these organisations at a strategic level, and we meet the standards required of these memberships.

We received two suppressions of contact through the Fundraising Regulator in this year, which were actioned, and received 3 other complaints during the year which responded to appropriately.

We review the frequency and appropriateness of our communications and provide an option for supporters to ‘opt-out’ of our communications. We contact based on legitimate interest, and also run vulnerability checks and have a self-exclusion form on our website for gambling-related products.

We continue to listen to our supporters and to learn from them to shape our fundraising activity. Our supporters are very important to us, and we put them at the heart of everything we do.

Thanking Trusts and Foundations

Thank you to all of the other Trusts and Foundations, which have supported our work during 2020/21

Funding from Suffolk Community Foundation through the Suffolk Coronavirus Community Fund, Bluebell Fund, Martineau Fund, Food and Drink Fund, Miller Fund and the Suffolk Giving Fund.

St Nicholas Hospice Care

54

Our annual Girls Night Out walk was transformed into a virtual event, with walkers participating nearer to their homes whilst they tuned into a live stream on social media. Hospice staff shared stories of hospice work, and pre-recorded messages and entertainment from local people were broadcast. We were thrilled to be able to engage the community in such a dynamic and digital way.

55

Annual Accounts 2020–21

Going concern

Like many other charities, the Hospice faces the challenge of providing an equitable service which can respond flexibly to the changing and growing needs expressed by people in the local community, as well as ensuring the charity remains financially sustainable, despite the additional challenges imposed as a result of the pandemic.

The Trustees have considered the following areas specifically in their assessment of going concern:

Reserves

At the end of the financial year 2020/21, the Charity has reserves amounting to £8.03m of which £5.60m are free reserves which exceed the target of six months total running costs. This allows for investment in services, income generation and infrastructure to further the Charity’s aims and objectives as well as providing funds to mitigate against economic uncertainty including from the impact of the pandemic.

The impact of Covid-19 on going concern

The senior management team produced a revised plan to deliver the new clinical model over three years within a reduced funding envelope. The approved plan was to maximise income and also to deliver recurrent savings by 2021/22 of over £1m. This included a restructure of clinical, fundraising and retail departments, which was completed in 2020/21 so that the full year effect of the savings is in place for 2021/22. The ongoing challenges of Covid-19 will mean plans will have to be continually reviewed, recognising the uncertain future impact on some income generation activities.

Fundraising

St Nicholas Hospice Care has a diverse range of income-generating activities including grants and donations, investments, fundraising, retail, events and lottery income. Some of these income streams are inherently volatile and our income generation strategy has been remodelled in recognition of the challenges of Covid-19. In addition, the Charity has policies in place to manage these risks including specific investment and reserves policies, explained in the Trustees Report. The ongoing use of designated funds to improve existing or develop new income streams will add to this diversification and enable the Charity to continue serving our local population.

NHS Grant Funding

West Suffolk Clinical Commissioning Group (WSCCG) is the main single NHS funder and continues to support the work of the Charity. The Charity has agreed with WSCCG that there will be a gradual increase in income over five years, from £945k to £1.4m March 2024.

St Nicholas Hospice Care

56

Trustees’ responsibilities in relation to the financial statements

The Trustees (who are also the directors for the purposes of company law) are responsible for preparing the Trustees’ Report and the financial statements in accordance with applicable law and regulations.

The law applicable to charities in England and Wales requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the state of the affairs of the charity and of the incoming resources and application of resources of the charity for that period. In preparing those financial statements, the Trustees are required to:

Select suitable accounting policies and then apply them consistently

The Trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the company’s transactions and disclose with reasonable accuracy at any time the financial position of the company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

The directors are responsible for the maintenance and integrity of the corporate and financial information included on the charity’s website. Legislation in the UK governing the preparation and dissemination of financial statements and other information included in the annual report, may differ from legislation in other jurisdictions.

Statement as to disclosure of information to the Auditor

In accordance with company law, as the charity’s Trustees, we certify that:

This Annual Report was approved by the Trustees on 8 December 2021.

Charles Simpson Chair

Annual Accounts 2020–21 57

Independent Auditors Report For the year ended 31 March 2021

58

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF ST NICHOLAS HOSPICE (SUFFOLK)

Opinion

We have audited the financial statements of St Nicholas Hospice (Suffolk) (the ‘parent charitable company’) and its subsidiaries (the ‘group’) for the year ended 31 March 2021 which comprise the Consolidated Statement of Financial Activities, the Group and Charity Balance Sheets, the Consolidated Cash Flow Statement and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland” (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the group and parent charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the group’s or parent charitable company’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Other information

The other information comprises the information included in the Trustees’ Report other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained within the Trustees’ Report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

St Nicholas Hospice (Suffolk) Independent Auditors Report for the year ended 31 March 2021

59

Opinions on other matters prescribed by the Companies Act 2006

In our opinion, based on the work undertaken in the course of the audit:

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the group and the parent charitable company and their environment obtained in the course of the audit, we have not identified material misstatements in the Directors’ Report or the Strategic Report included within the Trustees’ Report.

We have nothing to report in respect of the following matters where the Companies Act 2006 requires us to report to you if, in our opinion:

Responsibilities of trustees

As explained more fully in the Statement of Trustees’ responsibilities set out on page 57, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the group’s and parent charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the group or parent charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

The extent to which the audit was considered capable of detecting irregularities, including fraud

Irregularities are instances of non-compliance with laws and regulations. The objectives of our audit are to obtain sufficient appropriate audit evidence regarding compliance with laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements, to perform audit procedures to help identify instances of non-compliance with other laws and regulations that may have a material effect on the financial statements, and to respond appropriately to identified or suspected non-compliance with laws and regulations identified during the audit.

In relation to fraud, the objectives of our audit are to identify and assess the risk of material misstatement of the financial statements due to fraud, to obtain sufficient appropriate audit evidence regarding the assessed risks of material misstatement due to fraud through designing and implementing appropriate responses and to respond appropriately to fraud or suspected fraud identified during the audit.

60 St Nicholas Hospice Care

Consolidated Statement of financial activities (incorporating the income and expenditure statement) for the year ended 31 March 2021

62

Note
Income from
Grants, donations and
Legacies
Donations
Legacies
Grants
Charitable activities2
Other trading activities:
Shops
Lottery
Fundraising
Other
3
Investments
4
Other
5
Total Income
Expenditure on:
Raising funds
Raising grants, donations
and legacies
Other trading activities
Investment management
Charitable activities
In patient care
Day care
Community services
Family support and bereavement
Education & research
Total Expenditure
6
Net (losses) /gains on
investments
12
Net movement in funds
9
Reconciliation of funds:
Total funds brought
forward
Transfer between funds
Total funds carried
forward		 2021
2020		 2021
2020
Unrestricted
Funds
Restricted
Funds
Endowment
Funds
Total
£
£
£
£
794,595
156,373
-
950,968
428,128
-
-
428,128
-
-
-
-		 Unrestricted
Funds
Restricted
Funds
Endowment
Funds
Total
£
£
£
£
929,119
182,576
-
1,111,695
1,014,155
15,000
-
1,029,155
-
-
-
-
1,222,723
156,373
-
1,379,096		 1,943,274
197,576
-
2,140,850
1,938,011
1,043,463
-
2,981,474
656,441
-
-
656,441
405,256
-
-
405,256
114,351
-
-
114,351
42,902
-
-
42,902		 1,274,998
-
-
1,274,998
1,468,721
-
-
1,468,721
456,457
-
-
456,457
454,039
-
-
454,039
57,792
-
-
57,792
1,218,950
-
-
1,218,950		 2,437,009
-
-
2,437,009
137,889
-
431
138,320
362,926
-
-
362,926		 178,147
-
861
179,008
165,000
-
-
165,000
4,880,499
1,199,836
431
6,080,766		 5,998,428
197,576
861
6,196,865
(625,132)
(2,767)
-
(627,899)
(1,840,781)
-
-
(1,840,781)
(35,965)
-
-
(35,965)		 (573,969)
(488)
-
(574,457)
(2,212,631)
-
-
(2,212,631)
(39,148)
-
-
(39,148)
(2,501,878)
(2,767)
-
(2,504,645)		 (2,825,748)
(488)
-
(2,826,236)
(1,392,707)
(576,020)
(431)
(1,969,158)
(66,976)
(9,800)
-
(76,776)
(1,003,817)
(594,163)
-
(1,597,980)
(394,683)
(4,743)
-
(399,426)
(204,797)
(1,210)
-
(206,007)		 (2,056,472)
(9,581)
(861)
(2,066,914)
(351,124)
(41,204)
-
(392,328)
(1,664,438)
(103,000)
-
(1,767,438)
(445,279)
(11,609)
-
(456,888)
(235,152)
(14,465)
-
(249,617)
(3,062,980)
(1,185,936)
(431)
(4,249,347)		 (4,752,465)
(179,859)
(861)
(4,933,185)
(5,564,858)
(1,188,703)
(431)
(6,753,992)		 (7,578,213)
(180,347)
(861)
(7,759,421)
698,913
-
2,493
701,406		 (211,036)
-
(981)
(212,017)
14,554
11,133
2,493
28,180		 (1,790,821)
17,229
(981)
(1,774,573)
7,895,025
11,088
59,656
(11,088)
44,130
-
7,998,811
-		 9,422,564
263,282
305,709
(263,282)
45,111
-
9,773,384
-
7,920,667
59,701
46,623
8,026,991		 7,895,025
59,656
44,130
7,998,811

St Nicholas Hospice (Suffolk) Consolidated statement of financial activities (incorporating the income and expenditure statement) for the year ended 31 March 2021

63

Group and Charity Balance Sheets

for the year ended 31 March 2021

64

Note
Fixed assets
Tangible assets
11
Investments
12
Current assets
Stock
Debtors
13
Cash at bank and in hand
Creditors: amounts falling due within one
year
14
Net current assets
Net assets
The funds of the charity
Restricted income funds
15
Unrestricted funds:
General fund
16
Designated fund
16
Endowment fund
17
Total funds
18		 Group
2021
2020
£
2,318,149
2,441,205
5,058,847
4,616,678
7,376,996
7,057,883
31,556
29,696
2,093,874
2,100,840
527,647
789,757
2,653,077
2,920,293
2,003,082
1,979,365
649,995
940,928
8,026,991
7,998,811
59,701
59,656
2,463,535
2,254,125
5,457,132
5,640,900
46,623
44,130
8,026,991
7,998,811		 Charity
2021
2020
£
£
2,318,149
2,441,205
5,093,853
4,651,684
7,412,002
7,092,889
-
-
2,117,040
2,125,650
510,514
760,255
2,627,554
2,885,905
2,038,963
2,037,869
588,591
848,036
8,000,593
7,940,925
59,701
59,656
2,437,137
2,196,239
5,457,132
5,640,900
46,623
44,130
8,000,593
7,940,925

A separate Statement of Financial Activities (SOFA) is not presented because the Charity has taken advantage of the exemptions afforded by Section 408 of the Companies Act 2006. The net movement in funds was a surplus of £59,668.

The financial statements were approved and authorised for issue by the Board of Trustees on 8 December 2021.

Charles Simpson

Chairman

The notes on pages 68 to 85 form part of these financial statements.

St Nicholas Hospice (Suffolk) Balance Sheet as at 31 March 2021 65

Consolidated cash flow statement for the year ended 31 March 2021

66

Note
Cash flows from operating activities:
Net cash used in operating activities
21
Cash flows from investing activities:
Dividends and interest from investments
Interest received
Proceeds from the sale of tangible fixed assets
Payments to acquire tangible fixed assets
Proceeds from the sale of investments
Purchase of investments
Net cash provided by investing activities
Change in cash and cash equivalents in the year
Cash and cash equivalents at the beginning of the year
Cash and cash equivalents at end of the year
22		 Group
2021
2020
£
£
(601,282)
(1,630,155)
137,973
176,549
971
2,459
-
-
(59,010)
(155,476)
1,408,838
3,421,283
(468,802)
(1,909,094)
1,019,970
1,535,721
418,688
(94,434)
927,816
1,022,250
1,346,504
927,816

St Nicholas Hospice (Suffolk) Cash flow statement for the year ended 31 March 2021 67

Notes forming part of the financial

statements

for the year ended 31 March 2021

68

Basis of preparation

St Nicholas Hospice (Suffolk) is a private company limited by guarantee, and is registered, domiciled and incorporated in England. The registered office of the company is Hardwick Lane, Bury St Edmunds, Suffolk, IP33 2QY.

The financial statements are prepared under the historical cost convention, with the exception of investments which are stated at market value, and in accordance with applicable accounting standards and the Companies Act 2006. The financial statements also comply with the Statement of Recommended Practice applicable to charities preparing their accounts in accordance with FRS 102 and the Charity SORP (FRS 102).

The financial statements are prepared in sterling, which is the functional currency of the company. Monetary amounts in these financial statements are rounded to the nearest £.

Going concern

The Trustees have considered the financial position of the Group and Charity. In light of the above, the investment portfolio, the 2021/22 and the 2022/23 budgets and the planned service delivery model. As a consequence, the Trustees believe that the Group and Charity are well placed to manage its business risks successfully through these difficult and uncertain times.

The Trustees have a reasonable expectation that the Group and Charity has adequate resources to continue in operational existence for at least 12 months from the date of approval of the financial statements, due to:

The Trustees have not identified any material uncertainties in relation to going concern and therefore continue to adopt a going concern basis of accounting in preparing the financial statements.

Group accounts

The consolidated financial statements incorporate the accounts of the Charity and those of its trading subsidiary, St Nicholas Hospice Trading Limited for the year ended 31 March 2021. The Charity has taken advantage of the exemption from disclosing the following information, as permitted by the reduced disclosure regime within FRS 102:

Income

Income is included in the Statement of Financial Activities when the charity is entitled to the income, the amount can be quantified with reasonable accuracy and there is probability of receipt.

Income from government and other grants, whether ‘capital’ grants or ‘revenue’ grants, is recognised when the charity has entitlement to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.

Income from NHS contracts and other grants is included on a receivable basis. Recognised when the charity has entitlement to the funds, any performance conditions attached to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.

Legacies and donations are included when the aforementioned recognition criteria have been met.

Dividends and interest on fixed interest securities are included in the accounts when due.

Lottery income is accounted for in respect of those draws that have taken place in the year.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2021

69

1 Accounting policies (continued)

Expenditure and irrecoverable VAT

All expenditure is accounted for on an accruals basis (that is, recognised once there is a legal or constructive obligation committing the charity to the expenditure), and has been classified under the headings that aggregate all costs related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with use of resources.

Irrecoverable VAT is charged against the category of expenditure for which it was incurred.

Volunteers

The value of services provided by volunteers is not incorporated into these financial statements. Further details of the contribution made by volunteers can be found in note 8 to the accounts and within the Trustees report.

Tangible fixed assets and depreciation

Fixed assets costing more than £500 are capitalised, with the exception of computer equipment which is capitalised where assets cost over £100 and capital project related expenditure all of which is capitalised irrespective of value.

Depreciation is provided to write off the cost, less estimated residual values, of all fixed assets evenly over their expected useful lives. It is calculated at the following rates:-

Leasehold buildings - remaining term of lease Furniture and equipment - 10% - 50% per annum Motor vehicles - 20% per annum IT Equipment - 10% - 50% per annum

Fixed assets donated

Donated assets provided for use by the charity are taken to income and capitalised in the accounts at their estimated market value when donated.

Investments

In the Group Balance Sheet, Investments are stated at market value, less any provision for impairment. The Statement of Financial Activity includes gains and losses arising on revaluation and disposals throughout the year.

Realised gains and losses represent the difference between the market value at the previous balance sheet date and the eventual sale proceeds or the acquisition price if bought and sold within the same year. Unrealised gains and losses represent the difference between market value at the previous balance sheet date or cost of any purchases during the year and the market value at the current balance sheet date.

In the Charity Balance Sheet, ‘Investments’ includes the investment in a subsidiary, which is recorded at cost.

Stocks

Stock of retail goods is included at the lower of cost and net realisable value. Donated items of stock for resale or distribution are not included in the financial statements until they are sold or distributed. The Trustees consider it impractical to be able to assess the amount of donated stocks as there are no systems in place which record these items until they are sold and undertaking a stock take would incur undue cost for the charity which far outweigh the benefits

Pension costs

The charity contributes to a group personal pension plan and a defined benefit pension scheme. Contributions paid into these pension arrangements are charged to the Statement of Financial Activity when due.

A number of employees contribute to the NHS Superannuation scheme and certain other employees participate in personal pension plans. Whilst the NHS Superannuation scheme is a Defined Benefit Scheme, it is a multi-employer scheme for which the Charity’s share of the underlying assets and liabilities cannot be identified; it is therefore accounted for as a Defined Contribution Scheme in accordance with FRS 102. The Charity’s contributions to these schemes are therefore charged to the Statement of Financial Activity when due.

Employee benefits

The best estimate of the expenditure required to settle an obligation for termination benefits is recognised immediately as an expense when the company is demonstrably committed to terminate the employment of an employee or to provide termination benefits.

70 St Nicholas Hospice Care

1 Accounting policies (continued)

Operating leases

Rentals paid under operating leases are charged to the Statement of Financial Activity over the period in which the cost is incurred.

Fund accounting

Unrestricted funds comprise accumulated surpluses and deficits on the general fund and designated funds. They are available for use at the discretion of the Trustees in furtherance of the charity’s objectives.

Designated funds are those funds designated for particular purposes or projects at the discretion of the Trustees.

Restricted funds are created when grants or donations are made for a particular purpose, the use of which is restricted to that purpose.

Endowment funds represent funds which must be held permanently by the Charity, principally as investments. Income arising on each of the endowment funds can be used in accordance with the objects of each fund and is shown as income against that fund and allocated to costs as appropriate. Any material gains or losses arising on the investment forms part of the fund.

Taxation

The income and gains of the charity are exempt from corporation tax to the extent that they are applied to its charitable objectives. Recoverable income tax is accrued within the financial statements.

Debtors

Trade and other debtors are recognised at the settlement amount due. Prepayments are valued at the amount prepaid. Accrued income and tax recoverable is included in the best estimate of the amounts receivable at the balance sheet date.

Creditors

Creditors are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors are normally recognised at their settlement amount after allowing for any discounts due.

Cash at Bank and in hand

Cash at bank and cash in hand includes cash and short term liquid investments with a short maturity of three months or less.

Financial Instruments

The charity only has financial assets and financial liabilities of a kind that qualify as a basic financial instrument. Basic financial instruments are initially recognised at transaction value and subsequently measured at amortised costs using the effective interest method, apart from listed investments, which are held at fair value, derived as noted within the investments accounting policy.

Critical accounting estimates and areas of judgement

Estimates and judgements are continually evaluated and are based on historical experience and other factors, including expectations of future events that are believed to be reasonable under the circumstances.

Critical accounting estimates and assumptions

The Group makes estimates and assumptions concerning the future. The resulting accounting estimates and assumptions will, by definition, seldom equal the related actual results. There are not considered to be any estimates or assumptions that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next financial year.

Critical areas of judgement

The Trustees do not consider that there are any critical areas of judgement applied in the preparation of these financial statements.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2021

71

2 Income from charitable activities

2021
£
In patient care
891,914
Day care
37,329
Community services
765,236
Family support & bereavement
149,314
Hospital services
597
Education and research
93,621
Hospice UK – NHSE Funding
1,043,463


2,981,474		 2020
£
558,125
56,463
493,073
79,726
-
87,611
-

1,274,998

The NHSE awarded funding to allow the Hospice to make available bed capacity and community support from April 2020 to July 2020 to provide support to people with complex needs in the context of the COVID-19 situation and to provide bed capacity and community support from November 2020 to March 2021 for the same purpose. The funding from NHSE under both Phase 1 and Phase 2 is restricted.

3

Other income

3
Other income
Catering income
Other income
4
Investment income
Dividend – equities
Interest – fixed interest securities
Bank interest		 2021
£
24,130
18,772

42,902

2021
£
129,579
8,394
347


138,320		 2020
£
51,585
6,207

57,792

2020
£
159,383
17,166
2,459

179,008

5 Other Incoming resources

Government Grant – Coronavirus Job Retention Scheme
Government Grant – Retail Business Grant		 2021
£
261,863
101,063

362,926		 2020
£
165,000
-

165,000

72 St Nicholas Hospice Care

6 Analysis of expenditure

Costs of raising grants, donations and
legacies
Other trading activities
Shop costs
Lottery costs
Events costs
Other income
Corporation tax
Investment management costs
In patient care
Day care
Community services
Family support & bereavement
Education and research
Total		 2021
Direct
Costs
Support
Costs (note
7)
Total Costs
£
£
527,384
100,515
627,899
527,384
100,515
627,899
1,173,380
245,499
1,418,879
157,616
12,096
169,712
30,112
44,657
74,769
94,129
79,075
173,204
4,217
1,459,454
381,327
1,840,781
34,801
1,164
35,965
2,021,639
483,006
2,504,645
1,447,497
521,661
1,969,158
54,699
22,077
76,776
1,297,061
300,919
1,597,980
304,667
94,759
399,426
158,024
47,983
206,007
3,261,948
987,399
4,249,347
5,283,587
1,470,405
**6,753,992 **		 2020
Total Costs
£
574,457
574,457
1,598,762
192,241
255,601
166,027
2,212,631
39,148
2,826,236
2,066,914
392,328
1,767,438
456,888
249,617
4,933,185
7,759,421

7 Analysis of support costs

2021 2020
Admin, Human Maintenance Catering Governance Total Total
Finance & IT Resources and Domestics Costs
£ £ £ £ £ £
Cost of raising grants, donations 52,980 16,493 13,406 - 17,636 100,515 110,696
and legacies
Other trading activities 248,255 77,283 17,034 - 38,755 381,327 376,324
Investment management costs - - - - 1,164 1,164 854
301,235 93,776 30,440 - 57,555 483,006 487,874
In patient care 137,566 42,826 164,521 128,343 48,405 521,661 515,594
Day care 15,441 4,807 - - 1,829 22,077 124,752
Community services 157,639 49,074 18,746 32,086 43,374 300,919 318,079
Family support & bereavement 31,122 9,689 33,065 10,695 10,188 94,759 131,230
Education and research 20,941 6,520 15,238 - 5,284 47,983 60,208
Charitable services 362,709 112,916 231,570 171,124 109,080 987,399 1,149,863
Total 663,944 206,692 262,010 171,124 166,635 1,470,405 1,637,737

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2021

73

8 Employee Costs

Wages and salaries
Social security costs
Pension costs
Other employee benefits		 2021
£
4,446,096
385,303
336,154
101,406

5,268,959		 2020
£
4,831,534
428,042
371,286
52,500

5,683,362

Full time equivalent employees during the year were 138 (2020:156) and analysis of the headcount in the year was:

Direct charitable services
Fundraising services
Support services		 2021
Number
108
50
17

175		 2020
Number
109
54
31

194

The number of employees whose total employee benefits excluding pension contributions earning over £60,000, classified within bands of £10,000 is as follows:

£60,000-£69,999
£70,000-£79,999
£80,000-£89,999
£90,000-£99,999
£100,000-£109,999
£110,000-£119,999
Total		 2021
Actual
Number

2
-
2
-
1
-

5		 2020
Actual
Number
2
2
1
-
1
1

7

Pension costs relating to those staff earning over £60,000 totalled £46,881 in 2021 (2020: £53,146).

Termination payments amounted to £101,406 (number of people 13) (2020: £52,500) and no funding was received relating to this payment.

The Hospice considers that the key management personnel comprise of six of the senior management team – who are the Chief Executive and five other key personnel. The total employee benefits of the key management personnel of the Hospice were £519,931 (2020: £598,391)

The Hospice had an average of 630 volunteers as at 31 March 2021 (2020: 657) who provided their services in the following areas:

Retail
Clinical
Hospice Neighbours
Fundraising and support services
Trustees
Associates		 2021
Number
276
137
109
86
12
10
630		 2020
Number
281
145
116
94
10
11
657

74 St Nicholas Hospice Care

9 Net movement in funds

Net movement is stated after charging/(crediting):
Depreciation
Auditor’s remuneration
-Statutory audit of charity and group
-Statutory audit of subsidiary
-Tax advisory
-Other services
(Profit)/loss on sale of fixed assets
Government grants
Operating lease rentals		 2021
2020
£
£
181,197
172,865
16,950
13,685
3,500
3,395
1,615
685
16,477
13,658
869
-
(362,926)
(165,000)
222,912
231,111

10 Taxation

St Nicholas Hospice (Suffolk) is a registered charity and as such is exempt from taxation on its income and gains falling within section 505 of the Taxes act 1988 or section 252 of the Taxation of chargeable Gains Act 1992 to the extent that these are applied for charitable purposes.

The subsidiary trading company paid £4,217 of corporation tax in the year (2020: £nil).

11 Tangible fixed assets (Charity and Group)

Cost
At 1 April 2020
Additions
Disposals
At 31 March 2021
Depreciation
At 1 April 2020
Charge for the year
Disposals
At 31 March 2021
Net book value
At 31 March 2021
At 31 March 2020		 Long
Leasehold
Buildings
£
4,046,596
4,167
-
4,050,763
1,890,295
90,997
-
1,981,292
2,069,471
2,156,301		 Furniture and
Equipment
£
1,366,814
10,558
(162,378)
1,214,994
1,227,524
37,494
(161,715)
1,103,303
111,691
139,290		 ICT
Equipment
£
418,843
44,285
(50,754)
412,374
297,947
39,250
(50,548)
286,649
125,725
120,896		 Motor
Vehicles
£
67,280
-
-
67,280
42,562
13,456
-
56,018
11,262
24,718		 Total
£
5,899,533
59,010
(213,132)
5,745,411
3,458,328
181,197
(212,263)
3,427,262
2,318,149
2,441,205

The long leasehold expenditure represents:

All fixed assets of the charity are used for charitable purposes.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2021

75

12 Investments

nvestments
Group Charity
A) Summary 2021 2020 2021 2020
£ £ £ £
At start of the year 4,478,619 6,202,825 4,478,619 6,202,825
Additions 468,803 1,909,094 468,803 1,909,094
Disposals (1,408,838) (3,421,283) (1,408,838) (3,421,283)
Realised gains / (losses) 113,319 43,032 113,319 43,032
Unrealised gains / (losses) 588,087 (255,049) 588,087 (255,049)
4,239,990 4,478,619
4,239,990
4,478,619
Cash held as part of the investment portfolio
818,857		 138,059 818,857 138,059
Equity investment in subsidiary - - 35,006 35,006
5,058,847 4,616,678
5,093,853
4,651,684
B) Analysis of investments
2021
2020
£ £
Equities 3,589,896 3,246,341
Fixed interest securities 650,094 1,232,278
Cash held as part of the investment portfolio 818,857 138,059
Total group
5,058,847
4,616,678
Equity investment in subsidiary 35,006 35,006
Total charity
5,093,853
4,651,684
C) Historical cost of investments
2021
2020
£ £
Rathbones 1,365,579 2,182,665
Sarasin & Partners 2,231,649 2,089,731

3,597,228
4,272,396
Equity Investment in Subsidiary 35,006 35,006
Total charity
3,632,234
4,307,402
D) Trading subsidiary

The Charity holds 100% of the issued share capital of St Nicholas Hospice Trading Limited (company number 02176804), a company incorporated in the UK. The principal activity of St Nicholas Hospice Trading Limited during the year was the sale of the bought in goods, house clearances and income from the Haven Café.

The company gifts its taxable profits to St Nicholas Hospice (Suffolk) under gift aid and the aggregate capital and reserves of St Nicholas Hospice Trading Limited at 31 March 2021 were £61,405 (2020: £94,392).

All items of income or expenditure reported on the Group Statement of Financial Activities have been shown after the removal of intra group transactions.

76 St Nicholas Hospice Care

12 Investments (continued)

The trading results for the year ended 31 March 2021 and 31 March 2020 are show below:

2021 2020
£ £
Turnover 223,613 403,492
Cost of sales (197,456) (224,750)
Gross profit
26,157		 178,742
Operating expenses (6,754) (90,121)
Other operating income 21,253
Profit on ordinary activities before interest
40,656		 88,621
Interest payable on concessionary loan to hospice (625) (625)
Net trading profit
40,031		 87,996
Assets
106,902		 132,274
Liabilities (45,497) (37,882)
Net assets
61,405		 94,392
Represented by:
Capital 35,006 35,006
Reserves 26,399 59,386
Net assets
61,405
 94,392

13 Debtors

Trade debtors
Taxation recoverable
Other debtors
Prepayments
Accrued income
Legacies
Amounts due greater than one year:
Loan due from subsidiary undertaking		 Group
2021
2020
£
£
1,319,067
975,291
25,673
41,967
23,633
3,919
211,727
283,077
216,402
272,148
297,372
524,438
2,093,874
2,100,840
-
-
2,093,874
2,100,840		 Charity
2021
2020
£
£
1,317,567
976,011
25,673
41,967
23,633
3,919
211,393
282,743
216,402
271,572
297,372
524,438
2,092,040
2,100,650
25,000
25,000
2,117,040
2,125,650

In 2018/19, the charity entered into a new loan agreement to the subsidiary undertaking to fund working capital, secured by a fixed charge over goodwill and a floating charge over all assets of the company with interest charged at 2.5%. The balance on this loan will be repaid in full on 15 November 2028.

Included within prepayments is £117,365 (2020: £121,358) for a lease which falls due greater than one year.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2021

77

14 Creditors: amounts falling due within one year

Group Group Charity Charity
2021 2020 2021 2020
£ £ £ £
Trade creditors 37,608 97,968 37,341 94,324
Amounts due to subsidiary undertaking - - 56,378 71,386
Taxation and social security 95,364 107,306 89,388 104,988
Other creditors 44,444 55,576 44,444 55,576
Accruals 264,896 213,074 257,592 208,974
Deferred income – lottery 65,902 74,956 65,902 74,956
Deferred income - other 1,494,868 1,430,485 1,487,918 1,427,665
2,003,082 1,979,365 2,038,963 2,037,869

Deferred income reconciliation – lottery

Balance brought forward
Amounts released to income in the year
Amount deferred in the year
Balance carried forward
Deferred income reconciliation – other
Balance brought forward
Amounts released to income in the year
Amount deferred in the year
Balance carried forward		 Group
2021
2020
£
£
74,956
76,513
(74,956)
(76,513)
65,902
74,956
65,902
74,956
£
£
1,430,485
34,989
(1,430,485)
(34,989)
1,494,868
1,430,485
1,494,868
1,430,485		 Charity
2021
2020
£
£
74,956
76,513
(74,956)
(76,513)
65,902
74,956
65,902
74,956
£
£
1,427,665
34,872
(1,427,665)
(34,872)
1,487,918
1,427,665
1,487,918
1,427,665

Deferred income relates to income for future events, house clearances, lottery subscriptions and the CCG grant paid in advance.

15 Restricted funds (Group and Charity)

In patient care
Day care
Community services
Family support and bereavement
Education and research
Fundraising		 Balance at
31 March 2020
Income
Expenditure
Transfers
Balance at
31 March 2021
£
£
£
£
£
2,053
582,070
(576,020)
(1,053)
7,050
47,887
15,763
(9,800)
(4,219)
49,631
5,676
594,162
(594,162)
(5,676)
-
155
4,728
(4,743)
(140)
-
3,885
-
(1,210)
-
2,675
-
3,113
(2,768)
-
345
59,656
1,199,836
(1,188,703)
(11,088)
59,701

78 St Nicholas Hospice Care

15 Restricted funds (Group and Charity) (continued)

In patient care
Day care
Community services
Family support and bereavement
Education and research
Hospice Boiler Fund
Fundraising		 Balance at
31 March 2019
Income
Expenditure
Transfers
Balance at
31 March 2020
£
£
£
£
£
164,304
10,581
(9,581)
(163,251)
2,053
118,957
57,940
(41,204)
(87,806)
47,887
3,054
103,000
(103,000)
2,622
5,676
150
11,614
(11,609)
-
155
4,397
13,953
(14,465)
-
3,885
14,847
-
488
-
(488)
(14,847)
-
305,709
197,576
(180,347)
(263,282)
59,656

In Patient Care Fund incorporates:

The Hospice UK NHSE awarded funding to allow the Hospice to make available bed capacity and community support from April 2020 to July 2020 to provide support to people with complex needs in the context of the COVID-19 situation and to provide bed capacity and community support from November 2020 to March 2021 for the same purpose. The funding was allocated pro rata between the In Patient Care Fund and Community Services based on the respective expenditure and was fully expended

The In-Patient Unit Refurbishment fund , specifically for the purpose of the refurbishment of the In-Patient Unit at the Hospice. The money has been expended and is represented within the leasehold land and buildings and furniture and equipment (Note 10). The transfer for the year reallocates the net book value of the fixed assets held within the restricted fund to the Building/Fixed Asset Fund to realign the fund.

The Beds fund specifically received and partly expended for the purchase of electric beds for the Hospice. Those beds that have already been purchased are represented within furniture and equipment (Note 11).

The Sylvan Ward Fund specifically received towards the revenue funding for the running cost of the in-patient unit.

Memorable Moments specifically received to provide a memorable experience for patients who are nearing the end of their life.

Day Care Fund incorporates;

The Garden, Orchard, Bradbury Green and Family Room Refurbishment fund specifically for the purpose of the refurbishment of those areas and includes funding from previous years including a capital grant from the Department of Health to deliver tangible physical improvements enhancing care provision to the garden, Chapel, Bradbury Green and Orchard Day Therapy areas. This funding has now been fully expended apart from small amount remaining in respect of the enhancements to the Family Room and is either represented within leasehold land and buildings and equipment (Note 11) or revenue expenditure relating to garden works, which has been proportionately allocated against patient areas that benefit from the work undertaken.

The Clinical Equipment fund was specifically received for and partially expended on palliative care equipment. The equipment that has already been purchased is represented within furniture and equipment (Note 11).

The Orchard Day Care fund was specifically received revenue funding towards the running costs of the Orchard Day Centre, which supports patients in achieving independence.

The transfer for the year reallocates the net book value of the fixed assets held within the restricted fund to the Building/Fixed Asset Fund to realign the fund.

Community services restricted funds incorporates;

The Hospice UK NHSE awarded funding to allow the Hospice to make available bed capacity and community support from April 2020 to July 2020 to provide support to people with complex needs in the context of the COVID-19 situation and to provide bed capacity and community support from November 2020 to March 2021 for the same purpose. The funding was allocated pro rata between the In Patient Care Fund and Community Services based on the respective expenditure and was fully expended.

The Hospice Neighbours Project fund relates to revenue funding to maintain and grow a volunteer scheme to provide practical support to people in their own homes.

The Burton Centre Refurbishment relates to funding received in order to develop an Outreach Centre in Haverhill. The capital spent to date is represented within long leasehold and furniture and equipment .

The Burton Centre Garden – Big Lottery Fund Grant , relates to capital funding to redevelop the garden space for users of the Burton Centre.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2021

79

16 Unrestricted funds

15 Restricted funds (Group and Charity) (continued)

The Burton Centre running costs fund relates to funding received and expended in the year towards the costs of operating the Haverhill Hub.

The Community Hospice Team fund relates to specific revenue funding received and expended in the year for the Community Hospice Team Service which includes Community Nurse Specialists and community based Nursing Assistants.

The Haven Café fund relates to a specific piece of funding received to upgrade the kitchen in the Haven Café.

The Refrigerator fund relates to a specific funding used to purchase a refrigerator display cabinet at the Haven Café.

The Hospice at Home IT project relates to a piece of funding received to assist us to upgrade our systems to allow access to SystmOne remotely.

The transfer for the year reallocates the net book value of the fixed assets held within the restricted fund to the Building/Fixed Asset Fund to realign the fund.

Family Support and Bereavement restricted funds incorporates;

The Nicky’s Way fund relates to specific revenue funding received and expended in the year for the children’s bereavement support service known as Nicky’s Way.

The Miscellaneous Non Clinical Equipment fund includes the following specific funding for:

Education and Research restricted funds incorporates;

The HOPE course fund relates to revenue funding received for co-ordinating a course for cancer patients entitled ‘Help Overcoming Problems Effectively’.

The Access to work fund relates to specific funding towards special IT equipment and training for individuals coping with Dyslexia. The IT equipment purchased is represented within furniture and equipment (note 11).

The Education for Hospice Staff fund relates to grants received and expended during the year towards clinical courses.

The My Care Wishes Fund is a specific piece of funding received from the Clinical Commission Group to deliver advanced care planning to west Suffolk care homes.

Hospice Boiler Fund relates to specific funding received to upgrade the hospice boilers at the Hardwick Lane site and was fully expended in 2019/20.

Fundraising restricted funds incorporates;

Community Fundraising Vehicle Sponsorship A number of individual corporate funders sponsored the organisation to cover the lease payments for a new fundraising vehicle.

Charity

Designated funds
Building / Fixed Asset Fund
New building and maintenance fund
IT Systems fund
Service development fund
Income generation project fund
General fund		 Balance at
31 March
2020
Income
Expenditure
Investment
gains/ (losses)
Transfers
Balance at
31 March
2021
£
£
£
£
£
£
2,441,205
-
-
-
(123,056)
2,318,149
2,250,000
-
-
-
-
2,250,000
76,005
-
(59,788)
-
-
16,217
475,026
-
(924)
-
-
474,102
398,664
-
-
-
-
**398,664 **
5,640,900
-
(60,712)
-
(123,056)
5,457,132
2,196,239
4,705,059
(5,297,218)
698,913
134,144
**2,437,137 **
7,837,139
4,705,059
(5,357,930)
698,913
11,088
7,894,269

80 St Nicholas Hospice Care

16 Unrestricted funds (continued)

Group

Designated funds
Building/Fixed Asset fund
New building and maintenance fund
IT Systems fund
Service development fund
Income generation project fund
General fund		 Balance at
31 March
2020
Income
Expenditure
Investment
gains/ (losses)
Transfers
Balance at
31 March
2021
£
£
£
£
£
£
2,441,205
-
-
-
(123,056)
2,318,149
2,250,000
-
-
-
-
2,250,000
76,005
-
(59,788)
-
-
16,217
475,026
-
(924)
-
-
474,102
398,664
-
-
-
-
**398,664 **
5,640,900
-
(60,712)
-
(123,056)
5,457,132
2,254,125
4,880,499
(5,504,146)
698,913
134,144
2,463,535
7,895,025
4,880,499
(5,564,858)
698,913
11,088
7,920,667

Charity

Designated funds
Building/Fixed Asset fund
New building and maintenance fund
IT Systems fund
Service development fund
Income generation project fund
General fund		 Balance at
31 March
2019
Income
Expenditure
Investment
gains/
(losses)
Transfers
Balance at
31 March 2020
£
£
£
£
£
£
2,053,596
-
(172,865)
-
560,474
2,441,205
2,250,000
-
-
-
-
2,250,000
167,408
-
(91,403)
-
-
76,005
608,051
-
(133,025)
-
-
475,026
398,664
-
-
-
-
398,664
5,477,719
-
(397,293)
-
560,474
5,640,900
3,893,024
5,680,492
(6,869,049)
(211,036)
(297,192)
2,196,239
9,370,743
5,680,492
(7,266,342)
(211,036)
263,282
7,837,139

Group

Designated funds
Building/Fixed Asset fund
New building and maintenance fund
IT Systems fund
Service development fund
Income generation project fund
General fund		 Balance at
31 March
2019
Income
Expenditure
Investment
gains/ (losses)
Transfers
Balance at
31 March 2020
£
£
£
£
£
£
2,053,596
-
(172,865)
-
560,474
2,441,205
2,250,000
-
-
-
-
2,250,000
167,408
-
(91,403)
-
-
76,005
608,051
-
(133,025)
-
-
475,026
398,664
-
-
-
-
398,664
5,477,719
-
(397,293)
-
560,474
5,640,900
3,944,845
5,998,428
(7,180,920)
(211,036)
(297,192)
2,254,125
9,422,564
5,998,428
(7,578,213)
(211,036)
263,282
7,895,025

Building/Fixed Asset fund

This is a designated fund representing the construction costs of the existing building to 31 March 2021 less depreciation charged thereon, together with funds transferred from the original foundation fund. During 2009/10 the balance on the capital appeal restricted fund (£511,529), which was held specifically for the purpose of the development and provision of accommodation for family bereavement and support services, was transferred into this fund. During 2019/20, the Trustees gave approval to reallocate the net book value of the fixed assets held within the restricted fund (£263,282) to the Building/Fixed Asset Fund, to realign the funds, subsequently a transfer to realign has been made during the year.

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2021

81

16 Unrestricted funds (continued)

New building and maintenance fund

This is a designated fund for the purposes of maintain and updating the existing hospice building and allocating funds for future building requirements. This fund has not been drawn on during 2020/21.

IT systems fund

The charity has a number of IT systems and hardware which require replacing or upgrading to develop greater reliance, functionality and efficiency to support the services we deliver and the way in which we work, now and in the future. During 2020/21, this programme of work included upgrading the servers and improvements to the patient record system and was funded from this designated fund.

Service development fund

The purpose of this fund is to develop and test new service delivery models across our entire service offering in all settings. The fund will continue to support the ongoing development, testing and planning of services.

Income generation fund

The fund is to develop income generation through new and existing income streams that are sustainable and resilient to economic and social challenges. This fund has not been drawn on during 2020/21.

17 Endowment funds

Balance at Balance at
1 April 2020 Income Expenditure Investment gain 31 March 2021
£ £ £ £ £
The Earl of Euston 2009 Fund 44,130
 431
 (431)
 2,493
 46,623

The income earned by the Group and Charity from the investment of the fund, £431 must be spent in accordance with the objects of the Charity.

The gain arising on the investment of the fund was £2,493 and the value of the fund was increased by this at 31 March 2021. The investment management charge attributable to the fund at £165 was immaterial and no adjustment has been made to the value of the fund

Balance at Balance at
1 April 2019 Income Expenditure Investment loss 31 March 2020
£ £ £ £ £
The Earl of Euston 2009 Fund 45,111
 861
 (861)
 (981)
 44,130

18 Net assets by funds

Group
Investments
Tangible fixed assets
Current assets
Creditors falling due within
one year		 General
Funds
Restricted
Funds
Endowment
Fund
Total Funds
31 March
2021
£
£
£
£
5,012,224
-
46,623
5,058,847
2,318,149
-
-
2,318,149
2,593,376
59,701
-
2,653,077
(2,003,082)
-
-
(2,003,082)
7,920,667
59,701
46,623
8,026,991

St Nicholas Hospice Care

82

18 Net assets by funds (continued)

Charity
Investments
Tangible fixed assets
Current assets
Creditors falling due within
one year
Group
Investments
Tangible fixed assets
Current assets
Creditors falling due within
one year
Charity
Investments
Tangible fixed assets
Current assets
Creditors falling due within
one year		 General
Funds
Restricted
Funds
Endowment
Total Funds
31 March
2021
£
£
£
£
5,047,230
-
46,623
5,093,853
2,318,149
-
-
2,318,149
2,567,853
59,701
-
2,627,554
(2,038,963)
-
-
(2,038,963)
7,894,269
59,701
46,623
8,000,593
General
Funds
Restricted
Funds
Endowment
Fund
Total Funds
31 March
2020
£
£
£
£
4,572,548
-
44,130
4,616,678
2,441,205
-
-
2,441,205
2,860,637
59,656
-
2,920,293
(1,979,365)
-
-
(1,979,365)
7,895,025
59,656
44,130
7,998,811
General
Funds
Restricted
Funds
Endowment
Total Funds
31 March
2020
£
£
£
£
4,607,554
-
44,130
4,651,684
2,441,205
-
-
2,441,205
2,826,249
59,656
-
2,885,905
(2,037,869)
-
-
(2,037,869)
7,837,139
59,656
44,130
7,940,925

19 Related party transactions

One of the charity trustees or connected persons received remuneration for the year of £1,350 (2020: nil).

Trustee indemnity insurance is included within total insurance costs of £53,947 (2020: £54,508). It is not possible to quantify the trustee indemnity element from the overall insurance cost.

Three trustees were St Nicholas Hospice Care Lottery subscribers in the year (2020: four) and in total paid £260 (2020: £312. Their winnings amounted to £10 (2020: £10).

During the year one trustee commissioned the services of the house clearance team and paid a fee of £300 (2020: £300)

During the year fourteen trustees and associates (2020: 12) made donations totalling £1,849 (2020: £10,775).

Transactions with the subsidiary undertaking were:

nsactions with the subsidiary undertaking were:
2021 2020
£ £
Loan outstanding from the trading company to the charity 25,000 25,000
Current account balance from the trading company to the charity 57,878 71,386
Gift aid donation from the trading company to the charity 68,801 84,931
Recharged costs from the charity to the trading company 4,019 256,709
Recharged income from the charity to the trading company 71,315 373,233
Interest paid/received on loan to subsidiary 625 625

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2021

83

20 Financial commitments

As at 31 March 2021, the charitable company had annual commitments under non-cancellable operating leases as set out below:


Operating leases which expire:
Within one year
Later than one year but not later than five
Later than five years		 Land and buildings
Other
2021
2020
2021
£
£
£
178,595
191,554
17,464
282,735
493,286
16,637
10,080
41,160
-


471,410
726,000
34,101		 2020
£
31,218
47,029
-
78,247

21 Reconciliation of net income / (expenditure) to net cash flows from operating activities

Net expenditure
Adjusted for:
Depreciation charges
(Gains)/ Losses on investments
Dividends received from investments
Interest received
Loss on the sale of fixed assets
Increase in stocks
Decrease/(increase) in debtors
(Decrease)/increase in creditors
Net cash used in operating activities		 Group
2021
2020
£
£
28,180
(1,774,573)
181,197
172,865
(701,406)
212,017
(137,973)
(176,549)
(971)
(2,459)
869
-
(1,861)
(406)
8,466
(1,480,751)
22,217
1,419,701
(601,282)
(1,630,155)

22 Analysis of changes in net funds

Opening net funds
Cash and cash equivalents
Changes in net fund arising from cash flow of the group
Closing net funds
Cash and cash equivalents		 Group
2021
2020
£
£
927,816
1,022,250
418,688
(94,434)
1,346,504
927,816

23 Analysis of cash and cash equivalents

Cash at bank and in hand
Cash held as part of the investment portfolio		 Group
2021
2020
£
£
527,647
789,757
818,857
138,059
1,346,504
927,816		 Charity
2021
2020
£
£
510,514
760,255
818,857
138,059
1,329,371
898,314

24 Members guarantee

The charity has no share capital but is limited by guarantee. Every member of the charitable company is a guarantor and undertakes to contribute to the assets of the charitable company, in the event of it being wound up, such amounts as may be required. Each guarantor’s liability is limited to £1.

84 St Nicholas Hospice Care

25 Pension costs

A group personal pension plan is operated on behalf of certain employees. The assets are held separately from those of the charity in independently administered funds. The pension charge represents contributions payable by the charity to the plan at rates ranging from 5% to 7%. Contributions paid by the charity during the year amounted to £157,792 (2020: £166,563). Contributions outstanding at 31 March 2021 amounted to £20,550 (2020: £25,742) and were included within other creditors.

In addition, certain other employees previously employed by the National Health Service have, by arrangement, continued to be members of the NHS Pension Scheme, a multi-employer defined benefit scheme, whilst in the employment of St Nicholas’ Hospice (Suffolk). Contributions paid by the charitable company during the year amounted to £179,157 (2020: £204,723). Contributions outstanding at 31 March 2021 amounted to £22,965 (2020; £28,182) and were included within other creditors.

The scheme is not designed to be run in a way that would enable NHS bodies to identify their share on the underlying scheme assets and liabilities. Therefore, the scheme is accounted for as if it were a defined contribution scheme: the cost to the Hospice of participating in the scheme is taken as equal to the contributions payable to the scheme for the accounting period.

Employers’ contributions to the NHS pension scheme were made at the rate of 20.68% (2020: 20.68%). The increase from 14.38% is still being funded by the NHS Pension Schemes transitional arrangements resulting in no additional costs to the charity. This transitional arrangement is to continue into 2021/22. Employee contributions ranged from 5.6% to 13.5%.

26 Material legacies

Legacy income is only included in incoming resources where receipt is probable and the amount can be measured reliably, or the legacy has been received. There were no additional notifications which could be determined to be probable, material or reliably measured over and above those already recognised in the financial statements as at 31 March 2021 (2020: £Nil).

27 Capital commitments

In respect of the Group and Charity, there was £18,634 of expenditure authorised and contracted (2020: £11,849) at the end of the financial year.

28 Financial Instruments

Financial assets:
Instruments measured at fair value through profit & loss		 Group
2021
2020
£
£
4,239,990
4,478,619		 Charity
2021
2020
£
£
4,239,990
4,478,619

29 Contingent Liabilities

The charity is registered within the VAT group with St Nicholas Hospice Trading Limited. The maximum potential liability at 31 March 2021 was £5,977 (2020: £2,319)

St Nicholas Hospice (Suffolk) Notes forming part of the financial statements for the year ended 31 March 2021

85

because you matter St Nicholas Hospice Care A Regi￿ered C￿rItY No. 287773