St Nicholas Hospice (Suffolk) 

## _Annual Report and Financial Statements_ 

Year ended 31 March 2021 






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## Contents 

## **4** Trustees’ Report 

- **4 Welcome** 

- 5 • Trustees and Advisors 

- 6 • Introduction from Chief Executive Officer and Chairman 

- 8 • Strategic report 

- 10 • Plans for future periods 

- 12 • Financial review 

- 18 • Vision, mission and values **20 Charitable activities** 

- 20 • Hospice services 

- 22 • Who uses and benefits 

- 22 • The growing need in our community 

- 24 • Stories of Equip, Provide, Strive 

- **36 Structure, governance and management** 

- **42 Our people** 

- **44 Clinical quality and assurance** 

- **48 Income generation 56 Going concern** 

- **57** Statement of Trustees’ Responsibilities 

- **58** Independent Auditors Report 

- **62** Consolidated Statement of Financial Activities 

- **64** Group and Charity Balance Sheets **66** Consolidated Cash Flow Statement **68** Notes to the Financial Statements 

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: 

- **Equip** everyone to live with dying, death and grief 

- **Provide** direct support 

- **Strive** for ‘something better’ through innovation 




**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.** 

- Community Connectors 

- Education 

- Specialist Nurse Support 

- Hospice Neighbours 

- Compassionate businesses 

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

- Inpatient services 

## **Delivered:** 

   - Specialist inpatient and community services during the pandemic 

   - Used digital platforms to provide: 

      - Psychological and bereavement support 

      - Clinical consultations 

- Virtual ward 

- Hospital liaison 

## **Ensure that:** 

- The charity is well run 

- • We make the most of donations and resources 

## **Implemented an organisational restructure:** 

- To deliver the new operational model 

- Deliver financial savings 

**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: 

- Stopping all-day services, group activities and non-essential face-to-face contact 

- Meeting daily with statutory colleagues to ensure care for people and their families was prioritised and coordinated across the healthcare system 

- Increasing the numbers of inpatient beds to be available if needed from 12 to 16 

- Increasing Medical Consultant support to the hospital and out of hours advice for the local community 

- Ensuring staff and volunteers were trained and equipped with appropriate PPE and new procedures were put in place to ensure environments were Covid-19 secure 

- Rapidly implementing IT solutions to support home working and virtual clinical consultations 

## **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. 

- Increasing psychological, spiritual and bereavement and support for community and local staff 

- Increasing online resources for the community, including for healthcare professionals to support symptom management and preparing for death and grief 

- Hospice Neighbours and Family Support Volunteers continuing to offer telephone support to people facing illness and grief. 

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 

- The wellbeing of our people 

- Implementing the clinical plan to extend the reach of our services 

- Income generation and financial management 

- Leadership 

**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:** 

- Can talk about dying, death and grief 

- • Are informed about and prepared for dying, caring, death and grief 

- Have the skills to cope with dying, caring, death and grief 

## **We will do this through:** 

**Implementing our equip approach in our communities by:** 

   - Mapping community resources and agreeing local plans 

   - An increased range of educational and support sessions 

- Feel inspired to help people living with dying, caring, death and grief 

## **That:** 

- People living with dying, death and grief have access to hospice specialist support, wherever they are and whenever they need it 

- Professionals supporting people living with dying, death and grief have access to advice and support 

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

- Increased reach across our community 

- Accessibility for minority groups 

- Collaborative working 

- Enhanced inpatient care across the community 

## **The:** 

- Wellbeing of our people 

- We make the most of every pound through robust financial management and seek income and savings opportunities 

- Recruitment of new members to the Leadership Team 

## **Focusing on:** 

- How we help our people recover and develop 

- Developing volunteer opportunities 

- • Developing financial understanding and management to support our aim of financial sustainability 

- The recruitment of a new CEO and Directors 

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 

**14** 



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


## **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 

**16** 



_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:** 

- Palliative care consultants and doctors 

- Advanced practitioners in nursing, psychological support, occupational therapy and physiotherapy 

- Chaplaincy and spiritual support team 

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

- Local healthcare teams including GP surgeries, care homes, primary care networks and integrated neighbourhood teams 

- Other voluntary and charitable organisations, community groups & volunteers 

- Local councils 

- Local businesses 

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

- Training for carers in nursing homes, 

- Clinical professionals, 

- Clinical and school students, 

- Training for hospital clinicians, and 

- Community groups and schools. 

**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 

- Those facing dying, death and grief. Our support is offered not only to those who are ill but to their family and friends, and this includes services for bereaved children and young people. 

- The local community by enhancing their role, ability and confidence to support each other when facing dying, death and grief. 

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


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 

**22** 



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


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


**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 -----**<br>
It’s ok to have some of the following thoughts and feelings...<br>**----- End of picture text -----**<br>


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 -----**<br>
I don’t know what you would want if you  I am worried about what<br>were really sick, how much treatment you want, or if you would want to  might happen if I get<br>go to hospital. coronavirus.<br>If I talk to my<br>I don’t think  loved one about  I don’t  I don’t<br>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.<br>**----- End of picture text -----**<br>


Having the conversation 


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


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



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


**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. 


**----- Start of picture text -----**<br>
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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. 



**St Nicholas** Hospice Care 

**34** 



## 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. 

**35** 

Annual Accounts **2020–21** 



## Structure, governance and management 


**----- Start of picture text -----**<br>
Chief Execu<br>Barbar<br>Clinical Services Human Resources  Head<br>Director Operations Manager Fina<br>Head of Education<br>and Outreach<br>Interim Head of<br>Head of Retail<br>Corporate Services<br>Care and Support<br>Operations<br>Manager<br>Catering<br>Head of  Manager<br>Psychological<br>Services<br>**----- End of picture text -----**<br>


**St Nicholas** Hospice Care 

**36** 




**----- Start of picture text -----**<br>
utive Officer<br>a Gale<br>**----- End of picture text -----**<br>



**----- Start of picture text -----**<br>
d of  Consultants in  Director of Fundraising<br>nce Palliative Medicine and Marketing (Deputy CEO)<br>Head of  Head of<br>Facilities Manager<br>Marketing Fundraising<br>**----- End of picture text -----**<br>


**37** 

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: 

   - Charity’s investment strategy and monitors investment performance, 

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

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

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

3. **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. 

4. **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: 

- Its assets are safeguarded against unauthorised use or disposition, 

- Proper records are maintained and financial information used within the Charity, or for publication, is reliable, and 

- The Charity complies with relevant laws and regulations. 

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: 

- Senior leadership recruitment process - by 9 November 2021, a new CEO, Clinical Services Director and Corporate Services Director had been appointed. 

- A system of financial controls designed to 

Annual Accounts **2020–21 39** 



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

- Regular scrutiny by the Trustees to monitoring actual performance against the budget and forecasts and to the formal delegation of authority to spend within clearly defined authorisation limits. 

- The restructure in 2020 demonstrated the management team’s ability and willingness to implement significant change. 

## **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. 

**St Nicholas** Hospice Care 

**40** 



## 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** 



**----- Start of picture text -----**<br>
Income<br>9%<br>Generation<br>Support and<br>16%<br>Admin<br>Service<br>75%<br>Delivery<br>**----- End of picture text -----**<br>


## **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 


**----- Start of picture text -----**<br>
Audit  Hospice<br>monitoring  Advisory<br>and review Group<br>**----- End of picture text -----**<br>


**St Nicholas** Hospice Care 

**44** 



## **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: 

- Are our services safe? 

- Are our services effective? 

- Are our services caring? 

- Are our services responsive to people’s needs? 

- Are our services well-led? 

## **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 

**St Nicholas** Hospice Care 

**46** 



_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]** 


**48** 


**----- Start of picture text -----**<br>
St Nicholas  Hospice Care<br>**----- End of picture text -----**<br>




## **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.” 


**St Nicholas** Hospice Care 

**50** 




## **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. 

**St Nicholas** Hospice Care 

**52** 



## **‘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 

- Observe the methods and principles in the Charities SORP; 

- Make judgments and estimates that are reasonable and prudent; 

- State whether applicable accounting standards have been followed, subject to any material departures disclosed and explained in the financial statements; and 

- Prepare the financial statements on the going concern basis unless it is inappropriate to presume that the company will continue in business. 

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: 

- So far as we are aware, there is no relevant audit information of which the charity’s auditor is unaware 

- • We have taken all the steps that we ought to have taken in order to make ourselves aware of any relevant audit information and to establish that the charity’s auditor is aware of the information. 

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:** 

- give a true and fair view of the state of the group’s and the parent charitable company’s affairs as at 31 March 2021 and of the group’s incoming resources and application of resources, including its income and expenditure, for the year then ended; 

- have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and 

- have been prepared in accordance with the requirements of the Companies Act 2006. 

## **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: 

- the information given in the Trustees’ Report, which includes the Directors’ Report and the Strategic Report prepared for the purposes of company law, for the financial year for which the financial statements are prepared is consistent with the financial statements; and 

- the Directors’ Report and the Strategic Report included within the Trustees’ Report have been prepared in accordance with applicable legal requirements. 

## **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: 

- adequate accounting records have not been kept by the parent charitable company, or returns adequate for our audit have not been received from branches not visited by us; or 

- the parent charitable company financial statements are not in agreement with the accounting records and returns; or 

- certain disclosures of trustees’ remuneration specified by law are not made; or 

- we have not received all the information and explanations we require for our audit. 

## **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**<br>**Income from**<br>**Grants, donations and**<br>**Legacies**<br>Donations<br>Legacies<br>Grants<br>**Charitable  activities**2<br>**Other trading activities:**<br>Shops<br>Lottery<br>Fundraising<br>**Other**<br>3<br>**Investments**<br>4<br>**Other**<br>5<br>**Total Income**<br>**Expenditure on:**<br>**Raising funds**<br>Raising grants, donations<br>and legacies<br>Other trading activities<br>Investment management<br>**Charitable activities**<br>In patient care<br>Day care<br>Community services<br>Family support and bereavement<br>Education & research<br>**Total Expenditure**<br>6<br>Net (losses) /gains on<br>investments<br>12<br>**Net movement in funds**<br>9<br>**Reconciliation of funds:**<br>Total funds brought<br>forward<br>Transfer between funds<br>**Total funds carried**<br>**forward**|**2021**<br>**2020**|**2021**<br>**2020**|
|---|---|---|
||**Unrestricted**<br>**Funds**<br>**Restricted**<br>**Funds**<br>**Endowment**<br>**Funds**<br>**Total**<br>£<br>£<br>£<br>**£**<br>794,595<br>156,373<br>-<br>**950,968**<br>428,128<br>-<br>-<br>**428,128**<br>-<br>-<br>-<br>**-**|**Unrestricted**<br>**Funds**<br>**Restricted**<br>**Funds**<br>**Endowment**<br>**Funds**<br>**Total**<br>£<br>£<br>£<br>**£**<br>929,119<br>182,576<br>-<br>**1,111,695**<br>1,014,155<br>15,000<br>-<br>**1,029,155**<br>-<br>-<br>-<br>**-**|
||**1,222,723**<br>**156,373**<br>**-**<br>**1,379,096**|**1,943,274**<br>**197,576**<br>**-**<br>**2,140,850**|
||**1,938,011**<br>**1,043,463**<br>**-**<br>**2,981,474**<br>656,441<br>-<br>-<br>**656,441**<br>405,256<br>-<br>-<br>**405,256**<br>114,351<br>-<br>-<br>**114,351**<br>42,902<br>-<br>-<br>**42,902**|**1,274,998**<br>**-**<br>**-**<br>**1,274,998**<br>1,468,721<br>-<br>-<br>**1,468,721**<br>456,457<br>-<br>-<br>**456,457**<br>454,039<br>-<br>-<br>**454,039**<br>57,792<br>-<br>-<br>**57,792**|
||**1,218,950**<br>**-**<br>**-**<br>**1,218,950**|**2,437,009**<br>**-**<br>**-**<br>**2,437,009**|
||137,889<br>-<br>431<br>**138,320**<br>362,926<br>-<br>-<br>362,926|**178,147**<br>**-**<br>**861**<br>**179,008**<br>165,000<br>-<br>-<br>**165,000**|
||**4,880,499**<br>**1,199,836**<br>**431**<br>**6,080,766**|**5,998,428**<br>**197,576**<br>**861**<br>**6,196,865**|
||(625,132)<br>(2,767)<br>-<br>**(627,899)**<br>(1,840,781)<br>-<br>-<br>**(1,840,781)**<br>(35,965)<br>-<br>-<br>**(35,965)**|(573,969)<br>(488)<br>-<br>**(574,457)**<br>(2,212,631)<br>-<br>-<br>**(2,212,631)**<br>(39,148)<br>-<br>-<br>**(39,148)**|
||**(2,501,878)**<br>**(2,767)**<br>**-**<br>**(2,504,645)**|**(2,825,748)**<br>**(488)**<br>**-**<br>**(2,826,236)**|
||(1,392,707)<br>(576,020)<br>(431)<br>**(1,969,158)**<br>(66,976)<br>(9,800)<br>-<br>**(76,776)**<br>(1,003,817)<br>(594,163)<br>-<br>**(1,597,980)**<br>(394,683)<br>(4,743)<br>-<br>**(399,426)**<br>(204,797)<br>(1,210)<br>-<br>**(206,007)**|(2,056,472)<br>(9,581)<br>(861)<br>**(2,066,914)**<br>(351,124)<br>(41,204)<br>-<br>**(392,328)**<br>(1,664,438)<br>(103,000)<br>-<br>**(1,767,438)**<br>(445,279)<br>(11,609)<br>-<br>**(456,888)**<br>(235,152)<br>(14,465)<br>-<br>**(249,617)**|
||**(3,062,980)**<br>**(1,185,936)**<br>**(431)**<br>**(4,249,347)**|**(4,752,465)**<br>**(179,859)**<br>**(861)**<br>**(4,933,185)**|
||**(5,564,858)**<br>**(1,188,703)**<br>**(431)**<br>**(6,753,992)**|**(7,578,213)**<br>**(180,347)**<br>**(861)**<br>**(7,759,421)**|
||698,913<br>-<br>2,493<br>**701,406**|**(211,036)**<br>-<br>**(981)**<br>**(212,017)**|
||||
||**14,554**<br>**11,133**<br>**2,493**<br>**28,180**|**(1,790,821)**<br>**17,229**<br>**(981)**<br>**(1,774,573)**|
||7,895,025<br>11,088<br>59,656<br>(11,088)<br>44,130<br>-<br>**7,998,811**<br>**-**|9,422,564<br>263,282<br>305,709<br>(263,282)<br>45,111<br>-<br>**9,773,384**<br>**-**|
||**7,920,667**<br>**59,701**<br>**46,623**<br>**8,026,991**|**7,895,025**<br>**59,656**<br>**44,130**<br>**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<br>**Fixed assets**<br>Tangible assets<br>11<br>Investments<br>12<br>**Current assets**<br>Stock<br>Debtors<br>13<br>Cash at bank and in hand<br>**Creditors: amounts falling due within one**<br>**year**<br>14<br>**Net current assets**<br>**Net assets**<br>**The funds of the charity**<br>Restricted income funds<br>15<br>Unrestricted funds:<br>General fund<br>16<br>Designated fund<br>16<br>Endowment fund<br>17<br>**Total funds**<br>18|Group<br>**2021**<br>2020<br>**£**<br>**2,318,149**<br>2,441,205<br>**5,058,847**<br>4,616,678<br>**7,376,996**<br>7,057,883<br>**31,556**<br>29,696<br>**2,093,874**<br>2,100,840<br>**527,647**<br>789,757<br>**2,653,077**<br>2,920,293<br>**2,003,082**<br>1,979,365<br>**649,995**<br>940,928<br>**8,026,991 **<br>7,998,811<br>**59,701**<br>59,656<br>**2,463,535**<br>2,254,125<br>**5,457,132**<br>5,640,900<br>**46,623**<br>44,130<br>**8,026,991 **<br>7,998,811|Charity<br>**2021**<br>2020<br>**£**<br>£<br>**2,318,149**<br>2,441,205<br>**5,093,853**<br>4,651,684|
|---|---|---|
|||**7,412,002**<br>7,092,889<br>**-**<br>-<br>**2,117,040**<br>2,125,650<br>**510,514**<br>760,255|
|||**2,627,554**<br>2,885,905<br>**2,038,963**<br>2,037,869|
|||**588,591**<br>848,036|
|||**8,000,593**<br>7,940,925|
|||**59,701**<br>59,656<br>**2,437,137**<br>2,196,239<br>**5,457,132**<br>5,640,900<br>**46,623**<br>44,130|
|||**8,000,593**<br>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<br>**Cash flows from operating activities:**<br>Net cash used in operating activities<br>21<br>**Cash flows from investing activities:**<br>Dividends and interest from investments<br>Interest received<br>Proceeds from the sale of tangible fixed assets<br>Payments to acquire tangible fixed assets<br>Proceeds from the sale of investments<br>Purchase of investments<br>Net cash provided by investing activities<br>**Change in cash and cash equivalents in the year**<br>Cash and cash equivalents at the beginning of the year<br>**Cash and cash equivalents at end of the year**<br>22|Group<br>**2021**<br>2020<br>**£**<br>£<br>**(601,282)**<br>**(1,630,155)**|
|---|---|
||**137,973**<br>**176,549**<br>**971**<br>**2,459**<br>**-**<br>**-**<br>**(59,010)**<br>**(155,476)**<br>**1,408,838**<br>**3,421,283**<br>**(468,802)**<br>**(1,909,094)**|
||**1,019,970**<br>**1,535,721**|
|||
||**418,688**<br>**(94,434)**|
||**927,816**<br>**1,022,250**|
||**1,346,504**<br>**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** 



- **1 Accounting policies** 

## _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: 

- Regular re-forecasting and monitoring of accounts including cash flow 

- Robustness of income generation and legacy forecasts 

- A regular review of investments 

- The management team’s planning and willingness to impliment significant changes to working practices and use of assets to ensure future sustainability to continue charitable activities. 

- Maintain current reserves policy. 

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: 

- Section 7 ‘Statement of Cash Flows’ – Presentation of a Statement of Cash Flow and related notes and disclosure. 

## _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. 

- Raising funds include expenditure incurred in seeking voluntary contributions and in trading activities and do not include the costs of disseminating information in support of the charitable activities. 

- Charitable activities include expenditure associated with the provision of hospice services and include both the direct costs and support costs relating to these activities. 

- Support costs are those costs incurred directly in support of expenditure on the objects of the charity and include project management carried out at the Hospice. Such costs have been allocated to activity cost categories on a headcount basis. 

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**<br>**£**<br>In patient care<br>**891,914**<br>Day care<br>**37,329**<br>Community services<br>**765,236**<br>Family support & bereavement<br>**149,314**<br>Hospital services<br>**597**<br>Education and research<br>**93,621**<br>Hospice UK – NHSE Funding<br>**1,043,463**<br> <br> <br>**2,981,474**|2020<br>£<br>558,125<br>56,463<br>493,073<br>79,726<br>-<br>87,611<br>-<br> <br>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**<br>**Other income**||||
|---|---|---|---|
|Catering income<br>Other income<br>**4**<br>**Investment income**<br>Dividend – equities<br>Interest – fixed interest securities<br>Bank interest||**2021**<br>**£**<br>**24,130**<br>**18,772**<br> <br>**42,902**<br> <br>**2021**<br>**£**<br>**129,579**<br>**8,394**<br>**347**<br> <br> <br>**138,320**|2020<br>£<br>51,585<br>6,207|
||||<br>57,792|
||||<br>2020<br>£<br>159,383<br>17,166<br>2,459<br> <br>179,008|



**5 Other Incoming resources** 

|Government Grant – Coronavirus Job Retention Scheme<br>Government Grant – Retail Business Grant|**2021**<br>**£**<br>**261,863**<br>**101,063**<br> <br>**362,926**|2020<br>£<br>165,000<br>-<br> <br>165,000|
|---|---|---|



**72 St Nicholas** Hospice Care 



## **6 Analysis of expenditure** 

|Costs of raising grants, donations and<br>legacies<br>Other trading activities<br>Shop costs<br>Lottery costs<br>Events costs<br>Other income<br>Corporation tax<br>Investment management costs<br>In patient care<br>Day care<br>Community services<br>Family support & bereavement<br>Education and research<br>**Total**|**2021**<br>Direct<br>Costs<br>Support<br>Costs (note<br>7)<br>**Total Costs**<br>£<br>£<br>527,384<br>100,515<br>**627,899**<br>527,384<br>100,515<br>**627,899**<br>1,173,380<br>245,499<br>**1,418,879**<br>157,616<br>12,096<br>**169,712**<br>30,112<br>44,657<br>**74,769**<br>94,129<br>79,075<br>**173,204**<br>4,217<br>1,459,454<br>381,327<br>**1,840,781**<br>34,801<br>1,164<br>**35,965**<br>2,021,639<br>483,006<br>**2,504,645**<br>1,447,497<br>521,661<br>**1,969,158**<br>54,699<br>22,077<br>**76,776**<br>1,297,061<br>300,919<br>**1,597,980**<br>304,667<br>94,759<br>**399,426**<br>158,024<br>47,983<br>**206,007 **<br>3,261,948<br>987,399<br>**4,249,347**<br>**5,283,587 **<br>**1,470,405**<br>**6,753,992 **|2020<br>Total Costs<br>**£**<br>574,457|
|---|---|---|
|||574,457<br>1,598,762<br>192,241<br>255,601<br>166,027|
|||2,212,631<br>39,148|
|||2,826,236<br>2,066,914<br>392,328<br>1,767,438<br>456,888<br>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<br>Social security costs<br>Pension costs<br>Other employee benefits|**2021**<br>**£**<br>**4,446,096**<br>**385,303**<br>**336,154**<br>**101,406**<br> <br>**5,268,959**|2020<br>£<br>4,831,534<br>428,042<br>371,286<br>52,500<br> <br>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<br>Fundraising services<br>Support services|**2021**<br>**Number**<br>**108**<br>**50**<br>**17**<br> <br>**175**|2020<br>Number<br>109<br>54<br>31<br> <br>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<br>£70,000-£79,999<br>£80,000-£89,999<br>£90,000-£99,999<br>£100,000-£109,999<br>£110,000-£119,999<br>**Total**|**2021**<br>**Actual**<br>**Number**<br> <br>**2**<br>**-**<br>**2**<br>**-**<br>**1**<br>**-**<br> <br>**5**|2020<br>Actual<br>Number<br>2<br>2<br>1<br>-<br>1<br>1<br> <br>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<br>Clinical<br>Hospice Neighbours<br>Fundraising and support services<br>Trustees<br>Associates|**2021**<br>**Number**<br>**276**<br>**137**<br>**109**<br>**86**<br>**12**<br>**10**<br>**630**|2020<br>Number<br>281<br>145<br>116<br>94<br>10<br>11|
|---|---|---|
|||657|



**74 St Nicholas** Hospice Care 



## **9 Net movement in funds** 

|Net movement is stated after charging/(crediting):<br>Depreciation<br>Auditor’s remuneration<br>-Statutory audit of charity and group<br>-Statutory audit of subsidiary<br>-Tax advisory<br>-Other services<br>(Profit)/loss on sale of fixed assets<br>Government grants<br>Operating lease rentals|**2021**<br>2020<br>**£**<br>£<br>**181,197**<br>172,865<br>**16,950**<br>13,685<br>**3,500**<br>3,395<br>**1,615**<br>685<br>**16,477**<br>13,658<br>**869**<br>-<br>**(362,926)**<br>(165,000)<br>**222,912**<br>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**<br>At 1 April 2020<br>Additions<br>Disposals<br>**At 31 March 2021**<br>**Depreciation**<br>At 1 April 2020<br>Charge for the year<br>Disposals<br>**At 31 March 2021**<br>**Net book value**<br>**At 31 March 2021**<br>At 31 March 2020|**Long**<br>**Leasehold**<br>**Buildings**<br>**£**<br>4,046,596<br>4,167<br>-<br>**4,050,763**<br>1,890,295<br>90,997<br>-<br>**1,981,292**<br>**2,069,471**<br>2,156,301|**Furniture and**<br>**Equipment**<br>**£**<br>1,366,814<br>10,558<br>(162,378)<br>**1,214,994**<br>1,227,524<br>37,494<br>(161,715)<br>**1,103,303**<br>**111,691**<br>139,290|**ICT**<br>**Equipment**<br>**£**<br>418,843<br>44,285<br>(50,754)<br>**412,374**<br>297,947<br>39,250<br>(50,548)<br>**286,649**<br>**125,725**<br>120,896|**Motor**<br>**Vehicles**<br>**£**<br>67,280<br>-<br>-<br>**67,280**<br>42,562<br>13,456<br>-<br>**56,018**<br>**11,262**<br>24,718|**Total**<br>**£**<br>**5,899,533**<br>**59,010**<br>**(213,132)**|
|---|---|---|---|---|---|
||||||**5,745,411**|
||||||**3,458,328**<br>**181,197**<br>**(212,263)**|
||||||**3,427,262**|
||||||**2,318,149**|
||||||2,441,205|



The long leasehold expenditure represents: 

- The building costs of the Hospice on land at Hardwick Lane, Bury St Edmunds for which a 60 year lease at a peppercorn rent was entered into on 15 August 1991 

- The refurbishment of the In Patient Unit during 2008 

- Office reconfigurations in 2013 

- Improvements to the Orchard Day Centre on the Hospice site 

- Expenditure on new and existing shops 

- The development of an Outreach Centre at the Burton Centre in Haverhill. 

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|<br>**4,239,990**|<br>4,478,619|
|Cash held as part of the investment portfolio|<br>**818,857**|138,059|**818,857**|138,059|
|Equity investment in subsidiary|**-**|-|**35,006**|35,006|
||**5,058,847**|4,616,678|<br>**5,093,853**|<br>4,651,684|
|B) Analysis of investments|||<br>**2021**|<br>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|||<br>**5,058,847**|<br>4,616,678|
|Equity investment in subsidiary|||**35,006**|35,006|
|Total charity|||<br>**5,093,853**|<br>4,651,684|
|C) Historical cost of investments|||<br>**2021**|<br>2020|
||||**£**|£|
|Rathbones|||**1,365,579**|2,182,665|
|Sarasin & Partners|||**2,231,649**|2,089,731|
||||<br>**3,597,228**|<br>4,272,396|
|Equity Investment in Subsidiary|||**35,006**|35,006|
|Total charity|||<br>**3,632,234**|<br>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|<br>**26,157**|178,742|
|Operating expenses|**(6,754)**|(90,121)|
|Other operating income|**21,253**||
|Profit on ordinary activities before interest|<br>**40,656**|88,621|
|Interest payable on concessionary loan to hospice|**(625)**|(625)|
|Net trading profit|<br>**40,031**|87,996|
|Assets|<br>**106,902**|132,274|
|Liabilities|**(45,497)**|(37,882)|
|Net assets|<br>**61,405**|94,392|
|Represented by:|||
|Capital|**35,006**|35,006|
|Reserves|**26,399**|59,386|
|Net assets|<br>**61,405**<br>|94,392|



## **13 Debtors** 

|Trade debtors<br>Taxation recoverable<br>Other debtors<br>Prepayments<br>Accrued income<br>Legacies<br>**Amounts due greater than one year:**<br>Loan due from subsidiary undertaking|Group<br>**2021**<br>2020<br>**£**<br>£<br>**1,319,067**<br>975,291<br>**25,673**<br>41,967<br>**23,633**<br>3,919<br>**211,727**<br>283,077<br>**216,402**<br>272,148<br>**297,372**<br>524,438<br>**2,093,874**<br>2,100,840<br>**-**<br>-<br>**2,093,874**<br>2,100,840|Charity<br>**2021**<br>2020<br>**£**<br>£<br>**1,317,567**<br>976,011<br>**25,673**<br>41,967<br>**23,633**<br>3,919<br>**211,393**<br>282,743<br>**216,402**<br>271,572<br>**297,372**<br>524,438|
|---|---|---|
|||**2,092,040**<br>2,100,650<br>**25,000**<br>25,000|
|||**2,117,040**<br>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<br>Amounts released to income in the year<br>Amount deferred in the year<br>Balance carried forward<br>**Deferred income reconciliation – other**<br>Balance brought forward<br>Amounts released to income in the year<br>Amount deferred in the year<br>Balance carried forward|**Group**<br>**2021**<br>2020<br>**£**<br>£<br>**74,956**<br>76,513<br>**(74,956)**<br>(76,513)<br>**65,902**<br>74,956<br>**65,902**<br>74,956<br>**£**<br>£<br>**1,430,485**<br>34,989<br>**(1,430,485)**<br>(34,989)<br>**1,494,868**<br>1,430,485<br>**1,494,868**<br>1,430,485|**Charity**<br>**2021**<br>2020<br>**£**<br>£<br>**74,956**<br>76,513<br>**(74,956)**<br>(76,513)<br>**65,902**<br>74,956|
|---|---|---|
|||**65,902**<br>74,956|
|||**£**<br>£<br>**1,427,665**<br>34,872<br>**(1,427,665)**<br>(34,872)<br>**1,487,918**<br>1,427,665|
|||**1,487,918**<br>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<br>Day care<br>Community services<br>Family support and bereavement<br>Education and research<br>Fundraising|Balance at<br>31 March 2020<br>Income<br>Expenditure<br>Transfers<br>**Balance at**<br>**31 March 2021**<br>£<br>£<br>£<br>£<br>**£**<br>2,053<br>582,070<br>(576,020)<br>(1,053)<br>**7,050**<br>47,887<br>15,763<br>(9,800)<br>(4,219)<br>**49,631**<br>5,676<br>594,162<br>(594,162)<br>(5,676)<br>**-**<br>155<br>4,728<br>(4,743)<br>(140)<br>**-**<br>3,885<br>-<br>(1,210)<br>-<br>**2,675**<br>-<br>3,113<br>(2,768)<br>-<br>**345**|
|---|---|
||59,656<br>1,199,836<br>(1,188,703)<br>(11,088)<br>**59,701**|



**78 St Nicholas** Hospice Care 



## **15 Restricted funds (Group and Charity)** _**(continued)**_ 

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

- The cost of a dolls house for Nicky’s Way, the children’s bereavement support service 

- Equipment for Nicky’s Way. 

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



**80 St Nicholas** Hospice Care 



**16 Unrestricted funds** _**(continued)**_ 

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



## **Charity** 

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



## **Group** 

|**Designated funds**<br>Building/Fixed Asset fund<br>New building and maintenance fund<br>IT Systems fund<br>Service development fund<br>Income generation project fund<br>**General fund**|Balance at<br>31 March<br>2019<br>Income<br>Expenditure<br>Investment<br>gains/ (losses)<br>Transfers<br>Balance at<br>31 March 2020<br>£<br>£<br>£<br>£<br>£<br>£<br>2,053,596<br>-<br>(172,865)<br>-<br>560,474<br>2,441,205<br>2,250,000<br>-<br>-<br>-<br>-<br>2,250,000<br>167,408<br>-<br>(91,403)<br>-<br>-<br>76,005<br>608,051<br>-<br>(133,025)<br>-<br>-<br>475,026<br>398,664<br>-<br>-<br>-<br>-<br>398,664|
|---|---|
||5,477,719<br>-<br>(397,293)<br>-<br>560,474<br>5,640,900<br>3,944,845<br>5,998,428<br>(7,180,920)<br>(211,036)<br>(297,192)<br>2,254,125|
||9,422,564<br>5,998,428<br>(7,578,213)<br>(211,036)<br>263,282<br>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<br>|431<br>|(431)<br>|2,493<br>|**46,623**<br>|



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<br>|861<br>|(861)<br>|(981)<br>|44,130<br>|



## **18 Net assets by funds** 

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



**St Nicholas** Hospice Care 

**82** 



## **18 Net assets by funds (continued)** 

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

|<br>Operating leases which expire:<br>Within one year<br>Later than one year but not later than five<br>Later than five years|Land and buildings<br>Other<br>**2021**<br>2020<br>**2021**<br>**£**<br>£<br>**£**<br>**178,595**<br>191,554<br>**17,464**<br>**282,735**<br>493,286<br>**16,637**<br>**10,080**<br>41,160<br>**-**<br> <br> <br>**471,410**<br>726,000<br>**34,101**|2020<br>£<br>31,218<br>47,029<br>-<br>78,247|
|---|---|---|



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

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



## **22 Analysis of changes in net funds** 

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



## **23 Analysis of cash and cash equivalents** 

|Cash at bank and in hand<br>Cash held as part of the investment portfolio|Group<br>**2021**<br>2020<br>**£**<br>£<br>**527,647**<br>789,757<br>**818,857**<br>138,059<br>**1,346,504 **<br>927,816|Charity<br>**2021**<br>2020<br>**£**<br>£<br>**510,514**<br>760,255<br>**818,857**<br>138,059|
|---|---|---|
|||**1,329,371**<br>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:<br>Instruments measured at fair value through profit & loss|Group<br>**2021**<br>2020<br>**£**<br>£<br>**4,239,990**<br>4,478,619|Charity<br>**2021**<br>2020<br>**£**<br>£<br>**4,239,990**<br>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** 



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