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2024-03-31-accounts

GARDEN HOUSE HOSPICE CARE

(A company limited by guarantee and not having a share capital)

TRUSTEES’ ANNUAL REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2024

Garden House Hospice Care Company Limited by Guarantee No. 2040989 Registered Charity No. 295257

Registered Office: Garden House Hospice, Gillison Close, Letchworth Garden City Herts SG6 1QU

GARDEN HOUSE HOSPICE CARE

REPORT AND FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

CONTENTS Page
Administrative information 1 - 2
Chairman’s Report 3 – 4
Trustees’ Report (incorporating the Strategic Report) 5 – 31
Independent Auditor’s Report 32 – 34
Consolidated Statement of Financial Activities 35
Charity and Consolidated Balance Sheets 36
Consolidated Cash Flow Statement 37
Notes to the Financial Statements 38-54

GARDEN HOUSE HOSPICE CARE

ADMINISTRATIVE INFORMATION

FOR THE YEAR ENDED 31 MARCH 2024

PATRONS Sir Simon Bowes Lyon KCVO
Mr Paul Cherry
Lord and Lady Fellowes
Mrs Sarah Harrison
Sir Oliver Heald QC, MP
MP for Stevenage (Steven McPartland)
MP for Hitchin and Harpenden (Bim Afolamai)
Mrs Diana Laing
The Chairman of North Herts District Council
The Mayor of Royston
The Mayor of Stevenage
The Bishop of St Albans
Mr Richard Whitmore
Mrs Boo Williams
HONORARY VICE PRESIDENTS Dr Frances Aldridge, Mrs Sally Alford, Mr Ivor
Barber, Mr Trevor Bentham, Mrs Mary Blaksley, Mrs Trudy
Bunday, Mr Bernard Davies, Mr Andrew Egerton-Smith MBE,
Mrs Janet Hill, Mrs Anne Houghton, Mr Anthony Isaacs,
Dr Viv Lucas, Mr Roger Manning, Mrs Janet Nevitt, Dr
Catherine Offer, Mrs M Guernier, Mr J Bush, Mr John
Procter.
TRUSTEES Mr Stephen Mellish1,2,3(Chairman)
Dr Simon Chatfield1
Mr Richard Dearden2
Mrs Melanie Flynn2
Mr Roger Gochin2, (Retired 29.11.23)
Professor Shahid Khan1(Resigned 19.04.24)
Mrs Gemma Manning3
Mrs Rhona Seviour3
Mr James Silsby2 (Resigned 29.02.24)
Mrs Jennie Mattin1
Dr Pauline Williams3
Mr Christopher Dare2(Appointed 29.11.23)
Mrs Joanna Heneker (Appointed 26.03.24)
SECRETARY Ms Edith Yembra
TREASURER Mr Roger Gochin (Resigned 29.11.23)
SENIOR LEADERSHIP TEAM Mrs Lisa Hunt (Chief Executive Officer))
(KEY MANAGEMENT PERSONNEL)
Dr Sarah Bell (Medical Director)
Mrs Elizabeth Kennedy (Director of Patient Services)
Ms Edith Yembra (Director of Finance & Resources)
Mrs Carla Pilsworth (Director of Income Generation)
Mr Derek Turnbull (Director of People)

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GARDEN HOUSE HOSPICE CARE

ADMINISTRATIVE INFORMATION (continued)

FOR THE YEAR ENDED 31 MARCH 2024

REGISTERED AUDITORS Haysmacintyre LLP
10 Queen Street Place
London EC4R 1AG
BANKERS Virgin Money
 Lloyds Bank Plc
7 Gold Street 1 Bancroft
Northampton Hitchin
Northamptonshire Hertfordshire
The Charities Aid Foundation NatWest Bank
Kings Hill Station Place
West Malling Letchworth Garden City
Kent Hertfordshire
HONORARY CHARTERED BUILDING Robert Lombardelli Partnership
SURVEYORS St Luke’s House
5 Walsworth Road
Hitchin
Hertfordshire, SG6 1QU
REGISTERED OFFICE Garden House Hospice Care
Gillison Close
Letchworth Garden City
Hertfordshire
SG6 1QU
COMPANY NUMBER 02040989
CHARITY NUMBER 295257
OPERATING NAME Garden House Hospice Care
TRADING COMPANY Garden House Hospice Trading Limited
(Company no. 02671267)

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GARDEN HOUSE HOSPICE CARE

CHAIRMAN’S REPORT

FOR THE YEAR ENDED 31 MARCH 2024

_________________

The 2023-2024 financial year will go down in our history as a landmark year for Garden House Hospice Care. As we go into the third and final year of our current strategy, I’m convinced that the foundations being put in place will provide the platform for Garden House Hospice Care to go on and make a significant difference in what hospice care can really provide in the future, nationally!

The Board of Trustees and the Executive Team, under the leadership of Lisa Hunt, have truly worked as ‘One Team’ this past 12 months. It certainly hasn’t been without its challenges but when you set out on a journey that requires significant change then a laser focus on organisational culture is paramount.

Our CEO, Lisa Hunt has strengthened the Executive Team with the appointment of Edith Yembra as Finance Director and Steve Collins as Director of Operations. The relationship between the Board and the Executive Team has never been stronger. There is a real and genuine feeling of being ‘one team with a shared vision’ and this has been proven with all that has been achieved over the past 12 months.

In regard to implementing the Hospice strategy, the Annual Delivery Plan for 2023/24 contained clear and measurable deliverables, supported by KPI’s that were agreed by the board in advance and linked to the budget and staff performance objectives. The main objectives for the second year of our strategy were that of consolidation, more effective use of all of our resources and preparing for growth. I can report that excellent progress was made, which is testament to the leadership and drive of Lisa and the team and everyone across the organisation.

As you may recall from my report last year, we set a 3-year plan to be cost neutral. Our year one control total deficit of £700,000 was more than achieved, coming in at £624,657. This was an astounding achievement, and my thanks go to our Finance Director, Edith Yembra who kept a very tight rein on spend across the whole organisation. We go into the new financial year with an agreed control total deficit of £559,000 and remain confident that we will break even in the 2025/26 financial year as planned.

One of the main highlights of the year was the successful launch of our new Frailty Service, which aims to address and improve the challenges of patients suffering from moderate and severe frailty. By addressing this we also aim to alleviate the pressures on the acute system, specifically East & North Hertfordshire Hospital. To prove it would work the ICB (Integrated Care Board) set out a challenging and comprehensive set of targets covering 3 months. It was more than achieved and I must acknowledge all the hard work put in over the course of the year by Lisa, the Executive Team and everyone else involved.

We are of course indebted to all those supporters who donated a total of £300,000 to fund the initial 3 months of the Frailty Service. Their kind donations were crucial in the launch of the pilot, helping us prove that the Frailty Service makes the positive difference we knew it could make. However, to maintain this service going forward we needed a funding commitment from the ICB for the long-term.

At the time of writing this report (in August), I am delighted to confirm that we have received confirmation of the funding required to continue the Frailty Service with a commitment to fund it for the next 5 years. This is the best news that we could have possibly hoped for and is just reward for all the hard work put in by all involved.

There has been no shortage of changes on the Board of Trustees over the past 12 months with James Silsby and Dr Shahid Khan resigning after 7 and 2 years’ service respectively. Roger Gochin retired after 10 years’ service as a Trustee. I would like to thank James and Shahid for their respective contributions during their time on the board. They were great people to have on the team and to work with.

Roger Gochin retired as a trustee after ten years’ service. In that time Roger had been Chair of the Trading Company, Treasurer and Chair of the Finance & General Purposes Committee. From a personal perspective Roger was the trustee who introduced me to the world of Garden House Hospice Care and certainly encouraged me to achieve more than I had imagined when I first joined! Roger shared his knowledge, experience and enthusiasm with many and his presence will be missed.

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GARDEN HOUSE HOSPICE CARE

CHAIRMAN’S REPORT

FOR THE YEAR ENDED 31 MARCH 2024

_________________

We were able to welcome two new trustees in Chris Dare and Jo Heneker. Jo had been an advisor to the board for the past couple of years. As a result of her advice, guidance and support we were able to launch a new sustainability strategy – ‘Our Planet’. This is new for us, and we understand and accept that we still have much to learn and much to do but we are fully committed in making Garden House Hospice Care as considerate and responsible as possible in protecting the environment for future generations.

Sadly, we were made aware of the passing of former General Manager of the Hospice, Jenny Lupton. Jenny served the hospice for 25 years up to her retirement in 2015.

So, we go into the new financial year with increased ambition and determination to grow further our range of services, making a profound difference to even more people across our community with a life limiting illness.

We will soon commence work developing our new ten-year strategy that will be launched in the Spring of 2025. We have ambition and determination to establish GHHC as an agent for change in how hospices across the UK can develop new services of care that not only better support patients but also makes a positive impact in reducing the pressures on the acute system.

As always, I end my annual report with heartfelt thanks and appreciation to all staff and volunteers who make this organisation so amazing. I’d also like to thank all those people and organisations, from across our community, who continue to support our work. On behalf of the Board of Trustees I would like to thank you all once again and look forward to your continued support and commitment in the years ahead.

Steve Mellish Chairman

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GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

_________________

Garden House Hospice Care (GHHC), being a company limited by guarantee and a registered charity, has adopted the practice that the Directors (Council Members) be called Trustees and the Board of Directors (Council of Management) be known as the Board of Trustees.

Objectives and Activities

GHHC exists to provide specialist palliative care for adults living in Stevenage, North Hertfordshire, and adjoining parts of Mid Bedfordshire with advanced cancer, motor neurone disease or other terminal illness.

GHHC also provides support and care to the families and friends of patients.

GHHC provides:

  1. Inpatient Care: The eight bed In-patient Unit provides consultant led specialist palliative care (the bed numbers had temporarily dropped to six, secondary to the effects of the Covid-19 pandemic and staffing levels).

  2. Home Care: Hospice at Home team of Nurses and Health Care Assistants provide care and support to patients and families at home to support wishes and preferences of those who wish to remain at home for end-of-life care support at home. The service also supports discharges from Hospital and Hospice. We also have 10 commissioned fast track Continuing Healthcare beds that the team support with up to 4 visits per day dependant on needs.

  3. Hawthorne Centre: Specialist Day services, palliative rehabilitation, living well, outpatient care and dropin services provided through a variety of face to face and virtual sessions.

  4. Family Support: A range of services including psychological support, bereavement counselling, carer support, spiritual care, social work support and advice for patients’ families. Children’s and Young Person’s Bereavement Service.

  5. Education: GHHC provides an education programme including mandatory training for all staff and volunteers. It provides a range of specialist education sessions that are open to all health and social care professionals. The organisation supports placements and training for junior staff in all relevant fields. Individual staff members contribute to the training of student nurses, medical students, GP trainees, specialist registrars and other professionals undertaking training in other fields e.g., paramedics. Volunteers all complete an induction course and mandatory training appropriate to their area of work.

  6. Telephone Advice: A specialist palliative care 24/7 telephone advice line.

  7. Community Engagement: Volunteers support all areas of the hospice; Compassionate Neighbours - community volunteers offer friendship through 1-1 matches or via Wellbeing Hubs and schools and colleges outreach to engage with young people about palliative and end of life care and the work of the Hospice.

  8. Frailty Clinical Nurse specialist support to Care homes. This is a commissioned service of 3 WTE Nurses who assess and support all residents in our locality with individualised care planning and ongoing support, working closely with the care home staff and GP for each home.

  9. Garden House Hospice Care Admiral Nurse: Employed by GHHC and works with families and people living with dementia at end of life in North Hertfordshire, to ensure they have the best possible care and support. at the end of their life. This post also delivers a wide range of education provision for Dementia awareness. and support to both healthcare professionals and families and carers.

  10. We have a commissioned Care Home Educator dedicated to support end of life education in our local care and nursing homes.

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GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

_________________

GHHC’s objectives are to:

The principal activities of the Trading Company are as general merchants and traders. The Trading Company provides an essential revenue stream for GHHC. Their directors have set out a strategy that aims to increase the Company’s contribution to GHHC year-on-year. This strategy is articulated in the Company’s annual report.

During the year, GHHC:

https://www.ghhospicecare.org.uk/about-us/our-reports

About Garden House Hospice Care

Mission statement

Garden House Hospice Care provides compassionate and holistic specialist palliative care to those in our community with life-limiting conditions, to enable them to live as well and as fully as possible. We share our knowledge and expertise to enable wider access to the best end of life care.

Vision

Support all people in our community living with life-limiting conditions and their families and carers, to live as well as possible and according to their own wishes. Caring today, tomorrow

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GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

Regulation and inspection

Garden House Hospice Care is regulated by the Care Quality Commission and was last inspected in May 2022, receiving a continued rating of ‘Good’ for all five key lines of enquiry.

Our Strategy

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GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

Garden House Hospice Care’s strategic objectives for 2023/2024

Our community: Sit at the heart of our community and local networks.

How we can demonstrate achievement

GHHC is committed to ensuring that we have the right people, with the right skills, in the right role, at the right time. This will enable GHHC to provide high quality services to our community.

We are committed to the upskilling of our community by way of our education programme which visits local schools. We are also committed, by way of our EDI strategy to having our people, supporters and patients reflecting the community that we represent.

Our services: Provide high quality services that meet the needs of the whole community. How we can demonstrate achievement

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Our people: Grow a strong, capable, resilient, highly skilled and motivated organisation. How we can demonstrate achievement

Our funding: Secure the future of the Hospice through sustainable funding How we can demonstrate achievement

Our Fundraising team has continuously developed initiatives, events, and campaigns within the community, resulting in an impressive fundraising total exceeding £3 million. This past year was exceptional for legacy donations, contributing over £1 million to our overall fundraising efforts.

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Summary of Priorities 2023/2024

Priority 1:

Increase the reach of all our services into our local neighbourhoods and grow by developing innovative models of care for the moderate to severely frail who would benefit from Palliative and end of life care.

During 2023, we worked in partnership across our Integrated Care System, to codesign and develop an innovative new model of care to support those with non-cancer life-limiting conditions and identified as living with moderate to severe frailty. This was to address inequalities in Palliative Care provision identified in our local community by using Public Health information.

Through adherence and quarterly monitoring and reporting of our progress against our Annual Plan, we developed KPIs to monitor the effectiveness of the service.

These KPIs were monitored through monthly reporting to our Hospice Management Board. Quarterly progress assurance was reported to our Clinical Governance Committee.

Priority 2:

Working within our budget allocation, make every penny count and where opportunities exist, increase our NHS contract potential, and reduce the risk of funding care and future service developments.

We reviewed our budget and adhered to monthly reviews, identifying areas for improvement or change. Through this, and a demand and capacity review completed through our transformation programme, we were able to make efficiencies within our 2023/2024 budget allocation, delivering 200% more patient facing activities within budget.

We focussed in all areas of the Hospice on our departmental budgets, reviewing monthly and reporting through our Hospice Management Board and Trustee Board against agreed KPIs.

We delivered on our new model of care with our Frailty Service in Priority 1 within budget.

Priority 3:

Invest in our staff and strengthen our resilience, to enable our organisation to become more agile and responsive to future opportunities.

We set up a work force group across all areas of the Hospice focusing on areas that required strengthening and resilience in their workforces. As part of this, our recruitment and retention models were reviewed alongside recruitment campaigns and benefits of employment. We will be completing a job evaluation in 2024/2025.

We commenced a staff forum because we believe our staff can identify risks, issues or concerns and because we empower all to work together, to find and implement the solutions.

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We have trained two new Freedom to Speak Up Guardians and raised the profile and awareness of this across the organisation.

We reviewed the working environment of all staff on site through a dedicated working group. This enabled our clinical teams to be relocated to work alongside each other and has improved communications and collaborative working. This has enhanced the patient experience through timely support for our patients and carers through informed and seamless transfer of care as required.

Priority 4:

Ensure that Garden House Hospice Care is recognised as an efficient and thriving organisation worthy of future investment and known as ‘Great’ at what it does.

Through our Transformation Board review of demand and capacity and working practices we were able to increase our productivity and streamline our pathways across our clinical service provision.

We introduced mobile working for our whole community team, investing in the equipment required for them to be able to access and deliver the care in a responsive and agile way, resulting in an increase of 200% patient contacts in the community with reduced waiting times.

Looking Forward 2024/2025: Our strategic objectives 2024/2025

As we continue our Quality improvement journey in the next 12 months we will focus on the three Healthcare Pillars of Quality, using these to underpin our priorities:

We will continue to work with our Integrated Care Board and be part of the Herts and West Essex Quality Improvement Network to monitor and develop.

Priority 1:

Expand our Compassionate Neighbours and increase Wellbeing Hubs aligned to pathways into and out of clinical services, becoming an integral partner in Integrated Neighbourhood Teams across PLACE.

We will increase and train our number of Compassionate Neighbour volunteers by 100 enabling increased provision for our community members and new referrals to our service in 2024/2025.

We will maintain attendance levels at current hubs and open six new hubs, linked to Neighbourhood Team locations.

This will increase the total number of Hubs to 12 to widen access to those in our community to our services.

Priority 2:

As part of our ongoing provision of care to those with frailty and those in need of palliative symptom control, we will commence ambulatory care services within our Inpatient Unit in partnership with our Community Trust.

We will undertake a scoping exercise to investigate and identify the difference and need of a Hospice ambulatory care service to support our local care provider and patient care. This will ensure equality in access to care and to provide a care setting of patient choice that is appropriate to each individual.

We will complete a Quality Impact Assessment and Equality Impact Assessment to ensure high quality provision.

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Within our implementation plan, we will equip our staff with the skills and training to expand and grow the service.

We will evaluate patient pathways and experience and impact of those referred to and accessing the service.

Priority 3:

In our ongoing annual improvement plan, we will invest in our staff in 2024/2025 .

We will build resilience and expertise in our teams, investing in training programmes across all levels to enable us to deliver high quality services within our current and future key priorities.

We will value our teams, investing in them and empowering them to be involved in the decisions, direction and implementation of our transformation plans for 2024/2025 as we strive for improvement in our service delivery and staff, patient and carer satisfaction.

Priority 4:

We plan to investigate the development of a response team to provide telephone advice and urgent domiciliary support to palliative patients on the ambulance stack.

We will work with other providers within our Integrated Care Board in the support to development of palliative care support to the Ambulance service to ensure equal access across the Herts and West Essex Integrated Care Board.

We will explore further opportunities for partnership working with other providers across the Integrated Care Board to support the avoidance of unwanted and unnecessary admissions to the acute trust. This will enable patients to remain in their own homes if this is their wish with the appropriate plan of care.

Mandatory statements of assurance

The following are statements that all providers must include in their Quality Accounts. Many of these statements are not directly applicable to specialist palliative care providers. An explanation of these statements and why they do not apply to Garden House Hospice Care has been included, where appropriate.

Review of services

During 2023/2024, Garden House Hospice Care received some NHS funding for its services. The income received from the NHS in 2023/2024 represents 25% of the overall running costs of Garden House Hospice Care.

The remainder of running costs are funded through voluntary income generation, donations, legacies, lottery activity, investment income, shop trading.

Participation in clinical audit

As a provider of specialist palliative care, Garden House Hospice Care was not eligible to participate in any national clinical audits or national confidential enquiries.

Local clinical audits

Garden House Hospice Care has an annual programme of clinical audits.

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A summary of audit results and action plans are reported to the Board of Trustees via the Clinical Governance Committee, a sub-committee of the Board of Trustees.

Research

The number of patients receiving NHS services provided or sub-contracted by Garden House Hospice Care in 2023/2024 who were recruited by the Hospice during the period to participate in research approved by a research ethics committee was NIL.

Use of the CQUIN payment framework

A proportion of an organisation’s income can be conditional on achieving quality improvement and innovation goals, through the Commissioning for Quality and Innovation (CQUIN) payment framework.

In 2023/2024, Garden House Hospice Care has not been subject to payments under the CQUIN payment framework from NHS Hertfordshire or NHS Bedfordshire.

Garden House Hospice Care will not be subject to CQUIN payments in 2024/2025.

Statement from the Care Quality Commission

Garden House Hospice Care is required to register with the Care Quality Commission and its current registration status is unconditional. Garden House Hospice Care has no conditions on registration.

The Care Quality Commission has not taken enforcement action against Garden House Hospice Care in 2023/2024.

Garden House Hospice Care has not participated in any special reviews or investigations by the Care Quality Commission during the reporting period.

Data quality

Garden House Hospice Care did not submit records during 2023/2024 to the Secondary Uses Service for inclusion in the Hospital Episode Statistics which are included in the latest published data. This is because the Hospice is not eligible to participate in this scheme.

Data Security and Protection Toolkit attainment levels

Garden House Hospice Care has the status ‘Standards Met’ for the Data Security and Protection Toolkit.

Learning from deaths

Providers are expected to report their progress in using learning from deaths to inform their quality improvement plans as part of the Quality Improvement toolkit. Garden House Hospice Care is not subject to the Quality Improvement toolkit.

Review of quality performance

Garden House Hospice Care explanation

During 2023/2024 there has been a formal review of the way that incidents are reported, Risk rated, investigated and reviewed. Part of this process was driven by the introduction of the PSIRF methodology and part by GHHC’s desire to continue to improve the way it informs itself of the incidents which form part of daily life within all aspects of the service.

Incident reporting is through a standardised model (Radar) and all staff are trained in how and what to report. We consider an incident is described as anything which could compromise our expectation that our

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patients, staff, volunteers and visitors are within an environment that is Safe, Secure, Sustainable and Supportive. This message is constantly reinforced through learning and development in each of the departments.

Every incident that is reported is reviewed by a member of the Integrated Governance team on a daily basis for accuracy, risk level and assigning the appropriate level of investigation.

There is a weekly Incident review meeting which all managers attend where each incident, or cluster of incidents, is discussed and remediation plans are constructed and put into place. This may include an extra level of investigation. Feedback from this meeting is the responsibility of the manager to the staff.

Where there is a deeper level of investigation required, the investigator is assisted and supported to carry this out.

There is a monthly review of all incidents reported which is submitted to the Hospice management Board and its members which identifies trends in reporting, risk and incident types this is in Patient Facing, NonPatient facing and Trading aspects of the organisation.

There are monthly meetings to discuss and analyse specific types of incidents which are more prevalent in our clinical setting. This includes a Falls Committee, A Medication Committee, a Pressure Ulcer Committee and a Risk assessment and management group.

We have introduced a new and active and dynamic corporate risk register which is reviewed, amended and updated daily by the governance team and Risk Owners.

This is a comprehensive register and covers Patient Facing, Non-Patient facing and Trading parts of the organisation.

Risks are managed within the organisation, when they arise, by the Governance team and comply with the process and timescales that are expected.

A considerable amount of time has been expended over the last 12 months reviewing the 5 years’ worth of data that we hold to ensure that it is accurate and reliable. This will support future participation on Benchmarking.

The organisation now has the ability to identify trends and accurate risk ratings, to support the setting of Key Performance Indicators and control and tolerance levels.

We have appointed a new Data Protection Officer and conducted a full review of our GDPR compliance. To complement our online training, we have introduced mandatory face to face training support for all staff, and training for new champions that will be commencing during 2024/2025.

We are undertaking a full Health and Safety review in 2024/2025 to include additional training and recruitment.

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Garden House Hospice Care activity data

The figures below provide one measure of Garden House Hospice Care's activity during the period 2023/2024.

2023/2024
Total number of patients, carers and community members cared for across all GHHC services 2,895
Inpatient Unit
Number of admissions 234
Average length of stay (days) 8.4 days
% of patients discharged to home / care home / hospital 43%
Number of advice line calls 256
Hospice at Home
Number of referrals 173
Number of visits to patients 1,509
Continuing Health Care Service
Number of referrals 63
Number of visits to patients 6,977
Rehab & Wellbeing
Number of referrals 236
Number of activities 2,808
Frailty Team
Number of referrals 384
Number of patients reviewed & support calls 3,657
Dementia Clinical Nurse Specialist
Number of referrals 37
Number of interventions 541
Outpatients
Number of unique patients attending 35
Number of medical appointments 105
Family Support Services
Number of referrals 444
Pre & Post Bereavement individual counselling sessions 682
Number of interventions 2,819
Compassionate Neighbours
Number of Community Members Supported 891

Patient Accidents, Incidents and Near Misses

All patient incidents are investigated lessons learnt, and concerns added to the risk register.

Garden House Hospice Care reports incidents quarterly to the East and North Herts Clinical Commissioning Group, BLMK Clinical Commissioning Group and the Care Quality Commission when required.

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Serious Incidents Requiring Investigation

In 2023/2024, there were no Serious Incidents Requiring Investigation (SIRI) which Garden House Hospice Care are required to report to the Care Quality Commission and East and North Herts Clinical Commissioning Group.

Duty of Candour

Candour is defined in the Francis Report (2013) as:

“The volunteering of all relevant information to persons who have or may have been harmed by the provision of services, whether or not the information has been requested and whether or not a complaint or a report about that provision has been made.”

Garden House Hospice Care is committed to the Duty of Candour and expects every healthcare professional to be open and honest with all patients and service users and their family and carers. During 2023/2024, there have been no Duty of Candour breaches at Garden House Hospice Care.

All Clinical and non-clinical patient-facing staff and volunteers receive annual mandatory training on safeguarding, mental capacity and deprivation of liberty safeguards.

SAFEGUARDING LEAD:

Director of Patient Services

SAFEGUARDING TRUSTEE:

Named responsible Trustee

ADULT SAFEGUARDING CHAMPION: Social Worker

Safeguarding adults at risk of abuse or neglect is everybody’s business. Garden House Hospice Care’s policy is in line with the Hertfordshire Safeguarding Adults Board’s multi-agency policy and procedure for working with adults at risk of abuse or neglect. GHHC’s Safeguarding of Adults at Risk policy was last updated in April 2024.

The Care Act 2014 and supporting statutory guidance describes safeguarding as protecting an adult’s right to live safely, free from abuse and neglect.

When abuse or neglect occurs, or is suspected, it needs to be responded to swiftly, effectively and proportionately to enable the adult in need of safeguarding to remain in control of their life as much as possible.

The Safeguarding information on how to raise a concern is displayed on the Safeguarding information boards and in team areas for hospice team members. Safeguarding posters are displayed, and leaflets are available for patients, family, friends and carers.

19 Adult Safeguarding concerns were raised in 2023/2024.

CHILD SAFEGUARDING CHAMPION: Social Worker

Garden House Hospice Care is committed to protecting and promoting the welfare of children who may come into contact with our services at all times.

The Safeguarding Children policy is to be read in conjunction with the Hertfordshire Safeguarding Children Partnership (HSCP) Manual. Garden House Hospice Care’s Safeguarding Children policy was last updated in April 2024.

The Safeguarding information on how to raise a concern is displayed on the Safeguarding information boards and in team areas for hospice team members. Safeguarding posters are displayed, and leaflets are available for patients, family, friends and carers.

No children Safeguarding concerns were raised in 2023/2024.

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TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

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Ethical fundraising at Garden House Hospice Care – our promise

GHHC exists to provide specialist palliative care . Delivering our vital care to those living with cancer and other life-limiting illnesses in Stevenage, North Hertfordshire and adjoining areas of Mid Bedfordshire is only possible because of the generosity and enthusiasm of our supporters.

Our promise to our supporters is to fundraise and communicate in an honest and transparent way. We aim to ensure that everyone who chooses to offer their support to GHHC - whether by making a donation or by giving their time to take part in events, online and digital actions or to simply share our message - has a positive and rewarding experience with us and understands that their support is very much valued.

In order for us to raise the funds needed to provide vital end of life care in Stevenage, North Hertfordshire and adjoining areas of Mid Bedfordshire fundraising is carried out by our staff, volunteers and third-party supporters. In the case of the lottery only, we use a company “Local Hospice Lottery” to generate additional income through lottery sales.

We do not solicit donations by ‘cold calling’ by telephone or door-to-door collections, and we do not share personal information with any third-party organisations. We do not pressure supporters to make donations and we will always take care to avoid contacting and asking vulnerable people for donations.

We will not solicit or accept donations from companies or individuals who participate in activities which could cause detriment to the charity’s reputation or work.

In any case where we may have contractual arrangements in place with agents, we take care to set the standards and obligations that must be met when fundraising on behalf of GHHC. We work closely with these partners to maintain the high standards that we, and the public, expect. This means ensuring that practices and policies are in place and closely adhered to.

GHHC is a member of the Institute of Fundraising and complies with the Fundraising Regulator. Alongside our high standards, we follow their and our own codes of practice to ensure that our fundraising meets the highest standards and supporters have the best possible experience. GHHC complies with the Data Protection Act and the Information Commissioners’ guides and codes. Last year (as in the previous year), we did not receive any complaints with regards to fundraising.

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GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

Financial Review

Income was received from the following sources:

----- Start of picture text -----
Garden House Hospice Care - Income
3,000
2,500
2,000
1,500
1,000
500
-
Legacies Trading NHS Donations Fundraising Grants and Covid-19 Other
Funding Trusts Grants
2021/22 2022/23 2023/24
£'000
----- End of picture text -----

For the year ended 31 March 2024, total income increased by 20% to £7.84 million. Total Income from NHS funding was similar to 2022/23 at £2.10 million.

Despite the continuing financial challenges faced by the public their generous support continued, through legacies, donations, and sales in the Trading company’s shops, resulting in increased giving. NHS East & North Hertfordshire and NHS Bedfordshire, Luton & Milton Keynes provided 28% of the funding required by GHHC. Legacy income was at its highest and more than the previous year at £1.29 million.

Expenditure shown analysed by activity comprises:

Total expenditure increased by 17.6% to £8.55m this year: spending on charitable activities increased by 17.8% and spending on income generation increased by 11%.

----- Start of picture text -----
Garden House Hospice Care - Expenditure
4,000
3,000
2,000
1,000
0
Inpatient care Day services Hospice at home Trading Fundraising
2021/22 2022/23 2023/24
£'000
----- End of picture text -----

20

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

The net result for the year was a deficit of £624,657 , compared to a deficit of £853,673 in the previous year. GHHC continues to need the help of our supporters to provide services in the medium to long-term otherwise the charity will have insufficient income to cover its ongoing costs.

GHHC does not have medium or long-term pension liabilities arising from obligations to a defined benefit pension scheme.

Reserves Policy

All charities are required to consider their level of reserves to ensure sustainability. Garden House Hospice Care provides a range of critical health services upon which our local community depends. These services are funded by fluctuating income streams; the existence of reserves ensures that services can be delivered continuously in the event of a short-term reduction in income.

During the financial year, the charity Trustees adjusted its reserves policy as they felt that the actual level of free reserves as at 31 March 2024 was higher than the target level. The Risk Management Reserves have been reduced from £1,874,397 to £670,303. However, a further reduction for 2024/25 has been approved by the Trustees to reduce the target level of the reserves held by £1.5m. This reduction is in furtherance of the charity’s objects. GHHC’s reserves policy requires that free reserves should not be less than 6 months’ operating costs, excluding costs relating to retail activities. The free reserves comprise of the aggregate of the Operating, Legacy Equalisation / Risk Management, Asset Management, Designated Fixed Asset and Strategic Development Reserves, as this assures the charity of considerable financial stability.

The Charity Commission does not make a specific recommendation on the level of reserves to be held by an individual charity but require, as minimum good practice, that Trustees:

In line with recommendations from the Charity Commission, the Board of Trustees have agreed that the Hospice should provide reliable and consistent services to its beneficiaries beyond the immediate future. The Hospice needs to be able to meet unexpected expenses, absorb setbacks and take advantage of change and opportunities for development when they arise. Taking all these factors into consideration, the Trustees approved a new Reserves Policy at its Board meeting on 26 July 2023 as details below.

Operating reserves

The key risk Garden House Hospice Care faces is the challenge of financial sustainability because of a temporary or longer-term fall in its resources, granted or earned income. Approximately 69% of the charity’s income comes from public funding, Fundraising, Trusts and Grants, Lottery, Trading Profits, with a heavy dependence upon general donations and legacy income, which can be unpredictable within a defined period. The Trustees consider it prudent and desirable to ensure that the risks and challenges to income in the short and medium term can be met without significant disruption to services. The Trustees consider that an operating reserve of 6 months of full running costs is appropriate to mitigate this risk, with an aim to keep the reserve at the top end of this range.

Legacy Equalisation / Risk Management Reserve

This reserve will be to smooth out any year-on-year fluctuations against perceived risks to fundraising and legacy income. Legacies are an important income stream for the hospice, generally comprising around a 25% of total income, but volatile. The charity therefore needs to include legacy income in its cost budgeting, so this reserve is an added contingency to avoid any disruption to day-to-day activity in the event of low legacy receipts in a given year. Funds would be taken from the reserve to make good any shortfall in legacies against the annual budget, unless compensated for by other income streams.

21

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

Asset Management Reserve

An asset management survey has been planned, which would identify potential upgrading and repair work which will be required going forward to the hospice and Ernest Gardiner buildings and plant. The Trustees have agreed therefore to set aside a minimum of 5% of surplus funds in any given year for future work.

Strategic Development Reserve

The Trustees recognise their responsibility to ensure that monies given to the charity are used to further the charity’s objects and meet the needs of its beneficiaries. Any funds surplus to those required for the other designated reserve funds are held in a strategic development reserve. The strategic development reserve is earmarked to contribute to the funding of the charity’s strategic aims, whether for revenue or capital expenditure. Some of this reserve was drawn on last year to support the exceptional item of expenditure. Part of the strategic development reserve is held in investment with Evelyn Partners yielding an income.

Restricted Reserve

Some funds are given to the charity to use for specific purposes and where this is the case they are held on trust in a restricted reserve and drawn on as the funds are required for the purposes for which they were given. Where a capital asset is bought with the funds, the reserve is drawn down in line with the depreciation of the asset rather than in totality at the time of purchase.

Designated Fixed Asset Reserve

This represents the net book value of the hospice’s amount of the total reserves that are tied up in tangible fixed assets that cannot be realised easily, mainly the hospice buildings, plant and equipment, and Furniture and Fittings. It has been setup to assist in identifying funds which are not free funds, as Garden House Hospice Care are not able to draw down on this reserve, which represents the value of its fixed assets as shown on the balance sheet.

As of 31 March 2024, the charity had a total reserve of £10.31m (2022-2023: £10.98m), represented as follows:

Funds 2024
£		 2023
£		 Description
Designated Reserves 6,442,176 6,281,403 The
designated
fixed
asset
fund
represents the net book value of Garden
House Hospice Care.
These are tangible fixed assets which
are not free funds.
Reserves excludingfixed assetfunds.
Restricted Reserves 257,302 31,667 These are restricted for specific projects.
Strategic Development
and Asset Management
Reserves		 2,944,166 2,751,135 This covers our planned and preventative
maintenance programme.
Risk
Management
Reserves		 670,301 1,874,397 General purposes - this is against
perceived risks to income.
Total **10,313,945 ** **10,938,602 **

For the financial year ending 31 March 2025. The Board of Trustees approved the sum of £1,461,765 of expenditure from our Reserves. The use of reserves is to support the 2024/25 deficit budget to enable the organisation to continue to provide the much-needed services to the community.

22

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

Investment policy

GHHC invests the funds held in its free and restricted reserves accounts to gain a financial return. GHHC appointed an investment manager, Evelyn Partners with the aim of generating an absolute return above the consumer price index.

The investment policy differentiates between:

The allocation of assets for investment is determined in relation to the Hospice’s cash flow projections.

During the year, the charity made gains on its investments of £78,948 (2023: losses of £108,212).

Principal Risks and Uncertainties

GHHC has a formal risk management process through which the Senior Leadership Team identifies the major risks to which the organisation may be exposed and has ranked these by likelihood and impact, culminating in risk control documents which are updated on a regular basis.

All significant risks, together with current mitigation actions, are reviewed regularly throughout the year by the Board of Trustees and committees of the Board. The Trustees are satisfied that systems have been developed and are in place to mitigate identified risks to an acceptable level.

All staff and volunteers are required to train to ensure that they are familiar with the operating systems of the Hospice and the risks of the activities in which they are involved.

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

_________________

The principal risks and uncertainties identified by the charity are as follows:

Risk identified Action taken to mitigate the risk.
A significant fall
in voluntary
income		 Income is monitored closely. Comprehensive management accounts are presented to
the Finance and General Purposes Committee six times a year and then to each meeting
of the Board of Trustees (at least 6 meetings per calendar year) with monthly and year-
to-date figures. Similar considerations apply in the case of the Trading Company where
management accounts are offered to each meeting of the Board of the Trading
Company (also at least 6 meetings per year).
The progress of key fundraising events is reported by the Director of Income Generation
to Trustees on a regular basis.
Close control of expenditure in both GHHC and the Trading Company is the other side
of the equation. The importance of an adequate level of reserves is crucial and the
reserves policy is noted elsewhere.
Unsafe or poor
clinical practice		 There are policies in place to ensure the recording and investigation of incidents in
clinical areas. All clinical incidents are reviewed at the Health & Safety Meeting with
monthly reporting and review of quality metrics at the Clinical Team Leaders meeting.
Incidents which require a change of practice are presented at the Hospice Clinical
Governance Committee. This is supplemented by having an education and learning
programme in place.
Adequate clinical
staff to ensure
safe clinical
practice		 Close monitoring of patient dependency and staff skills mix, and regular review of the
Hospice case load are in place. There is flexibility with bank staff who cover during
periods of holiday or sickness.

24

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

_________________

Governing Document

Garden House Hospice Care is a company limited by guarantee incorporated on 25[th] July 1986 (Company Number 02040989, Registered Office Gillison Close, Letchworth Garden City, Herts SG6 1QU) and registered as a charity on 23[rd] September 1986 (Charity Number 295257). Its Memorandum and Articles of Association govern GHHC. In the event of GHHC being wound up, the members are required to contribute an amount of £1 each.

The Trustees comply with the objects of, and work within the scope of the powers set out in, the Memorandum of Association. The Trustees follow the seven principles of good governance as set out in the 2017 Good Governance Code for larger charities.

Public Benefit

The Trustees have paid due regard to the Charity Commission’s Public Benefit Guidance and complied with section 17 of the Charities Act 2011 in exercising their powers and duties.

They note that were it not for GHHC and its work, adult hospice care would not be available in Stevenage and North Hertfordshire.

At the time GHHC was established in 1986, its two founding principles were that all treatment and care would be offered to the public without discrimination – that is without regard for age, race, colour, religion, gender, sexual orientation, or financial means of the patient – and that all treatment and care would be supplied free of charge.

The Trustees are proud to confirm that GHHC has not deviated from those principles.

Recruitment and Appointment of Trustees

Trustees are recruited by a professional interview process. The Board considers candidates for appointment as Trustees after being duly proposed usually by existing Trustees, associated professionals, or staff; or following advertisement. Trustees must be members of GHHC. The Trustees seek to ensure that all proposed Trustees enhance the existing committed and diverse body of Trustees, come from a variety of backgrounds with experience relevant to the work and management of GHHC, and can provide the necessary commitment before being elected .

Trustees’ Induction and Training

All potential Trustees undergo a period of induction during which they are shown all aspects of GHHC’s work, attend relevant meetings and identify with their area of particular interest or expertise.

Trustees must prove their eligibility for trusteeship (Fit and Proper Person Test), sign a formal declaration to that effect, and have a Disclosure and Barring Service check.

All existing and potential Trustees are expected to familiarise themselves with the Charity Commission Guidance CC3 “The Essential Trustee” and Companies House’s document “Life of a Company part 1; Annual requirements”. They have access to national training opportunities specifically for Trustees. Links with

25

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

_________________

Trustees from other hospices are fostered and opportunities for training within the wider hospice movement can be accessed as appropriate. All Trustees have easy access to all policy and report documents relating to the GHHC’s activities. Personal copies of key documents such as the Memorandum and Articles of Association are provided.

Organisational Structure

The Trustees meet for Board meetings at least six times throughout the year. There are also a similar number of meetings of two committees: Finance and General Purposes, Hospice Care and Clinical Governance; a subcommittee; and the Trading Board. The CEO and members of the Senior Leadership Team attend and provide reports for all meetings. Additional meetings are scheduled if/when necessary. Minutes of the previous meeting together with the agenda and relevant papers for the forthcoming meeting are circulated in advance. The Trustees individually represent the Board on several internal forums and are, increasingly linked to specific areas of the Hospice’s work. Three of the Trustees are also Directors of the Trading Company, Garden House Hospice Trading Limited.

A programme of announced visits by two Trustees to a particular area of GHHC’s work results in improved communication between the Board of Trustees and volunteers and staff. Each visit gives rise to an action plan which is discussed and monitored by the Board.

The Trustees establish the strategic plan and approve relevant policies. A scheme of delegation is in place whereby senior managers are responsible for the overall day-to-day management of the organisation and for ensuring that policies are adhered to, and plans brought to fruition.

The Chief Executive is Lisa Hunt. The Senior Leadership Team members at 31 March 2024 were:

Medical Director: Dr Sarah Bell Director of Patient Services: Elizabeth Kennedy Director of Income Generation: Carla Pilsworth Director of Finance & Resources: Edith Yembra Director of People: Derek Turnbull

The members of the Senior Leadership Team attend the Trustees’ meetings but do not have voting rights. From time-to-time other members of staff, independent advisers, or experts in various fields are invited to attend meetings for specific purposes to support or facilitate the Trustees’ decisions.

The Senior Leadership team support 226 staff and up to 1,422 volunteers whose contribution is crucial to the success of the charitable work and fundraising. Donated services, in the form of voluntary help, are not reflected in the Statement of Financial Activities.

Volunteers support the work of GHHC by providing assistance as receptionists, serving light refreshments to patients and visitors, flower arranging, undertaking administrative tasks, working as Compassionate Neighbours, working within the Day Services and In-patient Unit, gardening, and providing transport for patients and fundraising. Volunteers also make a considerable contribution towards the work of the Trading Company as shop assistants and helping with the sorting and delivering of donations from the Distribution Centre.

GHHC is an equal opportunities employer.

GHHC is a member of Hospice UK which is an umbrella organisation. However, it does not impact on the operating policies of GHHC.

26

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

_________________

Pay Policy for senior staff.

The Trustees consider that the Board of Trustees and the Senior Leadership Team comprise the key management personnel of the charity in charge of directing and controlling, running, and operating the Charity on a day-to-day basis. All Trustees give of their time freely and no Trustee received remuneration in the year.

Details of Trustees’ expenses and related transactions and Senior Leadership Team salaries are disclosed in note 6 to the accounts. The pay of the Chief Executive and members of the Senior Leadership Team and all staff are reviewed annually and normally increased in accordance with average earnings to reflect a cost-ofliving adjustment. In view of the nature of the charity, the Trustees benchmark remuneration against pay levels in other charities. The remuneration benchmark is the mid-point of the range paid for similar roles in similar charities of similar size.

Trustees

The Trustees who served during the year were:

Mr Stephen Mellish[1,2,3] (Chairman) Dr Simon Chatfield[1] Mr Richard Dearden[2] Mrs Melanie Flynn[2] Mr Roger Gochin[2] , (Retired 29.11.23) Professor Shahid Khan[1] (Resigned 19.04.24) Mrs Gemma Manning[3] Mrs Rhona Seviour[3] Mr James Silsby[2] (Resigned 29.02.24) Mrs Jennie Mattin[1 ] Dr Pauline Williams[3] Mr Christopher Dare[2] (Appointed 29.11.23) Mrs Joanna Heneker (Appointed 26.03.24)

Committees

  1. Clinical Governance.

  2. Finance and General-Purpose.

  3. People and Culture.

In accordance with Article 39 of the Hospice Articles of Association there are no Trustees retiring by rotation at the Annual General Meeting:

Trustees’ Interest in the Shares of the Hospice

GHHC is a company limited by guarantee and not having a share capital, therefore the Trustees have no financial interest other than the extent of the limited guarantee as denoted in the Memorandum of Association of the Hospice.

Trustees’ Responsibilities

The Trustees (who are also the directors of GHHC for the purposes of company law) are responsible for preparing the Trustees’ Annual Report and Accounts in accordance with applicable law and regulations. Company law requires the Trustees to prepare accounts for each financial year. Under that law the Trustees have elected to prepare the accounts in accordance with United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards and applicable law).

27

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

Under company law, the Trustees must not approve the accounts unless satisfied that they give a true and fair view of the state of affairs of the charity and of the group and the incoming resources and application of resources, including the net income or expenditure of the group for the year.

In preparing those accounts, the Trustees are required to:

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

In so far as the Trustees are aware:

Annual Delivery Plan 2024/2025 Strategic roadmap

Last year we developed the operating model to deliver on Garden House Hospice Care’s strategic goals. This two-year plan set out the emerging clinical models to expand our clinical reach whilst recognising the economic challenges that lay ahead.

During 2023/2024 our improvement journey commenced. Improving our responsiveness, our productivity and value for money - whilst developing and implementing innovative care models to address future need.

For the coming year 2024/2025 our focus will be:

GARDEN HOUSE HOSPICE CARE

TRUSTEES’ REPORT

FOR THE YEAR ENDED 31 MARCH 2024

Our annual priorities 2024/2025

The five annual priorities for 2024/2025 are to:

1.Increase the reach of all our services into our local neighbourhoods by continuing the role out of our Frailty Service for the moderate to severely frail who benefit from palliative and end of life care.

It is important that we build on the progress made during 2023/2024 to complete the roll out of the Frailty model across the whole patient pathway, ensuring equity of service provision for all patients requiring palliative and end of life care. We will achieve this by: 

2.Working within our budget allocation, make every penny count. Maximise the income generated from our Fundraising team and Trading Company, constantly horizon scanning for potential new income streams.

Last year we set ourselves a challenging 3-year improvement trajectory to break even.

At the end of 2023/2024 we improved our financial position, reducing our deficit to -£700,000. Our control target for 2024/2025 is £559,000.

To achieve this financial position, we need: 

The financial plan is largely funded from £2,753,220 charity contributions, £452,000 trading profit, £181,300 income from training and conferences and NHS income based on outturn plus a 3% uplift on the 2023/2024 contract value. Within the plan we have budgeted for:

  1. Capital expenditure of £115,354 schemes across Estates, IT and clinical equipment.

  2. Resource funding of c£300,000 required to expand our clinical services.

  3. A contingency of £75,000 to complete on our commitment to align pay to NHS pay scales and maintain our competitiveness within the market.

  4. Pay increases of 3% on top of the living wage uplift.

3. Invest in our staff and strengthen our resilience to enable our organisation to become more agile and responsive to future opportunities.

Our workforce is the driving force behind what we deliver as an organisation, for our patients and our community.

29

It is vital that we develop our relationships and support our people in becoming the best at what they do. When our staff perform at their best, we deliver the highest quality of care and patient experience, this makes staff proud to work for our organisation and act as positive advocates for us as a provider of palliative and end of life care and an employer of choice.

People performing at their best requires sustained effort and contribution on their part, together with a working environment that encourages and supports excellence all of the time.

The following planned actions are reflective of these goals: 

4.Ensure that Garden House Hospice Care is recognised as an efficient and thriving organisation worthy of future investment and known as ‘great’ at what it does.

Patient experience, patient safety and clinical effectiveness are the three aspects of quality in health care provision, and a high-quality service exhibits all three.

We are known to be a ‘good’ provider of palliative and end of life services, but we aim to be ‘great’. To achieve this, we need to benchmark in the upper quartile across all aspects of the business if we are to provide every patient who needs our services with a high quality, personalised experience, at every contact – every time.

In the coming year we will: 

5.Ensure that Garden House Hospice Care is recognised as an organisation that is championing positive change to protect our planet.

During 2023/2024 we developed our sustainability strategy ‘Our Planet’ and supporting objectives.

Our sustainability programme of work is realistic and achievable. Our focus over the next 12 months will be to build sturdy foundations within our organisation and harness a culture that champions positive change.

30

We will achieve this through training our people and embedding sustainability into their roles. When we work in partnership or procure services, we will actively work to ensure our sustainable goals align.

We will develop standards that deliver on our goals across our estate, making informed decisions on environmental impact.

Transformation programme 2023/2025 - ‘From Good to Great’

We will continue to evaluate our services, our support functions and processes across all areas within the organisation during 2024/2025 and apply a programme management approach to design and delivery.

Our focussed programmes for the coming year will be:

1. Our Estate

2. Digital

Maximising the benefits from our Digital platform, continuing our ambition to digitise, connect and transform services safely and securely.

Ensuring smart foundations and fit for purpose IT platforms enable us to be:

3. Quality and governance improvement programmes

During the year we have completed an in-depth review against the CQC key lines of enquiry. We have a good understanding of where we are and the improvements that we need to make this year. Task and finish project groups have been established and a programme management approach applied.

4. Clinical models

We will continue to review our demand and capacity, further driving up productivity and improving pathways, processes and system alignment. Developing the next phase of the Frailty model will become essential to delivering on our commitment to cover the whole patient journey.

In approving this Trustees’ Report, the Trustees are also approving the Strategic Report of the company, in their capacity as company directors.

Approved by the Trustees on 23[rd] October 2024 and signed on their behalf by:

Mr Stephen Mellish Chairman of Trustees

31

GARDEN HOUSE HOSPICE CARE

FOR THE YEAR ENDED 31 MARCH 2024

_________________

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF GARDEN HOUSE HOSPICE CARE

Opinion

We have audited the financial statements of Garden House Hospice Care for the year ended 31 March 2024 which comprise the Consolidated Statement of Financial Activities, the Consolidated and Charity Balance Sheets, the Consolidated Statement of Cash Flows and notes to the financial statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion, the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the group 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 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 trustees are responsible for the other information. The other information comprises the information included in the Chairman’s Report and in 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.

In connection with our audit of the financial statements, 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 audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. 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.

32

GARDEN HOUSE HOSPICE CARE

FOR THE YEAR ENDED 31 MARCH 2024

_________________

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF GARDEN HOUSE HOSPICE CARE

Opinions on other matters prescribed by the Companies Act 2006

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

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the group and the parent charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the Trustees’ Report (which incorporates the strategic report and the directors’ report).

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

Responsibilities of trustees for the financial statements

As explained more fully in the trustees’ responsibilities statement set out on pages 27 and 28, 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 groups and the 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 the 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.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below:

Based on our understanding of the group and the environment in which it operates, we identified that the principal risks of non-compliance with laws and regulations related to health and social care and charity and company law applicable in England and Wales, and we considered the extent to which non-compliance might have a material effect on the financial statements. We also considered those laws and regulations that have

33

GARDEN HOUSE HOSPICE CARE

FOR THE YEAR ENDED 31 MARCH 2024

_________________

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF GARDEN HOUSE HOSPICE CARE

a direct impact on the preparation of the financial statements such as the Companies Act 2006 and the Charities Act 2011 and consider other factors such as sales tax and payroll tax.

We evaluated management’s incentives and opportunities for fraudulent manipulation of the financial statements (including the risk of override of controls) and determined that the principal risks were related to the improper recognition of revenue and management bias in accounting estimates. Audit procedures performed by the engagement team included:

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.

A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.

Use of our report

This report is made solely to the charitable company's members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company's members those matters we are required to state to them in an Auditor's report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company's members, as a body, for our audit work, for this report, or for the opinions we have formed.

Lee Stokes (Senior Statutory Auditor) For and on behalf of Haysmacintyre LLP, Statutory Auditors

10 Queen Street Place London EC4R 1AG

Date: 23 October 2024

34

GARDEN HOUSE HOSPICE CARE

CONSOLIDATED STATEMENT OF FINANCIAL ACTIVITIES (Incorporating an income and expenditure account)

FOR THE YEAR ENDED 31 MARCH 2024

Unrestricted Restricted Total Total
Funds Funds 2024 2023
Note £ £ £ £
Income from:
Donations and legacies
Donations, legacies, and grants 2 1,917,650 356,677 2,274,327 1,202,848
Charitable activities
NHS funding 3 2,103,416 - 2,103,416 2,107,627
Other trading activities
Shop income and fundraising 7 2,708,958 - 2,708,958 2,502,662
Fundraising events 539,944 - 539,944 579,732
Investments 4 76,996 - 76,996 63,184
Other income 137,915 - 137,915 68,200
---------------------- ------------------ --------------------- ---------------------
Total income 7,484,879 356,677 7,841,556 6,524,253
---------------------- ------------------ --------------------- ---------------------
Expenditure on:
Raising funds
Trading activities 5 2,137,669 - 2,137,669 1,831,465
Donations and grants 5 288,286 - 288,286 248,069
Fundraising 5 712,120 - 712,120 714,778
Charitable activities 5 5,276,044 131,042 5,407,086 4,475,402
---------------------- ----------------- --------------------- ---------------------
Total expenditure 8,414,119 131,042 8,545,161 7,269,714
---------------------- ----------------- --------------------- ---------------------
Net operating surplus/(loss) (929,240) 225,635 (703,605) (745,461)
Net gains / (losses) on investments 10 78,948 - 78,948 (108,212)
--------------------- ------------------ ----------------- -----------------
Net (expenditure) / income (850,292) 225,635 (624,657) (853,673)
Transfers between funds - - - -
--------------------- ------------------ ----------------- -----------------
Net movement in funds (850,292) 225,635 (624,657) (853,673)
Total funds brought forward 10,906,935 31,667 10,938,602 10,938,602
---------------------- ------------------ -------------------- --------------------
Total funds carried forward 20 10,056,643 257,302 10,313,945 10,938,602
============ ========== =========== ===========

The notes on pages 38 to 54 form part of these financial statements.

The Statement of Financial Activities includes all gains and losses in the year. All income and expenditure derive from continuing activities.

Full comparative figures for the year ended 31 March 2023 are shown in note 23.

35

GARDEN HOUSE HOSPICE CARE

COMPANY NUMBER: 02040989

CHARITY AND CONSOLIDATED BALANCE SHEETS

AS AT 31 MARCH 2024

Group Charity Charity
2024 2023 2024 2023
Note £ £ £ £
FIXED ASSETS
Tangible assets 9 6,442,176 6,281,403 6,117,578 6,098,448
Investments 10 2,944,066 2,751,135 2,944,166 2,751,235
--------------------- --------------------- ----------------------- -----------------------
9,386,242 9,032,538 9,061,744 8,849,683
--------------------- --------------------- ---------------------- ----------------------
CURRENT ASSETS
Stock 11 2,678 3,769 - -
Debtors 12 1,252,875 756,902 1,513,805 1,130,474
Cash at bank and in hand 1,062,862 1,781,748 769,704 1,381,824
--------------------- --------------------- --------------------- ---------------------
2,318,415 2,542,419 2,283,509 2,512,298
-------------------- -------------------- ------------------- -------------------
CREDITORS: amounts falling
due within one year 13 (1,390,712)
(636,355)		 (1,031,308) (423,379)
--------------------- --------------------- --------------------- ---------------------
NET CURRENT ASSETS 927,703 1,906,064 1,252,201 2,088,919
--------------------- --------------------- --------------------- ---------------------
NET ASSETS 22 10,313,945
10,938,602		 10,313,945 10,938,602
============
============		 =========== ===========
FUNDS OF THE CHARITY
Unrestricted funds
General 3,614,467 4,625,532 3,939,065 4,808,487
Designated 6,442,176 6,281,403 6,117,578 6,098,448
--------------------- --------------------- --------------------- ---------------------
10,056,643 10,906,935 10,056,643 10,906,935
Restricted funds 257,302 31,667 257,302 31,667
---------------------- ---------------------- --------------------- ---------------------
20 10,313,945 10,938,602 10,313,945 10,938,602
============ ============ =========== ===========

The unconsolidated deficit of GHHC was £624,657 (2023: deficit £853,673).

The financial statements were approved and authorised for issue by the Board of Trustees on 23[rd] October 2024 and were signed below on its behalf by:

Mr. Stephen Mellish Chairman of Trustees

The notes on pages 38 to 54 form part of these financial statements.

36

GARDEN HOUSE HOSPICE CARE

FOR THE YEAR ENDED 31 MARCH 2024

_________________

CONSOLIDATED STATEMENT OF CASH FLOWS

2024 2023
Note £ £
CASH PROVIDED BY / (USED IN) OPERATING ACTIVITIES 17 (318,335) 150,756
-------------------- --------------------
CASH FLOWS FROM INVESTING ACTIVITIES:
Dividends, interest, and rents from investments 21,456 12,550
Investment Additions (625,928) (1,363,108)
Investment Disposals 216,446 587,547
Movement in investment cash 295,498 (262,045)
Purchase of property, plant, and equipment (308,023) (191,904)
---------------------- ----------------------
CASH PROVIDED BY / (USED IN) INVESTING ACTIVITIES (400,551) (1,216,960)
---------------------- ----------------------
(DECREASE) / INCREASE IN CASH AND CASH EQUIVALENTS (718,886) (1,066,204)
Cash and cash equivalents at the beginning of the year 1,781,748 2,847,952
---------------------- -----------------------
Cash and cash equivalents at the end of the year 18 1,062,862 1,781,748
============ ============

37

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

1. ACCOUNTING POLICIES

The principal accounting policies adopted, judgements and key sources of estimation uncertainty in the preparation of the financial statements are as follows:

Basis of preparation

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (Second Edition, effective 1 January 2019) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

Garden House Hospice Care meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy note(s).

Preparation of accounts on a going concern basis

The trustees consider there are no material uncertainties about the Charity’s ability to continue as a going concern. The funding uncertainty may have an impact on future revenue and costs but continual review of our financial position, reserves levels and future plans gives Trustees confidence the charity remains a going concern for the foreseeable future (being a period of at least twelve months from the date of approving these financial statements).

Critical accounting judgements and estimates

In preparing these financial statements, management has made judgements, estimates and assumptions that affect the application of the charities accounting policies and the reported assets, liabilities, income and expenditure and the disclosures made in the financial statements. 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. Specific judgements taken are included elsewhere within this note, including those over the depreciation rates utilised and the non-depreciation of the Garden House Hospice premises.

Group financial statements

The financial statements consolidate the results of the charity and its wholly owned subsidiary Garden House Hospice Trading on a line-by-line basis. A separate Statement of Financial Activities and Income and Expenditure Account for the charity has not been presented because the charity has taken advantage of the exemption afforded by section 408 of the Companies Act 2006.

Income recognition

All income is recognised in the financial statements once the charity has entitlement to the income, it is probable that the income will be received, and the amount of income receivable can be measured reliably.

Donations and legacies

Receipt of a legacy must be recognised when it is probable that it will be received. Receipt is normally probable when:

There has been grant of probate, the executors have established that there are sufficient assets in the estate, after settling any liabilities, to pay the legacy, and any conditions attached to the legacy are either within the control of the charity or have been met.

38

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

Grants

Clinical commission groups’ grants are credited to the Statement of Financial Activities in the year in which they are receivable. Grants related to specific deliverables are included once the performance has been considered completed. Where income is received in advance of performance its recognition is deferred and included in creditors. Where entitlement occurs before income is received the income is accrued.

Shop income, fund-raising sales and lottery income

Income from the commercial activities of operating shops (mainly selling donated goods), fund-raising sales and lottery are included in the year in which the group is entitled to receipt.

Investment income and rental income

Income from investments and from rental is included in the Statement of Financial Activities in the year in which it is receivable.

Fundraising

Income from fundraising events is included in the year during which the event took place.

Expenditure recognition

Expenditure, including any irrecoverable VAT, is included in the financial statements on an accruals basis and is recognised when there is a legal or constructive obligation to make payment to a third party.

Expenditure is allocated to the particular activity where the cost relates directly to that activity. Other costs are apportioned to areas of activity based on the staff time or usage attributable to each area.

Fixed assets

Fixed assets are stated at cost less accumulated depreciation and impairment losses. Depreciation is calculated to write off costs on a straight-line basis as follows:

The buildings are maintained as a matter of policy, by a programme of repair such that the residual values of the buildings taken as a whole are at least equal to the book value. This policy is regularly reviewed by the trustees who are satisfied it remains appropriate given the rebuild costs which would be required and taking into account the service potential of the building (i.e., it continues to be used for charitable activities and therefore brings significant benefit). Having regard to this it is the opinion of the Trustees that depreciation of any such property as required by the Companies Act 2006 and the accounting standards would be immaterial to the financial statements especially as there is a very long lease in place. Any permanent diminution in value of such buildings would be charged to the Statement of Financial Activities as appropriate.

Financial instruments

The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments, including trade and other debtors and creditors are initially recognised at transaction value and subsequently measured at their settlement value.

39

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

Investments

Investment in subsidiary

The investment in the subsidiary is stated at cost, less any provision for any permanent diminution in value.

Other investments

Investments are shown in the financial statements at market value, taken to be the bid price ruling at the balance sheet date. Gains and losses arising on disposals of investments are recognised in the Statement of Financial Activities. Unrealised gains and losses, upon restating investments to market values at the balance sheet date, are recognised in the Statement of Financial Activities.

Creditors and provisions

Creditors and provisions 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 and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.

Stock

Stock is stated at the lower of cost and net realisable value. Items donated for resale are included in the financial statements when they are sold. The Trustees consider that the time and cost involved in valuing the donated goods at the time of donation and including them as stock at the year end, outweigh the benefit to the user of the accounts.

Pensions

The Charity operates and contributes to the following pension schemes:

Employees entitled to join the National Health Service Superannuation Pension Scheme are required to contribute a percentage of salary according to the scheme’s rules. Employees who join the Standard Life Pension Scheme are required to contribute a minimum of 3% of salary.

Other employee benefits

Short term benefits

Short term benefits including holiday pay are recognised as an expense in the period in which the service is received.

Employee termination benefits

Termination benefits are accounted for on an accrual basis and in line with FRS 102.

Leasing commitments

Rentals paid under operating leases are charged to income on a straight-line basis over the lease term.

40

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

Gifts in Kind

The Hospice receives donated services in the form of voluntary help. In line with section 6 of the Charities SORP (FRS 102) this is not reflected in the Statement of Financial Activities as the financial value of the contribution of volunteers is not quantifiable.

Fund accounting

Funds held by the Charity are:

Unrestricted general funds

These are funds which can be used in accordance with the charitable objects at the discretion of the Trustees.

Designated funds

These are funds set aside by the Trustees out of unrestricted general funds for specific future purposes or projects together with funds transferred from restricted funds when no restrictions are considered to remain.

Restricted funds

These are funds that can only be used for particular restricted purposes within the objects of GHHC. Restrictions arise when specified by the donor or when funds are raised for particular restricted purposes.

Further explanations of the nature and purpose of each fund is included in Note 19.

41

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

2. DONATIONS AND LEGACIES
2024 2023
£ £
Donations 508,426 349,499
Legacies 1,291,508 674,699
Charitable foundations 474,393 178,650
---------------------- ---------------------
2,274,327 1,202,848
============ ===========
3. INCOME FROM CHARITABLE ACTIVITIES
2024 2023
£ £
NHS East and North Hertfordshire 2,016,889 2,029,871
NHS Beds, Luton & Milton Keynes 86,527 77,756
___ __
2,103,416 2,107,627
=========== ===========
4. INVESTMENT INCOME
2024 2023
£ £
Bank interest received 21,456 12,550
Investment income 55,540 50,634
---------------- ----------------
76,996 63,184
======== ========

42

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

______
5.
TOTAL EXPENDITURE 2024
Costs directly allocated to activities:
Staff costs
Cost of sales & services
Travel
Audit & accountancy
Support costs allocated to activities:
Hire of land, buildings & equipment
Premises costs
Communication
Legal & professional fees
Audit & accountancy
Depreciation
Bank charges
Other
TOTAL EXPENDITURE 2023
Costs directly allocated to activities:
Staff costs
Cost of sales & services
Travel
Audit & accountancy
Support costs allocated to activities:
Hire of land, buildings & equipment
Premises costs
Communication
Legal & professional fees
Audit & accountancy
Depreciation
Bank charges
Other		 _________________
Hospice Charitable Activities
Total
Commercial
activities
Donations &
Grants
Fundraising
Inpatient Care
Day Services
Hospice at
Home
1,149,229
242,476
513,470
2,831,606
473,512
1,144,809
6,355,102
184,952
9,018
106,573
224,857
85
333
525,818
17,506
-
1,195
6,342
396
35,688
61,126
4,002
376
928
4,577
708
1,764
12,355
400,210
2,874
7,100
35,002
5,417
13,495
464,098
201,697
22,465
55,494
273,593
42,341
105,481
701,071
17,980
2,972
7,342
36,197
5,602
13,955
84,048
50,782
5,445
13,451
66,317
10,263
25,568
171,826
4,002
376
928
4,577
708
1,764
12,355
82,012
3,034
7,493
36,944
5,717
14,243
149,443
25,297
279
688
3,393
525
1,308
31,490
-
(1,029)
(2,542)
(13,199)
(1,940)
(4,862)
(23,572)
2,137,669
288,286
712,120
3,510,206
543,334
1,353,546
8,545,161
1,013,898
211,057
479,896
2,311,880
382,221
1,022,405
5,421,357
189,477
9,868
155,551
232,113
9,008
1,010
597,027
16,827
-
1,122
21,959
3,828
1,285
45,021
2,245
315
907
3,658
563
1,460
9,148
312,805
1,375
3,964
15,980
2,460
6,381
342,965
141,217
18,168
52,349
211,015
32,488
84,268
539,505
29,329
2,828
8,150
32,852
5,058
13,119
91,336
23,233
2,684
7,732
31,169
4,799
12,447
82,064
2,245
315
907
3,657
563
1,460
9,147
74,183
2,665
7,678
30,948
4,765
12,359
132,598
26,006
273
786
3,167
488
1,265
31,985
-
(1,479)
(4,263)
(17,189)
(2,645)
(6,863)
(32,439)
1,831,465
248,069
714,779
2,881,209
443,596
1,150,596
7,269,714

Support costs include governance costs of £24,254 (2023: £18,290)

43

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024
_________________
5.
TOTAL EXPENDITURE (continued)		 2024 2023
£ £
Included in total expenditure:
Depreciation – owned assets 147,251 132,485
Auditor’s remuneration:
Audit fees 16,250 13,800
Operating lease charges:
Hire of equipment 62,150 30,161
Hire of land and buildings 400,210 312,805
========== ==========
**6. ** STAFF COSTS AND NUMBERS.
2024 2023
£ £
Salaries and wages 5,583,580 4,825,566
Social security costs 432,050 336,312
Pension costs 339,472 259,479
-------------------- --------------------
6,355,102 5,421,357
=========== ===========
Included in the above are termination/ex-gratia payment of £0 (2023: £23,500).
Number
Number
Charity and group:
The average number of employees analysed by function:
Income generation 14 14
Retail 64 68
Clinical 91 88
Administration and other activities 57 53
--------- ---------
226 223
===== =====
The number of employees whose emoluments as defined for taxation
purposes amounted to over £60,000 in the year were as follows:
£60,001 - £70,000 1 -
£70,001 - £80,000 - -
£80,001 - £90,000 3 2
£90,001 - £100,000 - 1
£100,001 - £110,000 1 -
£110,001 - £120,000 1 -
-------------- --------------
6 3
======= ======

The key management personnel of the group are considered to be the Senior Leadership Team listed on page 1. The total employee benefits of the key management personnel of the Group were £566,563 (2023: £535,927).

The Trustees provide their services voluntarily and are not included in the above analysis. During the year, one trustee received travel expenses of £0 (2023: £89). The directors of the subsidiary undertaking provide their services voluntarily and are not included in the above analysis. The directors of the subsidiary undertaking had no expenses paid to them throughout the current or previous year.

44

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

7. SHOP INCOME, FUNDRAISING SALES, LOTTERY INCOME AND RELATED EXPENDITURE

GHHC Charitable Total GHHC Charitable Total
Trading 2024 Trading 2023
£ £ £ £ £ £
Shops and fundraising sales
Turnover from donated goods - 2,438,839 2,438,839 - 2,238,852 2,238,852
Retail gift aid - 50,259 50,259 - 62,518 62,518
Turnover from purchased goods - 22,160 22,160 - 30,169 30,169
---------------- -------------------- -------------------- ---------------- -------------------- --------------------
Shop and fundraising sales income - 2,511,258 2,511,258 - 2,331,539 2,331,539
---------------- ------------------- -------------------- ---------------- ------------------- --------------------
Cost of sales - 184,952 184,952 - 189,478 189,478
Management and admin expenses - 1,952,717 1,952,717 - 1,641,987 1,641,987
----------------- --------------------- --------------------- ----------------- --------------------- ---------------------
Shop expenditure - 2,137,669 2,137,669 - 1,831,465 1,831,465
---------------- -------------------- -------------------- ---------------- -------------------- --------------------
Lottery
Income from lottery 197,700 - 197,700 171,123 - 171,123
---------------- ----------------- ----------------- ---------------- ----------------- -----------------
Operating expenses
Management and admin expenses - - - - - -
---------------- ---------------- ---------------- ---------------- ---------------- ----------------
Lottery expenditure - - - - - -
---------------- ---------------- -------------- ---------------- --------------- --------------
Net income from shops and - 273,071 273,071 - 500,074 500,074
fundraising sales
Net income from lottery 197,700 - 197,700 171,123 - 171,123
----------------- ----------------- ---------------- ----------------- ----------------- ----------------
Net income from trading 197,700 273,071 470,771 171,123 500,074 671,197
========= ========= ========= ========= ========= =========

The charitable income from the sale of donated and purchased goods is through shops at various town locations throughout North Hertfordshire. The charitable income from the lottery was generated through a weekly lottery operated by Local Hospice Lottery Ltd.

8. RELATED PARTY TRANSACTIONS

Transactions between the parent charity and its subsidiary comprised:

a) Interest charged by the charity on the loan agreement in place of £8,628 (2023: £5,873) b) Donations collected by the subsidiary on behalf of the charity were £2,321 (2023: £1,023)

c) Salary and other costs recharged by the charity to the trading subsidiary of £1,246,261 (2023: £1,013,530)

Donations received from Trustees during the year were £3,681 (2023: £2,875). As set out in note 6, no Trustee received remuneration.

45

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

9. TANGIBLE FIXED ASSETS Land &
buildings Furniture,
Long Fixtures & Motor
Group Leasehold Fittings Equipment Vehicles Total
£ £ £ £ £
Cost
At 31 March 2023 5,908,437 599,008 260,670 39,000 6,807,115
Additions - 218,600 89,423 - 308,023
---------------------- ----------------- ---------------- ---------------- ---------------------
At 31 March 2024 5,908,437 817,608 350,093 39,000 7,115,138
---------------------- ---------------- --------------- ---------------- ---------------------
Depreciation
At 31 March 2023 - 406,145 96,441 23,125 525,711
Provided during the year - 86,983 53,868 6,400 147,251
--------------------- ----------------- --------------- ---------------- -----------------
At 31 March 2024 - 493,128 150,309 29,525 672,962
--------------------- ---------------- --------------- --------------- -----------------
Net Book Value
At 31 March 2024 5,908,437 324,480 199,784 9,475 6,442,176
============ ========= ======= ======== ===========
At 31 March 2023 5,908,437 192,863 164,228 15,875 6,281,403
============ ========= ======= ======== ===========
Charity
Cost
At 31 March 2023 5,908,437 301,265 184,323 - 6,394,025
Additions - 35,926 48,337 - 84,263
--------------------- ----------------- ---------------- ---------------- ---------------------
At 31 March 2024 5,908,437 337,191 232,660 - 6,478,288
--------------------- ---------------- --------------- ---------------- ---------------------
Depreciation
At 31 March 2023 - 229,886 65,690 - 295,576
Provided during the year - 29,039 36,095 - 65,134
-------------------- ---------------- --------------- ---------------- -------------------
At 31 March 2024 - 258,925 101,785 - 360,710
-------------------- ---------------- --------------- --------------- ------------------
Net Book Value
At 31 March 2024 5,908,437 78,266 130,875 - 6,117,578
============ ========= ========= ======== ============
At 31 March 2023 5,908,437 71,379 118,633 - 6,098,448
============ ========= ========= ======== ============

The long leasehold buildings represent the capitalised costs of converting the Letchworth Hospital into the Garden House Hospice, together with extensions and improvements carried out in later years.

46

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024
_________________
10. FIXED ASSET INVESTMENTS Group Charity
2024 2023 2024 2023
£ £ £ £
Investment in subsidiary undertaking - - 100 100
Equities and pooled funds 2,944,066 2,751,135 2,944,066 2,751,135
---------------------- ---------------------- ---------------------- ----------------------
2,944,066 2,751,135 2,944,166 2,751,235
============ ============ =========== ===========

The wholly owned trading subsidiary, Garden House Hospice Trading Limited, which is incorporated in the United Kingdom, pays all its profits to the charity annually by gift aid.

The principal activities of Garden House Hospice Trading Limited are general merchants and traders.

The charity owns the entire issued share capital of 100 Ordinary Shares of £1 each.

2024 2023
£ £
Summary of investment
Shares at cost 100 100
====== ======
Extracts from the accounts of the subsidiary undertaking
Summary profit and loss account
Turnover 2,511,258 2,331,539
Cost of sales and administrative expenses (2,137,670) (1,831,465)
Interest receivable less interest payable (2,555) (4,284)
---------------------- ----------------------
Profit on ordinary activities before taxation 371,033 495,790
Tax on profit of ordinary activities - -
-------------------- --------------------
Profit for the financial year 371,033 495,790
-------------------- --------------------
Amount covenanted to the Charity 371,033 495,790
=========== ===========
The assets and liabilities of the subsidiary undertaking were as follows:
Fixed assets 324,598 182,956
========== ==========
Current assets 494,754 633,584
Creditors amounts falling due within one year (819,252) (816,439)
-------------------- --------------------
Net current assets / (liabilities) (324,498) (182,855)
-------------------- --------------------
Creditors amounts falling due after one year - -
-------------------- --------------------
Net assets 100 100
-------------------- --------------------
Aggregate share capital and reserves 100 100
========== ==========

47

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024
_________________
10. FIXED ASSET INVESTMENTS (continued) 2024 2023
£ £
Investments
Market Value 1 April 2,751,135 1,821,741
Additions during the year 625,928 1,363,108
Disposals (216,446) (587,547)
Unrealised investment (losses) / gains 78,948 (108,212)
Movement in cash investment (295,499) 262,045
______ ______
Market Value at 31 March 2024 2,944,066 2,751,135
=========== ===========
Historic cost 31 March 2024 2,563,851 2,254,434
=========== ===========

The investments comprise a portfolio held with Evelyn Partners consisting of a mix of investment types.

11. STOCK Group Group Charity Charity
2024 2023 2024 2023
£ £ £ £
Goods for resale 2,678 3,769 - -
======== ======== ====== =======
12. DEBTORS Group Charity
2024 2023 2024 2023
£ £ £ £
Trade debtors 808,617 459,474 765,535 424,943
Profit due from subsidiary under Gift Aid - - 372,852 442,976
Other amounts due from subsidiary - - 80,000 80,000
Other debtors 19,652 14,527 - -
Prepayments and accrued income 243,382 207,592 145,749 136,387
VAT recoverable 181,224 75,309 149,669 46,168
--------------------- ------------------ --------------------- ---------------------
1,252,875 756,902 1,513,805 1,130,474
=========== ========= =========== ===========

The amounts owed by the subsidiary undertaking include loans of £80,000 (2023: £80,000) which are unsecured and repayable on demand. Interest was charged on the amount at 5% above Base Rate.

Subsidiary profits are payable under Gift Aid. A deed of covenant is in place which requires the payment to be made.

48

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

13. CREDITORS: AMOUNTS FALLING DUE Group Charity Charity
WITHIN ONE YEAR 2024 2023 2024 2023
£ £ £ £
Trade creditors 502,359 445,446 177,005 182,762
Accruals and deferred income 658,447 71,160 617,398 40,380
Other creditors 229,906 119,749 236,905 200,237
----------------- ----------------- ----------------- -----------------
1,390,712 636,355 1,031,308 423,379
========= ========= ========= =========

14. CAPITAL COMMITMENTS

The Trustees maintain a policy of continually enhancing the facilities offered to patients, families, and their guests. There were no capital commitments in the current or prior year.

15. PENSION COMMITMENTS

Garden House Hospice Care

GHHC operates and contributes to the following Pension Schemes:

The assets of the schemes are held separately from those of GHHC in independently administered funds.

Employees entitled to join the National Health Service Superannuation Pension Scheme are required to contribute as specified by the scheme rules. The annual commitment by GHHC under this scheme is for contributions of 14.3% of gross salary of those employees who are members of this scheme.

All other employees join the Standard Life Pension Scheme and contribute a minimum of 3% of salary. The annual commitment by GHHC under this scheme is for contributions of 5% of gross salary.

Subsidiary

The subsidiary undertaking operates and contributes to a defined contribution pension scheme for those employees who wish to participate. The assets of the scheme are held separately from those of the Company in an independently administered fund. All employees join the scheme and contribute a minimum of 3% of salary.

The estimated GHHC and Subsidiary commitment for contributions to both pension schemes in 2024/2025 is £297,350 (2023/2024: £293,650).

49

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

16. OTHER FINANCIAL COMMITMENTS

At 31 March GHHC and its subsidiary undertaking had minimum total commitments under noncancellable operating leases as set out below:

GHHC Subsidiary Undertaking
2024 2023 2024 2023
£ £ £ £
Operating leases which expire:
Within one year 15,529 16,066 2,578,040 820,695
Within two to five years 22,178 38,508 73,481 444,795
After more than five years - - - -
------------------ ------------------ ------------------ ------------------
37,707 54,574 2,651,521 1,265,490
========= ========== ========== ==========

The Garden House Hospice Care premises are provided at a peppercorn rent. The lease on the premises expires in 2138.

17. RECONCILIATION OF NET MOVEMENT IN FUNDS TO NET CASH 2024 2023
FROM OPERATING ACTIVITIES £ £
Net movement in funds for the year (624,657) (853,673)
Depreciation 147,251 132,485
Net (gains) / losses on investments (78,948) 108,212
Interest and dividends receivable (21,456) (12,550)
(Increase)/decrease in stock 1,091 (926)
increase/(decrease) in debtors (495,973) 708,420
(Decrease)/increase in creditors 754,357 68,788
------------------ ------------------
Net cash from operating activities (318,335) 150,756
========== ===========
18. ANALYSIS OF THE BALANCES OF CASH AND CASH 2024 2023
EQUIVALENTS AS SHOWN IN THE BALANCE SHEET £ £
Cash at bank and in hand 1,062,862 1,781,748
=========== ===========

19. FUNDS

UNRESTRICTED FUNDS

General

General unrestricted funds comprise the accumulated surpluses arising from the objectives of GHHC which may be used for its charitable purpose at the discretion of the Trustees.

Designated

Designated funds comprise accumulated surpluses where the GHHC trustees have decided to reserve funds for specific purposes. These sums are for fixed assets which benefit the charity.

50

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

19. FUNDS (CONTINUED)

RESTRICTED FUNDS

Restricted funds comprise the value of donations where the donor has requested a specific use for their donation, and where at the date of reporting, the sums have not yet been expended.

At 31 March 2024, restricted funds comprise sums restricted to pay for:

2024 2023
£ £
Assets for Patients’ use - -
Patient Services - 22,017
The Hospice befriending project 7,252 -
Education 50 3,139
Other 250,000 6,511
----------------- -----------------
257,302 31,667
========= =========

20. ANALYSIS OF MOVEMENT IN GROUP FUNDS

Balance Unrealised Balance
1 April Movement in Resources Investment 31 March
2023 Income Expenditure Transfer Gains 2024
£ £ £ £ £ £
Unrestricted funds
General 4,625,532 7,484,879 (8,414,119) (160,773) 78,948 3,614,467
Designated 6,281,403 - - 160,773 - 6,442,176
--------------------- -------------------- ------------------------ ------------------- ----------------- ---------------------
10,906,935 7,484,879 (8,414,119) - 78,948 10,056,643
--------------------- -------------------- ------------------------ ------------------
------------------		 ---------------------
Restricted funds
Fixed assets - - - - - -
Patient services 22,017 118 (22,135) - - -
Befriending - 35,597 (28,345) - - 7,252
Education 3,139 2,985 (6,074) - - 50
Other 6,511 250,000 (6,511) - - 250,000
Frailty Services - IPU - 67,977 (67,977) - - -
------------------ -------------------- ---------------------- ---------------- ----------------- ------------------
31,667 356,677 (131,042) - - 257,302
------------------ -------------------- ----------------------- --------------- ------------------ ------------------
Total 10,938,602 7,841,556 (8,545,161) - 78,948 10,313,945
=========== =========== ============= ======== =========== ===========

Transfers between funds reflect additional spend over that available in designated funds.

51

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

21. ANALYSIS OF MOVEMENT IN GROUP FUNDS - YEAR ENDED 31 MARCH 2023

Balance Unrealised Balance
1 April Movement in Resources Investment 31 March
2022 Income Expenditure Transfer Gains 2023
£ £ £ £ £ £
Unrestricted funds 5,369,598 6,430,831 (7,007,266) (59,419) (108,212) 4,625,532
General 6,221,984 - - 59,419 - 6,281,403
Designated --------------------- -------------------- ------------------------ ------------------- ----------------- ---------------------
11,591,582 6,430,831 (7,007,266) - (108,212) 10,906,935
--------------------- -------------------- ------------------------ ------------------
------------------		 ---------------------
Restricted funds
Fixed assets 4,441 - (4,441) - - -
Patient services 48,441 75,078 (101,502) - - 22,017
Befriending 94,596 18,256 (112,852) - - -
Education 31,360 - (28,221) - - 3,139
Other 21,855 88 (15,432) - - 6,511
Hospice UK Covid-19
Government Grant - - - - - -
------------------ -------------------- ---------------------- ---------------- ----------------- ------------------
200,693 93,422 (262,448) - - 31,667
------------------ -------------------- ----------------------- --------------- ------------------ ------------------
Total
11,792,275 6,524,253 (7,269,714) - (108,212) 10,938,602
=========== =========== ============= ======== =========== ===========

Transfers between funds reflect additional spend over that available in designated funds.

52

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024 FOR THE YEAR ENDED 31 MARCH 2024
_________________
22. NET ASSETS BETWEEN FUNDS Unrestricted Designated Restricted Total Unrestricted Designated Restricted Total
Funds Funds Funds 2024 Funds Funds Funds 2023
£ £ £ £ £ £ £ £
FIXED ASSETS
Long leasehold land and buildings - 5,908,437 - 5,908,437 - 5,908,437 - 5,908,437
Furniture, fixtures and fittings - 324,480 - 324,480 - 192,863 - 192,863
Equipment - 199,784 - 199,784 - 164,228 - 164,228
Motor vehicles - 9,475 - 9,475 - 15,875 - 15,875
Investments 2,944,066 - - 2,944,066 2,751,135 - - 2,751,135
--------------------- --------------------- -------------- --------------------- --------------------- --------------------- -------------- ---------------------
2,944,066 6,442,176 - 9,386,242 2,751,135 6,281,403 - 9,032,538
-------------------- -------------------- -------------- --------------------- -------------------- -------------------- -------------- ---------------------
CURRENT ASSETS
Stocks 2,678 - - 2,678 3,769 - - 3,769
Debtors 1,252,875 - - 1,252,875 756,902 - - 756,902
Cash at bank and in hand 805,560 - 257,302 1,062,862 1,750,081 - 31,667 1,781,748
--------------------- --------------- ---------------- --------------------- --------------------- --------------- ---------------- ---------------------
2,061,113 - 257,302 2,318,415 2,510,752 - 31,667 2,542,419
--------------------- --------------- --------------- -------------------- --------------------- --------------- --------------- --------------------
CREDITORS
Amounts falling due within one year (1,390,712) - - (1,390,712) (636,355) - - (636,355)
--------------------- --------------- ----------------- --------------------- --------------------- --------------- ----------------- ---------------------
NET CURRENT ASSETS 670,401 - 257,302 927,703 1,874,397 - 31,667 1,906,064
--------------------- --------------- ----------------- -------------------- --------------------- --------------- ----------------- --------------------
TOTAL ASSETS LESS CURRENT
LIABILITIES AT 31 MARCH 3,614,467 6,442,176 257,302 10,313,945 4,625,532 6,281,403 31,667 10,938,602
============ =========== ======== =========== ============ =========== ======== ===========

53

GARDEN HOUSE HOSPICE CARE

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2024

_________________

23. COMPARATIVE GROUP STATEMENT OF FINANCIAL ACTIVITIES - 31 MARCH 2023

Unrestricted Restricted Total
Funds Funds 2023
Note £ £ £
Income from:
Donations and legacies
Donations, legacies, and grants 2 1,109,596 93,252 1,202,848
Charitable activities
NHS funding 3 2,107,627 - 2,107,627
Other trading activities
Shop income and fundraising 7 2,502,662 - 2,502,662
Fundraising events 579,732 - 579,732
Investments 4 63,184 - 63,184
Other income 68,030 170 68,200
---------------------- ------------------ ---------------------
Total income 6,430,831 93,422 6,524,253
---------------------- ------------------ ---------------------
Expenditure on:
Raising funds
Trading activities 5 1,831,465 - 1,831,465
Donations and grants 5 248,069 - 248,069
Fundraising 5 714,778 - 714,778
Charitable activities 5 4,212,954 262,448 4,475,402
---------------------- ----------------- ---------------------
Total expenditure 7,007,266 262,448 7,269,714
---------------------- ----------------- ---------------------
Net operating surplus/(loss) (576,435) (169,026) (745,461)
Net gains / (losses) on investments (108,212) - (108,212)
--------------------- ------------------ -----------------
Net income / (expenditure) (684,647) (169,026) (853,673)
Transfers between funds - - -
--------------------- ------------------ -----------------
Net movement in funds (684,647) (169,026) (853,673)
Total funds brought forward 11,591,582 200,693 11,792,275
---------------------- ------------------ --------------------
Total funds carried forward 20 10,906,935 31,667 10,938,602
============ ========== ===========

54