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2024-03-31-accounts

Company Limited by Guarantee

Group financial statements for the year ended 31st March 2024 Company registration number: 1843427

Registered charity number: 515516

Hospice of The Good Shepherd Annual Report and Accounts – Year Ending 31[st] March 2024 | 1

Contents

Our Year in Numbers .............................................................................................................................................. 6 Chair’s Report ......................................................................................................................................................... 7 Welcome to 2023/24 Annual Report for the Hospice of the Good Shepherd ............................................... 7 Results ............................................................................................................................................................ 7 Governance .................................................................................................................................................... 7 Trustees' Report (Incorporating Directors' and Strategic Reports) ........................................................................ 8 About Us ............................................................................................................................................................. 8 Public Benefit Statement .................................................................................................................................... 8 Our Vision, Mission & Values .................................................................................................................................. 9 Looking Back at our 2023/2024 Charitable Activities Highlights .......................................................................... 10 Our In-Patient Unit ........................................................................................................................................... 10 Making a difference every day ............................................................................................................................ 11 Our Clinics ......................................................................................................................................................... 12 Medical Outpatients ..................................................................................................................................... 12 Complementary Therapy ............................................................................................................................. 12 Living Well ........................................................................................................................................................ 12 Carers Support ............................................................................................................................................. 13 Helping People Live Well .................................................................................................................................. 13 Bereavement Support ...................................................................................................................................... 14 Adult and Children and Young People’s Counselling Services at the Living Well ......................................... 14 Being your voice ............................................................................................................................................... 14 Delivering against our Quality Priorities ........................................................................................................... 15 Our Quality Highlights 2023/2024 ........................................................................................................................ 16 Ned the dog ...................................................................................................................................................... 16 Music Therapy .................................................................................................................................................. 17 LGBTQIA+ .......................................................................................................................................................... 17 Homelessness work .......................................................................................................................................... 18

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High Sheriff Award ............................................................................................................................................ 19 Clinical Learning and Education ........................................................................................................................ 19 How we funded our achievements 2023/2024 .................................................................................................... 20 Donations & Legacies ................................................................................................................................... 20 Other Trading Activities ............................................................................................................................... 20 Charitable Activities ..................................................................................................................................... 20 Investments .................................................................................................................................................. 20 Corporate Support and Events ......................................................................................................................... 21 Community Fundraising and Challenge Events ................................................................................................ 22 Gifts in Wills ...................................................................................................................................................... 24 Retail & Lottery ................................................................................................................................................. 24 Retail ............................................................................................................................................................ 24 Cafe .............................................................................................................................................................. 24 Lottery .......................................................................................................................................................... 24 Investments ...................................................................................................................................................... 24 Trusts and Foundations .................................................................................................................................... 25 We would like to thank the following Trusts, Foundations and major funders for their continued support: . 26 How we spent your donations .............................................................................................................................. 27 Our passionate and dedicated people .................................................................................................................. 28 Support ............................................................................................................................................................. 28 Safeguarding ..................................................................................................................................................... 28 Volunteers ........................................................................................................................................................ 28 Freedom to Speak Up ....................................................................................................................................... 29 Our Equality and Diversity Work ...................................................................................................................... 30 Technology and Sustainability .............................................................................................................................. 31 Supporting the environment ............................................................................................................................ 31 Use of Technology ............................................................................................................................................ 31 Looking Forward and delivering our Strategy .................................................................................................. 32 Structure, Governance and Management Statement of Trustees' Responsibilities ............................................. 37

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Our Senior Management Team ........................................................................................................................ 38 Subsidiary Undertakings ................................................................................................................................... 39 The Board and Subsidiary Committees ............................................................................................................ 40 Terms of Reference for Our Committees ......................................................................................................... 40 Our Board ..................................................................................................................................................... 40 Care Committee ........................................................................................................................................... 40 Clinical Governance Committee ................................................................................................................... 41 Finance & Fundraising Committee ............................................................................................................... 41 Hospice Promotions Board ........................................................................................................................... 42 Health, Safety & Estates Committee ............................................................................................................ 43 Information Governance Committee ........................................................................................................... 43 People & Development and Remuneration Committee .............................................................................. 44 Chief Executive ................................................................................................................................................. 44 Corporate Governance ..................................................................................................................................... 44 Risk Management and Assurance..................................................................................................................... 44 Financial Review ................................................................................................................................................... 46 Management of reserves ................................................................................................................................. 46 Statement of Trustees' Responsibilities for the Financial Statements and Corporate Governance ..................... 47 Independent Auditors' Report Financial Statements ............................................................................................ 48 Consolidated Statement of Financial Activities (Incorporating a Consolidated Income and Expenditure Account)51 Balance Sheet for the year ended 31st March 2024............................................................................................. 52 Notes to the Financial Statements for the year ended 31st March 2024 ............................................................. 54 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 55 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 56 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 57 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 58 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 59 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 60 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 61

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Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 62 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 63 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 64 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 65 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 66 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 67 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 68 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 69 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 70 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 71 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 72 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 73 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 74 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 75 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 76 Notes to the Financial Statements for the year ended 31st March 2024 cont. ........................................... 77 Our supporters ................................................................................................................................................. 78

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Our Year in Numbers

Our retail team stopped 21599kg going to landfill

Our hospice lottery generated £723k

We claimed £185k back from HMRC in gift aid

Our retails shops generated £1,024k

Our combined annual raffle generated £67k

Counselling sessions (adult & children) – 1100

Living Well Sessions – 1584

Complementary Therapy sessions – 1083

IPU admissions – 140

Social work supported 103 patients/ family members

Monies left in wills and legacies totalled £458k

Carer Support – 144 carers supported

Spiritual Care supported 96 patients/ family members

We have 400 volunteers (76% of our workforce)

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Chair’s Report

Welcome to 2023/24 Annual Report for the Hospice of the Good Shepherd

It is an honour to be writing to you as Chair of the Board of Trustees for the Hospice of the Good Shepherd. The Hospice is at the heart of our community, and this year we celebrate the 35[th] anniversary of staff and volunteers supporting the lives of those affected by a life limiting diagnosis in the West Cheshire and Deeside area.

I hope the results in the Annual Report demonstrate the high quality and compassionate care provided by the Hospice to our communities. One of our major challenges continues to be the lack of adequate and fair funding from government to a sector that is an essential part of the health system and one that, sadly, continues to be overlooked. Many of you will have seen both the national and local TV coverage highlighting the funding issues being experienced by many hospices including the Hospice of the Good Shepherd.

If there is one reflection since taking on the role of Chair, I know that there is so much more that we could do for those that we aim to support and serve. However, as a Charity, it is our duty to ensure that we have the necessary funding to remain financially viable and deliver services which we can afford. Continuing to lobby government collaboratively with other hospices locally and nationally to secure adequate funding will continue to be a key priority in 2024 and beyond. As we continue to campaign for more funding, I would like to take this opportunity to express my immense thanks to all those who tirelessly fundraise for us. Fundraising and the many donations we receive are fundamental to providing key services for our community.

Results

The Hospice delivered a net operating loss of £(249)k ,with an overall surplus of £158k. we were fortunate to receive a one-off donation of £75k which helped us achieve this surplus. This performance was driven mainly by another strong set of results by our fundraising team, income from student placements and the team keeping a very close eye on costs.

For 2023/24 only 21% of our costs were funded from statutory income from government and in 2024/25 this is set to fall to just 17%. We continue to be humbled by the incredible support of our community, who enter our lottery, buy raffle tickets, spend in our shops, run marathons, and donate in so many other ways. However, with our operating costs set to rise to over £5.2 million, it is imperative that we have as many people as we can lobbying all governments to provide the NHS (for us both England & Wales) with increased funding to support the hospice sector adequately.

Governance

I would like to thank my fellow Trustees for their time, commitment, advice, and support to me in my first year as Chair. A special thank you to Dr Isabelle Hughes who stepped down in October 2023 after serving with distinction as a Trustee for 9

years. I was also delighted to welcome Liz Redmond as a new trustee to our Board. The Board is also pleased to be working with the new Head of Finance Yvonne Thurman who joined the Senior Management Team in July 2023.

Finally, I would like to express my sincere thanks to our Chief Executive, Rhian Edwards, her leadership team, and all our talented and dedicated staff and volunteers. I would like to thank each one of them for their considerable efforts and achievements in 2023/24.

Yvonne Emmett Cannell - Chair of Trustees, Hospice of the Good Shepherd

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Trustees' Report (Incorporating Directors' and Strategic Reports)

The Trustees, who are also directors for the purposes of company law, are pleased to present their Annual Directors report together with the Financial Statements of the charity for the year ending 31st March 2024 which are also prepared to meet the requirements for a Directors Report and Accounts for Companies Act purposes.

The financial statements comply with the Charities Act 2022, the Companies Act 2006, the Memorandum and Articles of Association, and 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 FRS102.

About Us

The Hospice of the Good Shepherd wants all people living in West Cheshire and Deeside with a life limiting illness, and those important to them, to have access to care and support wherever and whenever they need it. We want to help people live well until they die and to support those affected by the death of a relative or friend. Our care is designed to meet the needs of each individual and we try to do this through a combination of expert clinical care, community support, education and partnership working with other organisations with the same aspiration. Last year we provided care and support to 140 inpatients, 320 patients attending either our Living Well Services or outpatient clinics, 144 carers and 173 counselling clients across West Cheshire.

Our specialist multi-disciplinary team includes doctors, nurses, physiotherapists, occupational therapists, social worker, chaplain, counsellor, music and art therapists and complementary therapy practitioners. Together they provide care and support to patients and those close to them.

Our care comprises support with social emotional spiritual and psychological issues as well as physical care to help with symptoms such as pain. Our patients have life limiting illnesses including advanced cancer, heart failure, respiratory failure, renal disease, and progressive neurological diseases such as Motor Neurone Disease.

We want people to live as well as possible, making sure they get the best possible care at the end of their lives whilst maintaining their dignity and respecting their wishes.

There is no charge for the care and support we provide, meaning that the services provided by our multidisciplinary team will be free at the point of delivery to everyone irrespective of their background.

Public Benefit Statement

The Hospice aims to serve the public by ensuring that everyone in Cheshire West, Chester, Ellesmere Port and Deeside has access to excellent high-quality specialist palliative care and support when they have illnesses which no longer respond to curative treatment. Our main activity continues to be the delivery of specialist medical and nursing care to patients and their families. The Trustees have regard to the Charity Commission guidance on public benefit. To achieve this, we have established a set of strategic priorities, and our business plan is based on these priorities.

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Our Vision, Mission & Values

Our Vision: Striving for Excellence is at the Heart of Everything We Do

Our mission for the Hospice of the Good Shepherd is to provide the highest quality specialist palliative care for the people of West Cheshire, Deeside and surrounding areas who have progressive, advanced life-limiting illnesses. Our main activity continues to be the delivery of a specialist medical and nursing service to patients and their families bya skilled and dedicated multi-professional team.

We have a range of strategic aims to ensure we deliver the best quality care.

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Looking Back at our 2023/2024 Charitable Activities Highlights

Our In-Patient Unit

Our Inpatient Unit consists of 10 beds, run by a dedicated and professional team of clinical and palliative care consultants, medical and nursing staff, physiotherapists, occupational therapist, administrators, social workers, complementary therapists, and our spiritual care team.

Each patient admitted to our Inpatient Unit (IPU) is treated with dignity and care and has access to 24-hour specialist palliative care. Our catering staff provide a delicious menu of home cooked food, and our housekeeping staff ensure the Hospice is clean and tidy every day. The Hospice also provides support for their families, friends, and carers.

There are several reasons people are referred to us for Inpatient care. Our main aim is to enhance quality of life, and we do all we can to ensure that everybody is comfortable during their stay. Whilst we care for people at the end of their life, around 40% of our patients go home after a stay with us.

Our team of staff have specialist training in many different areas. Together, they not only provide excellent nursing and medical care, but they also look after emotional, spiritual, social and psychological needs.

We have a mixture of single rooms combined with a 4 bedded ward and these are allocated depending on the individual needs of our patients. Patients may be admitted to our inpatient wards for:

Each bed has a TV, with headsets for those in bays. Free Wi-Fi access is available, and we have a selection of talking books. A member of our catering team visits our patients each day to go through our menu of freshly prepared home cooked meals. In 2023/24, we have cared and treated for 140 people and supported their family, friends, and carers on the lead up to, during and after their loved ones stay with us. This equated to an average bed occupancy of 85% and an average length of stay of 11.6 days.

The Hospice received 21% funding contribution toward the cost of the Inpatient Unit and charitable activities from the Cheshire and Merseyside Integrated Care Board for 2023/24, a reduction of 1% on the previous year. Although we support patients from North Wales, whilst the Hospice receives no fixed funding from Betsi Cadwalader Health Board we charge on a per patient basis.

We have also continued our work with Liverpool University to educate medical students to help bring through the next generation of palliative clinical staff which is incredibly important to the Hospice.

Our Medical Director and teams of Speciality Doctors have worked to develop the treatments that can be delivered in our acute care setting. Increased access to intravenous therapies on the in-patient unit helps us keep patients here at the Hospice avoiding unnecessary patient transfers between us and the Countess of Chester.

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Making a difference every day

Historically the Hospice has not matched NHS pay banding, however, in January 2023 we took the decision to match Agenda for Change, for our clinical staff. This has significantly increased our costs; however, it has allowed us to recruit and retain nursing staff, without whom we would be unable to deliver services to our patients.

Whilst we have been recruiting additional nursing staff, and to maximise the use of our Speciality Doctors we also piloted a virtual ward. Our doctors saw 37 patients on the Virtual Ward

The Hospice continues to provide a 24-Hour Telephone Advice line

for health and social care professionals within the West Cheshire Area. This line is provided by nursing and medical staff who give clinical advice and support out of hours or signpost to other professionals where appropriate.

In line with our plan, we also rolled out our integrated Single Point of Referral initiative which is a collaborative alliance between the Hospice, Countess of Chester Hospital, and the Community Specialist Palliative Care Teams. These teams come together triaging patients during a daily meeting where the referral is passed to the most appropriate service, to include our own services. We continue to support the Fountains Medical Centre, the designated GP practice for the care homes in the Chester catchment area and the wider GP community in West Cheshire and Deeside where we take our referrals from, all of which will help reduce hospital admissions and help patients achieve their preferred place of care and death.

“The staff at the Hospice were so caring, there for her day and night to provide whatever she needed. The chef would prepare whatever she wanted to eat at any time. She was comfortable and she was at ease and that was so important. The complementary therapy sessions really made a difference.”

This is what Ashley English had to say about the care and support his wife and family received from the hospice following his wife’s stay with us. As a young family Ashley and Tanya had so much to look forward to. Tanya gave birth to their second child, Myles in July 2021. Within a few weeks Tanya noticed a lump whilst breastfeeding Myles. Tests confirmed the couple's worst fears, Tanya was diagnosed with breast cancer. Despite gruelling radiotherapy and chemotherapy, the

cancer spread throughout Tanya’s body. Eventually Tanya decided to stop further treatment.

“Tanya had endured so much, the pain, the shattered hopes and crushing disappointments, the constant travelling to and from hospitals, the waiting and all the pain and discomfort, month after month. She fought so incredibly hard for me and the children, but she had just had enough,” said Ashley.

In April 2023 Tanya was referred to the hospice primarily to provide a respite break for Ashley and Tanya’s parents Mark and Annette. However, following the great care and support the whole family received and having experienced the benefits of the specialist care, equipment, and facilities we provide the family agreed that the hospice was the right place for Tanya. The whole family were made to feel at home and were cared for in such a sensitive way.

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“It wasn’t at all what we were expecting as we knew so little about Hospice care. Nothing was too much of an issue and the staff went above and beyond in caring for us as a family. They did everything they could, and that was a great deal to help us focus on Tanya and to there for her,” said Ashley.

Ashley also praised the Hospices bereavement support team for their help.

“It’s not easy finding a way of telling such young children their Mummy is going to die. I got such good advice and reassurance from the Reflect team” continued Ashley.

Our Clinics

As well as the palliative care offered by the Hospice in our in-patients beds, we also provided a range of care in our out-patient clinics. Of those who attend these clinics, many have been discharged from a stay at the Hospice and others have been referred by their healthcare professional.

As with all our services, these out-patient attendances are provided free of charge by experienced, qualified professionals. We do not receive funding from the Integrated Care Board for these clinics; these must be funded from charitable donations.

Medical Outpatients

Our specially trained Hospice doctor or Hospice consultant will meet with all patients referred to our out-patients department (either for initial or follow-up appointments). Clinics are held on various weekdays by our medical team. Patients can attend with their family or carer if required. Each patient’s symptoms and conditions are assessed and monitored. To ensure seamless delivery of care the out-patients team works closely with all other medical professionals involved in a patient’s care, such as the GP, hospital consultant, Macmillan nurse or district nurse. In 2023/2024 we held 419 Outpatients appointments.

Complementary Therapy

The Hospice offers a range of complementary therapies to both patients and carers. These therapies are delivered by trained staff and can be helpful in reducing stress and anxiety, thus easing physical pain, and assisting symptom control. During the year, there were 667 sessions provided to patients and their carers.

Living Well

Our dedicated team of skilled staff and volunteers continued to support patients and carers to ‘live well’ and improve the quality of their life. By working with them to provide guidance so that informed choices can be made our team help improve symptom management, manage, and address individual concerns and enhance coping strategies.

The Living Well Centre provides a range of support therapies, including medical, nursing, rehabilitation, and well-being support. During the year, the team delivered 1,584 sessions.

We are fortunate that we receive some funding from

Trusts and Foundations who recognise the important of Living Well Services, but we receive no funding from the Integrated Care Board. In the main these services are funded from charitable donations.

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Carers Support

Helping People Live Well

Robin has been attending the Living Well Centre at the Hospice for a few years following his diagnosis with prostate cancer, and on a Tuesday his wife Rose joins him for our very active and lively coffee and chat sessions. Our Living Well Centre makes such a difference to how our patients can continue to live their daily lives at home.

“My dad died in a hospice and so when I was first referred to the Hospice of the Good Shepherd, I assumed that was what was going to happen to me. I was terrified but I couldn’t have been further from the truth,” Robin told us. “Discovering the reality of what it’ really like at the Hospice of the Good Shepherd is simply mind-blowing.”

Robin was full of real fear and anxiety when he first came to the Hospice after being initially referred for acupuncture. He didn’t really know what to expect, but the support that both him and his wife Rose have received has been a real revelation. “The hospice has turned out to be the safest place I’ve ever known. Even the acupuncture was surprisingly effective, and I was terrified of needles!” said Robin.

Robin continued: “They can’t do enough for you. I had significant pain when I first came here but they sorted that within a week. It was amazing. I felt as if all the worry was taken off my shoulders. The team here made me feel as if they had really taken me under their wing. They are always at the end of a phone day or night, regardless of whatever support or advice you need.

It's not a surprise that the hospice deals with a patient's physical conditions but there’s so much more to it than that: there are the psychological and emotional aspects which play such a big part in the lives of hospice patients.

“The team here supports you brilliantly in so many different ways including the weekly Coffee and Chat sessions where we have the opportunity to talk with people in the hospice’s fantastic Living Well Centre who are in a similar position.”

The Living Well team not only support the patient but also offer support to carers and this work is partly funded by a grant from Cheshire West Council.

Robin was initially reluctant to open-up to wife Rose and never suggested that she came with him to hospice sessions because he thought it would be too upsetting for her, so he came on own for six months – purposefully keeping Rose at a distance. As Robin explained “It’s so hard and so very emotional sharing this kind of thing and you don’t want to feel that you’re upsetting anyone.”

However, after attending the Living with Cancer course that the hospice runs Robin changed his mind and Rose began to come with him to the Coffee and Chat sessions. Following Rose’s attendance at the Coffee and Chat sessions Rose then went on a carers’ course run by the hospice. She felt it was helpful and gave her information and coping tools to work with.

Rose said “The hospice is remarkable in the way that it recognises how important carers are and how it supports them. Family members are actively encouraged to come to the hospice, to participate, talk, ask questions, get counselling or benefit from complementary therapies.

“We’re all so lucky to have this hospice. It’s such an important place. We really need this facility in our community, and we all need to support it.” say both Robin and Rose.

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Bereavement Support

Adult and Children and Young People’s Counselling Services at the Living Well

Our dedicated, professional, and empathic team of counsellors and volunteers provided support to 96 adults and 77 children with pre and post bereavement support through 1100 sessions.

We are fortunate that we receive some funding from Trusts and Foundations who recognise the important of Bereavement, but we receive no funding from the Integrated Care Board. In the main these services funded are from charitable donations.

Being your voice

The Hospice is committed to ensuring that the voice of our service users and the local community are integral to service development and improvement. The Hospice of the Good Shepherd is a founding member of the Cheshire and Mersey Hospices Collaborative, which our CEO, Rhian Edwards Chairs. Rhian also sits on the Board of Hospice UK.

We continue to partner with the End-of-Life Partnership, Strategic Collaborative Cheshire, our Hospice External Stakeholders Group and are now an active member of the new Northwest Hospice Forum. We have also continued with our Service User Group and in growing its membership we will be reviewing the Terms of Reference for this group to ensure that we achieve maximum patient participation and involvement.

All these partnership approaches seek to address the ever-increasing demands of service provision, education, training, and workforce development. These collaborations demonstrate a region wide commitment to working in partnership to improve palliative and end of life care for all patients, regardless of demography or diagnosis.

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Delivering against our Quality Priorities

Our clinical services operational plan for 2023/24 had eight objectives that linked to our strategic aims, with each of these objectives seeking to achieve improvements in these key areas:

Table 1 highlights the 8 of 9 quality priorities that were achieved in 2023/2024.

Quality Area Quality Priorities we wanted to achieve Quality Priority
Achieved
Patient Safety
~~/___———~~		 Develop and implement a bespoke Patient Safety Incident Response Plan and
Policy by December 2023
~~ee~~
~~___———~~		 ~~ee~~
To continue to have an annual audit cycle, to review the quality of our care and
identify areas for improvement.
~~——1¢~~
~~___———~~		 ~~——1¢~~
Develop and implement a Safeguarding Forum to enhance Hospice best
practices to ensure that adults and children are safeguarded.
~~——1¢~~
~~___———~~		 ~~——1¢~~
Clinical
Effectiveness
~~/___———~~
~~-~~		 Maximise the use of our electronic clinical systems to improve responsiveness
to individualised patient care and advance care planning
~~ee~~
~~___———~~
~~-~~		 Ongoing Progress
~~ee~~
~~-~~
Design and develop a data reporting system to measure clinical outcomes to
demonstrate positive clinical outcomes due to hospice care.
~~-~~		 Ongoing Progress
~~-~~
Improve the effectiveness of the hospice policy and procedure quality
management system
~~ee~~
~~-~~		 ~~ee-~~
~~e~~
~~-~~
Patient
Experience

 Work in partnership with our Service User Participation Group to enhance the
quality and accessibility of Hospice information.


~~a~~
Enhance patient and service user feedback activity to include utilising all
methods through the innovation of digital platforms
~~O~~
~~a~~		 ~~O~~

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Our Quality Highlights 2023/2024

Ned the dog

Ned our Therapy Dog featured in ITV Granada News.

They said:

A special dog is working hard to help people with mental health problems they may be facing. Ned, the three-year-old Australian labradoodle, has been approved by Therapy Dogs Nationwide and goes around visiting patients, prisoners and pupils.

He has been described as a "teddybear", who has been regularly visiting a hospice in Chester to help stimulate and distract inpatients.

Dave Artell, an inpatient at Hospice of the Good Shepherd is "a big animal lover".

He said: "You can see he's just a comfort. It's like having a real teddybear with you. I've always had dogs myself, I'm a big animal lover.

"We are allowed dogs in here, my dog has been to visit me but she can't do what this beauty does.

Mark Wilson, who was diagnosed with blood cancer three years ago, said: "Ned's amazing. He's just that constant, and he always give you a lovely wag of his tail and a cuddle.

Debbie Evans, Inpatient Unit Manager believes although hospices are important for end-of-life care, quality of life is also vital.

She said: "Quality of life is what we focus on, people can come in for end-of-life care but that's not everyone that comes into the hospice.

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"We want people to live well with their disease and then people who do need further support from their disease, we're here to provide that.

Therapy Dogs Nationwide say that the benefits of Animal Assisted Therapies have been studied, results show that the sessions improve wellbeing, general health and increased confidence levels.

The use of animals for therapy has been used for more than 40 years.

Brenda Maddocks, Ned's owner also takes Ned to visit many care homes in Chester.

She said: "Therapy dogs nationwide is a registered charity and the volunteers with their registered and assessed dogs visit all different type of establishments: hospices, hospitals, colleges, universities, prisons, mental health clinics and schools."

Music Therapy

Funding for a music therapist 5 hours per week has been secured until December 2024 by Music Place. Our Music therapist says:

“My work as music therapist at Hospice of the Good Shepherd began in June 2023 and I have really enjoyed developing the service since then. In my sessions I aim to connect with my clients through developing a musical relationship where I aim to meet their needs and celebrate their musical identities. Sessions may involve using pre-composed songs to connect with someone’s musical past and affirm their musical identity, creating

something new in the present through free exploration of instruments which in turn often leads to emotional expression, or learning a new skill such as in how to play simple songs on the piano or build a music playlist that can help give someone a purpose in their everyday life. These are just a few examples of many things that occur in my sessions.

I regularly see outpatients supported by the living well centre alongside offering a group session to those attending the Living well day, alongside doing 1-1 sessions with inpatients at the hospice, sometimes alongside their family members. I have recently started a waiting list for outpatient 1-1 sessions to begin once an existing client’s block has finished as I am currently full. In December 2023 I was able to support the Light up a life service at the hospice through a musical performance, and in January 2024 I delivered a presentation open to all staff at the hospice to share more about my music therapy service.

I have several ideas on how this service may progress in the future if funding for additional hours was secured:

LGBTQIA+

In 2021 we appointed our first LGBTQ+ Development Facilitator following a successful grant application from St Lukes Hospice on behalf of the three Hospices within the Cheshire footprint.

We extended the position to October 2025 to support the hospices to:

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The LGBTQ+ facilitator has worked across all 3 of the hospices and has developed and delivered training which continues to be rolled out to all staff and volunteers. We recruited LGBTQ+ champions to act as a point of contact within the organisation for advice or support. Work is ongoing regarding raising awareness.

Homelessness work

Thanks to continued funding from Cheshire and Merseyside Integrated Care Board, the three hospices across Cheshire; Hospice of the Good Shepherd St. Luke’s Hospice (Cheshire) and East Cheshire Hospice, have continued their collaboration throughout 2023-2024 to provide the Cheshire Hospice Homelessness Service. The service employs a co-ordinator who works three days a week across the whole of Cheshire providing essential support to people with palliative and end of life care needs but who are also experiencing, or at risk of, homelessness.

It is widely published that there is inadequate care provision for the homeless population across the UK at end of life and it is a sad fact that men and women who are homeless have a life expectancy which falls far short of the national UK average. The national life expectancy average in the UK is 79 to 83 years for men and women respectively, however for those experiencing homelessness the figures fall sharply to 45 and 43 years respectively.

The continued work of the Cheshire Hospices Homelessness Service has shown that people experiencing or at risk of homelessness and in the last year of their life, have increased complex health, social and mental health needs. The Cheshire Hospice Homelessness Service works with, and advocates, for individuals when appropriate, but in particular when they feel their voice is not being heard. It has proven that the right promotion and advice supports access to many different services, thus promoting the individual's choices around care and dying alongside helping them to live well.

In order to reduce the barriers to accessing palliative and end of life care for the Homeless community the Cheshire Hospices Homelessness Service works in close partnership with other supportive organisations, across all sectors, to offer choice and care at the right time. This enables improvements to the existing health inequalities for homelessness individuals.

In brief the service provides:

In January 2024 the Cheshire Hospice Homelessness co-ordinator presented a service education session to approximately 50 guests who worked within the health, social care and charity services in Cheshire, at an Equality, Diversity and Inclusion (EDI) Conference held by St Luke’s Hospice (Cheshire) at Crewe Alexandra Football Club. Positive feedback was received from the guests who attended.

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Additionally, the Cheshire Hospice Homelessness Service works in affiliation with the Cheshire West and Chester Borough Council Multi Agency Rough Sleepers Service (MARS) to provide free and confidential one to one trauma informed counselling to individuals with a history of rough sleeping. The counselling is delivered by the Hospice of the Good Shepherd counsellors who also deliver education sessions to professionals who support people experiencing homelessness with deteriorating health or a palliative diagnosis.

21 individuals supported with 1-1 counselling sessions. (12 in West Cheshire and Chester and 9 in East Cheshire)

2 education sessions to students undertaking the MSc Cancer Care (University of Liverpool).

We helped 10 individuals to secure permanent accommodation.

High Sheriff Award

In August 2023, the hospice was lucky enough to receive the gift of an award-winning garden that was rebuilt on site following the RHS Tatton Flower Show. The sensory garden was gifted to the hospice for the use of patients, families and staff by the garden designers who won a Silver Guilt medal for their design. The garden is a fantastic asset, and a peaceful and relaxing space where families can spend time together. The High Sherriff of Cheshire attend the opening celebration and thanked the designers and the volunteers who had helped to replant the garden. During the year the High Sherriff also awarded the Hospice a special High Sherriff's Community Award.

Clinical Learning and Education

In 2023, we launched our new ‘You Matter’ People and Development Strategy. Alongside our mandatory e-learning and face to face training programmes delivered by our training provider Blue Stream, there have been further learning opportunities to continuously develop and for staff to attain professional qualifications.

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How we funded our achievements 2023/2024

Our income in 2023/24 was £5.3m (2022/23: £4.6m). Income increased by 0.7m in 23/24 We secured one year of additional funding from the ICB £200k f (to help fund our consultant post and keeps our IPU beds at 10), we received in total £1,091k ICB funding for palliative care being 21% of total income. Donations and Legacy income increased by £300k from 22/23, retail increased by £120k. Investments generated £80k more than 22/23 Despite challenging financial circumstances, the success of our fundraising income is, due to the incredible commitment of our local community, volunteers, and staff. Our income can be broken down into monies given through grants, earned from investments and through trading, and fundraising and funding from the CCG/ICB.

Donations & Legacies

This is money that is donated by our supporters, either directly or through their fundraising activities or money that comes to us when someone kindly leaves a gift in their Will; this is a vital income stream for us.

Other Trading Activities

This is money raised through our weekly lottery, high street charity shops, our eBay channel, on-line shop, café and seasonal trading activities.

Charitable Activities

The hospice receives direct grant support from Government funding grants from charitable trusts and foundations.

Investments

This is income from our investment portfolio and bank interest.

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During 2023/2024, we have continued to invest in generating more sustainable regular income, from our other trading activities. This helps generate money we can rely on, and means we are able to plan. We are committed to being responsible and respectful with our fundraising, and continue to be registered with the Fundraising Regulator, abiding by their code of practice and regulations and the Gambling Commission for our lottery.

Corporate Support and Events

Without our generous donors and supporters, we would not be able to keep the Hospice doors open and services running as we only received 21% of our funding from statutory sources.

We would like to thank all of our supporters and donors who work tirelessly for our cause as without them there really would be no hospice.

We would like to thank our corporate partners who engaged their customers and employees in fundraising activities, who sponsored an event or those who provided us with gifts in kind. These gifts in kind make a valuable contribution towards costs

saving and to the bottom line of our event expenditure and overall, our total budget.

Our relationship with Redrow Homes continued during 2023/24 and they have very kindly replaced all of the existing Hospice external signage with new large bold signs making the hospice more visible and helping our visitors find their way around the site. Their generous support saved the hospice a considerable amount of money with this project.

We also developed our partnership with Encirc who, as well as sponsoring our Christmas Tree collection also donated bottles of wine for our Winter Ball and Summer Celebration events saving us a considerable amount of money on the cost of the events.

We were fortunate enough to be selected as Charity of the Year for several organisations during the year, and we were very grateful to have been chosen for a second year to continue our charity of the year partnership with Sykes Cottages. This continued partnership saw staff members abseiling down the side of their Chester office building, as well as holding a Fire Walk and the staff fundraising received a very generous boost in the way of matched funding from the company. These partnerships are valuable as they help to raise both funds as well as the awareness of our work.

Although we continued with some of our traditional events, we also launched some new fundraising initiatives with our corporate partners which included a new Corporate Networking Group, and in the first year has proved very popular with 33 members. The group meets 4 times a year and we pride ourselves on networking with a “twist.”

In September we held our first Pantomime Horse Race. This event saw 12 businesses taking to the racecourse at Chester Racecourse all donning a pantomime horse costume, however we did have the odd zebra, unicorn and cow for interest. Not only did this event develop some new partnerships, but it also created a stronger link between the Hospice and Chester Racecourse Ltd and we were very grateful for their continued support. The event raised £13K.

During the year we received corporate sponsorship for several events including our Sparkle Walk, Christmas Tree Collection and Gala Ball.

In total £781K (£749K 2022/23) was generated from fundraising, events and corporate support.

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We would like to thank the following for their support:

Bristol Myers Squibb Centric Energy Solutions Chester Business Club Ellis and Co Chartered Accountants

Encirc

Engage Web Gordale Garden Centre Howden Insurance Jolliffes Solicitors KJ Bell Scrap Metal Medicash NatWest

Oliver & Co Solicitors Promedica24 Redrow Plc Sykes Cottages West Cheshire and North Wales Chamber of Commerce

White Oak UK

Wurkplace Urenco

Community Fundraising and Challenge Events

We continued to receive great support from our community, and this has led to growth in income from this sector. This growth reflects the new community fundraising strategy introduced during 2022/23 whereby we strengthen our team with an additional fundraiser. Many people in our community hold fundraising events on our behalf and continue to champion our cause which this year yet again included the Farndon Soap Box Rally and the Cosmic Cape music festival. We have also continued to develop our fundraising partnerships with schools and nurseries who support our festive activities, and we had over 4100 children taking part in our bunny hop/festive fun run with 21 schools and nurseries taking part raising £23k. Our partnership with Gordale Garden Centre and the Santa’s Grotto goes from strength to strength with 42 Santa’s and 98 Elves welcoming over 400 children and raising £35K.

Those members of our community who undertake a personal challenge never cease to amaze us with their energy, determination and stamina. We had 140 brave people take up a challenge and their activities included wing walking, sky diving, running, mountain climbing and even walking over hot coals.

We continue to receive the support of our local dedicated Hospice Support Groups, many of whom started fundraising nearly 40 years ago to enable the hospice to be built.

Our support groups are in Blacon, Hoole, Malpas, Upton and Waverton.

Thanks to this fantastic support our community fundraising generated an income of £367K (22/23 £275K). Our Challenge fundraising generated an income £121k (22/23 £125K)

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Sparkle Walk 469 participants raising £22,850

Santa Dash 2062 Santas raising £20,000 (our 50% share of profit)

Schools Festive Fun Run raised £29500

Panto 13 companies took part raising £8720

Christmas Tree collection – over 3000 trees collected raising £43500

Christmas Grotto at Gordale raised £35,000

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Gifts in Wills

We continue to be incredibly grateful to the generosity of people who leave a gift in their Will, which this year equated to £458k (22/23 £336k). Gifts in Wills are a vital source of income to the Hospice.

Knowing that people may wish to support us, but that they may not have the disposable income at the time, we continue to invest in legacy marketing, including our popular regular monthly Wills Clinics, kindly provided free of charge by Oliver and Co Solicitors who have now been supporting this initiative for over 6 years.

Retail & Lottery

Retail

In line with our retail strategy, we opened 2 new charity shops in quarter three of the financial year. One located on Frodsham Street in Chester and the other in Eddisbury Square Frodsham, we also continued with the new boutique style of branding. This now brings our number of charity shops to eight. Our shops continue to generate substantial income for the charity and our retail team are supported by an army of volunteers who play such an important part in supporting our staff, however recruiting volunteers into our retail business is still challenging.

Retail income (including our cafe) for the year increased to £1,024K (2022/23 £903K) with much of this increase coming because of the two new shops. The success of our retail business demonstrates the hard work, dedication and performance from the staff and volunteers in our team along with the generosity of our community in donating good quality stock for us to sell.

Cafe

Following a relaunch of our popular on-site hospice cafe, which included a new menu, the cafe has gone from strength to strength. The team have introduced a series of special events which included sparkling afternoon teas and series of traditional festive Christmas dinners, all of which are very well supported and have increased the turnover.

Lottery

Our Hospice lottery continues to operate successfully generating a sustainable income of £723k (2022/23 £757k). We maintained our membership at approx. 13,500 members and have continued to recruit new members to the weekly drawer to counteract the natural attrition. We held 2 very successful raffles during the year generating an income of £67K.

In total our retail and lottery operations generated an income of £1,748K (2022/23 £1,660K)

Investments

Our fixed asset investment portfolio continues to be used to underpin our ongoing activities and maintain capital to support future development. The growth of the portfolio is designed to supplement our reserves and our other income-generating activities for the medium to long term. We have engaged external investment managers, Investec who in September 23 became part of the Rathbone Group, monitored by the Financial Conduct Authority, who manage a balanced portfolio on our behalf.

Although the financial markets continued to remain volatile during the financial year the Hospices investment portfolio increased by £57k 10.7% for the year ending March 2024 (2022/23 £28k loss).

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The Board operates a diversified investment policy, balancing risk with income and capital growth. The Trustees nominate and appoint advisers, brokers and/or fund managers and will agree the terms of appointment. No investments are made without the prior approval of the Trustees. The advisers provide professional investment advice and will assist in the review of performance and future strategy. Our policy is not to invest in any stocks or shares in businesses involved in activities inconsistent with our values.

The Trustees are mindful to maintain a balanced portfolio and regularly monitor the performance of the investments via the Finance and Income Committee.

Trusts and Foundations

Grants are an important source of income for us and allow us to fund capital expenditure such as building improvements and essential patient equipment that we would otherwise be unable to fund.

We would like to give special thanks to all the Trusts and Foundations whose grants have supported us to continue our vital work or to buy equipment that helps us support patients, families, and their carers. During the year we received over £300k in grant income.

We received a generous grant from the Majorie Boddy Trust to help fund our Living Well service and this grant will run for three years, we have also had the grant renewed for a further two years to continue our Carers Support Groups that runs every week in our Living Well Centre and also provides complementary therapies for carers.

A significant grant from both Cheshire West Council and The Wolfson Foundation has helped us improve our environmental footprint as well as reduce our energy costs through supporting the installation of new windows, solar panels and LED lighting.

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We would like to thank the following Trusts, Foundations and major funders for their continued support:

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How we spent your donations

Our charitable expenditure amounted to £5.1m (2022/23: £4.9m). Like all business and our community, we faced the additional pressure on our staff and supplier costs largely due to the continued rise in inflation.

We undertook an annual review of our salaries for non-clinical staff many of whom were paid under the median benchmark resulting in issues to both recruit and retain staff.

The move in January 23 to Agenda for Change (NHS England Terms and Conditions) pay for our nurses and SAS (Staff, Associate specialist, and Specialty doctor) terms for our medics placed increased pressure on our salary budgets, this has been compounded by the continued high inflation rate throughout 23/24 which has influenced pay increases under these contracts.

During the year we installed additional solar panels to the Hospice building costing £38k from a donated grant, this will enable the hospice to reduce electricity usage going forward..

We have continued to make sure every penny will count whilst delivering our agreed strategies which has seen us invest in renewable technology with the addition of solar panels to help reduce utility costs.

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Our passionate and dedicated people

We simply could not achieve what we do without our incredible staff and volunteers. In the year to March 2024, we employed 134 staff with a wide range of skills, knowledge, professional qualifications, and experience and had the support of 400 volunteers.

Support

Our aim is for our staff to be well-rewarded and to be paid a salary that is competitive and benchmarked externally against other charities of a comparable size and location. We do not have any bonus schemes or performance-related pay but are looking to introduce this in the future. We have introduced Agenda for Change (NHS) terms and conditions for all our IPU staff and Clinical Director, and we also have SAS terms and conditions for our doctors. Staff not on these terms and conditions are on a different pension scheme and different sickness scheme.

We invest in a Benchmarking tool with the aim to pay our staff the median salary. Currently 85% are paid the median and we review pay regularly with our People and Development Committee and Board of Trustees.

In addition to the NHS pension scheme for pre-existing members of clinical staff we also run an auto-enrolment pension scheme for the benefit of our staff who are not members of the NHS scheme. The auto-enrolment scheme involves employee and employer contributions. The auto enrolment scheme is managed on our behalf by Royal London and the finances are completely independent of the charity's finances. The charity's contributions are recognised within our statement of financial activities, in the month in which the salaries are paid.

We continue to operate both hybrid and flexible working policies, which help to attract and retain staff. We have an Employee Assistance Programme in place providing free mental health support and we have made available discounted options for gym memberships to our staff.

Safeguarding

To protect our staff and volunteers, we take safeguarding extremely seriously and have a policy in place. All staff and volunteers undertake mandatory Safeguarding training as appropriate and applicable to their role. We have a dedicated safeguarding officer who is clearly identifiable within the organisation.

Volunteers

Our 400 volunteers support all departments at the Hospice, and we are grateful for their support as we know that without them our Hospice just would not be able to operate. Volunteering at the Hospice benefits our patients, Hospice staff and of course the volunteer themselves. We understand that volunteering can make a real difference.

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We have made significant improvements to our volunteer experience and have launched the Volunteer Handbook. We have developed our volunteer database and carry out regular volunteer audits. We continue to attract high quality, high calibre volunteers to the Hospice and benefit from their skills and knowledge in many areas of the Hospice including patient and family services, retail, fundraising, lottery, and support services. They bring a wealth of experience, passion and commitment from diverse backgrounds and careers. In June 2023 a special volunteer recognition event to present some of our fantastic volunteers with certificates and pin badges in recognition of their long service. It was inspiring to see so many of our volunteers’ receiving awards, especially

those that received their 20-, 25- and 30-years’ service awards.

We are so lucky to have such fantastic volunteers on our team, here is one of them, Mally, describing how volunteering has made a difference to his life.

Mally started volunteering with the hospice in January 2024 after his wife Rebecca died at the hospice. Mally and his family were so impressed and grateful for the care and support that Rebecca received that he really wanted to give something back. Mally was aware of the hospice and where we were based, but until Rebecca had to access our services and became an inpatient, he had no idea of how fantastic the level of care was and what a difference we made at such a difficult time in his life.

Since Mally has volunteered in our community café, he has enjoyed every single minute. Volunteering has given Mally a sense of purpose, routine, and something to look forward to each week. He enjoys meeting people and being part of the volunteer team.

Mally would say to anyone who is considering volunteering, do not hesitate, it's great to be part of something where you can see what you do makes a difference.

We recognise the invaluable contribution of all our volunteers, and we would like to take this opportunity to acknowledge their contribution and thank them for their continued commitment, dedication, and support.

Freedom to Speak Up

The Hospice of the Good Shepherd actively encourages staff engagement. We are registered with the National Guardian Office and currently have one Freedom to Speak up officer. We facilitate staff and volunteer engagement groups represented by each team quarterly.

We undertake the Birdsong Charity survey every two years, with the next one due to take place in June 2024. We have worked with our staff to make changes following the results from the 2022 survey and a new action plan will be put in place for staff and volunteers, following the results 2024 survey.

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Our Equality and Diversity Work

Our Equality and Diversity Steering group meets quarterly to review and plan for increased access to services by all members of the community as well as addressing workforce issues.

Due to a significant homeless population in our catchment area, we have focussed on this client group over several years. Our specialist homelessness nurse has enabled one person to access the right care and treatment in a nursing home which is funded by continuing health care funding. The nurse has supported the patient to access living well centre services. During 2023/2024 we have increased awareness to enable the accessibility of services for people with protected characteristics.

We work with the Wirral Multicultural Centre to access face to face translation services for patients and carers where English is not their first language, in addition we can access a telephone service for urgent needs and we have also worked with a deaf translator to support a patient. Protected characteristics are monitored to highlight any specific needs, and we work to the Accessible Information Standard 2017 (DCB1605 Accessible Information).

We have been working with our external stakeholders within the Veterans Covenant Healthcare Alliance to explore how we can further support the armed forces community to access the best care.

There are two key principles:

We aspire to be a Veteran Aware Accreditation organisation. A report is shared with the Board each quarter to highlight the priorities and progress in EDI for the Hospice.

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Technology and Sustainability

Supporting the environment

Where we can the team at the Hospice works hard to ensure we respect the environment with sustainability and recycling initiatives.

During the year, with the support of grants, we installed additional solar panels on the roof of our In-patient unit. We also changed the lighting within the IPU to LED. We have started a programme to replace our outdated and inefficient windows on the IPU with new steel modular framed windows that make use of the most up-to-date technology not just to reduce our heating bills but to also reduce our emissions and carbon footprint. The first phase of this window replacement programme has been completed.

During the year we saw a saving of 26403 kwhs from the impact from our solar panels and LED lighting, this equates to £5198 saving or 11% of our financial outlay. We would have seen much greater financial savings, but for the fact that we had already secured a good tariff, with a fixed contract with the utility suppliers.

In January 2024, our fundraising team collected 3400 Christmas Trees from homes within the catchment area. These were then chipped and used for mulch therefore reducing landfill and saving 43,394kg of carbon emissions.

Not only does our retail business generate a profit to support the hospice financially, it also has an impact on our local environment by reducing landfill. In 2023/24 based on our sales figures for ladies, men’s, and children’s clothing we achieved the following.

Total Pre-Loved Clothing Items sales (£) 418316.37
No Pre-Loved Clothing Items Sold 75595
Estimated weight stopped going to Landfill (KG) 21598.57
Estimated Co2 being diverted (KG) 194387.14
Estimated volume of Water being saved (Cubic Metres) 34557.71
Estimated equivalent trips around the word in a medium sized car 29.59
Estimated equivalent number of trees planted 647.31

Use of Technology

We made a significant and timely investment in technology in 2022/23. This included the deployment of a new patient management system (EMIS) that gives us shared access to patients’ GP records and community services. However, the installation of this improved system has now increased running costs by £20k per annum.

We have continued in 23/24 to develop and expand the use of our HR system Cascade and as part of this, developed and implemented a fully integrated online e-recruitment solution. This has streamlined our recruitment processes and enabled us to broaden our reach with job adverts to attract a high number of good quality and more diverse applicants.

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We have introduced the RADAR Healthcare Risk, Quality and Compliance software system which helps us to better manage our hospice policies and procedures as well as our compliments, complaints, and accident reporting.

Looking Forward and delivering our Strategy

The Trustees and Senior Management Team have been working on a new five-year strategy setting out the services the Hospice should offer and the best way in which to deliver them.

Our vision is that everyone impacted by a progressive life-limiting illness can receive excellent support and care, whenever and wherever they need it. To achieve this, our role is to provide high-quality, safe, compassionate, person-centred care, support and treatment for people, families and carers impacted by a progressive life-limiting illness and living in the West Cheshire & Deeside community.

To deliver our strategy, we have the following activities planned for 2023/24 that link back to our Strategics Aims (SA) , our defined Strategic Objectives (SO) and Quality Priorities (QP) set out in (Table 2):

SA 1 - Promote equitable access to optimum quality care and support.

SA 2 - Evidence a safe, effective, caring, responsive and well led organisation.

SA 3 - Foster a culture that prioritises our values and maximises opportunities for skills and development.

SA 4 - Deliver sustainability through continuous quality improvement and innovation.

The golden thread that underpins the delivery of our revised Strategic Aims will be our values and how we as a team go about our work to achieve them. We will consult with our staff about what our culture and behaviours need to be. How we behave with each other will help us to drive our strategy forward.

Strategic Objective 2022/2023 SA 1 SA 2 SA 3 SA 4 QP
SO1 - Maximising our reach.
▪
Ensure our resources and services are used to maximum
capacity.
▪
Ensuring the website has accessible, relevant information for
service users & the broader public requiring information on
hospice services & palliative care.
▪
Move to weekend admissions.		 X X
SO2- Maximising our impact through creativity and innovation.
▪
We will identify opportunities for delivering services
differently.
▪
We will Identify patient groups who are underrepresented
and develop a plan for targeting them		 X X
SO3- Developing our collaborative relationships. X X

Hospice of The Good Shepherd Annual Report and Accounts – Year Ending 31[st] March 2024 | 32

▪
Chairing and joint working with the Cheshire and Merseyside
Hospice Collaborative.
▪
Membership of and working with Hospice UK to lobby for
better funding and support for the Hospice Sector.
SO4- Influencing the improvement of palliative care across the locality.
▪
Active Membership of the Cheshire West Palliative and End
of Life Care Steering Group		 X
SO5- Adapting our services to meet the demands on changing needs.
▪
Maximise the use of our electronic clinical systems to
improve responsiveness to individualised patient care and
advance care planning.
▪
Agree a plan for ongoing and sustained development and
management of patient website/information.
▪
Ensure we have a broad representation at the Hospice
external stakeholder group which will inform development of
Hospice services, ensure the local community are referred
appropriately to Hospice services and Hospice staff are
familiar with external services which can enhance the patient
and carer experience.		 X
SO6- Operating an open and transparent culture.
▪
Develop and implement a bespoke Patient Safety Incident
Response Plan and Policy.
▪
Develop and implement a Safeguarding Forum to enhance
Hospice best practices to ensure that adults and children are
safeguarded.
▪
Improve the effectiveness of the Hospice policy and
procedure quality management system.		 X X
SO7- Embracing opportunities to learn and improve.
▪
Through our annual audit cycle and incident management,
review the quality of our care and identify areas for
improvement.
▪
Implement the guidance regarding the Managing Medical
Device standards.		 X X
SO8- Optimising the use of data throughout the organisation. X X
▪
Chairing and joint working with the Cheshire and Merseyside
Hospice Collaborative.
▪
Membership of and working with Hospice UK to lobby for
better funding and support for the Hospice Sector.
SO4- Influencing the improvement of palliative care across the locality.
▪
Active Membership of the Cheshire West Palliative and End
of Life Care Steering Group		 X
SO5- Adapting our services to meet the demands on changing needs.
▪
Maximise the use of our electronic clinical systems to
improve responsiveness to individualised patient care and
advance care planning.
▪
Agree a plan for ongoing and sustained development and
management of patient website/information.
▪
Ensure we have a broad representation at the Hospice
external stakeholder group which will inform development of
Hospice services, ensure the local community are referred
appropriately to Hospice services and Hospice staff are
familiar with external services which can enhance the patient
and carer experience.		 X
SO6- Operating an open and transparent culture.
▪
Develop and implement a bespoke Patient Safety Incident
Response Plan and Policy.
▪
Develop and implement a Safeguarding Forum to enhance
Hospice best practices to ensure that adults and children are
safeguarded.
▪
Improve the effectiveness of the Hospice policy and
procedure quality management system.		 X X
SO7- Embracing opportunities to learn and improve.
▪
Through our annual audit cycle and incident management,
review the quality of our care and identify areas for
improvement.
▪
Implement the guidance regarding the Managing Medical
Device standards.		 X X
SO8- Optimising the use of data throughout the organisation. X X

Hospice of The Good Shepherd Annual Report and Accounts – Year Ending 31[st] March 2024 | 33

SO9- Support the health and wellbeing of all our people.

SO10- Providing a great employee experience which attracts and retains talent.

SO11 - Inclusion and belonging for all.

Hospice of The Good Shepherd Annual Report and Accounts – Year Ending 31[st] March 2024 | 34

▪
To improve the capture and use of IPU EDI Data.
▪
To monitor improvements in inclusivity and access to Hospice
services.
▪
LGBTQ Training for all staff and volunteers and integrate as
part of induction for new starters.
SO12 - Supporting learning.
▪
To ensure high completion rates (above 90%) for mandatory
training for all non-clinical and clinical staff to ensure our
staff are trained and equipped to do their roles effectively.
▪
To support the development of staff through identified and
prioritised development via PDP’s and 1-2-1 discussions
throughout 2024/25 and contribute to the achievement of
the Hospice Business Priorities.
▪
To roll out Autism Training and Awareness in line with new
mandatory requirements which will ensure all our staff are
skilled in identifying and supporting people with autism.		 X
SO13 - Harnessing talents and maximising opportunities for
development.
▪
To identify and support the development of aspiring leaders
in the Hospice through leadership development opportunities
gifted to the Hospice and other leadership development
initiatives.
▪
To use the Hospice Succession Planning Framework for timely
and effective succession into key roles as appropriate.
▪
To complete a volunteer's audit to ensure up to date and
accurate records are in place for all our volunteers and an
accurate assessment of their skills and knowledge as far as
possible.		 X
SO14 - Strong financial management and governance assurance
▪
Recruitment of a new Head of Finance.
▪
Roll our Multi Factor Authentication		 X
SO15- Developing relationships with the wider community or working
in partnership with the wider community.
▪
Continue to build quality relationships with our key
stakeholders and identify opportunities to collaborate to		 X X
▪
To improve the capture and use of IPU EDI Data.
▪
To monitor improvements in inclusivity and access to Hospice
services.
▪
LGBTQ Training for all staff and volunteers and integrate as
part of induction for new starters.
SO12 - Supporting learning.
▪
To ensure high completion rates (above 90%) for mandatory
training for all non-clinical and clinical staff to ensure our
staff are trained and equipped to do their roles effectively.
▪
To support the development of staff through identified and
prioritised development via PDP’s and 1-2-1 discussions
throughout 2024/25 and contribute to the achievement of
the Hospice Business Priorities.
▪
To roll out Autism Training and Awareness in line with new
mandatory requirements which will ensure all our staff are
skilled in identifying and supporting people with autism.		 X
SO13 - Harnessing talents and maximising opportunities for
development.
▪
To identify and support the development of aspiring leaders
in the Hospice through leadership development opportunities
gifted to the Hospice and other leadership development
initiatives.
▪
To use the Hospice Succession Planning Framework for timely
and effective succession into key roles as appropriate.
▪
To complete a volunteer's audit to ensure up to date and
accurate records are in place for all our volunteers and an
accurate assessment of their skills and knowledge as far as
possible.		 X
SO14 - Strong financial management and governance assurance
▪
Recruitment of a new Head of Finance.
▪
Roll our Multi Factor Authentication		 X
SO15- Developing relationships with the wider community or working
in partnership with the wider community.
▪
Continue to build quality relationships with our key
stakeholders and identify opportunities to collaborate to		 X X

Hospice of The Good Shepherd Annual Report and Accounts – Year Ending 31[st] March 2024 | 35

further improve palliative care and funding in our locality or nationally.

further improve palliative care and funding in our locality or
nationally.
SO16- Leading improvement, change and innovation.
▪
In line with our procurement framework, we will tender for
our back-office IT services.
▪
Work with our partners to seek further improvements in
ways to share patent medical data.		 X X
SO17 Embedding digitally enabled solution.
▪
Continue to develop and improved usage of EMIS our Patient
Data system.
▪
Enhance patient and service user feedback activity by
deploying I Want Great Care.		 X X X
SO18- Enabling new ways of planning for the future.
▪
Review how we are using our resources and estate to ensure
we are there to meet the changing needs of our population
to include the growing need for specialist palliative care and
support.		 X X
SO19 - Commitment to improving our environmental and social
impact.
▪
Relaunch our Environment Staff Focus Group		 X

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Structure, Governance and Management Statement of Trustees' Responsibilities

The Hospice of the Good Shepherd is an independent charity (registration no. 515516) operating as a private company limited by guarantee (01843427).

The Hospice is governed by a Board of Trustees and run by the Chief Executive and the Senior Management Team made up of a Medical Director, Director of Clinical Services, Director of Income Generation, Director of People and Development and Finance Manager. The Hospice is registered with, and inspected by, our regulators the Care Quality Commission (CQC).

Our Trustees and their Committee responsibilities are listed below.

C – Chair
*– Member		 Committee and Sub-Committees Committee and Sub-Committees Committee and Sub-Committees
Trustee Board Care Clinical Governance
 (subcommittee)
Finance & Income		 Health, Safety & Estates Information Governance People, Development &
Renumeration
Yvonne Emmett Cannell C *
Robert Mee * *
Gary Barr * * *
Bill Benoy * C *
Suzanne Crutchley
C from 05/02/24		 * C
Isabelle Hughes
Resigned 05/12/2023		 * C C
Lesley Mills * * *
Justine Watkinson * *
Neil Fergusson C from 05/12 * C C

Hospice of The Good Shepherd Annual Report and Accounts – Year Ending 31[st] March 2024 | 37

Mike Davies * * *
Martin Howlett (SIRO)
Resigned 05/02/2024		 * C
Elizabeth Redmond Dr
Appointed 19/03/24		 * * *
Jamie Christon
Resigned 19/03/2024		 * * C

Our Senior Management Team

Our Senior Management Team
Chief Executive Office Rhian Wyn Edwards
Director of Clinical Services Liz Taylor
Director of Income Generation Caroline Siddall
Director of People and Development Julie Davies
Head of Finance Yvonne Thurman (Appointed July 2023)
Medical Director/ Consultant in Palliative Medicine
(Caldicott Guardian)		 Dr Alison Coackley
Director of Quality and Improvement Lisa Parker

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Principle Registered Address Hospice of the Good Shepherd, Gordon Lane, Backford, Chester, CH2 4DG Auditors Xeinadin Audit Ltd. 116 Duke St Liverpool L1 5JW Bankers NatWest PLC Chester Commercial Office, 2[nd] Floor, 33 Eastgate Street. Chester CH1 1LG Investment Advisors Investec/Rathbones Wealth & Investment Ltd 100 Old Hall Street Liverpool L3 9AB

Subsidiary Undertakings

The Hospice of the Good Shepherd has one wholly owned subsidiary, Hospice of Good Shepherd Promotions Limited (Company Number 3350371). This company shares its registered office with Hospice of Good Shepherd.

Hospice of Good Shepherd Promotions Limited conducts trading activities selling donated goods and greetings cards and other purchased goods for sale in Hospice of Good Shepherd retail shops and at events, as well as the café located at Gordon Lane, with all profits being covenanted to Hospice of the Good Shepherd. The results and year end position of the subsidiary are shown in Note 8 to the financial statements. Our Lottery is regulated by the Gambling Commission, Operating Licence No. 000 005134 N 100425 013 and Remote Operating Licence 000 005134 R 322300 004.

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The Board and Subsidiary Committees

The Board of Trustees is responsible for governance of Hospice of the Good Shepherd. The Trustees as members are also Directors of Hospice of the Good Shepherd. As set out in the Memorandum and Articles of Association, the Chair of the Trustees is nominated by the Board of Trustees and elected by them.

New trustees are appointed following a selection process using a range of methods to attract potential new members. When considering new trustees, the Board considers specialist skills required through a skills audit. New trustees are appointed by a majority of the Board of Trustees, initially for a period of three years, but can be invited to serve for a further three-year term. New trustees are provided with an induction, giving them an overview of the responsibilities and activities carried out by the charity. Training on external and organisational issues is provided as required.

The Board of Trustees and Executive Directors meet at least four times a year, and as members at an Annual General Meeting, and is responsible for setting an appropriate strategy for the charity. It also ensures that relevant performance measures are in place. The Board receives regular reports on all aspects of the charity's work.

There are six established Committees and one Sub-Committee. The members of these Committees include Trustees meeting with Executive Directors and are also attended by external advisors when required. The Terms of Refence for these Committees are summarised below.

Terms of Reference for Our Committees

Our Board

The Board has ultimate responsibility for directing the affairs of the Hospice in accordance with its Memorandum and Articles of Association. The Trustees have control of the charity and its property and funds. The Trustees will set clear aims and objectives, establish priorities, safeguard the charity’s assets, and use them effectively and exclusively for the beneficiaries of the Hospice.

The Board, as a whole, and trustees individually, accept collective responsibility for ensuring that the charity has a clear and relevant set of aims and an appropriate strategy for achieving them.

Care Committee

To provide the Board of Trustees with assurance that adequate and appropriate governance structures, processes and controls are in place which ensure that the organisation delivers quality care and services and provides a safe environment for patients, families, and visitors to the Hospice.

Take delegated responsibility on behalf of the Board of the Hospice of the Good Shepherd by undertaking the following objectives:

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Clinical Governance Committee

Duties and responsibilities of Clinical Governance Committee

Clinical governance improves the quality of care, by

Finance & Fundraising Committee

To provide the Board of Trustees with assurance that adequate and appropriate governance structures, processes and controls are in place which ensure that the organisation delivers quality care and services and provides a safe environment for patients, families, and visitors to the Hospice.

Take delegated responsibility on behalf of the Board of the Hospice of the Good Shepherd by undertaking the following objectives:

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Hospice Promotions Board

To provide the Board of Trustees with assurance that adequate and appropriate governance structures, processes and controls are in place which ensure that the Hospice of the Good Shepherd Promotions Company is meeting needs of the charity and is operating legally.

To cover

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Take delegated responsibility on behalf of the Board of the Hospice of the Good Shepherd by undertaking the following objectives:

Health, Safety & Estates Committee

To provide the Board of Trustees with assurance that adequate and appropriate governance structures, processes and controls are in place which ensure that the organisation delivers quality care and services, and provides a safe environment for patients, families, and visitors to the Hospice.

Information Governance Committee

To provide the Board of Trustees with assurance that adequate and appropriate governance structures, processes and controls are in place which ensure that the organisation delivers quality care and services and provides a safe environment for patients, families, and visitors to the Hospice.

Take delegated responsibility on behalf of the Board of the Hospice of the Good Shepherd by undertaking the following objectives:

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People & Development and Remuneration Committee

To provide the Board of Trustees with assurance that adequate and appropriate governance structures, processes and controls are in place, which ensures that the organisation delivers quality care and services and provides a safe environment for patients, families, and visitors to the Hospice.

Take delegated responsibility on behalf of the Board of the Hospice of the Good Shepherd by undertaking the following objectives:

Chief Executive

Authority to conduct the day-to-day activities of the Hospice of the Good Shepherd is delegated to the Chief Executive, who is responsible for ensuring that the Board’s strategy and policies are carried out. The Senior Management Team reports to the Chief Executive and meets every two weeks.

Corporate Governance

The Trustees complete an annual review against the charity governance code to highlight any areas for potential improvement. This is used to develop the charity's future policies and internal procedures to ensure we continue to follow best practice.

Risk Management and Assurance

The Trustees with the support of the SMT consider the major strategic, business, and operational risks that face the charity each year when preparing the budgets and business plans.

The charity has detailed organisational and departmental risk registers which are reviewed regularly by the Senior Management Team and quarterly by each Committee and the Board. Significant new risks are brought to the attention of this Committee and the Board as necessary to ensure they are being actively managed and wherever possible suitable mitigation is put in place. A traffic light system is used to rank the key organisational risks with controls agreed and documented providing a revised score for each risk. Our assurance framework then monitors progress and application of the controls, with the Board also giving direction when further action needs to be taken to improve our controls.

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During the assessment process we identified the following major organisational risks (classified as red based on their score) as at the date of signing:

Major Risks Controls Major Risks Controls
The Hospice continues to anticipate year-on-year
deficits before legacy income, especially with the
move to Agenda for Change Salaries for our Clinical
Staff, high inflation, and our grant from the
Integrated Care Board, insufficient to cover the cost
of our Nursing and Medical staffing; a current
shortfall of £1million. As a result, our current free
reserves are 4.7 months of forecast expenditure
which is outside of the recommended Charity
Commission for resilience. The Boards target is 4
months.		 •
Continued monitoring and scrutiny of all
costs is in place as reserves remain lower
than target.
•
Daily monitoring of cash and bank balances.
•
Monthly monitoring of income and
expenses against budget and three-year
projections.
•
Monthly monitoring of balance sheet and
key solvency measures.
•
Regular monitoring of movements in freely
available Reserves.
•
Annual budgeting and update of three-year
projections.
•
Joint working with the Integrated Care
Board with the view to securing sufficient
long-term support, with the ambition being
for the ICB to cover the medical and clinical
costs of the Charity as per the 2022 Health
and Social Care Act.
Failure to attract, recruit and retain the right staff
and volunteers for key posts.
across the organisation.		 •
NHS Agenda for Change terms and
conditions and honouring continuous
service for clinical staff
•
SAS contracts for medics.
•
Benchmarking of non-clinical staff roles
with ambition to pay the median salary.
•
Succession planning.
•
Apprenticeships
•
Volunteer strategy and development

Regular monitoring and review of the risks identified is a priority for the Hospice to support control and mitigation of each risk. The Trustees believe the major risk facing the Hospice is growing our reserves to protect our financial position. In addition, with the known national shortage of nursing and medical staff, we will always have to run the operation at safe staffing levels and consequently we flex our operational capacity of our In-Patient Unit to ensure we are always operating safely.

In addition to the above, full risk assessments are undertaken as required under the Hospice’s Health and Safety and Infection Control Policies.

Staff and volunteers as appropriate are required to complete annual mandatory training covering Information Governance, Fire Safety, Manual Handling, Food Hygiene, Infection Control, Safeguarding, Equality and Diversity and Dignity at Work together with Incident Awareness and Quality Control.

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Financial Review

Details of the results for the year are shown in the Statement of Financial Activities and Notes forming part of the Financial Statements. The Trustees have noted the results for the year and remain mindful of the continuing difficulties of operating in the current financial climate. The Group Statement of Financial Activities is set out beginning on page 51 of these accounts. The Trustees report a surplus for the year of £157,589 (2023: deficit of (£361,232)).

We received £1,090,802 (21%) of our income from the Integrated Care Board (ICB). Within this total is a one-year non recurrent payment of £200k to support our consultant cost and help the hospice to run 10 IPU beds for 23/24.

The SAS contracts and NHS Agenda for Change terms for pay along with the continued rise in inflation has continued to impact on the expenditure of the Hospice. The SAS and NHS Agenda for change were adopted due to the Hospice being unable to recruit or retain nursing and medical staff, both crucial to the running of the Hospice and its operation as an acute medical centre for those patients at end of life.

We need to continue to ensure that we can retain and attract staff in a competitive employment market.

Our non-clinical staff, which includes our finance, facilities and administration teams are equally as important as the clinical staff ensuring the smooth and safe running of the hospice’s services. Our Income Generation team raise the funds needed to provide the £4.2m shortfall in funding that we need to run our hospice.

The surplus for the year of £157,589 is after receipt of legacy income of £457,971. The Hospice has returned a small surplus, we still hold a comparative low level of free reserves which in March 2024 stood at £1,940k. Free reserves have increased from £1,593k to £1,940k in March 2024. Free reserves represent 4.7 months of 23/24 expenditure our target level of reserves was review by the Trustees and revised to 4 months of forecast expenditure during the year.

Our financial investment portfolio increased in value by £57k, finishing the year at £590,356 (2022/23 £533,326).

Management of reserves

The Trustees annually review our reserves policy to take account of uncertainties in the health economy and potential fluctuation in fundraising income. This is with a view to match variable income streams with the fixed level of expenditure incurred in delivering our services. This will help protect the long-term viability of the Hospice.

Our contracted income is, supplemented from retail, lottery, and fundraising income, including legacies. The aim of the charity is to maintain sufficient reserves to support four months’ running costs to accommodate any unexpected funding issues. The charity would like to hold sufficient cash reserves (50%) to meet its immediate short-term needs with the balance held in investments (50%).

This policy allows us to react to challenging economic circumstances and potential threats and liabilities. We are also committed to spending prudently to achieve our aim of delivering charitable activity in the short term.

The calculation of the required level of reserves is an integral part of our planning, budgeting, and forecasting cycle. The current financial climate, for 2023/24 means we remain cautious regarding any continuing impact on income generation whilst maintaining our ambition to retain our free reserves to four months of projected expenditure in line with the stated policy.

In March 2024, group reserves stood at £5.3m (2023: £5.1m). This was made up of restricted funds £37k (2022/23 £203k), and unrestricted reserves of £3.3m (2023: £3.3m). We recorded a surplus in the year on our unrestricted general fund of £ 323k (2022/23 £(273)k). This included the £57k surplus on our investment portfolio (2021/22 £(28)k deficit)

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Statement of Trustees' Responsibilities for the Financial Statements and Corporate Governance

The Trustees (who are also Directors of Hospice of the Good Shepherd for the purposes of the Companies Act) are responsible for preparing the Trustees' Annual Report (incorporating the Directors' report) and the financial statements in accordance with 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).

Company law requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charitable company and the group and of the income and expenditure of the charitable group for that period. In preparing these financial statements, the Trustees are required to:

The Trustees are responsible for maintaining proper accounting records which disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and the group and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

As far as the Trustees are aware:

Auditors

A resolution will be proposed to appoint auditors at the following Board Meeting

Signed by order of the Trustees

Bill Benoy – Trustee and Treasurer

Date: 10/12/2024

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Independent Auditors' Report Financial Statements

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Consolidated Statement of Financial Activities (Incorporating a Consolidated Income and Expenditure Account)

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Balance Sheet for the year ended 31st March 2024

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Consolidated Cash Flow Statement for the year ended 31st March 2024

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Notes to the Financial Statements for the year ended 31st March 2024

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Notes to the Financial Statements for the year ended 31st March 2024 cont.

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Our supporters

We would like to sincerely thank all those people who have supported the Hospice during this financial year, with their generous donations, time and gifts in kind. The support we receive makes such a difference to our patients and their families.

Hospice of the Good Shepherd, Gordon Lane, Backford, Chester, CH2 4DG

Hospice:01244 851091 Fundraising:01244 851 811 Lottery:0151 356 8899

Email:info@hospicegs.com

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