Annual Review 2016 | 17
An outstanding year Annual Review 2016 | 17
www.iwhospice.org |1
Annual Review 2016 | 17
Earl Mountbatten Hospice
Welcome
The challenges we face
This Annual Review comes half way through Earl Mountbatten Hospice’s 35th Anniversary year. During the past year, it has become clear that we are at an extraordinary, but challenging time in our development. It has been an exceptional year: of awards, of innovations and of an Outstanding rating by our regulator the Care Quality Commission. We have also managed to continue to stabilise our finances, and hopefully, we have remained worthy and humble recipients of the wonderful and unfailing support of our local community. We are very fortunate and we are extremely grateful.
‘I now live on the mainland, but I am so proud to be an Islander by birth. We walk to remember our brother, who was looked after by your hospice team at home. Having the experience of seeing our wonderful Island at its best, supporting what we can only describe as the best charity not only on the Island but across the UK, fills us with such pride that we feel so fortunate and content that our brother had the opportunity to be part of it all...’
Above all, in line with our mission and vision, we have continued to care for our community when they need us most. The vulnerability which comes with dying and bereavement constantly reminds us of what we are here for and enables each and every one of us to persist in being the best that we can be, at all times, to all people. All of our staff and volunteers are committed to make sure that as many people as possible can die without pain, can have opportunities to resolve family and relationship issues, and can remain part of their communities and social networks right up until the end of life. Our new Island-wide children, adult and family bereavement service also supports people to move on with their lives as well as they can, often following deeply traumatic experiences. As the son of a lady who recently died under our care said to me:
I salute our Hospice’s magnificent workforce, both staff and volunteers, who continue on a daily basis to make miracles happen. Following a recent volunteers training programme, a new volunteer wrote on their evaluation form:
‘The last two weeks of Mum’s life were amongst some of the best times we had ever shared together. Your staff came into the picture with such calmness and confidence that they enabled us to be at our best and to understand how important it was to create good memories of what could have remained an unspeakably destructive and horrible time. We can never thank you enough...’ Quite frankly we attempt at all times to be at our best, and this past year continues to show the benefits of us all working to an agreed set of values and behaviours. I know that our Island community is proud of what we do, and I join them in being proud of our team’s work and commitment. Following the latest Walk the Wight event someone wrote to me:
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‘Occasionally in life you get lucky; I am so lucky to be able to volunteer for an organisation which not only cares about patients and families with such minute detail, but which obviously pays the same amount of attention to its staff, volunteers and the wider community. I know that I am joining something which will ultimately change the way that I live my life...’ This report highlights some of our achievements from the past year. Our volunteer service received a Queen’s Award for Voluntary Service and our lead Inpatient nurse was named Palliative Care Nurse of the Year at the International Journal of Palliative Nursing awards. Other innovations have included growing Domiciliary Care Services, supporting our local hospital with timely and appropriate discharges and also developing a specialist dementia nursing service. We have additionally made great strides in training and education. Our new education programme focuses on offering our Health and Social Care partners bespoke training packages, and our partnerships with the University of Southampton grow and flourish.
You will agree that this is all good stuff. However, we continue to develop what we do against a backdrop of struggle and uncertainty. Many of our Health and Social Care partners, along with their colleagues across the whole of the UK, face increasing deficits. Growing financial pressures, workforce and recruitment issues, as well as a rapidly increasing need for care and support pose immediate problems and risks which currently have no potential let-up or easy resolution. Latest predications from the Cicely Saunders Institute at King’s College, London (2017) show a future which will bring unparalleled challenges, demanding each and every one of us work together at our best, even if only to keep what we have already afloat. By 2040 those needing hospice care are set to rise between 25 and 42 percent; these figures are supported by the predication that by 2040, those people dying with dementia are set to rise up to 300 percent, and those people dying with cancer are predicted to rise by almost 100 percent. We are also told that on the Isle of Wight our demographic is 15 years ahead of the rest of the UK. These are pretty sobering figures. If the calculations are true, and they are based on the most recent data available and calculated by a team of world experts, we are moving towards what can only be described as a seismic societal and demographic shift, which our community is currently by no means prepared for or even fully aware of. Our response is both to continue to innovate but also to challenge both ourselves and others. We have a great deal of experience and expertise to share, and we can no longer afford to sit back and watch our Health and Social Care services persistently struggle. We know what we do is Outstanding, but we also know that we can achieve so much more through influencing others. With the continued and increased support of our Island community, we can maintain the provision of high quality training and education so that all people learn, understand and emulate what good care looks like; we can show how important it is to manage finances well, spending the money we have wisely and prudently; we can challenge the unnecessary aversion of some of our partners to taking risks and doing things differently; and we can persist in influencing the future care and support of those who assist us unfailingly: our Island community. Alongside this, we can continue to care for people when they are at their most vulnerable, and we can aspire to be the best that we can be, constantly persevering in pointing out when things are not as they should be across the wider system, offering a much-needed bold and dynamic response.
The current drive for partnership working and integration needs leadership. As an Outstanding organisation, we must take action now. We have a moral responsibility to put our heads above the parapet and to charge forward. We do not want our partners to follow behind. We need our partners to come alongside us as we progress into a predicted yet unprecedented future. However, we will not fritter away our time waiting for those around us to act. ‘Our work is our message and what we do matters’. We have had an Outstanding year thanks to many different people supporting us in many different ways. The future is by no means certain, but together we can commit to being at our best, whatever challenges we face. In 35 years’ time we want our Outstanding Island to look back and say that our Outstanding hospice led the way and continued to make an Outstanding difference. Nigel Hartley CHIEF EXECUTIVE
Our mission, vision and values OUR MISSION
To promote and to provide good care and support for those people living with, affected by, or curious about death, dying and bereavement, across the Isle of Wight. OUR VISION
A world where all dying people and those close to them have access to expert, compassionate and cost-effective care of the highest quality, whatever the illness, whoever they are and wherever they happen to be. OUR STRATEGIC AIMS ARE
To reach more people to achieve scale To work in partnership to achieve our aims To ensure our services to, and our impact on our Island community are sustainable for the future OUR VALUES ARE
We care about what we do We are experts in our field We are innovative and bold We respect our community
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Annual Review 2016 | 17
Earl Mountbatten Hospice
An outstanding year... May 2016
June 2016
A series of short films featuring our experts was launched on social media to encourage Islanders to talk openly about death, dying and bereavement as part of national Dying Matters Awareness Week.
The iconic Isle of Wight Festival was the setting for the launch of our 2016 fundraising Sunflower, sales of which helped generate around £15,000 for patient and family care at the annual event.
Renowned Island chef Robert Thompson donated his time, expertise and Island produce to create a special meal for patients, their families, staff and volunteers.
A celebration of patients’ lives was staged, thanks to a project by students at the Isle of Wight College, who interpreted anecdotes and stories from patients they got to know in the John Cheverton Centre to produce a show called “Memoirs and Music Hall”.
July 2016 In gloriously sunny conditions, over 7,500 walkers, dogs and alpacas took part in Walk the Wight, the largest charity walk of its kind in Europe, raising around £300,000 to support patient and family care. At the same time, Schools Walk the Wight celebrated its tenth birthday.
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Over £10,000 was raised at the popular annual Barton Manor Open Garden event, held in the beautiful grounds of the private Barton estate in Whippingham, which included a summer garden PIMMS bar, Big Sing singing workshop, live music, arts, crafts and children’s activities. Celebrity gardener and Island resident Alan Titchmarsh MBE officially opened our Chelsea Garden in the grounds of the hospice, a space which was transformed thanks to the relocation of the Royal Bank of Canada 2015 show garden by Greenfingers, a charity
dedicated to creating gardens for children in hospices.
August 2016 An evening of engaging and original music from pianist and BBC Radio 3 broadcaster Sarah Walker was among those on the bill as part of our Social Programme, which aims to encourage people to visit the hospice and see it as a warm, welcoming environment. Working in partnership with KissyPuppy, the Sophie Rolf Trust, a new children and families bereavement service was launched offering free, expert advice and specialist support to anyone who is experiencing loss through death on the Isle of Wight.
September 2016 Rt Hon Lord Howard of Lympne CH, QC was welcomed to the hospice for the official launch of the hospice’s specialist dementia service and appointment of our first Admiral Nurse Jill George.
Hundreds of staff and volunteers gathered for a special celebration to mark the presentation of the Queen’s Award for Voluntary Service, given by Her Majesty’s Lord Lieutenant of the Isle of Wight Major General Martin White CB CBE JP. A night of celebration was held to pay tribute to the stars of Walk the Wight 2016, with 21 awards presented to winners in a range of categories, such as top fundraiser and special achiever.
October 2016 The importance of making a Will was highlighted with the launch of Make a Will Fortnight, during which a number of generous Island solicitors provided their support and expertise. Over 70 postcard-sized pieces of original artwork went on display to celebrate Isle of Wight Day on the walls of the hospice’s own art gallery, with visitors bidding on the creations at a special fundraising auction which raised £650. An incredible £65,000 was raised by supporters at a fundraising dinner at the Royal Yacht Squadron in Cowes, which included an auction and a number of generous donations from guests.
November 2016 The annual hospice Christmas Fayre provided festive fun and entertainment for visitors to the John Cheverton Centre, with a delicious two-course Sunday lunch on offer as well as tours of the Chelsea Garden. Armistice Day was marked with a drift of hand crocheted poppies installed outside patients’ rooms in the Oak Garden, created by volunteer gardener Sue Clerkin and regular crafters at our Knit and Natter group.
December 2016 Communities across the Island came together to remember their loved ones at Lights of Love services in many towns, as well as at a major event at the hospice itself, where hundreds gathered for prayers, inspirational readings, singing of carols and lighting of candles. A sea of over 200 Santas made a dash along Ryde seafront for the ever-popular annual fundraising festivity,
which starts and finishes at Ryde Superbowl and includes a 5km run, jog or walk along the route – and a mince pie at the finish line. The doors of the John Cheverton Centre were opened to anyone who wanted to join us for a traditional meal on Christmas Day, with staff and volunteers ensuring the day was festive and fun for all who came along.
January 2017 Celebrations marking 35 years of Earl Mountbatten Hospice began with a well supported Open Day, offering the community the chance to hear about our plans for the forthcoming year, such as a 35th anniversary Thanksgiving Service and a day of events on the birthday itself – 13 October. Legal professionals were thanked for their continued support of the hospice at a special dinner, courtesy of chef Robert Thompson. The founder of Bates Wells Braithwaite, Lord Phillips of Sudbury OBE gave the keynote speech. A new partnership with national music charity Nordoff Robbins was launched supporting people to live life to the full and offering
opportunities for creativity and expression at a time when these can be difficult to achieve. As well as this new music therapy service, a Community Choir was formed, regularly attracting up to 70 members.
February 2017 A series of free, pop-in sessions supporting people to develop skills to improve their own wellbeing was launched, called Positive Steps to Wellbeing, which included sessions on eating well, living with fatigue, protecting your skin and relaxation. To celebrate the 35th anniversary, a unique opportunity to run through the grounds of Osborne was launched, called Osborne Run, to be held in the summer and taking in areas of the grounds not often frequented by visitors.
March 2017 Earl Mountbatten Hospice was proud to announce that it had been judged to be “Outstanding” by the Care Quality Commission – the highest possible rating given by the independent regulator. You can read more about their findings throughout the remainder of this Annual Review.
A grant was awarded by the National Lottery Heritage Fund to enable the hospice to celebrate its 35th anniversary with a “Mountbatten Memories” project – a collection of oral history interviews with past staff, volunteers and supporters, creating a lasting legacy for the Island. Support for apprenticeships was extended during National Apprenticeship Week, when the hospice announced it was growing its workforce with the introduction of two new Health and Social Care apprenticeships, providing training with the hospice’s clinical experts in end of life care. Our ward sister Jackie Whiller was named “Palliative Nurse of the Year” at the International Journal of Palliative Nursing Awards, which recognise and celebrate achievement and excellence in the work of palliative care.
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Annual Review 2016 | 17
Earl Mountbatten Hospice
Who said what?
During 2016 | 17
I wish to pay tribute to Earl Mountbatten Hospice: its work is critical in caring for people at the end of their lives, as well as supporting loved ones to prepare for loss and to cope afterwards. From a partnership perspective, the hospice has led the way locally in developing services that are “Care Close to Home” - enabling people to die at home when they choose to do so, surrounded by love and everything that is most dear to them. However, more needs to be done in this area as too many people still die in hospital. The hospice is providing systems-wide leadership in supporting and challenging health and social care to change our current ways of working, and to work towards making a reality of every health and social care provider being able to respond positively and effectively to those we serve in need of palliative care. Carol Tozer | DIRECTOR OF ADULT SOCIAL CARE, ISLE OF WIGHT COUNCIL
The joy and consolation of music can be powerful and sometimes lifechanging for those facing death or serious illness, and those who are bereaved. Nordoff Robbins is proud to be associated with the fantastic work of Earl Mountbatten Hospice, and to provide through our partnership the support and care of music therapy where it is most needed. We value hugely our relationship with this inspirational charity and look forward to maintaining and developing this into the future. Julie Whelan CHIEF EXECUTIVE, NORDOFF ROBBINS
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The Hospice represents a vibrant community of practice that extends way beyond the walls of the building. Its impact can be felt by patients, families, and carers, local health care professionals and the Island community at large. What the hospice is achieving truly matters for the growing number of people who need that care today or might need it at some point in the future. In particular the work they have underway to reach beyond the palliative phase, to those living with a life limiting illness, means they are responding in a positive way to the changing needs of the Island. Professor Alison Richardson PROFESSOR OF CANCER NURSING AND END OF LIFE CARE & DIRECTOR SOUTHAMPTON ACADEMY OF RESEARCH
We are very pleased to be working in partnership with Earl Mountbatten Hospice to provide families with specialist dementia support at the end of life, through Admiral Nursing. Jill George, the Admiral Nurse, has had an immediate and positive impact on families in the community, in care homes and within the Hospice environment by giving families the oneto-one support, expert advice and practical solutions that they need to live more positively and face challenges with more confidence. Dr Hilda Hayo CHIEF ADMIRAL NURSE AND CHIEF EXECUTIVE, DEMENTIA UK
The CCG are delighted with the recognition of the outstanding work being done by Earl Mountbatten Hospice and believe the awards achieved during the year are a well-deserved reflection of the commitment and effort across the organisation. ISLE OF WIGHT CLINICAL COMMISSIONING GROUP
The status that Earl Mountbatten Hospice has achieved, as an independent charity but with such tight links with the NHS community and hospital services, is an exemplar which provides me with more than a little hope for the future of healthcare in our present troubled times. Dr. Andrew M Hoy CONSULTANT IN PALLIATIVE MEDICINE
I am writing to congratulate you and your team on the exceptional quality of care at Earl Mountbatten Hospice that has come together to mean that you were rated as Outstanding by the Care Quality Commission. From visiting organisations throughout the country, I know that the immense amount of day-to-day hard work that will have been behind this outcome cannot be overestimated. It is greatly appreciated, not just by me, but by all your patients who will be benefiting as a result. It should be particularly pleasing to you to have been recognised for your outstanding care, responsiveness and leadership. Rt Hon Jeremy Hunt MP SECRETARY OF STATE FOR HEALTH
Earl Mountbatten Hospice plays a hugely important role in the Island’s community by providing outstanding end of life care to people with a terminal illness as well as support and respite for their family and friends. The value of this service to our community is almost immeasurable. For 35 years now, the Hospice has been working in partnership with our local hospital, GP surgeries, care homes, charities and the wider community. Doctors, nurses and volunteers go out of their way to provide people with a positive experience. Earl Mountbatten Hospice is also well known on the Island and beyond for its innovation, best practice and excellent educational experiences, which are shared with others through their partnership with the Faculty of Health Sciences at the University of Southampton. Joanna Smith | MANAGER, HEALTHWATCH ISLE OF WIGHT
On behalf of the Isle of Wight NHS Trust, I am delighted to congratulate Earl Mountbatten Hospice on its 35th Anniversary and on the range of creative services and support that it offers, not just at the Hospice but for people living at home and their families across the Island. I am very proud that the Hospice was recognised as outstanding in its recent inspection by the Care Quality Commission and the IW NHS Trust is now working even more closely with their team to ensure that we can learn from their success. Eve Richardson | CHAIR IW NHS TRUST
The Isle of Wight College is a proud supporter of Earl Mountbatten Hospice. They provide a vital service to the Isle of Wight and we are pleased to be working alongside them locally to recruit and train a new generation of Apprentice Healthcare assistants to support their team in delivering high quality care for their patients and families. Debbie Lavin PRINCIPAL, ISLE OF WIGHT COLLEGE
The organisation that is Earl Mountbatten Hospice is so demonstrably all about the people within it. Its leaders are the people who ‘know’ and the strengths of all those involved - staff and volunteers, people who use the services, their families and supporters, other public and voluntary sector partners - are highly valued. This is reflected in their many achievements and accolades. Thank you, Earl Mountbatten, for being a motivational exemplar to all those working and volunteering in our Island’s public, charity and independent health and social care services and groups. Maggie Bennett MANAGING DIRECTOR, ISLAND HEALTHCARE LTD
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Annual Review 2016 | 17
Earl Mountbatten Hospice
Outstanding care
at home for Islanders and families... ...the hospice was outstandingly responsive to the needs of people using their service, their families and the wider community. The hospice worked pro-actively with their local acute hospital to ensure people who wanted and could safely receive end of life care at home or in the Inpatient Unit were identified promptly and transferred from hospital without delay... Care Quality Commission MARCH 2017
We know that most people want to be cared for at home until their death but, unfortunately, too many people die in hospital. We have been working hard to support the local NHS, which continues to be under serious pressure, by finding creative ways to support people returning to their own home. There are a number of ways we are doing this; our Care@Home team is just one example. Making sure people have good practical and personal care is crucial, if they are to be able to die at home. This can include helping someone to wash, take their medication and manage the symptoms of their illness. Our expert end of life domiciliary, or personal care service was initially launched as a pilot in 2015/16. Its value was quickly recognised and last year the Care@Home team, as they are now known, became part of our everyday work. The team has expanded to employ 11 community support workers who are able to rapidly support patients in the last few weeks of life. We are the main provider for people who need two carers to support them, and we look after people in remote rural areas. Often, we visit people up to four times a day to provide care and support. Working with our Community Clinical Nurse Specialists, our colleagues in the hospital, and our team on the hospice ward (Inpatient Unit), this is how we are supporting more Island people to die in the place they would prefer. At the end of February, the Isle of Wight Council carried out a Quality Assurance visit to ensure the quality of our care. We were delighted to be awarded a score of 102, out of a maximum of 105, with inspectors saying that they were “very impressed with the way the service has been developed.”
Year in numbers
571
new people supported by our Community Clinical Nurse Specialists
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Patients were in contact
7508
Home visits were made by our Community Team (including our Care@Home team)
5569
times with our Community Clinical Nurse Specialists (at home, in the John Cheverton Centre, on our ward and by phone)
They are brilliant They come in every day and care for me and attend to anything I need. They have a chat afterwards and I look forward to them coming. We talk about all sorts of things! I think it’s better to be at home. They are all lovely girls; I get on well with every one of them. Eileen, 84 | ROOKLEY
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Annual Review 2016 | 17
Earl Mountbatten Hospice
Outstanding creativity to meet people’s needs... Partnerships are very important to us; with the support of other organisations, we can reach many more Islanders who need our help. This is true across many areas of our work and, during the last year, we have formed new relationships so we can extend our care to meet the needs of people who we have not previously been able to support. Working with Dementia UK, and thanks to a community fundraising campaign led by Bembridge resident Lady Sally Grylls, we appointed a new Admiral Nurse to support people who are living with dementia and approaching the end of their lives, as well as their families and carers. Jill George, Community Nurse Specialist, was appointed to the new role in September 2016.
Mum has always loved music, dancing and anything theatrical. She finds it really hard to communicate using speech, but if you give her music or something to sing she remembers it. It brings tears to my eyes; it’s like how she always used to be. Today, I’ve got my old mum back! Pru Spokes | DAUGHTER OF JILL FENNIMORE (PICTURED)
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Jill now leads specialist dementia training and education sessions, sharing her expertise with our own staff, other care providers and nursing and residential homes across the Isle of Wight. In April last year, we launched a new Children and Families Bereavement Service, in partnership with KissyPuppy. Over the last few months, the number of children supported by the new service has grown rapidly. We receive requests for support from GPs, schools and other charities and we now hold a weekly Bereavement Group for children, monthly Children’s Days, and are helping teachers and parents to support bereaved children. Among other new services developed through the year is Music Therapy, which has been achieved in partnership with Nordoff Robbins, the UK’s leading independent music therapy charity. One-to-one music sessions are held in people’s rooms on the Inpatient Unit, in groups in the John Cheverton Centre, including children living with life-limiting illnesses, and for a specific group of people and their families living with dementia. Additionally, a community choir has been formed which is open to anyone, of any ability, to simply enjoy the experience of being together and singing.
Year in numbers
129 care home staff
completed our dementia training, with a focus on end of life care
...the hospice found creative ways to meet people’s needs, such as those of youngsters with life-limiting conditions. This meant that families did not need to travel from the Isle of Wight if they wished for their child to receive end of life care in a hospice setting... Care Quality Commission MARCH 2017
34 families
Up to
70 people of all ages regularly attend our new Community Choir
were supported by the new KissyPuppy Children’s Bereavement Service throughout the year
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Earl Mountbatten Hospice
Outstanding education and training...
Developing our staff and volunteers is essential to continue offering outstanding care for our Island. Over the last year, we have put a great deal of effort into providing training and education – not only for our own organisation but also extended to many other health and social care professionals across the Island and beyond. Our staff are experts in their field and, in line with one of the main aims of the hospice movement, we feel it is important to share their skills and knowledge, so that as many Islanders as possible receive excellent care wherever they may be. Over 200 staff from residential and nursing homes, care agencies and the Island’s prison have benefited from specialist training sessions in end of life care provided by our team. We have also used the experience of our Admiral Nurse to deliver specialist education on caring for people who are at the end of their life and also have dementia.
Our Clinical Teaching Fellowship has been developed over the last year with Southampton University, offering education to pre-registration nurses in palliative care as well as contributing to post graduate and Masters programmes. The university is one of only a handful who consider Palliative and End of Life Care as a core module within their pre-registration programmes. The sharing of our expertise is extending even further afield, with the development of a twinning arrangement between our hospice and the Archangel Michael Hospice in Paphos. During the year, we have hosted two visits from our Greek colleagues who, after 20 years of fundraising, finally realised their vision of a hospice building in 2015.
...staff had outstanding skills and an excellent understanding of the needs of people who may be vulnerable because of their circumstances... People and their relatives told us they received high quality care from skilled staff. Relatives told us “I am very confident in the staff’s abilities” and “They are excellent, I can assure you they are doing their jobs properly. They are all top of the class! Care Quality Commission MARCH 2017
Year in numbers Over
100
volunteers took part in our new volunteer training programmes
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96%
of participants rated our dementia/end of life training as excellent or good
Over
270
staff from care homes or care providers undertook one of our training sessions
This year has flown by. I have enjoyed it immensely and I am learning so much – both personally and professionally. The feedback and comments from students has been positive and they see me as having clinical credibility, which I feel is vital for their learning. My role combines the reality of clinical practice with the theory and policy that informs nurse education. Dee Curless | CLINICAL TEACHING FELLOW AND CLINICAL NURSE SPECIALIST
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Earl Mountbatten Hospice
Outstanding innovation to care for our Island...
It’s not unusual to be fearful when coming to the hospice for the first time, particularly when coming to stay on our ward (Inpatient Unit). People often don’t know what to expect, but many tell us that they are pleasantly surprised by what they find. Many are also unaware that people often go home again, having received treatment to relieve their pain and symptoms. We have worked hard this year to spend even more time with our patients and their families on our 16-bed hospice ward. Good communication is key and, after an innovative pilot project last year, our nursing staff are more able than ever to spend time making people feel at ease. Nurses now lead the care on the ward for a number of patients, which frees up time for medical staff to respond rapidly to the more complex needs of some patients who are cared for at home. The ward sister is now in charge of making sure that an individual treatment plan is in place for patients: prescribing medicines, managing symptoms and making patients feel as comfortable as possible.
I’ve been a recluse. I wouldn’t go out because of not feeling well. My wife was concerned and my nurse told me I should come here. I didn’t want to, because I thought it was going to be depressing. But I just couldn’t believe it; it blew my socks off. The friendliness, the care, the art, the physio – I couldn’t believe it. Brian Newnham | SHANKLIN
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The change has also empowered our nursing staff to develop; our ward Sister is a non-medical prescriber working towards a Master’s degree in Advanced Clinical Practice. Our Deputy Sister is also a nonmedical prescriber and commencing a masters degree, and is developing skills in nurse-led care by shadowing the ward Sister. It has also led to huge changes in the culture and attitudes towards nurseled care within the organisation. Our ward Sister presented at last year’s national Hospice UK conference, sharing our unique experience of developing nurse-led care.
Year in numbers
442
admissions to our ward Inpatient Unit
Nearly
1/5
of admissions to our ward were due to diseases other than cancer
...the hospice implemented an innovative nurseled approach for the Inpatient Unit (ward) which saw five beds for people without complex symptoms being managed by the nursing staff. This enabled more medical time to be deployed in the community to keep people with more complex needs in their home, if this is their preferred place of care... Care Quality Commission MARCH 2017
37% of people admitted to our ward (Inpatient Unit) returned to their home or nursing and residential care
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Earl Mountbatten Hospice
Outstanding support to promote independence... Being diagnosed with a terminal illness is very challenging in many ways. Sometimes people feel that there is little point in carrying on, and that they can longer enjoy the things they used to. Some people find friends become more distant, as they fear knowing what to do or say.
Our team of experts at Earl Mountbatten Hospice are here to support both the patient, and their family and friends. All of the services provided in the John Cheverton Centre are centered on wellbeing and independence, and above all the ethos of living until you die. During this year, we have been working to promote this in everything we do: our rehabilitation gym has been used to deliver a circuit programme for people with advanced illness and at the end of life, including sessions for those with Lymphoedema, we have introduced support workers to help people identify what matters to them and to work towards the goals they want to achieve.
...the hospice focused on people’s wellbeing and developed innovative ways to promote quality of life... Care Quality Commission MARCH 2017
We have also held a series of group sessions called “Positive Steps to Wellbeing”. This self-help programme has covered topics including financial help, keeping your skin in good condition, and how to cope with breathlessness. The focus of all of this work has been to promote independence and to shift the culture to enable people, rather than to disable them by ‘over-caring’.
Year in numbers
322
home visits were made by our Occupational Therapists and Physiotherapists
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80
home visits were made by our Lymphoedema team
72 new people attended day services in the John Cheverton Centre
I do half an hour on the bike, then go on the walking machine. It builds up stamina, every week they increase it a bit more. I’m getting quite intermediate now! My first goal is to walk from my house to Shanklin without stopping. I’m getting there! I’d hate to be sat indoors doing nothing. Brian Paulling | SHANKLIN
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Earl Mountbatten Hospice
Outstanding engagement with our Island community... The hospice had hosted a lunch at their Sunflower Café for older people in the community on Christmas Day so that people did not have to spend Christmas alone. One staff member told us “It is important that we give back to the community and support wherever we can; we are like a big family on the Island. Care Quality Commission MARCH 2017
We have spent the past year continuing to challenge people’s preconceptions about what a hospice is like. We want to show people that the hospice is a warm and welcoming environment and that there are many opportunities to create good memories together. Our social programme has continued to develop and has included a series of live music concerts throughout the year and an art gallery that features new artists each month. A hospice Community Choir was launched at the beginning of the year as a way to encourage new visitors to use our facilities. It has proved incredibly popular and up to 70 people regularly attend weekly rehearsals, led by our Music Therapist Fraser Simpson. Our Chelsea Garden was officially opened in July last year by celebrity gardener and Island resident Alan Titchmarsh. This open space has been transformed from what was a bare patch of grass into an exquisite landscape offering peace and tranquillity to its visitors. This inspiring place has given us another opportunity to attract new visitors and for them to feel part of our hospice. ‘Death chat’ is another way in which we encourage people to break the taboo of talking about death and dying. Sessions are held weekly and are an opportunity for people to chat informally about anything they are curious about. Our Sunflower Café is open to the public and this year we have highlighted our support for local food producers. Thanks to the support of additional volunteers, we have been able to extend the café’s opening hours, meaning people using our services can enjoy high quality meals into the evening.
Extract from a thank you letter from Alison, whose mother Sheila Dalladay is pictured meeting Alan Titchmarsh at the official opening of our Chelsea Garden.
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Year in numbers Over
Photo: Chris Mathews
The more we think about her last few weeks, the more we realise how incredibly blessed we all were that she was looked after in such a loving way and in such a lovely, peaceful place. It could so easily have been very different…
150 people attended an Open Day to launch our 35th anniversary celebrations
15 live music concerts held in the John Cheverton Centre attended by patients, families, staff, volunteers and the public
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Annual Review 2016 | 17
Earl Mountbatten Hospice
Outstanding support
for Islanders coping with death and dying... Our care for Islanders does not stop after the death of a loved one or friend. When someone dies, it has a huge impact on your life and we have a team of experts and volunteers ready to be there when people need us most. Our Psychology and Bereavement Service has developed considerably over the past year and we now provide a range of Islandwide services that have grown to cater for all ages. Our support includes individual talking therapy as well as group support and art therapy. This year, we have launched a new music therapy service that helps patients and families who may find talking on a one-to-one basis difficult, and have now been able to discover other ways of expressing themselves. The important role of carers is also recognised and, during this year, we have developed a carers’ group for those looking after people with an end of life diagnosis. Meeting with others to share knowledge and experiences, feeling understood and supported, and knowing which of our experts to turn to is an important part of what we can offer. We know that special occasions such as Christmas can rekindle memories for families and friends. For the first time last year, we focused our efforts on a Lights of Love service based at the hospice itself, so that people could remember those
who have died in the company of our staff, volunteers and friends. Hundreds of people came together to sing carols and a huge Christmas tree was lit in our grounds. The community itself supported the Lights of Love campaign with their own events in towns and villages across the Island, which included a main service at St Thomas’ Church in Newport. It’s not just adults that we support. Every year many young people experience the death of someone they love or care for. Thanks to the generous support of our KissyPuppy partners, last year we launched a new Children and Families Bereavement Service. Since launching in October last year, we have seen a sharp monthly increase in the number of children and families who are seeking our support. A weekly bereavement group for children and monthly children’s days are held, alongside support for teachers and parents on how to care for bereaved children. We will continue to meet the needs of these Islanders wherever and however they have been bereaved.
Year in numbers
340
patients and families referred to our bereavement services
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...we heard numerous examples of staff having an in-depth appreciation of people’s individual needs around the end of their lives or preferred place of death and how staff went out of their way to honour people’s wishes. For example, this was evident in the pre-bereavement support and guidance staff provided to children’s teachers and guardians so that people’s wishes for their children to be supported after their death could be honoured. Care Quality Commission MARCH 2017
Nearly
84 people came to our ‘Positive Steps to Wellbeing’ group sessions
300 people gathered at the hospice for our Lights of Love event
Rather than sitting at home and moping, it’s good to come here. We don’t talk about life expectancies, it’s just a way of being with each other. Here I can be me. I can relax and enjoy myself instead of everyone wanting to do things for me. Tracey Clarke | SANDOWN
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Annual Review 2016 | 17
Earl Mountbatten Hospice
Outstanding leadership from floor to board... The past year has seen incredible change and many positive results, culminating in an ‘Outstanding’ rating from the Care Quality Commission. This has been a remarkable achievement for all our staff, volunteers and supporters.
I lead and care for a number of patients whom I manage totally, ensuring the appropriate individualised treatment plan is in place and updated. Symptoms are managed and medication is prescribed. The opportunity has been very rewarding and I believe has been a great success. I believe the most valuable asset of this model is that I have managed to spend more time with patients and their families. Jackie Whiller | SISTER ON THE WARD (INPATIENT UNIT)
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Outstanding leadership has been instrumental in supporting our organisation to move quickly and respond to the growing needs of our Island community. We are very fortunate to have the vision and strategic leadership of our Chief Executive Officer, who has brought new energy and focus across all areas of our work, alongside a dedicated and knowledgeable Senior Management Team. Our leadership has been recognised by the Care Quality Commission in its recent report as being “outstanding”; inspectors commented on the many examples of where they had seen our values put into action across our work and said that we are a transparent organisation with clear links of accountability from the ‘floor to the board’. Our values, which were developed in partnership with staff and volunteers, have an important role in shaping our behaviour and attitudes; they enable each and every one of us to feel confident and competent to lead in our own roles on a daily basis.
We are very fortunate to benefit from the diverse and wide experiences of our Trustees, who continue to contribute to our strategic direction and ensure we fulfil our objectives. We are grateful to them for their support across many areas, including the planning of our 35th anniversary celebrations during 2017. Also highlighted in the CQC report was the positive impact of a programme designed for middle managers called Leading from the Middle. This was said to be an outstanding example of enabling staff to contribute to personal and hospice development. Staff had also told inspectors that their views mattered and they felt able to influence the service. Although there are many exceptional examples of leadership throughout the organisation, one deserves special mention. During the year, our ward Sister Jackie Whiller has challenged the culture and practice on our ward and developed a new nurse-led model of care. Her outstanding leadership style led to the presentation of the ‘Nurse of the Year’ Award at the International Palliative Care Nursing Journal Awards, which recognise and celebrate achievement and excellence.
...the management team promoted a culture of openness, reflection and excellence. Staff were involved in the development of the values and vision of the service. An outstanding example of enabling staff to contribute to personal and hospice development was the bespoke “Leading from the Middle programme” designed for middle managers across the organisation. We saw this project had empowered staff to work on operational challenges and creatively deliver tangible outcomes for the hospice. Care Quality Commission MARCH 2017
Annual Review 2016 | 17
Earl Mountbatten Hospice
Outstanding and award-winning volunteers and staff...
Care Quality Commission MARCH 2017
During 2016, we were delighted to be presented with the Queen’s Award for Voluntary Service by the Lord-Lieutenant of the Isle of Wight, Major General Martin White. Known as the ‘MBE’ for volunteer groups, the prestigious award recognises the dedication and commitment of current volunteers, along with the many others who have given, and continue to give, their time for free in so many ways and on so many occasions. As part of being put forward for the Queen’s Award, two volunteers were invited to join a Royal Garden Party at Buckingham Palace.
Year in numbers
500
volunteers supporting all areas of our work
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Our volunteers give more than
Over
hours of help every year
members of staff
60,000
200
Our volunteers are helping in new ways, enabling us to support even more Islanders. Our Sunflower Café is now open for longer, thanks to their support, and this means that we can offer good food and space for people visiting relatives or friends on our ward into the evening, as well as to people attending our craft nights, live music concerts and death chats. Our community volunteers programme has been relaunched, supporting people at home, wherever that may be. This includes providing respite for carers, helping people settle back into home after being in hospital or on our ward, taking them shopping and helping them to reach goals to live independently. Because we value the extraordinary efforts of our volunteers, we have worked hard this past year to make sure they really feel part of our wider team. A new Volunteer Charter sets out clear expectations for both the volunteer and our organisation; new role profiles have been developed to clarify their immense contribution in both clinical and non-clinical areas. We have launched a new induction programme for staff and volunteers, and a six-session programme for volunteers to gain a greater understanding of all areas of our work. The development and training of staff has also been reviewed and enhanced during the year, and a new Director of Human Resources was appointed in February to work with all departments to build a strong, resilient and dynamic workforce. Our staff have had national influence; our learning from a number of innovative projects was shared at the 2016 Hospice UK conference along with presentations on nurse-led care and new models of care. During the year, our Chief Executive has presented at both UK and international conferences.
I feel very proud and very privileged to have received the award on behalf of volunteers, both past and present. My wife died of cancer eight years ago and the community services were absolutely brilliant, so I feel I am giving something back.
Image credit: Michael Dunkason
...staff had the skills and knowledge to meet people’s needs. Care staff had undergone an induction programme that met the requirements of the Care Certificate standards. All new volunteers were provided with an orientation programme and mandatory training. Staff were complimentary about the training opportunities they were provided with. Their comments included The best induction I have ever had, it covered everything and was enlightening.
We’re extremely fortunate to have the support of around 500 volunteers, who make a huge contribution to every area of our work. We could not provide our outstanding levels of service without the help of these inspiring individuals who give up their time and share their skills in support of our Island’s hospice.
David Dann, Volunteer (right) | YARMOUTH
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Annual Review 2016 | 17
Earl EarlMountbatten MountbattenHospice Hospice
Outstanding fundraising support from our Island... ...staff viewed the hospice as belonging to the Isle of Wight and were highly motivated and inspired to offer support that was kind and compassionate to the community as a whole... Care Quality Commission MARCH 2017
We are only able to provide our care, support and education to Islanders and their families thanks to your extraordinary efforts. Last year, it cost almost £7 million to provide our services and we rely heavily on support from our Island community: whether that’s through donations or legacies, using our ten hospice charity shops, playing our lottery, buying a hospice sunflower at the Isle of Wight Festival or taking part in fundraising events. The remaining 35% of funds needed to run our services came from the NHS.
or sponsored run. Every penny raised really does make a difference to the support we can provide to Islanders. Our flagship fundraising event, Walk the Wight, continues to inspire and engage thousands of people of all ages and from all backgrounds. The walk, believed to be the biggest of its kind in Europe, regularly attracts over 7,500 participants. It is a truly humbling experience to see a united front marching across our spectacular Island landscape in support of Islanders when they need it most. Last year, in bright sunshine and perfect walking conditions, people raised around £300,000 – a staggering sum and a phenomenal community effort. Whether you took part in Walk the Wight or any other fundraising activity, a heartfelt ‘thank you!’ to you all.
Photo: Stephanie Mackrill Photography
Last year, Peter MIddleton from Freshwater surprised everyone by walking the last four miles of Walk the Wight from Freshwater Bay to the Needles. It was not long after he had been told he only had a week to live. Peter had cancer which was no longer treatable, and regularly stayed at the hospice for pain management. Peter loved the idea of giving something back and, despite his illness, he was determined to take part in Walk the Wight. His wife Gail said: “By that time, he was on crutches because he could barely walk. We didn’t think he would even get up the hill, but he just stared at the ground and concentrated on putting one foot in front of the other. His colleagues from Freshwater Lifeboat were at his side, encouraging him all the way. We raised over £3000.” Three months later, Peter sadly died at the hospice. In 2017, Gail and the Freshwater Lifeboat crew walked in Peter’s footsteps to honour his memory and his incredible achievement.
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Laura Holmes Photography
On behalf of our patients, their families and carers, staff and volunteers, we are truly grateful for every fundraising activity you were involved with last year, whether that’s Walk the Wight, Santa Dash, Go Yellow! or your own challenge, cake sale
Walk the Wight 2016 in numbers
Over
220
volunteers on the day
21 awards presented at our annual Walk the Wight Awards evening
12,750 bottles of water handed out
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Annual Review 2016 | 17
Earl Mountbatten Hospice
Our income & where it goes We can only care for Islanders and their families thanks to the amazing contributions and donations of our supporters. Last year, an incredible 55% of our income came from your generosity: holding your own events, playing our lottery, taking part in challenges, Walking the Wight, buying things in our shops, dropping pennies in our bright yellow collecting boxes, remembering us in your Will and much, much more. Your support is an essential part of being able to provide our services, at no charge to those who need them, at the most challenging of times. Our priority is to ensure that we spend these precious funds wisely and always for the benefit of our patients and their loved ones. We are also grateful to the Clinical Commissioning Group on the Isle of Wight, who last year contributed 35% towards the running of our services. We received a further 8% from other income, such as grants. Full accounts (year ended March 2017) will be filed with the Registrar of Companies and the Charity Commission and copies can be obtained from our Finance Department, phone (01983) 217313 or email info@iwhospice.org
Facts about Earl Mountbatten 2016 | 17
Income
Our services
March 2016 to March 2017 3% Our
hospice lottery
On any one day, 650 Islanders receive physical, psychological, social and spiritual care at home
2% Other income (investments)
4% Walk
35% Clinical
the Wight 2016
Commissioning Group
8% Other
7508 home visits our community team made during the year
grant funding
16 beds
10% Other
fundraising and donations
16% Our
22% Legacies
hospice shops
Governance
6% Fundraising
Activities
39% Inpatient
and Day Services
12% Shops and Related Activities
Community Care
26% Premises,
Volunteer and Other Support Costs
Up to 70 people sing in our community choir We held 15 live music concerts last year
Our Sunflower Café
We have a hospice team working in St Mary’s Hospital
is open to the public 7 days a week, until 8pm most nights
Our care includes expert psychological, bereavement and spiritual support
More than 12 artists displayed their work in our Hospice Art Gallery
Art and music therapy are available to all 273 written compliments received
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60,000 hours
Our community
We have a rehabilitation gym in the John Cheverton Centre focussing on rehabilitation and self-management
16%
support all areas of our work
More than 1/3 of people admitted to our ward were able to return home
St Mary’s Hospital 1% Audit and
Around 500 volunteers
on our hospice ward
received our care at home, on our ward and day services during 2016/17
March 2016 to March 2017
We employ around 200 people
Our volunteers give more than 60,000 hours of help every year
1800 Islanders
How we spent it
Our people
Our 10 shops
Our figures It cost nearly £7m last year to run our services; that’s nearly
£20,000 a day Our supporters helped raise an amazing
55% of this funding We received more than
£1.5m in legacies (22%) Our Clinical Commissioning Group commission us to deliver services at the cost of
£2.5m per year (35%)
Our history Earl Mountbatten was the former Governor of the Isle of Wight He was killed in an IRA attack in 1979 He was great-uncle to Prince Charles, who was particularly close to him Earl Mountbatten Hospice was officially opened on 13 October 1982 by HRH Duchess of Kent
are on nearly every high street across our Island
Did you know All of our staff are paid for by Earl Mountbatten Hospice, and we take no funding from any other major national charities | 29
Annual Review 2016 | 17
Earl Mountbatten Hospice
What next?
Looking ahead to 2017/18 An outstanding future?
We are working closely with our partners to focus on some key innovative areas for the next year. These include: Island-wide System resilience With funding from the local System Resilience Group, a new End of Life Care Hospital Discharge Coordinator beginning in September 2017. The person in this role will work at the ‘front door’ of St Mary’s Hospital, liaising closely with the Earl Mountbatten Hospital team, the Local Authority Discharge Team, Domiciliary Care Providers and the Earl Mountbatten Care@Home Domiciliary Care Team to ensure quick and effective discharge of people in the last months of life to their preferred place of care Although funding for this has not yet been agreed, we are developing and firming up plans for a new Islandwide End of Life Co-ordination Centre. We hope to secure funding and move forward as soon as possible during the next year. This new centre will be based at Earl Mountbatten Hospice and will accept referrals from General Practitioners of people who are thought to be in the last two years of life. An Earl Mountbatten end of life expert will then visit the person at home with their community key worker to undertake a formal assessment. Records will be held at the hospital via SystmOne, the new Islandwide Electronic patient record system, and people will then be reassessed at regular intervals. This will be supported by a 24/7 advice line which will also be run from the hospice and delivered by Earl Mountbatten experts
Advance Care planning facilitator Working with funding through the Commissioning for Quality and Innovation (CQUINs) payments framework, over a period of two years, this new role will work with GP practices to identify all those people living with longterm conditions, including old age and frailty as well as dementia. The person in this role will support the system to ensure that all people identified will have in place an Advance Care Plan as early as possible
Young adults transition coordinator This new post, with funding from a private trust for three years, will identify all young adults between the ages of 14 and 25 living with a life-limiting illness, across the Isle of Wight 30 |
Care plans will be agreed and centralised with key providers and Earl Mountbatten will offer regular social/ therapeutic days for young adults and their carers at the John Cheverton Centre
Education and training With funding via the Isle of Wight Better Care Fund, Earl Mountbatten Hospice will be delivering a new comprehensive Training and Education programme for all Nursing and Residential Homes as well as all Domiciliary Care providers across the Island. This will focus on four areas: leadership development, a suite of ongoing key training programmes including Safeguarding and Medicines Management, Workforce Development and preparation for CQC inspections A new Head of Education jointly hosted with the University of Southampton will help Earl Mountbatten develop a strategy and partnerships for future education delivery both locally and nationally We hope to report on the progress of these innovations in our 2017/18 Annual Review and Quality Account
SENIOR MANAGEMENT TEAM
Nigel Hartley Chief Executive Liz Arnold Director of Nursing Dr Paul Howard Medical Consultant Michael Edmonds Director of Finance
TRUSTEES
Sara Weech Chair Edward Nicholson Deputy Chair Anne Axford Carol Alstrom Alan Comer David Farnham
Dr Jane Hazeldine Director of Psychosocial Care
Nitin Pradhan
John Kempton Director of Human Resources
John Pulsford
Rosamond Poncia Sue Price Josephine Smith Philip Shears John Trotter
It has been an outstanding year for Earl Mountbatten Hospice, thanks to all the support and commitment of staff, volunteers and the Island community. We have supported and cared for more people than ever and worked hard alongside the Island’s health and social care services to make sure those at the end of their life have the best possible care in the place of their choice. We always strive to be the best we can be and so it was extremely gratifying, and a very proud moment, when the Care Quality Commission rated us as an outstanding organisation in March. Of course, that doesn’t happen without the daily efforts of so many people, all working to a common purpose and with shared values. We know that every patient and family we care for are at their most vulnerable and deserve the greatest compassion and thoughtfulness we can offer. All our staff and volunteers go above and beyond, time and time again to help ensure we always provide the best possible service. My thanks go to all of them. Much of our focus this year has been on planning and celebrating our 35th anniversary, which is such an important milestone for the Hospice. It is an opportunity – to look back and remind ourselves how far we have come, celebrate our current success and the support we have, and, importantly, look forward with our exciting plans to ensure we are sustainable for at least the next 35 years. It has been extraordinarily moving to meet and hear from hundreds of people who have, over the years, contributed to the work of the hospice and the care of Island people. There are more events and celebrations planned for the rest of 2017, when there will be further opportunities to recall memories and celebrate our success and plans for the future. I hope you will be able to join us.
Going forward, we are excited about building on our outstanding service, reaching more people and sharing our success with other providers of care, such as care homes and home care agencies. We want to make sure our facilities are fit for the future and we use our hardraised funds to the best possible effect. There will no doubt be uncertainty and challenges ahead, but with the support and commitment of the Island community alongside us we are confident we can grow from strength to strength. Finally, I want to personally thank the Island community for their unstinting support of Earl Mountbatten Hospice. It is a tough challenge to raise the £7million each year required to run the Hospice but time and time again the Island steps up and together we make it happen. Walk the Wight is an amazing example of how the Island comes together in support of the hospice – from the sponsors, the marshalls, the IW Council, to the emergency services, community groups, and not least the 7,500 participants who stepped out and raised around £300,000 last year! Earl Mountbatten Hospice is for the Island and of the Island. The Island can be very proud. Sara Weech CHAIR OF TRUSTEES
Thank you! Earl Mountbatten Hospice thanks wholeheartedly all those who have contributed so generously in support of our work in 2016/17. There are far too many people, families, groups, companies, trusts, foundations and organisations to list, as so many have been involved during this highly successful period. Of course, all those committed to supporting us have our sincerest gratitude; both from everyone at the hospice and from all of those who are affected by our work. Thank you to all the people who have given us their consent to publish their stories in our Annual Review.
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Earl Mountbatten Hospice
“Many people are afraid of those who are dying. They are afraid of their own incompetence and clumsiness, of their inability to say the right and helpful word, and consciously or unconsciously, they fear their own mortality. So the dying person is left alone with his illness, all too often alone with the truth from which others are persuading themselves they are protecting him. The sighted find the blind make them too uncomfortable and they avoid them. The living stay away from the dying and isolation may be the greatest suffering these people have to endure” Dame Cicely Saunders | FOUNDER OF THE MODERN HOSPICE MOVEMENT 1918 – 2005 *2017 marks 50 years of the modern hospice movement
Earl Mountbatten Hospice, Halberry Lane, Newport, Isle of Wight PO30 2ER Tel: 01983 217301 (Main switchboard) | Email info@iwhospice.org
www.iwhospice.org
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| EMH32 Registered Charity No. 1039086 | Company No. 2929267 and Trading Company No. 3083127.
Earl Mountbatten Hospice