THE ROYAL HOSPITAL DONNYBROOK

ANNUAL REPORT & ACCOUNTS 2017 THE ROYAL HOSPITAL DONNYBROOK \ ANNUAL REPORT & ACCOUNTS 2017

CONTENTS

Structures and Committees 02 Chairman’s Statement 04 Governance 06 Chief Executive’s Report 10 Medical Director’s Report 12 Nursing Report 14 SPARC 16 PARC 17 General Rehabilitation 18 Specialist Stroke Rehabilitation 19 Specialist Neurorehabilitation 20 Day Hospital 21 Residential Care 22 Physiotherapy 23 Occupational Therapy 24 Speech and Language Therapy 26 Podiatry 26 Nutrition & Dietetics 27 Medical Social Work 28 Psychology 29 Patient/Resident Feedback 30 Summary Financial Information 31 Schools involved in Aos Óg Programme 34 and Gaisce – the President’s Award List of Governors 35 THE ROYAL HOSPITAL DONNYBROOK \ ANNUAL REPORT & ACCOUNTS 2017 THE ROYAL HOSPITAL DONNYBROOK \ ANNUAL REPORT & ACCOUNTS 2017

STRUCTURES AND COMMITTEES

BOARD OF MANAGEMENT REMUNERATION COMMITTEE 2018 HOSPITAL MANAGEMENT TEAM 2018 CONSULTANT PHYSICIAN IN STROKE MEDICINE Jerry Kelly, Chairman (retired December 2017) Robin Simpson, Chairman Acting Chief Executive Officer Dr. Tim Cassidy Robin Simpson, Vice-Chairman (Chairman from Caroline O’Shea Colm Moloney January 2018) Brendan Pigott Medical Director CONSULTANT IN Caroline O’Shea (Vice-Chair from January 2018) Dr. Lisa Cogan NEUROREHABILITATION MEDICINE Brendan Pigott, Hon. Treasurer EXECUTIVE COMMITTEE 2018 Director of Nursing Dr. Paul Carroll Rev. Alastair Graham Robin Simpson, Chairman Evonne Healy David Gunning (joined September 2017) Caroline O’Shea Financial Controller CONSULTANT PHYSICIANS IN Rev. Canon Sonia Gyles (joined November 2017) Brendan Pigott GERIATRIC MEDICINE Colm Moloney Tom Hayes Conor O’Connor Dr. Lisa Cogan Miriam Hillery David Gunning Occupational Therapy Manager Cllr. Frank Kennedy (nominated by City Colm Moloney Jo Cannon Dr. J. J. Barry Council) Physiotherapy Manager Dr. Morgan Crowe Dorothy MacCann (joined February 2017) CLINICAL GOVERNANCE COMMITTEE 2018 Barbara Sheerin Dr. Nichola Boyle Cllr. Paddy McCartan (nominated by Dublin City Deirdre-Ann Barr, Chair Council) Principal Medical Social Worker Dr. Lisa Cogan Bernadette Casey Prof. Geraldine McCarthy Dr. Morgan Crowe Michele McCormack (joined November 2017) Operations Manager Dr. Tim Cassidy The Royal Hospital Donnybrook is a Conor O’Connor Conor Leonard Dr. Paul Carroll registered charity. Oisín Quinn Miriam Hillery Human Resources Manager Charities Regulatory Number: 20001605 Philomena Shovlin (retired May 2017) Prof. Geraldine McCarthy Sharon Lawlor The hospital’s Annual General Meeting will be AUDIT COMMITTEE 2018 Michele McCormack Corporate & Clinical Affairs Manager held on Tuesday 29th May 2018 at 5.30pm in the Donald McShane Denise Heffernan hospital’s Concert Hall. Conor O’Connor, Chairman Rev. Canon Sonia Gyles Alan Gough Colm Moloney Brendan Pigott Evonne Healy Katrina Strecker MISSION COMMITTEE 2018 NOMINATIONS AND GOVERNANCE COMMITTEE 2018 Rev. Alastair Graham Robin Simpson, Chairman Heather Tennant Miriam Hillery ESTATES COMMITTEE 2018 Cllr. Frank Kennedy Dorothy MacCann Caroline O’Shea Caroline O’Shea Colm Moloney Conor Leonard

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CHAIRMAN’S STATEMENT

I wish to thank our hospital The Friends of the Royal Hospital Donnybrook management, staff and volunteers have had a successful year with Oisín Quinn as for their dedicated service over the Chairman and they have planned a full schedule of events to support the hospital in its mission. past year. Their 2017 golf outing raised a record sum and the next golf outing will be held on Tuesday, 3 July One of the first tasks that Caroline O’Shea and I 2018. Towards the end of the year, your Board undertook after becoming your Vice Chairman and transferred the bulk of the hospital’s private funds Chairman was a full tour of the hospital. We were to the Friends. This means that all our funds can humbled by seeing a team of dedicated women and now be managed and allocated for the benefit of men continuing to make such a difference to the patients as a single entity. lives of so many vulnerable people. This team effort After a long lead time, we were pleased to welcome stands at the centre of the high standard of care During 2017, our Director of Nursing, Olivia provided by The Royal Hospital Donnybrook (RHD) Sinclair, and our Chief Executive Officer, Irene Leo Varadkar and Minister Eoghan Murphy to a for many years. On your behalf and on behalf of Frazer, resigned from the hospital and we wish the Board of Management, I wish to thank our them well in their new careers. We would like to sod-turning ceremony for a new development in Beech Hill, hospital management, staff and volunteers for extend a warm welcome to Evonne Healy as our Donnybrook. This will provide much needed social sheltered their dedicated service over the past year. Your new Director of Nursing. We hope to announce the Board will support our management and staff in appointment of a Chief Executive Officer before housing in the area. their efforts to maintain this standard in the years too long. We greatly appreciate the work that ahead. Colm Moloney and Patricia O’Reilly have been undertaking in fulfilling the responsibilities of In the light of this team dedication, it was most these two posts while they have been vacant. disappointing that we had to close beds for the second year in a row because of a lack of funds. We were delighted to welcome David Gunning, By the time that funds were made available, it was Michele McCormack and Sonia Gyles to the Board too close to Christmas to recruit staff to re-open of Management and to welcome Deidre-Ann Barr beds and this was further delayed by an influenza as Chair of the Clinical Governance Committee outbreak early in the New Year. As a result, the during 2017. Regretfully, I record the retirement of hospital had beds closed during the usual January Jerry Kelly as Chairman and Phil Shovlin from the acute hospital bed crisis. We will continue to Board. We will all miss their collegiate spirit and work with the HSE to try to avoid this regrettable their wise counsel. situation arising in future years. Finally, I would like to thank all members of the The RHD Housing Association’s provision of Board of Management and its Committees for their housing for older people with rehabilitation support and hard work during the year. I can only supports continues under the chairmanship of hope that the Independent Review Group recently Derek Scally. After a long lead time, we were appointed by the Minister for Health will pleased to welcome Taoiseach Leo Varadkar understand the enormous commitment and and Minister Eoghan Murphy to a sod-turning contribution that volunteerism makes to our ceremony for a new development in Beech Hill, health services. Donnybrook. This will provide much needed social sheltered housing in the area. Robin Simpson Chairman

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GOVERNANCE

The Royal Hospital Donnybrook (RHD) was founded in 1743 and is one of the oldest charities in . It received its Royal Charter in 1800 and is BOARD MEMBERS’ ATTENDANCE consequently a charter corporation. The Bye-laws of the RHD can only be For Period 01/01/17 to 31/12/17 changed by decision of the Governors with the consent of the Oireachtas.

The Governors of the RHD are drawn from There is a comprehensive committee structure the local community. At AGMs, the Governors with written Terms of Reference for each of the receive the annual report and accounts and elect following Board committees

the Board of Management. n Executive Committee

The Bye-laws permit the Governors to elect up n Nominations & Governance Committee

n OF BOARD MANAGEMENT EXECUTIVE COMMITTEE AUDIT COMMITTEE to 25 persons to the Board of Management. Audit Committee NOMINATIONS & GOVERNANCE COMMITTEE REMUNERATION COMMITTEE CLINICAL GOVERNANCE COMMITTEE MISSION COMMITTEE ESTATES COMMITTEE However, in line with current best practice, the n Clinical Governance Committee Board has been reduced in recent years. Today, 5\7 2\2 n Remuneration Committee Rev. Alastair Graham there are 12 members elected by the Governors 3\3 n David Gunning and two members nominated by Dublin City Mission Committee 2\2 1\1 Council for election by the Board. The Board meets Sonia Gyles not less than five times per year. There is a written The attendance record of the Board Members at Tom Hayes 4\7 2\2 statement of the Reserved Powers of the Board. All Board meetings and committee meetings during Miriam Hillery 7\7 3\3 5\5 elected members of the Board are volunteers and 2017 is shown in the chart opposite. do not receive any fees or expenses for attending Jerry Kelly 7\7 3\3 3\3 1\1 Board meetings or undertaking other work on Cllr. Frank Kennedy 7\7 1\1 behalf of the RHD. Dorothy MacCann 5\5 0\1 Cllr. Paddy McCartan 5\7 Prof. Geraldine McCarthy 4\7 4\5 Michelle McCormack 2\2 0\1 Conor O’Conor 6\7 1\1 3\3 Caroline O’Shea 7\7 3\3 2\2 Brendan Piggot 3\7 1\3 1\3 0\1 Oisín Quinn 6\7 Philomena Shovlin 2\3 2\2 4\5 Robin Simpson 7\7 3\3 2\2 3\3 1\1

Member does not sit on this committee

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GOVERNANCE / continued Risk Management is a standard item on the agenda for every

An internal evaluation of the Board of Management 5.4 Procurement Policy Board meeting. The Board is satisfied it has appropriate risk and the Board committees was undertaken in 2017. 5.5 Internal Audit management and other internal controls in place to ensure the The resulting recommendations were accepted by 5.5.1 Internal Audit Charter the Board. 5.5.2 Internal Audit Programme safety of patients and the appropriate control of expenditure. Overview Risk Management is a standard item on the 5.5.3 Internal Audit Three Year Plan agenda for every Board meeting. The Board is satisfied it has appropriate risk management 6. NOMINATIONS & GOVERNANCE and other internal controls in place to ensure the 6.1 Board Nominations Procedures safety of patients and the appropriate control of 6.2 Nomination Criteria expenditure. 6.3 Induction Programme The RHD has a Code of Governance Manual which 6.4 Re-election of Board Members has the following contents: 6.5 Procedure for Appointment of Governors 1. STATUTORY INSTRUMENTS AND BYE-LAWS FOR 7. HEALTH SERVICES EXECUTIVE THE MANAGEMENT OF THE HOSPITAL 7.1 Service Level Agreement (SLA) – 2. PRINCIPAL DUTIES OF BOARD MEMBERS Introduction 3. ETHICAL BEHAVIOUR 7.2 SLA Compliance Procedures 3.1 Code of Conduct 7.3 Annual Compliance Statement 3.2 Protected Disclosure 7.4 S.13.1 Code of Practice for the Governance of State Bodies 4. BOARD OF MANAGEMENT 4.1 Standing Orders of the Board A copy of the Code of Governance Manual is given 4.2 Reserved Powers of the Board to all new members of the Board and Committees as part of their induction programme. All staff and 4.3 Terms of Reference of Committees of the Board Board members are required to sign the Code of Conduct on appointment. 4.4 Annual Conflict of Interest & Eligibility Letter The RHD derives most of its income from the 5. RISK MANAGEMENT Health Service Executive with which it has an annual Service Arrangement. Employees of the 5.1 Risk Management Overview hospital are subject to public pay policy guidelines 5.1.1 Risk Management Historical and regulations. The RHD complies with such Background guidelines and regulations. No member of staff was 5.1.2 Risk Management Policy in receipt of any payments from donations received 5.1.3 Annual Report on Risk Management by the RHD or via The Friends of the Royal Hospital 5.2 Clinical Governance Donnybrook during 2017 or prior years. 5.2.1 Clinical Governance Overview Ongoing compliance with public pay policy is 5.2.2 Annual Clinical Governance Report monitored by the Remuneration Committee and a 5.3 Financial Procedures report is provided annually by the Internal Auditor 5.3.1 Financial Procedures Overview to the Audit Committee. 5.3.2 Financial Procedures Manual

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“The RHD will consult with members of the voluntary hospitals’ group to ensure that the special contribution being made by the voluntary sector to healthcare in Ireland is clearly set out to the Independent Review Group CHIEF EXECUTIVE’S REPORT which has been set up by the Minister.”

The Royal Hospital Donnybrook (RHD) provides strain in 2017. We commenced the year with the Independent Review Group which has been The hospital continues to work with the Health a team based care environment for its patients a significant reduction in funding and with a set up by the Minister. Service Executive, related hospitals, patients and and residents. The multidisciplinary team continual growing demand for the services we their families, to provide the best experience and consisting of medical, nursing, health and social provide. This resulted in increased pressure on Both now and in the future, The Royal Hospital care possible. care professionals work tirelessly to enhance the staff. With continuous and ongoing consultation Donnybrook will continue to rely on donations lives of those under our care. with the Health Service Executive, the hospital and support to ensure that it can continue to Colm Moloney secured additional funding for the hospital’s fund research and capital projects which will Acting Chief Executive Officer Through continuous improvement and quality services, and was able to achieve an effective enhance the comfort and amenities of patients initiatives, there is a focus on developing a care break-even financial position at the end of 2017. and residents at The Royal Hospital Donnybrook. environment that enhances our patients’ and In spite of the difficulties, the hospital has managed As always, the hospital is grateful to The Friends of residents’ experience. The ongoing review of to maintain an excellent patient-focussed service. The Royal Hospital Donnybrook for spearheading fundraising initiatives on behalf of the hospital. our performance and the quality of our care It is a privilege to work with staff and management through audits, reviews, metrics and risk registers who, working within challenging constraints, provides transparent results in the quality of The hospital is lucky to have an exceptional group provided ongoing support to patients/residents care we provide. of volunteers dedicated to the hospital and its and to each other. Our team’s dedication to patients residents/patients. They continue to enhance the I would like to acknowledge all members of and residents is the reason we get such great lives of all patients and residents within the management and staff involved both directly and outcomes and feedback on the service we provide. hospital and I would like to take this opportunity indirectly in the committees and working groups to thank them for their ongoing support. Pay restoration under the Financial Emergency that keep us quality focussed and keep patients and Measures in the Public Interest Act 2015 (FEMPI) residents safe. I was appointed as Acting CEO on will be a significant cost driver in health funding 15th December 2017 and I would like to thank the for 2018. Accordingly, overall budgets, including outgoing CEO, Irene Frazer, for her assistance to funding for non-pay and capital items, will remain me in my new role. challenging for 2018. In June 2017, the hospital secured re-registration by the Health Information Quality Authority There is an increasing focus on the voluntary (HIQA) as a designated centre for residential sector of the health services. In July 2017, care of older persons. Funded early in 2017 by Minister for Health, Simon Harris TD, announced the RHD’s own funds, the development and the establishment of an independent review group refurbishment of a new ward for our under 65 to examine the role of voluntary organisations in year old long term care patients (the Rowans Ward) the operation of health and social care services in was acknowledged and welcomed by HIQA. Ireland. The terms of reference provide for The Rowans Ward accounts for 12 of the hospital’s n An examination of current arrangements 66 residential care beds. across the health and social care sector

n Concerns highlighted by HIQA specifically related Consideration of issues currently arising, and to the environment and the remaining five-bedded those likely to arise in the future units, which impact the residents’ dignity and n Recommendations on how the relationship privacy. Discussions are ongoing with the HSE between the State and voluntary regarding the provision of funding to refurbish organisations should evolve in the future. these areas and reduce the number of beds in multi-occupancy rooms in line with HIQA The RHD will consult with members of the standards. voluntary hospitals’ group to ensure that the special contribution being made by the voluntary The hospital experienced another year of financial sector to healthcare in Ireland is clearly set out to

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MEDICAL DIRECTOR’S REPORT We continue to improve the clinical pathway for our patients

The core philosophy of care that transferred to SVUH. With the support of our End who become medically unstable and need access to is provided to all our patients of Life Working Group, advanced care planning specialist care in St. Vincent’s University Hospital (SVUH). discussions have been facilitated. The majority of and residents here in The Royal our residents die here with an end of life care plan Hospital Donnybrook (RHD) is based in place and in a single room when available. on Comprehensive Geriatric Assessment (CGA). Our Maples Unit provides a neurorehabilitation programme for younger adults with complex A consultant geriatrician-led multidisciplinary neurological, medical and physical disabilities. service is provided to our rehabilitation patients This service is led by a Consultant in Rehabilitation and residents in residential care. Medicine. A dedicated multidisciplinary therapeutic assessment rehabilitation programme is accessed CGA is fundamental to the assessment, planning by community dwelling patients with Multiple and intervention required to meet the health and Sclerosis (MS). This is called the ‘Living well with social care needs of all older people receiving MS’ programme. A respite service of two beds is care. CGA improves diagnostic accuracy and also provided in this unit. optimisation of medical and rehabilitation treatment. It improves functional outcomes The outpatient Day Hospital programme resulting in reduced complications of hospitalisation continues to provide time limited (usually 6-10 and facilitates effective discharge planning. The weeks) rehabilitation to older patients living in older patient group that are being admitted to the the community. The aim of this programme is to acute hospitals, and subsequently on to us for maximise independence and enable and support rehabilitation, have an increasing number of people living at home. The principal diagnoses comorbidities with multiple medical conditions of patients accessing this service are Stroke, often accompanied by frailty and dementia. Parkinson’s disease and rehabilitation following a The majority, two-thirds, of our rehabilitation fragility fracture. patients are referred with falls and fragility fractures from the orthopaedic service in The RHD remains a designated university teaching St. Vincent’s University Hospital (SVUH). Pain centre for the UCD Medical School with 2017 being management, rationalisation of medications the eighth year of the “Medicine in the Community” and stabilisation of medical conditions are core module. Feedback from students remains positive, components of medical care. We continue to especially in relation to the time students had to improve the clinical pathway for our patients interview patients and residents. Students reported who become medically unstable and need access a better understanding of the frail older person and to specialist care in SVUH. the importance of multidisciplinary rehabilitation. They particularly benefitted from the dedicated In our older residential care services, CGA focusses teaching sessions they received from nursing and on the provision of individualised care plans for health and social care professionals. A number each resident. There is an emphasis on maintenance of successful collaborations between nursing and rehabilitation with particular attention to seating medicine were progressed this year. This included and positioning. This maximises function and the successful introduction of “Hello my name is” reduces complications such as pressure ulcers campaign and Schwartz ™ Rounds to the hospital. and pain. Many of our residents have complex Both these initiatives focus on the importance of neurological conditions. Where possible, all supporting our staff in giving compassionate care. medical complications are managed on site. Residents who develop acute medical or surgical Dr. Lisa Cogan conditions that require specialist intervention are Medical Director

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DIRECTOR OF NURSING REPORT

Throughout 2017, our commitment feedback for improving our residents’ experience. are fortunate that, once a month on a Sunday, we to deliver high quality, safe and welcome vocal talent into our Concert Hall. A number of significant quality improvement person-centred care to patients and initiatives have been undertaken throughout the Embracing the significance of overall holistic residents with complex healthcare year; one of these was the “Hello My Name Is” healthcare, Pastoral Care attends to the spiritual needs remained our focus. Continuous campaign. The aim of this project is to improve and emotional needs of residents, patients, their professional development, education communication between staff and patients and families and staff. Pastoral Care is available to and training for all staff continued to promote person-centred and compassionate care. people of all faith traditions or none and every Led by the Nursing Quality Manager, the Schwartz effort is made to support people in a way that be a priority. Rounds were introduced to the hospital. These is meaningful and significant for them. Support Rounds are a forum for all staff to come together is provided through visiting, listening, ‘being The Health Information and Quality Authority once a month to discuss, reflect and understand present’ to what the person is uniquely experiencing, (HIQA) carried out an inspection of our residential the challenges and rewards that are intrinsic to prayer, accompaniment at times of challenge, units for older people in May 2017. The purpose providing care. serious illness and death. In partnership with other of the inspection was to inform the decision of the disciplines, Pastoral Care endeavours to ensure that Authority in relation to the hospital’s application We participated in Project ECHO (Extension for our residents, patients and their loved ones, feel to renew the registration of our residential units. Community Healthcare Outcomes). The project supported, understood, respected and valued here The monitoring inspection was announced and aim was to support the knowledge, build skills and at The Royal Hospital Donnybrook. took place over two days. The inspection report confidence of nursing staff in managing residents was positive in relation to residents’ health and with life-limiting conditions. The Hospital Chaplain is supported by visiting social care and the residents’ safeguarding and chaplains of a variety of denominations who safety. The inspector was satisfied that there Led by our Risk Manager, we continue to actively provide religious services each week. We also have was evidence of good governance structures in manage risk both clinical and non-clinical and a team of Eucharistic Ministers and volunteers place and that the hospital was compliant in facilitate patient and resident safety by promoting who facilitate patients and residents in receiving health, safety and risk management. However, a culture of proactively monitoring and analysing the sacrament of Holy Communion and attending environmental concerns relating to multi-occupancy information from incident reporting, incident religious services of their choice. rooms, which impact on the residents’ dignity and reviews, satisfaction surveys, risk registers and rights, were raised. through audit. Our Risk Management Policy is in Patricia O’Reilly line with the HSE Integrated Risk Management Interim Director of Nursing Central to our approach to quality and safety is the Policy 2017. focus of capturing the experience of our patients and their families. Throughout the year, service Over the year, we have welcomed many new user experience surveys were carried out across all volunteers who continue to be committed, giving rehabilitation wards. These are used by the heads of their free time to support and enhance the Central to our approach of department and ward teams to inform quality quality of life for our patients and residents. improvement where appropriate. The results of the to quality and safety is the surveys are discussed at ward level and feedback We are fortunate to have the involvement of focus of capturing the given to the patients through the “You Said We transition year students on social placements to the Did” template. hospital. We have at least six students volunteering experience of our patients each week throughout the academic year. Some of Our complaints process provides our residents these continue to participate in the Aos Óg and their families. and patients with an opportunity to express any Programme Gaisce - The President’s Award. concerns and provide us with feedback if their experience has not been optimal. The Residents’ The recreational activities team continues to Council and Family Forum continued to meet provide a range of social and recreational activities throughout 2017 and provide us with useful and events throughout the year. In addition, we

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SPARC PARC Short-term Post-Acute Rehabilitative Care Post-Acute Rehabilitative Care

The SPARC unit delivers rehabilitation for patients The continued development of the SPARC service The PARC unit is one of the five consultant-led The initiative resulted in patients being more over 65 years of age who are medically stable has relied on a successful collaboration between rehabilitation facilities in the hospital that provides empowered in their progress and encouraged and fit for discharge from acute hospital care. The our colleagues in the acute hospitals as well as rehabilitation services following an acute hospital family members’ involvement. This also motivated majority, two-thirds, of our rehabilitation patients community services. A dedicated monthly fracture stay with the aim of optimising patients’ functional and increased the patient’s determination to have been referred from the orthopaedic service pathway meeting in SVUH, attended by members level of independence. The unit offers a rehabilitation recover. in St. Vincent’s University Hospital (SVUH). These of the SPARC team and the SVUH orthopaedic programme to female patients age over 65 who include hip fracture and other fragility fractures team, continues to improve the flow of orthopaedic require a further period of inpatient care from A service user experience was conducted twice such as suprapubic ramus, vertebral and cervical patients to the unit. three to six months enabling them to be discharged within the year which yielded a very positive fractures. These patients benefit from coordinated back safely to their own homes and community. response to the care being provided in the unit. multidisciplinary care to maximise their functional Noreen Frawley The success of the PARC unit in its efficient delivery status and the team facilitates a smooth transition Clinical Nurse Manager Individualised patient-centred care and a dedicated multidisciplinary team are fundamental in of patient care relies on the ability to work together home. achieving the aim of the unit. These structures are as a team. Effective teamwork creates a positive impact on a patient’s recovery and well-being. The philosophy of the SPARC unit is to provide key to the provision of the service. To be able to the highest standard of care to every patient every facilitate this, the multidisciplinary team holds a Cherry Almonicar time. The anticipated length of stay on the SPARC weekly comprehensive meeting with the patients’ involvement. Patients are encouraged to participate Clinical Nurse Manager unit is four to six weeks. in setting their individualised rehabilitation goals All patients receive a pre-admission assessment; with due regard to their specific needs. The multi- this is carried out by either the Medical team or disciplinary team collectively assesses and regularly the Clinical Nurse Manager to ensure the patient reviews each patient’s progress to ensure delivery of a structured and patient-centred plan of care. would benefit from a dedicated period of SPARC UNIT PARC UNIT rehabilitation. DISCHARGE DESTINATIONS 2017 Seeing patients achieving their set goals and DISCHARGE DESTINATIONS 2017 returning to their functional level of independence In SPARC, the multidisciplinary team meets is both rewarding and fulfilling. Where discharge twice weekly and an individualised rehabilitation home is not possible, the team provides support programme is coordinated for each patient. All to the patient and family in deciding on appropriate patients receive medical, nursing, physiotherapy alternative placement options. and occupational therapy input and are referred to medical social work, speech & language therapy, In the first quarter of 2017, nursing quality profile nutrition & dietetics and the wound viability nurse was introduced in every unit as part of clinical based on clinical need. 86% quality improvement. The emphasis is on 88% HOME continuous delivery of high standard and good HOME The process of care also includes referral and quality patient care that is person-centred, safe, follow-up with mainstream hospital services effective and leads to better health and well-being. such as orthopaedic outpatient and geriatric day hospital programmes, community health and social In April, a physiotherapy initiative called care professionals, social work. On discharge, a “Physiotherapy Plus” was introduced in the PARC detailed multidisciplinary report summarising all unit; this is an add-on to the patient’s rehabilitation medical interventions such as medication changes timetable wherein each patient receives a tailored and investigations as well as assessment reports on exercise programme which aims to: cognition, balance, nutrition and functional score n Develop strategies to empower patients to be 6% 6% is completed. This is sent to the patient’s GP, the 8% 6% ACUTE OTHER active ACUTE OTHER referring hospital consultant and the Public Health HOSPITAL n Increase levels of physical activity for patients HOSPITAL Nurse. A hard copy is given to the patient. n Entice patients to be active within and outside their bed environment

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GENERAL SPECIALIST STROKE REHABILITATION REHABILITATION

The General Rehabilitation unit provides n Health promotion and education given by The primary goals of stroke rehabilitation are to the therapists on the stroke unit, launched the first rehabilitation services to older adults (65 years the MDT to patients in order to meet their encourage and foster functional improvement ever stroke survivor support group for people under and above) with complex needs. There is a specific needs. and neurological recovery. Organised stroke care, 65 years of age in Ireland. It was a tremendous multidisciplinary team approach and through team processes of care, early timing of rehabilitation success and the patients have since met and the n Working closely with undergraduates assessments and rehabilitation, the team facilitates and high intensity of rehabilitation therapies are IHF has organised interactive activities and group in Nursing, Occupational Therapy, patients in achieving their maximum potential in important factors which have been identified as sessions for those interested. Physiotherapy, Nutrition and Dietetics, the physical, social and psychological aspects of promoting better overall outcomes for individuals Speech and Language Therapy, and Medical their wellbeing, ensuring dignity and respect at all with stroke. A patient satisfaction survey was carried out three Social Work. times. When a patient’s condition improves, the times in 2017. Patients were asked to rate their team ensures that they are integrated into their Effective stroke rehabilitation programmes are experience overall on a scale from 1 to 10, whereby Mary Mae Salomon most appropriate environment. In addition, the characterised by a multidisciplinary team working 10 equalled “I had a very good experience” and Clinical Nurse Manager unit provides short term respite admissions, cohesively and closely to provide a comprehensive 0 equalled “I had a very poor experience”. rehabilitation boosters, maintenance rehabilitation rehabilitation programme for each patient. These The average rating given by patients was 8.8. and urgent admission from our Day Hospital. programmes vary in terms of the types of therapies offered as well as their intensity and duration. Ramya Ravikumar Last year, an additional respite care bed was added Clinical Nurse Manager to the existing two respite beds on the unit which The stroke unit embraced a number of initiatives in facilitate respite care for older adults in the 2017 including: community. The provision of respite care provides n Stroke exercise classes for patients, facilitated a much needed break for carers. by the physiotherapy team, three times a week. Where discharge home is not possible, the team GENERAL REHABILITATION supports patients and families in considering other n Use of the Graded Repetitive Arm STROKE REHABILITATION options. DISCHARGE DESTINATIONS 2017 Supplementary Programme (GRASP) to help DISCHARGE DESTINATIONS 2017 strengthen a weak/affected arm following The general rehabilitation team continued to a stroke. This programme was facilitated by maintain the highest standard of care by: the occupational therapy and physiotherapy n Multidisciplinary (MDT) in-house education departments. sessions; relevant topics were chosen and n Education sessions for stroke patients and this had a great impact on the delivery of family members. The sessions were 30 care. minutes long and ran twice weekly for six n Exploring the use of powered mobility 92% weeks. Each member of the multidisciplinary HOME 88% options for suitable patients. team presented a stroke related topic to the HOME patients and their relatives/carers. n Providing nurses with education on various n physiotherapy aids and devices to facilitate Group talking sessions, once a week, patients’ independence. organised by the Speech and Language Therapy department. n Accessing spasticity services as required A lack of community support for patients under n Continence Promotion the age of 65 years of age discharged from hospital n Infection Control Prevention post recovery was highlighted by all younger 3% 5% patients admitted to the unit. In September 2017, ACUTE OTHER 6% 6% the Irish Heart Foundation (IHF), in conjunction ACUTE OTHER HOSPITAL with the patients discharged from the RHD and HOSPITAL

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SPECIALIST NEUROREHABILITATION DAY HOSPITAL

The Specialist Neurorehabilitation unit provides a disabilities. We took this opportunity to share The Day Hospital facilitates up to 25 clients per specialised neurological service for adults under information and strengthen links as this centre day, providing an essential community service that 65 years of age with varying degrees of disability. has become one of our referral sources, along with enables people to stay safely in their own homes The multidisciplinary team, led by a Consultant St. Vincent’s University Hospital, the National while reducing acute hospital admissions. in Rehabilitation Medicine, caters for patients who Rehabilitation Hospital, and the community. Our have experienced a sudden decrease in their ability aim is to develop a better understanding of what We provide medical, nursing and therapeutic to look after themselves following an acute our patients need, and enhance our rehabilitation interventions for people living in the community neurological episode, as well as providing a services to enable people with disabilities and their who have ongoing health and rehabilitation needs. programme for patients with general deconditioning families/carers to maintain their independence It is an easily accessible service that aims to who have a chronic neurological condition. within their own communities. promote patients’ independence, health and well-being. The work is undertaken by a Our philosophy of rehabilitation is to work Elaine Foley multidisciplinary team committed to rehabilitation, with our patients to help restore and maintain Clinical Nurse Manager health education and empowerment of the service the best possible level of functioning which will users. enable them to achieve their life goals. Our multidisciplinary team works with them, their The majority of the referrals come from families and friends to achieve their goals St. Vincent’s University Hospital as well as other throughout their rehabilitation stay. south Dublin hospitals and GPs. The team is also part of an essential support network to the RHD The “Living well with MS” (multiple sclerosis) patients and their families/care givers following programme continued throughout 2017, providing discharge from the RHD inpatient rehabilitation individuals with MS access to therapy specific to SPECIALIST NEUROREHABILITATION units. Clinical areas of expertise in the Day their symptoms as well as providing practical advice DISCHARGE DESTINATIONS 2017 Hospital are falls prevention, Parkinson’s disease and access to the services they need in order to treatment and assessment and treatment of successfully manage their disabilities. cognitive/memory impairment.

During the year, the team forged links with the We have a good working relationship with local MS Society, invited a research group from UCD to community services which helps ensure patients talk about a care planning day for carers/families are given all possible assistance to maintain of patients with MS. In November 2017, the team independent living and a good quality of life. We have a good working visited the Springfield Centre in Co. Westmeath. Attendance levels during 2017 remained high and relationship with local This centre combines work, education, and leisure 95% an increase in the demand for the Day Hospital pursuits with assessment, rehabilitation, and care HOME services was recorded. community services which needs for its service users with physical and sensory Maura Fitzgerald helps ensure patients are Clinical Nurse Manager given all possible assistance to maintain independent living and a good quality of 5% life. OTHER

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RESIDENTIAL CARE PHYSIOTHERAPY

Led by the Clinical Nurse Managers, the residential Palliative Teams. Our Hospital Chaplain provides While many of us face challenges in managing the strength exercises is facilitated on the ward by the care wards in the Cedars, Oaks and Rowans units invaluable support to each resident and their delivery of a high quality clinical service within physiotherapy team. continue to deliver a high standard of individualised, family during their time with us. the Irish health system, 2017 saw an energised holistic, person-centred care to our residents Physiotherapy Department committed to ensuring DAY HOSPITAL: A pilot Parkinson’s neuro fitness maintaining dignity and respect in the care process. The multidisciplinary team has worked tirelessly that physiotherapy within the hospital is based class incorporating large amplitude exercise and to provide the best quality care possible for our upon the latest research, evidence based practice circuit training proved very successful. Dance This care is provided by our multidisciplinary residents with the support of Pastoral Care and the and continual professional development. and Tai Chi classes have also been introduced in team comprising nursing, medical, and health and Volunteers, providing for the spiritual, emotional the Day Hospital, based on emerging evidence on social care staff. Our nursing care is measurable and social needs of the residents. Within the rehabilitation sections of the hospital, the efficacy of dance and Tai Chi on balance and and quality assured by assessment and audit in best practice in physiotherapy is being adhered to mobility. conjunction with our Nurse Quality Manager and Currently, there are different activities provided for by using outcome measures that are recommended our Tissue Viability and Risk Manager. each resident tailored to their needs, a multisensory by the National Clinical Hip Fracture Database. STROKE UNIT: A dedicated stroke exercise class session is in place for the minimally-responsive running three times a week commenced in 2017. The service is measured against the Health residents and some meaningful activities were There has been a concerted effort across the Thirty six patients attended, their ages spanned Information Quality Authority’s (HIQA) National provided by the volunteers to suit the individual department to augment treatment beyond one to from 18 – 95 years. Feedback from all the patients Standards for Residential Care Settings for Older needs of each resident. A new hairdressing service one physiotherapy sessions through the provision was overwhelmingly positive as they felt the People in Ireland. The most recent HIQA inspection provides the residents with greater choice as to of regular physiotherapy led group exercise classes. benefits of increased physical activity, social took place in May 2017. where they get their hair done, if they wish to visit These new initiatives have been introduced in the interaction and peer support. In addition, we all ‘the Salon’ downstairs or remain on the ward. following areas of the hospital: enjoyed the upbeat sound of music emanating The Rowans unit, previously called Phoenix, was from the department at the end of the day. extensively refurbished in 2017 to bring it in Anne Dooley STROKE UNIT: A Graded Repetitive Arm line with the HIQA standards. Each resident was Clinical Nurse Manager, Cedars Supplementary Programme (GRASP) has been Continual professional development has been at involved in the planning and decoration for their introduced twice a week, the aim being to improve the forefront of our minds with impending State room. They were consulted and their preferences Dileta Zibaite hand and arm function for people living with Registration for all the ’s in terms of decor/colour scheme for the room were Clinical Nurse Manager, Oaks stroke. This is a joint initiative working alongside physiotherapists in 2018. We continued to be considered. To showcase the residents’ talents, Sheila Ballebar our Occupational Therapy colleagues. proactive in our attendance at courses, which some of their art works are on display in their Clinical Nurse Manager, Rowans included: NEUROREHABILITATION: Research is ongoing into rooms. n the area of respiratory assessment and monitoring The Stroke Forum in the UK Our residents are invited to participate in the of patients with progressive neurological diseases n The Irish Association of Rehabilitation Residents’ Council meetings which take place every such as Multiple Sclerosis. Links have been made Medicine two months. The Residents’ Council empowers with Beaumont Hospital Neuro Respiratory Clinic n residents to speak out with their views and with a view to establishing protocols in the The Irish Stroke Conference represent their wishes and influence decisions treatment of these patients with respiratory needs. n The National Clinical Audit Hip Fracture regarding their care environment and associated Symposium care needs. PARC (Post Acute Rehabilitative Care): A pilot scheme was introduced to promote appropriate Once a month, we hold a journal club to critique Family Forum meetings are facilitated at ward level You have a great staff team ward based guided physical activity outside the relevant contemporary articles in order to inform where family members and residents meet with patients’ scheduled physiotherapy time. Nursing best clinical practice. the staff and exchange information regarding here and they work very hard and care staff on the ward and family members the designated centre, the facilities and services were involved in this initiative and feedback from We are constantly striving to improve our services available, complaints, suggestions and upcoming - Resident’s Feedback the patients was very positive. and are continuously researching and exploring events. innovative practices and equipment. SPARC (Short-term Post Acute Rehabilitative Care): We also provide quality End of Life Care and A weekly ward based exercise class with a focus on Barbara Sheerin maintain links with the Hospice Community and hip rehabilitation, balance training and general Physiotherapy Manager

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Occupational Therapists focus on identifying and eliminating environmental barriers to independence and participation in daily activities by adapting the OCCUPATIONAL THERAPY environment, modifying the task and teaching new skills.

Occupational Therapy (OT) is the use of We have seen positive results on a patient self Feedback from Occupational Therapists has been assessment and treatment to develop, recover, rating scale of their ability to use memory extremely positive and it has opened up a whole or maintain the daily living skills of people with strategies. This work was presented at the Older new treatment modality for engaging patients. physical, functional, or cognitive impairments. Persons Advisory Group Forum last November in Occupational Therapists focus on identifying and Harold’s Cross Hospice. FUTURE PLANS eliminating environmental barriers to independence n Training of two Occupational Therapists Multidisciplinary Group Based Therapeutic Programme and participation in daily activities by adapting the in carrying out LSVT – Parkinson’s disease - Fatigue Management for People with Multiple environment, modifying the task and teaching new Therapy which will enhance the service in the Sclerosis (MS) skills. Day Hospital. Up to 80% of patients diagnosed with MS report n Joint bid with Physiotherapy for an Andago OCCUPATIONAL THERAPY INITIATIVES IN 2017 fatigue as one of their most significant symptoms. Mobile Gait Trainer. This could potentially A group based Fatigue Management Programme External Rotation agreed with St. Vincent’s University look at facilitated movement during comprising of cognitive behavioural strategies Hospital functional tasks earlier in a patient’s alongside energy effectiveness techniques We are delighted to have been able to secure, as rehabilitation continues in our neurorehabilitation service. The part of the Basic Grade Occupational Therapist programme aims to normalise the experience of rotation, an external rotation to St. Vincent’s Jo Cannon fatigue for patients and teaches them ways to use University Hospital. This commenced at the end of Occupational Therapy Manager available energy more effectively. Statistically, October 2017. This is a wonderful opportunity to significant outcomes have resulted from this work share learning and work collaboratively across the and patient feedback has been hugely positive. two hospital sites.

Task – Specific Upper Limb Training for Action Van Service Neurological Impairment This is a collaborative approach to patient safety In June 2017, a Senior Occupational Therapist and facilitating discharges home from hospital. presented this work at the UK Stroke Forum in It is an Occupational Therapy led HSE funded Belfast. The main element of this project follows service, hosted and managed by The Royal the principles of motor learning and the therapist Hospital Donnybrook. The Occupational Therapy systematically provides knowledge of results and services within the four participating hospitals progresses task difficulty to keep participants (St. Vincent’s University Hospital, St. Columcille’s challenged, motivated and engaged. On several Hospital, St. Michael’s Hospital and The Royal standardised outcome measures, the results of this Hospital Donnybrook) complete an assessment of therapeutic input has been shown to be statistically each appropriate patient’s home environment and significant for hand function. prescribe the installation of essential equipment or minor adaptations to the home environment Jog Your Memory Group - Cognitive Rehabilitation facilitating a safer and rapid discharge. In 2017, A Memory Rehabilitation Group has been set up 332 hospital discharges and a total of 466 referrals that: have been facilitated by the Action Van service. n Provides patients with information on how Bioness Integrated Therapy System memory works We are delighted to be the first hospital in Ireland n Explores and simplifies strategies to assist to use this system. This new technology allows memory in everyday life Occupational Therapists to use a whole new n Provides education on how a healthy lifestyle treatment modality for the interactive treatment can influence memory and improve confidence of visual and cognitive impairments.

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SPEECH AND LANGUAGE THERAPY NUTRITION & DIETETICS

The Speech and Language Therapy (SLT) department A Senior Speech Therapist has completed a The role of the dietitian in the rehabilitation n To work as part of the Nutrition Steering has continued to enhance its knowledge base and supervision course run by the Association of and the continuing care process is multifaceted, i.e. Group, involving the multidisciplinary team develop its clinical skills throughout 2017. The Speech and Language Therapy in Ireland and is and the catering provider, to ensure patients n To maximise the patients’ nutritional status SLT department completed two clinical audits in putting this training into practice and developing meet their nutritional requirements with the so they are able to derive the maximum relation to: Standards of Documentation – 100% competency checklists for basic grade therapists. menus that are provided. benefit from their rehabilitation/continuing compliance with the National Hospital’s Office Consultation with the multidisciplinary teams n Standards was achieved. A Dysphagia Meal Time within the hospital continued in 2017 aiming to care programme. To facilitate dietetic students from the Dublin Institute of Technology, Kevin Street Audit has been completed and results demonstrate enhance communication access for all patients n To prevent nutrition related complications and on their Practice good compliance with the Irish National Consistency and residents. which could interfere with the ability to Placement B. Students from the Clinical Descriptors. engage in rehabilitation/continuing care, e.g. Nutrition and Dietetic Masters course in The acquisition of new standardised assessment pressure sores, excess weight. The SLT department has successfully agreed a in 2017 further enhanced the cognitive linguistic UCD were taken for placement into the partnership with St. Vincent’s University Hospital testing and treatment of our stroke patient profile n To prevent recurrence in at risk groups, e.g., RHD for the first time in 2017. to jointly run Videofluroscopy Clinics for RHD in the RHD. secondary stroke prevention. n To work on their professional, work patients. This is a very exciting development and based, self-directed and formal continued will result in quicker assessment and diagnosis of We look forward to planning further service During 2017, dietetic referrals from the professional development, in line with CORU swallowing difficulties for our patients and also developments in the forthcoming year whilst rehabilitation wards across the hospital increased (regulating Health and Social Care build on our therapists’ clinical skills. focusing on quality improvement initiatives within by 21% when compared to dietetic referrals the Speech and Language Therapy Department. from the same wards in 2016. Referrals were Professionals) requirements. Speech and Language Therapists attended a prioritised based on clinical need and nutritionally As a department we look forward to 2018 and workshop in the use of Cedar’s Information Jo Cannon assessed in chronological order. The majority of the to developing the Nutrition and Dietetic service Processing and Comprehension (Auditory) Profile Designated Line Manager for referrals were for nutrition support, e.g., enteral further in the hospital in order to improve patient (CIPCAP) – Part 2, which is a diagnostic cognitive Speech and Language Therapy tube feeding, weight loss, poor appetite and high care. linguistic test for Speech and Language Therapists Malnutrition Universal Screening Tool (MUST) working in acquired brain injury. score. Other referrals included dietary advice Zoe McDonald in relation to unstable blood glucose levels, Senior Dietitian ileostomy/colostomy dietary advice, advice re various kidney disease dietary issues, weight reduction advice, and cholesterol lowering PODIATRY dietary advice.

Podiatry is a healthcare profession that is involved faster. As Diabetes Type 2 is increasing amongst During 2017 the dietitians continued: with the diagnosis and treatment of diseases and the elderly population, podiatry provides an disorders of the lower limb and foot. In The Royal important role in educating the patient about foot n To keep outcome measure data on all Hospital Donnybrook, Podiatry aims at achieving care and encouraging regular visits to the podiatric patients who were nutritionally assessed the following goals: clinic. and advised. n n To develop dietetic resources to help with Diagnosis and Assessment Podiatry plays a significant role in preventing patient and family education; in 2017 the n Treatment minor lesions progressing to more serious dietitians designed a new weight reducing n Education and Advice systemic conditions, promoting and maintaining diet sheet to help patients lose weight. n Prevention mobility, providing comfort - all greatly enhancing the patient’s quality of life in the hospital n To give nutrition education talks to Multiple n Palliative Care Sclerosis patients and to medical students. Jo Cannon The Podiatrist provides appropriate treatment, Designated Line Manager for Podiatry advice, education and correction of biomechanical disorders thus helping the patient to rehabilitate

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MEDICAL SOCIAL WORK PSYCHOLOGY

The Medical Social Work (MSW) team provides a for social work services along with a new referral A Senior Clinical Psychologist, employed in a Complex cognitive presentations and questions social work service on referral from all areas of the form, and case allocation process. This system half time post (2.5 days), provides psychological regarding decision making ability and mental hospital including the Day Hospital and Residential identifies and prioritises patients and residents in support to patients and residents across all areas capacity. Psychology input in this area involves Care wards. receiving support. of the hospital. This service also provides a clinical specialist neuropsychological assessment, provision service to patients’ and residents’ families and of recommendations regarding rehabilitation needs Medical Social Workers engage with the patients The lack of carers available to the carer agencies carers during admission to the hospital. A range and future work or educational issues, and support and residents to support the process of adjusting in supporting patients to return home, the lack of of services are provided, including assessment, regarding significant decision-making (in accordance to illness and disability, with all the social, appropriate accommodation in the community and intervention, consultation and education, in order with the Assisted Decision Making (Capacity) Act emotional and practical implications this entails. homelessness were all major challenges for Medical to address psychological difficulties arising from 2015. Medical Social Workers also play an important part Social Workers throughout the year in planning neurological and physical illness, disability and Support vulnerable persons at risk of abuse, and in supporting families and carers. We link in with discharges. injury, and to facilitate adjustment to resulting to support care staff, and the multidisciplinary the public, community, statutory and voluntary changes in ability, relationships and identity. The team, to develop and implement safeguarding services to maximise patient independence The Residents’ Council meetings continue to majority of referrals received by the department in plans. and quality of life. The social workers provide a be facilitated by the principal medical social 2017 were from the neurorehabilitation and stroke person-centred approach to care planning which worker. These meetings are held quarterly where units and the remainder were from Residential During 2017, Psychology continued to provide involves managing and coordinating referrals to residents are supported to advocate for changes Care, General Rehabilitation and the Day Hospital. patient education sessions on the psychological appropriate support services, funding for home and improvements. aspects of Stroke and Multiple Sclerosis, as part supports, discharge planning to the patient’s home The main areas of clinical activity included: of multidisciplinary programmes on the or care facility, processing applications for the Through new initiatives in 2018, our aim is to Mood disturbance, including anxiety, depression neurorehabilitation wards. Nursing Homes Support Scheme (Fair Deal) and continue providing a high quality professional and anger, associated with neuropsychological Home Care Packages. We work with the Medical Social Work service to all our patients, changes and physical illness or injury; problems Bernadette Casey multidisciplinary team on many psycho-social residents and their families. adjusting to changes in ability and functioning; Designated Line Manager for Psychology issues, including therapeutic support, promoting and difficulties with insight into the sequelae of the patients’ rights, autonomy, self-determination, Bernadette Casey Principal Medical Social Worker illness or injury. Following initial assessment, preventing social isolation and empowering the majority of patients referred received regular patients to engage in social activities. psychotherapy sessions to support emotional The hospital has zero tolerance of any form of well-being and facilitate coping with loss and abuse of vulnerable persons. The social work team change. actively manages and coordinates the response to Complex behavioural changes associated with concerns raised by patients, family, staff, visitors stroke, dementia, and acquired brain injury, e.g. and volunteers. This is done in collaboration with problems of agitation, aggression, or impulsivity, HSE Safeguarding Team. All concerns of abuse that present a challenge to staff and family members are reported in accordance with Safeguarding of providing care and support to the patient. Vulnerable Persons at Risk of Abuse Policy, 2014, HSE. Psychology input comprises assessment of the The social work team has been proactive in sharing physiological, environmental and psychological their expertise with other disciplines, and support- causes of behaviour change; development of ing staff, to ensure that all patients and residents guidelines for the care and support of the patient; are protected against any form of abuse. and provision of staff support and training in the management of behaviour that challenges, and All social workers are registered with CORU - supporting staff to deliver person-centred care to regulating Health and Social Care Professionals - meet the patient’s complex needs. and engage in continued professional development as a registration requirement. In 2017, the MSW team developed a new centralised referral system

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SUMMARY PATIENT /RESIDENT FEEDBACK FINANCIAL INFORMATION

Year ended 31 December 2017

The full set of audited accounts, with accompanying notes and the Independent Auditors’ Report, SPARC: SPECIALIST STROKE REHABILITATION: will be available after the AGM on the hospital’s website www.rhd.ie or by phoning the Corporate & Clinical Affairs Office at (01) 406 6629. Hard copies will be available at the hospital’s AGM on “Thank you for the care and attention I received.” “Carers are excellent, wonderful staff; they bend Tuesday 29th May 2018. over backwards for you. “ “Lovely atmosphere, friendly accepting atmosphere.” “Two meals offered but similar in terms of cooking style therefore limited choice, almost the “Yes – this is my second time here as a patient same kind of cooking every afternoon.” and each time I have enjoyed the relaxed atmosphere and the very helpful nursing staff “It’s like a little family here and it’s lovely.” and carers.” “They haven’t time to talk as they are very busy due to cutbacks.” PARC:

“It is clear that the caring ethos is core in the SPECIALIST NEUROREHABILITATION: RHD and it is well and truly above the norm.” “I have received excellent care here. Everything “You have an outstanding team and they are works well here and everyone gives 100% of their a shining example to the medical and nursing time.” profession.” “I highly recommend the hospital at all levels.” “Breakfast is too late and makes meals very close together.” “I was treated with dignity and professionalism by each and every one of your staff.” “An occasional fried or poached egg instead of always scrambled egg.”

GENERAL REHABILITATION:

“It is such a happy occasion to take Dad home a well confident happy man, thanks to all for your wonderful care”.

30 31 THE ROYAL HOSPITAL DONNYBROOK \ ANNUAL REPORT & ACCOUNTS 2017 THE ROYAL HOSPITAL DONNYBROOK \ ANNUAL REPORT & ACCOUNTS 2017

PROFIT AND LOSS ACCOUNT BALANCE SHEET

For the Financial Year ended 31 December 2017 As at 31 December 2017

2017 2016 2017 2016 € € € € Income Fixed assets Charitable activities 21,291,974 20,619,184 Financial assets - quoted investments - 252,136 Voluntary Income 197,287 145,642 Current assets Total income and endowments 21,489,261 20,764,826 Allocations due - Revenue 1,727,914 1,736,831 Expenditure Receivables and prepayments 264,960 220,213 Charitable activities 21,301,157 20,554,836 Cash and cash equivalents 885,927 4,873,876 Other expenditure 429,712 158,459 2,878,801 6,830,920

Total Expenditure 21,730,869 20,713,295 Creditors falling due within one year Payables and accrued expenses (2,142,245) (2,152,104) Net (expenditure)/income (241,608) 51,531 Patient Funds (478,905) (430,546) (2,621,150) (2,582,650) Transfer of previously donated unrestricted funds to the Friends of The Royal Hospital Donnybrook (4,001,147) - Net current assets 257,651 4,248,270

Excess of (expenditure)/income (4,242,755) 51,531 Creditors falling due after one year - - Total net assets 257,651 4,500,406

Capital and reserves Unrestricted funds 181,563 4,415,134 Restricted funds 76,088 85,272 257,651 4,500,406

On behalf of the Board of Management On behalf of the Board of Management Robin Simpson Robin Simpson Brendan Pigott Brendan Pigott

32 33 THE ROYAL HOSPITAL DONNYBROOK \ ANNUAL REPORT & ACCOUNTS 2017 THE ROYAL HOSPITAL DONNYBROOK \ ANNUAL REPORT & ACCOUNTS 2017

SCHOOLS INVOLVED IN THE LIST OF GOVERNORS AOS ÓG PROGRAMME AND GAISCE – Mrs. Yvonne Acheson Mr. David P. Clarkin Mrs. Flo Fennell THE PRESIDENT’S AWARD Mrs. Iris Agnew Mr. Stephen Cloonan The Hon. Ms. Justice Mr. Brian Aherne Judge Patrick Clyne Mary Finlay Geoghegan Mrs. J. Ansell Mr. Charles Coase Mr. Vincent Finn Ms. Fiona Ashe Mr. Anthony E. Collins Mr. Mark Fitzgerald 1. 15. Newpark Comprehensive School Ms. Tania Banotti Mr. Mark Collins Mr. Michael Forde Mrs. Sylvia Fry 2. Catholic University School 16. Ms. Deirdre-Ann Barr Ms. Anne Connolly Dr. Graham Fry Mr. Roy Barrett Mr. Alan Cooke Mr. Pascal Fuller 3. De la Salle 17. St. Louis High School Mr. Charles Barry Mr. Mr. Jim Gahan 4. Dominican College Sion Hill 18. St. Conleth’s College Ms. Myra Barry Ms. Joan Costello Mr. Colm J. Galligan Mrs. Barbara Baynham The Hon. Ms. Justice Mr. Cecil Geelan 5. East Glendalough School, Co. Wicklow 19. St. Andrew’s College Mr. Walter Beatty Caroline Costello Ms. Ita Gibney 6. Firhouse Community College 20. Scoil Mhuire, Co. Clare Mr. Keith Blackmore Mrs. Catherine Coveney Ms. Jill Gibson Mr. R. Blakeney Ms. Lucinda Creighton 7. 21. Mr. David Gibson Brabazon Dr. Alec Blayney Judge Timothy Crowley Mrs. Catherine Gibson Brabazon 8. Gaelcholaiste Na Mara, Co. Wicklow 22. Santa Sabina Dominican College Ms. Lainey Blayney Mr. Vincent Crowley The Honourable Mr. Justice Dr. Paul Brady Mr. Frank Cunneen 9. 23. Synge Street CBS Paul Gilligan Mr. Declan Cunningham Prof. Niamh Brennan Mr. Eamonn Glancy Mr. James Darlington 10. Loreto Secondary School, Bray 24. Stratford College Mrs. Loretta Brennan-Glucksman Mr. Peter Gleeson Mr. James Breslin Mr. Sean Davin 11. Our Lady of , Beaumont 25. The Teresian School Mr. Michael Gleeson Mr. Joseph Davy Dr. Brian D. Briscoe Mr. Pat Glennon 12. C.B.C. Monkstown 26. Dr. David Brophy Mr. Michael Dawson Mr. E. R. A. Glover Mr. Frank Buckley Mr. John de Vere White 13. Mount Anville Secondary School 27. Wesley College Mr. George Good Mr. David Burnett Mr. Hubert Dennison Mr. Billy Gorman 14. Mr. Alex Burns Dr. Audrey Dillon Mr. Alan Gough Mr. Douglas Burns Ms. Connie Dowling Mr. Hugh Governey Mrs. Joyce Byrne Mr. Mark Doyle Miss D. Graham Mr. Paddy Byrne Mr. Derek Earl Rev. Alastair Graham Ms. Daire Byrne Mrs. Audrey Emerson Mr. Alan Graham Ms. Margaret Cagney Mr. Derek England Dr. Marie Elaine Grant Mrs. Ruth Carnegie Mr. Rodney Evans Mr. Randal N. Gray Mr. David Carrigy Mr. Patrick Ewen Mr. Gerald Griffin Mr. Harry Carroll Ms. Denise Fanagan Mr. Niall Gunne Mr. J. D. Carroll Ms. Kaye Fanning Rev. Sonia Gyles Mr. John Carroll Mr. Paul Fanning Miss Ruth Handy Dr. Marguerite Carter Prof. Ronan Fanning Mr. Tom Hayes

34 35 THE ROYAL HOSPITAL DONNYBROOK \ ANNUAL REPORT & ACCOUNTS 2017

LIST OF GOVERNORS / continued

Mrs. Eithne Healy Cllr. Dermot Lacey Mr. Donald McShane Ms. Niamh O’Regan Mr. Derek Scally Mr. Donal Thornhill Mr. Ivan J. Healy Mr. John Lacy Mrs. Mary Geraldine Miller Mrs. F. J. (Teresa) O’Reilly Ms. Edwina Scanlon Ms. Maura Thornhill Dr. Carmencita Hederman The Hon. Miss Justice Mr. Matt Minch Mr. John O’Reilly Mr. Brendan Scannell Mr. John Tierney Mr. William P. Hederman Mary Laffoy Mr. Tony Mulderry Mrs. Beatrice Ormston Mr. Frank Scott Lennon Ms. Mary Tunney Mrs. Miriam Hillery Mr. Peter Ledbetter Mrs. Margaret Murphy Ms. Caroline O’Shea Mr. Sean Sexton Mr. Anthony Twomey Dr. Claire Hogan Mr. Victor Levingstone Mrs. T. Murphy Mr. Liam O’Sullivan Mrs. Ruth Shanahan Mr. Stephen Vernon Mr. John Hogan The Venerable Gordon Linney Judge Catherine Murphy Miss Terri O’Sullivan Mr. H. K. Sheppard Mr. Arthur Vincent Mr. Laurence J. Holmes Mr. Jerry Liston The Hon. Mr. Justice Mr. Brendan Pigott Mrs. Jeremy Sherwell-Cooper Mr. C. Garrett Walker Judge Seamus Hughes Mrs. Helen E. Lowe Francis Murphy Mr. Gordon Poff Mr. Tom Shields Ms. Helena Walsh Ms. Kathleen Hunt Ms. Caroline Lundy Mr. Mark W. Murphy Mrs. Anne Potterton Ms. Philomena Shovlin Mr. John White Dr. Una Hunt Ms. Aine Lynch Mr. Eoghan Murphy, T. D. Mrs. Margaret Power Mr. Robin Simpson Mr. Gerry White Mrs. Ruth Hurson Mr. Brendan Lynch Mr. Gerard Murtagh Mrs. Penelope Proger Mr. David Simpson Mr. Joseph A. Whitten Ms. Gemma Hussey Mr. Peter Lynch Mr. Liam Nicholl Mr. Michael Purcell Mr. Ian Slattery Ms. Brenda Wilkes Ms. Noella Hynes Mrs. Patricia Madigan Mrs. Katherine Nixon Mr. Paul Quilligan Prof. Susan Smith Ms. Jane Williams The Hon. Ms. Justice Mary Irvine Mr. David Martin Mr. John D. Nunan Mr. Lochlann Quinn Mr. Barry Smyth Mrs. Maeve Woods Ms. Paula Jennings Mr. Michael Maughan Mgr. Lorcan O’Brien Ms. Liz Quinn Ms. Jacqueline Smyth Mr. James Wyse Mrs. Olive Jones Mrs. Gemma Maughan Ms. Cathy O’Brien Ms. Brenda Quinn Mr. Victor Stafford Mrs. Susan Wyse Mr. Padraic Jordan Mrs. Marcella Maughan Ms. Moira O’Brien Mr. Ruairi Quinn Ms. Katrina Strecker Mr. Mark Younge Prof. Michael Keane Mrs. Margot McCambridge Mr. Jim O’Callaghan, S. C. Mr. Oisín Quinn, S. C. Mr. Colin Sullivan The Hon. Mr. Justice Ms. Dorothy MacCann Mr. Roland O’Connell Mr. Brian Ranalow Ms. Steph Sullivan Nicholas Kearns Cllr. Paddy McCartan Mr. Michael G. O’Connor Dr. Fintan Regan Mr. Garratt Sullivan Dr. Donal J. Kelly Prof. Geraldine McCarthy Mr. Conor O’Connor Mr. John C. Reid Mr. G. J. R. Symes Mr. Jerry J. Kelly Mr. Jim McCarthy Mr. Tom O’Connor Mr. W. J. Reid Mr. Malcolm Taylor Mr. James Kelly Mr. Timothy McCormick Judge John O’Connor Mr. Thomas Rice Rev. Jack Teggin Mr. Patrick A. Kelly Ms. Sunniva McDonagh Mrs. Susan O’Connor Mr. Graham Richards Mr. Gary R. Tennant Mr. Peter F. Kelly Mr. Brendan McDonald Mr. John O’Donnell Ms. Joyce Rigby-Jones Mrs. Sylvia Tennant Mr. Patrick Kelly Mr. Michael McDowell Mr. Marc O’Dwyer Mr. Henry N. Robinson Ms. Heather Tennant Mr. Niall Kelly Mr. Lonan McDowell Dr. Alan O’Grady Mrs. Breda Ryan Mrs. Rosemary Thompson Miss Rosaleen Kennedy Ms. Christine McElhinney Dr. Ann O’Grady-Walshe Cllr. Frank Kennedy Ms. Patricia McGettrick Mrs. Clare O’Halloran Mr. David Kennedy Mr. Patrick McGilligan Mr. Desmond O’Halloran Mr. Charles Kenny Dr. Noel McGrath Ms. Maire O’Higgins Mr. Conor Kenny Mrs. Olive McGuckin Dr. Nial O’Leary Dr. Brian Keogh Mr. Paul McLaughlin Mr. John O’Leary Dr. David Kevans Mr. Paid McMenamin Ms. Rosemary O’Loughlin Mrs. Gladys Kingston Mr. Paul McQuaid Ms. Laura O’Mara

36 THE ROYAL HOSPITAL DONNYBROOK Dublin 4, Ireland Telephone +353 (0)1 406 6600 e-mail [email protected] www.rhd.ie