1. OUR ORGANISATION A BRIEF INTRODUCTION INPATIENT PROJECT PLAN AUGUST 2013 SKANDA VALE HOSPICE CONTENTS 4. Executive summary 7. Our organisation 15. Our work 25. Our project statement 55. Evidence of need 73. Evidence of consultation 92. Project delivery 105. Our project finances 131. Workforce recruitment 141. The back up plan 162. Service evaluation 169. Exit strategy 171. References and appendices 175. Recruitment appendix 182. Financial appendix 190. Letters of support 4. EXECUTIVE SUMMARY EXECUTIVE SUMMARY Inpatient project development at Skanda Vale Hospice The problem The UK population is rapidly ageing. We are living longer than any generation that have gone before us, and there is no sign of this trend reversing. South West Wales, (where we are based) has the highest proportion of over-65 year olds in Wales. 100 years ago, most people died at a younger age from acute illnesses and infec- tions. Now we are more likely to die from long term illnesses such as cancer and heart disease, yet our healthcare services are still geared toward short term acute care. The rapid ageing of our society demands innovative new healthcare services designed to meet the specific needs of an older population. In South West Wales, 59% of people die in hospitals, even though only 11% would choose to die there. Most people (56%) want to die at home, yet only 21% actu- ally do. These statistics indicate that people are dying in expensive-to-run hospital beds, when they do not wish to be there. It is an outdated, inefficient and dehuma- nising care model that has to be changed. Our project presents a local solution to a very large, well-recognised national problem. Our history and current service: Skanda Vale Hospice began as a home-care service in 1993. For ten years we of- fered simple non-clinical respite care, helping hundreds of people to die with dig- nity in their own homes, rather than in hospital. In 2003 we opened a hospice day care centre near Llandysul in Carmarthenshire, offering respite, complementary therapies, home cooking and assisted bathing services. Our goal: Since 1987, our goal has been to provide a full range of palliative and end of life care services under one roof. We have been fundraising toward this goal for 20 years and are now ready to realise our ambition. Our project will integrate diverse communities, enhance choice and equity of ac- cess to palliative care resources, whilst providing a range of new volunteering, training and employment opportunities. 5. EXECUTIVE SUMMARY The outcomes of our project will be: • Increased numbers of people experience improved quality of care during a life-limiting illness. • Carers feel less traumatised and overwhelmed by their duties. • People feel more included and purposeful through volunteering. • Patients and families will have improved access to other service providers. Here’s what we plan to do: • Enhance our existing day care service by including on-site clinical nursing care. • Provide a new six bed in-patient care facility. • Offer both respite care and end of life care to in-patients, through a fully ho- listic and clinically based palliative care service. • Provide new accommodation and facilities at the hospice for families and carers of patients. • Provide heating and hot water for the whole hospice building from a new biomass boiler, fuelled by wood chips from the charity’s own woodland. • Install external wall insulation and other energy saving measures to minimise our environmental impact and benefit the long term economic sustainability of the project. • Develop a comprehensive volunteer program covering every single depart- ment of hospice staffing. Professional clinical and specialist staff will join our volunteer bank and work alongside our employed clinical staff. Our beneficiaries: Our service will be free to anyone over the age of eighteen with respite or end of life care needs. The vast majority of our service beneficiaries will come from South West Wales – the rural communities of Carmarthenshire, Ceredigion and Pem- brokeshire. Our service will not be limited by geography, so we anticipate receiving a small number of referrals from outside this region. Our partners: This project has been co-designed by our regional network of palliative care pro- viders. We have developed strong partnership working arrangements with our local health board and other key organisations to ensure that our service does not duplicate resources. Our project will increase choice and equity of access to servic- es for patients and carers, whilst helping existing palliative care services to operate much more efficiently. 6. EXECUTIVE SUMMARY Our timetable: We plan to phase our service in gradually – after the construction phase has been completed, we will offer day care and planned periods of inpatient respite for five days a month. After approximately one year we will start providing full time re- spite and end of life care. • Construction phase: July 2014 to August 2015. • Service phase one – day care and five days inpatient respite a month: September 2015 to August 2016. • Service phase two – 24 / 7 inpatient respite and end of life care: September 2016 onwards. The project costs: • Total capital project costs: £1,953,936 • Funds we have already paid: £23,420 • Total capital project costs remaining: £1,930,516 • Money we’ve already raised: £1,238,000 • BIG Lottery Fund grant: £500,000 • Our future income: £192,516 (available from surplus to the end of the construction period) This grant application is to meet a shortfall in our capital building costs. Our future running costs have been budgeted for. And finally... Skanda Vale Hospice is a secular project run by a multi-faith monastic order and registered charitable trust known as ‘the Community of the Many Names of God’. We understand that the BIG Lottery will not fund religious activities. The equality section of this application sets out the reasons why we feel it is important that our hospice provides a non-religious, non-exclusive service. 7. OUR ORGANISATION A BRIEF INTRODUCTION ABOUT US The Community of the Many Names of God Registered Charity Number 511166 We are a multi-faith monastic community based at Skanda Vale – a monastery we established in 1973 and registered as a place of worship in 1975. We became a reg- istered charitable trust in 1981. Over the past 40 years, we have evolved steadily from very humble beginnings. The monastery now is home to a resident community of 26 monks and nuns, and covers 300 acres of farmland and mixed woodland. We have three multi-faith temples offering free public worship, six times a day, 365 days a year. We have become a renowned international centre of pilgrimage, at- tracting an annual congregation of around 90,000 pilgrims, to whom we provide spiritual counsel and practical support. Skanda Vale is a sanctuary for life. We care for a temple elephant, a herd of cattle and water buffalo, deer, llamas, goats, exotic birds, horses, ponies, donkeys and guinea pigs. Looking after them (in all weathers) teaches us selflessness, and adds fun, companionship and vitality to our lives. Every year we supply over 60 tonnes of donated food to various local and na- tional charities, and we run a popular multi-faith religious education programme for schools, universities and a wide variety of community groups. One of our main areas of work is Skanda Vale Hospice; a day care centre situated eight miles from Skanda Vale, in the rural village of Saron, near Llandysul. The monastery and the hospice are integrally linked. The hospice is an expression of selfless service, steadfastly supported by a vast, culturally diverse community of people. In this document we will: • Set out our charitable objectives. • Present the organisational structure of our charity. • Give an overview of our finances. • Share the history and development of the hospice. SKANDA VALE MONASTERY FAR LEFT: The monastery is set in over 300 acres of beautiful countryside. LEFT: Volunteers moving stores in our food aid program warehouse. BOTTOM: Some of the 90,000 visitors who come to Skanda Vale every year. SKANDA VALE HOSPICE RIghT: Our current day care centre in Saron, near Llandysul. BOTTOM LEFT: The conservatory with views over the garden and beyond. BOTTOM RIghT: A sunny spot in the garden. 10. OUR ORGANISATION A BRIEF INTRODUCTION OUR AIMS AND OBJECTIVES In our Declaration of Trust, our charitable objectives are: 1. To promote, for the benefit of the public, the public worship of God in his Univer- sality in accordance with the spiritual teachings of Krishna as set out in the Bhaga- vad Gita, at the Hindu Temple maintained by the Community at Skanda Vale or any other places of public worship maintained or used by the Community. 2. To advance religion and religious education by propagating to the public the said spiritual teachings about the worship of God in his Universality. 3. To maintain a community of people living together in accordance with the afore- said spiritual teachings as a religious community promoting such public worship both at the temples maintained by the Community and elsewhere, offering shel- ter, hospitality and spiritual refreshment and where relevant relief from poverty to those who by reason of penury, physical disability or any form of mental or spiri- tual breakdown are in need of such refuge without regard to race or creed, send- ing out members of the Community to provide spiritual refreshment and spiritual advice to members of the public who are for the foregoing reason in need of such refreshment or advice and assisting in the rehabilitation of alcoholics, drug addicts or delinquents who are in need of such rehabilitation. 4. To relieve the poverty of deserving persons who are in need and to support by donations and otherwise charitable institutions for the relief of poverty.