unique experience

SUPPORT, CARE & DIGNITY

unique experience

Annual Report 2012

contents

3 101 Years of Care

5 Our Eden

7 Highlights of 2012

10 Chairman’s Report

12 Chief Executive’s Report

21 Looking Ahead

23 Governance

25 Directory


Annual Report 2012

ELIZABETH KNOX HOME & HOSPITAL 2

101 years of care

3

Elizabeth and Charles Knox settled in Auckland from Northern Ireland. in the early 1840’s.

Charles Knox successfully farmed 500 acres in West Tamaki and, in time, gained a reputation as a philanthropist who generously assisted fellow settlers. Dying in 1871, his wife Elizabeth continued contributing to public institutions.

Elizabeth died in 1908, aged 99, leaving a bequest for the “purpose of building, endowing and maintaining a hospital or home for poor people suffering from incurable diseases”.

The Knox Home Trust Board was formed in 1911 with the early task of constructing the Home located on a portion of the Knox farm in Tamaki - in the vicinity of Morrin Road, St Johns.

On completion of building in 1914, patients were transferred from Auckland Hospital. As time went by, the Home increased services to a wider range of patients including physiotherapy and occupational therapy. In 1939 the Minister of Health granted the Home recognition as a hospital accepting returning wounded or sick soldiers.

Through the 1950’s improvements were made to the facilities until the late 1960’s when the decision to relocate to a more central location was made. By 1974 the new Home was opened on the current Ranfurly Rd site in Epsom.

Today the Elizabeth Knox Home and Hospital admits both subsidised and fee paying private residents with care extended across the age spectrum from young to older residents.

We are now an Eden Alternative registered home focused on being a very ‘human habitat’ where we offer loving companionship, meaningful activity and high quality service.

The vision and values of Elizabeth Knox remain as pertinent today as they did over 100 years ago.

Annual Report 2012


our eden

By combating loneliness, helplessness and boredom we reduce most of the suffering experienced by our residents, through the Eden Alternative.

5

Elizabeth Knox Home and Hospital (Knox Home) adopted the Eden Alternative in 2009. Knox Home is now a livelier place. There is continuing evidence of higher levels of spontaneity, increased care and partner engagement.

Animals, plants, and children are part of everyday life. The wider community is also increasingly involved in the life of the home.

Edenising is no longer a project; it is part of who we are. Knox Home residents are living enriched lives.

There is obvious change ... you can feel it, see it, touch it.

Our Eden Alternative journey continues, and we are enjoying the ride.

Annual Report 2012


7

Eden Alternative Seedling award winElizabeth Knox Home and Hospital has become the first facility in Australasia to win an international Eden Award. The Seedling Award recognises a home or community-based service, new to the Eden Alternative process that has demonstrated a level of commitment and progressiveness that challenges others to grow.

NZACAtraining and development awardFor the second time, Knox Home has won this national award recognising superior training and staff development innovations.

Nikau link corridor and multi-purposeroomConstruction for the corridor linking the existing xxxxxx building and the new Nikau building now under construction, was completed together with a multi-purpose room and landscaped exterior space.

highlights of 2012



Three further Eden Alternative principles achievedRegistering to become an Eden home, facility or organisation requires continuing reviews and an active ongoing application of the ten Principles throughout the organisation. Knox Home has now achieved five of the ten necessary Eden Principles.

Nikau building planning completed for consent Designs and plans were refined and finalised for submission for building consent. Construction of the new 58-bed facility due to open in 2014, has since commenced.

Annual Report 2012

9

Knox Home residents are encouraged and assisted by staff and volunteers to pursue any pastimes they desire.

chairman’s report

Annual Report 2012


Elizabeth Knox Home and Hospital (Knox Home) provides care to a wide clientele including aged care – both rest-home and hospital, young physically disabled and short term care clients.

Knox Home endeavours to provide outstanding service and clinical care, second to none to our clients. This is a continuous process, and in the past year there has been an emphasis on staff training, Eden Alternative training; reviews of clinical processes and also an increase in resident’s participation in decision making. Many new and individually focussed resident activities have been established ranging from gardening, crafts, cooking and Resident Committee.

Quality team members are critical to achieving our desired level of care. So, we are fortunate to have an excellent team, limited staff changes and many well qualified and experienced staff who have been with Knox Home for many years. The Board is truly grateful to the staff for their dedication to caring for the Knox Home residents and in many instances their inputs go well beyond their duty.

During the year, Knox Home has won the 2012 Eden Seedling Award which was announced at the Eden Alternative International Conference in the USA.

Knox Home also became the first Auckland residential care home to achieve Eden Registration. In addition,

Knox Home won the New Zealand Aged Care Association (NZACA) Training and Development Award at the national conference.

After many years of planning the redevelopment of our premises in Epsom, there is now significant tangible evidence of the redevelopment. In 2011, the rebuild and refurbishment of the central part of the building was completed. This was followed by the complete refurbishment of Karaka (Hospital) creating single, ensuited rooms.

This project was immediately followed by the construction of the new Link Corridor, Totara Lounge and Multi-purpose Room which was completed in April 2013. This development was important as it will provide the connection with the new Nikau building, a 58-bed two-storeyed facility consisting of four ‘homes’ for hospital residents. Construction commenced in April 2013 and is due for completion in July 2014.

The Trust Board recently acquired an adjoining property and concept plans are presently being developed for the Griffin Road-end of our site including the new acquisition.

Knox Home endeavours to be an integrated part of the neighbourhood and interacts with local organisations, churches and neighbours on a regular basis. Recently, a very successful volunteer programme has been established which has introduced

many new people to the Knox community. Over the years Knox Home has been involved in joint ventures with a number of local organisations for mutual benefit.

Our CEO, Jill Woodward has established a strong presence in the care industry due to her involvement in sector groups, advisory panels and regular speaking engagements.

Jill has been with Knox Home for the past five years and under her watch, we have seen major culture changes with the commencement of the Eden Alternative journey, planning and construction of premises, managing of associated decanting of residents and services; at the same time maintenance of high levels of occupancy, stable and happy staff, increased resident involvement and strong fiscal management have resulted in another really good year at Knox Home. The Board is extremely grateful to Jill for her commitment to Knox Home.

Finally, I would like to express my thanks to all the Board members for their very significant input and long term commitment to Knox Home. The past year has seen further growth in the effectiveness of the sub-committees of the Board which utilise the diverse skill set of Board members.

WARWICK PEACOCK

11

Knox Home residents are encouraged and assisted by staff and volunteers to pursue any pastimes they desire.

chief executive’s report

Annual Report 2012


Knox Home has undergone substantial development across all areas of the organisation over the past year.

We became the first home in Australasia to achieve an Eden International Award and national recognition as a training centre.

We have continued our progress towards full Eden Alternative registration and worked through major building works which have been challenging but ultimately rewarding for all of us at Knox Home.

In September we won, for the second time, the New Zealand Aged Care Association Training and Development Award at the national conference. This is awarded in recognition of training and staff development innovations that improve education, well-being, safety and staff satisfaction.

A highly successful certification and accreditation audit, progress with quality initiatives and continued planning for achievement of key strategic objectives relating to the further stages of the site development have all been features of the past year.

With 137 residents, occupancy has remained high during the Karaka refurbishment, decanting was managed with minimal disruption to life at Knox Home.

My thanks to all residents and their families for their patience and support.

Planning for the development of the Knox Home facilities, aligned closely to opportunities for service development and growth has also continued.

Physical movement is fundamental to all human wellbeing. We have focused on improving movement to increase individual independence. The dynamic Knox Physiotherapy team is an integral part of providing the skills and motivation to keep all residents and staff moving.

Considerable progress has been made in master-planning for future site development.

Exciting facility development2012 saw a considerable focus on planning, design, consultation, communication, decanting and day-to-day decisions regarding building and services for the new Nikau Link Corridor (to the Nikau building now under construction), Lounge and Multi-purpose Room.

Consultation with residents regarding the redevelopment has been a high priority with weekly meetings. We have also held bi-monthly evening meetings with residents, families and friends.

Nikau building underwayRefinement of the design, planning, communication, consultation, and consent processes has been completed. Construction for this

significant new addition to Knox Home commenced in April 2013 on the site bordering both Ranfurly Road and Market Road.

More details about this impressive development are on page 21.

Landscaping adds to residents’ lifestyleLandscaping of four courtyards and gardens has been completed, creating accessible spaces for residents and family which include raised gardens, lush plantings and dining areas.

Drainage projectA substantial stormwater drainage project is now complete and takes into account planned site development.

Eden Alternative journey continues

Since adopting the Eden Alternative in 2009, 130 team members have trained as Eden Associates through three-day on-site training provided by Eden in OZ&NZ. The CEO participates as a trainer on-site and at external training courses.

In 2012, Knox Home was nominated for and won the Eden Alternative Seedling Award announced at the 6th Eden Alternative International Conference in Grand Rapids, USA.

The Seedling Award recognises a home or community based service,

JILL WOODWARD

new to the Eden Alternative programme that has demonstrated a level of commitment and progressiveness that challenges others to grow. This award not only engenders great pride for the Knox Home team but also underscores that we are working very positively in the right direction.

Eden Alternative projects have been successfully launched and sustained. The variety of projects led by team members was seen in the projects put forward for the Quality Awards, which

ran for the third time in 2012.

Animals continue to be a well established feature of Knox Home life. We have increased the number and variety of animals we have with fish and birds now making their home with us too. We also have seven cats in the Knox Home community and miniature schnauzer Buster, who comes to work with the CEO every day.

The Eden Alternative visit occurred in November 2012 and Knox Home achieved an additional three Principles, taking Knox Home’s achieved Principles to five.

Eden Alternative Principles 2 and 10 were achieved in 2011. Principles 3, 4 and 5 are our latest achievements.

3. Loving companionship is the antidote to loneliness. Elders deserve

easy access to human and animal companionship.

4. An Elder-centered community creates opportunity to give as well as receive care. This is the antidote to helplessness.

5. An Elder-centered community imbues daily life with variety and spontaneity by creating an environment in which unexpected and unpredictable interactions and happenings can take place. This is the antidote to boredom.

This visit was undertaken by Eden colleagues and is a very robust and thorough evaluation of achievement of the Principles.

Weekly Eden Alternative sessions have continued for residents, family and the Knox Home team.

This shared experience has challenged conventional thinking regarding organisational hierarchies and has united the team’s attention on ensuring that residents remain central to all that happens at Knox Home.

Resident satisfaction high

Knox Home Residents committee meetings are well established.

The committee meets every six weeks to provide a forum for residents to ensure that their needs, ideas and initiatives for residents are discussed, reviewed and actioned as appropriate.

Resident satisfaction as reported in 2009 had 91% of residents rating Knox Home as 8, 9 or 10 (on a scale of 1 – 10, 1 very poor and 10 excellent).

92% of residents in 2012 reported ‘Yes’ when answering the question ‘Would you recommend Knox Home to others?’.

13


Construction at Knox Home has been almost constant over the past two years. The support of residents and excellent contractors has been much appreciated.


Residents look forward to our fun events that include family, friends, Knox Home staff and volunteers.

15


It is heartening that 76% of residents also reported their health as ‘Good, Very Good or Excellent’.

In the 2012 Family Survey, 92% of re-spondents ‘Would recommend’ Knox Home and 8% ‘May recommend’. 56% felt their ‘Family member’s health had improved’ since coming to Knox Home.

Enhanced daily experiences Increased decision-making by residents regarding the direction of Knox Home, means we continue to focus on activities that have real meaning to individuals.

In addition to the Residents’ Committee, the gardening group has continued, as have the variety of celebrations and the range of outings which make Knox Home life more

interesting and rewarding.

Residents have developed new activity groups such as those for knitting and handcrafts. There is increased resident involvement in cooking too with regular baking to share.

Impressive volunteer growth

Participation at Knox Home by volunteers has been a significant focus in 2013. Volunteer roles have expanded in depth and are now much closer to the resident. This has been possible with the appointment of a Volunteer Coordinator taking volunteer numbers from 15 at the beginning of this report’s period to 140 at the end.

Students from nearby girl’s school St Cuthbert’s College, have also played a significant role in the lives of residents

and this has been both close and continuous.

Other volunteers assist in a wide range of activities including walking with a resident who benefits from daily exercise but finds remembering directions challenging; playing board games; touching up paint on residents’ personal furniture, watering the plants and gardens under the direction and guidance of the resident who loves managing the garden but needs support with some physical tasks; supporting a visually-impaired resident with a sewing project and showing residents how to get the most out of their iPads and how to use Skype.

Volunteers often gain as much from residents as the residents do from them.

Knox Home offers sunny, comfortable and contemporary surroundings with a range of flexibly designed spaces for both privacy and socialising.


We’re delighted to give couples like Mr and Mrs Singh, the opportunity to make Knox their home.

17

OPERATING EXPENDITUREFOR THE PERIOD ENDING 30 JUNE 2013

RESIDENT CARE 54.9%

CATERING 8.2%

CLEANING & LAUNDRY 5.2%

PROPERTY 14%

ADMINISTRATION 12.3%

OPERATING SURPLUS 5.4%

5.4

54.9

8.2

5.2

14

12.3

RESIDENT CARE 54.9%

CATERING 8.2%


PROPERTY 14%

ADMINISTRATION 12.3%

OPERATING SURPLUS 5.4%

% Resident Care % Catering

% Cleaning and Laundry

% Property

% Administration

% Operating Surplus

Knox team development

Knox Home has continued to invest substantially in team and individual development. This has been across general areas of clinical and non-clinical education and in specialist areas of education such as InterRAI, palliative care, Eden Alternative training, wound management and occupational therapy and physiotherapist education.

In our last staff survey in 2011, 100% of staff members surveyed were either ‘Satisfied’ or ‘Extremely Satisfied’ with Knox Home as a place to work.

Knox Home has participated in the Auckland District Health Board NETP programme – with our first ‘New Entrant to Practice’ Registered Nurse having completed her post-graduate entry to practice year.

At the time of writing we have no vacancies and this has been the case for most of 2012.

Sound financial performance

Knox Home enjoyed strong occupancy in the current year with resident occupancy up 3% on the previous year with a favourable mix of Hospital to Rest Home level residents. There were no major renovations in the current year affecting occupancy. This compares to the previous year when Karaka renovations adversely affected occupancy. Fees and subsidies received for residential care have been limited to a 1.5% increase compared to associated costs and expenses of running these services increasing 2.5%. The net result is that fee revenues are 6% up on the previous year, contributing to an improved operating result.



Our full time Physiotherapy team has a strong focus on movement and balance within its rehabilitation programmes. Tai Chi Balance classes are popular.

19

OPERATING INCOME BY SERVICEFOR THE PERIOD ENDING 30 JUNE 2013

FEES HOSPITAL AGED CARE 56.1%

CATERING 22.6%


PROPERTY 15.9%

15.9

56.1

5.2

22.6

FEES HOSPITAL AGED CARE 56.1%

CATERING 22.6%


PROPERTY 15.9%

% Fees Hospital Aged Care % Fees Hospital Young Disabled

% Fees Hospital Interim Care

% Fees Rest Home Care


Site redevelopment planning and expenditure continued with the new Nikau building and including storm water drainage works and construction of the new Link Corridor, Totara Lounge and Multi-purpose Room.

The Trust Board remains in a sound financial position to complete the current building programme.

Telling our story

Newsletters continue and have been a superb vehicle for spreading the Knox Home message to both families, community and neighbours.

Speaking engagements across a variety of settings has also strengthened external knowledge of Knox Home and have included the University of Auckland, women’s groups, service groups and District Health Board amongst others.

Rewards are evident

It is truly gratifying to see the continuing improvement of resident’s lives at Knox Home through the hard work and dedication of an outstanding team who I have the pleasure of working with. My thanks to them and a very supportive Trust Board.

Knox Home has a very bright future; one which I am excited to be part of.

Education for the Knox team, volunteers, residents and families in a multitude of areas is a significant focus.


The redevelopment of Knox Home’s physical environment has already provided many positive benefits to residents and families.

Supported living excellence

The innovative Nikau building will add capacity for 60 residents to Knox Home’s community in four households of 15 residents each. Each household is designed around it’s own kitchen and lounge which take advantage of Epsom views.

Nikau has been designed to provide a home-like, supported living environment which maximises the independence of residents.

The ‘houses’ have been designed using dementia design audit tools as a baseline to ensure suitability for a full range of residents. There has been substantial design input by Knox Home staff including cutting-edge bathroom innovations.

Each house features plenty of natural light and flexible spaces that will allow an array of activities for residents and their families. There will be a homely fireplace in each lounge and better-than domestic kitchens where residents can cook and prepare meals and snacks.

There has been considerable thought applied to the design of the ground level gardens including the addition of an oversized exterior chess set.

The Nikau project is a rare and unique opportunity to develop a leading care model within a residential facility.

Construction is expected to be completed in the middle of 2014.

21

looking ahead

Nikau Building

Nikau Building



Nikau Link Corridor

Reception

Ranfurly Road

Multi- purpose Room

Totara Court

governance

Members of the Knox Home Trust Board are all accomplished individuals who continue to bring tremendous acumen, experience and expertise to the governance of Knox Home.

Warwick PeacockChairman

Warwick is a Chartered Accountant member of the New Zealand Institute of Chartered Accountants. He is currently a consultant to HLB Mann Judd Ltd, Chartered Accountants having been a principle in Chartered Accountancy practices in New Zealand for approximately 40 years.

Warwick was appointed to the Board in 1994 and has been Chairman since 1997.

Christine HartTrustee

Christine is a specialist human resources and business adviser with a background in both private and public sectors. For the past thirteen years she has run her own consultancy following experience as a senior HR executive in multinational and corporate, legal environments. She has served as President of MS Auckland and continues to act as an adviser to the organisation.

Christine was appointed to the Board in 1999.

Dr Bruce FoggoTrustee

Bruce is a Palliative Medicine Specialist and Medical Team Leader at Mercy Hospice Auckland and has some 30 years of general and palliative medicine experience.

Bruce was appointed to the Board in 2008.

23

Dr Alastair MacCormickTrustee

Alastair has governance, executive and consulting experience spanning the business, government, not-for-profit, health and education sectors in Asia, Australia, New Zealand, the UK and the USA. He has held directorships in a diverse range of listed and private companies.

Currently he is Chairman of Caldera Health, a cancer diagnostic company, and of Photonz Corporation, which manufactures Omega 3 oil from microalgae, and a director of Refract Group, providing services for people with diabetes.

Alistair was appointed to the Board in 1982.

Dr Ross McCormickTrustee

Ross is Associate Dean (Postgraduate) Faculty of Medical and Health Sciences at the University of Auckland. He is an ex-general practitioner and ex-medical superintendent of a major Auckland private hospital and residential care complex.

Ross was appointed to the Board in 2004.

Bal MathesonTrustee

Bal is a specialist in resource management and environmental law with over 15 years experience, specialising in large development and infrastructure projects.

Bal has been a partner at Russell McVeagh since 2005, and has been on the Board of Management of Russell McVeagh since 2012.

Bal was appointed to the Board in 2011.

Andrew SmithTrustee

Andrew has extensive business experience spanning 19 years with Smith & Smith Ltd, eventually becoming the Managing Director, and then 20 years with Metropolitan Glass which was sold in 2006. Since then, Andrew has become involved with Outward Bound NZ, and Outward Bound International, as well as the Auckland Art Gallery Foundation, the Museum Circle Foundation and the Mackelvie Trust Board.

Andrew was appointed to the Board in 1998.


Annual Report 2012

25

directory

Knox Home Trust Board Registered Office

10 Ranfurly Road Epsom Auckland 1023

Charities Commission Registration Number

CC20460

Auditors

Hayes Knight Audit NZ L1 1 Broadway Newmarket Auckland 1023

Solicitors

Russell McVeagh The Vero Centre 48 Shortland Street Auckland 1010

Bankers

Bank of New Zealand


Annual Report 2012

We welcome and encourage family involvement in the day-to-day life of their family members at Knox Home. Here, Eric Smith visits Knox daily to be with his wife, Laurel.


10 Ranfurly Road, Epsom, Auckland 1023

PO Box 74 060, Market Road, Auckland 1543

Telephone 09 523 3119

knox.co.nz

unique experience

Documents

hospital knox home

elizabeth knox home

knox home residents

new home

home recognition

knox home trust board

charles knox

knox farm