· 3 min read · Features

Case study: ensuring staff wellbeing at Helen & Douglas House hospice


Recruiting the right people, informing them of ethical debates, and individualised support are critical

Location: Oxford

Number of employees: 300

Number in HR team: 15

Case study focus: Ensuring the wellbeing of staff who perform highly demanding, emotional roles

The organisation

Helen & Douglas House was established in 1982 as the world’s first children’s hospice. The hospice has 15 beds and cares for around 250 children and young adults (aged 0 to 35) in the community at different stages of terminal illness.

The challenge

The challenge that working in a children’s hospice presents is clear for anyone to see. And it is important such organisations fully recognise the scale and nature of the emotional pressures put on staff, and how these exist no matter the job description, says HR director Sarah Westmorland.

“People can be users for protracted periods of time, so we get to know them over periods of more than 20 years sometimes. And we have long-serving members of staff, so people develop long-term relationships,” Westmorland says.

She adds: “And that’s not just clinical teams. Employees at our charity shops will often end up talking to people who have brought a deceased relative’s belongings in. And our van drivers who collect donations recently said ‘we get into these kinds of conversations all the time so can someone check we’re doing the right thing?’

“The hospice environment is not like a hospital at all, we have an open environment – everyone is in contact with our service users all the time and can develop relationships with them,” Westmorland explains.

Volunteers are another category people might not immediately think of in relation to equipping staff with emotional resilience, she adds. “Those volunteers bring important skills that help us respond in an individualised way; for example we had one young adult who wanted to learn Russian,” she says, explaining that such individuals will typically not be already trained to cope with such tough circumstances.

The method

With such a range of employees and volunteers it’s important that support is individualised. “Resilience is individual to a person; people’s tolerances are different,” says Westmorland. “So we put in place services that allow people to take ownership of their needs.”

This is split into three categories: knowledge, understanding and education. On the understanding front, it’s about staff realising that the point of death might not be the most traumatic part of caring for a terminally ill young person. Westmorland explains that at this point there is usually a sense of calm surrounding next steps, with all decisions regarding care having been made.

“Whereas over a period of time there will be changes and degeneration, and at each point staff members need to decide how they’re going to treat the user, so with medication and surgical intervention for example,” she says. “That can be more challenging.”

Therefore it’s important that all employees are kept thoroughly well-versed in all the knowledge they will need to make confident decisions. The hospice runs a research forum and holds debates and discussions where staff can learn about the latest palliative care research and talk about any ethical grey areas.

Westmorland explains the importance of this and keeping all workers up to speed with the basics: “If you’re approaching a decision where you’re naturally less confident in how to do something you’re naturally less resilient.”

Staff will also be less resilient where they’re experiencing anxiety or trauma in their personal lives, she says, explaining that her team has to be highly sensitive to this. “The role of line managers is really important,” she adds. “We provide individualised care and that’s reflected in the way we manage staff – managers knowing people’s tipping points, not just in the context of the workplace. Line managers need to be able to say ‘you don’t seem resilient at the moment, let’s talk'.”

Before all of this, however, a specifically-designed recruitment process ensures people with the requisite mental resilience are selected. “It’s checking people have the ability to take ownership for their own responses and reactions,” says Westmorland. She explains that the team has to be highly analytical of the skills someone will bring, ensuring they are skilled enough in their role to be confident in their decision-making here, and that people who have recently experienced a bereavement themselves or are perhaps too motivated by a desire to “feel better about themselves”, are warded out.

The result

Feedback surveys ensure support has been successful. The organisation also carefully monitors absence rates for concerning patterns, and garners feedback from individuals on a regular basis. This last element is particularly important when the individual nature of what staff encounter day-in day-out is considered.

Though their employees won’t be facing anywhere near the same level of emotional pressure, Westmorland feels other organisations could take a leaf out of Helen & Douglas House’s book when it comes to workforce wellbeing.

“Your people are your biggest, most costly resource. When you look at the cost it takes to recruit, train and retain someone, a small investment in wellbeing makes a lot of sense,” she says. “And viewing best practice here through the lens of resilience can be very insightful. There’s a lot you can learn from an organisation like us that has to really look after staff.”