Bethesda / Consultation


Consultation paper
The Bethesda trustees are conscious that the AGM does not provide an appropriate opportunity to inform subscribers of all the issues facing Bethesda or to address fully any questions or concerns. Consequently, this discussion document has been written to provide subscribers and other interested parties with a background to the issues facing Bethesda and its future direction.
Bethesda’s origins arose from a concern identified in 1944, by the Committee of the Gospel Standard Aid and Poor Relief Societies, about the elderly in GS chapels, who were no longer able to care for themselves, being compelled to spend their last days in the uncongenial atmosphere of unsuitable old people’ s homes. In 1951, Mr S F Paul, regarding Bethesda, stated “in the case of the Lord’s people, who have been separated in heart and spirit from the ‘the world which lieth in wickedness’, it may well be an added affliction to be taken from their homes and compelled to live with others who have no fear of God before their eyes; and the worldly influence and atmosphere of the public home would be distressing to them in their latter days. It was with an endeavour to remedy this that the Committee of the Gospel Standard Societies conceived the idea of establishing homes for the aged and infirm connected with our Gospel Standard causes of truth, so that they might be favoured in their declining days or times of affliction, to dwell with those who are like-minded with themselves, and to be cared for in a spiritual as well as a home-like atmosphere.”
The position set out in this statement, of providing accommodation and personal care and support for the elderly, in a spiritual as well as a home-like atmosphere, who are members of Gospel Standard Strict and Particular Baptist chapels, or who regularly attend Gospel Standard chapels, is one that Bethesda trustees seek to maintain and uphold.
Since the opening of the first home in 1948 at Redhill there has been a noticeable decline over the years in the number of Gospel Standard chapels and size and composition of congregations. As a consequence, this has resulted in a reduction and closure of the number of Bethesda homes (Haydock; Redhill; Croydon; and Tunbridge Wells) and at the current time there are three homes (Brighton; Harpenden; and Studley) in addition to the flatlets at Redhill and Harpenden.
Operating environment
Bethesda is a Christian charity that seeks to conduct its activities in the fear of the Lord and to act responsibly in managing the financial, physical and human resources at its disposal.
As part of its business planning, Bethesda undertakes an annual analysis of its internal and external operating environment. The following extract from this analysis highlights the key points impacting on and determining Bethesda’s operation.
Bethesda has a caring and committed staff and management team that have the safety and well-being of residents at their heart. (This has been commented on by residents, relations and external agencies.)
There are robust systems and procedures, in place, that underpin the management of the homes. These systems and procedures have been developed in response to ensuring the needs of residents are met and that compliance with external agencies and legislation is evidenced.
Bethesda is responsive to the changing needs, within the resources available, of existing and future residents.  In recent years Bethesda has developed strategies to support those with dementia and provide day-care.
Allied to this is the good working relationship with local agencies, social services and surgeries. This has allowed Bethesda to provide care to residents who may have previously had to be moved to a ‘nursing’ environment.
Sadly, the incoming resources of Bethesda are substantially exceeded by the outgoing expenses. Occupancy levels are a key determinant of income and there have been major variations in the occupancy of each of the homes over recent years. In addition to occupancy, both the level of fee charged and local authority contribution have not risen significantly to offset expenditure. Although budgetary controls are in place, most of Bethesda’s expenditure is on staff and it is difficult to influence this cost significantly due to the minimum levels of staffing required to provide a safe environment for the residents.
Although Bethesda has operated with significant deficits over recent years these have been offset by legacies, however, this means that this source of income cannot be used for reinvestment.
Currently, Bethesda’s fees are significantly lower than many other care providers. One option would be to increase Bethesda’s fees over a period of three years to ensure a break-even position. The increase in fees needed, over this period, would be in the order of 40-50%.
Bethesda has an ageing building fabric and services particularly at Brighton and Harpenden. Repairs and renewals are also a significant cost to Bethesda.
As mentioned earlier, the decline in the numbers within the Gospel Standard chapels has been reflected in the occupancy of Bethesda. Additionally, there is a trend of individuals staying in their homes longer and the average age of residents coming into Bethesda has increased over recent years. This in turn has impacted on the need to review the services offered.
The ramifications of the 2008 financial collapse/credit crisis are still being felt by central and local government and the austerity measures in place have had a detrimental effect on the level of local authority support for residents. This in turn has drawn on Bethesda funds to supplement the difference between the fees charged by Bethesda and the income from local authorities. In addition, there has been an increasing burden on self-funding residents. (Outside of this paper, nationally there is a growing concern regarding the cost of providing residential care for the elderly and the financing of this.)
Another consequence of the 2008 financial collapse/credit crisis has been on the rates of return on monies that may be held for investment. This has had an adverse effect on Bethesda and investments held by residents to offset their care costs.
The ever-changing regulatory framework brings additional responsibilities to Bethesda both financially and the time to implement external requirements and initiatives. A recent example has been the introduction of the National Living Wage. Although each of the Bethesda homes have received positive reports from the CQC, there is, however, a cost in terms of management and staff time together with ensuring systems are continually and consistently robust.
The foregoing provides an overview of those factors influencing Bethesda’s internal and external operating environment and these in turn bring their own challenges. In summary, these challenges may be identified as:
  • Maintaining the distinct identity of Bethesda in an age of compromise and an increasing secular society.
  • Maintaining the financial viability of Bethesda to ensure levels of care and support are sufficient to meet the needs of residents together with ensuring Bethesda’s physical assets (e.g. buildings, equipment) are fit for purpose.
  • Responding to and providing high levels of care for the increasing range of residents, needs in the Bethesda homes.
  • Recruiting (operational and management) staff who are in sympathy with the ethos of Bethesda. (Another impact of the reduction in the congregations within Gospel Standard chapels has been the availability of young people willing to pursue a career within Bethesda.)
The future
The Bethesda trustees are well aware of the responsibility placed upon them as stewards of the Bethesda charity and homes. There has been much prayer and discussion in committee meetings as to the future of Bethesda set against the backcloth of the low state of the Gospel Standard chapels and the cry has often been “neither know we what to do: but our eyes are upon thee”.
In its simplest, there appear to be four options available to Bethesda and these are:
  • Maintain the status quo and continue with the existing approach with the continued drain on reserves
  • Comment: this is not considered to be a viable or responsible option as ultimately Bethesda would arrive at a position where there would not be sufficient funds to continue its activity.
  • Maintain the status quo and continue with the existing approach together with seeking to increase significantly, over three years, the fees to stabilise the current financial position
  • Comment: although this may not be a popular option, there is a need to address fee income to help offset the expenses incurred in the running of Bethesda.
  • Maintain the existing three homes alongside a significant financial investment in refurbishment to ensure facilities are fit for purpose in meeting future needs.
  • Comment: the Bethesda committee has made preliminary investigations into the costs and actions needed to create/update the physical environments within the three homes to meet the needs of current and future residents. Various scenarios have been considered, and the challenge, in the case of Harpenden and, to some extent, Brighton, is identifying workable and cost effective structural alterations within the limitations of the existing buildings. Serious consideration has been given in looking at the feasibility of building a new home in the Harpenden grounds to cater for the needs and age range of future residents.
  • Consolidate (relocate) the existing three homes into one home to realise the economy of scale that this would bring.
  • Comment: a business case could be developed around having only one home. However, the question then arises where this home might be located and also such a move would be contrary to providing local homes for residents that are accessible to their families and allowing continued contact with their chapel.
[Both of these latter options would still require a review/alignment of fees charged.]
The Bethesda trustees have explored and debated each of the options and at the current time, there is no apparent preferred option.
What next?
The Bethesda trustees are keen to seek written comments, from subscribers and others interested in the future of Bethesda, on the options available and would extend an invitation to those reading this paper, to do so.
The following questions have been posed to help the Bethesda trustees in their understanding of the needs and views of those in Gospel Standard chapels and other interested parties. (In asking these questions, the trustees are mindful of the need to seek the will of the Lord in all things and the wisdom to do so.):
1.What would be the reason for you coming into Bethesda?
2a). What are the factors, in your opinion, preventing eligible residents coming into the Bethesda homes?
2b). How might these factors be addressed?
3. Considering the options set out in this document, what do you see as the way forward for Bethesda? (Where possible please set out the reasons for your views.)
4. What other activities/services could Bethesda offer to meet the needs of the elderly within Gospel Standard chapels?
We would ask, however, that responses are legible, brief and to the point (maximum 1500 words) and that details of respondents are provided (this is to allow, if needed, clarification of points made and provide evidence of the ownership of the views expressed). In any published analysis, any points made will not be attributable to any individual(s). Please note: any anonymous contributions will not be considered.
All the comments made will be considered in helping inform the future thinking of the Bethesda trustees. The Bethesda trustees are also considering the best way to communicate the outcomes of this consultation with subscribers and other interested individuals.
Please return your submissions by Tuesday, 19 December 2017, either electronically to or in writing to: 

Bethesda Consultation
c/o Gospel Standard Bethesda Fund,
12(b) Roundwood Lane, 
AL5 3BZ .

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