Hope House was designed to take a total of eight children in specially designed single rooms with up to five families accompanying them in separate accommodation. However, pressure on bed space has been such that all eight beds are now fully used for pre-booked periods of respite care. In very exceptional circumstances two extra beds can be brought into use when emergencies arise. These may be medical emergencies - perhaps a sudden deterioration in a child’s condition - or an emergency within the family that incapacitates the usual carers.

 Under normal circumstances the maximum period of stay for planned respite is two weeks. However, when a child reaches the terminal phase of life they are admitted without any limitation on time: both the child and immediate family can use the facilities of the hospice for as long as necessary. Hope House care continues after the death of the child - for as long as the family needs our support. This may be counseling from the Social Worker or continuing contact with the staff who shared the last days of the child with family members. Siblings often develop close ties with the hospice after prolonged periods of stay with a life-limited brother or sister. It is part of the service to invite these children back to Hope House to spend further time with the Team after the death of the life-limited child. Sessions with the Play Leader may help them to express feelings of sadness or anger through the medium of carefully structured games or art. A special programme of continuing bereavement counseling for children who have lost a sibling is under way. It is called "Building Bridges" and involves Care Team Staff, trained counselors and volunteers.


    
Hope House makes no charge to families for any of the facilities or services provided. All funds are raised by appealing to the general public and commercial organisations and through the efforts of a network of Friends Support Groups. A small team of Appeals staff is employed to encourage these efforts under the guidance of an Appeals Director of considerable experience.
Less than 5% of the cost of running Hope House is met by contributions from Health Authorities, the bodies charged with Statutory responsibility for the care of terminally ill children. Various Government Ministers in the past six years have urged Health Authorities to enter into agreements with voluntary sector hospices to fund up to 50% of bed costs, viewing them as the most cost-effective providers of palliative care. The campaign to encourage Health Authorities to adequately meet their responsibilities in this regard continues - with little apparent effect.
        
The nursing staff of the hospice has now been expanded to facilitate the introduction of home care for children – predominantly those already using the hospice. In the wide rural area covered by Hope House road communications are not always good and there are many circumstances when it is more appropriate for the support to travel to the family home rather than for the vulnerable child to journey to the hospice. This additional burden on the revenue costs of the organisation is met by increased fundraising efforts and a modest grant from the NCLB