Report and Financial Statements - Integrated Neurological Services

Transcription

Report and Financial Statements - Integrated Neurological Services
Integrated Neurological Services
Report and Financial Statements
for the year ended 31 March 2014
Certified member
ISO 9001
Registered Firm
International
Accreditation Board
This organisation has been
certified as a producer of reliable
health and social care information.
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Registration No. 0044/1
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Supporting people with Multiple Sclerosis, Parkinson’s disease, Stroke and other neurological conditions.
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Contents
Our work in 2013/14
Introduction from the Chairman and Summary of Achievements 13/14
2
Introduction to our Services
3
Service Activity
4
Long Term Groups
4
Day Respite
4
Short Term Groups
4
Community Independent Living – CILS (Richmond)
5
Health & Well-being (Hounslow)
5
Care Navigation (Hounslow)
5
Carers Outreach (Hounslow)
5
Carers Peer Support and Training (Hounslow)
7
Carers Services (Richmond)
7
Volunteers7
Befriending7
Future Plans for 14/15
8
Our Organisation
Report of the Trustees for the year 2013/14
9
Changes to INS Objectives
9
Governance, Management and Committees
9
Organisational Structure
9
Clinical Governance
9
Risk Management
11
Staff Restructure
11
Engagement11
Education11
Events12
Communication12
Premises12
Our Finances
Financial Review
14
Statement of Financial Activities (summary)
16
Balance Sheet
17
Notes18
Independent Auditor’s Report
25
About us and Thank you
Grants/Thank You List of Major Funders and Donors
About INS
Legal and Administrative Information
27
28
29
Introduction from the chairman
I am pleased to introduce a new look Annual Report,
which I hope successfully blends the best of the wellestablished INS approach with a new twist in response
to the challenging new world of health and social care
in which we are working. This statement summarises the
past year for INS.
The voluntary sector faces new challenges as charitable
donations reduce and grant funding from Councils and
the NHS is replaced with contracts and commissioning.
INS has responded enthusiastically to this new world and
has won new contracts in both boroughs including:
• An innovative approach to 3rd sector capacity building
in Richmond (CILS – Community Independent Living
Service) and
• An innovative approach in Hounslow to supporting
people access services (Care Navigation).
We have also maintained our long standing original range
of services for both clients and their carers, including
long term and short term groups, individual support and
annual reviews for every client and carer.
We have refreshed the Board of Trustees and updated our
charitable objectives – and to do this we had to satisfy the
Charity Commission that by widening our objectives we
would not lose any of our focus on continuing to support
those with neuro-disabilities.
Demand for our services continues to rise – 30% of GP
appointments and 70% of hospital in-patient beds are
used by people with long term conditions. To take one
example, the success of new approaches to acute stroke
services in the last decade means that the death rate in
London has halved – however there are now 50% more
stroke survivors needing support in the community to
maximise their well-being while NHS community services
remain short of resources and unable to provide long
term support.
We continue to benefit from a wide range of student
placements including medical, allied health professionals,
social work, sports science and music therapists.
In the forthcoming year we face more changes with
the implementation of the new Care Act and planned
changes in the provision of health and social care in
north west and south west London, linked to the Better
Care fund.
The organisation has developed significantly with major
changes to the staffing structure and the staff group
almost doubling in size, funded by the new contracts.
We thank all who have generously made donations or
provided support which has enabled us to maintain our
services in a challenging funding environment for the
sector. In particular we would like to record our thanks
to the Big Lottery Fund who have provided us with
management cost funding which has enabled us to
achieve these successful developments.
Finally, on behalf of all Trustees, I express my thanks to
all our staff. They, with our volunteers, befrienders and
supporters, are our strength.
.
Dugald Millar
Chair INS, July 2014
2 | Annual Report and Accounts | Our Work in 2013/14
Improving Quality of Life is at the Core of INS
INS provides ongoing professional support for people
with complex long term conditions and their carers.
Our aim is to support individuals to maintain their
independence and mobility and achieve the best
possible quality of life.
INS was initially established in 1993 to fill a major gap in
the ongoing support of people living with long term
neurological conditions, predominantly Parkinson’s
Disease (PD), Multiple Sclerosis (MS) and Stroke. It
was registered as a charity in 1999. In the last decade
additional neurological conditions have been supported
as long as the skills have been within the team to provide
a quality service e.g. Brain Tumour, Ataxia, Motor Neurone
Disease (MND), Multiple Systems Atrophy (MSA), Primary
Supranuclear Palsy (PSP) and Head Injury.
Since then INS has expanded and now operates in
Richmond and Hounslow boroughs, out of dedicated
premises, supporting clients and carers through tailored
programmes of individual support. We now also provide:
• Care Navigation services to signpost and support
people with long term conditions to gain access
to services
• Support for unpaid carers of people with long term
conditions such as dementia and diabetes and
• Lead delivery of a range of community well-being
services.
services provided by
“Neurorehabilitation
state-funded NHS Trusts and Social Services
are by necessity focused on short-term
resolutions. For maximum effectiveness
of rehabilitation, ongoing participation
in a structured programme of therapy
represents the ideal and this is the form
of service provided by Integrated
Neurological Services (INS).
This unique charity has helped to bring
about dramatic improvements in disability
and quality of life for many of my own
patients, by improving their confidence and
self-worth, alleviation from isolation and
importantly establishing effective strategies
As far as we know, INS is the only organisation
of its kind in the UK.
INS provides ongoing rehabilitation for our
neurological clients through therapy and education,
together with practical self help techniques and solutions.
Our integrated services are delivered by specialist
Physiotherapists, Occupational Therapists, Speech
and Language Therapists, Social Workers and
Rehabilitation Assistants. People with other long term
conditions are supported by care navigators and their
carers are helped by carer support workers.
In a population of 100,000, approximately 1,000 people
will be living with a neurological condition (Neurological
Alliance). People with long-term conditions now account
for about 50 per cent of all GP appointments, 64 per cent
of all outpatient appointments and over 70 per cent of all
inpatient bed days (NHS 2012).
Treatment and care for people with long-term conditions
is estimated to take up around £7 in every £10 of total
health and social care expenditure. The number of people
with three or more long-term conditions is predicted
to rise from 1.9 million in 2008 to 2.9 million in 2018
(Department of Health 2012, Report: Long-term conditions
compendium of Information: 3rd edition). It is due to this
extensive level of unmet need that INS amended its
articles to include other long term conditions.
for coping with complex disabilities.
Interventions are carefully tailored to the
needs of each individual, which together
with education for both clients and their
carers, is designed to maximise their
independence and dignity.
I have been most impressed by the
enthusiasm and dedication of INS staff
and I am glad that I can refer my patients
to these passionately committed
professionals, who significantly enhance
the care of those suffering from serious
neurological disorders.
Dr. R.K.B. Pearce,
Consultant Neurologist
”
Integrated Neurological Services | 3
Service Activity
The full range of our clinical services is available to all
residents of both boroughs with neurological conditions.
Any gaps in funding are bridged by charitable grants and
donations thanks to the generosity of our supporters. This
allows the INS clinical team the flexibility to continue to
support individuals in a way that is most relevant for them
and for as long as is needed, often until the end of life.
During the year, INS supported a total of 683 clients with
neurological conditions and 438 carers. Chart 1 (right)
shows the breakdown of clients by condition over the
past three years:
from 104 the previous year. 56% of clients taken on were
from Hounslow and 44% from Richmond.
Chart 1
Clients by Condition
683
228
504
438
172
130
155
98
80
253
These clients received over 7,400 individual interventions:
42% in long term groups, 24% in short term groups and
34% in one-to-one sessions.
153
Their family carers received 777 interventions, through
one-to-one and group support.
50
58
72
2011/12
2012/13
2013/14
A total of 179 people with neurological conditions were
referred to the clinical team during the year 2013-14, up
Parkinson’s
176
MS
Stroke
Other
Neuro-specific Service Delivery
Every new client and their carer receive an assessment
at home by professional staff leading to joint agreement
of goals, which are reviewed regularly. There is ongoing
monitoring and evaluation of all interventions.
Long Term Groups
Following changes introduced in January 2013 to increase
capacity in the long term groups, the majority now meet
fortnightly. This has enabled us to start two new stroke
groups as well as additional groups for people with MS,
PD and communication difficulties.
Day Respite
INS continues to run a joint day respite project with
another local charity – Homelink. INS@Homelink was
set up in 2012 and runs one day a week to offer carers
respite with INS delivering physiotherapy, occupational
therapy (OT) and speech input to provide a stimulating
environment for the clients who attend, with nursing care
provided by Homelink. It is very popular, with a 100%
satisfaction rate for both clients and carers. There is huge
unmet need for stimulating day respite services in both
Hounslow and Richmond resulting in a long waiting list
for INS@Homelink. This service is currently unfunded and
being covered by INS reserves.
One client commented “Love coming! Socialising is good”
and a carer said “I am so much more relaxed and feel that
we have more to talk about. Thank you so much.”
4 | Annual Report and Accounts | Our Work in 2013/14
Short Term Groups and One-to-One Programmes
INS has continued to develop the range of short term
groups it offers. The following are examples of just a few
of the innovative new programmes introduced during
the year:
• ‘Helping Communication’ - teaching people who have
had a stroke and suffer with aphasia and their partners
strategies to communicate more effectively, improving
relationships and helping to reduce isolation.
• iPad use – exploring the potential of tablet technology
for communication, social media or pleasure.
The majority of our clients are older people who
are nevertheless keen to learn how to use technology
to improve their quality of life.
• Music therapy – through both an instrumental/singing
group and one-to-one sessions – initiated by a music
therapy student on a 6 month placement which will
now continue with a small Lottery grant and Richmond
Community Learning funding. This has brought great
pleasure and stimulation to the participants, several
of whom had not sung or played an instrument since
being diagnosed with their condition.
• Counselling – offering one-to-one sessions with a
counselor for both clients and carers, helping them
to come to terms with their condition and their change
in roles.
Contracted Services for
Long-term Conditions
Community Independent Living Service (CILS)
This new initiative for Richmond aims to ensure local
health and well being services are developed and
managed in partnership with local people. In January
2014 INS was awarded the contract
for the Richmond, Kew,
Community
Ham & Petersham area of
Partnership
the borough. Richmond
AID was awarded the contract for Teddington and
The Hamptons. Together we formed the Community
Partnership with 8 other local organisations: Kew
Community Trust, Alzheimer’s Society, Richmond Mind,
Richmond Adult Community College, Ethnic Minorities
Advocacy Group, Richmond Homes and Lifestyle Trust,
Hampton and Hampton Hill Volunteer Group and Elleray
Hall to deliver the service.
extend the remit each year. The programme enables
clients and carers, many of whom do not come to
regular INS groups, to try out different activities and do
something enjoyable in a supportive environment. This
year we offered 26 different activities, with something for
everyone: creative groups, physically demanding activities
such as modified water-skiing, relaxing interludes such as
massage and many outdoor events. The activities were
all very popular with an overall satisfaction rate of 98%.
Our Richmond Health and Wellbeing and Information
Navigation service was launched in May. It aims to work
in partnership and promote independence, choice and
control to enable individuals to stay healthy and actively
involved in community life. The key areas are:
Care Navigation (Hounslow)
The Care Navigation Service, a specialist care coordination
service linked to each of the 5 GP localities in Hounslow,
has developed during the year with more referrals from
GPs and Practice Nurses. From the start in September
2013 to end March 2014, 247 referrals were made to the
new service. The referral rate continues to grow steadily.
An extension to our funding enables us to continue to
improve the quality of care for individuals with long term
conditions and their families; empowering and supporting
people to maintain independence and enabling them
to lead active lives in their local communities. It has
supported health and social care professionals to work
together in creating networks to implement this personcentered model of care.
• Early intervention and prevention – enabling people
to access the personalized support needed to stay
independent for as long as possible.
“A responsive service. Really co-operative and easy to
work with. Our patients give great feedback on the
service they get.”
• Social capital – building strong communities through
the development of informal support networks to
contribute to a sense of belonging and wellbeing.
Sue Jeffers, Managing Director,
Hounslow Clinical Commissioning Group (CCG)
Any local resident can refer to and use the service and
we look forward to working collaboratively with Age UK
Richmond, the other lead provider, to ensure there is
a seamless and effective service across the whole
of Richmond borough.
Carers Outreach Service (Hounslow)
After being awarded a 3 year contract, the Carers
Outreach Service was set up in June 2013, for the carers
of people who have long term conditions (including
dementia). It is delivered by INS, in partnership with the
Alzheimer’s Society, Ealing Mencap and Richmond AID.
Health and Wellbeing (Hounslow)
Through this initiative we are working with Age UK
Hounlsow and St Mary’s Univerity College to support
our clients and carers to access a wide range of activities
in the community, helping to increase their community
participation. Examples incude Nordic walking, yoga
and Zumba exercise.
We were also able to deliver our “Expanding Horizons”
summer programme for Hounslow residents: an initiative
we developed a couple of years ago and for which we
All carers referred are assessed by an allocated Carers
Outreach Worker to identify how best to support their
needs and improve carer well-being. Common themes
include the need for carer training; referral for local
authority assessment for funded services; support to liaise
with other agencies; support with housing, and ongoing
emotional support.
Carers Outreach Workers can support carers individually,
provide time to listen to concerns and respond proactively
to needs.
Integrated Neurological Services | 5
Ruhi Grover,
Care Navigator for INS
Ruhi is a Care Navigator for the Isleworth &
Brentford areas for INS. After working at Mencap
for 11 years, she was so impressed with Ann
Bond, CEO of INS, she was easily persuaded
to take on the new role.
“I work with clients who have a wide range of
long term conditions to provide navigation
through issues which can arise with any of
them. GP’s refer their vulnerable patients
to us who find they may have depression,
financial issues, or needing housing
benefit, to name just a few of the common
issues. Some of our clients have falls and
are in need of an OT from Social Services
for an assessment, which could take
up to 48 days. As we know the right
channels, we can get this help much
quicker, often within a week.
My role is much more than
signposting. I will actually organise
services for the client, getting them
what they need in a quicker time
scale. This helps to avoid more
hospital admissions and repeated
doctor’s appointments as we are
based in the community and get
to know who is in need of more
care and help.
I know it sounds clich´e but I love
my job as I can see it clearly makes
a difference to the people I help. I
lost my parents four years ago and
remember good friends being
there for them and helping them
out. Many of us are so busy with
life, we don’t have time to be there
for older or long-term sick family
members. I know I can be there
for them.
INS is a compact but varied team
which I feel is a microcosm in a larger
society. We help give a more holistic
approach of care to our clients.
I just wish we could replicate what
we provide throughout the UK.”
Service Activity continued
Carers Peer Support and Training,
including Counselling (Hounslow)
This service delivers a programme of training and peer
support to carers and ex-carers. The Carers Outreach
Service is developing an expert carer programme
– to build confidence and independence, peer
support groups, and online support and training.
The support and information that Carers receive
empowers them to have a life of their own whilst
continuing their caring roles. Types of training offered
include first aid, back care and injury prevention and
information on how to develop new interests and skills.
A monthly employment drop-in service for working
carers has been established. This flexible service
provides materials and resources on job searching and
employment rights. one-to-one support with searches
is also provided when appropriate.
Carer Peer Support groups provide positive emotional
support focusing on empowerment and the importance
of carers taking care of their own emotional wellbeing
and physical health.
Access to a counsellor is available for 8 weeks of
counselling. We are also offering Taking Back Control
for carers, and a ‘Fit and Well’ exercise group.
These services for Hounslow carers received 276 referrals
in the period June 2013 to March 2014.
Carers Services (Richmond)
INS is part of the Richmond Carers Hub, working with
Richmond Carers Centre and several other partners,
referring any carers to the Carers Centre for support with
wellbeing. INS is contracted to provide emotional support
and leisure breaks to carers of people with neurological
conditions.
true that, like me, many GPs are
“Itnotis probably
very aware of the work of INS. However
when I asked some of our patients recently
it was a real eye opener. One carer described
INS as “a smashing organisation, always there
but never in your face, just really supportive.
I couldn’t speak more highly of them”.
Another spoke of the opportunities for her
husband to participate in life enhancing
Volunteers
Following on from Innovation Grant funding from
Hounslow borough, we have retained our Volunteer
Coordinator post to focus on the recruitment,
development, induction and training of new volunteers.
This has included the development of induction sessions
for groups of volunteers which have proved highly
successful and have improved recruitment and retention.
INS is supported by over 80 volunteers, 23 of these
recruited in the last 12 months including many clinical
professionals. Over 12,000 volunteer hours of activity
were provided during the year, delivering invaluable
support. The clinical volunteer roles have been extended
to include not only group support and befriending but
the development of ‘buddies’ to accompany clients to
new activities in the community and help minimise social
isolation. We are recruiting volunteers from amongst both
clients and carers as well as external sources to provide
peer support and to act as ‘buddies’.
With the growth of INS we also continue to have a
significant demand for volunteers to assist with admin
and clerical roles and fundraising activities.
Befriending
The befriending service continues to develop with those
clients considered in highest need all being matched with
a suitable volunteer. Anyone assessed by the INS clinical
team (in Hounslow or Richmond) is eligible for this service.
Regular visits from supportive volunteers help to reduce
isolation, loneliness and depression for clients and make a
real difference to their quality of life and well-being. This
service may also support a carer experiencing high levels
of stress, who would appreciate “time out” from their
caring role and can do so knowing that the person
they care for is in safe hands.
activities and said “It’s just so good to have
them there to help”. As GPs we have a
tendency to focus on the medical side of
things but that is only a part of what people
with long term disabling conditions need
to cope with. INS really does seem to fill an
important gap and improve quality of life
for patients and carers alike.
Dr. Marilyn Plant,
Glebe Road Surgery
”
Integrated Neurological Services | 7
Future Plans for 2014/15
INS aims to continue to deliver on its charitable objectives,
providing services that complement the statutory
health and care services and advocating on behalf of
neurological and other long term conditions (LTC) for a
new model of care for LTC which promotes independence
whilst providing ongoing support when needed.
We plan to strengthen partnerships with other voluntary
organisations and to work closely with professional
colleagues in the health and social care teams in
Hounslow and Richmond both in the provision of
services, including cross-referral of clients, and in
strategic planning.
We will continue to work with commissioners and
providers in Hounslow and Richmond both to shape
future service design and to help deliver Borough and
CCG plans to provide integrated care in response to the
Better Care Fund and Care Act.
We will be submitting proposals for the expansion of the
Health and Wellbeing project in Hounslow, in partnership
with Alzheimer’s Society, and for the expansion of the
current Hounslow Carers Outreach Service to include the
provision of a Carers rights service.
Our focus will remain on outcomes based delivery,
working with clients and carers to co-deliver the support
necessary to maximise their well-being. We will also
continue to share our specialist expertise in developing
care pathways and in providing training opportunities.
We are interested in helping to pilot new approaches with
partners and will continue to explore opportunities to
expand our services into nearby areas.
INS music therapy session
The Challenge we Face
for our services is increasing each
“Demand
year. We have responded to the new world
of commissioning by winning a number of
contracts on our own and in partnership
with others. We are unique in the services
we provide which are clinically effective
and delivered to a high standard. Our
services are cost effective and save the NHS
significant sums by helping maintain people’s
independence and reducing the need for
expensive bed based services.
However the challenge we face is that our
core support for people with neurological
conditions is unfunded by the state and
totally dependent upon charitable donations.
8 | Annual Report and Accounts | Our Work in 2013/14
It is becoming increasingly difficult to raise
charitable funds in the current financial
climate.
Waiting lists are developing for our services
and we urgently need funds to recruit
additional occupational, physio, and speech
and language therapists. Each additional
£30,000 will allow us to recruit and pay for
another urgently needed member of staff
for a year.
Please help us to continue delivering
essential support for people with neurological
conditions in Richmond and Hounslow.
Ann Bond,
Chief Executive, INS
”
Report of the Trustees for the Year 2013/14
The Trustees of Integrated Neurological Services (INS)
present their report and audited financial statements for
the year ended 31 March 2014. The Trustees confirm that
they have had regard to the guidance contained in the
Charity Commission’s general guidance on public benefit
when reviewing the charity’s aims and objectives, and in
planning and implementing its activities.
Changes to our Objectives for the Public Benefit
Established in 1993 and originally registered as a charity
in 1999, Integrated Neurological Services (INS) became
a charitable company limited by guarantee in 2004.
The company was established under a Memorandum
of Association which established its objects and powers
and is governed under its Articles of Association.
In October 2013, INS made minor but important changes
to our objects, which were agreed by the Trustees and the
Charity Commission. These objects are designed to align
the charity with current directions in health and social
care, as well as more accurately reflect the areas we serve.
The charity is established to relieve sickness by:
• The provision of support for people with neurological
disabilities (such as Parkinson’s Disease, Multiple
Sclerosis and Stroke) and other long term conditions
and their carers.
• Advancing education in the care of people with
neurological conditions.
• Providing services in the London Boroughs of Richmond
upon Thames and Hounslow and other neighbouring
areas of Middlesex and Surrey.
Structure, Governance and Management
Recruitment and Appointment of Trustees
Trustees are elected to serve for a period of three years
after which they may stand for re-election at the Annual
General Meeting for a further 3 years.
The Board of Trustees currently consists of twelve
members and contains a broad mix of skills, including one
service user, several experienced clinicians in the field of
neurological conditions and individuals with business,
financial, legal, marketing and fundraising experience.
Trustees
During the year Dugald Millar was appointed chairman.
The Board would like to thank Alan Britten for taking
on this role during the period of interregnum.
During the year three new trustees were appointed.
Trustee Induction and Training
New Trustees receive an induction from the Chair, the
Chief Executive and the Clinical Manager. They are
invited to view a range of INS services in action. They
are provided with Charity Commission publications on
the roles and obligations of trustees and are invited to
familiarise themselves with the charity and the context
within which it operates.
Organisational Structure
The Board of Trustees of INS meets four times a year in
addition to the AGM and is responsible for the strategic
direction and policy of the charity. The Chief Executive
meets regularly with an Advisory Group of Trustees, to
discuss issues that cannot wait until the next meeting of
the full Board. Detailed work is undertaken through the
following committees which meet quarterly:
• Finance and Fundraising
• Clinical governance (clinical policy,
audit and safeguarding)
• Events
• Marketing and communication
Clinical Governance
In May 2013 a Clinical Trustees subcommittee was
restarted. We have a clear focus on clinical governance
and risk management and meet the relevant
requirements of both the NSF and NICE guidance. This
focus has led to the development of detailed policies and
procedures. We have continued to focus on reviewing
and improving our internal practices including on-going
note audits, improving monitoring of accidents and near
misses and refining our electronic recording to improve
our reporting, especially demographics.
Integrated Neurological Services | 9
Harbans Singh King and
hi s Wife, Parminder,
Stroke Client
Parminder had a stroke a year and a half
ago and had an operation at Charing Cross
hospital before being transferred to West
Middlesex hospital. She lives at home,
cared for by her husband, Harbans.
“At first my wife couldn’t speak and couldn’t
swallow well. Her right hand was affected
and she could only walk short distances.
She can be very emotional. I felt it was role
reversal. I had to now take care of her.
After hospital Parminder was given
physio for about four or five weeks.
Then that was it. You are left to your
own devices. They said to us, ‘You
don’t understand you have to live
with this now’. This kind of speak is
not professional. I felt very frustrated
and it broke my heart. We don’t have
any family close by and are on our
own. I can’t leave Parminder on her
own in case she has a fall. I have to
watch her but she can handle the
stairs now.
INS helped a lot. Their behaviour
is so good. I feel they are part of
our family. I was very impressed.
Whenever I call the office they
are all lovely and give you so
much information. They have
given Parminder the opportunity
to try new things. The latest is
hydrotherapy. Why not?
Their communication is so good.
We get letters delivered so we know
what is happening and when.
We had a few home visits from INS and
Parminder had one-to-one physio. They
helped her use her right hand again and
start writing as well as other exercises.
We can call any time if we need more help.
INS are so helpful. They are lovely.
They are angels!”
10 | Annual Report and Accounts | Our Work in 2013/14
The committee meets quarterly and is made up of
trustees with valuable and extensive clinical experience.
In November 2013 we held a clinical strategy meeting and
are very grateful to external advisors who also attended
this event. The meeting explored how we can ensure
that we deliver our services to all areas of the community,
improve communication with other teams and support
clients on their whole journey.
Risk Management
INS adopts a rigorous policy of risk assessment and
review. The risk register assesses all perceived major
risks in terms of likelihood and gravity, to which the
Chief Executive and the senior management team
append mitigation notes. The register is subjected
to full annual review by the Trustee Board, or more
frequently by exception. The Finance Committee
reviews the risks at each quarterly meeting.
All major risks are reviewed, but Trustees are particularly
sensitive to risk associated with the loss of key personnel,
the expiry dates of contracts, partnership working,
funding limitations and of course the safety risk for clients,
staff, volunteers and befrienders, both during treatment
sessions and home visits.
Staff Restructure
INS has expanded rapidly in this last 12 months and a full
HR review has been carried out to respond to the changes
that are being brought about by the Tender process and
to ensure that job descriptions and employment contracts
reflect the requirements and responsibilities of any
contracts.
To this end we have employed a Care Navigation team
to fulfil the requirements of the Hounslow CCG pilot, a
Carers Outreach and Training team to deliver the London
Borough of Hounslow Carers contracts and an additional
social worker has been appointed to ensure the ongoing
needs of existing clients are fully met while these new
services are developed by our social work manager.
A second fundraiser has been employed to increase grant
applications, challenge events and boost our unrestricted
income.
The clinical team has expanded with the introduction of a
new full-time band 5 Occupational Therapy post in April
2013 and part time volunteer co-ordinator in May 2013. INS
has been able to recruit to all vacancies without long gaps
or needing to use agency staff.
Engagement with Clients and Carers
Working in partnership with client and carers is central to
our philosophy and development at INS. At the heart of
INS is a commitment to work alongside every client and
carer to maximise autonomy. It is a genuine partnership
in which interventions are tailored to help each individual
reach his or her goals in a timeframe that works for them.
This enables people living with long term conditions to
remain independent for longer through the provision of
disciplined and effective strategies for coping with their
complex disabilities, both physical and psychological.
This, combined with a strong emphasis on peer support
and regular input on a long term basis, distinguishes INS
services and produces significantly improved results.
Consultation with service users is central to the
development of INS, carried out through a variety of
channels including regular informal discussions, feedback,
questionnaires and involvement in strategic planning
events. The INSight Group, an active and independent
group of clients and carers, representing all sections of the
INS community, meets quarterly with the Chief Executive
and the Clinical Manager to provide crucial input into
the development and direction of INS. Minutes of the
meetings are presented to the Board and Trustees are
invited to attend INSight meetings.
INS carried out a biennial survey of clients and carers in
2013. We piloted using an electronic questionnaire as well
as paper copies. The use of electronic questionnaires will
be further developed for 2015. The survey indicated that
98% of our clients would recommend INS to others, 79%
of clients said that INS helped them understand their
condition better and 65% said INS helped them feel part
of a group or community.
In August 2013 we introduced a news-sheet: INSide News.
This is sent three times a year to all INS clients explaining
the range of short and long term groups that are available.
INSupport has been devised as a regular news bulletin for
carers in addition to our Newsletter INSpire which is sent
to all involved with INS.
Education
INS is a learning environment not only for clients and
carers but for staff. INS has provided fieldwork placements
for Physiotherapy, Occupational Therapy and social
work students, as well as sports science, psychology and
social science students on shorter term placements from
different universities. For the first time INS supported a
Integrated Neurological Services | 11
music therapy student from Nordoff Robbins College
on a six month placement. Moving forwards INS plans
to increase the number of student placements it is able
to offer including the development of placements for
speech and language therapy students.
Clients play a pivotal role in teaching sessions with
physiotherapy students from South Bank University and
regular teaching sessions for medical students from St
Georges University of London. This includes modules in
neurology, inter-professional working and rehabilitation.
The students find the direct contact with people with
neurological conditions and their carers of immense
benefit. Students’ comments from these sessions
include “the small student groups per patient was extremely
rewarding and useful” and “understanding the increased
health risk to carers that is often ignored”.
Specialised training is provided to other organisations
as required.
Events
A wide range of both large and small events has been
held during the past year. These activities are critical to
our successful fundraising and also help promote INS.
We continued our tradition of an annual major lecture
and a large and appreciative audience gave a warm
welcome to Professor Robert Winston on 23 October,
when he delivered a fascinating and wide-ranging talk
(“Are we facing the end of Humanity?”), held once again
at Hampton School Performing Arts Centre.
INS offers iPad workshops to help improve coordination and dexterity.
Communication
We have been fortunate to receive ongoing support
from Sara Challice, Trustee in developing our brand and
marketing materials. Through her we were put in touch
12 | Annual Report and Accounts | Our Organisation
with Stich Communications who have assisted with
developing a communication strategy and through votes
from our supporters we have been awarded £10,000
of in kind support from NUDGE Digital to develop
our website and deliver our communications strategy,
to help us promote our service and demonstrate our
effectiveness to the wider community.
Communication with supporters and other interested
parties are conducted in various ways, including the
Annual Report, Newsletters, the charity’s websites
www.ins.org.uk and www.inspartnership.org.uk, tailored
mailings and events such as the annual Open Day at the
charity’s premises.
Premises
Responding to growing demand for our services, INS
signed a new lease for the whole of 82 Hampton Road,
Twickenham, increasing our floor space by 45%.
Additional space was required to meet the ever-increasing
demand for our services and because local councils
and GPs encouraged INS to use its expertise to support
beneficiaries across the wider spectrum of disabilities
and long term conditions, resulting in INS winning new
commissions. This additional space brings a number of
advantages to INS and our clients, most importantly by
moving all our office functions to the first floor. This has
enabled the whole of the ground floor to be converted
to accessible client facilities, consisting of: a main group
therapy room, a second therapy room where individual
sessions can take place, a meeting room for groups
such as communication, memory, music therapy and
carer support, a small meeting room for counselling or
clinical supervision and our outdoor accessible garden
space with graded raised flowerbeds for the popular
gardening groups.
In Hounslow we continue to use the excellent facilities
provided by the Council at Sandbanks Resource Centre on
two days a week. We have also taken on office space and
meeting facilities at the Hounslow Treaty Centre, where
newly-refurbished space for the voluntary sector is being
managed by CAN-Mezzanine. Staff employed under the
Hounslow contracts are now based there. Partnership
working in Hounslow has also offered the opportunity to
deliver groups in new venues such as Isleworth Town Hall
and Tolson House.
Darren Cooper, Parkinson’s Client
Darren was diagnosed with Parkinson’s
disease over 11 years ago. Since then he
has undergone DBS (Deep Brain Stimulation)
due to the disease becoming so severe.
“Before I was diagnosed with Parkinson’s I was
a travelling musician, playing the guitar and
singing in over 40 countries. I had to come back to
Twickenham, to have DBS which helped stabilise me.
My partner, along with our daughter, left me as it
was all too much for them and I now live on my own.
Parkinson’s was life changing. Before that it was
about me and work. You don’t think about much
else until something big happens to you.
INS gave me my confidence back. Before then I
was becoming a recluse because I felt embarrassed
to go out. The ‘Taking Back Control’ group at INS
helped me meet other people with my condition
and it gave me a chance to evaluate. We shared our
experiences and it gave me different ideas about
day-to-day issues which affected me. Every week
was varied.
I go to the Fit Club which is really good. It’s very
physical and got me up and running again. I feel
a lot livelier.
The Music Group has given me the confidence
to play guitar and sing again. Some of the other
guys are wheelchair bound but they’re smiling
and enjoying it.
INS has given me the strength to carry on.
Without them I don’t know where I’d be. They
have shown me things I would never consider.
I find it unbelievable they are the only charity
like this in the country.”
Our Finances
Results
The net result for the year was a surplus of £29,493
(2012/13: (£18,820)) an increase on the prior year of £48,313.
Income
The income for the year was £977,239 (2012/13: £553,470)
this substantial increase being credited to the extension
of existing contracts as well as being awarded a number
of new contracts throughout the year.
The transition from statutory grants to commissioning
is still ongoing but steady progress has been made.
As previously predicted, contracts now make up the
largest section of income amounting to £548,019 during
the year (including statutory grants). This is expected to
continue to grow at a steady pace (see below Chart 2).
Chart 2
1.47%
Income by Type
4.81%
Total: £977,239
1.80%
1.47%
4.81%
1.80%
Charitable expenditure increased during the year by
£382,207 to £826,714. This increase in expenditure is
in line with the increase in income from new and
extended contracts awarded.
Expenditure on fundraising fell to £75,881
(2012/13: £87,155).
Chart 3
Expenditure by Activity
Total: £947,746
60.00%
50.00%
40.00%
20.00%
56.08%
33.16%
1.98%
0.03%
0.68%
33.16%
1.98%
0.03%
0.68%
31.36%
30.00%
10.00%
56.08%
55.87%
0.00%
4.76%
8.01%
£45K
£297K
£529K
£75K
Governance Social Work Clinical Fundraising
Costs
Services Services
Total funds at 31 March 2014
£548KGrants
Contracts & Statutory Grants
£548K Contracts & Statutory
£102,000
£14K Income from teaching
£14K Income from teaching
£47K Donations & Legacies
£47K Donations & Legacies
Investment Policy
£18K Voluntary
contributions from users
£18K Voluntary contributions
from users
All the charity’s funds are required for expenditure to
£324K Grants
£324K Grants
maintain the services in the short term. There are no
£19K
Fundraising
activity
income
£19K Fundraising activity income
£0.3K income
Interest & investment income
£0.3K Interest & investment
funds available for long term investment, although
£7K Other income £7K Other income
where practical, surplus cash under the Reserves Policy
Expenditure
During 2013/14, 81 pence in every pound of total
expenditure was spent on direct costs towards providing
long term rehabilitation and support for people with
neurological conditions particularly Multiple Sclerosis,
Parkinson’s disease or those who have had a stroke.
(2012/13: 78 pence).
The remaining 19 pence in every pound was spent to
support our frontline activities. Costs included premises,
office costs and communication and marketing costs.
14 | Annual Report and Accounts | Our Finances
is invested in a high-interest, relatively short-term
deposit account.
Reserves Policy
At the end of the financial year, the Trustees’ policy of
maintaining the equivalent of at least three months’
expenditure in unrestricted reserves remained unmet.
However the trustees are committed to building on
the current unrestricted reserves going forward. As at
31 March 2014 the total reserve position was £102,172
(£72,679, 2012/13) an increase of £29,493. This includes
a restricted fixed assets fund of £12,313.
Responsibilities of the Board of Trustees
Company law requires the Board of Trustees to prepare
financial statements each financial year which give a true
and fair view of the state of the affairs of the charitable
company as at the balance sheet date and of its incoming
resources and application of resources, including income
and expenditure, for the financial year. In preparing those
financial statements, the Trustees should follow best
practice and:
• Select suitable accounting policies and then apply them
consistently;
• Make judgments and estimates that are reasonable and
prudent; and
• Prepare the financial statements on the going concern
basis unless it is inappropriate to assume that the
company will continue on that basis.
The Trustees are responsible for maintaining adequate
accounting records which disclose with reasonable
accuracy at any time the financial position of the
charitable company and to enable them to ensure that
the financial statements comply with the Companies Act
2006. The Trustees are also responsible for safeguarding
the assets of the charitable company and hence for taking
reasonable steps for the prevention and detection of
fraud and other irregularities.
Members of the Board of Trustees
Members of the Board of Trustees, who are directors for
the purpose of company law and trustees for the purpose
of charity law, who served during the year and up to the
date of this report are set out in the section entitiled
‘Legal and Administrative Information’ which is on the
inside back cover.
In accordance with company law, as the company’s
directors, we certify that:
• So far as we are aware, there is no relevant audit
information of which the company’s auditors are
unaware; and
• As the directors of the company we have taken all
the steps that we ought to have taken in order to
make ourselves aware of any relevant audit information
and to establish that the charity’s auditors are aware
of that information.
Auditors
Coulthards Mackenzie were re- appointed as the
charitable company’s auditors at the Annual General
Meeting.
This report has been prepared in accordance with the
Statement of Recommended Practice: Accounting and
Reporting by Charities (issued in March 2005) and in
accordance with the special provisions of Part 15 of
the Companies Act 2006 relating to small entities.
Approved by the Board of Trustees on 24th July 2014
and signed on its behalf by:
Alan Britten
Trustee
Integrated Neurological Services | 15
Statement of Financial Activities:
for the year ended 31 March 2014
(including an Income and Expenditure Account)
Notes Unrestricted Restricted Total Funds Total Funds
FundsFunds 2014 2013
££ £ £
Incoming Resources
Incoming resources from
generated funds
Voluntary Income:
Donations and legacies
46,968
46,968
30,748
Voluntary contributions from users
17,583
17,583
19,692
Grants
2/16
31,250292,776 324,026 299,606
Activities for generating funds:
Fundraising activities income
Investment income (bank interest)
Other income
3
19,367
270
6,621
19,367
270
6,621
21,615
960
4,395
Incoming resources from
charitable activities
Grants and Contracts
4/16
548,019
Income from teaching
14,385
Total incoming Resources
136,444
840,795
548,019
14,385
161,060
15,394
977,239
553,470
Resources expended Cost of generating funds
5 29,07546,806 75,881 87,155
Charitable activities5
Clinical services
53,267
476,195
529,462
315,600
Social work services
28,613
268,639
297,252
128,907
Governance costs
5 14,57430,577 45,151 40,628
Total resources expended
5
125,529
822,217
947,746
572,290
Net incoming resources
before transfers Transfers
10,915 18,578
29,493 (18,820)
6,265(6,265)
-
-
Net movement of funds
17,180
12,313
29,493
(18,820)
Reconciliation of funds
Total funds brought forward
72,679
0
72,679
91,499
Total funds carried forward
15
89,85912,313 102,172 72,679
The statement of financial activities includes all gains and losses in the year. All incoming resources and
resources expended derive from continuing activities.
16 | Annual Report and Accounts | Our Finances
Balance Sheet as at 31 March 2014
Notes
2014
2013
££
Fixed Assets
Tangible Fixed Assets
10
16,348
7,197
Current Assets
Debtors
11
16,524
25,672
Cash at bank
267,688
189,637
284,212
215,309
Creditors: amounts falling due within one year
12
(198,388)
(149,827)
Net Current Assets
85,824
65,482
Net Assets 14
102,172
72,679
Unrestricted funds
Restricted funds
15
89,859
16
12,313 72,679
0
Total Funds
102,172
72,679
These accounts are prepared in accordance with the special provisions of Part 15 of the Companies Act
2006 relating to small companies.
Approved by the Board of Trustees on 24th July 2014 and signed on its behalf by:
Alan Britten
Trustee
Integrated Neurological Services | 17
Notes forming part of the Financial Statements
for the year ended 31 March 2013
1. Accounting Policies
The principal accounting policies are
summarised below. The accounting policies have
been applied consistently throughout the year.
a) Basis of accounting
The financial statements have been prepared
under the historical cost convention and in
accordance with the Statement of Recommended
Practice “Accounting and Reporting by Charities”
(SORP), the Financial Reporting Standard for
Smaller Entities (FRSSE) (effective 2008) and the
Companies Act 2006.
b) Fund accounting
Unrestricted funds are available for use at the
discretion of trustees in furtherance of the general
objectives of the charity.
Designated funds are unrestricted funds
earmarked by the trustees for particular purposes.
Restricted funds are subject to restrictions on their
expenditure imposed by the donor or through the
terms of an appeal.
c) Incoming resources
Incoming resources are included in the statement
of financial activities when the charity is entitled
to the income and the amount can be quantified
with reasonable accuracy.
Voluntary income by way of donations, legacies
and gifts is included in full in the Statement of
Financial Activities when receivable.
Restricted grant income received in advance of
related future costs is treated as deferred income.
Restricted grants are used as specified by the
grantor. Details are provided in Note 16.
Donated services are included at their value
where this can be quantified. The value of services
provided by volunteers has not been included in
these accounts.
d) Resources expended
Expenditure is recognised on an accrual basis as a
liability is incurred. VAT which cannot be recovered
is recorded as part of the expenditure to which
it relates.
18 | Annual Report and Accounts | Our Finances
Costs of generating funds comprise the costs
associated with attracting voluntary income and
the costs of trading for fundraising purposes.
Charitable expenditure comprises those costs
incurred by the charity in the delivery of its
activities and services for its beneficiaries. It
includes costs that can be allocated directly to
such activities and also those costs of an indirect
nature necessary to support them.
Governance costs include those costs associated
with meeting the constitutional and statutory
requirements of the charity and include the audit
fees and costs linked to the strategic management
of the charity.
All costs are allocated between the expenditure
categories of the SoFA on a basis designed to
reflect the use of the resource. Costs relating to
a particular activity are allocated directly, others
are apportioned on an appropriate basis e.g. time
allocation.
e) Tangible fixed assets
Individual fixed assets costing £500 or more are
capitalised at cost. Tangible fixed assets are stated
at cost less depreciation.
Depreciation is provided at rates calculated
to write off the cost of fixed assets, less their
estimated residual value, over their expected
useful lives on the following basis:
Furniture and Equipment – 30% straight line
f) Cash Flow
The financial statements do not include a cash
flow statement because the charitable company,
as a small reporting entity, is exempt from the
requirement to prepare such a statement.
2. Incoming resources from generated funds:
Voluntary Income
Grants
Unrestricted Restricted
£
£
Big Lottery Fund Grant
Richmond Parish Lands Charity
Henry Smith Charity
City Bridge Trust
Hampton Fuel Allotment Charity
Awards for All
The Victoria Foundation
Skills for Care Ltd.
The Dunhill Medical Trust
The Childwick Trust
Barnes Workhouse Fund
4,000
James Tudor Foundation
10,000
Other Grants
17,250
Total
31,250
2014
Total
£
2013
Total
£
86,630
45,240
35,300
31,750
30,000
-
10,000
-
31,147
8,333
-
-
14,376
86,630
45,240
35,300
31,750
30,000
-
10,000
-
31,147
8,333
4,000
10,000
31,626
84,105
45,700
35,300
30,750
15,000
9,880
8,837
4,737
2,596
1,667
3,000
10,000
26,034
292,776
324,026
299,606
20142013
££
3. Other Income
Client payments towards cost of specific unfunded services
Total
6,621 4,395
6,621
4,395
4. Incoming resources from Charitable Activities
Grants /Contracts
Unrestricted
Restricted
£
£
2014
Total
£
2013
Total
£
London Borough of Hounslow
Contracts 0
427,820 427,820 83,142
Grants 0
54,900 54,900 14,920
London Borough of Richmond
Contracts 0
21,304 21,304 10,670
Grants 0
43,995 43,995 52,328
Total
0
548,019 548,019 161,060
Integrated Neurological Services | 19
5.
Total Resources expended
Direct (Staff)
Support Direct (other)
Total
Total
costs costs
costs20142013
£
£
£
£
£
Fundraising
43,132 31,939
81075,881 87,155
Clinical Services
431,746
87,180
10,536 529,462 315,600
Social Work Services
244,761
46,831
5,660 297,252 128,907
Governance
29,107 15,719 325 45,151
40,628
Total resources expended
Analysis of support costs
748,746
181,669
17,331 947,746
Fundraising
Clinical Social Work Governance
Services Services
£
£
£
£
Total
2014
£
572,29
Total
2013
£
Premises including
refurbishment
4,223
51,094
27,447
1,689
84,453
30,710
1,204
14,565
7,823
1,313
24,905
10,798
Office costs Communications
including Marketing
Event costs/consultancy
1,172 14,175
24,733
0
Depreciation
466 5,638
Management Including Professional fees
141
Total
Analysis of Direct (other) costs
31,939
1,708
87,180
7,615
0
3,029
917
46,831
47023,432 15,545
0
24,733
14,044
1869,3195,607
12,061
14,827
6,574
15,719181,669 83,278
Fundraising
Clinical Social Work Governance
Services Services
£
£
£
£
Total
2014
£
Total
2013
£
Staff expenses
Direct Project costs
Recruitment
Equipment/Supplies
309
3,737
378
4,571
0 742
122 1,487
2,008
2,455
397
799
124
6,178
4,159
152
7,556
5,472
01,1391,541
502,458 2,073
Total
809 10,537
5,659
32617,33113,245
20 | Annual Report and Accounts | Our Finances
6. Net Incoming Resources for the year 20142013
£
£
This is stated after charging:
Auditor’s remuneration
3,282 2,796
Depreciation
9,319 5,607
20142013
£
£
7. Staff costs and numbers Staff costs were as follows:
Salaries and wages Social Security costs Pension costs 669,492 61,107 18,147 421,026
34,928
19,813
Total 748,746 475,767
No employee received emoluments of more than £60,000.
The average number of employees during the year, calculated on the basis of full time equivalents,
was as follows:
Administration Social Work Services Clinical Services Fundraising 20142013
6.25 4.50
9.60 1.80
10.41 6.30
1.20 1.20
Total 27.46 The charity does not operate any pension scheme for its employees but does administer contributions
to a stakeholder pension scheme for 9 (2013–9) staff. The company makes contributions to this scheme.
8. Trustee Remuneration & Related Party Transactions
No trustee received any remuneration during the year.
No trustee or other person related to the charity had any personal interest in any contract or
transaction entered into by the charity during the 12 months.
9. Taxation
As a charity Integrated Neurological Services is exempt from tax on income and gains falling within
section 505 of the Taxes Act 1988 or section 256 of the Taxation of Chargeable Gains Act 1992 to the
extent that these are applied to charitable objects. No tax charges have arisen in the charity.
13.80
Integrated Neurological Services | 21
10. Tangible Fixed Assets Equipment
£
Cost at 1 April 2013 32,470
Additions 18,470
Cost at 31 March 2014 50,940
Depreciation at 1 April 2013 Charge for the year 25,273
9,319
Depreciation at 31 March 2014 34,592
Net Book Value at 31 March 2014 16,348
Net Book Value at 31 March 2013 7,197
20142013
£
£
11. Debtors Debtors, prepayments and accrued grant income 12. Creditors: Amounts falling due within One Year 16,524 Taxation and social security Grant income received in advance (Note 13) Accrued sub-contractors payments and expenses (20,285) (98,608) (75,872) (198,388) 20142013
£
£
Balance at 1 April 2013 Amount released to incoming resources Amount deferred in the year Balance at 31 March 2014 127,394 (127,394) 98,608 98,608 14. Analysis of Net Assets between funds
Unrestricted Restricted Funds Funds £
£
Tangible Fixed assets Current Assets Current Liabilities 22 | Annual Report and Accounts | Our Finances
(10,305)
(127,394)
(12,128)
(149,827)
20142013
£
£
13. Deferred Income
25,672
61,552
(61,552)
127,394
127,394
Total Total
Funds Funds
20142013
£
£
4,035 110,180 (24,356) 12,313 174,032 (161,719) 16,348 284,212 (198,388) 7,197
215,309
(149,827)
89,859 12,313 102,172 72,679
15. Movement of Funds Total Restricted Funds Unrestricted funds Total Funds At 1 Incoming Outgoing Transfers At 31
April 13 Resources Resources March 14
£
£
£
£
£
-
840,795 (822,217) (6,265) 12,313
72,679 136,444 (125,529) 6,265 89,859
72,679 977,239 (947,746) -
102,172
16. Purposes of Restricted Funds
All restricted funds are held as liquid assets and are used within the time period specified by the
grantor. The accounts show the amount applicable to this period. Balances are carried forward to
the next period as grant income received in advance.
Awards for All
This Lottery fund provides music therapy. A balance of £7,350 has been carried forward.
Big Lottery Fund Grant
The accounts show the amount applicable to the year of a 5-year grant to support the development
of the charity. The balance of £14,615 has been carried forward as grant income received in advance.
The City Bridge Trust
The last year of a three year grant to support older people living with a neurological condition.
The balance of £8,000 has been carried forward as grant income received in advance.
The Dunhill Medical Trust
The accounts show the amount applicable to the year of a 3 year grant to support the post of Review
Coordinator. The balance of £28,560 has been carried forward as grant income received in advance.
The Childwick Trust
The accounts show the amount applicable to the year of a 1-year grant to support the provision
of Hydrotherapy sessions for people with neurological conditions.
Hampton Fuel Allotment Charity
The total shown in the accounts is made up of two grants:
1. £15,000: A one year grant to support the cost of providing communication support to INS clients
and carers in the Borough of Richmond upon Thames.
2. £15,000: An additional one year grant was awarded to support the essential building and
refurbishment work carried out during the expansion of premises at Hampton Road.
The Henry Smith Charity
The accounts show the final year of a 3-year grant to support the costs of INS administration and
finance posts as well as the first period of a new 3-year grant for the same purpose. A balance of
£26,475 has been carried forward as grant income received in advance.
Integrated Neurological Services | 23
Richmond Parish Lands Charity
The total shown in the accounts is made up of two grants:
1. £21,715: A grant to support the costs of INS therapists. The accounts show the amount applicable
to the period. £10,875 has been carried forward as grant income received in advance.
2. £24,000: Year two of a 3-year grant to support the cost of providing communication support to
INS clients and carers in the Borough of Richmond upon Thames.
The Victoria Foundation/London Community Foundation
A grant for equipment for the new therapy area at Hampton Road.
17. Lease Commitments – Operating Leases
At 31 March 2014 the charity had commitments for payments in the following year under
non-cancellable operating leases as set out below:
Operating lease which expires:
After 5 years 24 | Annual Report and Accounts | Our Finances
20142013
Land and Land and
Buildings Buildings £
£
31,000 20,865
Independent Auditor’s Report to the
Members of Integrated Neurological Services
We have audited the financial statements of Integrated
Neurological Services for the year ended 31 March
2014 which comprise the Statement of Financial
Activities, the Balance Sheet, and the related notes.
The financial reporting framework that has been
applied in their preparation is applicable law and
the Financial Reporting Standard for Smaller Entities
(effective April 2008) (United Kingdom Generally
Accepted Accounting Practice applicable to Smaller
Entities).
This report is made solely to the company’s members,
as a body, in accordance with chapter 3 of Part 16 of
the Companies Act 2006. Our audit work has been
undertaken so that we might state to the company’s
members those matters we are required to state to
them in an auditor’s report and for no other purpose.
To the fullest extent permitted by law, we do not
accept or assume responsibility to anyone other than
the company and the company’s members as a body,
for our audit work, for this report, or for the opinions we
have formed.
Respective responsibility of directors and auditors
As explained more fully in the Trustees’ Responsibilities
Statement, the trustees (who are also the directors of
the charitable company for the purposes of company
law) are responsible for the preparation of the financial
statements and for being satisfied that they give a true
and fair view. Our responsibility is to audit and express
an opinion on the financial statements in accordance
with applicable law and International Standards on
Auditing (UK & Ireland). Those standards require us
to comply with the Auditing Practices Board’s Ethical
Standards for Auditors.
Scope of the audit of the financial statements
An audit involves obtaining evidence about the
amounts and disclosures in the financial statements
sufficient to give reasonable assurance that the financial
statements are free from material misstatement,
whether caused by fraud or error. This includes an
assessment of: whether the accounting policies are
appropriate to the charitable company’s circumstances
and have been consistently applied and adequately
disclosed; the reasonableness of significant accounting
estimates made by the trustees; and the overall
presentation of the financial statements. In addition,
we read all the financial and non-financial information
in the Trustees’ Report to identify material
inconsistencies with the audited financial statements
and to identify any information that is apparently
materially inconsistent with, the knowledge acquired by
us in the course of preforming the audit. If we become
aware of any apparent material misstatements or
inconsistencies we consider the implications for
our report.
Opinion on financial statements
In our opinion the financial statements
• give a true and fair view of the state of the
charitable company’s affairs as at 31 March 2014
and of its incoming resources and application
of resources, including its income and expenditure
for the year then ended;
• have been properly prepared in accordance with
United Kingdom Generally Accepted Accounting
Practice applicable to Smaller Entities; and
• have been properly prepared in accordance
with the Companies Act 2006.
Opinion on other matters prescribed
by the Companies Act 2006
In our opinion the information given in the Trustees’
Annual Report for the financial year for which the
financial statements are prepared is consistent with
the financial statements.
Integrated Neurological Services | 25
Matters on which we are required to report
by exception
We have nothing to report in respect of the following
matters where the Companies Act 2006 requires us to
report to you if, in our opinion:
• adequate accounting records have not been kept,
or returns adequate for our audit have not been
received from branches not visited by us; or
• the financial statements are not in agreement
with the accounting records and returns; or
• certain disclosures of trustees’ remuneration
specified by law are not made; or
Signed • we have not received all the information and
explanations we require for our audit; or
• the trustees were not entitled to prepare the financial
statements in accordance with the small companies
regime and take advantage of the small companies’
exemption in preparing the trustees’ report and to
take advantage of the small companies’ exemption
from the requirement to prepare a strategic report.
Dated 26 September 2014
C J Pexton FCA
Senior Statutory Auditor for and on behalf of:
Coulthards Mackenzie
Chartered Accountants Statutory Auditors 9 Risborough Street
London SE1 0HF
Dugald Millar
Chairman, July 2014
Work in 2013/14
26 | Annual Report and Accounts | Our Finances
Thank you
With thanks to those who have supported us with grants and awards in 2013-14
001
ed Firm
GB2003688
The Barnes Workhouse Fund
James Tudor Foundation
The Bernard Sunley Foundation
The Lambert Charitable Trust
The Big Lottery Fund
London Borough of Hounslow/NHS Hounslow
The Childwick Trust
London Borough of Richmond upon Thames/NHS Richmond
The City Bridge Trust
London Community Foundation
The Dunhill Medical Trust
Richmond Parish Lands Charity
ExxonMobil Volunteer Programme
The Screwfix Foundation
Hampton Fuel Allotment Charity
The Victoria Foundation
The Henry Smith Charity
William Grant & Sons
International
Accreditation Board
Registration No. 0044/1
Hampton Fuel
Allotments Charity
Richmond Parish
Lands Charity
Thanks to all who have generously made donations or provided support, including
Church of St. Winefride, Kew
Rotary Club of Kew Gardens
Kew Community Market
Sandown Court
The Lensbury
Scirra Ltd.
Lions Club, Hounslow
Squires Garden Centre
The Original Maids of Honour, Kew
Sincere thanks to our service users, friends and supporters for their donations.
Integrated Neurological Services | 27
About INS
INS works in partnership with clients and their carers
to deliver integrated services that are tailored to their
needs at every stage of their condition. We are the only
community organisation delivering long term professional
rehabilitation, maintenance and psychological support
to people with a wide range of long term neurological
conditions until the end of life.
• Peer support and opportunities for social interaction
to reduce isolation
We provide:
• Wide range of services from mainstream therapy
and social work to music, art and Nordic walking, etc.
• Ongoing professional help to improve or maintain their
physical and cognitive abilities
• Open ended care for those with on-going conditions
– be they in rehabilitation(stroke) or managing
decline (PD and MND)
• Signposting and supporting access to other
community services
• Carers support
• All provided in local centre or at home
We also provide signposting and support to access
appropriate services for people with other long term
conditions and support and training for their carers.
• Flexible support to rebuild self-confidence and
develop coping mechanisms
For further information about INS, please contact:
Chief Executive
Clinical Manager
Social Work Manager
Ann Bond,
BSc (hons) OT, DMS
Carol Hopkins,
MSc Advanced
Physiotherapy, MCSP
Carol Williams
Tel: 020 8755 4000
Email: abond@ins.org.uk
Tel: 020 8755 4000
Email: chopkins@ins.org.uk
Websites: www.ins.org.uk & www.inspartnership.org.uk
28 | Annual Report and Accounts | About us
Tel: 020 8755 4000
Email: cwilliams@ins.org.uk
Legal and Administrative Information
Charity Name
Integrated Neurological Services
Charity Registration Number
1107273
Company Registration Number
5292539
Patrons
Major General Sir Michael Carleton-Smith CBE, DL
The Baroness Cumberlege CBE, DL
Robin Jowit OBE
The Right Rev. Bishop Peter B. Price
The Baroness Wilkins
Sir William Wells
Founder President
Eleanor Kinnear
Vice President
Dr. Elizabeth Grove
Advisors
Neurological Consultants:
Dr. Peter Bain, MBBS MA MD FRCP,
Dr. Ronald KB Pearce, MD PhD FRCPC FRCP,
Clinical Psychologist:
Dr Jason Spendelow, BSocSc(Hons), MSocSc,
PhD, PGDipClinPsych
Neuro Physiotherapist:
Richard Sealy, BSc (Hons) MCSP SRP
Auditors
Coulthards Mackenzie, Chartered Accountants
and Registered Auditors,
9 Risborough Street, London SE1 0HF
Operational Centre and Registered Address
82 Hampton Road, Twickenham,
Middlesex TW2 5QS
Tel: 020 8755 4000 Fax: 020 8755 4003
Email: manager@ins.org.uk
Website: www.ins.org.uk
Board of Trustees
Dugald Millar, Chairman (appointed 24/04/2013)
Alan Britten CBE, Vice Chair
Telfer Saywell JP, FCA, Treasurer
Jenny Brown
Sara Challice
Caroline Hill
Virginia Myer (appointed 31/10/2013)
Sophie Norton
Faith Pozzy (retired 24/04/2014)
Isabelle Rabier-Wood (appointed 24/04/2014)
Lynda Reynolds (appointed 24/04/2014)
Richard Sealy (retired 19/11/2013)
Susan Stevens
Christopher Williams
Senior Management
Chief Executive
Ann Bond, Occupational Therapist
Clinical Manager
Carol Hopkins, Physiotherapist
Social Work Manager
Carol Williams, Social worker
Bankers
CAF Bank Limited,
West Malling, Kent, ME19 4TA
HSBC,
67 George Street, Richmond,
Surrey, TW9 1HG
Integrated Neurological Services | 29
Connecting • Supporting • Inspiring
Integrated Neurological Services
82 Hampton Road, Twickenham, Middlesex TW2 5QS
Tel: 020 8755 4000 Fax: 020 8755 4003
Email: admin@ins.org.uk
www.ins.org.uk
Cover image: Clinical Manager, Carol Hopkins with INS MS Client Chris Unsworth
Designed by INS Trustee, Sara Challice, Bluestone Patnership. Tel: 0794 651 3665 Email: sara_creative@hotmail.com
Registered Charity No: 1107273 Limited Company No: 5292539