## **Mothers for Mothers** (A company limited by guarantee) Report for the year ending 31[st] March 2021 Charity number 1185281 Company number 08764052 Page 1 of 18 ## **Report of the Trustees for the year ending 31 March 2021** The Trustees present the report for the year ended 31 March 2021. The audited financial report is presented separately. ## **Index** ||**Section header**|**Page**| |---|---|---| |1|Reference and administrative information|3| |2|Objectives and activities|4| |3|Structure, governance and management|5| |4|Achievement and performance|6| |5|Case study|17| |6|Ambition and long-term strategy|18| |7|Financial review|18| Page 2 of 18 ## **1. Reference and Administrative Information** Company name: Mothers for Mothers Charity registration number: 1185281 Company registration number: 08764052 Registered office and Operational address: New Fulford Family Centre 237-239 Gatehouse Avenue Bristol BS13 9AQ **Trustees** Belinda Cox Chair Joined January 2021 Laura Ward Vice Chair Amanda Clarke Treasurer Emily Matthew Secretary Annette Lang Caroline Scrase Nicky Pedwell Pip A’Ness Christy Burden Joined 12 November 2020 Karen Joash Joined 4 December 2020 Kelly Avis-Hay Joined 12 November 2020 Mel Lloyd Joined 12 November 2020 Sarah Tyndall Chair Resigned Autumn 2020 Karly Hunter Treasurer Resigned Autumn 2020 Linda Hicken Resigned Autumn 2020 **Senior Management Team** Maria Viner CEO Justine Rowe Finance Manager **Bankers:** CAF Bank Ltd 25 kings Hill Avenue, Kings Hill, West Mailing, Kent, ME19 4JQ **Solicitors:** Orrick, Herrington & Sutcliffe, 107 Cheapside, London, EC2V 6DN Page 3 of 18 ## **2. Objectives and activities** ## **Purposes and Aims** Our Primary objective is to maintain and develop a sustainable peer support organisation which provides high quality services to meet the emotional health needs of clients and their families from pregnancy until the youngest child reaches school age. Our charity’s purposes as set out in the objects contained in the company’s Articles of Association are: - the advancement of mental health for mothers, particularly through the care of those suffering from emotional or psychiatric disorder or mental illness associated with pregnancy and childbirth and those affected by their conditions, including their children, spouses, partners and other family members; and - the advancement and promotion of high standards of education and care in all matters concerning emotional or psychiatric disorder or mental illness associated with pregnancy and childbirth. The services cover the Bristol, South Gloucestershire, and North Somerset areas. ## **Ensuring our work delivers our aims** We review our aims and objectives in line with our 3-year development plan. The current plan runs from April 2019 – March 2022. However, due to the pandemic the focus has been on ensuring the service has been able to deliver our aims while following COVID guidance and ensuring the safety of the beneficiaries and staff. ## **Why our work is needed** Pre-pandemic, up to 20% of women experience a mental health issue during pregnancy or after giving birth[1] . Symptoms include feelings of despondency, guilt, anxiety and isolation, panic attacks and maternal Obsessive Compulsive Disorder (OCD.) Maternal mental health can inhibit a mother’s ability to bond with her baby and provide sensitive and responsive care, affecting the emotional, cognitive and physical development and long-term health of her children[2] . The pandemic has increased isolation during the perinatal period, made it more difficult for women to access support, and has led to a decrease in mental wellbeing[3] . The first step to recovery is for women to recognise they are unwell and be prepared to talk about how they feel. However, half of new mothers’ mental health problems do not get picked up by a health professional, and 34% of women fear their baby will be taken away if > 1 NHS – Perinatal Mental Health https://www.england.nhs.uk/mental-health/perinatal/ 2 Quartet Community Foundation Vital Signs Report 2017 > 3 Maternal mental health during a pandemic: A rapid evidence review of Covid 19’s impact, Maternal Mental Health Alliance, March 2021 Page 4 of 18 they disclose their feelings[4] . Around 3,000 women in the Bristol area suffer from moderate to more serious maternal mental health every year[5] . The challenges faced by women experiencing maternal mental health are compounded by additional factors and we are working with women and families who are experiencing domestic abuse, uncertain housing, abuse and exploitation, uncertainty about their leave to remain as well as financial hardship. Adopting a trauma-informed approach supports this work across all our services underpinned by a robust safeguarding system. The complexity of this work requires skill and resilience in the staff and volunteer team as well as good working relationships with multiagency partners to ensure that clients and families receive the services they require. As the figures in this report demonstrate, each of the services provided by Mothers for Mothers has been affected by the increased complexity of keeping clients and staff safe from infection by the SARS-CoV-2 virus. None of this would be possible without the team of dedicated and skilled volunteers who show such commitment to ensuring that peer support is available to families across the area. They not only provide the life blood of the organisation, but they remind us of our heritage as an organisation and keep us firmly rooted in the values of women of lived experience supporting other women and families. ## **3. Structure, governance, and management** Mothers for Mothers is a company limited by guarantee. The nature of the governing document is Articles of Association altered by Special Resolution on 10 January 2019 and 16 July 2020. There is a Board of Trustees made up of up to 12 women of lived experience and others who bring specific professional skills to the board. A small staff team is led by CEO Maria Viner. Also led by Maria Viner is the team of volunteers providing the Helpline Service and some of the support services. The Board has shown ongoing commitment to maintaining the values and ethos of the charity whilst at the same time evolving to meet the ever-changing context in which we operate. There have been changes to the Board of Trustees in this reporting period, and thanks for donating their time, commitment, and passion for the aims of the organisation must go to those who have stepped down from their roles: - Sarah Tyndall Chair - • Kirsty Hunter Treasurer - Linda Hicken Trustee > 4 Perinatal Mental Health Experiences of Women and Health Professionals, Boots Family Trust Alliance, October 2013 > 5 Bristol, North Somerset & South Gloucestershire Clinical Commissioning Groups Maternity Transformation Plan 2017-2021 Page 5 of 18 Thanks must also go to the new Trustees who in addition to me, have joined the Board this year: - Amanda Clark Treasurer - Mel Lloyd - Christy Burden - Karen Joash - Kelly Avis-Hay I know that Sarah and Maria continued to enjoy a strong and productive working relationship until the time commitment of Sarah’s substantive role forced her resignation from the Chair. I joined the Board in the final quarter of this reporting year, and Maria and I have begun to develop what I anticipate will be an equally effective relationship. Potential trustees are identified by current trustees or the CEO dependent on their knowledge, skills and substantive role. New trustees are invited to join the board by the current board of trustees. ## **4. Achievements and performance** ## **Pandemic Response** Of course, the pandemic has been at the forefront of the challenges over the 2020-21 reporting period, demanding reactive and rapid changes to the services over days rather than weeks, carried forward by Maria’s exceptional leadership and a committed and competent team of staff working on the front line, and supported by Nadia in her administrative role and Justine keeping the books in order. The delivery of each of the services was impacted on by lockdown restrictions, becoming virtual, and then moving onto a blended service when government guidance allowed. Staff and volunteers were working mainly from home. Maria set up regular online meetings to ensure isolation of staff and volunteers was minimised and mental wellbeing was supported. Despite the pandemic, the combination of good leadership, a strong staff team and an equally capable volunteer team has enabled the delivery of services to support women and their families to continue, but with restrictions to some, and extensions to others. We participated in another Maternal Mental Health week, ensuring a strong social media presence in the absence of organised activities due to lockdown. The Board development work funded by the Lloyds Bank Foundation, which was commenced in the previous reporting period and delayed due to the pandemic was picked up again at towards end of this reporting period. A series of zoom meetings gave the trustees an opportunity to understand their roles, responsibilities and what they offer to the organisation. The trustees found it useful and interesting to hear fellow trustees responses on the subjects discussed. This will continue into the 2021-22 year and outcomes will reported after completion of the project in the next reporting period. Page 6 of 18 Maria’s participation with the Royal College of Obstetricians and Gynaecologists and Maria and Christy’s involvement with Tommy’s National Centre for Maternity Improvement offer numerous opportunities to advocate for, and increase the understanding of, the needs of families experiencing the impact of maternal mental health. It also provides a platform to highlight the excellent work that Mothers for Mothers is doing. ## **Legal structure** The work to restructure into the legal form of a company limited by guarantee was completed, and the charity’s funds and assets were gifted to the successor company which has taken on the charitable activities. Work is currently ongoing with Orrick providing _probono_ advice to review and update the Articles of Association. ## **Inclusion** Mothers for Mothers is committed to encouraging equality, diversity, and inclusion among our workforce, and to eliminating unlawful discrimination. Our aim is for our workforce to be truly representative of all sections of society, and for all employees to feel respected at work, and able to give their best. Mothers for Mothers is also committed to avoiding unlawful discrimination towards service users, or members of the public. In February 2021, staff and volunteers attended a two-day cultural competency workshop with Mars Lord. This workshop enabled us to address unconscious bias, how it effects our practice and to learn skills to make meaningful changes. We have an Equality and Diversity Policy and are committed to ensuring that all staff and volunteers understand and know how to implement the policy. The policy will be updated following the CEO’s attendance t a workshop in June 2021. We will take action to challenge any discrimination that may arise. We continue to have conversations with the other organisation we work closely with and will share learning to further reduce discrimination or victimisation. In our service delivery we take actions to remove barriers and enable increased participation by taking our support service into communities to connect with women we know have struggled to access our services and we pro-actively work with specialist organisations to engage with diverse groups to ensure our work is accessible, for example during lockdown we worked with Bristol Bangladeshi Women’s Health Project to make our services more accessible to Southern Asian women. We engage with the knowledge and connections of our link peer support workers from minority communities and ensure that this informs all our services. This has also enabled us to include the celebration of cultural festivals within our service delivery. We only use accessible venues, and we ensure these are on good public transport routes. Most of our services take place during the day when older siblings are at school however due to requests from our participants our antenatal / wellbeing in pregnancy group has a weekly evening session. We will continue to have conversations with the other organisations we work closely with and ensure that we are all working towards greater inclusion; we hope that we can continue to build further on our reach to other groups who find our services difficult to access. Page 7 of 18 We will continue to ensure the competency of our staff and volunteer team through our training programme. Our Trustee, Karen Joash will be leading a session on The Psychological Impact of Racism in the next reporting period. Mothers for Mothers could not do this work without the support of our funders, and we have continued to benefit from ongoing relationships with some long-standing funders as well as gaining new funding during this year. We are immensely grateful for the commitment shown by all our funders and the benefits that their investment brings to families across Bristol, South Gloucestershire and North Somerset. I am confident that this report will demonstrate the difference that this investment makes. Mothers for Mothers is an exceptional organisation which, as we notch up 40 years as a peer support organisation, remains firmly committed to its founding vision. The recognition of the value of women of lived experience offering peer support to other women and their families remains at the heart of all that we do. This core value has been maintained whilst the organisation has grown and adapted in response to increasing demand and changing contexts. The commitment to a shared vision is embodied in an amazing staff and volunteer team who achieve an astonishing amount of high-quality work and this report evidences something of the extent of that achievement. Last but by no means least, our clients and families who show such courage in sharing their vulnerability and engaging in the hard work that leads back to health. Their voices echo through this report and I am confident that the inclusion of a small sample of the feedback will illuminate the importance and impact of all the services which Mothers for Mothers provides. ## **Impact and value of the services Mothers for Mothers delivers** This section of the report will detail both quantitative and qualitative data to illustrate the extent, impact, and value of the work that we do. The figures showing the number of clients in our services are collected on a continual basis and the qualitative feedback is obtained through regular completion of feedback forms and focus groups with clients. This feedback is compiled to inform quality improvement of our services as well as meeting the monitoring requirements of our funders. With the isolation, changed birth choices and experiences of women brought about by the pandemic, the instances of Maternal Mental illness and trauma increased as has the additional burden of poverty in our client population. Our open services and support via social media have given clients a sense of connection, knowing that they are cared for and supported, that they are not alone and that they are understood. The number of families we worked with decreased slightly due to the pandemic. However, there were 257 new families to the service and overall, the complexity was hugely increased. That coupled with the changes to other services negated the capacity to take on new families. Discussions are taking place regarding how new families will be able to access services during the 2021-22 year. Page 8 of 18 ## Families worked with **----- Start of picture text -----**
500
440
450 415
400
350 320
286
300
250
200 174
150
96
100
50
0
April 2015 - April 2016 - April 2017 - April 2018 - April 2019 - April 2020 -
March 2016 March 2017 March 2018 March 2019 March 2020 March 2021
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## Home visiting service The home visiting service is aimed at women who are too unwell to attend a group or access counselling but feel the need for face-to-face support. Our Home Visitors offer listening and planning visits and work with women to decide what will be most helpful for their individual circumstances. This service can help increase emotional wellbeing and resilience and have a positive effect for the whole family. The service helps women to increase their confidence and progress to accessing other services such as support groups or other activities in their own communities. Due to lockdown restrictions and the need to keep clients and staff safe, the first half of this year saw no new families being taken on by the home visiting service and support being offered through long telephone calls, video calls and texts. However, once restrictions were relaxed socially distanced face-to-face visits were able to commence. The data below demonstrates a significantly increased demand for this service caring for the most unwell women during this year. The number of children accompanied on activities by the home visiting team were not collated for this year as they were very small numbers due to no soft play areas etc. being open to visit. A total of 100 women from across all services, including the 59 accessing the home visiting service, received delivery to their home items such as kettles, nappies, activities for children, and wellbeing-focused items for women. This work allowed us to spend some time face-to-face with some of our families most in need, assessing how well they were coping, ascertaining further needs and giving hope for recovery. Grateful thanks must go to Bristol Charities Community Chest for funding the purchase of the items. Page 9 of 18 **----- Start of picture text -----**
350
295
300
250
200 181
135
150
100
56
39
50 24 31
7
0
Total number of home visits Total number of women Total number of children
made receiving visits who have been accompanied
on activities by home visitors
2018-2019 2019-2020 2020-2021
**----- End of picture text -----**
## Peer support groups 190 peer support groups took place over the year and there is no duplication of numbers – a woman is only counted once even if she attends all 190 sessions. There were 166 sessions in the previous reporting year. Due to the lockdown restrictions, it was not possible to continue delivering the peer support groups as physical meetings. In the first part of the year the groups met virtually, and once restrictions were relaxed they were delivered as walking groups visiting parks across the service area. The data here demonstrates that the demand for peer support groups increased significantly during the reporting year. **----- Start of picture text -----**
Peer support groups
300 273
239
250
185
200
162
147
150
100
50
18
0
Number of women who have attended Number of children who have attended
groups groups
2018-2019 2019-2020 2020-2021
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Additionally, the MfM social media closed group was used by a significantly increased number of women for peer support and other activities such as Music with Mummy and Star Jumpers. Page 10 of 18 Number of women accessing support through the social media closed group **----- Start of picture text -----**
600
532
500
400
295
300
200
100
0
2019-2020 2020-2021
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## Counselling services and art psychotherapy Art Psychotherapy is a talking therapy allowing women to express and communicate emotions through the creative process. It can help support clients to take ownership of their experiences and change their view of current challenges they may face. The art psychotherapists offer clients non-judgemental and compassionate support through the process. Some clients can feel nervous about using the art materials, perhaps because they aren’t familiar with them or fear that they are not good enough, however many find that they build in confidence and enjoyment using the materials and some continue using these new skills after the therapy has ended. Sessions can usually take place face-to-face or via zoom, with art packs provided for those attending remotely. This breaks down the barriers of travel and childcare. At the beginning of the pandemic the service moved to only online until relaxed restrictions allowed more flexibility. Qualified and placement student Art Psychotherapists and Counsellors provide sessions to clients who have maternal mental illness and are experiencing many other life complexities and socio-economic disadvantages which further contribute to anxiety and distress; all of which have been exacerbated by the pandemic and restrictions. The service is co-ordinated by a qualified Art Psychotherapist. Women take part in a full assessment prior to sessions beginning. Part of the assessment addresses whether Art Pschyotherapy or Counselling is more appropriate for the individual. Art Psychotherapy enhances the difference we already make by improving women’s confidence, resilience and relationships with children and family, leading to faster recovery from their maternal mental illness. This can improve the mothers capacity to parent responsively and to build healthy attachments which lead to better mental health outcomes benefitting the whole family. Page 11 of 18 Creative therapies such as Art Therapy are often reserved for more wealthy communities, and MfM is the only organisation in the area providing this therapy free of charge, so enabling women with deprived socio-economic circumstances to access a therapeutic service usually only accessible to those with funds. Sessions are delivered in line with the British Association of Art Therapists (BAAT) and British Psychological Society (BPS) guidelines. Art materials are provided for use in their sessions and beyond the therapy. Clients are given the opportunity to engage in the sessions without the need for existing artistic ‘skill’ or previous art experience. With the compassionate support of the registered art psychotherapist, clients are encouraged to utilise the art making process to express and communicate their emotional states, the increased challenges they face in the current climate and to develop tools to regulate and maintain their wellbeing. Crucially this project aims to support the development of a sense of connectivity. This service ensures that the clients facing the most challenges have a therapeutic intervention alongside the peer support provided by the rest of the MfM team, and therefore our peer supporters are not providing the only means of support to women living with high levels of complexity. **----- Start of picture text -----**
Counselling and art psychotherapy
300
264
250
210
199
200
150
100 71
50 35 29 15 19
3 0 0 0
0
Total number of Number of women Number of men who Number of children
counselling & art who attended attended couselling who attended art
psychotherapy counselling and art and psychotherapy with
sessions psychotherapy their mothers
2018-2019 2019-2020 2020-2021
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Helpline and support calls The helpline provides an opportunity for women to talk to someone who understands what they are going through. It can be a lifeline for women suffering from postnatal illness. It can help to ‘normalise’ their symptoms and the reassurance that ‘you will get better’ is validated by the recovery of the volunteers they are speaking to. The helpline is often the first step for a mother in accessing other services provided by Mothers for Mothers or in their community. We can also sign post to other services when appropriate. The support line offers women a regular weekly support call or text. This is a confidential listening and planning service. The calls also work to increase resilience to enable women to Page 12 of 18 access the most appropriate services available to meet their current needs. Mothers for Mothers can facilitate help women identify and make contact with other services they may find helpful. The helpline and support calls operate five days a week and are staffed by an amazing group of volunteers. Additionally, during the pandemic every staff member worked in the Reach service on the helpline and making support calls. During the pandemic the demand for helpline and support call services rose by 162.7%, and for the first time in the history of MfM the support call list had to be closed to new women accessing the service. Maria and the Trustees worked really hard to mitigate any impact on the wellbeing of staff and volunteers, but it was inevitable that due to the increased demand and complexity of the beneficiaries’ needs staff and volunteers became tired. Some volunteers stepped away due to increased demands in the substantive or home life due to the pandemic. New volunteers were able to be recruited and trained in the second half of the reporting period. **----- Start of picture text -----**
Helpline and support calls
8000 7293
7000
6000
5000
4000
2776
3000
2000
1155
741 748
1000 366
0
Number of calls received Number of calls made
2018-2019 2019-2020 2020-2021
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Whilst the figures show how many people are accessing our services the qualitative feedback that we gather adds powerful evidence of the impact the services have. A report compiled in April 2021 looked at the evidence that we were meeting our stated objectives on the basis of the qualitative feedback for 2020-21 and I include highlights of that report here. We aim to achieve the following outcomes for the women and families we work with: - Improved confidence, resilience and relationships with children and family, leading to faster recovery. - Improving children’s emotional development by supporting mothers to be sensitive and responsive in their relationships with their children - Reduced social isolation and improved social and support networks. - More awareness of maternal mental health and the support available. - Improved care and services for maternal mental illness. Page 13 of 18 ## Improved confidence, resilience and relationships with children and family, leading to faster recovery The feedback strongly evidences an increase in confidence and resilience with significant numbers also reporting an improvement in their mental health. - Mothers for Mothers were available on the **phone** instantly when I needed help. They were helpful and available. I wasn’t with MfM very long but when I needed help they were there for me. - **Support calls** offered by Mothers for Mother’s have been a life saver! During the pandemic and during my most recent mental health crisis, my support calls with Rachel have been the only reliable support. They have been great listeners, provided practical ideas to help and general emotional support. It has saved my life. - The most useful thing for me with my **home visitor** was to gain confidence getting back out into the community and public places by going out for walks and meeting in cafes. Everything you have done and continue to do is perfect, I am so grateful for everything. - **Support group** is where my healing began. I'll forever be grateful for mother's for mother's - **Counselling -** I’m kinder to myself while parenting. I know it’s not the end of the world if something goes wrong. Also, now I take time in stressful situations and understand that it’s a phase, a temporary situation It will pass. - Realising that I lacked boundaries, or the understanding as to why I have struggled with them; accessing therapy has enabled me to understand the root causes and start implementing them in my life. **[Art] Therapy** has been amazing in allowing me to realise this. The artwork has been brilliant in allowing me to tap into my emotions and that now I have finished the sessions I have physical, positive reminders in the art to remember the therapy and to continue in my progress. This will continue to be a source of ongoing self-care. Honestly it has been life changing. Thank you. - [ **Counsellor** ] encouraged me to challenge myself and truly reflect on what would be the best for me and my family in the long run, this in turn helped me to feel strong (and not so scared) to make decisions with potentially very big ramifications for my family. The improvement of my self-confidence, self-awareness and self-love. The provision of the space every week to dedicate to myself. Encouragement of self-care. Improving children’s emotional development by supporting mothers to be sensitive and responsive in their relationships with their children - The support was excellent. Prior to the support life was awful was debating whether I had to put the children in to respite care. We were living on takeaways. Now we are making homemade pasta! Now I can be a mother to them enjoying them rather than just surviving the day. Everything is different now. I was nearly losing them. Now with the support from M4M I'm able to keep them. It was helpful being able to have someone to talk to, someone who can relate. Helped me learn how to play with M. I Page 14 of 18 watched how R would play and I copied it. Its saved us as a family. Wouldn't be here without the intervention of you guys. - I have been able to re-bond with my eldest son and I am a lot more present for him. It has been revolutionary for my youngest son; I’ve been able to bond with him. Feeling less depressed and connected to myself has enabled me to bond and love him. - I definitely feel a more confident mum and this has rubbed off on my son; as he is not picking up on my emotional states. I feel that our bond is stronger and that we are a team, whereas before I thought I was messing up his life. I feel now I am doing right by him, by doing right by me. - It enabled me to be less angry towards my child. My feelings of resentment have reduced through being kinder to myself. I feel I am now a better mum on the whole and that I am noticing my daughter is becoming more settled. ## Reduced social isolation and improved social and support networks The home visitor was seen to play a major role in reducing isolation and improving access to networks, both Mothers for Mothers services and wider support networks in the community. - The home visiting service helped improve my emotional wellbeing and helped me to access other services. My home visitor was a massive help in general and was a brilliant spokesperson for me when the mental health team let me down. She helped me to feel more confident and enjoy my children. My experience has been amazing and it would have been nice to have group meets but due to Covid-19 that was obviously not possible. I know groups are now back with walks etc which is great. The groups were also seen as a vital source of social support. - The support groups at the children’s centre were very helpful and allowed time to speak openly with other Mums and feel much less lonely. Having been replaced with zoom group, this still provides very similar support again has been brilliant during these tricky times. Also very grateful for the frequency of these zoom calls. The support calls have saved my life. They have been the only consistent and reliable support I have reviewed from any service. - The support groups and art therapy stop me from feeling isolated and make me feel like a person and not just a mother. It’s helpful to see that other people are also finding things hard - I’m not the only one. It’s great when I can also help other people. - M4M was there for me. The most helpful things was going for a coffee as I needed to go out. Having a coffee with someone I trust and talking to someone in confidence was really helpful. Everything was excellent. Consistency is important to mothers accessing the service - The most helpful think is how constant the support was. Talking to the same person the whole way through every week means you build up a relationship. It also means you don’t have to repeat the same background information to different people every week. It was brilliant. Page 15 of 18 - The support calls were nice, and great to have a listening ear every week. The support from MfM was consistent and caring. It was helpful to talk through concerns during the support calls and this gave me confidence to put better boundaries in place in my life. Being non-judgemental is also seen as important. - It’s very ‘real’ and there is no barriers such as class, culture, and most importantly I can come with greasy hair and don’t get judged. - Friendly people who you can say anything to and not be judged about it. If I’m having a bad day with my anxiety generally I can’t get myself to go anywhere but always made myself go to group and by the end felt loads better. - Groups, socialising again, not feeling judged and down. - Flexibility and no pressure, constant peer support and friendly advice always there when I needed it most. - Just having someone who is non-judgemental to talk to. I’ve also made some wonderful friends within the support group. - Mothers for Mothers is supportive of other mums with nice open ears and listening without judgement. ## More awareness of maternal mental health and support available - My [support worker] was absolutely invaluable in supporting me through an incredibly difficult pregnancy. She gave practical and emotional support and also helped me access other support. I honestly don’t know if I could have continued with the pregnancy without this support. I am so grateful. - Mothers for Mothers have saved my life. I would now be completely isolated with no support from the NHS services or other charities. They have supported me to get all the help and support I have needed. - I feel more control over certain situations. Interacting with the kids more, they get their full potential out of me. The most helpful things was being referred to the MfM counselling service, this had a big impact on life. If it wasn't for L I wouldn't have sought counselling. ## Improved care and services for maternal mental illness There is ample evidence that the care and services provided by Mothers for Mothers were valuable - _It is really good how you keep track of people and keep trying to get in touch. When I didn’t answer my weekly support call I would still receive a call the next week. It’s good how you still keep in touch with people. The fact you keep trying is key._ Page 16 of 18 What is beyond the remit of the feedback that is collected is evidence about the wider impact Mothers for Mothers may have in influencing improvements in the care provided by other providers and this needs to be included in future evaluation work. ## **5. Case Study** Written by a client about her journey through the MfM services _I was struggling to cope with family life and was barely functioning due to ill health. I had started to develop severe anxiety._ _I had convinced myself that I was dying and I was consumed with this continuous fear of leaving my children. On top of this, I was new to Bristol and didn't have a support network. I was desperate for some help and reassurance but didn't know where to turn. Everything was so alien to me and life seemed unbearable. I remember one visit to the GP where I begged for help._ _He gave me the details for Mothers for Mothers. I was too anxious to pick up the phone but was able to message them on Facebook. They quickly responded with kindness and understanding and someone phoned me for a chat._ _From there they took me under their wing and arranged for me to have a weekly support call and this became my saving grace. They immediately understood what I was going through. The relief I felt at having someone understand was immense. Slowly I was able to start communicating about my health and my anxiety and make sense of what I was experiencing. They have been my rock through a very bleak time and have_ ~~_b_~~ _een able to give me the tools to help me recover both physically and emotionally._ _There were days when I was too paralysed with fear to get out of my bedroom. In those darkest days I was able to call the helpline and speak to someone from Mothers for Mothers and know that I was not alone. Just knowing that the helpline is there is often enough to take away some of the loneliness of anxiety and motherhood._ _I had weekly home visits and felt immediately comforted. We chatted and I realised that she had once been where I was, yet here she was helping and supporting me. I was still having consuming fear and anxiety and they offered to come with me to visit my GP and discuss the way forward. This was exactly the support I needed. Their humour and non-judgemental support has held me through the tough times and kept me going._ _Mothers for Mothers have basically been my advocate when things were at their worst and I was unable to see a way forward. Even when I literally thought the world was going to end, they kept me going. They have helped to shine a light during the dark times and enable me to keep moving forward with some hope that things would get better. Things did get better and I'm now back to a fully functioning and mostly happy and content individual. I have also managed to improve my parenting skills by engaging in their online zoom group and their_ Page 17 of 18 _Building Children's Resilience course. I will be forever grateful to this wonderful group of women from this remarkable organisation._ ## **6. Ambition and long-term strategy** Our Primary objective is to maintain and develop a sustainable peer support organisation which provides high quality services to meet the emotional health needs of clients and their families from pregnancy until the youngest child reaches school age. The pandemic has impacted on our ability to work strategically as detailed in our three-year development plan (2019 - 2022). As we are now towards the end of this plan’s life, a new development plan will be written for the 2022-2025 period, and this will be reported on in the next Annual Report. We continue to seek funding to match the increase in demand whilst maintaining our commitment to providing a safe, high-quality service. Mother for Mothers recognises the importance of adopting a holistic approach to perinatal mental health in which the needs of the individual are seen within their wider context and support is offered which recognises the importance of infant mental health, wider determinants of health and the impact of all these on a client’s health and wellbeing. As we journey out of the pandemic, the rich learning from delivering virtual services as a necessity during lockdown and the continued learning from moving to a blended approach as and when restrictions allowed, ensuring any step backs could be made with ease, will not be forgotten and will be fully utilised as we design and develop our future services. As always, the ethos of Mothers for Mothers as peer support, person centred organisation will put Mothers and their families at the heart of our services. We will be seeking new opportunities to expand our Groups service in areas of high need, develop the Home Visiting Service for the families with most complex needs, offer Art Psychotherapy as one of the core services, and continue to respond to the demand for the helpline and support calls which are so often the doorway into other services. ## **7. Financial review** Our audited annual accounts for the reporting period are attached. Mothers for Mothers holds a general reserve to cover funding shortfalls and interruption to normal operating activities. This is included in the Financial Policy & Procedures. The level is based on 3 months' budgeted core operating costs for the following financial year, which in this reporting period is £50,000. **Belinda M B Cox** Chair of Trustees Page 18 of 18 MOTHERS FOR MOTHERS (A Company Limited by Guarantee) FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2021 Registered Chanty Number. 1185281 Company Number. 08764052 TYRRELL PROCTER Chartered Accolllltants Business Advisors Beaulort Honse 113 Parson Street Bristol SQH MOTHERS FOR MOTHERS FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2021 CONTENTS Page Company Information Rewrt of the DIr￿t0￿ and Trustees Independent Examine¢s Report to the Trustees Slalement of Financial ActNities Balan¢e Sheet Notes lo the FinarKtal Statements 8-11 Trustees Onty: Detailed Income & Expenditure Account 13 MOTHERS FOR MOTHERS COMPANY INFORMATION FOR THE YEAR ENDED 31 MARCH 2021 Administrative Inforniation Charity Name: Mother5 for Mothers Charity Number. 1185281 Company Number: 08764052 Registered office and Operational address: New Fulford Family Centre 237-239 Gatehouse Avenue Bristol BS13 9AQ Directorn and Trustees Belinda Cox Mrs Sarah Tyndall- left during year Mrs Annette Lang Ms Pip A'Ness Mrs Karty Hunter Mrs Laura Ward Mrs Emily Matthews Linda Hicken- left during year Nicky Pedwell Amanda Clarke Mel Lloyd Dr Christy Burden Dr Caroline Scrase Chairperson left during year Vice chairperson Treasurer Miss Karen Joash Kelly Avis-Hay Secretary Accountants TYRRELL PROCTER Chartered Accountants Beaufort House 113 Parson Street Bristol, BS3 5QH MOTHERS FOR MOTHERS REPORT OF THE DIRECTORS AND TRUSTEES FQR THE YEAR ENDED 31 MARCH 2021 The Trustees present th￿r direclors, ￿pOrt financial statemeTts for the year ended 31 March 2021. T￿￿tee3 Statement The charity has restr￿aured into the legal ftTh of a (￿7panY limited by guarantee. Structure. Governance and Management Mothers for Mothers is a charitable company limited by guarantee. incorporated on 6 November 2013 and originalty registered as a charty on 10 Juty 1992. The ￿MpanY was established under a Memorandum of Associakn'on which established the objecas and powers of the chafitable company and is governed by its Artides of Asswation. In the event of the company being would up members a￿ required to ￿ntribUte an amount not eX￿dIng £1. The directors of the company are also the chafivs trustees for the purposes of chartty law. Responsibllities of the Trustees Under charity aTrJ company Iw, the Trustees are responsible for preparing fina￿al statements for each financial year, which give a true and fair view of the stste of affairs of the charitable company as at the balance sheet date and of rts incoming resources and application of resour￿$, including in(xJme and expenditure, lor the finanual year. In preparing these finanoal statements. generalty accept￿1 a¢u)unling p￿tti entails that the tntstees: select suiiable accounting poli￿eS and then app￿ them conststenttr, make judgements and estimates that are resFonsible and prudent" prepare the financial statements on the going concem basis unless it is inapproprrate to Pfesume thal Ihe chartty will continue its ad1Vit￿S. The Trustees are responsible for rnainlaining proper accA)unting recr)rds which disclose wth reasonable accuracy at any lime the financial tx)srtion of the charitable company and to enable them to ensure that the financaal statements 0)Mp￿ ¥￿th the Companies Act. The Trustees are also responsible for safeguarding the assets of the chantable company and hen￿ foi taking reasonable steps for the prevention and detection of fraud and other irregularities. (￿ntinued) MOTHERS FOR MOTHERS REPORT OF THE DIRECTORS AND TRUSTEES Icontinued) FOR THE YEAR ENDED 31 MARCH 2021 Directors Responsibilities The Diredors, wulated ty o)mpany law are also tfustees for the pUr￿}seS of charity law. who served during the year and up to the date of this report are sel out on page 2. In acrordance with company law. a$ the ts)mpany diredors. certify that: so far as we are aware. there is no relevant inforn￿tIon of which the ￿mPan￿5 fjxamingrs are unaware.. and as the directors of the compary have taken all the necessary steps that we ought to have taken in order to make oursefves &vare of any relevant information necessary for Ihe independent examination and to establish that the tharitys examiners are aware of that infom)ation" and the Stalement of Recommended Practi￿ {"A(uunting ty Charrt￿s') have been followed, subject to any material departures disclosed and explained in the finan￿81 statements. Approved by the Trustees Beli ..Oated i* od.br 2(JLI MOTHERS FOR MOTHERS INDEPENDENT EXAMINER'S REPORT TO THE TRUSTEES FOR THE YEAR ENDED 31 MARCH 2021 We have exarnine(J the finanGial statements set out on pa9e 6. R•spgCtlv• r8sponsibilits•s of tnstsès and ex•mlnor The ¢hariVs trustees are re5r￿n$l￿e for the preparation of accounls. The charl￿S m•mLws consKler that an audit is rK)t required forthL8 year under 3￿t￿n 144 of the Charit*s Act 2011 (the Charities Act) and that an independent examination is needed. It is our responsibilty to.. . èxamine the a¢￿Unts under Sect￿ 145 of the Charibes Act. * to follow the procedures Liid down in the general Directions gNen by the Charty Commisskjn (under section 14515){bl of the Charit￿$ Act). atMI . to state bthether pathcuPdr matters have eome to our attÈnts"on. Basls of Ind8pand•nt •x•mÈnoe$ rni>ort Our examination was ¢arr*d out in 8¢ts)rdance with the General Direct*Jns gwen by the Charity Commission. An examination indudes a revEw of the accounting recxjrds kept by the charity and 8 comparison of the accounts presented those records. It also incJ(Kles ¢onsiderab"È)n of any unusual items or disdosures in the wxounts, and seeking explanations from trustee5 concemirg SLKh matters. Th¢ procedures undertaken do not prowdè all thé evidence that V*Y)ukl t* required in an audit, , and consequentty no own¥Jn ts given as to whether the accounts pre$ent a kn and fair" view and the report is limf(Èd to those matters set out in the ststement beknv. This report is made to you in accordance vAth the tern￿ of our engagement and for no other purposo. To the ftjllest extent permitted by I￿. we do not ￿cept or ass¢me responsibi16ty to anyone otrier the trustees, for OUT bwrk or for this repJrL Indgpondont axamlnerfs statsment In connection ￿th our examirrdtion. no matter has coffle to our attention: 1. which gNes us reasonable cause to believe that in. any material respect, the requ1￿Ments. to keep accounting record5 in accordance WTth sec*1￿ 130 olthe Charthes Act,. and to pr￿re x¢ounts 8¢¢ord with the 8¢¢ounting re¢ord$ and compty wth the accounting requirements of the Charilies Acl and the Regulations have not been met or 2. to which, in my opinKJn, *tents"C￿ $I￿UkI be dr¥%bn Mi order to enable a proper ￿)¢jers￿n￿1n9 of the ac¢ounts to L* w¢hed. TYRRELL PROCTER Chartorod Accountants Boaufort Hous¢ 113 Parson Street Bristol BS3 5QH MOTHERS FOR MOTHERS STATEMENT OF FINANCIAL ACTNMES FOR THE YEAR ENDED 31 MARCH 2021 Total Funds 2020 Funds Funds Funds 2021 INCOME AND EXPENDITURE: Income Resour￿$. Local Authority Grants Fund Raising and Other Income Inveslment Income Statutory NHS funding Other Grants 19.236 16.662 63 58.000 56.475 19.236 16,662 63 58.000 117,695 9,455 11,325 156 61.220 89,799 TOTAL INCOMING RESOURCES 150.436 61,220 211,656 110,735 RESOURCES EXPENDED: Direct Charitable Expenditure Management. Administration and Support of the Charity 116.828 855 44.023 160.851 855 101.728 TOTAL RESOURCES EXPENDED 117.683 44.023 161,706 102,573 NET INCOMING RESOURCES 32.753 17.197 49.950 8,162 Balance of Funds- Brought Forward 69.300 47.000 116.301 108.138 Balance of Funds- Carried FopNard 102.053 64.197 166.251 116.301 The notes on pages 8 to 11 foTh part of these acryjunts. MOTHERS FOR MOTHERS BALANCE SHE AS AT 31 MARCH 2021 2021 2020 FIXED ASSETS Tangible Assets 76 100 CURRENT ASSETS Debtors Balance at Bank 10,441 158.710 845 118.881 169.151 119.726 CURRENT LIABILITIES Creditors falling due wrthin one year 2.976 3.526 NE[ CURRENT ASSETS 166,175 116.201 NEf ASSETS 166,250 116,300 Represented ty. UNRESTRICTED FUNDS GENERAL DESIGNATED - Staff conlingency - 3 months running costs - Staff ￿$truCtUre & development RESTRICTED FUNDS 17,053 S,OCM) 50.000 30,000 64,197 4,800 4,500 30.000 30,000 47,000 166.250 116.300 Approv rd of Trustees and signed on its behalt. - Chairperson - Arting Treasurer Date The notes on pages 8 to 11 fom part of these acrounts. ISA cdok MOTHERS FOR MOTHERS NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2020 PRINCIPAL ACCOUNTING POLICIES The principa accounling policies adopted in the preparalion of the financrdl statements ar8 set oul below and have remained unthanged from the preNllous year. (al Basis of A¢Munting The financial statements have been prepared under the historical cost ￿nventIOn, and in accordance wth the Slalement of R￿OrnMended PractNx. (b) Fund Ac¢ounting Unrestricted fijnds are aVaila￿e for use at the dIs¢ye￿n of the trustees in furtherance (rf the general obiecbves of the charity. lil) Designaled funds are Unrestr￿ funds earmarked by the Management Committee for particular purposes. (iii) Restricted funds are subjected to restrictions on their expenditure imposed by the )nor or through the tenns of an appeal. (cl Incomlng Resources All in¢xHning resour￿ are induded in the ststement of financial activities when the tharity is enlitled to the income and the amount be quanttfied with reasonable ac￿racY. The following Specif￿ pol￿eS are applied lo particular categories of income. (il Voluntary income is receNed by way of grants. donations and gifts and is induded in full in the Stslement of Financial Act￿￿e$ when recewable. Gran1$, where entidemenl is not ￿ndItIOnal on the delNery of a specTfic performance by the charity, are rec¥yJnised when the charity becomes unconditionalty entitled to the grant. (li) Donated services and facilittes are i￿1￿jed at the value to the charty where this can be quantified. (iii) The value of Se￿1￿ provided by volunteers has not been included in these accounts. (iv) Investment Inco￿ is included when re￿wable. (vl Incoming resources from charitable trading aclNty are ￿lUnted for when eamed. (vi) Incoming resources from grants, where related to Performan￿ and specific deliverables, are accounted for as the charity eams the right to consideration by its perf0M￿nCe. MOTHERS FOR MOTHERS NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2020 Contlnued (d) Resources Expended Expenditure is recognised on an accnjal basis as a liability is irmxrred. EX￿dIt￿re includes any VAT which cannot be fully re￿vered. {1) thts of generating funds comprise the costs asKtiated wrth attracting voluntsry inccrfne and the cosls of trading for fundraising purFoses. (li) Charitable expendtture wmprises the costs associated wtth attrxtin9 voluntary income and the costs of trading for fundraising purFM)ses. (iii) Governance costs indude those cx)sts associated wilh meeting the CA)nstitulional and statutory requirements of the charity and include the audit fees and cosls linked lo the slralegic managemenl of the charity. (Iv) All costs are allocated bet¥4Een the expenditu￿ faiewries of the SOFA on a bask8 designed to reflect the use of the r￿￿Urce. Costs relating to a particular *ivity are allocated directy. others are apFQrtioned on an appropriate basis. (e) Fixed Assets Tangible fixed assets a￿ wrrllen off over the expected useful lrfe of the asset, at 25% per annum on the red￿ang balan￿ basis. MOTHERS FOR MOTHERS 10 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2021 continued TANGIBLE FIXED ASSErs 2021 2021 COST Balance Brought Forward Additions during the Year 6.010 6,010 6.010 DEPRECIATION Balance Broughl Forvrard Charge for the Ye 5,909 25 5.875 NET BOOK VALUE CARRIED FORWARD 76 100 NET BOOKVALUE BROUGHT FORWARD 101 135 DEBTORS 2021 2020 Trade Debtors HMRC 10.441 10,441 CREDITORS- FALLING DUE WITHIN ONE YEAR 20 2020 Payroll Sundry Creditors Accruals 2.691 285 3,241 285 2.976 3.526 MOTHERS FOR MOTHERS 11 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2021 continued MOVEMENTS IN FUNDS Balance 01x142020 Incorning Outyoing Funds Transfer Balan¢e 31.03.2021 Restricted Funds Children in Need James Tudor Foundation Evelyn May Quartet St James Place NHS K213 Newby AtrM)ve & Beyond TNL Awards for All Tampon Tax Wesleyan Trust Bromford Merlin Dame Violet Wills Trust Garfietd Weston Foundation bert Hunl Trust John James Brislol Foundalion Lloyd Robinson Total 8,333 10,000 5.000 4.000 10.000 10.000 5.000 5.000 3,700 8,520 10,000 4,700 656 8,333 300 3.344 10.000 10.000 5.000 5.000 3,700 8,520 9,167 10,000 1,000 1,000 10,000 2,CwJO 5,000 500 47,000 9,167 10,000 1.000 1.000 10,000 2,000 5,000 500 44.023 61,220 64.197 Unrestrlcted Funds Designated Funds Staff ContiNJency Reserve 3 months running cosls Staff resIrL￿tUre & developmerrt General Funds 4.500 30,000 30,000 4,800 500 20.000 5.000 50,000 30,000 17,053 150,436 117,683 {20,500) Total 69,300 150,436 117.683 102053 Total 116.300