2022-03-31-accounts

British Home and Hospital for Incurables

Report and Financial Statements for the year to

31 March 2022

Charity Registration Number 206222

Contents

Reports
Reference and administrative details	1
Report of the Board of Trustees	3
Independent auditor’s report	21
Financial statements
Statement of financial activities	25
Balance sheet	26
Statement of cash flows	27
Principal accounting policies	28
Notes to the financial statements	32

British Home and Hospital for Incurables

Reference and administrative details

Patron	Her Royal Highness Princess Alexandra
	(retired December 2021)
Honorary President	Professor, The Lord McColl of Dulwich
Chair	Mrs Kay Sonneborn BA
Deputy Chair	Mr David Green MA (Cantab)
Board of Trustees	Mrs Patricia Collinson, Dip NUR, RNT
	Mr Kenneth Dunn MA, DipMS
	Ms Alison Hughes RN, MHSM
	Mrs Rowenna Hughes GradDip MCSP, SRP
	(resigned September 2022)
	Mr James Mill TD, CA
	Mr Derek Prentice
	Ms Rebecca Sycamore
	Ms Jane Fisher
	Mr Tom Walker (appointed 28 July 2021)
Chief Executive Officer to the Board	Mr Paul Perkin
Director of Care	Mr Keith Crowhurst, RN (resigned November
	2021)
	Mr Douglas Webb – Interim (appointed January
	2022)
Director of Finance and Resources	Mrs Natasha Charles-Lewis, ACMA
Address	Crown Lane
	Streatham
	London
	SW16 3JB
Website	www.britishhome.org.uk
Charity registration number	206222
Auditor	Buzzacott LLP
	130 Wood Street
	London
	EC2V 6DL

British Home and Hospital for Incurables 1

Reference and administrative details

Investment advisors	CCLA Investment Management Limited
	80 Cheapside
	London
	EC2V 6DZ
	Sarasin & Partners LLP
	Juxon House
	100 St Paul’s Churchyard
	London, EC4M 8BU
Bankers	Barclays Bank plc
	Clapham Common Group
	PO Box 4038
	London, SW12 9YB
Legal advisers	Hempsons
	40 Villiers Street
	London, WC2N 6NJ

British Home and Hospital for Incurables 2

Report of the Board of Trustees Year to 31 March 2022

The Board of Trustees (‘the Board’) presents the statutory report and financial statements of British Home and Hospital for Incurables (‘British Home’) for the year ended 31 March 2022.

The financial statements have been prepared in accordance with the accounting policies set out on pages 28 to 31 and comply with British Home’s Charter of Incorporation and Regulations, the Charities Act 2011 and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102).

A Note from our Chair

Over the last two years the Covid Pandemic has taken up most of the Board’s attention which has delayed the progress of our strategy. As we recover from the pandemic, we have a renewed focus on our principal objective, to become a centre of excellence of neuro-care and rehabilitation. Our residents’ expanding needs are at the forefront of our vision, as well as the recognition that demand for our rehabilitation and re-ablement services is increasing.

This requires us to rapidly continue the development of our services for the benefit of current and future residents. In the last year we increased our therapy Services, which included training our Care Assistants in basic therapy techniques, to further integrate re-ablement into all aspects of resident’s care.

Our future strategy requires us to ensure that our buildings can provide a more therapeutic environment including the facilities and infrastructure for new technologies, to support those with more complex needs. The Board has reaffirmed its commitment to ensuring that our building development programme remains a key tenet of the charity’s 5-year strategy.

Strong governance remains key to how our Trustees fulfil their role and we are continuingly reviewing our processes. Our adoption of a new terms of appointment, in line with the Charities Code of Governance, will mean that several of our current Trustees will retire from their roles over the next year. In anticipation of this, Trustees underwent a skills review last year to identify the gaps in skills and experience of the current Board, particularly within the context of stewarding the charity towards its strategic objectives.

The Board has reaffirmed its commitment to Equality, Diversity, and Inclusion (EDI) across all areas of the Charity and ensuring a more diverse Board will be key to future Trustee recruitment. In July 2021, Thomas Walker was appointed onto our Board. Thomas has extensive experience in global strategy, property, and corporate governance and he has already made a significant contribution to the charity’s future planning since taking up his role.

Covid is still having an impact on the Charity even though restrictions were lifted earlier in the last year. Our infection control and testing are still continuing at significant cost to the Charity and further, temporary lockdowns still occur as and when new cases of COVID are identified. We have recognised that for visitors this still presents frustration, and difficulty. This has also had an impact on our staff who have remained resilient throughout and their care and concern are commendable.

British Home and Hospital for Incurables 3

Report of the Board of Trustees Year to 31 March 2022

A Note from our Chair (continued)

However, despite this, our controls have allowed us to see volunteers returning to the Home together with local groups providing sport and rehab-based activities. We were also able to hold our Summer Party in the garden and whilst we were restricted on numbers it was a wonderful afternoon with many Residents, accompanied by staff and family members.

Other highlights of the last year included our regulator, the CQC, awarding us a good grading across all of the five standards. The Board would like to thank all of our staff for their hard work and efforts towards achieving this. In June we successfully launched our national Neurodisability Awareness Day to raise awareness of the 1 in 6 people living with a neurological condition in the UK. This was supported by a fundraising and media campaign, which received wider coverage across national press, TV, and social media.

Our Patron, HRH Princess Alexandra retired in December 2021 having been our Patron since 2003, succeeding as Patron from HRH Queen Elizabeth the Queen Mother. HRH has always given us unwavering support and visited us so frequently over her time as Patron. The Board would like to thank her Royal Highness and wish her well in her retirement.

Finally, the Board would like to thank our staff for their continued dedication to our residents and the Charity as a whole. We remain proud and grateful for their contribution and recognise that it is because of their skills and continued professional development, that we are able to meet the needs of people with ever more complex needs, We can, and we will continue to offer more with every year and look forward to a brighter future for our residents and everyone who is part of British Home.

British Home and Hospital for Incurables

4

Report of the Board of Trustees Year to 31 March 2022

Composition of the Board of Trustees (continued)

The Charity Board of Trustees is:

Chair: Kay Sonneborn

Kay was an investment analyst for a US investment bank for many years. She has been involved with the charity and health sector for over 30 years and has held senior non-executive roles in the NHS. Kay was Chair of the largest Primary Care Trust in London for ten years.

Deputy Chair: David Green

David worked in Merchant banking before a long involvement with the charitable sector in London, firstly as Finance Director of the London Voluntary Service Council and subsequently as Chief Executive for the Cripplegate Foundation and the St Luke’s Parochial Trust, allocating millions of pounds in grants to projects in Islington.

Patricia Collinson

Patricia has spent her career in nursing and nurse education with experience of both the NHS and Government work. Her last post before retirement was Nurse Director for the Medical Devices Agency, Department of Health. Since then she has worked as an Expert Nurse Witness and as an Editorial Consultant. She has been a Trustee of the Crossroads Caring for Carers Association.

Kenneth Dunn

Kenneth Dunn joined the Board of Trustees in December 2014. Kenneth has some 30 years of social care experience. He has a broad knowledge of the care industry and government policies and procedures regulating care.

British Home and Hospital for Incurables 5

Report of the Board of Trustees Year to 31 March 2022

Composition of the Board of Trustees (continued)

Alison Hughes

A nurse and midwife with 36 years’ experience, Alison trained at University College Hospital before moving to Oxford and then Australia to practice. She spent four years overseas before joining the cardiac unit at St George’s Hospital Tooting, moving from Sister to Head of Nursing and finally Divisional Director of Nursing and Governance. Alison retired from the NHS in 2015 and currently works part time on a consultancy basis.

Rowenna Hughes (retired from the Board September 2022)

Rowenna trained as a physiotherapist at Guy’s Hospital and went on to specialise in working with disability. For thirty years she managed a team of physiotherapists at King’s College Hospital working with young adults and children with disabilities and then served as Staff Governor on the Council for Governors at KCH NHS Foundation Trust. Rowenna is Chair of the Friends of KCH. She was awarded an MBE in 2012 for her work in the field of disability.

James Mill

James worked in oil and gas exploration for much of his career, operating in Libya, Pakistan and Canada amongst other places. For the last ten years of his working life he was Finance Director of the Royal Star & Garter Home, a 180-bed nursing home and military charity in Richmond, and consequently has extensive experience of the challenges facing charities like British Home.

Derek Prentice

Derek spent the majority of his career in consumer affairs, spending over twenty years with Consumers’ Association (Which?) and serving as the President of the European Consumers Organisation BEUC. Derek is a Council Member and Trustee of the Royal College of Emergency Medicine and Chairs its Lay Group. Derek has been the Vice Chair of the Lay Group of the Academy of Royal Medical Colleges, the Chair and Lay Member of the General Dental Council and a Trustee of King’s College Hospital.

British Home and Hospital for Incurables 6

Report of the Board of Trustees Year to 31 March 2022

Composition of the Board of Trustees (continued)

Rebecca Sycamore

Rebecca has considerable experience of Director level posts within large charities. She is currently Executive Director of Development at the homelessness charity and Housing Association, St Mungo’s where she has responsibility for fundraising, communications and marketing, business development and strategic asset management. She has also been a specialist social worker, helping homeless people experiencing mental health problems for the London Borough of Ealing, as well as holding positions with Crisis and Homeless Link

Jane Fisher

Jane has worked in the NHS for over thirty years, starting as a nurse with a special interest in trauma. After twenty years on the front line, she moved into NHS management and now manages the North West London Renal and Transplant Service (the largest such unit in Europe). Jane is passionate about healthcare and has a strong commitment to delivering equality and diversity.

Tom Walker

At its meeting in July 2021 Trustees agreed to appoint Mr Tom Walker to the Board of British Home. Tom is currently Co-Head of Global Listed Real Assets for Schroders

Mrs Rowenna Hughes tendered her resignation in July 2022 and will step down from her role as Trustee at the Annual General Meeting in September this year. The Board and Executive Team would like to thank Mrs Hughes for seventeen years of tremendous service. Mrs Hughes has provided great guidance and insight into all clinical matters concerning British Home and has been instrumental in embedding the rehabilitation services that remain an integral part of the support provided by the Charity.

British Home and Hospital for Incurables 7

Report of the Board of Trustees Year to 31 March 2022

Board Responsibilities Statement

The charity’s trustees are responsible for preparing the report and financial statements in accordance with applicable law and United Kingdom generally accepted accounting practice. Charity law requires the Board, as trustees, to prepare financial statements which give a true and fair view of the financial activities of British Home during the year and its financial position at the end of the year. In preparing the attached financial statements, the Board is required to:

•  select suitable accounting policies and then apply them consistently;

•  observe the methods and principles in Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102);

•  make judgements and estimates that are reasonable and prudent;

•  state whether applicable UK accounting standards and statements of recommended practice have been followed, subject to any departures disclosed and explained in the financial statements; and

•  prepare the financial statements on the going concern basis unless it is inappropriate to presume that British Home will continue to operate.

The Board is responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of British Home and which enable it to ensure that the financial statements comply with the Charities Act 2011. The Board is also responsible for stewarding the assets of British Home and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

The Board is responsible for the maintenance and integrity of the charity and financial information included on the charity’s website. Legislation in the United Kingdom governing the preparation and dissemination of accounts may differ from legislation in other jurisdictions.

Structure, governance, and management

British Home was granted a Royal Charter on 1 November 1899. It is governed by a Charter of Incorporation and Regulations (revised 8 January 2009) and is a registered Charity (No. 206222). Responsibility for British Home rests with the Board who are the trustees of the charity for the purposes of charity legislation.

British Home is regulated by the Charity Commission, by the Care Quality Commission (CQC) and, as a Royal Charter Company, by the Privy Council.

The Board met 4 times in the year to 31 March 2022 and more informally on a number of occasions to discuss British Home’s future strategy. At 31 March 2022 the Board comprised 11 members who held office throughout the year (unless otherwise stated on page 1).

No member of the Board received any remuneration for services as a member of the Board.

British Home and Hospital for Incurables 8

Report of the Board of Trustees Year to 31 March 2022

Structure, governance, and management (continued)

Board Committee Structure

The Board continues to review its governance committee structure annually, to ensure that it remains fit for purpose and responsive to emerging, strategic opportunities and risks. At its meeting on the 13 of May 2020 the Board completed a formal review of its governance structure including the terms of reference for each of its sub-committees and their alignment with those objectives included in the charity’s 5-year strategy.

Care Governance Committee

The Care Governance Committee provides assurance to the Board by having Trustees with relevant health and social care experience to review the provision of care in the Home, and to offer support and counsel to the Director of Care in this regard. The Care Governance Committee maintains oversight of British Home’s clinical practice and care provision including quality assurance, service improvement, safe practice, and regulatory compliance. At its meeting in May 2021 the Care Governance Committee agreed a new suite of strategic performance indicators which support the charity’s aspiration to become a Specialist Level-2 Neuro-rehabilitation provider.

Finance Committee

The Finance Committee has delegated responsibility from the Board to oversee all financial aspects of the Charity’s operations including the Charity’s investment strategy and appointment of its Investment Managers The Finance Committee also has responsibility for British Home’s human resources, building and maintenance services, as well as the development of the Charity’s IT and digital strategy. The Finance Committee continues to set annual targets to reduce the current deficit and achieve an annual operational surplus

In April of 2021, the Finance Committee oversaw the development of a new Financial Sustainability Plan, intended to eliminate the operational deficit over the next four years. This plan was approved and adopted by the Board at its meeting in May 2021, with its key focus on levelling -up care fees for those residents whose costs are not fully met by commissioners. Since the pandemic, the recruitment of care staff within a challenging market has emerged as the Charity’s key strategic risk. The Finance Committee continue to review staff salaries and benefits to ensure that these remain competitive and to advise the Remuneration and Nominations Committee in this regard.

Redevelopment Oversight Committee

In December 2019, the Board agreed to terminate its earlier agreement with a development partner to build a new care facility on the existing site of the British Home. Over the following year, the Charity’s development aspirations were placed on hold as it responded to the operational and financial challenges brought about by the global pandemic.

British Home and Hospital for Incurables 9

Report of the Board of Trustees Year to 31 March 2022

Structure, governance, and management (continued)

Redevelopment Oversight Committee (continued)

In November 2020 the Board agreed the terms of reference for a new Redevelopment Oversight Committee, to oversee the design and completion of the refurbishment of British Home. A feasibility study was commissioned in late 2021 to explore the options for monetising part of the existing site to meet development costs. The initial findings of the study determined that current market conditions are as such, that the full costs of any refurbishment would not be met by part-sale of the existing site. In view of this, the Committee continue to explore further options to develop a new, state-of-the-art facility for British Home’s residents. This will include a significant capital fundraising programme as well as consideration to a new development on an alternative site if more viable.

Remuneration and Nominations Committee

The Remuneration and Nominations Committee was reconstituted in 2018 to oversee the balance and effectiveness of the Board, including the appointment of new Trustees. The Remuneration and Nominations Committee is also responsible for the remuneration of the executive management team of the Charity, as well as the annual review of staff salaries and benefits.

Trustee recruitment, induction and training

The Board annually reviews the mix of skills and experience of its members and seeks new trustees where specific skill gaps are identified. New trustees are offered an individually tailored induction programme to familiarise themselves with all aspects of the charity’s work, legal and statutory responsibilities including all relevant regulatory requirements determined by the Charity Commission. Over the next year, the Remuneration and Nominations Committee will begin a recruitment process to support the Board’s succession planning, as several Trustees approach the end of their fixed tenures. As part of this process, the Board will seek to increase the diversity of its membership to ensure that it remains reflective of British Home’s residents, staff and wider community.

The Board is regularly updated on all key operational and clinical developments within the Home and each Trustee participates in the monthly Board visitor programme where they can hear first-hand from residents, staff, and families about the quality of service being provided.

Management of British Home

The key management personnel of British Home responsible for directing and controlling the operations of the charity comprises the Board of trustees, the Chief Executive Officer, the Director of Care and the Director of Finance and Resources.

Mr Paul Perkin (BA Hons) is the Chief Executive Officer of British Home. Paul took up this post in April 2017. Paul has over twenty years’ experience within the social care and housing sector. Paul holds a BA Hons degree in Urban Policy from Lancaster University and has a long track record of campaigning and advocating on the behalf of society’s most vulnerable people. Paul is also Chair of the Board of Evolve Housing and Support a London based homelessness charity and registered social landlord.

British Home and Hospital for Incurables 10

Report of the Board of Trustees Year to 31 March 2022

Structure, governance, and management (continued)

Management of British Home (continued)

Mr Keith Crowhurst RN (MSc) was the Director of Care and Development until October 2021. Keith took up this role with effect from May 2017. Keith is a registered nurse and an experienced care home manager with qualifications in the leadership and management of care services. Keith holds an MSc. from University College London and has written and lectured on specialist nursing and care. Keith resigned from his role in October 2021. The Board and the Executive Team would like to thank Keith for his contribution to British Home over his tenure.

Mr Douglas Webb is the Interim Director of Care. Douglas took up this role with effect from January 4 2022 to support British Home until it could make a substantive appointment to the role. The objectives of the role are to ensure high quality care and drive continuous improvement within its clinical services, as well as support the home in its ambition to deliver innovation and models of care for people with neurological conditions.

Mrs Natasha Charles-Lewis ACMA (MSc) is the Director of Finance and Resources at British Home. Natasha took up this role in September 2019. Natasha has over sixteen years’ finance experience within the healthcare and charitable sector. Natasha is an associate member of the Chartered Institute of Management Accountant and holds a further degree in strategic business management.

Aims Objectives and Strategy

British Home provides specialist nursing care, rehabilitation, and social support to adults with a neuro-disability. This will typically include people living with severe impairment often resulting from brain injury, stroke or through a degenerative illness. We work with each of our residents to tailor a holistic and bespoke package of care and rehabilitation, enabling them to live as full and independent lives as possible. British Home also provides end of life care, ensuring that dignity, comfort, and choice remain at the heart of all that we do.

British Home is registered to look after a maximum of 127 residents; however, in 2013 the Board agreed to decommission 49 beds to achieve a more optimum operational capacity of 78 beds, and to ensure that all available accommodation continues to meet our aspirational standards. In 2019, a further three respite beds were re-commissioned due to an increased demand for this provision in the last year. Average occupancy over the year on this basis was 88% or 70 residents (2021 – 86% or 69 residents).

In 2019, the Board agreed its 5-year strategy, with a central aim to build upon its experience and become a specialist provider of neuro-disability rehabilitation. Over the next three years of its current strategy, the Board will continue to invest charitable income to develop British Home into a centre of excellence for specialist rehabilitation, in line with The British Society of Rehabilitation Medicine (BSRM) standards. In doing so, we will enable more people to manage their disability and illness more effectively, with an emphasis on increased independence, pain relief and greater enjoyment of life (including those approaching end of life).

British Home and Hospital for Incurables 11

Report of the Board of Trustees Year to 31 March 2022

Aims Objectives and Strategy

COVID-19

The global COVID-19 pandemic and subsequent lockdown had a significant impact on the health and wellbeing of all the Charity’s residents. The commitment and resilience demonstrated by our staff over that time was exemplary and ensured that we could continue to meet the needs of all our residents in the most challenging of circumstances. While the majority of COVID restrictions have been lifted across most of society, this has not been the case for providers of health and social care.

Over the last year we have continued to implement robust infection control procedures as required to protect our vulnerable residents. In January of this year, we were delighted to welcome visitors back into British Home following almost two years of lockdown. However, the risks around infection have remained and we have since been required to close the Home to visitors on several occasions due to new infections. We continue to monitor infections through a weekly testing regime to ensure that our residents remain safe and that further lockdowns are a last resort for controlling infection. As noted in previous year’s accounts, COVID had a significant impact on occupancy levels within British Home as mortality increased amongst more vulnerable residents, and new referrals into the service were paused. As COVID restrictions have begun to lift, the rate of referrals has not yet returned to pre-pandemic levels; however, the Board remain confident that occupancy levels will increase as renewed demand for the service continues to grow.

Public benefit

In setting the charity’s objectives the trustees have given careful consideration to the Charity Commission’s guidance on public benefit. The Board believes that British Home continues to meet the Charity Commission’s public benefit test principally in that the majority of residents in British Home have for many years benefited from the availability of statutory funding. The charity subsidises the running cost of British Home and provides a range of additional rehabilitation and social support to residents from its own charitable funds.

Personalised Support

At British Home, we recognise that each resident is an individual and that they and their families will often provide the greatest insight into how our staff can best meet their care needs. Residents at British Home are continually assessed by a multi-disciplinary team comprising of clinical staff and therapist to ensure they receive an appropriate service offer commensurate with their individual needs. We work with residents and their families to develop personalised care plans, ensuring that they direct and control the care we provide. Over the next year we will continue to train and develop all our nursing and care staff in rehabilitation support, which will ensure greater integration of each resident’s individual therapy and treatment plans across all aspects of their daily care. We continue to work with residents receiving palliative care to develop personal end of life care plans. Last year 100% of residents had an agreed end of life plan in line with their personal wishes.

British Home and Hospital for Incurables 12

Report of the Board of Trustees Year to 31 March 2022

Aims Objectives and Strategy (continued)

End of Life Care Gold Standard Framework

In January 2020, British Home underwent re-accreditation with the Gold Standard Framework for its End of Life Care. Trustees were delighted that the Charity was awarded the Platinum Care Hallmark in recognition of its high quality and person centred, End of Life support. British Home’s End of Life Care is delivered through a multi-disciplinary team that brings together nurses, therapists and other professionals involved in a resident's care under the direction of our Director of Care and Home Manager. All residents, for whom it is appropriate, are supported to develop an End of Life Care Plan, to direct the support and care they receive from British Home. British Home will undergo re-accreditation for the Gold Standard Framework in March 2023.

Risk management

The Board regularly reviews the potential major risks to the charity and undertakes a formal risk audit each year to identify any additional risks that the charity may be exposed to and to ensure that adequate control measures are in place to mitigate identified risks. To protect the assets of the charity, British Home maintains a comprehensive suite of insurance policies.

The Board considers the ‘failure to reduce its operational deficit’, as its key strategic and operational risk, given that this would have a detrimental impact on the future sustainability of the Charity and the well-being of its residents. The Charity’s 5-year strategy has guided British Home’s transition from a traditional nursing care model to that of a specialist provider of neurodisability nursing care and rehabilitative support. This will ensure that care fees are more commensurate with residents’ support needs and that the Charity is not required to subsidise the costs for those residents who no longer require the level of specialist nursing and support provided within the Home.

Given the unique challenges posed by the recent COVID -19 pandemic, it has been necessary to revise the Charity’s business continuity plan to ensure the well-being and safety of all who live and work at British Home. It is expected that COVID-19 will continue to effect life at British Home for some time to come. A primary focus of the Board’s risk management plan will be to ensure that those measures intended to manage new infections remain effective and in line with the most recent guidance.

In recent years the health and social care sector has experienced significant challenges around recruitment and retention of experienced care staff. British Home is not immune to this, and over the last year the recruitment of skilled staff into British Home has emerged as a key risk for the charity. The Executive Team has introduced a range of measures to attract talented staff and to reduce its dependency on temporary workers, with some success. However, this has not been without significant cost as the Charity has sought to increase salaries and benefits to attract skilled workers within a competitive market. Over the next year, the Executive Team will engage with local Integrated Care Boards to ensure that care fees reflect the demands of local labour markets, and that British Home remains able to attract and retain highly skilled and experienced staff.

British Home and Hospital for Incurables 13

Report of the Board of Trustees Year to 31 March 2022

Aims Objectives and Strategy (continued)

Volunteers & Carers

Volunteers at British Home make a positive difference to the lives of residents at British Home through their involvement in a wide range of activities including rehabilitation support, recreational activities, befriending and fundraising.

Since the easing of lockdown restrictions this year, we have been able to welcome volunteers back into British Home. In September 2021 we hosted a summer event for all our residents, families, and staff to celebrate us being able to come together as one community for the first time since lockdown. The Board remain grateful to our volunteers who contributed to this event, as well as the continued support of Fitzgerald Orchestra who provided such wonderful music on the day.

British Home also places significant value in the views and contributions of its community of resident’s families and carers. The Charity offers a variety of ways for families and carers to have their say on how care and support is delivered at British Home, recognising their role as advocates and experts in how their loved ones are cared for. Over the last year, families and carer’s views were heard through online quarterly families and carer’s meetings as well as through our annual family and carer surveys.

Fundraising

The shortfall in our operating income, as noted earlier, is made up in part from generous donations and legacies bequeathed to the Home. British Home remains reliant on voluntary contributions to enable the charity to innovate and develop new ways of working to support people with neurodisability to live as independent and full a life as possible. The Board are grateful for all charitable contributions from our generous donors and would like to pay particular thanks to the following Trusts and individuals for their continued support:

I V Askew Charitable Trust J H Bartlett Charitable Trust Bothwell Charitable Trust Davis Rubens Charitable Trust Gilbert & Eileen Edgar Charitable Trust D G Ryder Charitable Trust

The Board would also like to thank Mr Keith Crowhurst and Mr Adam Grimwood for their significant individual contribution to British Home’s fundraising efforts over the last year.

As a charity registered with the Fundraising Regulator, we are committed to ensuring our fundraising is legal, open, honest, and respectful. British Home did not actively pursue donations from individuals and the general public and did not use the services of a professional fundraiser. No complaints were received in relation to how the charity conducted its fundraising activity.

British Home and Hospital for Incurables 14

Report of the Board of Trustees Year to 31 March 2022

Aims Objectives and Strategy (continued)

Environmental, Social and Governance

Since its inception British Home has provided care and support to some of the most vulnerable people within its community. We remain proud of the public benefit we continue to provide to severely disabled people, and we also recognise the wider role we can and should play towards reducing our environmental impact, increasing diversity and inclusion, and ensuring strong and ethical governance practices.

The charity continues to ensure that its investments are managed in compliance with ESG criteria, through dedicated funds in line with Charity Commission Guidance. Over the next two years we will continue to build upon this commitment to ESG practices in a variety of ways; from how we manage our carbon footprint, including procuring services and influencing our suppliers’ environmental practises; to how we ensure the welfare of our staff and increase opportunity and diversity across our workforce.

Our Values

All at British Home are committed to upholding our organisational values which have been developed in collaboration with our residents, staff and other stakeholders and partners.

These values inform every aspect of our work, including the care we provide to residents and the way we support our staff to carry out their important roles.

Our Values determine that we:

• put the individual at the heart of their care;

• understand that every individual will have their own targets and motivations, and that rehabilitation is a process that people take at their own pace;

• recognise the advantages that our diversity provides, we will harness the talent and energy of everyone at British Home: staff, volunteers, residents, families and carers;

• will always act with integrity, openness and honesty; and

• are committed to the highest standards and will embrace innovation and models of best practice.

Our Royal Patron

Her Royal Highness Princess Alexandra first visited the Home deputising for Her Majesty Queen Elizabeth, The Queen Mother, who was our patron for more than seventy years. Her Royal Highness became patron of the Home in 2003 and supported the Charity’s work and continued development since that time. After twenty years of committed patronage, Her Royal Highness has retired from her role with the Charity. The Trustees and staff of British Home are very grateful for the years of support and dedication of Her Royal Highness to British Home, and we wish her a restful and enjoyable retirement. As we look to the future, the Trustees will seek to engage a patron who can demonstrate the required commitment and support as is required for the Charity and its current and future residents.

British Home and Hospital for Incurables 15

Report of the Board of Trustees Year to 31 March 2022

Financial review

Performance in the year

The operating deficit for the period was £1,977,961 (2021 – £2,240,535) as shown in the table below:

	2022 £	2021 £
Fees Less: Expenditure Operating deficit Donations Investment income Other Income Deficit before legacies Legacies Net expenditure for theperiod before investmentgains and losses	4,833,020 (6,810,981)	4,258,763 (6,499,298)
	(1,977,961) 159,224 362,118 303,638	(2,240,535) 45,574 420,172 369,931
	(1,152,981) 130,669	(1,404,758) 526,842
	(1,022,312)	(877,916)

a) Fees

Income from fees charged increased by 13% to £4,833,020 (2021 – £4,258,763). The decrease in average occupancy as a result of the current pandemic was augmented by higher fees generated in respect of new admissions with continued focus on attracting specialist needs residents with neurological conditions and a greater emphasis on the charity’s therapy provision. As in recent years, a very low level of fee increase was awarded for longer term residents and only by a small number of funders putting continued pressure on the charity’s resources.

b) Expenditure

Expenditure in 2022 increased by 5% to £6,810,981 (2021 – £6,499,298).

Within this total, staffing costs amounted to £3,771,193 (2021 – £3,882,795) a decrease of £111,602. British Home staff are the heart of our organisation, whenever possible the Board endeavours to provide a real increase in pay ~~a~~ nd ensures that staff are paid in line with industry standards.

c) Fundraising and publicity

Costs, with allocated support costs, totalled £190,514 (2021 – £124,141). This included costs for the external marketing of British Home to continue raising awareness of British Home and its work, to support its fundraising endeavours.

d) Donations

Donations increased within the last year to £159,224 (2021 – £45,674). The Covid pandemic impacted on fundraising activities during the year and contributed to a decline in donations received compared to previous years. In the current year we received a significant donation from J H Bartlett Charity Trust which resulted in an overall increase. The charity is thankful for the great support of individual donors and charitable trusts, a number of whom have been loyal supporters of British Home for many years. The Board equally values every contribution regardless of size and is particularly grateful for the dedication of local groups and individuals in helping to fundraise.

British Home and Hospital for Incurables 16

Report of the Board of Trustees Year to 31 March 2022

Financial review (continued)

Performance in the year (continued)

e) Income

Income from legacies decreased within the last year to £130,669 (2021 – £526,842). In line with the legacy income recognition policy, whereby a future legacy receipt is recognised as income provided probate has been granted and eventual receipt is probable, £109,000 (2021 – £233,000) has been recognised as income ahead of receipt in cash. Historically the legacy income of British Home has fluctuated and is unpredictable from year to year. As with a number of charities, British Home’s fundraising income continued to be adversely affected as participatory fundraising events were compromised, or postponed, as a result of the pandemic. We look forward to engaging more of our supporters in a variety of fundraising events and initiatives over the coming year as COVID restrictions are lifted.

Pension Liabilities

The charity previously operated a final salary pension scheme which closed to new members as of 31 March 2014.

The Board engaged KPMG to advise it as to whether measures could be taken to potentially mitigate the liabilities of the scheme and whether securing member’ benefits under the scheme through an insurance company buy-out might be an affordable option for British Home. The Board considered that removing at an affordable cost the risk to its reserves represented by an open-ended obligation to fund any future deficits in the scheme would be in the best interests of the charity.

In February 2018 the trustees decided to withdraw from the scheme and a total liability of approximately £1,788,000 crystallised. This quotation also included costs for legal and actuarial fees associated with the buy-out, as well as provision for any unforeseen costs arising from a final data cleansing exercise of the scheme, which will be jointly conducted by Aviva and the scheme’s actuary.

The trustees paid over the sum of £1,010,000 on 3 March 2018. There remains a provision in the accounts at the reporting date of £778,000. The data cleansing exercise was still in progress at the reporting date and the provision remains unchanged.

The Board are pleased to have secured a buy-out of the closed defined benefit scheme with an established and reputable insurer such as Aviva. This will ensure greater security in the longer-term for the members of this pension scheme, while removing a significant liability from the charity’s balance sheet.

The replacement to the now closed final salary scheme is a defined contribution Group Personal Pension Plan provided through Royal London. Under this arrangement British Home contributes 10% of pensionable salary while employees contribute 5%. Employees who have not elected to join the GPPP are, if eligible, subject to auto-enrolment at contribution rates set as part of the Government’s pension membership initiative.

British Home and Hospital for Incurables 17

Report of the Board of Trustees Year to 31 March 2022

Financial review (continued)

The Home’s Net Assets

The net assets of British Home at 31 March 2022 were £14,214,997 (2021 – £14,585,366). Of these £569,654 (2021 – £338,617) related to fixed assets which were comprised mostly of freehold buildings, which are wholly used for charitable purposes and are represented by a specific designated fund. Fixed asset purchases and disposals during the year are shown in the notes to the financial statements. The net assets also included £12,477 of endowment funds not expendable by the charity. After allowing for further designated funds as described below the general unrestricted funds of the charity at 31 March 2022 were £5,732,866.

Reserves policy and financial position

In determining the level of reserves necessary to continue the work of British Home, the Board balances its long-term obligations and risks with the needs of current beneficiaries. Where there is a capital commitment, a need to generate income for a specific purpose, or a need to ring-fence funds for the future stability of the charity, the Board has established designated funds. COVID- 19 had a significant impact on the charity’s reserves and highlighted the need to retain an appropriate level of free reserves in order to respond to unforeseen events and to protect the wellbeing of the charity’s beneficiaries.

Designated reserves

At the end of the financial year 2021/22 the British Home held £14,151,164 in investments which were otherwise unrestricted and free reserves. These fund’s were split between general reserves £5,732,66 and £8,469,654 designated funds for fixed assets, continutiy of care and major and cyclical maintenance. The Board is awaiting costings for the planned redevelopment project which would require a further designation along with capital fundraising to fund the project. The Board has currently made the following designations.

Continuity of Care Fund : The Board of Trustees is conscious of its long-term obligation to the residents in its care, their sponsors and their carers and to balance the needs of current residents with those of the future. The Board believes that the equivalent of 12 months anticipated costs is required to meet its obligations to provide essential services for all parties in the event of a critical incident. The Board has therefore designated £5.9M of its reserves to this fund, to provide for one year’s running costs.

Major and Cyclical Maintenance Fund: The British Home operates from an old, Victorian building which is both expensive to maintain and will also occasionally require costly unplanned repairs. Trustees have therefore created a fund to meet the costs of major and cyclical maintenance when the need arises. The Board has designated £2M of its reserves to this fund, in the event that major repairs are required to the buildings infrastructure .

Investment policy and performance

The investment objective of the Board is to maintain the real value of the fund over time whilst generating a stable and sustainable return on investments in the form of dividend payments to supplement the charity’s income. The Finance Committee has responsibility for agreeing strategy and monitoring the investment assets. The committee meets quarterly and reviews the portfolios performance.

British Home and Hospital for Incurables 18

Report of the Board of Trustees Year to 31 March 2022

Financial review (continued)

Investment policy and performance (continued)

The market value of the portfolio at 31 March 2022 was £13,801,164 (2021 - £14,491,862 and 2020 - £12,985,863). This is a book valuation and may differ significantly from the price achieved when the funds are sold. The value of the portfolio fell during the year because of withdrawals to cover cash shortfalls arising from the deficit. The amounts drawn down at 31 March 2022 were £500,000 (2021 - £2,500,000 and 2020 - £1,000,000). The underlying investment performance showed net unrealised investment gains of £651,943 for the year (2021 - £2,496,626 gains and 2020 - £136,995 losses) reflecting the change in market value of investments since 31 March 2021. The income produced from these investments amounted to £362,042 (2021 - £419,585 and 2020 - £484,944).

The past two years have seen big movements in markets. In March 2020 Covid-19 brought lockdowns all over the world with consequent reductions in economic activity and falls in market value. By March 2021 much of that decrease in value had been recovered only for world markets to be hit in 2022 by big increases in energy prices, war in Ukraine and inflation at a level not seen for 30 years. The unwinding of quantitative easing after the financial crisis of 2008 still hangs over the market.

Whilst the charity’s funds are of a sufficient size to have a segregated portfolio, the Trustees decided, after a review some years ago, to invest in pooled and common investment funds for charities. The saving in costs is considerable but it means that the charity loses its power to directly influence and control the underlying investments made or the detail of the Environmental, Social and Governance (ESG) policies to be followed.

The two funds in the portfolio are the COIF Charity Investment and Fixed Income Funds, managed by CCLA, and the Sarasin Consolidated Alpha Fund for Endowments, managed by Sarasin & Partners. Both these managers are mindful of the ethical concerns of their charity clients and pursue active ESG research. This research informs not just asset allocation, assessment of risk and stock selection but also how they vote the shares they buy. Both managers talk to the management of those companies to raise concerns. Both managers publish detailed ESG policies and descriptions of how they assess risk. Both managers also present annually to the Finance Committee illustrating the analysis of the financial return, risk, asset allocation, the funds’ performance against agreed market benchmarks, and the investment objectives.

Auditor

Buzzacott LLP, the Home’s auditors have indicated their willingness to remain in office for a further year.

British Home and Hospital for Incurables 19

Report of the Board of Trustees Year to 31 March 2022

Thanks, and acknowledgements

The Board continues to be highly appreciative of the support for the Home shown by commissioners of social care. British Home as an independent charity well understands the cost pressures associated with the provision of social care and hopes that the Board and Commissioners can work together to ensure the ongoing provision of first class, affordable care at Crown Lane long into the future.

The success of British Home as a charity is down to the combined efforts of many individuals and organisations. However, one group clearly stand out as being the bedrock on which the charity stands, and that group is its dedicated and caring staff. The Board would like to say ‘thank you’ to every member of our staff who ‘day in, day out’ do a wonderful job in supporting, caring and enriching the lives of the residents of British Home.

Approved by the Board of Trustees and signed on its behalf by:

Kay Sonneborn

Trustee

Approved on: 3 November 2022

British Home and Hospital for Incurables 20

Independent auditor’s report Year to 31 March 2022

Independent auditor’s report to the members of British Home and Hospital for Incurables

Opinion

We have audited the financial statements of British Home and Hospital for Incurables (the ‘charity’) for the year ended 31 March 2022 which comprise the statement of financial activities, the balance sheet, statement of cash flows, the principal accounting policies and the notes to the financial statements. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 ‘The Financial Reporting Standard applicable in the UK and Republic of Ireland’ (United Kingdom Generally Accepted Accounting Practice).

In our opinion, the financial statements:

•  give a true and fair view of the state of the charity’s affairs as at 31 March 2022 and of its income and expenditure for the year then ended;

•  have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and

•  have been prepared in accordance with the requirements of the Charities Act 2011.

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the charity in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the Trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charity’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

British Home and Hospital for Incurables 21

Independent auditor’s report Year to 31 March 2022

Other information

The trustees are responsible for the other information. The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Matters on which we are required to report by exception

We have nothing to report in respect of the following matters in relation to which the Charities Act 2011 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

•  we have not received all the information and explanations we require for our audit.

Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement, the trustees are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the charity’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charity or to cease operations, or have no realistic alternative but to do so.

British Home and Hospital for Incurables 22

Independent auditor’s report Year to 31 March 2022

Auditor’s responsibilities for the audit of the financial statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

How the audit was considered capable of detecting irregularities including fraud

Our approach to identifying and assessing the risks of material misstatement in respect of irregularities, including fraud and non-compliance with laws and regulations, was as follows:

•  The engagement partner ensured that the engagement team collectively had the appropriate competence, capabilities and skills to identify or recognise non-compliance with applicable laws and regulations;

•  We identified the laws and regulations applicable to the charity through discussions with management and trustees and from our knowledge and experience of the charity sector;

•  We focused on specific laws and regulations which we considered may have a direct material effect on the accounts or the activities of the charity. These included but were not limited to the Charities Act 2011; Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable to the United Kingdom and Republic of Ireland (FRS 102) (effective 1 January 2019); Care Standards; Health and Safety Regulations; The Code of Fundraising Practice; Safeguarding Regulations; and Data Protection; and

•  We assessed the extent of compliance with the laws and regulations identified above through making enquiries of management and those charged with governance and review of minutes of trustees’ meetings.

We assessed the susceptibility of the charity’s financial statements to material misstatement, including obtaining an understanding of how fraud might occur, by:

•  Making enquiries of management and trustees as to where they considered there was susceptibility to fraud, their knowledge of actual, suspected and alleged fraud; and

•  Considering the internal controls in place to mitigate risks of fraud and non-compliance with laws and regulations.

To address the risk of fraud through management bias and override of controls, we:

•  Performed analytical procedures to identify any unusual or unexpected relationships;

•  Tested and reviewed journal entries to identify unusual transactions;

•  Assessed controls over the opening of post;

British Home and Hospital for Incurables 23

Independent auditor’s report Year to 31 March 2022

Auditor’s responsibilities for the audit of the accounts (continued)

How the audit was considered capable of detecting irregularities including fraud

(continued)

•  Tested the authorisation of expenditure;

•  Assessed whether judgements and assumptions made in determining the accounting estimates were indicative of potential bias; and

•  Investigated the rationale behind significant or unusual transactions.

In response to the risk of irregularities and non-compliance with laws and regulations, we designed procedures which included, but were not limited to:

•  Agreeing financial statement disclosures to underlying supporting documentation;

•  Reading the minutes of meetings of trustees; and

•  Enquiring of as to actual and potential litigation and claims.

There are inherent limitations in our audit procedures described above. The more removed that laws and regulations are from financial transactions, the less likely it is that we would become aware of non-compliance. Auditing standards also limit the audit procedures required to identify non-compliance with laws and regulations to enquiry of the trustees and other management and the inspection of regulatory and legal correspondence, if any.

Material misstatements that arise due to fraud can be harder to detect than those that arise from error as they may involve deliberate concealment or collusion.

We did not identify any irregularities, including fraud.

A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.

Use of our report

This report is made solely to the charity’s trustees, as a body, in accordance with section 144 of the Charities Act 2011 and with regulations made under section 154 of the Act. Our audit work has been undertaken so that we might state to the charity’s trustees 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 charity and the charity’s trustees as a body, for our audit work, for this report, or for the opinions we have formed.

Buzzacott LLP Statutory Auditor 130 Wood Street London EC2V 6DL

Buzzacott LLP is eligible to act as an auditor in terms of section 1212 of the Companies Act 2006.

Date: 30 November 2022

British Home and Hospital for Incurables 24

Statement of financial activities Year to 31 March 2022

Notes	Un- restricted funds £	Restricted funds £	Endowment funds £	2022 Total funds £	2021 Total funds £
Income from: Donations and legacies 1 Investment income 2 Charitable activities 3 Other income 4 Total income Expenditure on: Raising funds 5 Charitable activities 6 Total expenditure Net (expenditure) for the year before investment gains Gains on investments 12 Net (expenditure)/ income and net movement in funds Fund balances brought forward at 1 April 2021 Fund balances carried forward at 31 March 2022	289,893 362,118 4,833,020 303,638	— — — —	— — — —	289,893 362,118 4,833,020 303,638	572,516 420,172 4,258,763 369,931
	5,788,669	—	—	5,788,669	5,621,382
	190,514 6,620,467	— —	— —	190,514 6,620,467	124,141 6,375,157
	6,810,981	—	—	6,810,981	6,499,298
	(1,022,312) 651,943	— —	— —	(1,022,312) 651,943	(877,916) 2,496,626
	(370,369) 14,572,889	— —	— 12,477	(370,369) 14,585,366	1,618,710 12,966,656
	14,202,520	—	12,477	14,214,997	14,585,366

All of the Home’s activities are derived from continuing operations during the above and prior financial period.

British Home and Hospital for Incurables 25

Balance sheet 31 March 2022

Notes	2022 £	2022 £	2021 £	2021 £
Fixed assets Tangible fixed assets 11 Investments 12 Current assets Debtors 13 Cash at bank 21 Creditors: amounts falling due within one year 14 Net current (liabilities) Net assets The funds of the charity: Endowment fund 16 Restricted funds 17 Unrestricted funds . Designated funds 18 . General fund	571,041 856,640	569,654 14,151,164	580,186 1,022,420	338,618 14,491,862
		14,720,818 (505,821)		14,830,480 (245,114)
	1,427,681 (1,933,502)		1,602,606 (1,847,720)
		14,214,997		14,585,366
		12,477 — 8,469,654 5,732,866		12,477 — 8,238,617 6,334,272
		14,214,997		14,585,366

Approved by the Board of Trustees on 3 November 2022 and signed on its behalf by:

Trustee

David Upton Kay Sonneborn

British Home and Hospital for Incurables 26

Statement of cash flows 31 March 2022

Notes	2022 £	2021 £
Cash outflow from operating activities: Net cash used in operating activities A Cash inflow from investing activities Dividends and interest from investments Sale of investments Purchase of fixed assets Net cash provided by investing activities Change in cash and cash equivalents in the year Cash and cash equivalents at 1 April 2021 B Cash and cash equivalents at 31 March 2022 B	**(1,150,695) **	(1,192,737)
	362,118 500,000 **(369,844) **	420,172 2,500,000 (83,590)
	492,274	2,836,582
	(658,421) 2,564,854	1,643,845 921,009
	1,906,433	2,564,854

Notes to the cash flow statement for the year to 31 March 2022.

A Reconciliation of net movement in funds to net cash flow from operating activities

	2022 £	2021 £
Net movement in funds (as per the statement of financial activities) Adjustments for: Depreciation charge Gains on investments Dividends and interest from investments Decrease (increase) in debtors Increase in creditors Net cash used in operating activities	(370,369) 138,809 (651,943) (362,118) 9,145 85,781	1,618,710 183,986 (2,496,624) (420,172) (133,960) 55,323
	(1,150,695)	(1,192,737)

B Analysis of cash and cash equivalents

Analysis of cash and cash equivalents
	2022 £	2021 £
Cash at bank and in hand Cash held by investment managers Total cash and cash equivalents	856,640 1,049,793	1,022,420 1,542,434
	1,906,433	2,564,854

British Home and Hospital for Incurables 27

Principal accounting policies Year to 31 March 2022

The principal accounting policies adopted, judgements and key sources of estimation uncertainty in the preparation of the financial statements are laid out below.

Basis of preparation

These financial statements have been prepared for the year to 31 March 2022 with comparative information provided in respect to the year ended 31 March 2021.

The financial statements have been prepared under the historical cost convention with items recognised at cost or transaction value unless otherwise stated in the relevant accounting policies below or the notes to these financial statements.

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (Charities SORP), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Charities Act 2011.

The charity constitutes a public benefit entity as defined by FRS 102.

The financial statements are presented in sterling and are rounded to the nearest pound.

Critical accounting estimates and areas of judgement

Preparation of the financial statements requires the trustees and management to make significant judgements and estimates.

The items in the financial statements where these judgements and estimates have been made include:

•  estimating the useful economic life of tangible fixed assets;

•  legacy recognition; and

•  estimating future inflows and outflows for the purpose of assessing going concern

Assessment of going concern

The trustees have assessed whether the use of the going concern assumption is appropriate in preparing these financial statements. The trustees have made this assessment in respect to a period of one year from the date of approval of these financial statements.

British Home and Hospital for Incurables 28

Principal accounting policies Year to 31 March 2022

Assessment of going concern (continued)

The trustees of the charity have concluded that there are no material uncertainties related to events or conditions that may cast significant doubt on the ability of the charity to continue as a going concern. At 31 March 2022 the charity had net current liabilities of £505,821 (2021 – £245,114). However, the trustees are of the opinion that the charity will have sufficient resources to meet its liabilities as they fall due. The most significant areas of judgement that affect items in the financial statements are detailed above. With regard to the next accounting period, the year ending 31 March 2023, the most significant areas that affect the carrying value of the assets held by the charity are the level of investment return and the performance of the investment markets (see the investment policy section of the trustees’ report for more information).

Income

Income is recognised in the year in which the Home is entitled to receipt thereof, the amount can be measured reliably, and it is probable that the funds will be received.

Legacies are included in the statement of financial activities when the Home is advised by the personal representative of an estate that payment will be made, or property transferred, and the amount involved can be quantified.

Donations are recognised when the charity has confirmation of both the amount and settlement date.

Dividends are recognised once the dividend has been declared and notification has been received of the dividend due.

Fees from medical and nursing services are recognised when the service has been provided.

Income from the Government’s Coronavirus Job Retention Scheme, and other Government COVID-19 related grants, is recognised when the charity has made a valid claim for the income, the amount can be measured and when it is entitled to receive the income.

Expenditure and the basis of apportioning costs

Liabilities are recognised as expenditure as soon as there is a legal or constructive obligation committing the charity to make a payment to a third party, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably.

Expenditure includes attributable VAT which cannot be recovered.

The majority of costs are directly attributable to specific activities. Support costs are allocated to expenditure on raising funds and charitable activities according to underlying activity levels. These were established using a number of suitable indicators including staff time and floor space.

British Home and Hospital for Incurables 29

Principal accounting policies Year to 31 March 2022

Expenditure and the basis of apportioning costs (continued) Expenditure comprises the following:

• a. Expenditure on raising funds includes the salaries, direct costs and support costs associated with generating donated income and the fees paid to investment managers in connection with the management of the Home’s listed investments.

• b. Expenditure on charitable activities comprises expenditure on the Home’s charitable purposes as described in the report of the Board of Trustees and includes support costs.

Tangible fixed assets

The original land and buildings were acquired in 1894. Between 1898 and 1994 their cost and subsequent additions were not recorded in the balance sheet. For many years the accounting policy for freehold land and buildings recognised that it was not possible to ascertain the cost of land and buildings and until 1 January 1994 the cost of additions were written off as incurred. In 1994 the accounting policy was changed and subsequent expenditure on additions and improvements to buildings have been capitalised. The book value, after depreciation, of land and buildings acquired prior to 1994 is not regarded as material. The New Wing, which opened in 1996, is classified as freehold buildings. The buildings were insured on a replacement basis for £37m at 31 March 2022 (at 31 March 2021 – £36m).

All assets costing more than £5,000 are capitalised. Depreciation is provided at the following annual rates to write off each asset over its estimated useful life:

•  Freehold buildings 4% on cost  Water Tank 10% on cost  Hospital and catering equipment 20% on cost  Office furniture and equipment 20% on cost  Computer equipment 20% on cost  Transport 20% on cost

Investments

Listed investments are a form of basic financial instrument and are initially recognised at their transaction value and subsequently measured at their fair value as at the balance sheet date using the closing quoted market price.

Realised gains (or losses) on investment assets are calculated as the difference between disposal proceeds and their opening carrying value or their purchase value if acquired subsequent to the first day of the financial year. Unrealised gains and losses are calculated as the difference between the fair value at the year end and their carrying value at that date. Realised and unrealised investment gains (or losses) are credited (or debited) in the statement of financial activities in the year in which they arise.

British Home and Hospital for Incurables 30

Principal accounting policies Year to 31 March 2022

Debtors

Debtors are recognised at their settlement amount, less any provision for non-recoverability. Prepayments are valued at the amount prepaid. They have been discounted to the present value of the future cash receipt where such discounting is material.

Cash at bank and in hand

Cash at bank and in hand represents such accounts and instruments that are available on demand or have a maturity of less than three months from the date of acquisition. Deposits for more than three months but less than one year have been disclosed as short-term deposits. Cash placed on deposit for more than one year is disclosed as a fixed asset investment.

Creditors and provisions

Creditors and provisions are recognised when there is an obligation at the balance sheet date as a result of a past event, it is probable that a transfer of economic benefit will be required in settlement, and the amount of the settlement can be estimated reliably. Creditors and provisions are recognised at the amount the charity anticipates it will pay to settle the debt. They have been discounted to the present value of the future cash payment where such discounting is material.

Fund accounting

Endowment Funds comprise monies donated which are not to be expended. Only the income can be used for the charitable objectives of the Home.

Restricted Funds comprise monies raised for, or their use restricted to, a specific purpose, or contributions subject to donor-imposed conditions.

Designated Funds comprise monies set aside out of unrestricted general funds and designated for specific purposes, although the Board of Trustees may ultimately use such funds for other purposes.

The General Fund comprises those monies which are freely available for application towards meeting the charitable objectives of the Home at the discretion of the Board of Trustees.

Pension costs

From 1 April 2014, British Home is operating a defined contribution scheme. Contributions are recognised in the statement of financial activities when payable.

British Home and Hospital for Incurables 31

Notes to the financial statements Year to 31 March 2022

1 Donations and legacies

	Unrestricted £	Restricted £	2022 £
Donations inclusive of reclaimed tax Legacies Total 2022	159,224 130,669	— —	159,224 130,669
	289,893	—	289,893
	Unrestricted £	Restricted £	2021 £
Donations inclusive of reclaimed tax Legacies Total 2021	45,674 526,842	— —	45,674 526,842
	572,516	—	572,516

2 Investment income

	Unrestricted funds	Unrestricted funds
	2022 £	2021 £
Sarasin – CIF ALPHA fund units COIF – Investment fund income units Interest receivable Total 2022	184,147 177,895	225,583 194,002
	362,042 76	419,585 587
	362,118	420,172

3 Income from charitable activities

Income from charitable activities comprises fees from medical and nursing services and is unrestricted.

4 Other Income

Other Income
	Unrestricted funds
	2022 £	2021 £
Social Care Infection Control Fund (ICF) Coronavirus Job Retention Scheme (CJRS) COVID-19 Sustainability Payment Coronavirus Statutory Sick Pay (SSP)	— — 303,638 —	190,736 131,479 43,625 4,091
	303,638	369,931

British Home and Hospital for Incurables 32

Notes to the financial statements Year to 31 March 2022

5 Expenditure on raising funds

Expenditure on raising funds
	Unrestricted funds
	2022 £	2021 £
Advertising and agency fees Other costs (including staff costs) . Direct costs . Support costs	— 145,477 45,037	1,275 80,896 41,971
	190,514	124,141

6 Expenditure on charitable activities

	Unrestricted £	Restricted £	2022 £
Medical and nursing services . Direct costs . Support costs	4,146,226 2,474,241	— —	4,146,226 2,474,241
	6,620,467	—	6,620,467
	Unrestricted £	Restricted £	2021 £
Medical and nursing services . Direct costs . Support costs	3,973,065 2,401,092	— 1,000	3,973,065 2,402,092
	6,374,157	1,000	6,375,157

7 Analysis of support costs

Analysis of support costs
	Raising funds £	Charitable activities £	2022 £
Staff costs Administration Housekeeping – fuel & rates Housekeeping – other Depreciation Repairs & maintenance Insurance Other costs Governance costs Total support costs	20,252 7,661 2,285 10,234 968 — 1,092 1,475 1,070	772,639 226,017 188,117 770,268 137,840 138,904 89,910 62,456 88,090	792,891 233,678 190,402 780,502 138,808 138,904 91,002 63,931 89,160
	45,037	2,474,241	2,519,278

British Home and Hospital for Incurables 33

Notes to the financial statements Year to 31 March 2022

7 Analysis of support costs (continued)

Analysis of support costs(continued)
	Raising funds £	Charitable activities £	2021 £
Staff costs Administration Housekeeping – fuel & rates Housekeeping – other Depreciation Repairs & maintenance Insurance Other costs Governance costs Total support costs	20,084 5,346 2,101 10,110 1,717 — 1,004 1,187 422	789,619 149,758 172,992 812,952 182,269 125,839 82,658 51,122 34,783	809,703 155,104 175,093 823,062 183,986 125,839 83,662 52,408 35,205
	41,971	2,402,092	2,444,063

Included within governance costs is auditor’s remuneration of £24,300 (2021 – £28,800) and £15,000 (2021 – £nil) for professional fees related to the preparatory work for the proposed development of the new care facility which has been aborted and replaced with a plan for refurbishment.

8 Staff costs

Staff costs
	2022 £	2021 £
Wages and salaries Social security costs Pension costs Redundancy costs	3,266,091 322,318 182,784 —	3,368,244 322,663 187,845 14,044
	3,771,193	3,882,795

The number of full-time equivalent employees during the period who earned over £60,000 in the year is as follows:

the year is as follows:
	2022 Number	2021 Number
£60,001 - £70,000 £70,001 - £80,000 £80,001 - £90,000 £90,001 - £100,000	2 1 — 1	1 1 1 1

The average number of employees analysed by function was:

*Full time Equivalent	FTE 2022*	Head Count 2022	FTE* 2021 89 3 4 11 107	Head Count 2021 111 5 5 11 132
Nursing and care Maintenance Reception and portering Management and administration	89 3 3 11	106 7 5 14
	106	132

Catering, cleaning and laundry are outsourced, but with staff dedicated to British Home. Average numbers of catering and cleaning staff during the year were FTE 13 / Head Count 21 (2021 FTE 14 / Head Count 20).

British Home and Hospital for Incurables 34

Notes to the financial statements Year to 31 March 2022

• 8 Staff costs (continued)

Remuneration of key management personnel

No trustee received any remuneration in respect of their services during the year. No trustees were reimbursed for travel expenses in the year (2021 – £nil).

During the year, the total remuneration, including pension contributions and employer’s national insurance contributions, of key management personnel was £299,800 (2021 – £312,846).

9 Related party transactions

No member of the Board of Trustees nor any officer of the Home had any beneficial interest in any contract with the Home during the year.

The Home has purchased insurance to protect it from any loss arising from any neglect or defaults of any member of the Board of Trustees or employee and to indemnify any Board Member or employee against the consequence of any neglect or default on their part. The total cover provided by such insurance is £2,000,000 (2021 - £2,000,000) and the insurance premium paid by the Home during the year totalled £1,581 (2021 – £5,600).

Donations from trustees totalled £140 (2021 – £190).

10 Taxation

British Home and Hospital for Incurables is a registered charity and therefore is not liable to income tax or corporation tax on income derived from its charitable activities, as it falls within the various exemptions available to registered charities.

11 Tangible fixed assets

Tangible fixed assets
	Freehold building £	Hospital equipment £	Computer equipment £	Transport £	Total £
Cost At 1 April 2021 Additions At 31 March 2022 Depreciation At 1 April 2021 Charge for the year At 31 March 2022 Net book values At 31 March 2022 At 31 March 2021	3,330,177 324,589	177,065 40,215	108,508 5,040	15,980 —	3,631,730 369,844
	3,654,766	217,280	113,548	15,980	4,001,573
	3,195,522 80,672	35,211 33,239	55,986 21,702	6,392 3,196	3,293,111 138,809
	3,276,194	68,450	77,688	9,588	3,431,920
	378,572	148,830	35,860	6,392	569,654
	134,656	141,853	52,521	9,588	338,618

British Home and Hospital for Incurables

35

Notes to the financial statements Year to 31 March 2022

11 Tangible fixed assets (continued)

The original land and buildings were acquired in 1894. Between 1898 and 1994 their cost and subsequent additions were not recorded in the balance sheet. For many years the accounting policy for freehold land and buildings recognised that it was not possible to ascertain the cost of land and buildings and until 1 January 1994 the cost of additions were written off as incurred. In 1994 the accounting policy was changed and subsequent expenditure on additions and improvements to buildings have been capitalised. The book value, after depreciation, of land and buildings acquired prior to 1994 is not regarded as material. The New Wing, which opened in 1996, is classified as freehold buildings.

12 Investments

Investments held at 31 March 2022 comprised the following:

	Investment property £	Listed investments £	2022 £
Market value at 1 April 2021 Disposals at opening book value Net gains Market value at 31 March 2022 Cash held by investment advisors for re-investment Total investments Historical cost of investments at 31 March 2022	350,000 — —	12,599,428 (500,000) 651,943	12,949,428 (500,000) 651,943
	350,000 —	12,751,371 1,049,793	13,101,371 1,049,793
	350,000	13,801,164	14,151,164
	—	8,713,910	8,713,910
	Investment property £	Listed investments £	2021 £
Market value at 1 April 2020 Disposals at opening book value Net gains Market value at 31 March 2021 Cash held by investment advisors for re-investment Total investments Historical cost of investments at 31 March 2021	350,000 — —	12,602,804 (2,500,000) 2,496,624	12,952,804 (2,500,000) 2,496,624
	350,000 —	12,599,428 1,542,434	12,949,428 1,542,434
	350,000	14,141,862	14,491,862
	—	8,761,441	8,761,441

The investment property is a share in land held on behalf of five charities.

13 Debtors

Fee debtors Prepayments and accrued income	2022 £	2021 £
	367,843 203,198	244,800 335,386
	571,041	580,186

Prepayments and accrued income at 31 March 2022 include legacies of £109,000 (2021 – £233,000).

British Home and Hospital for Incurables 36

Notes to the financial statements Year to 31 March 2022

14 Creditors: amounts falling due within one year

Creditors: amounts falling due within one year
	2022 £	2021 £
Trade creditors Amounts held on behalf of residents Accruals and deferred income Social security and other taxation Other creditors Liability on withdrawal from pension scheme	212,230 58,039 479,204 160,627 245,402 778,000	122,019 45,458 468,520 167,465 266,258 778,000
	1,933,502	1,847,720

Note: A corresponding asset for residents’ monies is included in cash at bank (see note 21).

Included above is deferred income which relates to income receivable in 2021/22 which can be analysed as follows:

	2022 £	2021 £
Deferred income brought forward Deferred in the year Released in the year Deferred income carried forward	195,639 162,844 (195,639)	158,816 195,639 (158,816)
	162,844	195,639

15 Operating lease commitments

At 31 March 2022, the Charity had the following total commitments under operating leases on plant and machinery as follows:

Amountspayable:	2022 £	2021 £
Within one year In two to five years	4,281 4,281	4,281 8,562
	8,562	12,843

16 Endowment fund

Endowment fund
	2022 £	2021 £
The D.O. Beale Trust	12,477	12,477

17 Restricted fund

In the year to 31 March 2022 the charity received no restricted funds (2021 – none).

British Home and Hospital for Incurables 37

Notes to the financial statements Year to 31 March 2022

18 Designated funds

The income funds of the Home include the following designated funds which have been set aside out of unrestricted funds by the Board of Trustees for specific purposes:

Tangible fixed assets fund Continuity of Care fund Major and Cyclical Maintenance fund		At 1 April 2021 £		Released/ added in year £	New designations £	New designations £	At 31 March 2022 £
		338,618 5,900,000 2,000,000		231,036 — (12,100)		— — 12,100	569,654 5,900,000 2,000,000
		8,238,618		218,936		12,100	8,469,654
		At 1 April 2020 £		Released/ added in year £		New designations £	At 31 March 2021 £
Tangible fixed assets fund Continuity of Care fund Major and Cyclical Maintenance fund		439,014 5,900,000 2,000,000		(100,396) — —		— — —	338,618 5,900,000 2,000,000
		8,339,014		(100,396)		—	8,238,618

Tangible fixed asset fund

An amount equivalent to the net book value of tangible fixed assets at the end of the year is designated to recognise that they are not available for general use as they are not readily realisable.

Continuity of care fund

This fund has been established to meet the charity’s obligations to provide essential services for all parties in the event of a critical incident.

Major and cyclical maintenance fund

This fund has been established as the charity operates from an old Victorian building which is both expensive to maintain and occasionally requires costly unplanned major repairs to the buildings infrastructure .

19 Analysis of net assets between funds

	Endowment fund £	Designated funds £	General fund £	Total 2022 £
Fund balances at 31 March 2022 are represented by: Tangible fixed assets Investments Current assets Creditors: amounts falling due within one year Total net assets	— 12,477 — —	569,654 7,900,000 — —	— 6,238,687 1,427,681 (1,933,502)	569,654 14,151,164 1,427,681 (1,933,502)
	12,477	8,469,654	5,732,866	14,214,997

British Home and Hospital for Incurables 38

Notes to the financial statements Year to 31 March 2022

19 Analysis of net assets between funds (continued)

	Endowment fund £	Designated funds £	General fund £	Total 2021 £
Fund balances at 31 March 2021 are represented by: Tangible fixed assets Investments Current assets Creditors: amounts falling due within one year Total net assets	— 12,477 — —	338,617 7,900,000 — —	— 6,578,944 1,603,048 (1,847,720)	338,617 14,491,862 1,602,608 (1,847,720)
	12,477	8,238,617	6,334,272	14,585,366

20 Pension commitments

The Home operated a defined benefit pension scheme providing benefits based on final pensionable pay until 31 March 2014. The defined benefit pension scheme closed to new members and future accrual as at 31 March 2014. The most recent triannual valuation of the scheme was at 1 April 2016.

In February 2018, after seeking advice from their advisors KPMG, the trustees took the decision to buyout of the scheme and a total liability of approximately £1,788,000 crystallised. During 2018 £1,010,000 was paid and the amount outstanding at 31 March 2022 is £778,000. The estimated liability is based on information provided by the trustees’ professional advisors and Aviva, the insurers.

The Federated Flexiplan No.1 (‘’the Plan’’) is a defined benefit pension scheme. It is a “last man standing scheme” which means that all participating employers are joint and severally liable for the Plan’s liabilities. However, because of the non-associated multi-employer nature of the Plan, the charity does not have sufficient information available (in particular to identify its share of the underlying assets and liabilities of the Plan) to use defined benefit accounting. As such and as permitted by FRS 102, it accounts for the Plan as if it were a defined contribution scheme. As a result, the amount recognised in the statement of financial activities represents the charity’s contributions payable to the Plan in respect of the accounting period.

Members of the Plan are entitled to benefits on either a “Pensions Capital” or “Target Pension” basis. Under the Pensions Capital basis, contributions paid by and in respect of members are accumulated up to retirement and then used to secure benefits for the member. Under the Target Pension basis, members receive a defined pension at retirement based on length of service in the Plan and their Pensionable Salary at date of leaving. The Plan is closed to new members and to future accrual of benefits.

21 Cash at bank

Cash at bank of £856,640 on 31 March 2022 (2021 – £1,022,420) includes £58,039 held on behalf of the residents of the Home (2021 – £45,458). A corresponding liability for these monies is included in creditors (note 14).

British Home and Hospital for Incurables 39