British Home and Hospital for Incurables Report and Financial Statements for the year to 31 March 2023 Charity Regi5tratign Number 2C6222 Contents Reports Reference and administrative details Report of the Board of Trustees Independent auditor's report 20 Flnancial statements Slalement of financial activities 24 Balance sheet 25 Statement of cash flows 26 Principal accounting policies 27 Notes lo the financial statements 31 British Home and Hospital for Incurables Reference and admlnistrative details Honorary President Professor, The Lord Mccoll of Dulwich Chair Kay Sonneborn BA Deputy Chair David Green MA (Cantabl Board of Trustees Patricia Collinson. Dip NUR, RNT Irelired January 20231 Kenneth Dunn MA, Dipms Alison Hughes RN, MHSM Rowenna Hughes GradDip MCSP, SRP Iretlred September 20221 James Mill TD, CA Derek Prentice Rebecca Sycamore Jane Fisher Tom Walker John Handley lappoinled 3 November 20221 Andrea Haug lappoinled 3 November 20221 Taras Fellah (appointed 3 November 20221 Chief Executive Officer to the Board Paul Peikin Director of Care Douglas Webb- Interim {conlract ended November 2022} Victoria Fields- lappoinled November 20221 Director of Finance and Resources Natasha Charles-Lewis, ACMA Address Crown Lane Slrealham London SW16 3JB Website www.brilishhome.or .uk Charity reglstration number 206222 British Home and Hospital for IncLJrables 1 Reference and admlnistratlve detalls Auditor Buzzacotl LLP 130 Wood Street London EC2V 60L Investment advlsors CCLA Investment Management Limited 80 Cheapside London EC2V 6DZ Sarasin & Partners LLP Juxon House 1 QO St Paul's Churchyard London, EC4M 8BU Bankers Barclays Bank plc Claph8m Common Group PO Box 4038 London, SVV12 9YB Legal advisers Hempsons 40 Villiers Street London, WC2N 6NJ British Home and Hospital for Incurables 2 Report of the Board of Trustees Year lo 31 March 2023 The Board of Trustees I'the Board'l presents the slatulory report and financial statements of Biilish Home and Hospital for Incurables {'Brilish Home'l for the year ended 31 March 2D23. The financial statements have been prepared in accordance with the accounting policies set out on pages 27 10 30 and comply with British Home's Charler of Incorporation and Regulations, the Charities Act 2011 and Accounting and Reporting by Charities.. Statement of Recommended Practice applicable to charitie5 preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of IreSand IFRS 1021. A Note from our Chalr Welcome lo our Annual Accounts and Report. On reading this you will see that much has happened in 202212023 both in activity and continued financial improvement and you will see the future for the British Home's ambitions. Before continuing il is important from the start to recognise the continued dedication that all staff - clinical, support and management make lo the continued life of the residents of the British Home and the Charity. Without their knowledge, dedication, and support in so many ways there would be no British Home, and the Trustees are forever grateful. 2023 has been a successfu5 year in that we have been fully discharged of Covid and all that sits around it. We have been able lo give much more attention lo the strategic plans that were first initiated in 2019 and then halted over the pandemic. We were able lo resurrect some of these plans in the middle of 2022 and we have seen far more activity happening with our 5- year Strategy over the last year. Al the heart of our 5-year strategy has been our ambition to develop even more specialist neuro-rehabililation services in response to greater demand from people with more complex neurological conditions. Our overarching aspiration is lo become a specialist level-2 service, as defined by the British Society of Rehabililalive Medicine.11 remains our firm belief that more specialist beds and services are needed for the population ol people living with severe neurological conditions. Towards the end of 2022 we appointed a new Director of Care and Registered Manager who brought with them the expert knowledge in nursing and rehabilitstive care that will support our strategy. The new clinical leadership team remain mindful ol the support. wellbeing, training and Gonlinuous development that our staff require for the journey ahead of u5. The staff al British Home are as diverse in background, culture and thought as our residents and we continue lo draw on the strengths and unique characlerislics of all al British Home, lo ensure our service is accessible and responsive to the needs of everyone we support. In the next year we will implement a new equality and diversity strategy with OUT Staff and residents, lo ensure that we continue to maintain an open and inclusive culluie for all al British Home. In our report last year, we discussed our revised governance arrangements and how this is important for our Board lo achieve ils slralegi¢ objectives. As part ol the Board's succession plan, we undertook a skills review of the Board earlier in the year. We identified the skills and knowledge gaps that we would need to address lo support the charity's stffitegic aims. British Home and Hospital for Incurables 3 Report of the Board of Trustees Year lo 31 March 2023 A Note from our Chair Iconlinuedl We began our first search in early autumn 2022 and were delighted with the number of individuals who applied for a Trustee position In November, we recruited three Trustees who bring with them experience of financial management as well as people and culture within senior, executive roles. In July this year we recruited a further two Trustees with clinical expertise in the field of neuTO- science. We expect that our recently appDinled Trustees will play a vital role in the British Home's journey towards becoming a sustainable and highly specialist provider of care and therapy for people living with neuro-disabilily. We continue lo look al the ever-increasing costs the Charity is bearing as a result of admitting residents who are requiring far more clinical and care needs. We 8re seeing many Commissioners acknowledging the specialist skills and care the British Home is providing and therefore referring individuals with more complex needs than we admilled prior to the pandemic. This has resultèd in a significant increase in our revenue. However, we have also seen an increase in our staffing costs, as the national shortage of qualified nurses and carers has resulted in a higher reliance of agency staff. This presents further challenges in reducing our operational defiGil which is a key objective of our strategy. In the last six months we engaged with the government's Skills Bootcamp initiative which aims lo provide London residents with the skills and experience required to lake up Careers in adult social care. We have reciuiled oveT 10 staff into British Home, providing continued training and support provided by our Care Trainer. Through this initiative we are abl8 lo offer new career opportunities to those who share our values and ambition lo improve the lives of our residents. This has the du81 benefit of reducing our reliance on costly, temporary staff and will go some way lo ensuiing that our fee income covers the cost of our specialist care. With Covid now not dominating our every action, this year has seen a shift in our activity as described above, be it our ambitious Clinical Strategy lo offer a Level 2 service", our Financial Strategy to eradicate our deficit position, or our Governance and appointment of new Trustees. The Board remain energised and determined to deliver on all of these key objectives and we are confident that the Brillsh Home has a bright future. I need lo acknowledge the retirement of hvo long standing Trustees - Rowenna Hughes and Patricia Collinson. Rowena retired after many decades 21 the Home giving much service to the development of our physiolherapy and occupational Services. Always a supporter of these services, Rowenna championed these at Board discussions and visited the service many times. Patricia has also been a Trustee for over 15 years, ensuring the Board remained focussed on Clinical governance and imparted much knowledge and support for continuous qU81ity and clinical safely. Their dedication lo these areas and a much wider tx)ard governance contribution and support is greatly acknowledged and appreciated. I must 81so thank Paul Perkin, and his team, who has steered the Charity through the last turbulent years, always doing so with huge knowledge and professionalism and a smile. He has enabled the Charity lo survive and come through looking ambitious and even brighter. British Home and Hospital for Incurables 4 Report of the Board of Trustees Year to 31 March 2023 Composltion of the Board of Trustees The Charity Board of Trustees is.. Chair.. Kay Sonnebom 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-execulive roles in the NHS. Kay was Chair of the largest Primary Care Trust in London for len years. Deputy Chair.. Davld 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 Islinglon. Patricla Collinson (retired from the Board January 2023) 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 .1.1 procedures regulating care. British Home and HospilaS for Incurables S Report of the Board of Trustees Year to 31 March 2023 Composition of the Board of Trustees IconlinLJedl Allson Hughes A nurse and midwife with 36 years. experience, Alison trained al University College Hospital before moving to Oxford and then Australia lo practice. She spent four years overseas before joining the cardiac unil al Sl George's Hospital Tooling, moving from Sister lo Head of Nursing and finally Divisional Director of Nursing and Governance. Alison retired from the NHS in 2015 and CLJrrenlly works pail time on a consultancy basis. James Mill James worked in oil and gas exploration for much of his caieer, operating in Libya, Pakistan and Canada amongst other places. For the last len 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 ch811enges facing charities like British Home. Derek Prentice Derek spent the majority of his career in consumer affairs, spending over twenty years with Consumers. Association IVVhich?l and serving as the President of the European Consumers Organisalion BEUC. Derek is a Council Member and Trustee of the Royal College of Emergency Medicine and Chairs ils 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. Rebecca Sycamore Rebecca has considerable experien￿ of Director level ws15 within large charities. She is currently Executive Director of Development al the homelessness charity and Housing Association, Sl 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 Home5ess Link. British Home and Hospital for Incurables 6 Report of the Board of Trustees Year to 31 March 2023 Composition of the Board of Trustees Iconb'nued) Jane Fishor 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 Norlhwesl London Renal and Transplant servi￿ (the largest such unit in Europe). Jane is passionate about healthcare and has a strong commitment lo delivering equality and diversity. Tom Walker Tom is currently Co-Head of Global Listed Real Assets for Schroders where he is responsible for a large real asset investment portfolio and has significant experience in investment management. John Handley At ils meeting in November 2022 Trustees agreed to appoint John Handley to the Board ol British Home. John is an inlernalionally experienced executive who has worked extensively with business leaders across small and large businesses, fully owned and joint venture partnerships, listed and not for profil se¢lors, in services and manufacturing industries and in emerging and mature markets including Saudi Arabia. India, Australia. the United Stales and the UK.An accredited WABC Executive Coach, John focuses on building very high levels of trust, before honing in on actions colleagues can take lo achieve significant performance improvement al a personal and organisalional level. John is currently the Executive Director of People al Hc-one Limited, having joined in 2021. Andrea Haug At its meeting in November 2022 Trustees agreed to appoint Andrea Haug to the Board of British Home. Andrea has successfully led HR in a number of sectors including retail. media and entertainment, hotels and hospilalily, infraslruclure, and financial services in both the UK and internationally. She has broad experience at both slralegi¢ and operational levels across all areas of HR. Her deeper specialisms include leadership. culture, employee engagement. and organisalional change. Andrea's passions are supporting leaders Ihrough peiiods of growth, uncertainty. and change, and building workplaces that are welcoming and inclusive, where everyone feels they belong and are able to contribute, achieve and progress. li British Home and Hospital for Incurables 7 Report of the Board ofTrustee$ Year lo 31 Maich 2023 Composltlon of the Board of Trustees Icontinuedl Taras Fellah Al ils meeting in November 2022 Trustees agreed to appoint Taras Fellah to the Board of British Home. Tams spent 7 years within the internal audit function of IQVIA. a US listed mulli-nalional healthcare company before taking up his current role of Senior Director of Financial systems. Patricia Collinson retired from her role as Trustee in January 2023. The Board and Executive Team would like lo thank Patricia for her significant conlribub'on lo the British Home over her enly-three years of service. Patricia provided great guidance and insight into all clinical mallers concerning British Home, specifically in relation lo quality assurance and resident care. Board Responsibilities Statement The charity's Iruslees 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 Iruslees, lo prepare financial slalemenls which give a true and fair view of the financial activities of British Home during the year and ils financial position al the end of the year. In preparlng the attached financial slatemenls, 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 lo charities preparing their accounts In accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland IFRS 1021., make judgements and eslimales that are reasonable and prudent. stale whether applicable UK accounting standards and slalements of recommended practice have been followed, subject lo any departures disclosed and explained in the financial slalements., and prepare the financial statements on the going concern basis unless it is inappropriate lo presume that British Home will continue to operate. The Board is responsible for keeping proper accounting records which disclose with reasonable accuracy al any time the financial position of British Home and which enable il lo 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. British Home and Hospital for Inourables 8 Report ofthe Board ofTrustee$ Year lo 31 March 2023 Board Responsibilities Slatement Iconlinuedl 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 difleT from legislation in olheT jurisdictions. Structure, governance, and management British Home was granled a Royal CharteT on 1 November 1899. 11 is governed by a Charler of Incorporation and Regulations Irevised 8 January 20091 and is a Tegistered Charity (No. 2062221. 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 ICQCI and, as a Royal Charter Company. by the Privy Council. The Board met formally in each quarter of the last linancial year. and also held ils annual away day lo review the charity's strategic plan. Al 31 March 2023 the Board comprised g members who held office throughout the year, with a further three new members appointed in November 2022. As previously noted, Patricia Collinson and Rowenna Hughes retired from the Board during the year. Trustees did not receive any remuneration for services as a membeT of the Board. Board Commiltee Structure The Board peTiodically reviews its govemance committee structure, to ensure that it remains fit for purpose and responsive lo emerging. Strat￿lC opporlunilies and risks. Al ils meeting on the 13 of May 2020 the Board completed a formal review of ils governance structure including the terms of Teference for each of ils sub-commillees 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 Boarcl by having Trustees with relevant Clinical experience lo review the provision of care and therapy in the Home, and lo offer support and counsel lo 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. Finance Commiftee The Finance Committee has delegated responsibility from the Board lo oversee and review 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 lo set annual targets lo reduce the current deficit and achieve an annual operational surplus. Since the pandemic. the recruitment of care staff within a challenging market has emerged as the Charity's key strat4ic risk. The Finance Committee continues lo review staff salaries and benefits to ensure that these remain competitive and to advise the Remuneration and Nominations Committee in this regard. British Home and Hospi181 for Incurables 9 Report of the Board of Trustees Year to 31 March 2023 Structure, governance, and management Iconlinuedl Redevelopment Oversight COmm￿e8 In November 2020 the Board agreed the terms of reference for a new Redevelopment Oversight Committee, to review the options for the refurbishment. or reprovision of the British Home. A feasibility study was commissioned in late 2021 to explore the options for monelising part of the existing sile lo 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 mel by parl-sale of the existing site. In view of this, the Committee continue lo explore fuTlher options lo develop a new, stale-of-lhe-arl facility for British Home's ￿SIdentS. This will include a significant C8pilal fundraising programme as well as further consideration lo a new development on an alternative site if this proves more viable. Rgmuneratlon and Nominatlons Committee The Remijneralion and Nominations Committee has oversight of the balance and effectiveness of the Board, including the appointment ol new Trustees. The Rerlluneration and Nominations Committee is also responsible for the remuneration ol the executive management team of the Charity, as well as the annual review of staff salaries and benefits. TnistO8 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 slalutory responsibilities, including all relevant regulatory requirements determined by the Charity CommissKJn. In November 2022, the Board appointed three new Trustees in line with ils succession plan. 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 Servi￿ being provided. Management of British Home The key management personnel of British Home responsible for directing and controlling the operations of the Gharily comprises the Board of Iruslees, the Chief Executive Officer, the Director of Care and the Director of Finance and ResOLJ￿es. Paul Perkin IBA Honsl is the Chief Executive Officer of British Home. Paul look 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 regisleled soci81 landlord. Natasha Charles-Lewis ACMA Imscl 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 ch8ritable sector. Natasha is an associate member of the Chartered Inslilule of Management Accounlanls and holds a further degree in strategic business management. British Home and Hospital for Incurables 10 Report ofthe Board ofTrustees Year lo 31 March 2023 structure, governance, and management Iconlinuedl Management of British Home (continued) Victoria Flelds Imscl is the Director of Care at British Home. Qualifying as a Midwife in 2013, Victoria developed an interest in brain injury, mental health, and complex families. She went on to complete her postgraduate diploma to become a Specialist Community PubliG Health Nurse. Later in her career Victoria worked in brain injury and autism technology before focusing more on Operations and leadership in the brain injury and neuro- disability sector. Aim5 Objectives and Strategy British Home provides specialist nursing and rehabilitation to adults living with neuro disability. This will typically include people living with severe impairment often resulting from brain injury, stroke or through a degenerative i1Sness. We work with each of our residents lo 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 lo look after a maximum of 127 residents., however, due lo the incfeasing complexities of residents over the last several years, the number of commissioned units has been reduced lo achieve a more optimum operational capacity of 80 beds This includes bed5 for both fasl-stream and longer-lerm rehabilitation, as well a5 palliative care and respite. During the pandemic. the average occupancy within the service reduce(f significantly due lo higher mortality rates amongst residents and delayed dlscharge from referring agencies. Since the end of the pandemic, we have Continued lo receive referials for residents with increasingly more complex needs. This has resulted in rnore time needed lo plan for admissions which has impacted on bed occupancy. Average occupancy over the last year on this basis was 85Vo or 68 residenls12022 - 88°A or 70 residents}. In February 2023, the Board Teviewed 115 5-year strategy, with a central aim to build upon ils experience and become a specialist provider of neuro-disability rehabilitation. Over the next three years. the Board will continue lo invest charitable income to develop British Home into a centre of excellen￿ for specialist rehabililalion, in line with The British Society of Rehabilitation Medicine IBSRMI standards. The Board remains commilled lo its objective of developing Specialist Level -2b Tehabililalion beds within British Home. In addition lo this. we wll continue to support more people lo manage their conditions moTe effectively. with an emphasis on increased independence, pain relief and greater enjoyment of life {including those approaching end of lifel. PubliTC beneflt In selling the charity's objectives the Iruslees have considered the Charity Commission's guidance on public benefit. The Board believes that British Home continues lo meet the Charity Commission's public benefit lest principally in that the majority of residents in British Home have for many years benefited from the availability ol statutory funding. The charity provides additional rehabilitation and social support to residents from its own charitable funds and through specific fundraising initiatives. British Home and Hospital for Incurables I I Report of the Board of Trustees Year to 31 March 2023 Aims Objectives and Strategy Icontinuedl Our Values All al British Home are committed lo upholding our organisalional 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 lo 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 tske at their own pace., recognise the advantages that our diversity provides, we will hamess the lalenl and energy of everyone at British Home.. staff. volunteers, residents. families and carers,. will a￿ayS act with integrity, openness and honesty,. and are committed lo the highest standards 8nd will embrace innovation and models of best practice. Pèrsonalised Support Al 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 Iherapisl to ensure they receive an appropriate service offer commensurate with their individual needs. We work with residents and their families lo 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 rehabililalion support, which will ensure greater integration of each resident's individual therapy and Irealmenl plans across all aspects of their daily care. We continue to work with residents receiving palliative care lo develop personal end of life care plans. Last year 1 OOQ/o of residents had an agreed end of life plan in line with their personal wishes. End of Life Care Gold Standard Framewo￿[ In January 2020, British Home undeTwenl re-accredilation with the Gold Standard Framework for ils End of Life Care. Trustees were delighted that the Ch8rily was awarded the Platinum Care Hallmark in recognition of its high quality and person cenlred, 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 Registered Manager. All residents, for whom il is appropriate, are supported to Llevelop an End of Life Care Plan, lo direct the support and care they receive from British Home. British Home is currently undergoing re-accreditation for the Gold Standard Framework as of June 2023. British Home and Hospital for Incurables 12 Report of the Board of Trustees Year lo 31 March 2023 Alms Objectives and Strategy {conlinued) Risk management The Board regularly reviews the potential major risks to the charity and undertakes a forma risk audit each year lo identify any additional risks that the charity may be exposed to and lo ensure that adequate control measures are in place lo mitigate identified risks. To protect the assets of the Charily, British Home maintains a comprehensive suite of insurance policies. The Board considers the 'failure lo reduce its opeTational defi'cit,, as ils 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 ils residents. The Charity's 5-year strategy has guided British Home's tmnsilion from a traditional nursing care model lo that of a specialist provider of neuro- disability nursing care and rehabilitative support. This wil5 ensure Ihal 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 longèr require the level of specialist nursing and support provided within the Home. In recent years the health and social care sector has experienced significant challenges around recruilmenl and retention of experienced care staff. British Home is not immune to this, and over the185t year the recruilmenl of skilled staff into British Home has emerged as a key risk for the Charily. The Executive Team has Introduced a range of measures lo allract talented staff and to reduce ils 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 lo attract skilled workers within a Compelilive market. Over the next year, the Executive Team will engage with local Integrated Care Partnerships lo ensure that care fees reflect the demands of IoGal latiour markets, and that British Home remains able to attract and relain highly skilled and eXperIen￿d staff. Volunteers & Carers Volunteers at British Home make a positive difference lo the lives of residents al British Home through their involvement in a wide range of activities including reh8bililalion support, recreational aclivilies, befriending and fundraising. The Board remain grateful for the significant contribution that all of our volunteers make lo the charity and its residents. British Home also p18ces significant value in the views and contributions of ils community of resident's families and carers. The Charity offers a variety of ways for families and carers lo have their say on how care and support is delivered at British Home, recognising their role as advocales 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 parl from generous donations and legacies bequeathed to the Home. British Home is reliant on voluntary contributions to provide resources and develop innovation lo improve the lives of everyone we support. The Board are grateful for all charitable contributions from our generous donors and would like to pay parlicular thanks lo the following Trusts and individuals for their continued support.. British Home and Hospital for Incurables 13 Report of the Board of Trustees Year lo 31 March 2023 Aims Objectives and Strategy Iconlinuedl Fundraising (conlinu&dJ Eunice Helen Johnson Trust J H Bartlell Charity Baroness D M Camburn Trust Melropolilan Hospital Saturday Fund Bolhwell Charitable Trust Gilbert & Eileen Edgar Foundation I V Askew Charitable Trust The Board would also like lo thank all who have donated lo British Home in memory of loved ones and lo the many people have supported us with a legacy in their Will. As a charity registered with Ihe Fundraising RegLJlalor, we are commilled lo 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 ils fundraising aclivily. Environmental, Social and Govern8n¢e Since ils inception British Home has provided care and support lo some of the most vulnerable people within ils community. We remain proud of the public benefit we continue lo provide lo 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 lo ensure that ils 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 eommilmenl to ESG practices in a variety of ways-, from how we manage our carbon foolprinl, including procuring services and influencing our suppliers, environmental practices., lo how we ensure the welfare of our staff and increase opportunity and diversity across our workforce. Recruiting and developing local p90ple In light of the current skills shortages affecting the health and soclal care sector, British Home partnered with The Green Man Skills Zone. a local community pfoject supporting unemployed people lo improve their skills, by raising awareness of the services that are available in the borough to support them. This Initiative is designed in conjunction with the government Skills Boolcamp initiative which aims lo provide prospective workers with up to 5 weeks of training lo improve their employability within Iheii chosen field. British Home is a very proud of its history as a local employer and through it8 partnership with the Green Man the charity has employed 10 local people into care roles. Each of these staff were supported by British Home's Care Trainer. who provided ongoing support and mentorship throughout their induction, ensuring that they built up the required Confiden￿ and experience lo practice their roles safely and competently. British Home and Hospital for Incurables 14 Report of the Board of Trustee5 Year lo 31 March 2023 Flnancial review Performance in the year The operating defi'cit for the period was £2,500,52312022- £1,977,961) as shown in the tsb5e below.. 2023 2022 Fees 5,482.299 4,833,020 Less.. Expendlture 17,982,822) 16,810,981) Operating deficit 12,500,523) 11.977,9611 Donations 72.785 159.224 Investment income 359,415 362.118 Other Income 14,828 303,638 Deficit before legacies 12,053.4951 {1,152.981} Legacies 212,621 130,669 Net 8xpèndlture for the period bèfore Investment gains and losses 11,840,874> 11.022,312) a) Fees Income from fees charged increased by 13Yo to £5,482,29912022 £4,833,020). The decrease in average occupancy as a result of impact of the pandemic was augmented by higher fees generated in respect of new admissions Wlth continued focus on allracling 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) Expenditu Expenditure in 2023 increased by 170/D to £7,982,82212022- £6,810,981). Within this lolal, staffi'ng costs amounted to £4,179,92912022- £3,771,193) an increase of £408,736. British Home staff are the heart of our organisalion, whenever possible the Board endeavours to provide a real increase in pay-and ensures that staff are paid in line with industry standards. c) Fundraisffng 8ndpublicily Costs, with allocated support costs, lolalled £147,37712022- £190,514). This included costs for the external marketing of British Home to continue raising awareness of British Home and its work, to support its fundraising endeavouTS. d) Donations Donations decreased within the last year lo £72,78512022 £159,224). In the current yeaf we received large donations from Eunice Helen Johnson Trust and J H Bartlell Charity Trust. The charity also raised £3,000 restricted donations for the replacement of the Charity's minibuses. We are thankful for the great support of individual donors and charitable trusts, 2 number ofwhom have been loyal supporters of British Home for many years. The Board equally values every contribution regardless of size and is parb'cularly grateful for the dedication of local groups and individuals in helping to fundraise. Brilish Home and Hospital for Incurables 15 Report of the Board of Trustees Year lo 31 March 2023 Flnanclal review Iconlinued) Performance In the year (continued) ej Income Income from legacies increased over the prior year to £212,621 12022 - £130,669). 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, £21,04412022 - £109,000) has been recognised as income ahead of receipt in cash. Historically the legacy income of British Home has flu¢lualed and is unpredictable from year lo year. Penslon Liabilities The charity previously operated a final salary pension scheme which closed lo new members as 0131 March 2014. The Board engaged KPMG lo advise it as to whether measures could be taken lo potentially miligale the liabilities of the scheme and whether securing member, benefits under the scheme IhroLJgh an insurancè eompany buy-out might be an affordable option for British Home. The Board considered that removing al an affordable cost the risk to ils reserves represented by an open-ended obligation lo fund any future defi'cits in the scheme would be in the best interests of the Gharily. In February 2018 the Iruslees decided lo withdraw from the scheme and a lotsl liability of approximately £1,788,000 cryslallised. This quotation also included wsls for legal and actuarial fees associated wrth the buy-out, as well as provision for any unforeseen costs arising from a final data cleansing exercise of the scheme. which will be jolntly conducted by Aviva and the scheme's actuary. The Iruslees paid over the sum of £1,010,OOa on 3 March 2018. There remains a provision in the accounts at the reporting dale 01 £778,000. The data cleansing exercise was still in progress at the reporting dale 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-lerm 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 1 OYO of pensionable salary while erllployees contribute So￿. Employees who have not elected lo join the GPPP are. if eligible, subject to autoenrolment al contribution rates set as parl of the Government's pension membership initiative. British Home and Hospital for Incurables 16 Report of the Board ofTrustees Year lo 31 March 2023 Financlal review Iconlinued) The Home's Net Assets The nel assets of British Home al 31 March 2023 were £11,773,66812022 £14,214,997). Of these £633.50412022- £569,654) 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 lo the financial slatemenls. The nel assets also included £12,477 of endowment funds not expendable by the charity. After allowing for further designated funds as described below the general unrestiicted funds of the charity at 31 March 2023 were £3,224,687. Reserves pollcy and financial posltlon In determining the level ol reserves necessary to Gontinue the work of British Home, the Board balances ils long-term obligations and risks with the needs of current beneficiaries. Vvhere there is a capital commitment, a need lo 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 Ihe Charity's reserves and highlighted the need to relain an appropriate level of free reserves in order lo respond lo unforeseen events and to protect the wellbeing of the charity's beneficiaries. Designated reseNes Al the end of the financial year 2022123 the British Home held £12,063,705 in investments which were otherwise unrestricted reserves. These funds were split be￿eell general reserves £3.224,687 and £8,533,504 designated fLJnds for fixed assets, continutiy of care and major and cyclical maintenance. The Board is awaiting coslings for the planned redevelopment project which would require a further designation along with capital fundraising lo fund the project. The Board has currently made the lollowing designations. Continui of Care Fund.. The Board of Trustees is conscious of ils loNg-tÈrm 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 ils obligations to provide essential services for all parties in the event of a critic81 incident. The Board has therefore designated £5.9M of ils reserves to this fund, lo provide for one year's running costs. Ma or and C cllcal Malntenance Fund: The British Home operates from an old, Victorian building which is both expensive lo maintain and will also occasionally require costly unplanned repairs. Trustees have therefore created a fund lo 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 lo the building's infraslruclure. Investmentpolicy andperfomiance The investment objective of the Board is lo maintain the Teal value of the fund over lime whilst generating a stable and sustainable return on investments in the form of dividend payments lo 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 portfolio's performan￿. British Home and Hospital for Incurables 17 Report of the Board of Trustee8 Year to 31 March 2023 Financial revlew lconlinuedl Investment policy andperfomiance (confinued) The market value of the portfolio at 31 March 2023 wa5 £11,713,70512022 £13,801,164 and 2021 £14,491,862). This is a book valuation and may differ signilicanlly from the price achieved when the fund5 are sold. The v21ue of the portfolio fell during the year because of withdrawals lo cover cash shortfalls arising from the deficit. The amounts drawn down on 31 March 2023 were £1.500,000 {2022 - £500,000 and 2021 £2,500,0001 The underlying investment performance showed nel unlealised investment losses of £600,455 for the yèar, 12022- £651.943 gains and 2021- £2,496,626 losses) reflecting the change in market value of investments since 31 March 2022. The income produced from these investments amounted 10 £359.41512022 - £362,042 and 2021- £419,585). Whilst the charity's ftjnds are of a sufficient size to have a segregated portfolio, the TrLJStees decided, after a review some years ago, to invest in pooled and common investment funds for charities. The saving in costs is considerable but il means that the eharity loses its power lo directly influence and control the underlying investments made or the detail of the Environmental, Social and Governance IESGI policies lo 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, m8n8ged 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 bul also how they vote the shares they buy. Both managers talk lo the management of those companies to raise concerns. Both managers publish detailed ESG policies and descriptions of how they assess iisk. Both managers also present annually lo the Finance Committee illustrating the analysis of Ihe financial return, risk, asset allocation, the funds, performance against agreed market benchmarks, and the investment objectives. Future plans In February of 2023, the Board of British Home revised the charity's 5-year strategic plan. Our new strategy 2023-2026, has been developed to focus on what we do well today ancj make il even beller. We will provide high quality specialist neuro rehabilitslion lo a local and wider population. As the complexity of resident care increases, we will expand our offer to new cohorts of residents including specialist Level- 2 provision which provides a much greater Iherapeulic input lo residents who will benefit from this higher level of intervention. These new service5 will complement our existing provision of longer-lem rehabilitation and palliative care and we will continue to invest in these areas as we progress our strategy. As part of this strategy. we will continue to work towards a long-lerm solution for redeveloping our building lo provide a slale-of-the-art ¢are facility . This will include new infrastructure and in-house facilities that will enable us lo incorporate the lalesl technologies lo support people with their rehabililalion. Furlhemiore, we will consult with our residents and sl8ff lo create a more modern and therapeutic environment for all who live and work al British Home. British Home and Hospital for Incurables 18 Report of the Board of Trustees Year lo 31 March 2023 Audltor Buzzacoll LLP, the Home's auditors have indicated their willingness to remain in office for a further year. 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 lo 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 lo the combined efforts of many individuals and organisalions. However. one group clearly stand out as being the bedrock on which the charity stands, and that gn)up is ils dedicated and caring staff. The Board would like lo say 'Ihank you, lo every member ofoLJr 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 ils behalf by: Trustee 201£ Approved on.. Kay Sonneborn British Home and Hospital for Incurables 19 Independent audllor's report Year lo 31 March 2023 Independent audltor's report to the members of British Home and Hospital for Incurables Oplnlon We have audited the financial slalemenls of British Home and Hospital for Incurables {Ihe 'charily'l for the year ended 31 March 2023 which comprise the statement of financial activities, the balance sheet, statement of cash flows, the principal accounting policies and the notes lo the financial slalements. The financial reporting framework that ha5 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 Praclicel. In our opinion, the financial statements.. give a true and fair view of the stale of the charity's affairs as al 31 March 2023 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 prepaTed in accordance with the requirements of the Charities Act 2011. Basis for opinion We conducted our audit in accordance with International Standards on Auditing IUKI IISAS IUKI) 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 15 sufficient and appropriate lo provide a basis for our opinion. Conclusions relating to going concern In auditing the financial stalemenls, we have concluded that the Trustees, use of the going con￿rn basis of accounting in the p￿paratIOn 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 doubl o the charity's ability to continue as a going concern for a period of al least twelve months from when the financial statements are aulhorised for issue. Our responsibilities and the responsibilities of the trustees with respect lo going concern are described in the relevant sections of this report. British Home and Hospital for Incurables 20 Independent auditor's report Year lo 31 March 2023 Other Information The Iruslees are responsible for the other information. The other infom81ion comprises the information included in the annual report, other than the financial statements and our auditor's report Ihereon. Our opinion on the financial statements does not cover the other information and, except lo the exlenl olhetwise explicitly staled in our report, we do not express any form of assurance conclusion Ihereon. In connection with our audit of the financial slalemenls, our responsibllily is to read the other information and, in doing so. consider whether the other information is materially inconsistent with the financial slalemenls or our knowledge obtained in the audit or otherwise appears to be materially misslaled. If we identify such material inconsistencies or apparent material misslatemenls, we are required to determine whether there is a material misstatement in the financial statements or a material misslalement 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 requiTed to Teport that fact. We have nothing lo report in this regard. Matters on which we are required to report by exceptlon We have nothing to report in respect of the following matters in relation lo which the Charities Act 2011 requires us to report lo you if, in our opinion.. adequate accounting records have not been kept, or relums 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 trkJStees' 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 s18tement. the trustees are responsible lor the preparation of the financial statements and for being satisfi'ed that they give a true and fair view, and for such internal control as the trustees determine is necessary lo enable the preparation of financial statements that are free from material misslalemenL whether due lo fraud or error. In preparing the financial slatemenls, the trustees are responsible for assessing the charity's ability lo continue as a going concern, disclosing, as applicable, mallers related lo going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charity or lo cease operations. or have no realistic alteTnalive but to do so. British Home and Hospital foT Incurables 21 Independent audltor's report Year lo 31 March 2023 Auditor's responsibilities for the audit of the financial statements Our objectives are lo obtain reasonable assurance about whether the financi21 slalemenls as a whole are free from material misslalemenl, whether due lo fraud or eiror, and lo issue an auditor's report that includes our opinion. Reasonable assurance is a high level of assurance bul is not a guarantee that an audit conducted in accordance with ISAS IUKI will always detect a material misstalemenl when il exists Misslalemenls Can arise from fraud or error and are considered material if, individually or in aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financialslalements. How the audit was considered capable of detecting irregularltles including fraud Our approach lo identifying and assessing the risks of material misslalemenl 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 lo identify or recognise non-compliance with applicable laws and regulations- + We idenlilied the laws and regulations applicable to the charity through discussions with management and trustees and from our knowledge and experien￿ of the charity sector, + We focused on specific laws and regulations wh￿h we considered may have a direct material effect on the accounts or the activities of the charity. These included bul were not limited lo the Charities Act 2011,. Accounting and Reporting by Charities.. Slalemenl of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable to the United Kingdom and Republi¢ of Ireland IFRS 1021 leffeclive 1 January 20191., Care Standards,. Health and Safety Regulations., The Code of Fundraising Practice,. Safeguarding Regulations,. and Data Protection., and • We assessed the exlenl of compliance with the laws and regulations identified above through making enquiries of management and those charged with governance and review of minutes of Iruslees, meetings. We assessed the susceplibillty of the ch8rily's financial slalemenls to material misslalemenl, including obtaining an understanding of how fraud might occur, by.. + Making enquiries of management and trustees as lo where they considered there was susceptibility lo 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 analyli¢al procedures lo identify any unusLJal or unexpected relationships-, + Tested and reviewed journal entries to identify unusual transactions; • Assessed controls over funds held for residents", British Home and Hospital for Incur2bles 22 Independent auditor's report Year to 31 March 2023 Auditor's responsibllllles for the audit of the accounts Iconlinuedl How the audit was consldered capable of detecting irregularitiT8S including fraud (continued) + Tested the aulhorisalion of expendilure,. Assessed whether judgements and assumptions made in determining the accounting eslimales were indicative of potential bias., and + Investigated the rationale behind significant or unusual transactions. In response lo the risk of irregularities and non-compliance with laws and regulations, we designed procedures which included, bul were not limited to: + Agreeing finanGial statement disclosures to underlying supporting documenlalion., • Reading the minutes of meets'ngs of Iruslees. and • Enquiring of as lo 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 il is that we would become aware of non-compliance. Auditing standards abso limil the audit procedures required lo identify non-compliance with laws and regulations lo 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 lo delect than those that arise from error as they may involve deliberate concealment or collusion. We did not identify any irregularities. including fraud. A further cjescriplion of our respon5ibililies for the audit of the financial statements is located on the Financial Reporting Council's website al www.frc.org.uklaudilorsresponsibililies. This description forms part of our audilols report. Use of our report This report is made solely to the charity's trustees, as a body, in accordance with section 144 ol the Charities Act 2011 and with regulations made under section 154 of the Act. Our audit work has been undertaken so that we might slate lo the charity's Iruslees those mallers we are required to slate to them in an auditor's report and for no other purpose. To the fullest exlenl permilled by law, we do not accept or assume responsibility to anyone other than the charity and the charity's Iruslees as a body, for our audit work, for this report, or for the opinions we have formed. Buzzacoll LLP Slatulory Auditor 130 Wood Street London EC2V 6DL Date.. 18 October 2023 Buzzacoll LLP is eligible lo act as an auditor in terms of section 1212 of the Companies Act 2006. British Home and Hospital for Incurables 23 Statement of linancial activitles Year to 31 March 2023 Un- restricted funds 2023 Total fund5 2022 Total fund$ Restricted Endowment funds funds Notes In¢ome from.. Donations and legacies Inveslment income Charitable a¢livilies Other income Total incorne 282,4( 359.415 5,482,299 14,828 6.138,g48 3,000 285.406 359,415 6.482,299 14,828 6,141,948 289,893 362.11B 4.833,020 303,638 5.788,669 3,000 ExpendIt￿re on: Raising funds Charitable activities Total expenditure 147,377 7,835,445 7,982,822 147,377 7,835,445 7,982,B22 190,514 6,620,467 6,810,981 Net {expendIt￿re Income for the year before investment 110ssesl gain$ 11,843,874) 3,000 11,840,874) 11,022,312) ILossesl gains on investments 12 1600,4551 1600.4551 651,943 Net lexpenditurelincome and net ¥novement In funds 12,444.3291 3,000 12,441,329) 1370.3691 Fund balances brought forward at 1 Aprll 2022 Fund balances ¢arrled forward at 31 March 2023 14,202,520 12,477 14,214.997 14,585,366 11,758,191 3,000 12.477 11,773,668 14.214,997 All of the Home's activities 8re derived from continuing operatsons during the above and prior financial period. British Home and Hospital for Incurables 24 Balance sheet 31 March 2023 2023 2023 2022 2022 Notes Flxed assets Tangible fixed assets Investments 633,504 12,063,705 12,697,209 569,654 14,151,164 14.720,818 12 Current assets Debtors Cash at bank 563,729 567,203 1,130.932 571,041 856,640 1,427.681 21 Creditors.. ￿￿O￿ntS falling due within one year Net current (liabilities) Net assets 14 12,054,473) 11,933.5021 1923,5411 11,773,668 1505,8211 14,214.997 The funds of the charity: Endowment fund Restricted funds Unrestricted funds Desunated lunds General fund 16 17 12,477 3.000 12,477 18 ,533,504 3,224,687 11,773,668 8,469,654 5.732.866 14,214.g97 Approved by the Board of Trustees on nd signed on ils behalf by.. Trustee Kay Sonneborn David Green British Home and Hospital for Incurables 25 statement of cash flows 31 March 2023 2023 2022 Notes Cash outflow from operating activities.. Nel cash used in operating activitie5 A 11,935,261) {1,150.695) Cash inflow from investlng activities Dividends and interest from investments Sale of inveslrllenls Purchase of fixed a58els Net cash provided by investing actlvltlès 359.415 362,118 1,500,000 500,000 1200,5951 1369.8441 1,658,820 492,274 Change in cash and cash equivalents in the year 1276,4411 1658,421} Cash and cash equivalents at l Aprll 2022 B 1,906,433 2.564,854 Cash and cash equlvalents at 31 March 2023 B 1,629,992 1.906,433 Notes to the cash flow statement for the year to 31 March 2023. A Reconclllation of net movement in funds to net cash flow from operating actlvitles 2023 2022 Net movement In funds las per the stst8ment of flnanclal activities) 12,441.3291 1370,3891 Adjustments for-. Depreciation charge Losses {gain51 on investments Dividends and interest frorn investments Dec￿ase in debtors In¢rease in creditors N8t cash used in operatlng actlvities 136,745 138,809 600,455 {651,9431 1359,4151 {362,118) 7,312 9,145 120.971 85,781 11,935,261) 11,150,695) B Analysis of cash and cash equivalents 2023 2022 Cash at bank and in hand Cash held by investmenl man&geis Total cash and cash equivalents 567.203 1,062,789 1,629,992 856,640 1,049.793 1,906.433 No separate reconciliation of net debt has been prepared as there is no difference between the net cash Idebtl of the charity and the above cash and cash equivalents. British Home and Hospital for Incurables 26 Prinelpal accounting policies Year lo 31 March 2023 The principal accounting policies adopted, judgements and key sources of estimation uncertainly in the preparation of the financial slalements are laid out below. Basis of preparation These financial slalemenls have been prepared for the year lo 31 March 2023 with comparative information provided in respect lo the year ended 31 March 2022. The financial statements have been prepared under the historical cost convention with items recognised at cost or transaction value unless otherwise slated in the relevant a￿OUntIng policies below or the notes lo these financial slalements. The financial statements have been prepared in accordance with Accounting and Reporting by Charities.. Statement of Recommended Practice applicable lo charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland IFRS 1021 (Chaiities SORPI, the Financial Reporting Standard applicable in the UK and Republic of Ireland IFRS 1021 and the Charities Act 2011. The charity conslitules a public benefit entity as defined by FRS 102. The financial statements are presented in sterling and are rounded to the nearest pound. Crltlcal accounting estimates and areas of judgement Preparation of the financial statements requires the Iruslees and management lo make significant judgements and estimates. The items in the financial statements where these judgements and eslimales have been made include: eslimaling the useful economic lile of tangible fixed assets., valuation of the investment land., + legacy recognition,. and estimating fvture 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 lo a period of one year from the date of approv21 of these financial statements. British Home and Hospital for Incurables 27 Principal accounting pollcies Year lo 31 March 2023 Assessment of going concern {¢ontinuedl The Iruslees ol the charity have concluded that there are no material uncertainties related to events or conditions that may cast significant doubl on the ability of the charity lo continue as a going concern. At 31 March 2023 the charity had nel current liabilits'es of £923,54112022- £505,821). The Iruslees are of the opinion that the charity will have sufficient resources lo meet ils liabilities as they fall due by drawing down on the investment funds when required. The most significant areas of judgement that affect items in the financial stslgmenls are detailed above. With regard lo the next accounting period, the year ending 31 March 2024, 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 enlilled lo receipt thereof, the amount can be measured reliably, and il is probable that the funds will be received. Legacies a￿ 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 dale. DNidends are recognlsed 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 Servi￿ has been provided. Expenditure and the basis of apportlonlng costs Liabilities arè recognised as expenditure as soon as there is a legal or constructive obligation commilling the charity lo make a payment to a third paty, 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 allribulable VAT which cannot be recovered. The majority of costs are directly attributable lo specific activities. Support costs are allocated lo expenditure on raising funds and charitable activities according to underlying activity levels. These were established using a number of suitable indicators including staff lime and floor space. Expenditure comprtses the following.. Expenditure on raising funds includes the salaries, direct costs and support Costs associated with generating donated income and the fees paid lo investment managers in connection with the management of the Home's listed investments. BTilish Home 8nd Hospital for Incurables 28 Princlpal accounting pollcles Year lo 31 March 2023 Expenditure and the basis of apportlonlng costs Iconlinuedl b. Expenditure on charitable activities comprises expenditure on the Home's charitable purposes as described in the report of the Board of Trustegs and includes support costs. Tangible fixed assets Thè 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 il was not possible lo ascertain the c05t 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 lo buildings have been capilalised. The book value, after depreciation, of land and buildings acquired prior lo 1994 is not regarded as material. The New Wing, which opened IN 1996, is classified as freehold buildings. The building5 were insured on a replacement basis for £42m at 31 March 2023 lat 31 March 2022- £37ml. ASI assets costing more than £5,000 are capitalised. Depreciation is provided al the following annual rates to write off each asset over its estimated useful life.. + Freehold buildings 4'h on cost + W8ter Tank 1 OO/D on cost • Hospital and catering equipment + Office furniture and equipment 20g/o on cost 20Q￿ on cost + Computer equipment 20°k on cost • Transport 20.10 on cost Investments Listed investments are a form of basic financial instrument and are inilia11y recognised al their transaction value and subsequently measured al their fair value as at the balance sheèt date using the closing quoted market PTlCe. Land held for investment is included in these accounts at fair value based on open market value. The land was last valued formally in January 2019 by Monlagu Evans. Realised gains {or losses) on investment assets aTe calculated as the difference be￿eell 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 dale. Realised and unrealised investment gains lor losses} are credited lor debited) in the slalement of fin8ncial activities in the year in which they arise. Debtors Debtors are recognised al their selllemenl amount, less any provision for non-recoverability Prepayments are valued al the amount prepaid. They have been discounted lo the present value of the future ¢ash receipt where such discounting is material. British Home and Hospital for Incurables 29 Prlncipal accounting pollcles Year lo 31 March 2023 Cash at bank and in hand Cash at bank and in hand represents such accounts and instrijmenls that are available on demand or have a malurily of less than three months from the dale of acquisition. Deposits for more than three months bul less than one year have been disclosed as shorl-term deposits. Cash placed on deposit for more than one year is disclosed as a fixed asset investment. Creditors and provlslons Creditors and provisions are recognised when the￿ is an obligation al the balan￿ sheet dale as a result of a past event, it is probable that a transfer of economic benefit will be required in selllemenl, and the amount of the selllement can be estimated reliably. Creditors and provisions are recognised at the amount the charity anlicip21es il will pay to sellle the debt. They have been discounted lo 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 lo 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 al the discretion of the Board of Trustees. Pension costs From 1 April 2014, British Horre is opèrating a defined contribution scheme. Contributions are recognised in the slalement of financial activities when payable. British Home and Hospitsl for Incurables 30 Notes to the f Inancial statements Year lo 31 March 2023 1 Donatlons and legacies Unieslricled Reslricled 2023 Donations inclusive of reclaimed lax Legacies Total 2023 69,785 212,621 262,406 3,000 72,785 212,621 285.406 3,000 Unre$lrioted Resliiolgd 2022 Donalions inclusiv8 of reclaimed 18X LegaGies Total 2022 759.224 130,669 269,893 159,224 130,669 289,893 2 Investment income Uni8stricted funds 2023 2022 Sarasin- CIF ALPHA fLEnd units COIF- Investment fund income units 183,710 174,259 357,969 184,147 177,895 362,042 Interest recewable Total 2023 1,446 359,415 76 362,118 3 Income from charitable activities Income from charitable activities comprises fees from medical and nursing seNices and is unrestricted. 4 Other Income Unreslrict8d funds 2023 2022 Other COVID-19 Sustainability Payment Digilising soaal care fund IDSCFI 1,828 303,638 13,000 14,828 303,638 5 Expenditure on ralsing funds Unrestricted funds 2023 2022 Other costs lincluding staff c051sl Direcl costs Support costs 96,813 50,564 147.377 145,477 45,037 190.514 British Home and Hospital for Incurables 31 Notes to the financial staternents Year lo 31 March 2023 6 Expenditure on charltable actSvities UnreslHcled Restricted 2023 Medical and nursing services Direct costs . Support ￿81$ 5,101,598 2,733.847 7,835,445 5,101,59B 2.733,847 7,835.445 Unreslricled R8s1ricled 2022 M8dical andnursing s8rvices D1￿ct costs Support cosls 4, 146,226 2,474,241 6.62Q,467 4. 146,226 2,474,241 6,620,467 7 Analysis of support costs Raising Charitable funds 2023 Staff costs Administration Housekeeping- fuel & rates Housekeeping- other Depr8cialion Repairs & maintenance Insurance Olher cost5 Governance costs Total support costs 22,645 7,482 2.725 13,059 881 860,212 225,454 224,361 851,381 135,865 196,495 96,462 58,234 85,383 2,733,847 882,857 232,936 227,086 864.440 136,746 196,495 97,634 59,797 86,420 2,784,411 1,172 1,563 1,037 50,564 Raising Charitsble funds aclivili9S 2022 Staff Gosls Adminisfratlon Housek8eping- fu81 & ￿leS Housekeepffng- other DepreGialion Repairs & maintenance Insur8nGe Otljercosts Goveménc@ Gosts Tot21supportcosls 20,252 7,661 2,285 10,234 968 772,639 226,017 188, 117 770,268 137,840 138,904 89,910 62,456 88,090 2,474,241 792,891 233,678 190,402 78Q.502 138,8Q8 138,904 91,Q02 63.931 89,160 2,519,278 1,092 1,475 1,070 45,037 Included within governance costs is auLlilor's remuneration of £28,20012022 - £24,300) and £55,620 12022 - £15,000) for professional fees which included strategy development work and trustee recruilmenl. British Home and Hospital for Incurables 32 Notes to the financlal statement5 Year lo 31 March 2023 8 Staff costs 2023 2022 Wages and salaries Social security costs Pension costs Redundancy costs 3,587,988 378,402 204,930 8,609 4,179,929 3,266,091 322,318 182.784 3,771.193 The number of full-lime equivalent employees during the period who earned over £60.000 in the year is as follows.. 2023 Number 2022 Number £60,001 - £70,ODO £70,001- £80,000 £80,001- £90,000 £90,001- £100,000 £100.001-£110,000 The average number of employees analysed by function was.. FTE. Hèad Count 2023 2023 FTE. He8d Count 2022 2022 'Full time Equivalent Nursing and care Maintenan Reception and portering Management and adminlstration 84 127 89 106 io 13 149 14 132 101 106 Catering, cleaning, and laundry are outsourced, bul with staff dedicated lo British Home. AveTage numbers of catering and cleaning staff during the year were FTE 111 Head Count 18 12022 FtE 13 1 Head Count 21). Remuneration of key management personnel No trustee ￿te1Ved any remuneration in respect ol their services during the year. No trustees were reimbursed for travel expenses in the year12022 - £nill. During the year. the total remuneration, including pension contributions and employer's national insurance contributions. of key management personnel was £344,739 12022 £299.8001. 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 flom any loss arising from any neglect or defaults of any member of the Board of Trustees or employee and lo indemnify any Board Member or employee against the consequence of any neglect 01 default on their part. The lolal cover provided by such insurance is £2,000,00012022 - £2,000,000} and the insurance premium paid by the Home during the year tolalled £2.55512022- £1,581). Donations from trustees lotalled £12012022 - £1401. British Home and Hospital for Incurables 33 Notes to the financial statements Year lo 31 March 2023 10 Taxation BTilish Home and Hospital for InGurables is a regislerecl charity and therefore is not liable lo income tax or corpomtion lax on income derived from its charitable activities, as il falls within the various exemptions available lo registered charities, 11 Tangible fixed asset$ Fieehold building Hospital equipment Computer equiprnenl Transport Total Cost Al 1 April 2022 Additions Al 31 March 2023 3,654,766 124,333 3,779,099 217,280 113,548 76,262 189.810 15,980 4,001.574 200,595 4.202,169 217.280 15,980 Depreclatlon At 1 April 2022 Charge lor the year At 31 March 2023 3,276.194 73,411 3,349,605 68,450 41,374 109,824 77,688 18,764 96,452 9.588 3,196 12,784 3.431.920 136,745 3,568,665 Net book values Al 31 March 2023 Al 31 March 2022 429.494 378.572 107,456 148,830 93,358 35,860 3,198 6.392 633,504 569,654 Al 31 March 2023 the Iruslees had commilled lo bul not contracted for expenditure of £34,056 in respect lo a project to upgrade the waler tank. 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 il was not possible lo ascertain the cost of land and buildings and until 1 January 1994 the cost of additions were wrillen off as incurred. In 1994 the accounting policy was changed and subsequent expendilLJre on additions and improvements lo buildings have been capilalised. 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 2023 comprised the following: Investment property Listed investments 2023 Market value 811 April 2022 Disposals at opening book value Net loss Market value 8131 March 2023 350,000 12,751,371 13,101,371 11,500,000) 11,500,000) 1600,4551 1600,4551 10,650,916 11,000,916 350,000 Cash held by investment advisors foi re-investment Total investments 1,062,789 1,062,789 11.713,705 12,063.705 350,000 Historical cost of investments at 31 March 2023 8,810,854 8,810,854 British Home and Hospital for Incurables 34 Notes to the financial statements Year lo 31 March 2023 12 Investments Iconlinuedl Inveslmenl property Listed Anvestmenls 2Q22 Markel v81ue at 1 Apnl 2027 Disposals 8t OP8nN17g book valu8 Nel gains Market value at 31 March 2022 350,QOO 12,599,428 12,949,428 (5QO,O(KJI 15t>o,ooo? 651,943 651,943 12.751,371 13, 101,371 35Q.QOO Cash held by inveslm8nl advisors forre4nveslment Tol81 inv8slm8rils 1,049, 793 7,049, 193 13,801, 764 14, 151, 164 35Q,OOQ Hisloric21 cost of invesEn7ents al JI Manh 2022 8,713,910 8, 713,910 The investment property is a share in land held on behalf of five charities. The valuation is at trustees, assessment based on a professional valuation by Montagu Evans in January 2019. 13 Debtors 2023 2022 Fee debtors Prepayments and accrued incorne 442.872 120,8S7 563,729 367,843 203,198 571.041 Prepayments and accrued income al 31 March 2023 include legacies of £21,044 12022 £109,000) 14 Creditors.. amounts falllng due within one year 2023 2022 Trade credilors Amoun15 held on bghalf of iesidents Accruals and deferred income S￿181 security and other laxalion Other creditors Liability on wilhdfawal from p6n8ion scheme 126,351 56,245 568.181 204,295 321.401 778,000 2,054,473 212,230 58,039 479,204 160,627 245,402 778,000 1,933.502 Note.. A corresponding asset for residents, monies is included in cash al bank Isee note 211. Included above is deferred income which relates lo income receivable in 2023124 which can be analysed as follows.. 2023 2022 Deferred income bioLsght forward Deferred in the year Released in the year Defeired income carried forward 162,844 195.639 113,944 1e2,844 1162,8441 {195,6391 113,944 162.844 British Home and Hospi181 for Incurables 35 Notes to the financial statements Year to 31 March 2023 15 Operating lease commitments Al 31 March 2023, the Charity had the following lot21 commitments under operating leases on plant and machinery as follows.. 2023 2022 Amounts payable". Within one year In two Its fivè yèats 4,281 4.281 4.281 8.562 4.284 16 Endowment fund 2023 2022 The D.0. Beale Trust 12,477 12,477 17 Restrlcted fund In the year to 31 Mareh 2023 the charity received £3,OOD in restricted funds12022 - none}. The funds are lo be used toward5 new minibuses. 18 Deslgnated funds The income funds of the Home include thè following designated funds which have been sel aside out of unreslricled funLls by the Board of Trustees for specific purposes.. At1 April 2022 Releasedl added New In year deslgnatSons At31 March 2023 Tangible fixed assets fund Conlinuily of Cale fund Major and Cydical Maintenance fund 569,654 5.900,000 2,000,000 8,469,654 1136.7461 200,596 633,504 5,900,000 18,847 2,000,000 219.443 8,533,504 118,8471 1155,593 Atl April 2021 Released/ added in year At37 Ma￿h 2Q22 New designations Tarpgible fixed assets fund Continuily of Care fund Majorand Gyclffcal Jllain¢enanG& tund 338,618 5.900,LIOO 2,000,QOO 8.238,618 231,036 569,654 5,900,000 12, 1(KJ 2,QOO,QOO 12. 700 8.469,654 (72, 100) 218.936 Tanglble fixed asset fund An amount equivalent lo the net book value of tangible fixed assets al the end of the year is designated lo recognise that they are not available for general use as they are not readily realisable. Continuity of care fund This fund has been estsblished lo meet the charity's obligations to provide essential services for all parties in the event of a critical incident. British Home and Hospital for Incurables 36 Notes to the financlal statements Year to 31 March 2023 18 Designated funds Icontinuedl Major and cycliTcal 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 lo the buildings infrastructure. 19 Analysis of net assets between funds Restricted Endowment Designated fund fund funds General fund Total 2023 Fund balatlces at 1 March 2023 are represented by.. Tangible fixed assets Investments Current as$els Creditors.. amounts falling due wilhin one year Total net assets 633.504 7,900,000 633,604 4.151,228 12.063,706 1.127.932 1,130,932 12,477 3,000 12,054,473) 12,054,473) 3.224.687 11,773,666 3,000 12,477 8,533.504 Endowment D8sign8led fund runds Gener81 fund rotBI 2022 Fund balances al 31 March 2Q22 a represenled by.. Tangible fixed assets Invsslments CunEnl &ssels Creditors.. amounls falling du8 Within Dne year Tolal net assets 569,654 7,90Q,OOQ 569,654 6,238,687 14, 151, 164 1,427,681 1.427,681 12,477 (1,933,502) (1,933,502) 5,732,866 14,274,997 12,47T 8.469,654 20 Penslon commltments The Home operated a defined benefit pènsion 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 8131 March 2014. The most recenl Iriannual valuation of the scheme was al 1 April 2016. In February 2018, after seeking advice from their advisors KPMG, the Iruslees took the decision to buyout of the schème and 8 lolal liabilily of approximately £1,788.000 cryslallised. During 2018 £1,010,000 was paid and the amount oulslanding at 31 March 2022 is £778,000. The estimated liability is based on information provided by the trustees, professional advisors and Aviva, the insurers. British Home and Hospital for Incurables 37 Notes to the financlal statements Year lo 31 March 2023 20 Pension ¢ommitm8nts Iconlinuedl The Federated Flexiplan No. 1 1"Ihe Plan'l is a defined benefit pension scherne. 11 is a 'las1 man standing scheme which means that all participating employers are joint and severally liable for the Plan's liabilities. However, because of the non-associaled multi-employer nature of the Plan, the charity does not have sufficient information available lin particular to identify its share of the underlying assets and liabilities of the Plan) to use defined benefit accounting. As such and as permilled by FRS 102, it accounts for the Plan as if il were a defined contribution scheme. As a result. the amount recognised in the slalemenl of financial activities represents the charity's contributions payable lo the Plan in respect of the accounting period. Members of the Plan are enlilled lo benefits on either a"Pensions Capital" or Target Pension" basis. Under the Pensions Capital basis. contributions paid by and in iespect of members are accumulated up lo retirement and then used to secure benefits for the member. Under the Target Pension basis, members receive a defined pension at reb'rement based on length of service in the Plan and their Pensionable Salary al date of leaving. The Plan is closed lo new members and lo future accrual of benefits. 21 Cash at bank Cash al bank of £567,203 on 31 March 202312022 - £856,6401 includes £56,245 held on behalf of the residents of the Home 12022 £58,039). A corresponding liability for these monies is included in credltors (note 141. British Home and Hospital for Incurables 38