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2023-03-31-accounts

TURNING POINT UAL EPORT 2022123

1 2 1 TumingPoint l AnnualReport 1 2023 2022123

Turning Point Annual Report 2023 3

CONTENTS CONTENTS
01 Strategic report 4
02 Visions and Values 8
03 Chair and Chief Executive’s Statements 12
04 Navigating the health and social care landscape 16
05 Our strategic intent 24
06 Progress and impact 30
07 Our organisational approach 52
08 Turning Point culture 60
09 Delivering Social value 68
10 Risk management 74
11 Directors’ Report 78
12 Independent Auditor’s Report 94

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TurningPoint l AnnualReport 1 2023 1 STRATEGIC REPORT

6 Turning Point Annual Report 2023

Who we are

At Turning Point, we constantly find ways to support more people to discover new possibilities in their lives.

We are a leading social enterprise, designing and delivering health and social care services in the fields of substance use, mental health, learning disability, autism, acquired brain injury, sexual health, homelessness, healthy lifestyles, and employment. We currently work in over 280 locations across England, empowering those we support to improve their health and wellbeing, learn, and bring about positive change in their lives.

What we do

Building on nearly 60 years of experience, we have expertise in delivering innovative, integrated support in a range of places including people’s homes, workplaces, communities, and specialist settings.

Most of our services are commissioned by the public sector, but increasingly we’re expanding ways in which people can access and pay for our support directly. We work closely with local authority adult social care and public health teams, the NHS, ICB (Integrated Care Boards), the Ministry of Justice, HM Prison and Probation Service, the Office for Health Improvement and Disparities, the Department for Work and Pensions and many private, benevolent, and voluntary, community and social enterprise (VSCE) organisations. As a social enterprise we invest any surplus we make back into the business, for the benefit of the people we support.

Turning Point Annual Report 2023 7

Our year in numbers In 2022/23

Turnover

£152.8m

Total number of people supported in 2022/23

171,468

Total number of people supported by our mental health services

94,201

Total number of people supported by our drug and alcohol services

65,124

Total number of people supported by our healthy lifestyle’s services

8,557

Number of colleagues

4,818

Total number of people supported by our learning disability services

1,211

Total number of people supported by our employment services

915

Total number of peer mentors

162

Total number of volunteers

68

Total number of locations

283

Percentage of employees with lived experience of the issues facing people we support for themselves or as a carer*

60%

Total number of people supported by our sexual health services

1,460

Regulated services rated Good or Outstanding by CQC 94%

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TurningPoint l AnnualReport 1 2023 1 VISION AND VALUES

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Our vision

To constantly find ways to support more people to discover new possibilities in their lives.

The quality of our services means everything to us. The people we work with inspire us and in turn we look for new ways to inspire change. We owe it to the people we work with to grow and shape the future, because we believe in what we do.

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----- Start of picture text -----
Our
values
We all communicate We treat each other
in an authentic and and those we support
confident way that as individuals
blends support however difficult
and challenge. and challenging.
We commit to
We believe that
building a strong
everyone has the
and financially
potential to grow, learn
viable Turning
and make choices.
Point together.
We deliver better We are here to embrace
outcomes by change even when
encouraging ideas it is complex and
and new thinking. uncomfortable.
----- End of picture text -----

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TurningPoint l AnnualReport 1 2023 1 13 1 CHAIR AND CHIEF EXECUTIVE'S STATEMENTS

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Peter Hay CBE

Chair of the Turning Point Board

2022/23 has been another turbulent year. As the challenges of COVID-19 eased, political and economic instability ensued, leading to a cost-of-living crisis that impacted everyone. The health and social care sector has been particularly affected, as cost and demand outpaced funding and recruitment. Across the sector we have seen organisations struggle to fill vacancies, hand back contracts, and have difficult conversations with commissioners.

We have not been immune to these issues but overall, we have seen our services grow, with innovative new services coming to fruition. Our increasing social impact goes beyond the immediate service outcomes we are commissioned to deliver, benefiting our communities and society.

The involvement of people we support and board member visits to our services, have continued to guide our decisions and has directly informed the creation of an impressive Health and Wellbeing Guide for people with learning disabilities, and new clinical interventions including our sectorleading Blood-borne Viruses Strategy.

I am continually impressed by the passion, resilience and ingenuity shown by our workforce, shaped by our culture, values and vision. You will see many examples in this report of how ‘Inspired by Possibility’ is more than just a strapline – it is the principle guiding everything we do, particularly when times get tough.

I would like to take this opportunity to say thank you to Julie Bass and the wider management team, who have continued to display impressive leadership, navigating often unforeseen hurdles while providing a leading voice for change in the sector. I would also like to thank Paul Picknett for his valued contributions while on the Turning Point Board. Paul served on the board for nine years and was Vice Chair and Chair of the Audit, Risk & Quality Committee. Finally, welcome to Dawn Kenson, who joined the board in January 2023, bringing a wealth of experience from across the NHS, public and private sector.

After almost 60 years, Turning Point is still thriving, successfully recruiting, and retaining the best people and providing more support to those who need it. Challenges of the last year are likely to continue in 2023-24, but I am confident in our ability to achieve our new strategic goals, and to constantly find new ways to support more people.

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Julie Bass

Chief Executive of Turning Point

I have always been proud to work at Turning Point and this year, as we responded to political and economic impacts beyond our control, it is even clearer what a truly inspiring place this is.

Post-COVID-19 and amid a cost-of-living crisis, Turning Point, and the health and care sector more widely, feel like very different places. Our partnerships across the VCSE (voluntary, community or social enterprise organisations) have been strengthened, as we work together to seek fairer funding, share innovations, fight against inequalities facing those who have learning disabilities and continue to challenge the stigma attached to mental health, substance use and sexual health support.

Despite the political and economic turmoil around us, Turning Point’s values and culture have remained steadfast. Our new strategic goals, launched in April 2022, strengthen our commitment, and resolve to deliver high quality services that have lasting social impact.

By listening and working alongside the people we support, we have brought new ideas and services to the fore, supporting more people in more places. The expansion of our clinical team, focus on safer lives, and use of digital tools in our learning disability services, all provide new opportunities to achieve our goals.

Our colleague networks, use of technology and learning opportunities have also flourished, helping to ensure our colleagues feel supported and valued. Our annual #ProudToSay campaign is an opportunity for our people and those we support to share accomplishments and the things they are most proud of. This year the social media campaign reached 113,000 people. We saw the launch of Writing for our Lives, an inspiring book of poetry and illustrations; people we support shared their stories of living independently and starting new hobbies; colleagues

I could not be prouder of our people and everything we continue to achieve as we look forward to 2024

shared the pride they feel challenging discrimination and learning new skills. Our Apprenticeship awards were also a lovely opportunity to recognise the successes of some of our team members.

Despite a challenging few years, we have seen incredible progress made by those struggling with their drug and alcohol use, their mental health, and unemployment issues. We have also witnessed significant achievements by many with a learning disability despite ongoing deep seated systemic inequalities.

I could not be prouder of our people and everything we continue to achieve as we look forward to 2024 when we mark our 60th anniversary – a significant milestone in our history. With a foundation of involvement, strong commitment to diversity and inclusion, and embracing innovation, it is exciting to think how far we’ve come over the last 60 years and how much more we are going to do.

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NAVIGATING THE HEALTH AND SOCIAL CARE LANDSCAPE

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A year of political and social turmoil

This has been a year of political change, economic challenges, and social turmoil.

Having come through the worst of the COVID-19 pandemic, external factors have continued to have a significant and direct impact on the people we support, the delivery of our services and the way they are commissioned. Our work to influence the policy and funding environment within which we operate, has never been more important.

During 2022, the cost of living increased sharply across the UK. The annual rate of inflation reached 11.1% in October 2022, a 41-year high. Low-income households spend a larger than average proportion of their disposable income on energy and food, so are more affected by price increases. Food bank charities reported an increase in demand while real household disposable income – a measure of real living standards – is expected to fall by a cumulative 5.7% during 2022/23 and 2023/24, the largest two-year fall since records began in 1956-57.

In response to the cost of living crisis, the government introduced a range of measures during 2022 including support for rising energy costs; payments for households receiving means-tested benefits, pensioners and people receiving disability payments; a council tax rebate for some households; a 5p cut to fuel duty; and an increase to the amount someone can earn before National Insurance Contributions are charged[1] . These measures provided much needed help, but financial pressures were of critical concern to many of the people accessing our services. We also provided additional support to our teams, as winter pressures were felt.

The UK employment rate was estimated at 75.7% between November 2022 and January 2023[2] with unemployment rates at their lowest for 50 years[3] .

However, labour market participation, having risen since 2010 (despite the ageing of the population), has fallen dramatically in the wake of the pandemic, especially among older workers[4] . This has left the total labour force 520,000 people smaller than expected prior to the pandemic, despite increasing net migration[5] , leading to labour supply issues. These workforce challenges have affected the health and social care sector particularly hard, requiring us to adopt new and distinct approaches to recruitment and retention in each of our areas of work.

Analysis by the ONS shows that between 2019 and 2022 the number of people aged 50-64 who were economically inactive due to longterm sickness rose by 16%, from nearly 1.137 million to 1.320 million and there is consensus on the fact that pressure on the NHS is likely to be a factor contributing to this increase[6] .

Strike action has also been significant, with 282 different strike actions across the UK in January 2023[7] having a knock-on effect on a wide range of public services.

In November 2022, the government committed an additional £3.3 billion for 2023-24 and 2024-25 to protect the NHS from inflationary pressures. However, high inflation throughout 2022 meant that NHS budgets will now grow by 2.9% in real terms per year, below the planned spending rises set out in 2021. The financial challenges facing the NHS are compounded by rising wait times, a lack of available beds and workforce pressures that have a knock-on effect elsewhere in the sector.

At the 2022 Autumn Budget the government put more money into social care, with up to £2.8 billion

1 https://commonslibrary.parliament.uk/research-briefings/cbp-9428/

2 https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/ employmentandemployeetypes/bulletins/uklabourmarket/latest

3 https://www.employment-studies.co.uk/resource/labour-market-statistics-march-2023

5 https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/ employmentandemployeetypes/bulletins/uklabourmarket/latest

6 https://blog.bham.ac.uk/cityredi/changing-labour-market-participation-of-people-aged-50-years-and-over/

Turning Point Annual Report 2023 19

more funding allocated for 2023-24 followed by £4.7 billion in 2024-25. However, social care continues to be under-resourced with significant unmet need and persistent workforce shortages.

Following a call for evidence, the expected announcement of a new 10-year mental health and wellbeing plan, was replaced by a ‘Major Conditions Strategy’ to include mental health and the longawaited Health Disparities White Paper. Many in the sector felt this was a missed opportunity to bring much needed focus to these distinct areas.

Planned social care reform[8] was also delayed. Further integration with healthcare and an intervention in the social care market intended to ensure local authorities pay a ‘fair price’ to providers for the care they commission from them, was due in 2023 but has now been delayed until October 2025.

Following the passage of the 2022 Health and Care Act, Integrated Care Systems (ICS) were formalised as legal entities with statutory powers and responsibilities. ICS are partnerships of organisations working together to plan and deliver joined up health and care services. They are tasked with improving outcomes in population health and health care, addressing inequalities in outcomes, experience, and access, and enhancing productivity and value for money.

ICS represent a fundamental shift in the way the English health and care system is organised. They move the system away from competition, and the separation of commissioners and providers, to collaboration and a focus on places and local populations as the driving forces for improvement[9] .

Turning Point, like others in the Voluntary, Community and Social Enterprise sector, remain concerned about the extent to which third sector providers can engage with the new structures and welcome the independent review of ICS launched in November 2022.

Throughout the last year, we have adapted to new commissioning environments, shone a light on challenges within the sector and worked with commissioners, partners and the people we support to develop new solutions in response to the everchanging external environment we work in. As we look ahead, further political and economic shifts are likely, which we are well placed to adapt to.

75.7% The UK employment rate was estimated at 75.7% between November 2022 and January 2023

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Substance use in the spotlight

By Nat Travis, National Head of Service Public Health and Substance Use

Following the publication of the Dame Carol Black report in July 2021 and the subsequent new Government Drug Strategy in December 2021, the last 12 months have brought about significant change within the substance use sector.

In April 2022 we saw the first year of a three-year period of funding to support the sector in realising the ambitions set out in the Drug Strategy and we had a keen focus on recruitment, retention, and workforce development. Overall, we increased our workforce by just over 140 roles in the last year with a range of professions and role types within this.

Our engagement with Collective Voice and working groups set up because of this has been invaluable in learning and sharing best practice. We have also been working with others across wider systems and communities, including through new Combating Drugs Partnerships, marking a new era of collaboration for the sector.

We continued our work within the Rough Sleepers Initiatives, funded by the Government in their commitment to end rough sleeping by 2025.

Whilst we retained our learning from the pandemic and kept remote delivery as a core part of our offer, we are seeing more and more of the people we support wanting to be seen face to face and many colleagues eager to work back in shared office spaces.

As we move forward and prepare for the second year of the funding, our focus is shifting to reviewing our wider treatment offer, ensuring we have a comprehensive learning and development offer and building our specialism around harm reduction and reducing drug and alcohol related deaths.

Overall, we increased our workforce by just over 140 roles in the last year

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Fighting inequalities for those with a Learning Disability

By Davinder Jhuty, National Head of Service Learning Disability

As we emerged from the peak of the pandemic, we reflected upon the inappropriate use of Do Not Resuscitate notices for people with a learning disability, and what this said about the systemic discrimination faced by those with a disability.

Following our successful campaign to stop this practice, we worked with Learning Disability England to amplify the voices and rights of this community and advocated for protections to be adopted to prevent prejudicial ways of working.

We have asked people with a learning disability about their experience of broader health inequalities. Based on what they told us, we have prioritised action to challenge and overcome unacceptable and unfair practices across the health system.

We were awarded NHS England & Improvement COVID-19 recovery funding to commence our Health & Wellbeing Programme. This targets health inequalities that disproportionately impact people with Learning Disabilities and

their families. Our first step is to have richer structured conversations with individuals about physical, emotional, mental, financial, and social determinants of health and wellbeing. Using this information, we are developing person-centred Health & Happiness Plans that celebrate and support equity in the value and quality of their lives.

Our success relies upon well-trained motivated colleagues driving positive change. Despite challenging public sector budget constraints, we significantly enhanced our workforce pay, benefits, and wellbeing offer. We were also successful in being awarded funding from Health Education England to deliver improved workforce learning on identifying and challenging health inequalities.

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Turning Point Annual Report 2023

Extending the reach of our Mental Health services

By Stephen Parker, National Head of Service Mental Health

This has been a challenging but exciting year within our Mental Health services, as we’ve seen our reach across the sector grow both geographically, and in terms of specialism.

Despite the disappointing decision by the government not to publish a new mental health and wellbeing strategy, it has been good to see commissioners continue to seek new ways of supporting people’s mental, not just physical, health.

We have developed projects in new areas, such as West Sussex, where we’ve opened supported accommodation and are about to launch a new service which will work with people in crisis as well as those who are leaving psychiatric hospitals. With a new learning disability service commencing in the summer, it is an opportunity to develop new management models and approaches for those who suffer from multiple issues.

We have also grown in scope, developing new projects with commissioners to reach more people. In Manchester, for example, we have developed a pilot, where we’re providing move-on support to people being housed by other mental health organisations. In Stafford we have commenced a service in conjunction with our substance use colleagues to house and support street homeless people, and in our Crisis Point service, we are about to start a pilot where our colleagues will work within the local A&E to redirect people suffering from acute mental distress to alternative, more appropriate services for their needs. Continuing to innovate and work in partnership with commissioners to co-design projects and services is something we want to do much more of in the year ahead.

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Clinical excellence and oversight

By David Bremner Medical Director

Having emerged from the pandemic, we have added new roles to our clinical team and extended the range of services that we are able to provide the people we support.

The new Medicines Safety Officer role will drive the organisation towards even safer, higher quality and more contemporary use of medicines. The Safer Lives Lead dedicates resource to harm minimisation and learning from drug related deaths, working closely with the new Morbidity and Mortality Co-ordinator. These roles all serve the new learning, governance, morbidity, and mortality processes adopted over the last year.

This year has seen investment in Continuing Professional Development (CPD) programmes for colleagues and career progression both within and at times outside the organisation. We can celebrate these achievements within professions such as our new Nursing Awards. These awards celebrate the achievements of our nursing colleagues across the range of roles, from entry level apprenticeship Associate Nurses and Healthcare Assistants to Specialist Nurse Practitioners.

Services offered by the clinical team continue to go from strength to strength including:

New treatment models such as the Mental Health Treatment Requirements (MHTR) which serve people with dual treatment orders across Somerset and Wiltshire. We are excited to have been involved in the shaping of national models and learning materials for Ministry of Justice and court colleagues.

The new Medicines Safety Officer role will drive the organisation towards even safer, higher quality and more contemporary use of medicines.

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TurningPoint l AnnualReport 1 2023 1 25 OUR STRATEGIC INTENT

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Our new strategic period

Our new strategic period runs from April 2022 to March 2027. The current strategy continues to see Turning Point forging new opportunities to integrate health and social care, while extending our reach, effectiveness, and use of technology.

Our vision and values remain an important constant in an uncertain world, while our strategic intent is now represented through the following strategic goals:

Support people to improve their health & wellbeing and bring about positive change in their lives;

Seek to reach more people and provide support at the earliest opportunity;

Prevent the escalation of need and reduce demand on the wider health and social care system

And, thereby creating enduring value for communities and society as a whole.

Turning Point Annual Report 2023 27

Our Stakeholders

Section 172 (1) statement

In discussions and decision-making during the year ended 31 March 2023, the Directors of Turning Point have acted in the way that is considered, in good faith, to be most likely to promote the success of the Company for the benefits of the people we support (recognised beneficiaries under company and charity law), with regards to all its stakeholders and to the matters set out in section 172 (1) (a-f) of the Companies Act 2006.

Our Stakeholders

The stakeholders of the organisation include the people we support, local communities, our employees, the purchasers of our services (public sector commissioners, businesses, and private pay clients), our regulators and our suppliers. Through active engagement, the views of stakeholders are gathered throughout the annual business cycle. A stakeholder framework has been developed to support with oversight of stakeholder groups and the material considerations of each group. This knowledge is considered when taking principal decisions throughout the year.

Strategy & Vision

The Turning Point Board met in November 2022 for focussed discussion on strategic matters relating to the new strategic period that commenced in April 2022. The charitable objects were reviewed in 2021 and updated to align with the new strategic period. The board regularly monitors and reviews the progress against the strategic intent through reports presented on operating and financial performance.

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Our approach to stakeholder engagement during 2022/23

The people we support

Communities and local partners

The Company is a registered charity and under charity law has beneficiaries to whom public benefit is delivered in accordance with the charitable purpose of the company. At Turning Point, we support over 171,000 people each year. We provide health & social care services in a number of markets, including the health, care, employment and criminal justice sectors.

Our engagement channels include:

Turning Point operates nationally, and our services are embedded within the wider community.

Our engagement channels include:

Outcomes of engagement:

Services work positively and collaboratively with partners in local systems and communities to meet the needs of their local population, improve access for under-represented groups and involve service users in improving services.

Outcomes of engagement:

For further details see Results of National Service user survey on page 55.

Environment

Due to the impacts of climate change, it is imperative that the Company has due regard to its activities and the impact these have on the environment.

Our engagement channels include:

Green Heart of Turning Point intranet site encouraging an environmentally conscious workplace.

Turning Point Annual Report 2023 29

Outcomes of engagement:

Environmental objectives are achieved through a clear policy and environmental management system. The Green Plan is approved by the board and sets out the commitment to minimising the impact on the environment from the business activities of the organisation.

Outcomes of engagement:

For further details see People report on page 62.

For further details see Environment and energy reporting on page 89.

Our people

At Turning Point, we are a team of over 4,800 people; our workforce is made up of employees, peer mentors and volunteers, spread across 280 sites and supporting over 171,000 people a year across England. We rely on our people to deliver health and social care outcomes under contract to commissioning authorities and other organisations. We encourage effective and open communication at all levels within our organisation.

Our engagement channels include:

Principal Decisions in 2022/23

For each matter that comes before the Board of Directors, the board considers the likely consequences of any decision in the long term, identifies stakeholders who may be affected, and carefully considers their interests and any potential impact as part of the decision-making process.

The board made the following principal decisions during the year:

1 The appointment of Dawn Kenson as a nonexecutive director on 17 January 2023;

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TurningPoint l AnnualReport 1 2023 1 31 1 PROGRESS AND IMPACT

32 Turning Point Annual Report 2023

Despite the challenges of 2022/23, the people we support, our teams and our services have continued to thrive. Existing services have reached new people in new ways, while new strategies and partnerships have allowed us to expand our reach to address unmet need in new areas.

With our new strategic goals as a guide, we share in this section some of the progress and impact we have made over the last year. Although activity may sit under a specific heading here, much of what we do applies to more than one goal at a time.

Strategic Goal

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1
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Support people to improve their health & wellbeing and bring about positive change in their lives

There are many ways we actively support people to improve their health and wellbeing. In this section we share details of some of the services we deliver that do just that.

This forced us to think differently about how peer mentors could share their lived experience and be visible examples that recovery is possible. As an organisation we adapted our approach, offering peer mentor learning online and developing remote interventions for the people we support to access peer mentors both online and on the telephone.

The last year has given us the opportunity to reflect on what worked and what did not; what we want to do more or less of; and to continue to develop some of the innovations we piloted during the pandemic. This includes online peer support groups, outreach, telephone support, and video content.

We provide an update on our peer mentoring work and new electronic tools that help support planning. We outline new ways of delivering social prescribing, ways in which we’re helping to end the need to sleep rough, and our new strategy to combat blood-borne viruses.

Slowly and steadily, we have seen the return of in-person peer mentoring across Turning Point and are excited to see the scheme continue to develop in the year ahead.

We also hear from Simon and David, with their personal experience of bringing positive changes to their lives.

The unique role that our peer mentors play

Deb Hussey, Turning Point Safer Lives Lead: ‘People with lived experience can provide unique insights into the issues that affect both themselves and their peer group, they can provide a connection to the communities we want to reach and an understanding of what interventions will be acceptable and successful. Daily I see the rapport that peer workers have with people we support and the unique and trusting relationships they build.’

The pandemic had a huge impact on peer mentoring, as it did on many other areas of health and social care services. Social distancing measures and health vulnerabilities meant peer mentors were unable to continue volunteering in person in our services.

Turning Point Annual Report 2023 33

CASE STUDY

David Turning Point Peer Mentor

Hello, my name is David. I am a Peer Mentor at Turning Point in Ipswich. I used to be a Service User at Turning Point in the past.

When I was a child, I struggled a great deal when I was at school. At primary school I was always on my own and tried to sit at the back of the class so nobody would notice me. I could never keep up with what the teacher was writing on the black board. When I moved up to secondary school this continued, and I become a victim of bullying.

When I left school, I worked on farms and did well at agricultural college. Socially I belonged to Ipswich Young Farmers Club and later joined East Ipswich Camera Club. I also used to go to night clubs when I was a young adult, but I only consumed very small amounts of alcohol. Alcohol was not a problem for me at that time, but I always struggled to make friends and struggled terribly when it came to girlfriends and relationships.

After leaving school I worked with dairy cows on various farms until I was in my late 20s. I then worked in factories until I went back to farming and worked on a couple of pig farms. The last job I had was in a meat processing factory, but I haven’t worked since then.

I got married when I was 42, but for all the wrong reasons. As a result, the marriage was a total disaster. I turned to alcohol to cope with those feelings and take those feelings that I couldn’t cope with away. I also made two suicide attempts as things got so bad during this time.

My marriage ended after five years with me being arrested for being drunk and disorderly. I spent the night in a Police cell. The next morning, I was admitted into a mental health hospital and stayed there for two weeks. At this point I was homeless, and the council found me a place in a Bed and Breakfast.

struggled to put drink down. After a while I started attending Turning Point as a service user. I attended various Turning Point groups including Introduction to Change, Recovery Skills, and the Pre-Hab group.

Turning Point found a place in Rehab for me, but I was asked to leave after four weeks because they said that I had Aspergers Syndrome (Autism) and struggled with group therapy sessions as a result. Turning Point then found another Rehab for me and this time I stayed for the full three months, but I still couldn’t stop drinking. I did some research into Aspergers Syndrome and Autism and I now have an NHS diagnosis of this.

I eventually managed to stop drinking. I have been sober since 17 January 2019 and haven’t had any alcohol since. When I was about two months sober, I had triple bypass heart surgery and a heart valve replaced. That’s over four years ago now.

In early 2022 I was offered a place on a course to train as a Peer Mentor for Turning Point. I completed my learning and once my enhanced criminal record check was done, I started mentoring.

I take a group called the Engagement Group now. I hope to continue this role in the future. I am also hoping to represent Turning Point in a Peer Mentor role at Woodlands, which is a mental health hospital in the grounds of Ipswich General Hospital. Turning Point are currently developing some dual diagnosis learning, and due to my own diagnosis of Autism, I am also hoping to contribute in this area as well.

It wasn’t long before I resumed drinking alcohol and started getting arrested for being drunk and disorderly again. Another consequence of my drinking was several visits to A&E normally by ambulance. In 2015 I lost my driving licence for drink driving. This was devastating for me, and I started going to Alcoholics Anonymous meetings, but I

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CASE STUDY
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Nourish: Using technology to enable happy, fulfilled lives

In 2022 the digital support planning tool, Nourish, was rolled out in seven of our homes. The introduction of Nourish across our learning disability support services enables us to spend less time updating time consuming paper records, and instead spend more time with the people we support.

What is it?

Nourish is an electronic tool accessible to staff via a computer or mobile device. It securely holds digital records for the people we support, allowing them to be updated in real-time without distracting from provision of care and support. Nourish also contains other tools to support care and improvement of outcome and experience for the people we support.

How does it help us?

Nourish helps us to create and keep all records and support plans for individuals in one place, instead of maintaining lots of records in multiple locations. However, Nourish is not just about making our records accessible electronically. It helps us to record information at the point of support, involving the person and facilitating truly personalised support planning.

Giving people’s support teams and their circles of support better visibility and evidence of care and planned activities, helps improve safety for everyone by identifying risk and preventing incidents.

The system notifies us when an action is needed, helping to ensure people are supported to attend all their health appointments and activities.

Simon’s love of swimming

Simon, who is supported by Turning Point in Bradford, has a learning disability and a physical disability, as well as being registered blind. Simon used to go swimming with his cousin when he was younger, and since COVID-19 restrictions have ended, they have started going swimming together again.

Colleagues at the leisure centre who observed Simon said he had the best time. They commented on the fact that Simon had the biggest smile on his face, he was so relaxed that he looked like he could fall asleep! They said it was clear by his facial expressions and body language that he was having a great time, and even when Simon returned home it was clear how much he had enjoyed himself. These are now going to be regular sessions for them both.

Nourish helps us to create and keep all records and support plans for individuals in one place

Linking the outcomes of people’s monthly Happy and Healthy Wellbeing meetings to any identified needs in their Health Action Plan, as well as their annual GP Health checks enables our teams to support people to live the healthiest life possible.

Turning Point Annual Report 2023 35

Specialist Social Prescribing in Birmingham

In 2021, Turning Point and Our Health Partnership (OHP), a GP partnership working across Birmingham and Shropshire, developed and launched the UK’s first specialist social prescribing service, serving a total patient population of over 200,000 across 29 surgeries.

The difference between this specialist service and other social prescribing services is the enhanced support on offer for vulnerable groups and people with complex needs who often face chronic discrimination and exclusion. This can include sex workers, those struggling with substance use, acute mental health issues and or homelessness.

Turning Point’s Specialist Link Workers work collaboratively with statutory and community organisations across Birmingham, including existing link workers. The team works with an individual for three to six months, visiting them in their own home and attending appointments with them, with a particular focus on ensuring they are getting the right support from specialist services.

As much as they want to, GPs are often unable to spend enough time with this cohort of patients. The specialist social prescriber role bridges the gap, reduces GP caseloads, and frees up clerical colleagues time by updating records directly.

Between October 2021 and September 2022:

the service supported over 580 people to engage with a huge variety of specialist services.

“Both anecdotally and in outcome data, it was clear that they were making an impact in a seldom heard cohort of patients. They are now supporting patients with a range of complex problems including life

events, domestic violence, alcohol-abuse, antisocial behaviour, physical disability, benefit related issues, homelessness, compensation, and eviction etc., and participating in MDTs with service users and other ARRs (Additional Roles Reimbursement scheme). The service overall is proving to be useful in alleviating health inequalities in our PCN.” Dr Phil Saunders, GP and Clinical Director at Quinton and Harborne Primary Care Network (PCN).

The service has proved successful in improving overall patient outcomes across all partner PCNs with 74.9% of people referred to the service achieving increased scores from most recent reporting[10] .

“The Social Prescribing Service is proving to be very beneficial and a great way to improve the lives of many vulnerable adults.” GP, Weoley Park Surgery

A 33-year-old male who suffers from severe epilepsy, frequent seizures, and deteriorating mental health, needed support around housing issues and a Personal Independence Payment (PIP) claim. One of the specialist link workers met him face-to-face as he struggled to communicate over the phone due to a poor concentration span and frequency of seizures. They contacted the Department for Work and Pensions with his permission, and it emerged that they had records of his claim, but it was with the third-party assessor, ATOS. The specialist link worker requested a three-way telephone assessment and as a result, he was awarded PIP and £4,000 arrears.

Another person was referred for support with his immigration status, as he was at risk of persecution in his home country and wished to claim asylum. He was also contacting a local GP biweekly with suicidal thoughts. The link worker wrote to the local MP who agreed to write to the Home Office to request an urgent interview. Once the interview date was received, the link worker helped him to collate supporting evidence to open a bank account and to enrol at a local further education college. In April 2022 he was granted leave to remain in the UK and has been referred to mental health services and is receiving treatment for PTSD (Post Traumatic Stress Disorder).

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Ending rough sleeping for good

Turning Point played a central role across the country as part of ‘Everyone In’; the joint Government, local authority, NHS, and voluntary sector programme to provide rough sleepers with accommodation and to prevent homelessness during the COVID-19 pandemic. In 2022 the Government launched the next step - a new ambitious strategy ‘Ending Rough Sleeping for Good’. The strategy commits £2 billion of funding until 2025 for tackling and preventing rough sleeping. Turning Point is committed to playing our part in addressing homelessness and ending the need to sleep rough in every area where we operate.

So many of the homeless people that we support in our services changed their lives with the support of ‘Everyone In’. With a joined up and compassionate approach, linked to high quality accommodation and treatment, even people who had slept rough for many years moved into and kept accommodation.

To respond to ‘Ending Rough Sleeping for Good’ we developed a new approach by ensuring that every plan we do with every individual is joined up with housing and health care. We have received funding from the Rough Sleepers Drug and Alcohol Targeted Grant in 12 areas of England to provide specialist substance use treatment for homeless people. This grant is an acknowledgement that to address homelessness, the integration of housing and health care treatment, including substance issue treatment, is essential.

In 2022/23 we have delivered specialist services funded by this grant in the City of London, Hackney, Westminster, Oxford, the Royal Borough of Kensington and Chelsea, Wiltshire, Rochdale, Oldham, Leicester, Somerset, Hereford, and Slough.

In the City of Westminster, we have also developed a specialist pathway to work with Spice. Spice is a synthetic cannabinoid that is a particular issue preventing some homeless people from being able to settle in and maintain accommodation. The service provides both outpatient treatment as well as access to residential detoxification.

Ambitious plans for eliminating bloodborne viruses (BBV)

This year has seen excellent progress within services for the provision of BBV testing. In total, 6,476 dried blood spot tests (DBSTs) were conducted across our drug treatment services.

Services have been implementing our Hepatitis C Strategy to ultimately achieve micro-elimination by the end of 2023. The strategy of micro-elimination is based on targets set by NHS England to ensure people accessing services are offered a hepatitis C (hep C) test, with the majority being tested and starting treatment if their test result is positive.

As a result of our commitment to eliminate hep C as a major health concern, services have participated in a range of events including World Hepatitis Day and National HIV Testing Week, as well as local events throughout the year. For example, an event in our Rochdale and Oldham active recovery service achieved 60 DBSTs in one day. Currently we have four services that are on track to achieve micro-elimination in less than 6 months.

In October 2022, Turning Point participated in the NHS England Needs Assessment Project, supporting our local Operational Delivery Networks (ODNs) to achieve the required testing targets. Some services completed an exceptional number of tests, particularly City and Hackney (174 tests in the six-week project). The project has provided useful data across the country, aiding in creating an accurate and up to date picture of hep C.

To support all the fantastic work, we have maintained excellent relationships with our ODNs and peers at the Hepatitis C Trust. Having clear referral pathways and effective joint working that meets the needs of people we support has enabled us to engage over 390 clients who are positive for hepatitis C into specialist treatment.

This year also saw the launch of the Turning Point HIV Strategy. The strategy was collaboratively written by a range of people living with HIV both from within Turning Point and externally. It aims to ensure all services provide a safe space in which clients and colleagues can discuss HIV, people accessing the service can receive advice and HIV testing, and there are clear referral pathways so every person who tests positive for HIV can access treatment and support.

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Strategic Goal

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Seek to reach more people and provide support at the earliest opportunity

Building on almost 60 years’ experience of delivering health and social care services, we continue to design and deliver new services, in new ways, to the people who need them most.

Livelife, Rightsteps, Fibroscan, our Resilience young person’s service, and the further development of our Dual Diagnosis learning, are examples shared of how we seek to support people at the earliest point possible.

Introducing livelife online payment and launching couple counselling

This year livelife changed its assessment process to improve access and customer experience. This was a significant operational, marketing, and technical project, and reduced the number of people not attending their assessment. The change also allowed us to introduce a new Financial Services Authority (FSA) compliant payment solution that greatly improved the customer experience.

The new approach was implemented in January 2023 in conjunction with a new offer of Couple Counselling. Delivered by British Association for Counselling and

Psychotherapy qualified therapists with specific learning in couple counselling, the service provides a space for partners to share wants and needs in a relationship, with an explicit aim of trying to improve the experience of the relationship for both people.

Both the new payment process and new Couple Counselling service have now successfully been implemented and incorporated into the website and other marketing materials, putting us in a far better position to reach more people looking for support.

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Evolving our mental health and wellbeing employer support

The world of workplace mental health and wellbeing has been transformed over the last three years, with the pandemic bringing employee mental health to the forefront of employers’ priorities.

Whilst some leading employers had already started their wellbeing journeys, for many this has represented a new area of focus, driven by a desire to meet their employees’ needs and to ensure they are able to compete for and retain talent. This is a process of discovery for organisations, understanding what their employees needs really are and how to best meet them; both internally through changes to the working environment, culture, and practice, but also through the engagement with trusted experts Rightsteps.

During the last year we have continued to see strong engagement with Rightsteps products and services. Our online support has been used over 36,000 times with most people engaging with our early interventions, developing their self-knowledge, and discovering how they can best manage their own health and wellbeing. At the same time over 950 people have accessed in-depth therapeutic support with Rightsteps, exploring the challenges they have experienced with the guidance of our team of dedicated therapists. We also supported people through our Mental Health First Aid Group and one-to-one support, as well as those who attended our webinars.

A new development for Rightsteps has been the delivery of consultation services for organisations, directly helping them to understand and define the wellbeing-related challenges facing their organisation and then working collaboratively to co-design bespoke solutions that can meet their specific needs. This has resulted in new models of delivery that utilise our organisational skills and experience in new ways, engaging with groups of individuals whose needs would have otherwise gone unmet.

We have also written several workplace guides, on the menopause and managing Winter Pressures, which have proven helpful to organisations seeking to take steps to best support the wellbeing of their workforce.

Our Resilience service: helping young people build positive relationships

Over the last year, our Resilience wellbeing service in the London Borough of Hammersmith & Fulham has demonstrated a significant impact with young people, helping them to improve their relationship with substances, as well as their sexual health and navigation around relationships.

Most young people are initially referred into our service by other professionals and most of the young people decide to continue with the creation and completion of their bespoke care plan.

80% of young people come to the Resilience service with substance use issues.

92% of young people left the service having achieved their personal aims. These aims are led by the young people themselves to ensure the care plans created are directly linked to their own interests and motivations – whether that’s focusing on hobbies, career paths or other passions.

Working closely with their personal relationships and exploring sexual wellbeing in the context of supporting with their substance use aims has proven to be useful, with 70% of those engaging in substance use support also working on sex and relationship goals simultaneously.

The feedback gathered from the young people engaging with the team indicates they value the ability to address both areas of their life in one place with a consistent practitioner, rather than experiencing a potential barrier of needing to form a new rapport with a different service to speak about the interlinking topics separately.

Turning Point Annual Report 2023 39

Developing dual diagnosis learning to support health and social care professionals

In the early 2000’s the term dual diagnosis (meaning the co-existence of harmful substance use and mental illness) rose to a level of prominence in the UK’s health and social care system. Many initiatives were set up to attempt to align drug treatment and mental health and social care, to stop service users from falling through the gap between existing services. At that time, Turning Point published a toolkit which was used nationally for practitioners to understand the relationship between the two conditions, with useful tips on how to work with this cohort.

We also established the All-Party Parliamentary Group on Complex Needs and Dual Diagnosis, ~~to raise awaren~~ ess of the challenges facing those with dual diagnosis with policy makers.

From 2009 onwards, in part due to austerity and evolving commissioning priorities, much of this work was withdrawn, and services largely became siloed again. Over the next decade virtually no research, development or learning was carried out worldwide, although the issue persisted.

Early identification of liver disease

Alcoholic liver disease accounts for many alcoholspecific deaths. A Fibroscan is a simple and noninvasive procedure used to accurately assess the health of the liver and helps identify poor liver health at an early stage. It can be offered in the community and can extend service reach to people who have not previously engaged in treatment but who are at higher risk of liver disease, including rough sleepers, ex-military personnel, and those with poor mental health.

Turning Point has received funding for Fibroscan in some service areas, although all areas would benefit from offering this service. The earlier we can identify and stage liver disease, the earlier individuals can access the support they need to reduce alcohol-related harmful behaviour.

Our national alcohol pathway is being updated to include the offer of a Fibroscan exam at the earliest opportunity. Our ambition is to offer Fibroscan to everyone who comes to us for alcohol treatment and to those already engaging with our services within the next 12 months.

In the summer of 2021, we updated our toolkit, and its launch showed there is a huge unmet need for information and strategies for working with this group. At the same time Turning Point was approached by a person whose daughter, who suffered from a mental illness and alcohol dependence, had died whilst in the care of another organisation. She recognised a lack of understanding of the issues that those who fall between services face and provided funding for us to commission some dual diagnosis learning.

A small working group of Turning Point experts developed an online learning platform to teach the basics of dual diagnosis, together with basic strategies for working with this group of people. This e-learning is about to be published and will be offered both internally and to the wider health and social care sector as a free resource to try to bridge the gap between mental health and substance use services.

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CASE STUDY

Using FibroScan in Leicester

The use of FibroScan technology by the Turning Point Leicester City service was initially funded by Leicester City Council with the aim of increasing the number of residents accessing alcohol treatment and to support positive behaviour change, to reduce harmful drinking behaviour. Funding has been initially agreed as part of an eight-month pilot with two specific cohorts:

the scan were referred to Hepatology, 28 had a liver stiffness higher than normal, five had a score indicating advanced Fibrosis and 16 had scores indicating cirrhosis of the liver.

2 Offered to registered patients within a pilot primary care GP site (Saffron Group Health) who are identified to have potential alcohol dependence but are ambivalent/ reluctant to engage in treatment. During the same period, 55 patients from this group were offered FibroScan exams. 11 (29%) had a liver stiffness higher than normal and were referred to Hepatology, five had a score indicating advanced Fibrosis and one service user had a score indicating cirrhosis. Approximately 30% of patients subsequently accepted a referral and entered structured treatment with Turning Point.

Strategic Goal

~~3~~ Prevent the escalation of need and reduce demand on the wider health and social care system

As well as delivering the right services in the right locations for the people referred to us, we take our role in the wider health and care system very seriously.

By recognising sometimes hidden needs, intervening early, providing a range of personcentred support and a broad range of effective interventions, we seek to prevent the escalation of need and reduce demand elsewhere. Our focus on safer lives and reducing alcohol and drugrelated deaths is a key aspect of this work.

In this section, as elsewhere in this report, we also detail how our work helps ease pressure on GPs, A&E, mental health hospital beds, the criminal justice system and over-stretched housing provision.

Turning Point Annual Report 2023 41

Evolving our crisis services in Manchester

GMMH have recently commissioned us to provide a ‘Crisis Navigator’ colleague every evening to be based in Manchester Royal Infirmary’s A&E department with the Mental Health Liaison Team (MHLT). The aim of this project is to test out the viability of having experienced non-clinical support colleagues working alongside and in partnership with the MHLT in a busy A&E.

In Manchester, the team at our long-running Crisis Point service has continued to build on our reputation for being a trusted partner to the Greater Manchester Mental Health (GMMH) NHS Trust.

Crisis Point is almost 25 years old, and as well as providing seven beds for short-stay accommodation in Manchester’s city centre for local people going through a mental health crisis, our team has successfully established The Recovery Lounge – also funded by GMMH.

For many people who find themselves in crisis and then having to attend A&E, a non-clinical and therapeutic intervention is safe and appropriate, and this pilot project is aiming to find out if by having one of our ‘Crisis Navigators’ on site, that the appropriate support and intervention can be quickly arranged and delivered using local voluntary sector resources, without the need for a hospital in-patient admission or other more traditional and formal interventions.

This new service is based on the ‘crisis café’ model of offering a non-clinical alternative to A&E for people in crisis, and already well over 1,000 interventions have been delivered. As well as building a good relationship with GMMH NHS Trust, we are now working with Greater Manchester Police and taking referrals from their city-centre based officers who have been called out to incidents that are low level mental health crisis and don’t require police resources.

It is hoped that if the pilot goes well, that this model will be rolled out to MHLTs in many other Greater Manchester Hospitals, and it has the potential to free-up significant NHS resources in our very busy and over-stretched A&E departments.

Expanding Talking Therapies in the local community

During 2022/23, Wakefield Talking Therapies and Total Wellbeing Luton received a total of 20,500 referrals of which 15,144 entered treatment. The average wait time to be assessed was 5.9 days, which engages people accessing our services quickly and as a result the average recovery rate for both services for the year was 52.3%. Satisfaction was also high at 91.2% in Luton and 95% in Wakefield, which is excellent.

including a workshop co-delivered with clinical health psychologists and guided self-help group - as we are aware the long-term impact that this can have not only on physical health but mental health too.

Meanwhile, the team at Total Wellbeing Luton have been focusing on culturally adapted cognitive behavioural therapy (CBT) to meet the needs of their population and to improve access to psychological therapies for black and people of colour (BPOC). Evidence has shown BPOC clients are often underrepresented in primary care mental health services yet are over-represented in secondary care mental health services. The service identified understanding different cultures as crucial to improving access into the service. Culturally adapted CBT learning looks at language and metaphors of specific cultures, with the aim of improving access to client groups. The team are encouraged to look and understand these factors when interacting with clients and possible implicit biases that they may hold. Bedfordshire University have been funded to provide an evaluation report.

Over the last year the Wakefield team focused on developing procedures to prioritise parents of children up to two years after birth. This included new perinatal and breastfeeding procedures and the introduction of several new workshops that are co-delivered with specialist midwives and health visitors. We also have two new groups around postnatal wellbeing and overcoming anxiety in pregnancy. As a result of this work, the service has now established a perinatal clinic which allows direct referral to perinatal assessment and allows them to access the service quickly.

In addition, the Wakefield service has worked with the local NHS Trust to set up a long COVID-19 hub –

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Co-creating supported living spaces in Stafford

2022 saw us expand our geographical reach in Mental Health support with an exciting new project in Stafford. In October Turning Point was commissioned by Stafford Borough Council and the Department of Levelling Up & Communities (DLUC) to deliver a project that will support entrenched rough sleepers with complex needs, to become increasingly engaged with enablement, treatment, and recovery- focussed services.

The project comprises two workstreams: development of a six-bed ‘high need’ supported accommodation service, which will be occupied in July 2023, and a co-production project.

The goal of the project is advancing mental wellbeing, moving towards substance abstinence, increasing physical health and safety, whilst achieving betterment in financial and housing tenure security.

The six-bed supported living service will provide high quality accommodation for a targeted population of individuals with a history of rough sleeping, mental ill-health, problematic substance use, behaviours that are often classified as challenging to services and, in many cases, offending behaviours and early childhood trauma.

Our client group have previously had multiple housing opportunities which have not enabled them to escape the revolving door of repeat homelessness. Many will have developed coping strategies which were helpful to keep them safe when living on the streets, but when in an accommodation service are considered ‘anti-social’ and have consequently resulted in eviction and disengagement from support.

This experience has often resulted in an understandable lack of trust in ‘the system’ and professionals and, in some cases, an entrenched reluctance to engage with different services which are designed to assist them to improve their circumstances.

The role of the Turning Point team is to support individuals with rebuilding bridges to previously accessed services. Our vision is to deliver a completely different approach to supported living, which builds on people’s strengths and maximises buy-in and co-production from the very beginning. We work in partnership with other agencies; engaging with people in a way that builds trust and makes sense to them, meeting them where they are on their journey.

The service is built with the input and direction of the people that will reside there at its heart. The service is staffed with a high skilled, highly motivated team who have received enhanced learning in mental health and substance use. They will work in a trauma informed, person-centred, whole person, multi-agency manner with tolerance levels much higher than similar services.

The team will work together with people who have been or are currently experiencing homelessness and other organisations with expertise, to shape Stafford’s homelessness strategy and services by 2025. The aim is to build a community where those with direct experience of rough sleeping is as powerful as it can be, has genuine impact and brings about sustainable change.

Turning Point Annual Report 2023 43

Reducing barriers to moving on in Manchester

The Manchester Move On Project went live in August 2022. The pilot brings together the expertise of a multi-disciplinary team all under one roof to support people with mental health conditions living in supported accommodation services who are either:

At risk of their existing placement breaking down.

The service works with individuals, their families and carers, service providers, Community Mental Health Teams, and commissioning teams to identify and seek to overcome the barriers facing individuals which may prevent them from progressing in their lives. The overarching aim of the team is to support a smooth transition along the recovery pathway based on the needs of the individual. This aims to prevent and reduce the length of hospital admissions, ensuring that appropriate plans are in place to enable individuals to stay well and participate meaningfully in their communities.

The team comprises specialist clinical, social work, occupational therapy, housing and welfare and psychology expertise to formulate and deliver time-limited support plans seeking to move people forward on their recovery journeys.

Feedback from those engaging with the service indicates that they enjoy the opportunity to participate in their long-term care and support planning. Providers are appreciative of access to the experience and expertise of the multi-disciplinary team. We are hopeful that the pilot will be extended and continue to form an integral part of the mental health services framework in Manchester.

Providing mental health treatment requirements in Somerset

A Primary Care Mental Health Treatment Requirement (MHTR) is a psychological intervention (non-medicating) provided in the community. It is a sentencing option given by the Courts for eligible individuals who suffer from low to medium mental health problems, and can be combined with other Court ordered interventions, including a Drug Rehabilitation Requirement (DRR) and an Alcohol Treatment Requirement (ATR). A Primary Care MHTR can help with issues such as sadness, mood swings, drug or alcohol use, feelings of hurting yourself, relationship issues, anxiety, panic attacks and stress, anger, and low self-esteem.

We were awarded the Somerset contract which began in April 2022 and the North Somerset part of the service began in April 2023. The new combined service has been commissioned until 2025 and has a Clinical Lead (Forensic Psychologist, Kate Dinning), two Senior Assistant Psychologists, five Assistant Psychologists and five Peer Support Workers.

Kate Dinning, our Clinical Lead for the service has been asked by the Ministry of Justice to assist in the preparation and delivery of learning materials on MHTR to the judiciary on a national basis.

The service has been well received by people using it. Jake (not his real name) has said multiple times that he feels a “big difference” in himself since starting the MHTR and has a more positive outlook in general. He is also looking at starting private counselling/ psychotherapy after the MHTR ending due to his positive experience (which he admitted he wouldn’t have even considered doing before).

We were awarded the Somerset contract which began in April 2022

Supporting our neurodiverse colleagues and clients

Turning Point services support many people who are neurodivergent and over the last 18 months, there have been several significant improvements made to our services.

The process started with the creation of the Autism and Neurodiverse Allies Forum. Around 90% of the membership are either colleagues who are autistic, have additional neurodiverse support needs, or have lived experiences through their children or immediate family, friends, and wider family members. We also have an autism lead and there are autism and neurodiverse allies in all Turning Point substance use services.

All colleagues complete the mandatory autism awareness learning regardless of their role within the organisation and are also offered advanced autism in practice learning. All substance use services are required to complete the autism friendly standards. Some people with autism can experience severe difficulties with the world around them including ‘unfriendly’ environments. The effect could be anything from a person having mild discomfort to symptoms of acute pain and deterioration in functioning. If the environment is distressing for the person this may stop them from accessing it.

Our autism standards are broken down into four sections: First is the physical environment (building and rooms). The second is colleagues understanding. Third is the support we provide people accessing our services. The fourth focuses on family and carers. Once completed we can look at any actions and consider any reasonable adjustments needed.

We’ve also adapted our initial paperwork across substance use services, including referral and assessment, to ensure we are asking the right questions around autism and neurodiversity from the very start.

Finding new ways to support sexual health and wellbeing

January 2023 saw the SASH (Support and Advice on Sexual Health) team host their first Mpox vaccination event at Teds Place in Soho. SASH is a partnership led by Turning Point, alongside NAZ, London Friend, METRO Charity and Marie Stopes UK. The service provides free, non-judgemental, and confidential support on sexual health, relationships, and mental health. Teds Place is a long-running gay venue hosting men-only nights, as well as nights for transexuals, gay men & their admirers.

Twenty individuals attended the event between 8.30pm and midnight, all had a sexual health discussion and fifteen received the Mpox vaccination. Of these, three were having their second and the other 12 having their first. Three of the five who didn’t have the vaccine reported to already having had it, with just two not keen on the idea of the vaccine but still happy to discuss sexual health in general.

All really liked being able to access our support at Teds Place, and many asked if we would be coming back.

Turning Point Annual Report 2023 45

Reducing harm in substance use

My name is Deb Hussey and I’m Turning Point’s National Safer Lives Lead. The purpose of my role is to support the development of Turning Point’s response to the increase in drug related deaths. It allows me to be part of our increased focus on harm reduction, an area I am extremely passionate about. A big part of my role is increasing Naloxone awareness, distribution and carriage, a lifesaving medication that can reverse an overdose of opiates.

One of the things I love most about working for Turning Point is that the knowledge and perspective my own lived experience has given me is valued and utilised. I see the involvement of people with lived and living experience as a key part of everything I do.

Our first Safer Lives Conference

On 30 November 2022, we welcomed around 100 delegates to our first Safer Lives conference, supported with an education grant from Ethypharm. Held in Birmingham, our aim was to bring together commissioners, public health officials, third sector organisations, the police, ambulance service and our partners in the sector to join in making a commitment to address the drug death crisis.

From across the drug and alcohol sector, colleagues from Change Grow Live, we are with you, Humankind and Cranstoun were in attendance, and it was inspiring to see so many people from different organisations coming together for a common goal.

At the start of the conference, Deb Hussey, Safer Lives Lead at Turning Point asked everyone in attendance to get trained and pick up a naloxone kit if they didn’t already have one. Turning Point colleagues provided this learning throughout the conference and by the end of the day had issued over 60 kits.

Speakers on the day included Professor Dame Carol Black, Independent Advisor to the government on drugs, Dr Ed Day, National Recovery Champion, and Pete Burkinshaw, Alcohol and Drug Treatment and Recovery Lead at the Office for Health Improvement and Disparities (OHID). The conference gave us the opportunity to reflect on where we are as a sector, what the future may hold and listen to examples of innovative practice in naloxone distribution from colleagues.

Professor Dame Carol Black reflected on the progress made in the year since she published her report on the sector. She reminded us that

I was recently part of a co-production project in Somerset, working alongside a group of five people who currently use Turning Point services. The project was to look at the barriers to carrying naloxone and to develop solutions to overcome those barriers. The priority for the group was not, as we had expected, to find solutions to make carrying the kits easier, but rather to challenge stigma with a public awareness campaign.

For me this highlighted why it’s vital we put the people we support at the heart of what we do in designing any interventions aimed at them. Not only were this group able to bring their unique understanding to the project, but they were also able to see that their input was valued and through the finished materials, brought to life.

the current economic uncertainty means we need to be “bold, determined, and innovative.“

The most moving presentation of the day came from Abigail Kearley, Turning Point’s National Involvement Lead. She spoke on behalf of Julie Rose, a mother who tragically lost her son to a heroin overdose. On a day when we were presented with a lot of statistical information this was a powerful reminder of the real people those numbers represent.

Julie McCartney and Lauren Sloey from the Scottish Ambulance Service discussed their role in widening the provision of naloxone and George Charlton spoke about his own experiences of childhood trauma and drug use, the discrimination experienced by people who use drugs and how this led to his development of multiple peer naloxone programmes.

Our aim for the day had been achieved. We had come together; shared learning and innovation and all left with ideas and inspiration to carry forward in our work. Two clear messages stood out from the day: The importance of collaboration and the sharing of knowledge, and the need to collaborate with those who are best placed to get naloxone to people furthest from treatment services, to reduce these tragic and avoidable drug deaths.

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Strategic Goal

~~4~~ Create enduring value for communities and society as a whole

Under the heading of our final goal, we share examples of how we are creating enduring value for the communities we work in, as well as for society.

All the examples shared in this report, not just this section, demonstrate the personal and social value our teams deliver daily, through empowerment, leadership, innovation, and investment in the form of our Community Innovation Fund and Ted’s Fund, both detailed below.

Launching the Turning Point Community Innovation Fund

The Turning Point Community Innovation Fund builds on the success of our national Innovation Fund launched in 2020. This year we made the decision to welcome applications from external community groups and organisations, based in areas where we are located, who are connected to us and share our values and goals. The fund is still open to all Turning Point employees with a key sponsorship role for our senior managers who support and enable teams to bring forward ideas.

The new scheme provides seed funding to support innovative projects that will:

Turning Point Annual Report 2023 47

Beyond the projects themselves, the scheme aims to showcase the great work people are doing in our communities, celebrating their success, driving feelings of recognition and appreciation. This year’s projects at a local level have included:

No Booze Cruise

This project took a group of friends and family members of the people we support in the Drug and Alcohol service on a riverboat cruise on the Thames. Feedback included: “I would just like to say how great the No Booze Cruise was. It was extremely well organised and superbly run. It was nice just to sit a talk to others in the group without other pressures intruding on the conversations. It was the best day out I have had for years.” Family member.

Community Sewing Project

This project in the London Borough of Hammersmith & Fulham was developed by the Eritrean Social Community in partnership with a women’s community group called The Bridge and a local Community Champion. The project set out to teach local women sewing skills and create a safe space for connection and building new friendships.

Together Again

The project aimed to engage isolated migrants, refugees and asylum seekers living in hotel rooms in the local area to come together through music, art, and therapy to promote greater wellbeing. Participants co-designed creative outputs together in a safe, sensitive, and secure environment. Feedback included: “It is the first time I see x and x in a group situation since I met them many years ago. It has been amazing! They don’t ever want to be with others. X does not even want to talk to any other member of colleagues other than me. It is great that she finally came”.

Making Teds Fund more readily available for the people we support

For the past few years, we have run Ted’s Fund, named after Ted Unsworth, who was Chair of the Turning Point Board from 1987 to 1995 and Chief Executive from 1998 to 2001.

Sadly, Ted passed away in 2013, and to honour his commitment to Turning Point and the crucial work we do, Ted’s family established a fund in his memory to help the people we support take a key next step in their lives. The fund exists to help people we support with their next steps in their journey. The fund focuses on individual needs and is open to all people we support at Turning Point.

Past applications have included:

Whereas Ted’s Fund used to run twice a year (once in the summer and once in the winter), it now runs constantly throughout the year. To help more people when they need it, nominations and awards are made monthly. Together with a new eligibility cap of up to £200 per individual and up to £500 total for the month, this enables the fund to go further by creating more opportunities for the people we support.

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Launching the Writing for our Lives poetry book

In March 2023 Turning Point launched a series of inspirational poems and illustrations, from people with experience of mental health or drug and alcohol problems. The book is titled, Writing for our Lives and aims to shine a spotlight on the role that expressive arts can play in the road to recovery.

Jody Lee, also known as The Skinny Poet, has shared several of his poems in the book. He appeared on BBC Radio 4’s the World at One to promote the book and explained how writing kept him “connected” to part of himself during his 20-year struggle with cocaine and heroin addiction.

It helped me to manage a lot of my feelings.

Jody Lee

“From a very young age, I always loved storytelling. I loved reading. I would often just sit down quietly reading books and writing. And through my addiction, it was one of the things that really kept me connected to a part of myself. It helped me to manage a lot of my feelings. Helped me to express my feelings in ways I didn’t have to express them otherwise and to understand myself a bit better.”

Jody stopped using drugs through the support of Turning Point and used his talent as a poet to inspire others on a similar journey to his.

“As I came through recovery, I started to realise, right I need start sharing some of this stuff. So, when there were recovery festivals, any events, Turning Point very kindly ushered me in and I very nervously got up on stage, with my knees knocking, and read these poems and they went down well. I found out just how connecting it (poetry) was through addiction. You feel so isolated, so withdrawn from people. I was a heroin user. For years and years, I was completely isolated. But when I started to share my poems, people would come up to me and say, ‘Oh my God, I get it. I understand. This is my experience.”

Turning Point Annual Report 2023 49

Harm reduction in Herefordshire

Across Herefordshire and the surrounding area, we have developed a range of services, working in different settings with one shared focus: to promote and maximise the wider benefits of harm reduction.

One element of the service is utilising a mobile recovery vehicle (called Lance) to provide assertive outreach and deliver harm reduction (including needle exchange) to more rural areas where existing services are not available. We are also increasing Blood Borne Virus (BBV) testing to eliminate Hep C and have a mobile Fibroscan machine to screen people who may not otherwise attend a clinical setting. Not only does this service make testing easier, by bringing it closer to people, it helps identify those people who may not have been diagnosed previously, increases access to treatment and provides a greater opportunity for harm reduction advice, including discussions about injecting drug use, sharing equipment, and offering learning on injectable Naloxone and Nyxoid.

We have also begun to re-develop our criminal justice work, working alongside experts by experience to support engagement and deliver interventions that reduce the risk of continued criminal behaviour. We have worked closely with HM Prison and Probation Service in Wales to develop a new learning and recruitment pathway. The Prison and Probation Service offer an 18-week learning programme which prepares participants for working in health & social care through a series of sessions covering a range of topics, including psychological elements

of dependency, drug and alcohol awareness, naloxone/harm reduction, safeguarding, brief interventions, and Adverse Childhood Experiences (ACEs). We have worked with the prison to arrange licensing and transport to facilitate attending the service during working hours and maintain contact with the security and reception teams to ensure compliance with licence conditions.

In addition, we work closely with local housing and outreach services to support engagement with service users and provide effective treatment pathways to support engagement, reduce missed appointments and offer support in locations that are accessible and familiar. This supports a reduction in disengagement, missed appointments and issues with challenging behaviour resulting from trauma. The service monitors equality and diversity information as part of referral and assessment, ensuring that access to the service is available for people with a range of needs, including offering interpreting and translating services.

There is a significant benefit to developing greater opportunities for people with lived experience to gain learning and placements within local services. Investing in local recovery communities to develop harm reduction champions, promote volunteering and eventual paid employment help services ensure they can continue to meet recruitment challenges and invest back into service users who have completed treatment.

Enabling good health & wellbeing in local communities

Enabling good health and wellbeing of the people we support; our communities and our colleagues is integral to all the work we do at Turning Point. Many people we support are at a greater risk of poorer health outcomes compared with the general population, so this year we continued our focus on reducing health inequalities wherever possible.

Taking a place-based approach, we involved people we support to consider how we could best explore local need and direct our efforts towards reducing health inequalities where we can have the biggest impact. Working in partnership with other local providers to find joint solutions is essential as our services only form part of the picture of health and wellbeing for people we support.

Our intention is to develop systematic approaches to engagement, which can be utilised across the country, to identify priority health and wellbeing areas.

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EXAMPLE

Quality of life engagement at DAWS

In our Drugs, Alcohol and Wellbeing Service (DAWS) in London which covers three diverse boroughs, we took a social determinants of health approach by talking to 100 local people who already use our services. We carried out the engagement across 3 months (Jun - Aug 2022) and talked to them about what impacts on their quality of life in relation to their:

Living and working conditions

Social and community networks Individual lifestyle factors

We explored some of the factors that people perceive to impact on their quality of life and asked them to consider their top priorities. There was a clear theme of housing as an area of people’s lives that has the potential to create safety and stability or cause uncertainty and isolation.

“To have somewhere to live has a massive impact. Previously I had nowhere to live and my addiction got worse, mainly because you don’t have a base. Now I have a home and a safe place and can access what I need. I have no worry on finding somewhere

to sleep. If I lost the property now I would feel lost.”

People also told us of the impact good relationships with family and friends has on their lives, and how difficult it can be to make meaningful connections with new people when you are early on in recovery.

“I often feel quite isolated. I find it difficult to find friends and connect with others.”

“Having a connection with family, friends and the wider community helps me to stay abstinent. Keeping in contact with positive people motivates me to work on myself”.

This approach has shaped a local action plan which will develop over time, with continued input from the team and our community partners who can co-create joint solutions with us.

The Quality-of-Life engagement has started to be rolled out in a variety of ways across other Turning Point services and will be instrumental in developing future services.

Additional support for families and carers

As part of our range of support, we now offer a 5-step family intervention – a simple method of support helping family members affected by a loved one’s substance use. We provide this support in a range of ways including face-to-face groups, online and a newly launched self-guided digital version.

In addition to this, each substance use service offers unstructured carers support groups with open rolling access, facilitated by Family Workers and Family Peer Mentors. There are also several activities that have been planned locally including recreational activities and ‘pop up’ well-being sessions for family members.

In Somerset we are joining up our 5-step family support with talking therapies, where a therapist attends 5-step and carers support groups to offer carers assessments for therapy related to their anxiety, depression and/or stress.

In Wakefield we are offering family members several options from our talking therapies service, again providing a wide range of targeted mental health interventions for those with loved ones experiencing substance use and mental health issues.

Turning Point Annual Report 2023 51

Raising awareness of the health and wellbeing of those with a learning disability

During Learning Disability Week, (20th-26th June 2022) we launched our new Health and Wellbeing Handbook. The information within the handbook has been designed specifically about people who have learning disabilities and covers everything from healthy lifestyles to staying safe, emotional health, physical health, sexual health, and relationships. It is not intended to be a ‘how to’ clinical document but rather a resource to raise awareness and hopefully empower social care colleagues to work with the people they support to take steps to improve their health and wellbeing.

People with a learning disability generally have poorer physical and mental health than people without a learning disability and they die significantly earlier than the general population, from preventable causes. This does not have to be the case and demonstrates the significant health inequalities experienced by people with a learning disability.

To help tackle these issues, this guide was codeveloped by our teams across the breadth of the organisation and people we support, to help anybody supporting people with a learning disability, including friends and family members. It is a resource which will help carers ensure essential information is included in hospital passports and provide the knowledge to help make a positive difference to people’s lives.

People with a learning disability generally have poorer physical and mental health than people without a learning disability

CASE STUDY

Meet Paul

This year Paul has been on holidays to York and Blackpool which is the first time he has ever stayed in a hotel. He also attended college for a full year and went to his first ever Prom.

More recently, Paul started a volunteer job at the local community café. On his first day he was tasked with setting up tables for customers and chatting with them. After he finished setting up, he headed to the community garden to help with some weeding. Paul found himself enjoying every moment of his work. He loved the feeling of helping and being a part of the community.

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TurningPoint l AnnualReport 1 2023 1 53 1 OUR ORGANISATIONAL APPROACH

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Involving and engaging the people that we support

Our approach to involvement

Involvement is key to ensuring the high quality of service we provide. We aim for people’s experiences to be embedded in all levels and corners of Turning Point. By working together across all that we do, and enabling voices to be heard and have impact, we learn and grow, and the care and support we provide becomes the best it can be.

Involvement at Turning Point is a wide spectrum of ways people’s voices shape their support and our organisation. For us, it starts within individuals’ support planning, through to working together on ideas to improve and design services, and collaborating to decide what the support we provide should look and be like. Across all our involvement, we aim for it to be underpinned by the principles of co-production – creating environments of true and equal partnership, with all perspectives valued and insight and ideas able to have real impact.

We recognise every individual as truly unique and, of course, as having a wealth of possibility. The person-centred support we provide is central to enabling new possibility to be realised and is where involvement begins. It happens every day across our services – with the individualised communication and interactions between people we support and colleagues, and the strong and trusting relationships that are built and empower their voices to shape their own support.

Beyond this, involvement and co-production sees people’s voices shaping what the services they use look like. From feedback workshops and listening events, through to specific co-production projects to develop new initiatives and ways of working. There are a huge variety of involvement methods used that are flexible and inclusive to suit the needs and preferences of those we support.

In May 2023 we launched our “My Turning Point Experience” survey to understand how people feel about their support from Turning Point.

We asked the same six multiple choice questions of everyone who is currently being supported by Turning Point or who has been within the last year.

These survey questions were put together with people we support and Turning Point colleagues. Where possible, we encouraged people we support to complete it themselves or with minimal help, so they can be as honest as they want to be.

Turning Point Annual Report 2023 55

The people we support told us:

of the people we support 92.5% rated our service as good or very good.

of the people we support 92.2% feel they get the support that matters to them from Turning Point.

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93.7%
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of the people we support feel safe in the service they use.

Across the organisation involvement is growing, with the perspectives of people we support feeding into the direction of the organisation, positions we take externally and how we communicate, as well as our policies and corporate governance.

Our commitment to working in partnership with the people we support is stronger than ever - enabling their experiences and perspectives to be central to all we do. We are excited to further strengthen our ways of working over the coming year.

Our Somerset Drug and Alcohol Service embarked on a project which saw people we support come together to develop a campaign to raise awareness of Naloxone. Together, information to promote the use of the lifesaving drug was codesigned as well as the development of an app to provide information about where to access it.

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92.4%
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of the people we support feel listened to and well communicated with.

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89.6%
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of the people we support feel involved in decisions about their support from Turning Point.

Our new Stafford Mental Health Supported Living Service has begun – and will be fully co-produced with people with lived and living experience of homelessness. As well as providing new accommodation, the service will lead the co-production of new pathways, developed collaboratively with the local homeless community and a range of expert organisations and services.

Our Bradford learning disability services have an active People’s Parliament, bringing people supported in our different accommodationbased services together to have a voice in their services and in the community. The group has had real local impact, raising its voice to improve local disability services – including success in increasing local disabled parking spaces near to where the group meets!

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Young Peoples Services at Turning Point

The youth programmes within Turning Point’s substance use services continue to grow, improve, and develop. Our young people’s workers are passionate about driving the youth agenda and inspiring the young people we support to face their challenges, overcome their difficulties, and reach their potential.

Our services not only support young people with concerns about their own relationship with substances, but also young people who are struggling to deal with the impact of another person’s substance use. Whether that be a parent, sibling, or other significant person in their life, both these groups of young people present to our services with a range of vulnerabilities.

To meet these young people’s needs, Turning Point has committed to embedding the Thrive approach into all their youth services. For many, we find that their developmental needs have not been met and/ or are being impacted by their, or others, substance use. Using the Thrive approach, our young people’s workers tailor support packages, enabling them to repair the harm caused, and to optimise their emotional health and wellbeing. This can include clinical, psychosocial, and specialist harm-reduction interventions that build the young people’s resilience and enables them to make change.

We meet young people wherever they are most comfortable. Our youth teams are out in the community, offering targeted harm reduction, one to one and group work sessions.

The education and harm minimisation work we deliver in schools enables pupils to increase their understanding of the impact of drugs and alcohol, raises awareness of issues around gangs and county

lines and gives young people the knowledge they need to keep themselves safe. Learning sessions are also delivered to teachers; increasing their awareness and enabling them to consider a pupils substance use issues in an informed context; reducing exclusions.

An intrinsic part of youth work is multiagency working. Linking in with Youth Offending Services, Child, and Adolescent Mental Health Services (CAMHS), as well as many other services, our young people substance use workers bring specialist knowledge and expertise, working holistically and without judgement. An example of this is where we have Turning Point youth workers based in A&E departments on Friday and Saturday nights. Working together with doctors, nurses, and psych liaison teams, we can reach the young people accessing medical help at the point of crisis - young people that would otherwise slip through the net.

The need for more specific support for families with parental substance use treatment requirements was highlighted in the recent Government drug strategy, ‘From Harm to Hope’. Our youth teams, alongside our Turning Point family and carers and family safeguarding workers, are engaged in providing this support.

We are also delivering the Moving Parents and Children Together (M-PACT) programme. This is a whole family, structured support programme through which we can acknowledge the overlooked voices and experiences of children and young people and can improve the wellbeing of families affected by substance use. The M-PACT programme supports families to address areas such as communication and coping strategies; most importantly, it puts children at its heart.

Huggy Monster

A 10 yr old who attended one of our M-PACT courses, drew this picture of what addiction means to him- “Cute and cuddly and then turns into something terrifying”. (His mum was a heroin/ Crack user – she is now abstinent)

Turning Point Annual Report 2023 57

CASE STUDY

The Leicester VIP (Violence Intervention Project)

Instead of attending lessons, Sam, who is 13 years old, would turn up at school then turnaround and go missing for hours (or even days) without returning to the family home.

Sam has severe ADHD and was skipping lessons to commit violent and serious crimes. Exploited by older people, Sam’s prolific offending included robbery, burglary, and assault. Sam was a habitual knife carrier for both his own protection and to use if told to by others. His association with older criminals and frequent missing episodes meant the police and other professionals deemed him at risk of child criminal exploitation.

Sam was offered ongoing support by Turning Point’s Violence Intervention Project (VIP) team. Through engagement with the team, and now on medication to manage his ADHD, Sam has moved away from his offending behaviour and from the peers who led him into crime. He’s not been detained in custody and has adhered to bail conditions including a 7pm to 7am curfew, avoiding town and not meeting up with specific acquaintances.

wellbeing and confidence, and participation in sports including football and basketball.

Sam is back in education five days a week. He’s not in mainstream school but in an alternative education provision with smaller class sizes, more one-to-one support, more vocational subjects.

The VIP team checks in regularly with Sam’s family and has supported them to get relocated by the council. Sam attends face-to-face appointments either at home or in a local park with his support worker with whom he’s built a good rapport.

What has also helped Sam turn away from crime has been programmes including awareness about the impact of county lines and knife crime. Learning how to say ‘no’, the dangers of exploitation, and the consequences of using weapons are among the topics addressed.

Other breakthroughs for Sam include an improved relationship with his family, better mental

Remembering Richard at Turning Point Station Road

Richard lived at Turning Point Station Road and passed away at the end of 2022.

He moved into Station Road a couple of years ago after living in another home for years. Over time, we found out that Richard is from a family of farmers. When he was younger and mobile, he rode the horses and worked on his parents’ farm.

Since living in the care home, he didn’t have any contact with animals or horses but spoke about them a lot. The team tried to focus on his love of horses. Richard could

only be supported in bed, so Mary, one of the team at Station Road, arranged for a pony to visit him.

Lisa Prendergast, Manager at Station Road: “Richard had the biggest smile on his face. God knows what he initially thought waking up to a pony in his room! His brother and sister just happened to be visiting at the same time as the pony, and both were overwhelmed by the gesture.

Well Mary thinks they were, unless they thought the colleagues had gone mad!

It such a lovely, personal thing to be able to do for someone.”

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Celebrating the Platinum Jubilee together

While we look with sadness on the death of Her Majesty in September 2022 (where Turning Point observed official mourning guidelines), in June we celebrated the Platinum Jubilee of Queen Elizabeth II, marking 70 years since her accession to the throne in 1952.

Below are some photos and details of some of the jubilee celebrations that took place across Turning Point, shared with thanks to our colleagues who arranged, attended, and recorded the fun!

Birchwood Nursing Home

Cranham Lodge

“To celebrate the Platinum Jubilee, colleagues and people we support at Birchwood held a crown decorating competition, with three colleague winners and three resident winners personally chosen by Turning Point’s Chief Executive Julie Bass.

As colleagues and residents indulged in a selection of treats, they watched as Janet came into the communal lounge dressed beautifully as the Queen, shortly followed by manager Lisa and support worker Leanne who were dressed vividly and excessively in Union Jack attire - everything from a Union Jack dress, stockings, glasses, and a red, white, and blue wig! They all looked fantastic and were applauded by colleagues and residents whilst they announced the winners of the crown making competition.

“Her Majesty the Queen may not have visited Cranham Lodge in body, but she was most certainly here in spirit! The party was a great day for all of us as we celebrated her Platinum Jubilee.

We had a posh high tea fit for a queen - finger sandwiches, cakes, nibbles, and Eton mess, then Pimms O’ Clock where everyone all got a little merry! We had a lot of fun playing music from all the decades of the Queen’s reign, as well as a sing-along, dancing, and laughter as we waved our flags and wore bowler hats to celebrate. God Save the Queen!”

The celebration went well, beginning with a coffee morning and followed by afternoon tea. ‘The Queen’ presented the crown winners with their certificates and prizes and everyone played a game of Royal Bingo. It was a wonderful day!”

Turning Point Annual Report 2023 59

Community Celebration at Kensington Palace

“During the weekend of the jubilee, Turning Point helped support a Community Celebration at Kensington Palace, hosted by Historic Royal Palaces. As well as celebrating the Queen’s milestone, the event was about sharing the social value of heritage engagement and the themes of community, unity, and friendship.

It was supported through collaboration with Community Access Scheme partners who helped produce activities and entertainment, including Turning Point’s Innovation Fund.

There were 300 people pre-booked for the event and tourists and day visitors that turned up on the day were welcomed too. Thankfully, the rain held off on

We had a lot of fun playing music from all the decades of the Queen’s reign

Sunday and those in attendance had a brilliant time despite cool weather and grey skies. There was never a dull moment with a constant flow of activity, including Rangoli and bunting making, a scavenger hunt in the garden and talks on LGBTQ+ history led by young people. Feedback from attendees was immensely positive, with the tone of the event, the activities and the levels of mixing and connection all praised!”

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TurningPoint l AnnualReport 1 2023 1 61 | TURNING POINT CULTURE

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Turning Point Culture

‘Inspired by possibility’ is not just our tagline, it is at the heart of our culture.

As an organisation we continually strive to inspire our people, those we support, our stakeholders and communities to discover new possibilities. Having the right people with the right values, behaviours and skills makes Turning Point the organisation it is. Engagement, recognition and equality, diversity and inclusion are also essential components to ensure our teams feel valued, inspired, and empowered to be the best they can be.

Engaging our colleagues

At Turning Point, we promote a range of opportunities for colleagues to share their views.

Our Speak Up listening channel is always open for direct feedback, and our Viva Engage communities provide space to connect, ask questions and interact with people from every service and specialism. Our company-wide Viva Engage community received over 140,000 engagements over the course of the year, with messages read over 366,000 times. An average of 80 messages per colleague.

A more formal opportunity for feedback is our annual Colleague Engagement Survey, which collects thoughts, feedback, and ideas to enable us to continuously improve. In October 2022 70% of those working for Turning Point responded to the survey, with almost 2,500 colleagues sharing their views.

The 2022 survey enabled us to further review the progress we have made since 2021. We saw improvements in engagement across many areas:

Top scoring statements

Largest improvement

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90%
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85%
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82%
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I understand how my role contributes to achieving Turning Point's outcomes.

I trust and respect my manager/supervisor.

People here are treated equally irrespective of ethnicity, gender, disability, age, sexual orientation or religion.

+7%

Bullying and harassment is taken seriously by this organisation and there are effective mechanisms for dealing with it.

+6%

I feel my contribution is valued.

+5%

I believe that Turning Point takes reasonable steps to ensure the physical and psychological safety of employees at work.

Turning Point Annual Report 2023 63

For the first time, all managers received direct access to their anonymous engagement survey results through the availability of a digital dashboard, enabling teams to create bespoke action plans. This investment in technology helps us to continuously improve transparency and trust across the organisation.

Long service

Between April 2022 and March 2023, 305 Turning Point colleagues celebrated long service milestones of five years or more, with 45 people achieving more than 20 years’ service. One person even reached the 40-year mark.

Inspired by Possibility Awards

Turning Point is a diverse organisation, operating in a range of locations and across several sectors. Despite having different responsibilities, priorities, and skills, we’re all here for the same reason - to effect positive change and a lasting impact on the lives of the people we support. Each day we work to inspire and empower people to discover new possibilities in their lives.

Our Inspired by Possibility Awards recognise the achievements, dedication, and inspirational work of our exceptional colleagues. In 2022 we received a record-breaking 432 nominations, demonstrating the range of talent across Turning Point. Here are four of our winners.

Oduro Achampong

Team Leader, Milestone

‘Oduro, you were chosen for continually demonstrating our values across the 17 years you have dedicated to Turning Point. You’ve helped hugely to promote a culture of acceptance and nurturing at the services you work in, where every individual – whether a colleague or a person we support – feels respected and valued. You never compromise on your commitment to the people who live and work at these services. Your ability to navigate conflicts calmly and fairly means they are usually short-lived, and you’re always on-hand to support the team and inspire confidence with a heart-warming smile at the start of every shift.’

Leah Robertson

Team Leader, Beacon Lodge

‘Leah, you were chosen for always going the extra mile to help and advocate for the people you support, offering them compassion, patience and importantly, a voice. When one individual was facing homelessness due to their challenging behaviour because of the trauma they’d experienced, your hard work in coordinating a team of professionals, conducting research and challenging decisions made by local authorities meant they could move to new accommodation and had the chance to recover in a safe environment. You’ve been described as “a wonderful person and an inspiring leader”, making your colleagues feel valued and always encouraging them to grow.’

Elizabeth Shallaker

Project Worker, Oldham Dispersed Accommodation

‘Elizabeth, you were chosen for your incredible commitment to the people we support. During a suspected COVID-19 outbreak, you stayed with a group of clients to make sure they felt safe and supported, and when a client received a diagnosis of stage four lung cancer, you went above and beyond to advocate on his behalf, accompanying him on a short break and working hard to try and have everything the way he wanted and giving him freedom to express himself and a safe space to offload. Your compassion, resilience, composure, and wholly person-centred approach make you an asset to the team and a thoroughly deserving winner.

Jonathan Cullum

Non-Medical Prescriber, Suffolk Recovery Network

‘Jonathan, you have been recognised in this year’s awards for being an inspiration and “a driving force”. Your passion to help the people we support means 35 of them have been able to access the Buvidal injection [for the treatment of opioid dependence] and move toward long-term abstinence, which has significantly improved their wellbeing. You inspire the team and lead by example, standing in when times are difficult and working hard to provide support and advice for anybody that needs it. You see the best in people which gives them the belief they need to progress, and you have a positive impact on the service as a whole.’

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Focussing on Equality, Diversity, and Inclusion

At Turning Point, we want to ensure that everyone feels able to be themselves and we’re proud of our commitment to external accreditations of good practice, including Disability Confident, Mindful Employer, Menopause Pledge, Neurodiversity in Business and Inclusive Employers.

We recognise that some groups may need extra support and we’re proud to see our diversity network groups having an amazing impact. We have groups to support LGBTQ+, disability and BPOC colleagues. This year we have strengthened our network groups by creating co-chair positions and through the introduction of senior sponsors, to help give a voice to the network groups at the top of the organisation.

The groups have influenced Turning Point policies, to help the organisation become more inclusive, alongside helping individuals feel more seen and heard and highlighting how Turning Point is a truly inclusive employer.

LGBTQ+ Network

Disability Network

The LGBTQ+ network supported local pride events across the country, with stalls promoting the work of Turning Point. To help raise awareness, members of the group had rainbow lanyards made. These started to be given out at Pride events, but before long colleagues were sporting them around the services and offices. As a result, we now have rainbow lanyards available for all new colleagues.

Along the way we have had the privilege to help families embrace and support having trans loved ones in the family or supporting parents ’coming out‘ as LGBTQ+ later in life. And in our SASH service, we have helped bring together organisations to help build a stronger offer to the LGBTQ+ clients who attend our services.

The Disability network has been working this year on an inclusivity passport. This allows colleagues to have a conversation with their manager about how they can be supported to be their best, the passport can stay with the colleague so that as they change and shift roles, they can take their requirements with them.

The introduction of two passionate and knowledgeable co-chairs this year has enabled the network to increase and reach more people and create lots of ideas for progress.

The network continues to provide a safe space of peer support whilst also informing important changes across the organisation in terms of disability.

The implementation of the autism standards, inclusivity passport and celebration of disability are all elements that are transforming the nature of disability in our workplaces and makes the voice of diversity very much heard.

Turning Point Annual Report 2023 65

BPOC Network

Menopause network

The BPOC network invested their energies into Black History month last year. This saw some brilliant engagement on our Viva Engage channels, with services across the country taking part. Services shared food, culture, and stories. The network is now looking at how they can continue this dialogue, so the focus is not just on one month but throughout the year.

The co-chairs of the BPOC network are focussed on improving inclusion from BPOC colleagues, through sharing knowledge and experience and by challenging the status quo.

Our Menopause Network is a new addition to Turning Point’s Diversity and Inclusion Network groups, and has three main aims;

In the last year the group held monthly meetings and shared a range of free resources to help support and prompt conversations across the organisation.

Fostering a culture of ongoing learning and development

Throughout 2022/23, we have been reviewing and expanding the learning opportunities that are available across Turning Point. We have listened to services and colleagues across the organisation and changed our approach to identifying learning needs, putting much more choice and control in the hands of our service managers.

All our people can draw on a huge catalogue of learning to further their own development, based on the needs of their team or individuals they support.

We have started work to rebuild our learning management system. The system will be more user friendly and accessible. We are not just focussed on online content. After several years having to deliver learning virtually, we have been steadily returning to in-person learning. This has been well received by attendees who’ve enjoyed getting back into the classroom to share learning and good practice.

Our leadership development offer continues to build. We have been working this year to understand better what we require from our leaders. We have a suite of leadership courses and have seen around 800 delegates on 80 leadership and management workshops. We also support our leaders with coaching, 49 managers have taken the opportunity to be coached in the past year.

We are expanding access to qualifications and the amount of apprenticeship standards available. By working closely with our providers and diversity network groups, we’re keen to support access to apprenticeships from groups that may not have the same equality of access to qualifications.

The learning and organisational development team are also working across the sector as active members of VODG L&D network and the Skills for Care large employers’ network. The team is also working with OHID and participating in the development of the Substance Use Capability Framework.

KEY FACTS

10,426 delegates trained on workshops

63,435 e-learning modules accessed

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Inspired by the people we work alongside, every day

Our passion for colleague engagement, health and wellbeing has not wavered with another year of improved impact. The support provided by our managers is valued by their teams, and this is reflected in extremely high levels of trust in them. We have broadened the additional benefits that we now offer, from a financial, emotional, and physical perspective.

In what has been a very challenging year for recruitment in the sector; Turning Point has done exceptionally well in attracting new people to join our team across the variety of roles and markets we deliver services to. We have continued to build our colleague offer and attractiveness, whilst also focusing on strengthening our relationships in local communities by offering exciting roles with clear career pathways, which make the very best of people’s skills enabling us to support even more people back into work.

We are proud that at Turning Point, our colleague retention is significantly better than industry average, meaning more of our people are choosing to stay with us for longer.

Workforce shortages and how we’ve tackled them:

The number of colleagues voluntarily leaving Turning Point reached a five-year low

Finding new ways to recruit and engage colleagues

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Keeping people healthy, well and in work

Our commitment to supporting neurodiversity in business

In March 2023 Turning Point joined a neurodiversity industry forum to build on our work in supporting individuals and help increase their participation in the workplace.

Neurodiversity in Business (NiB) is a businessled forum supporting organisations to share good practice on neurodiversity recruitment, retention, and empowerment. NiB’s mission is to help develop more neuroinclusive workplaces by working collaboratively to improve conditions for people and support them to navigate independent, fulfilling careers.

This is a new journey for Turning Point, with the NiB membership helping us to support improved equity and inclusion across the organisation for our neurodiverse colleagues and candidates.

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TurningPoint l AnnualReport 1 2023 1 69 1 DELIVERING SOCIAL VALUE

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Delivering Social Value

Social value is the added value services can deliver to the economy, community life, the health of the local population and the environment. It is an integral part of everything we do and increasingly important to Commissioners, who are now more than ever taking social value into account when making their procurement decisions.

Our commitment to being ‘inspired by possibility’ and improving the health and wellbeing of the people we support, the communities we work in and our teams, is what makes this so important to us.

Accelerating apprenticeship opportunities

Our apprenticeship programme grew from 15 programmes in 2021-22 to 23 programmes for 2022/23 with pilot apprenticeships planned throughout 2023-24.

Turning Point is dedicated to developing and inspiring our workforce to unlock their potential. Providing colleagues with access to apprenticeships within their field of work is an important part of this.

THIS YEAR

2

26

20

69%

colleagues who have completed their level 7 Senior Leader apprenticeship achieved Distinctions.

of learners achieved either a Merit or Distinction for their apprenticeship.

colleagues started their apprenticeship.

colleagues completed their apprenticeship.

National Apprenticeship Week 2023: 6-12 February 2023

We also announced our first apprenticeship award winners;

This year we celebrated our first National Apprenticeship week with a series of events. 153 colleagues attended one of our webinars, and we celebrated the 55 graduates since the programme started.

Apprentices of the Year - Ellie Rising Star of the Year - Lorna Manager Award - Clare

Turning Point Annual Report 2023 71

Network membership

Part of our ongoing work is to make apprenticeships accessible across Turning Point and our wider networks. We joined the Apprenticeship Ambassador Network (AAN) to engage & influence employers around the benefits of apprenticeships within the workplace and engage with young people on the opportunities apprenticeships can bring to them.

We also joined the Apprenticeship Diversity Champion Network. The aim of this network is to encourage more people from diverse backgrounds to consider apprenticeships. Turning Point have made a pledge to support & grow our apprenticeship network in four key areas.

Turning Point has become part of the research group for Education Skills Funding Agency (ESFA) & Skills for Care to review and update apprenticeships nationally and be involved in trailblazer groups to develop future management & leadership apprenticeships. The Explore Apprenticeship Programme also works with our Diversity Networks to ensure the programme can be as inclusive as possible.

MEET OUR APPRENTICE OF THE YEAR

Ellie, Kent Learning Disability

Lead Practitioner in Care

Level 4 Apprenticeship: Completion date October 2022.

What drew you to Turning Point?

The genuine passion for providing a highquality standard of care and going beyond this to provide the people we support with a good and full life, with one-to-one support and the genuine focus on person-centred approach.

Why did you want to do an apprenticeship?

I wanted to develop my abilities and learn more skills, to better the provision of service to the people we support, my support workers and colleagues. I enjoy studying and wanted to support my career development within Turning Point.

What benefits do you feel the apprenticeship has brought to you and your service?

I learnt a lot through the apprenticeship. It enhanced my knowledge of the law and procedural foundations behind the care we provide and developed my thinking on the ways we can enhance the care we provide as well as building my managerial skills.

How did you find the experience?

I thoroughly enjoyed the learning aspect of the qualification. It certainly enhanced my knowledge of the policies and procedures behind the support we provide. The coursework pushed me to think about the support provision and, through study of case examples, research time, and increased knowledge, I could directly improve my Supported Living service. I felt thoroughly supported through the coursework, with regular set meetings and ad-hoc discussions with my tutor. I would like to complete the NVQ level 5 in the future, to continue developing my knowledge, supporting my career and improving the support I can provide to others.

Would you recommend an apprenticeship?

I would recommend completing an apprenticeship, as it improves knowledge of the policies which are embedded into our work, the reason that quality care is so important, and directly built my own skills within the supported living workplace.

72 Turning Point Annual Report 2023

Supporting our colleagues through the cost-of-living crisis

During 2022/23 the senior leadership team and all levels of management within Turning Point have had a focus on the rising cost of living and its impact on our colleagues’ teams and the people we support. The Operating Board established a working group to focus on what we could do better to help people in difficult circumstances.

The group brought together existing activities and prompted new actions. Through 2022/23 we have focussed on the following priority areas:

Many of our services have been working with local authorities and other local organisations

Some of the most significant actions achieved through our focus on this have been:

Many of our services have been working with local authorities and other local organisations to be able to signpost people we support towards resources and partners who can help people best manage the rising cost of living. This has included direct financial advice and support or access to warm spaces during the day.

For 2023-24 we plan to further develop directory resources, to provide direct access to resources and information about local groups offering support and advice to people who need help with the rising cost of living.

Turning Point Annual Report 2023 73

Social value in the supply chain

Widening access to employment

Improving social value and the use of local supply chains is embedded within the Turning Point Procurement and Environmental Strategies. From sourcing through to onboarding and contract award, our focus is on ensuring value for money and the impacts that this has on local economies and the environment. Our procurement of good and services looks at the benefits from national agreements and economies of scale and the local knowledge and the benefits that this brings through employment to local economies.

We continue to work with local pharmacies, landlords, venues for room hire and SME’s (small and medium-sized enterprises) together with several local sub-contracting partnerships. We contract with several charities and have recently awarded contracts to two social enterprises, Exchange Supplies in harm reduction and Furniture Resource Group (FRC) who supply residential furniture.

Access to employment is one of the most important ways we offer social value to the communities we work in.

There are a broad range of routes to access our employment opportunities, including our work with ex-offenders, career changers, early careers, returners to the workplace, as well as those that have been unemployed for periods of time. For many roles, it’s the person rather than their qualifications or experience that matters most.

Trainees are supported with learning in a wide range of ways, supervision to support this learning, coaching, mentoring peer learning, qualification support etc. There are also opportunities for progression, which we know is important to encourage people to stay within the organisation.

We are particularly proud of our peer mentors and people with lived experience, both paid and unpaid, for their passion, commitment, and dedication.

1 74 1 TurningPoint l AnnualReport 1 2023

TurningPoint l AnnualReport 1 2023 1 75 | RISK MANAGEMENT

76 Turning Point Annual Report 2023

Turning Point operates in a business with significant risks. The people we support can have mental health conditions and learning disabilities requiring intensive support, or substance dependency requiring clinical prescribing of medicines.

----- Start of picture text -----
Principal risk or uncertainty Mitigation & Controls Movement
Financial risk: Possible loss of Review cost base and other Increase
contract income due to highly income opportunities.
competitive operational environment.
Review pipeline for new contract
opportunities to replace lost income.
Investment in cost control measures
and robust financial monitoring.
Regular assessment and monitoring of
the quality of service and performance.
Operational risk: By the very Investment in robust clinical governance No change
nature of the contracts undertaken frameworks, policies, and procedures
the people supported through (including health & safety) that meet
those service contracts are or exceed regulatory requirements.
often adults at risk of self-harm,
Comprehensive risk management
injury, abuse and even death.
and incident reporting and
monitoring systems.
Cyber Security: Increasing Implementation of a robust information Increase
dependency on technology systems security model drawing upon the
gives rise to cyber risk comprising ISO27001 standard, Control Objectives
the risk of financial loss, disruption for Information Technologies (COBIT
to business operations or potential 2019), NHS Data Security & Protection
damage to the reputation of the Toolkit, Centre for Internet Security
organisation from a failure of (CIS Top 20) and Cyber Essentials. The
information technology systems. organisation is ISO27001 certified
and working towards Cyber Essentials
Information security: Increasing
Plus certification later in 2023.
reliance on data, information held
in systems gives rise to information Implementation of robust policies and
security risk leading to potential awareness learning serves to minimise
Data Protection Act breaches cyber risk from various sources.
and harm to data subjects as
well as potential damage to the
reputation of the organisation.
----- End of picture text -----

Turning Point Annual Report 2023 77

Strategic: Changes in government policy, continuing public sector funding cuts in a challenging economic trading environment.

PESTLE analysis

Commitment to the principles of emergent strategy, being agile and responsive to market risks and opportunities.

No change

People: Our people are our most important asset and the primary means through which we are able to add value to the lives of the people we support. Within a low margin business and increasingly competitive market, this presents risks around recruitment, retention and colleagues development.

We benchmark our pay and Increase benefits across the sector.

We have appropriate recognition and development opportunities.

Succession planning and talent mapping for critical roles.

Recruitment and attraction strategy aligned with outcomes of talent management.

Ongoing market reviews to ensure local pay is appropriate for geography and roles.

Emerging Risks

Internal Controls Assurance

The Operating Board considers long term trends in the health and social care sector that could present both risk and opportunity for the organisation. Any new emerging risks identified by the management are considered and acted on as appropriate.

The board recognises that no system of internal control can provide absolute assurance or eliminate all risk. The system of internal controls is designed to manage risk to an acceptable level and to provide reasonable assurance that key business objectives and expected strategic outcomes will be achieved.

The board confirms that the process for identifying, evaluating, and managing the significant risks faced by the company is on-going, has been in place for the whole of the financial year and up to the date of approval of the annual financial statements, and is regularly reviewed by the Board.

The company adopts a ’three lines of assurance‘ model for risk management. The board has reviewed the effectiveness of the system of internal controls in existence for the year ended March 2023 and through to the date of approval of these accounts. No significant weaknesses were found in the internal controls that resulted in material losses, contingencies or uncertainties that required disclosure in the financial statement or in the auditor’s report on the financial statements.

mlng Poi IRe

TurningPoint l AnnualReport 1 2023 1 79 | DIRECTOR'S REPORT

80 Turning Point Annual Report 2023

Chair’s introduction

The Board of Directors presents their annual accounts and reports for the year ending 31 March 2023.

Since April 2019 the Board has adopted the Wates Corporate Governance Principles for large private companies as the framework. The table on Page 87 summarises how we have applied the Wates Principles.

The Board has ensured with management that the views of the people we support, the communities in which they live, employees, and our suppliers drive the work of the Board and the decisions that it makes.

The Board was provided with an inspirational account of the experiences of some of the people we support at its Away Day in November 2022.

The Directors’ Report sets out the composition of Board of Directors and the Operating Board as well as our corporate governance arrangements, processes, and activities throughout the year for the Board and the Committees.

During 2022/23, as part of the succession planning exercise following the departure of Paul Picknett, Nicola Gilham became Chair of Audit, Risk and Quality Committee and Vice-Chair of the Board and Christian Van Stolk was appointed a member of the Audit, Risk and Quality Committee.

We have strengthened our Board through the appointment of Dawn Kenson who joined the Board in January 2023.

We are currently assessing the way we review board effectiveness moving forward to ensure that we optimise board performance in what are challenging yet opportune times for the health & social care sector.

Our Board of Directors approved this report on 25 July 2023.

Peter Hay Chair of the Turning Point Board

Turning Point Annual Report 2023 81

Our board of directors

Executive Directors

Amarjit Dhillon

Julie Bass

Chief Information Officer

Chief Executive

Amarjit joined Turning Point in March 2014 as Chief Information Officer with accountability for Commercial Ventures since September 2018 and was appointed as an executive board member in April 2020. Amarjit trained as a technologist in the NHS and then moved into the corporate sector where he specialised in directing transformation and change in global organisations. He has technology and information management experience as well as time spent in production and operations management, sales and customer facing roles. Amarjit is a non-executive director for a housing association. He is a Chartered Engineer, a Chartered IT Professional and a Fellow of the British Computer Society and a Member of the Institution of Engineering and Technology.

Julie has been an executive board director at Turning Point since 2009 and has held the position of Chief Executive since April 2020. Prior to this Julie worked in financial services in the UK and overseas in a wide variety of roles including holding responsibility for strategy, organisational effectiveness, performance and development and people related functions. She is passionate about supporting individuals to discover new possibilities in their lives through the provision of high quality, constantly evolving services, and interactions. In September 2022 Julie was appointed as associate non-executive director on the Trust Board at Surrey and Sussex Healthcare NHS Trust. Julie is also a Chartered Insurer and a fellow of the Chartered Institute of Personnel and Development.

----- Start of picture text -----
Institution of Engineering and Technology.
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82 Turning Point Annual Report 2023

Non-Executive Board Members

Peter Hay, CBE

Chair of the Board

Peter became Chair of Turning Point Board in September 2018. After a long career as a director of social care services, and a past president of the Association of Directors of Adult Social Services, Peter is now pursuing a range of interests in different roles across social care, housing, and wellbeing. Peter is curious about ways of developing people’s control over their own health and wellbeing, passionate about building good lives and fascinated by the leadership styles that support these aims. Peter was awarded a CBE in 2012 for services to health and care.

Nicola Gilham

Chair of the Audit, Risk & Quality Committee from July 2022

Nicola joined the Turning Point Board in May 2018. She is Vice-Chair of the Board and Chair of the Audit, Risk and Quality Committee. As a qualified chartered accountant, she enjoyed her first career with Arthur Andersen where, for many years, she led consulting assignments, both in the UK and overseas. Whilst living in Australia, she moved into recruitment and worked in the sector for over twenty years. Nicola now pursues a portfolio non-executive career working for businesses across health and social care. She also has a long-standing interest in her local community. As such, currently, she is non-executive director for Brighter Futures for Children in Reading, which runs Children’s Services for the borough, and non-executive member of the Buckinghamshire Healthcare NHS Trust and North West London Integrated Care Board. She is Vice Chair of Child Bereavement UK, and separately she spent several years, in a voluntary capacity, as a telephone counsellor for emotional support services.

Dawn Kenson

Dawn joined the Turning Point Board in January 2023. After a career where she was responsible for the combined regulated sales forces of The Woolwich and Barclays Bank, Dawn moved into non-executive work and built a portfolio in, and supporting, the public sector.

Dawn has held roles in a wide variety of organisations spanning central government, Arms Length Bodies, a housing association, and the NHS. Currently she sits on the NHS Lincolnshire Integrated Care Board, with a special interest in service delivery and has been the Senior Independent Director at Frimley Health NHS Foundation Trust for the past seven years.

Dawn holds a degree in Mathematics and Statistics and qualified as an Associate of the Chartered Insurance Institute.

Paul Picknett

Chair of Audit, Risk & Quality Committee until July 2022 and non-executive director until 21 March 2023

Paul joined the Turning Point Board in March 2014 after working in financial services for more than 30 years both in the UK and overseas. His career included 14 years as a main board director of Groupama Insurance company, where he was Corporate Services Director. He has been actively involved in several strategic acquisitions, including the acquisition of an award-winning healthcare operation. He is Trustee Chair of a pension scheme with assets over £310m. He has a degree in management studies and is a Fellow of the Chartered Insurance Institute. Paul’s tenure ended in March 2023.

Turning Point Annual Report 2023 83

Dr. Victoria Tzortziou Brown

Victoria joined the Turning Point Board in May 2021. Victoria is an east London GP and the Research Lead of East London Health and Care Partnership. In her academic role at Barts and The London School of Medicine and Dentistry, Victoria undertakes research on the design and evaluation of healthcare interventions and their impact on professional behaviour and health inequalities.

Victoria is also the Royal College of General Practitioners joint Honorary Secretary, a director at Healthcare Quality Improvement Partnership (HQIP) and a Founding Senior Fellow and Council member of the Faculty of Medical Leadership and Management. She has extensive clinical commissioning experience and served as a board member and clinical vice chair of the Tower Hamlets Clinical Commissioning Group.

Victoria is a Council member of the Faculty of Sexual and Reproductive Health. She also sits at the Council of the Faculty of Sport and Exercise Medicine and has a clinical and research interest in musculoskeletal medicine and education.

Dr. Christian Van Stolk

Christian joined the board in December 2020. He is a member of the Audit, Risk and Quality Committee. He has worked extensively on health and wellbeing in the workplace including research on improving the health and wellbeing of colleagues in the National Health Service in the UK, maintaining, and gaining employment for those with common mental health conditions, building an evidence base for health interventions in workplace settings, and looking at the relationship between productivity and health and wellbeing outcomes.

Christian sits on several expert panels for the UK government including those on occupational health, mental health, and employee health and wellbeing in the NHS. He holds a Ph.D. from the London School of Economics and Political Science and fellowships at the Royal Society of Medicine and Royal Society of the Arts.

84 Turning Point Annual Report 2023

Our Operating Board

Our operating board oversees the day-to-day operations of the organisation. The operating board is chaired by Chief Executive, Julie Bass and includes Amarjit Dhillon, Chief Information Officer, both of whom are executive board members. In addition, the operating board includes:

David Foord Director of Quality & Risk

David joined Turning Point in December 2021 and comes with a wealth of experience as a qualified clinician. With 25 years’ experience in the NHS, he is a registered mental health nurse and has worked at board level for over a decade leading quality, risk, safeguarding and clinical governance teams.

David Slegg

Chief Financial Officer

David has worked in the health and social care sector through-out his career. He joined Turning Point in June 2020 having previously spent his career in the NHS where he worked in Finance Director roles for 27 years.

Clare Taylor

Caroline James Nock

Chief People Officer

Caroline was Chief People Officer at Turning Point from April 2022 until March 2023. She led the HR community in the development and execution of the people strategy.

Sarah Kennedy

Director of External Affairs and Marketing

Sarah joined Turning Point in 2009, having previously spent 8 years working with the National Lottery operator, Camelot, and Breast Cancer Care. Sarah has also worked in politics in numerous roles and was a local government councillor in an innercity London Borough. Sarah is a Member of the Chartered Institute of Public Relations and a member of the Company of Communicators.

Chief Operating Officer

Clare has overall responsibility for Turning Point’s service delivery across its different areas of work. She has worked in health and social care for over 26 years including roles within universities, service providers, local authority commissioning and public health. She is ViceChair of Collective Voice, the umbrella body for third sector drug and alcohol treatment providers, and is passionate about improving access to services, particularly for those who need help the most. Clare has an MSc in Addiction Studies and through her varied leadership roles has a keen interest in supporting the development of women leaders within the wider system.

Philip Newton

Director of Corporate Governance

Philip joined Turning Point in 2007 after many years working for British Telecommunications PLC. He supports the board, executives, and senior management teams to shape the organisation from the perspective of corporate governance and strategy. Philip is a Fellow of the Chartered Management Institute.

Turning Point Annual Report 2023 85

Structure, governance & management

Turning Point is private company limited by guarantee without share capital, a registered charity, and also a registered provider under the Regulator of Social Housing. The governing document of the company is the Articles of Association.

Subsidiary companies

Turning Point board meetings

Turning Point has one wholly owned subsidiary, Turning Point (Services) Limited which is the trading arm of the parent charity. The subsidiary board meets twice a year and has a board composition of five directors from the Turning Point board and two independent directors.

The Turning Point Board met formally six times between April 2022 and March 2023.

----- Start of picture text -----
Board attendance in 2022/23 Turning Point
Number of meetings in 2022/23 6
Numbers Attended:
Peter Hay (Chairman) 6
Paul Picknett (Vice-Chair) 6
Nicola Gilham 6
Julie Bass 5
Amarjit Dhillon 6
Christian Van Stolk 5
Victoria Tzortziou Brown 5
Dawn Kenson 1 of 1
----- End of picture text -----

86 Turning Point Annual Report 2023

Board appointment

The directors of Turning Point form a unitary board of non-executive and executive members as defined by the Articles of Association. The directors are also the Trustees for the purpose of charity law. Executive members are appointed according to the terms of their employment with the company under a Relevant Qualifying Position. Non-executive members are appointed by the board following an open recruitment process overseen by the Nomination Committee. Directors are appointed for a three-year term with the option to be reappointed to a second term on a resolution of the Board. Directors can, following sufficient review, be appointed to a third three-year term should circumstances require this. Newly appointed directors go through an induction process that includes service visits, meetings with key senior managers and other directors of the board. There is also an introduction to the regulatory and market environment, the strategic intent of the company and the associated risk and opportunities.

Dawn Kenson was appointed as Non-Executive Director of Turning Point on 17 January 2023.

Nicola Gilham was appointed Chair of the Audit, Risk and Quality Committee from 26 July 2022 and Vice-Chair of the Turning Point Board on 21 March 2023 as part of the succession plan following the expiry of the tenure of Paul Picknett (the previous holder of these roles).

Statement of Directors’ Responsibilities

The directors are responsible for preparing the Annual Report and the Financial Statements in accordance with applicable law and regulation.

Company law requires directors to prepare financial statements for each year which give a true and fair view of the state of affairs of the company and of the income and expenditure for the period of account.

In preparing these financial statements,

the Board is required to:

The Board is responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the Charity and enable it to ensure that the financial statements comply with the Companies Act 2006, Charities Act 2011 and the Housing and Regeneration Act 2008, Housing SORP 2018 and the Accounting Direction for Private Registered Providers of Social Housing 2022. The Directors are also responsible for safeguarding the assets of the company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

The Directors are responsible for the maintenance and integrity of the corporate and financial information on the Group’s and charitable company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

Board effectiveness

At the beginning of 2022, the board carried out an internal board effectiveness evaluation via a self-assessment questionnaire focussed on key areas including strategy, board composition, risk management, stakeholder engagement, agenda management, virtual ways of working and knowledge and information with outcomes considered by the board in May 2022.

Conflicts of interest

Turning Point has a policy in place to manage conflicts of interest. Upon appointment, all directors are required to declare their interests. On an annual basis, all members are asked to update the register of interests, which includes the fit and proper persons requirements. At each meeting of the Board and Audit Risk & Quality Committee, members and attendees are required to state any interests with regard to specific items on the agenda in line with their duties under the Companies Act 2006.

Payments to Directors

Non-executive directors of Turning Point receive remuneration of £7,500 per year for the Chair and £5,000 per year for the other non-executive directors. There has been no increase in non-executive director remuneration during the year. Executive directors are paid for their executive roles and do not receive additional payment for their responsibilities as directors of the organisation. Apart from the reimbursement of expenses entailed in the course of the company’s business, there have been no other payments to executive directors in 2022/23.

Turning Point Annual Report 2023 87

Corporate Governance report

For the year ended 31 March 2023, under the Companies (Miscellaneous Reporting) Regulations 2018, the Company has applied the Wates Corporate Governance Principles for Large Private Companies.

Each of the six Wates Principles has been considered individually within the context of the company’s specific circumstances and a short supporting statement is set out below to explain how each principle has been applied to achieve better outcomes.

Principal Summary

Purpose and leadership

An effective Board develops and promotes the purpose of a company, and ensures that its values, strategy and culture align with that purpose.

The Board promotes the purpose of the Company through strategic intent and emergent strategy.

Board composition

Effective Board composition requires an effective chair and a balance of skills, backgrounds, experience and knowledge, with individual Directors having sufficient capacity to make a valuable contribution. The size of a Board should be guided by the scale and complexity of the company.

The Turning Point Board comprises of Independent Non-Executive Chair, Chief Executive, Chief Information Officer and four Independent NonExecutive Directors. The size and composition of the Board is considered appropriate to the size, nature and complexity of the Company.

The Board has delegated some functions to board committees which focus on audit, risk & quality, and a committee for remuneration. More information regarding committees is included on page 88..

There is process in place for appropriate board effectiveness reviews. More information regarding board effectiveness is included on page 82.

Director responsibilities

The Board and individual Directors should have a clear understanding of their accountability and responsibilities. The Board’s policies and procedures should support effective decisionmaking and independent challenge.

The Board receives regular reports on strategic performance, financial performance, stakeholder engagement, and management of key business risks along with updates on activities and decisions of its committees.

In addition, certain responsibilities are delegated to the board committees in accordance with the approved Governance Standing Orders.

At each Board meeting, all Directors are asked to declare any potential conflict of interest. Any declaration is noted and where there are potential conflicts, appropriate safeguards are implemented.

Opportunity and risk

A Board should promote the long-term sustainable success of the company by identifying opportunities to create and preserve value, and establishing oversight for the identification and mitigation of risks

The Board seeks out opportunity while mitigating risk. The Board engages with the strategy dialogue and organisational performance at Board meetings throughout the year and specifically through the annual strategy away day.

The Audit, Risk & Quality Committee, consisting of Independent NonExecutive Directors, receives assurance reports from the internal and external auditors. Material risks are identified and managed and where required the substantive issues are escalated to the Board.

The principal risks of the company are set out on page 76.

Remuneration

A Board should promote executive remuneration structures aligned to the long-term sustainable success of the company, taking into account pay and conditions elsewhere in the company

The Remuneration Committee has clearly defined terms of reference and is responsible for determining remuneration. The Committee considers benchmarking data and where appropriate advice from external consultants. More information regarding Committees is included on page 88.

Stakeholder relationships and engagement

Directors should foster effective shareholder relationships aligned to the company’s purpose. The Board is responsible for overseeing meaningful engagement with stakeholders, including the workforce, and having regard to their views when taking decisions.

Accountability and transparency with stakeholders is key to the long term success of the Group.

The table within the Section 172(1) Statement on pages 27-29 sets out the details of some of the engagements that takes place at the operational or group level with the key stakeholders.

88 Turning Point Annual Report 2023

Our people

The health and social care sector faced many challenges coming out of the COVID-19 pandemic, one of the most pressing was to its workforce. As labour participation decreased and people left the care workforce for alternative employment, organisations including Turning Point, had to approach recruitment and retention very differently. Over the course of 2022/23, we have tried and successfully adopted new recruitment techniques, while also focusing on colleagues retention through learning – in-person and virtual - and developing new career pathways to keep talent within the organisation.

We have strengthened our involvement channels, continue to develop our ED&I (Equality, diversity, and inclusion) networks, and have championed our people through the Inspired by Possibility awards, Apprenticeship awards and Nursing Awards. We have grown our clinical team, continue to empower our peer mentors to find paid employment within the organisation and beyond, and prioritised colleagues wellbeing and health at work as the impact of the cost-of-living crisis was felt.

Our suppliers

We work with several suppliers throughout the year for the delivery of many essential services, including harm reduction products, facilities management, technology, and agency staff cover. We have good working relationships with all our suppliers and value the contribution they make. Central to our procurement process is the assured delivery of value for money, social impact, and environmental commitments.

Board committees

Audit, Risk & Quality Committee (the “ARQ Committee”)

The ARQ Committee is a standing board committee, and it supports the Board by providing assurance that robust and effective systems are in place to manage risks and ensure standards in financial management, internal & external audit, quality, safeguarding and clinical governance. The ARQ Committee receives reports from both internal and external auditors as well as executives and senior managers.

As at 31 March 2023, the members of the ARQ Committee were as follows:

Nicola Gilham, non-executive director (Chair) Victoria Tzortziou Brown, non-executive director Christian Van Stolk, non-executive director

The Chief Financial Officer is invited to ARQ Committee meetings as a matter of course. Other executives and senior managers are invited to ARQ Committee meetings as required. The committee met four times between April 2022 and March 2023. All meetings were quorate. The Chief Financial Officer attended all ARQ Committee meetings.

Nomination Committee

When required, the Nomination Committee is convened to make recommendations to the Board on recruitment, membership, and succession planning. Hunter Healthcare was appointed to conduct the initial market search and shortlisting for the position of Non-Executive Director on behalf of the committee. The committee interviewed the shortlisted candidates and recommended the appointment of Dawn Kenson as director of the company to the board. The board accepted the recommendation of the Nomination Committee and appointed Dawn Kenson to the board on 17 January 2023.

Remuneration Committee

In January 2021, the board took the decision to create a permanent Remuneration Committee to deal with executive and non-executive remuneration with different membership to manage conflicts of interest. The membership comprises three non-executive directors for executive director remuneration.

The Remuneration Committee did not meet in the 2022/23 fiscal year but will meet in September 2023.

Turning Point Annual Report 2023 89

Review of objectives

Environmental & energy reporting

The charitable objects of the company are for the public benefit, to promote or assist in promoting the protection of health of those with learning disability; and/or those at risk of, or with mental health conditions; and/or drug or alcohol use, misuse, or dependency, and/or other addictive behaviours.

The charitable objects are met through the provision of services across England for people to improve their health and wellbeing whether that is at home, within the workplace or through specialist services. In doing the company builds upon nearly 60 years of experience in substance use, mental health, learning disability, autism, acquired brain injury, sexual health, healthy lifestyles, and employment services.

Turning Point greenhouse gas emissions, reportable under SECR for the financial year 2022/23 were 1,256 tonnes CO2e.

These include the emissions associated with UK electricity and natural gas consumption, as well as business travel in company operated and private vehicles by employees. Turning Point’s greenhouse gas emissions were 29.3% lower this financial year than in the 2021-22 financial year. The intensity of 8.2 tonnes CO2e per £m revenue is 33.6% lower than the last financial year.

The board of directors who are also the trustees under charity law has given careful consideration and due regard to the Charity Commission’s general guidance on public benefit in reviewing the activities of the Turning Point group. The directors are satisfied that the objects of the charity and the activities it undertakes remain entirely for the public benefit in accordance with Section 17 of the Charities Act 2011.

Greenhouse gas emissions

----- Start of picture text -----
2021/2022 2022/2023
Emissions source Location-based Market-based % Share YoY % Change
Fuel Combustion: Natural Gas 962 868 69.1% -9.7%
Purchased Electricity 569 54 4.3% -88.6%
Fuel Combustion: Transport 346 335 26.6% -3.3%
Total Emissions (tC02e) 1,777 1,256 100% -29.3%
Annual Turnover (£m) 143 153 6.5%
Intensity (tC02e per
12.4 8.2 -33.6%
£m Turnover)
----- End of picture text -----

Figure 1 Greenhouse gas emissions by year (tonnes CO2e) – Market-based

90 Turning Point Annual Report 2023

----- Start of picture text -----
Emissions source 2021/2022 2022/2023 % Share YoY % Change
Scope 1 1,062 921 73.3% -13.3%
Scope 2 431 10 0.8% -97.6%
Scope 3 284 326 25.9% 14.6%
Total Emissions (tC02e) 1,777 1,256 100% -29.3%
----- End of picture text -----

Figure 2 Greenhouse gas emissions by scope (tonnes CO2e) – Market-based

Scope 1: Natural gas and company-operated transport. Scope 2: Electricity. Scope 3: Losses from electricity distribution and transmission, private vehicles used for business travel. This only includes emissions reportable under SECR and may not reflect the entire carbon footprint of the organisation.

Energy consumption

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Category 2021/2022 2022/2023 % Share YoY % Change
Fuel Combustion: Natural Gas 5,252,131 4,757,390 55.5% -9.4%
Purchased Electricity 2,031,257 2,448,336 28.6% 20.5%
Fuel Combustion: Transport 1,423,706 1,367,576 16.0% -3.9%
Total 8,707,093 8,573,302 100% -1.5%
----- End of picture text -----

Figure 3 Energy consumption by year (kWh)

Boundary, methodology and exclusions

Energy efficiency initiatives

An ‘operational control’ approach has been used to define the Greenhouse Gas emissions boundary. This approach captures emissions associated with the operation of buildings in the Turning Point Estate for example the residential properties, independent hospital, office sites and storage facilities, plus company-owned, leased and employee-owned vehicles. This information was collected and reported in line with the methodology set out in the UK Government’s Environmental Reporting Guidelines, 2019. Emissions have been calculated using the latest conversion factors provided by the UK Government. The emissions from the transmission and distribution of electricity are voluntarily reported under Scope 3. There are no material omissions from the mandatory reporting scope. A percentage of emissions relating to gas and electricity has been estimated, due to invoicing end dates, this is allowed under the guidance of the Regulation. The reporting period is April 2022 to March 2023, as per the financial accounts.

In the period covered by the SECR Report Turning Point has not undertaken any significant energy efficiency actions within the business.

Achievements & performance

There have been many challenges over the last year – recruitment, a cost-of-living crisis, political and economic turmoil, and funding pressures to name a few. Despite this, we continue to strengthen our learning, recruitment, and progression opportunities; win new contracts; and see our existing services reach more people, in novel ways.

With the start of our new strategic period, and adoption of refreshed strategic goals, we are well placed to navigate uncertainty. Commissioners trust us to design and deliver services that reach the most vulnerable groups in our communities and shape the national frameworks within which we work. Our social value also continues to grow, as the impact of our work continues to reach beyond the people we support, to their families, carers, and communities.

Turning Point Annual Report 2023 91

Value for money

For Turning Point value for money means delivering the best possible health and social care outcomes for the service price. We deliver value by continually improving the efficiency and effectiveness of our people, processes, and systems to drive ever better outcomes. This means we need to ensure there is money available to invest in our people and our technology infrastructure. We understand value for money along the lines of the National Audit Office definition which assesses value across three criteria:

This approach is governed through our Governance Framework and provides us with the means of achieving cost effectiveness, which we define as the optimal use of resources to achieve the intended health and social care outcomes.

As a provider of health and social care services Turning Point benchmarks its Care Quality Commission (CQC) regulated services against other providers to ensure that service effectiveness compares favourably and serves as an indicator of value we deliver through the quality of our services.

Turning Point Overall Ratings (April 2022) – 94% Good or Outstanding

Our overall rating for our CQC regulated services is 94% Good or Outstanding. We are regulated by the CQC for our care home services with and without nursing; community-based services for people who use substances; domiciliary care services; hospital services for people with mental health needs; rehabilitation services; residential substance use treatment and/or rehabilitation services and our supported living services.

Our substance use services are also benchmarked based on successful completion outcomes for each Public Health England Partnership Area compared to other Partnership Areas that share the same client characteristics. This information forms part of the Public Health England official statistics and is therefore subject to reporting restrictions beyond internal use for management, quality assurance and briefing purposes.

Turning Point is first and foremost a national provider of health and social care services and therefore provides little social housing and where it does so this is only in conjunction with, and for the purpose of health and social care provision. Most of the value for money metrics required of a typical Registered Provider by the Regulator for Social Housing do not provide meaningful information for the annual report and are therefore not included. The following two metrics are included:

----- Start of picture text -----
2023 2022
Return on Capital Employed 9% 17%
Operating Margin 1% 2%
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Governance & financial viability

The company has carried out an annual assessment of compliance with the Governance & Viability Standard and the board confirms continued compliance.

92 Turning Point Annual Report 2023

Financial Review

Financial performance

Turning Point has returned another year of income growth and sustained positive contribution. Having recovered from the impact of Covid-19, Turning Point faces the new challenge of managing the impact of high inflation, energy price increases and a requirement to continue to invest in our employees so that there is a continued improvement in recruitment and retention in each market.

The financial results for the year show that, despite adapting to the changed operating environment, financial performance remains strong. Overall turnover increased by 6.3% to £152.8m, generating an operating surplus of £1.3m.

Within the Public Health and Substance Use business unit we have worked closely with many of our commissioners to utilise monies from Public Health England to extend our activities via Universal, Rough Sleepers and ADDER funding totalling £6.6m. Last year we also secured funding from the Office for Health Improvement and Disparities (OHID), launched in October 2021, which is enabling Turning Point to support even more people. This initiative has an initial timeframe of the 3 years to March 2025, and in 2022/23 we received income of £4.2m. We will use the extra income to reduce caseloads for our employees and increase the number of clients in treatment.

The Commercial Ventures arm of the business continues to develop its Rightsteps and livelife brands, supporting business to business and direct to customer activity respectively. The product range has extended, with market exploration and customer engagement increasing.

Turning Point has responded well in this postpandemic environment, continuing to grow revenue and maintain financial viability. Turning Point faces many challenges ahead, particularly with high inflation rates and the increases to the National Living Wage, but the company is working closely with commissioners to ensure that it delivers safe and high-quality services for the people we support and employees.

A corner stone to the strategic period 2022 to 2027 is the continued improvement to the financial sustainability of Turning Point. Financial sustainability continues to improve, and Turning Point enters the financial year 2023-24 in a stronger position compared to 2022/23 and better placed to face the challenges ahead.

Growth opportunities widened in 2022/23 after the constraints in the prior year caused by the pandemic. Turning Point was also successful in the retender for the PHSU contracts in Slough, Oldham and Rochdale, and Wiltshire. Unfortunately, our contracts in Medway and Swindon were not retained. The Mental Health business unit secured new services in West Sussex, expanded its crisis services and extended service in Nottingham. Learning Disabilities services were boosted by new services in Sheffield and Manchester.

Turning Point Annual Report 2023 93

Reserves

Reserves are that part of a charity’s unrestricted income funds that are freely available to spend to further the charity’s objects and have been set aside for future use. Turning Point has no designated and £nil (2022: £428k) restricted funds.

In the financial year 2022/23 reserves improved by £6.2m and Turning Point will enter the financial year 2023-24 with positive total reserves of £3.6m. Reserves are in surplus for the first time since the pension changes in FRS102 were introduced in March 2016. The ambition is to continue to build reserves and the 2023-24 budget is expected to continue the improvement in this area.

Total reserves include the pension reserve which represents the discounted value of the Group’s future contributions to the defined benefit pension scheme and is provided for on the Group’s balance sheet in compliance with FRS 102. This is an accounting adjustment and does not directly impact our operating cashflows.

We are ambitious for the years ahead and aim to continue building our reserves through a determined focus on key priorities, including:

Developing our strategic relationship management, including with Integrated Care Boards as they develop, leading to growth opportunities outside of the tendering process;

The board assesses the risks to the organisation annually and sets the target level of unrestricted funds. We have now achieved the short-term goal for unrestricted reserves to cover the pension reserve, thereby bringing total reserves back to a positive position. In 2008-09 the directors established a target for unrestricted reserves of 8.3% of income, which is £12.7m based on the income from operations in 2022/23. This target was achieved during the financial year ending 31st March 2023, but it will be an ongoing target as it will be affected by income growth and profitability in future years.

The board has reviewed the budgets and cashflow forecasts for 2023-24 and 2024-25, which reflect all the known opportunities and challenges, both internally and in the external environment. They consider the cash balance to be adequate for the purpose of meeting the working capital requirements for the foreseeable future and coping with the financial impacts of the risks faced by the organisation. The approach to reserves is approved with input from the Audit, Risk & Quality Committee.

This report was approved by the board on 25 July 2023 and signed on its behalf.

Peter Hay (Chair) Director

New and evolving attraction and recruitment approaches linked to competitive rewards for our employees;

Continued systems development investment, including in risk management, care planning and client records system.

94 Turning Point Annual Report

Turning Point Annual Report 2023 95 INDEPENDENT AUDITOR'S REPORT

96 Turning Point Annual Report 2023

Independent Auditor’s Report to the members of Turning Point

Opinion

We have audited the financial statements of Turning Point (the ‘Charitable company’) and its subsidiary (the ‘Group’) for the year ended 31 March 2023, which comprise the Group and Charity Statements of comprehensive income and Statements of financial position, the Group Statement of cash flows, the Group Statement of changes in reserves and the related notes, including a summary of significant accounting policies. 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 Group’s and of the charitable company’s affairs as at 31 March 2023 and of the Group’s and charitable company’s incoming resources and application of resources, including its income and expenditure for the year then ended;

have been prepared in accordance with the requirements of the Companies Act 2006, Housing and Regeneration Act 2008 and The Accounting Direction for Registered Providers of Social Housing from April 2022.

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 Group in accordance with the ethical requirements that are relevant to our audit of the financial statements in the United Kingdom, including the Financial Reporting Council’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 Board’s 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 Group’s or charitable company’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 Board with respect to going concern are described in the relevant sections of this report.

Other information

The trustees are responsible for the other information within the Annual Report. 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.

Turning Point Annual Report 2023 97

Opinion on other matters prescribed by the Companies Act 2006

In our opinion, based on the work undertaken in the course of the audit:

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the Group and the parent Charity and its environment obtained in the course of the audit, we have not identified material misstatements in the Group strategic report or the Directors’ report.

We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 requires us to report to you if, in our opinion:

Responsibilities of directors

As explained more fully in the directors’ responsibilities statement on page 54, 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 directors are responsible for assessing the Group’s and the parent 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 Group or the parent Charity or to cease operations, or have no realistic alternative but to do so.

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.

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.

98 Turning Point Annual Report 2023

Extent to which the audit was considered capable of detecting irregularities, including fraud

Irregularities, including fraud, are instances of noncompliance with laws and regulations. We identified and assessed the risks of material misstatement of the financial statements from irregularities, whether due to fraud or error, and discussed these between our audit team members. We then designed and performed audit procedures responsive to those risks, including obtaining audit evidence sufficient and appropriate to provide a basis for our opinion.

We obtained an understanding of the legal and regulatory frameworks within which the charitable company and group operates, focusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Companies Act 2006, the Charities Act 2011, the Housing and Regeneration Act 2008 and The Accounting Direction for Registered Providers of Social Housing from April 2022 together with the Housing SORP. We assessed the required compliance with these laws and regulations as part of our audit procedures on the related financial statement items.

In addition, we considered provisions of other laws and regulations that do not have a direct effect on the financial statements but compliance with which might be fundamental to the charitable company’s and the group’s ability to operate or to avoid a material penalty. We also considered the opportunities and incentives that may exist within the charitable company and the group for fraud. The laws and regulations we considered in this context for the UK operations were CQC Regulations for service providers and managers, Employment legislation, the Wates Principles and requirements imposed by the Regulator of Social Housing.

We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be within the timing of recognition of contract income, the override of controls by management and the assumptions used to estimate the pension liability. Our audit procedures to respond to these risks included reviewing the income recognition policy, sample testing the funding agreements and reviewing for restrictions and clawbacks, tracing the income receipts to bank, reviewing the controls in place for income recognition, enquiries with management, review of internal audit reports, review of the fraud reports made to the Audit Committee, sample testing on the posting of journals, reviewing correspondence with the regulators, reading minutes of meetings of those charged with governance, reviewing accounting estimates for biases and testing the assumptions used to estimate the pension liability.

Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. For example, the further removed noncompliance with laws and regulations (irregularities) is from the events and transactions reflected in the financial statements, the less likely the inherently limited procedures required by auditing standards would identify it. In addition, as with any audit, there remained a higher risk of non-detection of irregularities, as these may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls. We are not responsible for preventing non-compliance and cannot be expected to detect non-compliance with all laws and regulations.

Auditing standards limit the required audit procedures to identify non-compliance with these laws and regulations to enquiry of the Trustees and other management and inspection of regulatory and legal correspondence, if any.

Turning Point Annual Report 2023 99

Use of our report

This report is made solely to the Charity’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006 and Section 128 of the Housing and Regeneration Act 2008. Our audit work has been undertaken so that we might state to the Charity’s members those matters we are required to state to them in an Auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the Charity and the Charity’s members, as a body, for our audit work, for this report, or for the opinions we have formed.

V Szulist Senior statutory auditor

for and on behalf of Crowe U.K. LLP Statutory auditor

3rd Floor The Lexicon Mount Street Manchester M2 5NT

Date: 28th July 2023

100 Turning Point Annual Report 2023

Group statement of comprehensive income for the year ended 31 March 2023

----- Start of picture text -----
2023 2022
Note £000 £000
Turnover 4 152,774 143,660
Operating charges 4 (151,427) (141,230)
Operating surplus 1,347 2,430
Interest receivable and
12 162 34
similar income
Loss on disposal of investment 16 (1) -
Impact of changing assumptions
and discount rate on pension 23 3,803 (737)
deficit reduction plan
Surplus for the financial year 5,311 1,727
Actuarial gains on defined
30 918 1,316
benefit pension schemes
Other comprehensive
918 1,316
income for the year
Total comprehensive surplus 6,229 3,043
----- End of picture text -----

All 2023 activities relate to continuing operations.

Turning Point Annual Report 2023 101

Charity statement of comprehensive income for the year ended 31 March 2023

----- Start of picture text -----
2023 2022
Note £000 £000
Turnover 5 151,322 142,307
Operating charges 5 (151,326) (141,117)
Operating surplus (4) 1,190
Interest receivable and
12 162 34
similar income
Loss on disposal of investment 16 (1) -
Impact of changing assumptions
and discount rate on pension 23 3,803 (737)
deficit reduction plan
Surplus for the financial year 3,960 487
Actuarial gains on defined
30 918 1,316
benefit pension schemes
Gift aid from subsidiary 32 1,232 1,242
Other comprehensive
2,150 2,558
income for the year
Total comprehensive surplus 6,110 3,045
----- End of picture text -----

All 2023 activities relate to continuing operations. Gift aid from the subsidiary of £1,232k relates to gift aid arising on profits generated in the previous accounting period (2022: £1,242k).

102 Turning Point Annual Report 2023

Consolidated statement of financial position as at 31 March 2023

----- Start of picture text -----
2023 2022
Note £000 £000
Fixed assets
Housing properties 14 4,250 4,228
Other fixed assets 15 249 292
Investments 16 - 1
4,499 4,521
Current assets
Debtors 17 21,483 24,283
Cash and cash equivalents 18 10,817 4,772
32,300 29,055
Creditors: amounts falling
19 (21,935) (19,687)
due within one year
Net current assets 10,365 9,368
Total assets less current liabilities 14,864 13,889
Creditors: amounts falling due
21 57 64
after more than one year
57 64
Provisions for liabilities
Defined benefit pension liability 30 - -
Pension provision 23 9,411 14,443
Reinstatement provision 23 1,735 1,950
Other provision 23 45 45
11,191 16,438
Reserves
Unrestricted reserves 13,027 11,402
Pension reserve (9,411) (14,443)
Restricted reserves - 428
14,864 13,889
----- End of picture text -----

The financial statements were approved and authorised for issue by the board and were signed on its behalf on 25 July 2023. Peter Hay (Chair), Director, Turning Point Company number: 00793558

Turning Point Annual Report 2023 103

Charity statement of financial position as at 31 March 2023

----- Start of picture text -----
2023 2022
Note £000 £000
Fixed assets
Housing properties 14 4,250 4,228
Other fixed assets 15 249 292
Investments 16 - 1
4,499 4,521
Current assets
Debtors 17 14,475
7,692
Cash and cash equivalents 18 10,789 4,694
18,481 19,169
Creditors: amounts falling
19 (10,808) (12,375)
due within one year
Net current assets 7,673 6,794
Total assets less current liabilities 12,172 11,315
Creditors: amounts falling due
21 57 64
after more than one year
57 64
Provisions for liabilities
Defined benefit pension liability 30 - -
Pension provision 23 9,411 14,443
Reinstatement provision 23 1,735 1,950
Other provision 23 45 45
11,191 16,438
Reserves
Unrestricted reserves 10,335 8,828
Pension reserve (9,411) (14,443)
Restricted reserves - 428
12,172 11,315
----- End of picture text -----

The financial statements were approved and authorised for issue by the board and were signed on its behalf on 25 July 2023. Peter Hay (Chair), Director, Turning Point

Company number: 00793558

104 Turning Point Annual Report 2023

Consolidated statement of changes in reserves for the year ended 31 March 2023

----- Start of picture text -----
Restricted Pension Unrestricted Total
reserves reserve reserves reserves
£000 £000 £000 £000
At 1 April 2022 428 (14,443) 11,402 (2,613)
Comprehensive income
for the year
- -
Surplus for the year 5,311 5,311
Actuarial gains on pension schemes - - 918 918
- -
Movement on pension deficit 5,032 5,032
-
Transfer from profit and loss account (428) (4,604) (5,032)
At 31 March 2023 - (9,411) 13,027 3,616
----- End of picture text -----

The notes on pages 108 to 137 form part of these financial statements.

Turning Point Annual Report 2023 105

Consolidated statement of changes in reserves for the year ended 31 March 2022

----- Start of picture text -----
Restricted Pension Unrestricted Total
reserves reserve reserves reserves
£000 £000 £000 £000
At 1 April 2021 10 (14,846) 9,180 (5,656)
Comprehensive income
for the year
Surplus for the year 418 - 1,309 1,727
- -
Actuarial gains on pension schemes 1,316 1,316
Movement on pension deficit - 403 - 403
- -
Transfer from profit and loss account (403) (403)
At 31 March 2022 428 (14,443) 11,402 (2,613)
----- End of picture text -----

The notes on pages 108 to 137 form part of these financial statements.

106 Turning Point Annual Report 2023

Consolidated statement of cash flows for the year ended 31 March 2023

----- Start of picture text -----
2023 2022
£000 £000
Cash flows from
operating activities
Profit for the financial year 5,311 1,727
Adjustments for:
Depreciation of tangible assets 476 521
Loss on disposal of investments (1) -
Amortisation of capital grants (7) (6)
Interest received (162) (34)
Decrease/(increase) in debtors 2,800 (4,259)
(Decrease)/increase in creditors 2,249 372
(Decrease) in provisions (4,337) (991)
Defined benefit pension -
(130)
contributions
Pension interest and service costs 8 337
Net cash generated from
6,337 (2,463)
operating activities
----- End of picture text -----

Turning Point Annual Report 2023 107

Consolidated statement of cash flows (continued) for the year ended 31 March 2023

----- Start of picture text -----
2023 2022
£000 £000
Cash flows from
investing activities
Improvement to housing properties (339) (447)
Purchase of tangible fixed assets (115) (143)
Interest received 162 34
Net cash from investing activities (292) (556)
Net increase in cash and
6,045 (3,019)
cash equivalents
Cash and cash equivalents at
4,772 7,791
the beginning of the year
Cash and cash equivalents
10,817 4,772
at the end of the year
Cash and cash equivalents at
the end of year comprise:
Cash at bank and in hand 10,817 4,772
10,817 4,772
----- End of picture text -----

The notes on pages 108 to 137 form part of these financial statements.

Analysis of net debt for the year ended 31 March 2023

----- Start of picture text -----
At 1 April 2022 Cash flows At 31 March 2023
£000 £000 £000
Cash at bank and in hand 4,772 6,045 10,817
4,772 6,045 10,817
----- End of picture text -----

The notes on pages 108 to 137 form part of these financial statements.

108 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

Accounting policies

1. General information

Turning Point is a company limited by guarantee and is incorporated in England. The registered office is America House, 2 America Square, London EC2N 2LU. The registered number is 793558.

2. Accounting policies

The principal accounting policies adopted, judgements and key sources of estimation in the preparation of the financial statements are as follows:

2.1 Accounting convention

Turning Point is registered under the Companies Act 2006 and is a registered housing provider.

The financial statements have been prepared in accordance with applicable Accounting Standards, including Financial Reporting Standard 102 (FRS 102), the Accounting Direction for Social Housing Providers from January 2022, and the Housing SORP 2018: Statement of Recommended Practice for Registered Social Housing Providers.

Turning Point meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at fair value or transaction value unless otherwise stated in the relevant accounting policy.

2.2 Going concern

On 31 March 2023, Turning Point had working capital of £10.4m (2022: £9.4m) and a cash balance of £10.8m (2022: £4.8m). Working capital has increased steadily over the last few years as surpluses have been retained in the business. Forecast cash available shows significant headroom against future working capital requirements and we are in a good position to meet the challenges ahead.

At the year-end, we had unrestricted reserves of £13.0m (2022: £11.4m) and total reserves, which include the pension reserve, of £3.6m (2022: -£2.6m). Our total reserves are now positive for the first time since FRS 102 was introduced in 2015/16, and we are progressing through our strategic period in good financial health.

We have successfully tendered for new contracts commencing in 2023/24 and look forward to opening new learning disabilities services in Birmingham, Kent and Nottingham and mental health services in Sussex and Nottinghamshire. These services demonstrate our ambition to continue with a sustainable growth of the business, which is evidenced by the year-on-year increase of both turnover and operating profit.

The business will continue to drive cost efficiencies, including roster management to improve efficiency and utilisation, and negotiating new supplier contracts. We are continuing to develop our products and find innovative ways of supporting people, through engagement with the people we support and commissioners, and this will drive future growth and secure retention of our current contracts.

These activities underpin the budgets and cash forecasts for 2023/24 and 2024/25, which have been reviewed and challenged by the Board. In addition, the Board has considered the organisation’s ability to respond to the longer-term challenges facing health and social care providers and changes in the economic environment and are implementing a corporate strategy that will ensure the continuing financial viability of the business.

After due consideration, the Board has a reasonable expectation that the Group has adequate resources to continue its activities for the foreseeable future. Accordingly, the directors continue to adopt the going concern basis in preparing the financial statements as outlined in the Statement of Directors’ Responsibilities.

2.3 Basis of consolidation

The financial statements consolidate the accounts of the Charity and its trading subsidiary, Turning Point (Services) Limited under the purchase method.

The Charity’s jointly controlled entity, Northern Pathways Limited, incorporated under the Companies Act 2006, was accounted for under the equity method of accounting. Northern Pathways Limited was dissolved on 12 April 2022.

Turning Point Annual Report 2023 109

Notes to the financial statements for the year ended 31 March 2023

Accounting policies (continued)

Investments in subsidiaries are accounted for at cost less impairment in the individual financial statements.

2.4 Turnover

Turnover represents contract and grant income from statutory sources (including rents net of voids), payments from residents and donations. Grant income is recognised when the related provisions for the grant have been met. Donations are recognised when the charity is legally entitled to the income and the amount can be quantified with reasonable certainty. All other income is accounted for on an accruals basis.

2.5 Value added tax (VAT)

Turning Point and Turning Point (Services) Limited are members of a VAT group and operate the standard method for partial exemption. Irrecoverable VAT is recognised as an expense when the tax point of the relevant expenditure is reached.

2.6 Taxation

A current corporation tax charge is recognised for the amount of corporation tax payable in respect of the taxable income for the current or past reporting periods using the tax rates and laws that have been enacted or substantively enacted by the reporting date.

Turning Point is a registered charity that is exempt from taxation on income and gains to the extent that they fall within the exemptions for charities in Part 11 Corporation Tax Act 2010 or s.256 of the Taxation of Chargeable Gains Act 1992.

The non-charitable subsidiary typically claims relief against its taxable profits by making gift aid payments to Turning Point.

2.7 Capital grants

Capital grants (including social housing grants) are provided for in creditors and written off in the Statement of Comprehensive Income over the expected period of the useful life of the assets acquired.

2.8 Accrued income

Accrued income is classified as “Debtors” and

includes contract and grant income (especially outcome related income) that will probably be received in a reporting period after that to which it relates.

2.9 Deferred income

Contract income and revenue grants are recognised as income in the period in which the performance criteria are met.

Deferred income is classified as “Creditors: amounts falling due within one year” and includes contract and grant income received in advance. These contracts and grants represent funds that have been received for specific purposes and are potentially refundable if the conditions of the contract or grant are not satisfied.

Contract and grant income received in the year but which remains unspent at the yearend is, with the agreement of the funder, carried forward in creditors at the year-end to be spent in the following year.

2.10 Fixed assets and depreciation

Depreciation is provided by the Charity to write off the cost net of grant less the estimated residual value of tangible fixed assets in equal instalments over their estimated useful economic lives as follows:

In accordance with the Housing SORP 2018: Statement of Recommended Practice for Registered Social Housing Providers, the overall cost of any property, fixtures and fittings, and office equipment will be split between significant components to enable each component to be depreciated according to its economic useful life. The categories of components and the relevant depreciation rates are those listed above. A ‘significant

110 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

Accounting policies (continued)

component’ will have a:

Cost greater than £10,000, AND

Where a component is replaced or restored, the carrying amount of the old component will be disposed of and the new component will be capitalised.

The Charity adopts a policy to write off, in the year of acquisition, items costing less than £3,000.

2.11 Improvement to properties

Expenditure on existing housing properties is capitalised to the extent that it improves the economic benefit of the asset either through an increase in rental income, a reduction in maintenance costs or through an extension of the life of the property.

2.12 Operating leases

Rents payable and motor vehicles under operating leases are charged on a straightline basis over the term of the lease.

Rental lease commitments are measured at the full cost of the lease payments to the date on which the Charity expects to leave each property.

2.13 Provision for liabilities

Provisions are recognised when the Group has a present obligation (legal or constructive) because of a past event, it is probable that the Group will be required to settle the obligation, and a reliable estimate can be made of the amount of the obligation. The amount recognised as a provision is the best estimate of the consideration required to settle the present obligation at the end of the reporting period, considering the risks and uncertainties surrounding the obligation.

2.14 Financial instruments

The Charity’s financial instruments consist of debtors, cash and creditors and as such are all basic in nature as defined in FRS 102. They are measured at the cash consideration expected to be paid or received.

2.15 Pension costs

The Charity operated a defined benefit pension scheme, which is contracted out of the State Scheme and provides benefits based on final pensionable pay. The scheme is a multi employer pension scheme and it is not possible to identify the assets and liabilities of the scheme which are attributable to the Charity. In accordance with FRS 102 the scheme is accounted for as a defined contribution scheme. The assets of the scheme are held separately from those of the Charity. The funds are valued every three years by a professionally qualified independent actuary, the rates of contribution payable then being determined by Pension Trustees on advice of the actuary. The latest completed triennial actuarial valuation took place on 31 March 2022. The Charity has provided for the committed contributions payable, discounted appropriately, to fund the deficit of the scheme.

The defined benefit scheme closed on 31 March 2012 and on 1 April 2012, Turning Point started a defined contribution scheme.

The Charity also has employees who are members of Local Government Pension Schemes which are defined benefit schemes. The defined benefit pension scheme current service costs are charged to the Statement of Comprehensive Income within staff costs. The expected return on the scheme assets less the scheme interest costs are credited within other interest. The scheme actuarial gains and losses are recognised immediately as other recognised gains and losses. The defined benefit scheme assets are measured at fair value at the year-end date. Scheme liabilities are measured on an actuarial basis at the year-end date using the projected unit method and discounted at a rate equivalent to the current rate of return on a high-quality corporate bond of equivalent term to the scheme liabilities. The resulting defined benefit asset or liability is presented separately after other net assets on the face of the Statement of Financial Position.

The Charity pays contributions to the NHS Pension Scheme in relation to employees who are members. This is a defined benefit public service scheme, and the costs are charged to

Turning Point Annual Report 2023 111

Notes to the financial statements for the year ended 31 March 2023

Accounting policies (continued)

the Statement of Comprehensive Income in the period to which they relate.

2.16 Designated reserves

The Charity has no designated reserves at 31 March 2023.

2.17 Investments

The only investments held by the Group are in its subsidiary and jointly controlled entity.

3. Judgements in applying accounting policies and key sources of estimation uncertainty

The principal risks and uncertainties of the business are set out in the Strategic Report, together with the actions taken to mitigate these risks.

The directors have considered the residual risks and have received adequate assurance that they do not cast significant doubt on the business’s ability to continue as a going concern.

In the application of the entity’s accounting policies, which are described in note 2, the directors are required to make judgments, estimates and assumptions about the carrying value of assets and liabilities that are not readily apparent from other sources. The estimates and underlying assumptions are based on historical experience and other factors that are relevant. Actual results may differ from these estimates.

to accounting estimates are recognised in the period in which the estimate is revised, if the revision affects only that period, or in the period of the revision and future periods, if the revision affects the current and future periods.

The key sources of estimation uncertainty that have a significant effect on the amounts recognised in the financial statements are summarised below:

The estimates and underlying assumptions are reviewed on an on-going basis. Revisions

112

Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

4

Turnover and operating surplus 2023 Group

----- Start of picture text -----
Turnover Operating costs Operating surplus
£000 £000 £000
Income and expenditure from
lettings
Supported housing
accommodation:
Residential services 66,417 (62,102) 4,315
Non-residential services 86,185 (75,546) 10,639
152,602 (137,648) 14,954
Other income and expenditure 172 (13,779) (13,607)
152,774 (151,427) 1,347
----- End of picture text -----

Turnover and operating surplus 2022 Group

----- Start of picture text -----
Turnover Operating costs Operating surplus
£000 £000 £000
Income and expenditure from
lettings
Supported housing
accommodation:
Residential services 62,546 (59,298) 3,248
Non-residential services 80,913 (69,311) 11,602
143,459 (128,609) 14,850
Other income and expenditure 201 (12,621) (12,420)
143,660 (141,230) 2,430
----- End of picture text -----

Turning Point Annual Report 2023 113

Notes to the financial statements for the year ended 31 March 2023

5

Turnover and operating surplus 2023 Charity

----- Start of picture text -----
Turnover Operating costs Operating surplus
£000 £000 £000
Income and expenditure from
lettings
Supported housing
accommodation:
Residential services 65,782 (62,182) 3,600
Non-residential services 85,361 (75,366) 9,995
151,143 (137,548) 13,595
Other income and expenditure 179 (13,778) (13,599)
151,322 (151,326) (4)
----- End of picture text -----

Turnover and operating surplus 2022 Charity

----- Start of picture text -----
Turnover Operating costs Operating surplus
£000 £000 £000
Income and expenditure from
lettings
Supported housing
accommodation:
Residential services 61,957 (59,172) 2,785
Non-residential services 80,151 (69,324) 10,827
142,108 (128,496) 13,612
Other income and expenditure 199 (12,621) (12,422)
142,307 (141,117) 1,190
----- End of picture text -----

The further analysis of income and expenditure from lettings in notes 6 and 7 reflects the disclosure required by the Accounting Direction for Registered Providers of Social Housing from April 2022.

114 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

6

Income and expenditure from lettings Group

----- Start of picture text -----
Non- Non-
Residential residential Residential residential
services services Total services services Total
2023 2023 2023 2022 2022 2022
£000 £000 £000 £000 £000 £000
Income from lettings
Rent receivable 790 8 798 718 - 718
Service charge receivable 1,282 74 1,356 1,281 41 1,322
Net rents receivable 2,072 82 2,154 1,999 41 2,040
Revenue grants from local
64,345 86,103 150,448 60,547 80,872 141,419
authorities and other agencies
Total income from lettings 66,417 86,185 152,602 62,546 80,913 143,459
Expenditure on
letting activities
Services 48,198 58,259 106,457 46,810 54,152 100,962
Management 11,709 14,153 25,862 10,336 11,958 22,294
Routine maintenance 404 516 920 369 508 877
Planned maintenance 125 156 281 109 109 218
Rent losses from bad debts 54 18 72 63 2 65
Property lease charges 1,472 2,304 3,776 1,469 2,378 3,847
Depreciation of housing properties 140 140 280 142 204 346
Total expenditure on lettings (62,102) (75,546) (137,648) (59,298) (69,311) (128,609)
Operating surplus on
letting activities 4,315 10,639 14,954 3,248 11,602 14,850
Void losses 3,816 5,109
----- End of picture text -----

Turning Point Annual Report 2023 115

Notes to the financial statements for the year ended 31 March 2023

7

Income and expenditure from lettings Charity

----- Start of picture text -----
Non- Non-
Residential residential Residential residential
services services Total services services Total
2023 2023 2023 2022 2022 2022
£000 £000 £000 £000 £000 £000
Income from lettings
Rent receivable 790 8 798 718 - 718
Service charge receivable 1,336 69 1,405 1,335 40 1,375
Net rents receivable 2,126 77 2,203 2,053 40 2,093
Revenue grants from local
63,656 85,284 148,940 59,904 80,111 140,015
authorities and other agencies
Total income from lettings 65,782 85,361 151,143 61,957 80,151 142,108
Expenditure on
letting activities
Services 48,262 58,114 106,376 46,717 54,162 100,879
Management 11,725 14,118 25,843 10,316 11,960 22,276
Routine maintenance 404 516 920 369 508 877
Planned maintenance 125 156 281 109 109 218
Rent losses from bad debts 54 18 72 50 3 53
Property lease charges 1,472 2,304 3,776 1,469 2,378 3,847
Depreciation of housing properties 140 140 280 142 204 346
Total expenditure on lettings (62,182) (75,366) (137,548) (59,172) (69,324) (128,496)
Operating surplus on
letting activities 3,600 9,995 13,595 2,785 10,827 13,612
Void losses 3,816 5,109
----- End of picture text -----

116 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

8

Operating surplus

The operating surplus is stated after charging:

----- Start of picture text -----
Group Group Charity Charity
2023 2022 2023 2022
£000 £000 £000 £000
Housing depreciation 317 364 317 364
Depreciation of other tangible
158 157 158 157
owned fixed assets
Amortisation of capital grant
(7) (6) (7) (6)
on housing properties
Audit fees payable 68 58 41 29
Loss on disposal of 1 - 1 -
investment in subsidiary
Hire of plant and machinery – rentals
903 699 903 699
payable under operating leases
----- End of picture text -----

Turning Point Annual Report 2023 117

Notes to the financial statements for the year ended 31 March 2023

9

Auditor’s remuneration

----- Start of picture text -----
2023 2022
£000 £000
Fees payable to the Group’s auditor 86 81
Fees payable to the
Group’s auditor and its
associates in respect of:
Audit of charity 34 29
Audit of subsidiary 34 29
Tax compliance and advisory services 4 8
Accounts preparation fee 14 15
86 81
----- End of picture text -----

10

Employees Group and Charity

Staff costs were as follows:

----- Start of picture text -----
2023 2022
£000 £000
Salaries 104,489 97,176
National insurance 8,771 7,742
Pension contributions 3,885 3,771
117,145 108,689
----- End of picture text -----

118 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

10

Employees (continued) Group and Charity

The average monthly number of employees, including the chief executive, during the year was as follows:

----- Start of picture text -----
2023 2022
No. No.
Management and administration 772 736
Operational 2,949 2,966
3,721 3,702
----- End of picture text -----

The key management personnel of the charity and the group comprises the executive directors, operating board members, and non executive board members. The headcount of key management personnel during the year was 7 executive directors and operating board members, and 8 non executive directors (2022: 7 ED and 8 NED).

The total employee benefits of the key management personnel of the charity and group were £1,124k paid to executive directors and operating board members and £35k paid to non executive directors (2022: £924k, £29k).

During the year, 11 employees were paid a total of £73k as compensation for the termination of their employment before the normal retirement date. A total of £70k was paid to 10 employees who accepted the offer of voluntary redundancy. The payments are fully recognised in the Statement of Comprehensive Income for 2022/23, being the period in which the plans were finalised.

The average number of full-time equivalent persons (including the chief executive) employed during the year:

----- Start of picture text -----
2023 2022
No. No.
Management and administration 612 555
Operational 2,518 2,514
3,130 3,069
----- End of picture text -----

Turning Point Annual Report 2023 119

Notes to the financial statements for the year ended 31 March 2023

10

Employees (continued) Group and Charity

The full-time equivalent number of staff whose remuneration payable in relation to the period of account fell within the following bands:

----- Start of picture text -----
2023 2022
No. No.
Group and Charity
£60,001 — £70,000 17 13
£70,001 — £80,000 7 12
£80,001 — £90,000 10 12
£90,001 — £100,000 6 -
£100,001 — £110,000 2 2
£110,001 — £120,000 3 3
£120,001 — £130,000 1 1
£130,001 — £140,000 4 5
£140,001 — £150,000 2 -
£150,001 — £160,000 2 1
£160,001 — £170,000 2 1
£170,001 — £180,000 1 -
£180,001 — £190,000 - 1
£190,001 — £200,000 1 -
- -
£200,001 — £210,000
- -
£210,001 — £220,000
£220,001 — £230,000 1 1
59 52
----- End of picture text -----

120 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

11

Directors’ and trustees’ emoluments Group and Charity

----- Start of picture text -----
2023 2022
£000 £000
Directors’ emoluments
(including pension contributions 456 446
and benefits in kind)
Directors’ pension contributions
21 20
(included above)
----- End of picture text -----

The headcount of directors during the year was 2 (2022: 2).

Two directors were paid pension contributions during the year (2022: 2).

----- Start of picture text -----
2023 2022
£000 £000
Non-executive trustees’
emoluments (including expenses)
36 28
£Nil (2022: £Nil) of travel
expenditure was reimbursed
to 0 (2022: 0) trustees.
----- End of picture text -----

Turning Point Annual Report 2023 121

Notes to the financial statements for the year ended 31 March 2023

11

Directors’ and trustees’ emoluments (continued)

Group and Charity

The emoluments of directors disclosed above (excluding pension contributions and benefits in kind) include amounts paid to:

----- Start of picture text -----
2023 2022
£000 £000
The highest paid director 232 227
Pension contributions of the
14 14
highest paid director
----- End of picture text -----

The company paid emoluments of £4k to two directors of Turning Point (Services) Limited during the year (2022: £4k to two directors).

Details of the nature of the chief executive’s pension arrangements:

The CEO is an ‘ex defined benefit’ member of the Group Personal Pension Plan with Legal & General, as she was an active member of the Turning Point Pension Scheme at 31 March 2012.

No enhanced or special terms apply.

The Group contributed 6% to the GPPP on behalf of the CEO, and did not contribute to any individual pension arrangements.

12

Interest receivable

----- Start of picture text -----
Group Group Charity Charity
2023 2022 2023 2022
£000 £000 £000 £000
Interest receivable 162 34 162 34
162 34 162 34
----- End of picture text -----

122 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

13

Taxation

Turning Point is a registered charity. Under Part 11 Corporation Tax Act 2010 and s.256 of the Taxation of Chargeable Gains Act 1992, it is entitled to exemption from Corporation Tax on donations, certain investment income and gains, property income, and on profits from any trading activities exercised in the course of carrying out a primary purpose of the charity, so long as they are applied to Turning Point’s charitable purposes.

Northern Pathways Limited did not trade during the year and was dissolved on 12 April 2022. The company did not make a profit for tax purposes and does not have a Corporation Tax liability.

There were no factors that may affect future tax charges.

Turning Point (Services) Limited intends to donate a sum equivalent to any taxable profits to Turning Point, to reduce the company’s tax liability to nil.

14

Housing properties Group and Charity

----- Start of picture text -----
Housing properties
£000
Cost
At 1 April 2022 8,484
Additions 339
At 31 March 2023 8,823
Depreciation
At 1 April 2022 4,256
Charge for the year 317
At 31 March 2023 4,573
Net book value
At 31 March 2023 4,250
At 31 March 2022 4,228
----- End of picture text -----

The aggregate amount of finance costs included in the cost of housing properties is £nil (2022: £nil). The aggregate market value of the properties is, in the opinion of the directors, in excess of net book value.

Turning Point Annual Report 2023 123

Notes to the financial statements for the year ended 31 March 2023

14

Housing properties (continued) Group and Charity

----- Start of picture text -----
2023 2022
£000 £000
Housing properties cost comprise:
Freeholds 2,758 2,758
Short leaseholds (less than 50 years) 5,217 4,861
Long leaseholds (more than 50 years) 848 848
8,823 8,467
----- End of picture text -----

----- Start of picture text -----
2023 2022
£000 £000
Expenditure on works to
existing properties
Capitalised in the year 339 447
Charged to income and expenditure 291 356
630 803
----- End of picture text -----

124 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

15

Tangible fixed assets Group and Charity

----- Start of picture text -----
Motor Fixtures and Office
vehicles fittings equipment Software Total
£000 £000 £000 £000 £000
Cost or valuation
At 1 April 2022 22 753 817 1,016 2,608
Additions 8 88 5 14 115
At 31 March 2023 30 841 822 1,030 2,723
Depreciation
At 1 April 2022 18 719 712 867 2,316
Charge for the year on
4 33 69 52 158
owned assets
At 31 March 2023 22 752 781 919 2,474
Net book value
At 31 March 2023 8 89 41 111 249
At 31 March 2022 4 34 105 149 292
----- End of picture text -----

In accordance with the Housing SORP 2018, the overall cost of any property, fixtures and fittings, and office equipment has been split between significant components to enable each component to be depreciated according to its economic useful life.

Turning Point Annual Report 2023 125

Notes to the financial statements for the year ended 31 March 2023

16

Fixed asset investments Group

----- Start of picture text -----
Group
Investments in joint venture
£000
Cost or valuation
At 1 April 2022 1
Disposals (1)
At 31 March 2023 -
Net book value
At 31 March 2023 -
At 31 March 2022 1
----- End of picture text -----

Turning Point, Charity and Group, owned 50% of the 1,000 £1 ordinary shares in Northern Pathways Limited amounting to £500 (2022: £500) until the company was dissolved on 12 April 2022. At 31 March 2022, Northern Pathways Limited had total net liabilities of £154k and made no profit or loss in the year 2021/22.

----- Start of picture text -----
Charity Investments in subsidiary company
£000
Cost or valuation
At 1 April 2022 1
Disposals (1)
At 31 March 2023 -
Net book value
At 31 March 2023 -
At 31 March 2022 1
----- End of picture text -----

Turning Point the Charity owns 100% of the 100 £1 ordinary shares in Turning Point (Services) Limited amounting to £100 (2022: £100). Turning Point (Services) Limited is a company incorporated in Great Britain that provides support services to the Charity. It has total assets less current liabilities at 31 March 2023 of £2,762k (2022: £2,574k). Its trading profit for the year after Gift Aid was £188k (2022: Loss of £1k).

126 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

17

Debtors

----- Start of picture text -----
Group Group Charity Charity
2023 2022 2023 2022
£000 £000 £000 £000
Rental debtors 126 90 126 90
- - - -
Less: provision for bad debts
Net rental debtors 126 90 126 90
Due from statutory sources 15,606 17,373 3,809 5,143
Less: provision for bad debts (320) (271) (156) (131)
Net statutory debtors 15,286 17,102 3,653 5,012
Prepayments and accrued income 5,785 6,860 3,388 2,368
Other debtors 286 231 286 231
Amounts owed by group - - 239 6,774
companies and joint ventures
21,483 24,283 7,692 14,475
----- End of picture text -----

Turning Point Annual Report 2023 127

Notes to the financial statements for the year ended 31 March 2023

18

Cash and cash equivalents

----- Start of picture text -----
Group Group Charity Charity
2023 2022 2023 2022
£000 £000 £000 £000
Cash at bank and in hand 10,817 4,772 10,789 4,694
10,817 4,772 10,789 4,694
----- End of picture text -----

In October 2019, the Charity entered into a debenture with Turning Point (Services) Limited and Barclays Bank, which includes a cross guarantee and indemnity. If either Turning Point or Turning Point (Services) Limited defaults under any agreement entered into with Barclays Bank, then Barclays Bank may seek to recover any debts due to it from the other party.

Turning Point holds a small number of bank accounts on behalf of clients who lack the required documents to open an account in their own name. Turning Point does not have control over the bank accounts. As a result, no amounts are recognised in the financial statements. The total held in such bank accounts as at 31 March 2023 was £104k (2022: £93k).

Turning Point and Turning Point (Services) Limited have entered into this agreement to best facilitate when Turning Point (Services) Limited bids for contracts and they are delivered by Turning Point.

19

Creditors: Amounts falling due within one year

----- Start of picture text -----
Group Group Charity Charity
2023 2022 2023 2022
£000 £000 £000 £000
Trade creditors 1,549 1,592 1,549 1,592
Other taxation and social
6,845 6,060 (322) 200
security costs
Other creditors 1,416 1,087 970 1,087
Accruals and deferred income 12,125 10,948 8,611 9,496
21,935 19,687 10,808 12,375
----- End of picture text -----

Barclays have a legal charge over 6 Penywern Road as security for Turning Point’s overdraft facility. The NBV of 6 Penywern Road as at 31 March 2023 is £2,182k.

128 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

20

Deferred income

----- Start of picture text -----
At 1 April 2022 Deferred Released At 31 March 2023
£000 £000 £000 £000
Group 4,340 6,702 (4,340) 6,702
Charity 2,888 3,186 (2,888) 3,186
----- End of picture text -----

Contract income and revenue grants are recognised as income in the period in which the performance criteria are met. Where funds are received for specific purposes and are potentially refundable if the conditions of the contract or grant are not satisfied, they will be deferred, with agreement of the funder, until the performance criteria are met.

21

Creditors: Amounts falling due after more than one year

----- Start of picture text -----
Group Group Charity Charity
2023 2022 2023 2022
£000 £000 £000 £000
Social housing and other grants 57 64 57 64
57 64 57 64
----- End of picture text -----

Turning Point Annual Report 2023 129

Notes to the financial statements for the year ended 31 March 2023

22

Financial instruments

----- Start of picture text -----
Group 2023 Group 2022
£000 £000
Financial assets
Financial assets that are
debt instruments measured 28,533 24,213
at amortised cost
28,533 24,213
Financial liabilities
Financial liabilities measured at
11,191 16,438
fair value through profit or loss
Financial liabilities measured
7,085 9,287
at amortised cost
18,276 25,725
----- End of picture text -----

Financial assets that are debt instruments measured at amortised cost comprise cash at bank, trade debtors, other debtors and accrued income.

Financial liabilities measured at fair value through profit and loss comprise the pension provision, reinstatement provision and other provision.

Financial liabilities measured at amortised cost comprise bank loans, trade creditors, other creditors and accruals.

130 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

23

Provisions Group and Charity

----- Start of picture text -----
Reinstatement
Pension provision Other provision Total
provision
£000 £000 £000 £000
At 1 April 2022 14,443 1,950 45 16,438
Releases (5,032) (215) - (5,247)
At 31 March 2023 9,411 1,735 45 11,191
----- End of picture text -----

The pension provision represents the discounted value of the agreed future contributions to be paid to the Turning Point defined benefit pension scheme by Turning Point. Turning Point agreed to pay contributions of £1,140k for the year ending 31 March 2022 and £1,229k for the year ending 31 March 2023, with contributions then increasing each year in line with CPI.

The reinstatement provision of £1,735k (2022: £1,950k) represents the amount set aside, based on individual property contracts, to cover expected building costs when Turning Point returns its leased properties to the landlord.

24

Restricted reserves

----- Start of picture text -----
2023 2022
£000 £000
Balance as at 1 April 2022 428 10
Restricted income/(expenditure) (428) 418
Balance as at 31 March 2023 - 428
----- End of picture text -----

Restricted reserves relate to income received to support the ADDER project. The £428k balance as at 1 April 2022 was fully spent in the year and related to support for adult social care providers to reduce the transmission of COVID-19 within and between care settings.

Turning Point Annual Report 2023 131

Notes to the financial statements for the year ended 31 March 2023

25

Legislative provisions

The Charity and its subsidiaries are incorporated under the Companies Act 2006.

26

Statement of capital grant movements

----- Start of picture text -----
2023 2022
£000 £000
Balance as at 1 April 2022 64 70
Amortised in year (7) (6)
Balance as at 31 March 2023 57 64
----- End of picture text -----

27

Bedspaces

----- Start of picture text -----
Care Homes Supported Living Total
No. No. No.
At 1 April 2022 396 554 950
Additions - 54 54
Disposals (10) (34) (44)
At 31 March 2023 386 574 960
----- End of picture text -----

28

Capital commitments

At 31 March 2023 the group has capital commitments of £nil (2022: £nil).

132 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

29

Pension commitments

Turning Point Pension Scheme

The total net pension cost for the group for the year was £2,949k for the defined contribution pension scheme (2022: £2,622k) and £1,229k for the defined benefit pension scheme (2022: £1,140k). Turning Point participated in the Turning Point Pension Scheme (“The Scheme”) which is a defined benefit pension scheme. This is a multi-employer scheme covering Turning Point and Turning Point Scotland employees (and former employees). Turning Point Scotland left the Group and became a separate entity in 1999.

The Turning Point Pension Scheme is a defined benefit plan but is being accounted for as a defined contribution plan because the Scheme is a multiemployer non-segregated arrangement. This means that the assets and liabilities of the Scheme are not separately identified for the two participating employers.

The latest completed triennial actuarial valuation took place on 31 March 2022. The results showed assets of £113.3m, liabilities of £137.1m, and a deficit of £23.8m on a technical provisions basis. In order to remove the deficit by 31 January 2031, Turning Point agreed to pay contributions of £1,353k for the year ending 31 March 2024, with contributions then increasing each year in line with CPI.

Turning Point Scotland agreed to pay contributions of £407k for the year ending 31 March 2024, with contributions then increasing each year in line with CPI.

Contribution levels are subject to review at subsequent actuarial valuations.

The Scheme assets comprise 6% equities, 22% government and corporate bonds, 19% diversified growth funds, 51% Liability Driven Investment (LDI) and 2% property as at 31 March 2023.

We understand that the Scheme is set up on a “last man standing basis” whereby if one employer becomes insolvent, the other employer will be responsible for all the scheme’s liabilities.

The pension liability shown on the balance sheet is measured as the discounted present value of the contributions payable by Turning Point to eliminate its share of the Scheme’s deficit. The deficit contributions are agreed with the Scheme’s Trustees

as part of the three-yearly actuarial valuation of the Scheme. The rate used to discount the future contributions is made by reference to market yields at the reporting date on high quality corporate bonds whose term is consistent with the estimated period of the future contributions. The unwinding of the discount rate is recognised as a finance cost in profit or loss in the period in which it arises.

Local Government Pension Schemes

Turning Point employs members of 5 Local Government Pension Schemes (LGPS) due to the takeover of services. These LGPSs are funded defined benefit schemes, with assets held in separate trustee-administered funds.

In March 2022, Turning Point left the Leicester and Leicestershire LGPSs and provided for the estimated exit payment of £908k. In July 2022, the actuary of the LGPS confirmed that no exit payment was owed to the fund. The provision was, therefore, released to the Statement of comprehensive income in 2022/23.

At March 2023, the West Yorkshire LGPS was in surplus and Turning Point’s share was valued at £529k. This surplus is not recognised as an asset in the Statement of financial position because it is not probable that Turning Point would receive a credit on exiting the fund.

The total defined benefit pension cost recognised in the Statement of Comprehensive Income is £8k and the projected cost for the year to 31 March 2024 is £6k.

Turning Point has bonds totalling £33k provided to commissioners in respect of some of the LGPSs. The reconciliation of the net pension scheme liability below relates to the Local Government Pension Schemes.

NHS Pension Scheme

Turning Point has employees who are covered by the provisions of the NHS Pension Scheme(s). Details of the benefits payable and rules of the scheme can be found on the NHS Pensions website at www. nhsbsa.nhs.uk/pensions. The scheme is an unfunded defined benefit scheme that covers NHS employers, GP practices and other bodies, allowed under the direction of the Secretary of State for England and Wales. They are not designed to be run in a way that would enable NHS bodies to identify their share of the underlying scheme assets and liabilities.

Turning Point Annual Report 2023 133

Notes to the financial statements for the year ended 31 March 2023

29

Pension commitments (continued)

Therefore, each scheme is accounted for as if it were a defined contribution scheme. The cost to Turning Point of participating in each scheme is taken as equal to the contributions payable to that scheme for the accounting period. The contributions payable to the scheme by Turning Point for the year to 31 March 2023 were £646k.

In order that the defined benefit obligations recognised in the financial statements do not differ materially from those that would be determined at the reporting date by a formal actuarial valuation, the Government Financial Reporting Manual (FReM) requires that “the period between formal valuations shall be four years, with approximate assessments in intervening years”. An outline of these follows:

The valuation of scheme liability as at 31 March 2023, is based on valuation data as 31 March 2022, updated to 31 March 2023 with summary global member and accounting data. In undertaking this actuarial assessment, the methodology prescribed in IAS 19, relevant FReM interpretations and the discount rate prescribed by HM Treasury have also been used.

The latest assessment of the liabilities of the scheme is contained in the scheme actuary report, which forms part of the annual NHS Scheme (England and Wales) Pension Accounts. These accounts can be viewed on the NHS Pensions website and are published annually.

----- Start of picture text -----
2023 2022
Reconciliation of present value of
LGPS plan liabilities and assets
£000 £000
Reconciliation of present value of plan liabilities:
At the beginning of the year 9,989 9,330
Release of scheme assets on exit from scheme (8,438) -
Current service cost 10 292
Interest cost 42 202
Actuarial (gains)/losses (458) 172
Contributions (12) (7)
Past service cost - -
At the end of the year 1,133 9,989
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134 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

29

Pension commitments (continued)

----- Start of picture text -----
2023 2022
£000 £000
Reconciliation of present value of plan assets:
At the beginning of the year 9,989 7,313
Release of scheme assets on exit from scheme (8,368) -
Interest income 44 157
Actuarial gains 9 2,396
Contributions (12) (7)
Employer contributions - 130
At the end of the year 1,662 9,989
2023 2022
£000 £000
Fair value of plan assets 1,662 9,989
Present value of plan liabilities (1,113) (9,989)
-
Non-recognition of pension scheme asset (529)
- -
Net pension scheme liability
----- End of picture text -----

The amounts recognised in the statement of comprehensive income are as follows:

----- Start of picture text -----
2023 2022
£000 £000
Current service cost 10 292
Interest cost (2) 45
Total 8 337
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Turning Point Annual Report 2023 135

Notes to the financial statements for the year ended 31 March 2023

29

Pension commitments (continued)

Principal actuarial assumptions at the Statement of financial position date (expressed as weighted averages):

----- Start of picture text -----
2023 2022
% %
Discount rate 4.70 2.70 – 2.75
Future salary increases 3.95 3.65 – 4.25
Future pension increases (CPI) 2.70 3.00 – 3.15
Mortality rates
- for a male aged 65 now 21.6 21.5 – 21.8
- at 65 for a male aged 45 now 22.9 22.4 – 22.5
- for a female aged 65 now 24.6 24.0 – 24.6
- at 65 for a female aged 45 now 25.7 25.7
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Major categories of plan assets as a percentage of total plan assets

----- Start of picture text -----
2023 2022
% %
Equities 82 60
Property 3 8
Bonds 10 29
Cash 3 3
Other 2 -
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136 Turning Point Annual Report 2023

Notes to the financial statements for the year ended 31 March 2023

30

Leasing commitments Group and Charity

Future minimum lease payments under non-cancellable operating leases are as follows:

----- Start of picture text -----
2023 2022
£000 £000
Land and buildings
Within one year 1,182 1,404
Within two to five years 2,188 992
After five years 586 148
3,956 2,544
Other
Within one year 879 765
Within two to five years 1,087 878
- -
After five years
1,966 1,643
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Turning Point Annual Report 2023 137

Notes to the financial statements for the year ended 31 March 2023

31

Related party transactions Group and Charity

Turning Point and Turning Point (Services) Limited are both entities incorporated in the United Kingdom. Turning Point is the only entity registered with the Regulator of Social Housing and is the parent company of Turning Point (Services) Limited, a wholly owned subsidiary. Turning Point is required to prepare consolidated financial statements that consolidate the accounts of the Charity and Turning Point (Services) Limited. Northern Pathways Limited was a jointly controlled entity, controlled equally by Turning Point and The Retreat York until it was dissolved on 12 April 2022. It was accounted for in the Charity and consolidated accounts under the equity method of accounting.

During the year, Turning Point (Services) Limited made an operating profit of £1,420k (2022: £1,241k). £1,413k (2022: £1,232k) will be gift aided to Turning Point. On 31 March 2023, Turning Point (Services) Limited owed £239k to Turning Point (2022: £6,774k).

Turning Point incurs all the costs associated with providing health and social care services to commissioners, including the employment of staff and contracting with suppliers. Turning Point charges Turning Point (Services) Limited a percentage of the total income due to Turning Point (Services) Limited each month, which reflects the risk that costs might exceed income in the future. The total recharged in the year was £114,828k (2022: £105,670k).

Northern Pathways Limited was a jointly controlled entity between Turning Point and The Retreat York until it was dissolved on 12 April 2022. During the year, Northern Pathways Limited made an operating loss of £nil (2022: £8k). No management fees were charged in the years ended 2022 or 2023.

NHS contracts are not deemed to be a related party transaction for 2022/23.

32

Subsidiary undertakings

The following were subsidiary undertakings of the Charity:

----- Start of picture text -----
Class of
Name Holding Principal activity
shares
Turning Point The provision of health and social care services primarily to people with
Ordinary 100%
(Services) Limited drug or alcohol issues, mental health issues or a learning disability.
Registered office
America House, 2 America Square, London EC3N 2LU
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The aggregate of the share capital and reserves as at 31 March 2023 and of the profit or loss for the year ended on that date for the subsidiary undertakings were as follows:

----- Start of picture text -----
Aggregate of share capital and reserves Profit/(loss)
£000 £000
Turning Point (Services) Limited 2,762 1,420
2,762 1,420
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138 Turning Point Annual Report 2023

Charity information

Turning Point is a private company limited by guarantee without share capital, incorporated in England on 27 February 1964.

Non-Executive Directors

Peter Hay (Chair) Paul Picknett (Resigned 21 March 2023) Nicola Gilham Christian Van Stolk Dr. Victoria Tzortziou Brown Dawn Kenson (Appointed 17 January 2023)

Executive Directors

Julie Bass Amarjit Dhillon All of the above are key management personnel of Turning Point Group and the Charity

Registered Office

America House 2 America Square London EC3N 2LU

Registered Company Number 00793558

Registered Provider Number H2509

Auditors

Crowe U.K. LLP 3rd Floor The Lexicon Mount Street Manchester M2 5NT

Bankers

Barclays Bank PLC Level 11 20 Chapel Street Liverpool L3 9AG

Solicitors

Eversheds Sutherland (International) LLP Eversheds House 6 Stanley Street Salford M3 5GX

Registered Charity Number 234887

Turning Point Annual Report 2023 139

We are inspired by possibility. The possibility that every single one of us can change and grow, make choices, and live healthier and happier lives. With our expertise in working in the areas of substance use, mental health, sexual health, healthy lifestyles and learning disability, including with people with complex needs, we aim to continue to adapt to an ever-changing external environment in order to extend our reach and support more people to improve their health and wellbeing.

Head Office: America House 2 America Square London EC3N 2LU Web: www.turning-point.co.uk Call: 020 7481 7600 Email: info@turning-point.co.uk

Turning Point is a registered charity, no.234887, a registered social landlord and a company limited by guarantee no. 793558 (England & Wales). Registered Office: America House, 2 America Square, London EC3N 2LU.