REGISTERED COMPANY NUMBER: 05292539 (England and Wales)

REGISTERED CHARITY NUMBER: 1107273

Report of the Trustees and

Unaudited Financial Statements for the Year Ended 31 March 2025

for

Integrated Neurological Services

Page

Chair's Report

1

to

2

Report of the Trustees

3

to

14

Independent Examiner's Report

15

Statement of Financial Activities

16

Balance Sheet

17

to

18

Cash Flow Statement

19

Notes to the Cash Flow Statement

20

Notes to the Financial Statements

21

to

29

It is my pleasure to introduce this Annual Report for Integrated Neurological Services (INS) for the year 2024-2025. You will find inside, as well as the financial report, details about the services INS provides together with some of the feedback and stories from INS clients.

Last year, INS celebrated 30 years of care provision for those with neurological conditions in the Boroughs of Richmond and Hounslow. We don't stand still, and INS' care and services continue to evolve to meet the needs of clients with the further development of our holistic approach to therapeutic support and wider social engagement for clients. The INS team offer a welcoming environment to our clients while providing a professional service to complement those provided by the statutory services.

Demand is increasing and during the year INS provided support for 800 people - 644 clients and 156 carers. The level of complexity of clients' conditions has also increased. You will be able to see more detail of the numbers of sessions held and people supported with service provision on page 6 of this report. In summary during the course of the twelve months:1,483 individual therapy sessions were held, with over 5,000 group attendances and over 3,000 group exercise sessions provided and facilitated.

When I joined INS as a Trustee in 2019, I knew I was joining a good organisation with strong values of inclusion, collaboration, empowerment and innovation and with an understanding of the needs of people who have long term conditions as well as those of their carers. It has been a pleasure to witness the care and commitment of staff and volunteers at INS.

I'm glad to share here that the team at INS has been further strengthened by the appointment of Evana Topolovec as Operations Lead. She brings a wealth of experience to INS to enable the further development of robust systems, planning and strengthening team capabilities which we at INS need more than ever for staff and volunteers to be matched to the needs of clients and to focus our fundraising capabilities in an increasingly competitive environment for funds (over 50% of INS annual income comes from fundraising and 36% from contracts).

I would like to take the opportunity here to thank our partners, supporters, funders, fellow trustees and our wonderful INS staff and volunteers, for their continued loyalty and commitment to the work of INS. It is because of their dedication that INS is able to support our service users within the boroughs of Richmond upon Thames and Hounslow to enable them to live as independently as possible through the support of INS's integrated approach.

I hope you will take the time to read on and that you find the report both interesting and inspiring.

Anne Gowan

Chair of Trustees

About INS

At Integrated Neurological Services (INS), we have over 30 years' experience supporting adults in Hounslow and Richmond with neurological conditions to access long-term, professional and peer support in the community. Together with their carers, we help them to manage symptoms, increase independence and live well with their condition.

We provide the affordable, ongoing neurological care and rehabilitation, which is not available on the NHS, to help people improve their condition or prevent it from deteriorating.

Our multidisciplinary team delivers therapy, social and emotional support tailored to people's individual rehabilitation needs and goals.

Neurological conditions can be life-changing if they cause long-term disability and affect people's ability to live independently.

We assess the whole person before providing services and support to help with physical, cognitive and communication issues and improve people's independence, confidence and social participation.

We offer support for as long as needed, often over many years. Help, advice and peer support is also available for family carers, many of whom have health issues of their own.

To make our services as accessible as possible all individual services including therapy and counselling sessions, carers' groups, and social and creative activities are free of charge. We make a small charge for some therapy groups.

The trustees who are also directors of the charity for the purposes of the Companies Act 2006, present their report with the financial statements of the charity for the year ended 31 March 2025. The trustees have adopted the provisions of Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019).

OBJECTIVES AND ACTIVITIES

Objectives and aims

Looking Back - Strategic aims for 2024/25

We have continued our strategic development to make the charity as resilient and agile as possible, so we can respond to future challenges and ensure a secure and sustainable service. Following our Strategy Day in April 2024, we identified the following as key priorities for 2024/25:

- Manage demand for service users to ensure sustainable growth within capabilities for resources and funding." Develop a multi-skilled workforce which is adaptable, flexible and responsive to meet changing needs and demand.

- Measure outcomes for service users and their journey through INS.

- Develop an adaptable working model for 'INS satellites' to reach more people and provide more accessible services.

- Increase partnerships with external providers to reach more service users, supplement our resources and provide wider expertise to the INS community.

- Develop our digital strategy to build skills and capabilities in technology, including INS website and IT systems, to help manage resources and achieve strategic aims.

- Build and diversify current funding and resources to ensure financial support for strategic aims.

- Develop our profile with statutory services and act as an influencer on behalf of the INS community within local health service changes.

- Develop a premises strategy to meet the needs of our future services.

.

ACHIEVEMENTS AND PERFORMANCE

Charitable activities

Demand and Complexity

INS continues to see high demand for services and high levels of complexity. In 2024 we received 284 referrals for clients and carers, a 2% increase from 2023. Despite this being smaller than the previous year's increase, our small team of administrative and clinical staff continue to work at full capacity, seeing more complex cases which require more input than before. Based on increasing demand and available resources, from April 2024 we stopped accepting new referrals from boroughs outside Hounslow or Richmond, with exemptions for cases where the person referred is registered with a Hounslow or Richmond GP practice.

The distribution of referrals received by borough has remained similar to previous years, with 51% of referrals originating from Richmond, 46% coming from Hounslow, and 3% coming from individuals living out of area but with GPs in Hounslow or Richmond: a reduction compared to the previous year's 8.6%. In Richmond, self-referral has continued to be the most common referral route, followed by referrals through the Richmond Rehab Unit. In Hounslow, referrals most often come from voluntary organisations like the Stroke Association, or Hounslow GPs.

Stroke is the most common neurological condition referred to our services, representing around 45% of all referrals received in the past year. 58% of referrals received for individuals living Hounslow were for Stroke clients. Stroke referrals have also increased in Richmond, growing from 25 referrals last year to 48 referrals this year. Most referrals we receive are for older people; 60% of people referred this year were over the age of 60, with the average age of referred people being 61.

Due to funding challenges in Hounslow, we have had to reduce our provision in the borough of Hounslow while ensuring a high quality of service for those Hounslow residents we support. This has been extremely challenging as many of the Hounslow service users face complex health and social issues.

This year we are proud to have supported 800 people, 60% of whom are aged 65 and older. An increasing proportion of our service users are adults of working age, with most of these individuals having experienced a stroke; 41% of service users aged under 65 who had interventions during the year were stroke survivors, and 46% of referrals received for people aged 65 and under were for people who have had a stroke compared to 44% in the previous year. People of different ages have changing needs and priorities, so over the year we have adapted our services to better accommodate the increasing number of service users who are in work by offering some sessions online and later in the day.

During the year we delivered an average of 19 interventions per person - a 19% increase compared to the previous year. We delivered 1,483 one-to-one complementary therapy and counselling sessions, which includes one-to-one physiotherapy, occupational therapy, and speech and language therapy as well as one-to-one support and advice.

During the year, we carried out 133 home visits to provide assessments, reviews, and 1:1 therapy sessions for service users who were unable to visit INS. We assisted some service users to access transport solutions such as Dial-a-Ride and blue badges, which gave them more independence to leave home and access community activities.

Following our strategic aim to increase our capacity, we increased our bank of Therapy Assistants, who support the clinical team in the delivery of groups and with clinical administration.

We were able to offer some new groups this year, while continuing to offer our core range of popular activities. We restructured some of our popular groups to accommodate more people in need while ensuring the safety of all participants. As a result, 359 individuals were able to attend group sessions, a 7% increase compared to last year.

To ensure that we have capacity for new service users to receive services we have in some cases changed groups to fortnightly: groups like our Neuro Exercise satellite in Barnes and our Monday Neuro Exercise group have changed to a fortnightly model, with two groups running on alternating weeks. Some activities, such as our popular Open Gym, have moved from continuous attendance to 8-week blocks, to provide flexibility and allow more people on our waiting lists to access services.

Additionally, we have increased information about alternative providers and other services available.

During the year, the proportion of interventions for Richmond service users has increased from 47% in 2023/24 to 50% of all interventions in 2024/25. The proportion of interventions for service users in Hounslow has decreased from 45% in 2023/24 to 40% in 2024/25 due to the closure of our Hounslow satellites, resulting in a reduction of activity in the borough.

Around 10% of interventions were recorded for people living outside the boroughs of Hounslow and Richmond. This includes some carers who we do not have borough data for, but their cared for live in the catchment areas and are receiving our services. 28% of service users who fall under this category are registered with a GP practice in Hounslow or Richmond.

Conditions Supported

Stroke, Parkinson's and Multiple Sclerosis (MS) remain the most prevalent conditions among our service users, with 40% of clients presenting with Stroke, 26% of clients having Parkinson's, and 11.6% of clients living with Multiple Sclerosis. We continue to see a rise in referrals for people living with multiple health conditions, and 36% of people we supported last year have more than one neurological diagnosis.

This year we supported twice as many people with Traumatic Brain Injury as the year 2023/24. We also experienced an increase in the number of people with Motor Neurone Disease (MND) receiving our support, for whom timely intervention is vital.

We supported 9 people with Functional Neurological Disorder (FND). INS is currently the only service in Richmond able to support people with this diagnosis, as the Community Neuro Team is not commissioned to cover this condition.

New Groups

Upper Limb group

In May, our physiotherapist and occupational therapist ran a six-week multi-disciplinary Upper Limb course for Stroke survivors. The course focused on Stroke education and establishing treatment plans based on the clients' individual goals. They supported clients to think about how they might increase the use of their affected arm in home-based activities and meaningful tasks. It was a great opportunity for peer support, and service users were encouraged to share their ideas and experiences of recovery and rehabilitation.

Music Therapy

In June, we collaborated with Otakar Kraus Music Trust to pilot an occupational therapy-led course of 8 Music Therapy sessions for clients with musical experience who wished to re-engage in music. Members explored musical influences with an aim to select a shared piece of music to learn and play together.

Online peer-support groups

As part of our aim to be accessible to all service users, in August we launched a monthly online group for people living with MS, focusing on peer support and with topics chosen by participants. The group meets online each month, with a topic chosen by members to research and share alongside general discussion.

In response to demand from our service users, we also launched an online peer support group for working age adults with Parkinson's. Both online sessions run later in the afternoon, which is ideal for service users who may have work commitments during the day.

Tai Chi

In February 2025 we ran a pilot course of 8 weekly Tai Chi sessions, delivered by Aileen at Dao Lu CIC. Feedback for the sessions was very positive, and participants felt that the group improved both their physical and their social and mental wellbeing.

Thinking Together

Our clinical team is seeing more service users who have cognitive issues due to their neuro condition and find it hard access community and statutory services they need. To help address these challenges for service users with neurological challenges and their carers, we piloted a new OT-led cognitive group called Thinking Together. The group aims to increase understanding of cognitive challenges which can result from conditions like traumatic Brain Injury, Stroke, Parkinson's, and Multiple Sclerosis, and to promote strategies for adapting together. It encourages shared understanding and collaborative problem-solving for both those with neuro conditions and their carers. By educating both parties, the group helps foster empathy, communication, and a team approach to managing everyday cognitive challenges.

Each session focused on a different aspect of cognition, with seven key areas such as memory and attention, emotional regulation, communication and executive function. Sessions included education, group discussions, and practical strategies that members participated in during the sessions. The group included 10 participants: 8 people with neurological conditions and 2 carers. Feedback was positive, with participants appreciating the opportunity to learn in a supportive and relatable environment.

We plan to deliver further Thinking Together groups as part of our programme, together with a structured workbook, developed in collaboration with the pilot group, to enhance the learning experience. This will contain detailed information and reflective exercises based on slide presentations from each session and will support both in-session learning and home practice.

Defining Outcomes

Our outcomes are complex for those with a long-term or progressive neuro condition, and given the varied nature of neurological conditions' presentations we are mindful that our service users' goals and outcomes will vary significantly. Our focus is on helping them, and their carers, to live well with their condition and stay as independent as possible. This may be through improving mobility, cognitive or communication skills, supporting them to walk or drive again, return to work, or to feel confident to engage with others. We want people to feel empowered to manage their condition and help them get effective and timely support from relevant statutory and voluntary organisations.

Many service users have cognitive and communication issues and need one-to-one support or input from carers or family to evaluate their response. For example, therapists may use standardised tools to measure progress or use communication friendly survey methods (e.g. forms designed for people with Aphasia).

Within the varied service user group at INS, it can be challenging to capture outcomes, however our re-energised approach enabled us to successfully bid for Motability Foundation funding where a key aspect of the project is to devise an assessment tool and review the progress of participants. The monitoring and evaluation process for this project is helping to advise other aspects of INS' provision and outcome measurement.

Moving forward - demonstrating the impact of our holistic support

We continue to develop this as one of our strategic priorities, focusing on the following actions:

- Moving away from an output-based focus, with more co-production with service users and partnership working.

- Review of assessment forms and processes.

- Increased team collaboration to define outcomes and measurement criteria relating to neuro conditions.

- Consultations with a representative sample of service users to develop best approach

- Piloting the Motability 'Travel with Confidence' project to develop assessment tools to measure barriers and successes and develop tools to capture overall changes.

- Biannual INS experiences survey - implementing suggestions and feedback.

Case Study: Bharti and Anil

In 2025, INS was chosen as one of the charities supported by local grant funder Hampton Fund, to feature in a short video about their work. Bharti, who is an INS client, and Anil, her husband, spoke with the Hampton Fund about how INS has supported them since Bharti was referred in 2013, following her diagnosis of Parkinson's.

At the time of her referral Bharti was working, while adjusting to her changing symptoms as her Parkinson's progressed. In her interview, Bharti describes how attending activities at INS and meeting other people with Parkinson's helped her both practically and emotionally.

"The staff here are wonderful. They gave me confidence."

Bharti has been able to attend a variety of groups and activities, including exercise groups like Move into Wellbeing, and Expanding Horizons activities like Creative Writing.

Bharti's husband, Anil, has also received support from INS, through direct support and advice as well as through respite when Bharti is attending sessions.

"When Bharti comes to any exercises here (to INS), my mind is at peace… Bharti's in safe hands… If Bharti had to go anywhere without me, where I didn't know the place, I'd be very anxious. When Bharti's at INS I can feel at ease."

(Document contains link to INS video feature created by Hampton Fund)

Carers' Support

In March we shared a survey with our carers, asking about their experience of using our services and the impact of their caring role on their lives. 22 carers responded. Most people who answered care for their spouse, while some people care for a sibling, adult child, or parent. 64% of respondents have been supporting someone with a neurological condition for more than five years.

People shared how their caring responsibilities impact their daily lives, with many saying they provide full time support for their family member, which has reduced their ability to work and engage with hobbies or social activities. One person said, "I think around my husband's needs first, then work around them."

We asked carers how INS has helped them. Many people wrote about the value of having someone to talk to, whether that person is a member of staff or another carer. The information and resources provided in conversations and sessions have helped carers to navigate often-challenging health and social care systems to access the support they need and are entitled to.

Some participants have accessed our counselling service, online Mindfulness drop-in sessions, and carers' exercise sessions, which they found helpful for their fitness and wellbeing. Some people also noted that they benefit from respite when their family member is attending sessions at INS.

91% of respondents agreed that support from INS had helped them to feel less isolated, even if they cannot regularly take part in sessions. One person shared, "I don't engage as much, because I am often looking after my dad. But the emails and info make me feel connected and, really importantly, I feel if I ever desperately needed some support for myself, I could start with INS for support and I feel there is expertise to help and empathise."

Although many carers refer to us for individual and group support, such as advice, counselling or our mutual support groups, some prefer to seek advice from our clinical team during INS therapy sessions with their cared for person. Increasingly carers want advice and information around their concerns for the future, as the person they care for may have changing needs.

Some individuals do not identify as an unpaid carer and do not present for help. We are always looking at new ways to support those people.

Partnership Working

Working with partners is very important as it enables us to reach more people to access our services, raise awareness of INS support, increase capacity and provide wider expertise to the INS community. These partnerships ensure INS continues to evolve and improve our practise and opportunities for our service users.

CILS partnership

INS continues to work as part of the Community Independent Living Service (CiLS) partnership, delivered by 20 local charities and led by Age UK Richmond. This includes accessing Age UK Richmond's Barnes Green Centre to deliver weekly neuro exercise groups.

Richmond Carers

For over a decade we have carried out a contract as part of the Carers Hub Service to provide support and advice for carers of adults with neurological conditions living in Richmond. The hub includes six local charities, led by

Richmond Carers Centre,

Hounslow Stroke Association

In 2025, we celebrated five years of our partnership with the Hounslow Stroke Association, as part of the Hounslow Stroke Services contract. This contract enabled us to expand our support further into Hounslow, which included our satellite venues in Brentford and Feltham.

Move Into Wellbeing

Our partnership with Move Into Wellbeing, who deliver blocks of chair-based dance sessions at our premises in Twickenham, has been consistently popular and well received by our service users since we started working together in 2023. The sessions are led by a Move Into Wellbeing instructor and supported by INS staff and volunteers.

Otakar Kraus Music Trust

We continue to work with the Otakar Kraus Music Trust to deliver group Music Therapy sessions throughout the year. This year we worked collaboratively to deliver pilot groups with input from our Occupational Therapist and our Speech and Language Therapist.

Kew Gardens Discovery Team

We were pleased to collaborate with the Kew Gardens Discovery Team, who led three nature discovery workshops for service users at our premises in Twickenham and at our satellite venue at the Barnes Green Centre. The sessions were well attended by INS service users and attendees at the Barnes Green Centre.

Queen Elizabeth's Foundation for Disabled People (QEF)

We have enjoyed a continued partnership with the Queen Elizabeth's Foundation for Disabled People, who deliver monthly driving assessment and adaptations' advice clinics at our premises in Twickenham. This is invaluable for those who have been recently diagnosed or whose condition has deteriorated.

Training for Medical Students

We have an annual contract to provide teaching sessions to medical students at St. George's Hospital, involving service users with lived experience of neuro disability and caring

for someone with a neurological condition. Over 300 students receive online training from INS each year.

Developing Our Profile

During the 2024/25-year INS has been involved in work across Hounslow and Richmond actively advocating for the needs of people with neurological conditions and their unpaid carers and creating engagement opportunities for their lived experiences to be shared.

This work has included playing an active part in Hounslow's Age and Disability Equality Group and working with South West London Healthwatch to engage with INS service users regarding Accessible Information Standards.

We have also participated in two Richmond work streams, the first as part of the Modern Day Services Future Design Work Group, and more recently a Joint Needs Assessment for people with neurological services led by Richmond Public Health.

The Team

Developing a multi-skilled team of staff means we can continue to be flexible and responsive to changing needs and demand in delivering our holistic therapy, social and emotional support. We have a multidisciplinary team which includes clinical therapists, social worker, counsellors and support staff. All clinical staff are registered with the Health and Care Professions Council and counsellors with professional bodies. We have continued to grow our bank team, enabling the charity to provide a wide range of services and respond to new projects; this has been particularly helpful in delivering satellite services. From a financial perspective, it allows us to staff services appropriately according to funding changes and challenges.

As part of our strategic plan, in February we successfully recruited Evana Topolovec to our new role as Operations Lead (4 days/week) to support the CEO/Clinical Lead in areas like Finance, HR and IT and lead on our future premises strategy. The CEO/Clinical Lead also works a 4-day week.

Our Therapy Assistants provide essential support to our clinical team, and last year both assistants left to train as a Physiotherapist and Occupational Therapist, following their work at INS. We recruited two new Therapy Assistants, who have been working with our therapy groups and supporting service users in a range of activities.

Last year we said goodbye to one of our Trustees, Karen Pearce, who chaired our Clinical committee. INS currently has nine Trustees on the board, and we are recruiting for a new clinical Trustee.

We have continued to offer longer-term student placements in different therapy areas, including physiotherapy and speech and language therapy. This provides them with the opportunity to support individual and group sessions, which gives them valuable hands-on experience, something we feel is important to support the next generation of professionals.

Feedback from the students about their placement experience at INS was very positive, with the two speech and language students saying how a placement at INS has helped them grow in confidence and develop their clinical skills, as well as having the opportunity to work with such kind and passionate clinicians.

Early in 2025, INS was awarded a three-year grant from Motability Foundation to support people with neurological conditions and their carers to travel with confidence, using public transport. This will be delivered by our occupational therapy team, and the project includes funding for a part-time Occupational Therapist and a part time

Therapy Assistant.

Our work would not be possible without our wonderful team of over 25 volunteers, who help with administration, IT and fundraising, as well as supporting a range of therapy, exercise and activity groups. Without them, we would struggle to give so many people the support they need and we always welcome new volunteers. We are also fortunate to have the support of several expert volunteers in areas like IT, database, and project management, who have helped us develop more efficient ways of working.

Digital Infrastructure

Building on work completed in the previous year, we have continued to improve and maximise the use of technology at INS. This is an area where expert volunteers have enhanced what has been achieved, particularly in upgrading our database. Our new Operations Lead has optimised our use of our cloud-based software by upskilling the team.

During the year, we developed and refined our online referral webform, which individuals and professionals can use to submit referrals to INS services. This form is linked directly to our database and means that referrals do not need to be sent by email, which improves our data security. Alternate versions of our referral form are still available for potential service users who may be unable to access the webform.

Having launched our new website in September 2023, our new web platform has enabled us to be agile in our communications, fundraising, and events advertising. Our team can easily create pages for challenge events and fundraising appeals, and the site's improved editing capabilities means that information is up to date.

We are continuously reviewing our data collection and reporting processes, and working with our IT volunteer, Patrick, to make improvements where we can. As part of this we recently updated our database to record the duration of our interventions with service users, which will enable us to analyse the amount of support received in more depth.

In August 2024, to prepare for the Big Give Christmas Challenge Appeal, we began to use Mailchimp for digital fundraising and communications. Using Mailchimp has allowed for improved supporter engagement, as well as more efficient communication with service users. We are continuing to explore Mailchimp, and we look forward to developing new and engaging ways to communicate with our supporters and the INS community.

INS in Barnes

We have continued to offer physiotherapist-led exercise classes at Barnes Green Centre for INS clients, in partnership with Age UK Richmond as part of the Community Independent Living Service (CILS). The neuro exercise group has become so popular that as of April 2025, we now run two groups on alternating weeks to increase opportunities for people to attend.

These sessions are ideal for people living further away from our main premises in Twickenham, who may not be able to travel regularly for exercise. 60% of service users who attended sessions at the Barnes Green Centre have only attended INS services at that venue within the last 12 months. Alongside the neuro exercise group, our Physiotherapist also delivers one-to-one assessments and reviews at the venue.

63% of Barnes satellite attendees are aged 70 and older, compared to 50% of all Richmond service users. According to the 2021 census almost 1 in 6 Richmond residents are aged 65 and older, and the borough is home to the 4th highest proportion of people aged 66 and older living alone in London. These factors contribute to an ageing population which is at a higher risk of developing neurological conditions.

This year we have been able to further diversify the range of activities offered at the venue. Our Speech and Language Therapist delivered an education session to satellite attendees, and in August the Kew Gardens Discovery team delivered a nature workshop in collaboration with INS, which was attended by INS clients and 13 Age UK Richmond service users.

INS in Hounslow

This past year has been a story of great success and disappointment. All three satellites had grown in both levels of activity and the diversity of sessions and partners delivered. For both Hounslow and Barnes service users it allowed access to INS nearer to home and therefore individuals were more likely to accept referrals to the service. As detailed below, Hounslow organisations were hugely disappointed about the closure of the satellites and concerned about the impact on their clients. Satellites provision will continue to be part of INS's strategic aims.

Our weekly satellite groups at venues in Brentford and Feltham continued to be popular last year. 19 clients and 7 carers came to Wednesday afternoon sessions at The Musical Museum in Brentford between April and December, and 43 clients and 14 carers attended sessions at Age UK in Feltham during the same period.

Despite growing numbers, due to a lack of funding, both Hounslow satellite projects were unfortunately forced to close in December 2024. The closure of the Hounslow satellites is of great concern, as the activities at both venues were a vital outreach for people at the far ends of the borough who may experience barriers to accessing services at our main premises in Twickenham.

To help reduce the impact of these closures, all Hounslow satellite attendees were contacted to discuss other support options that INS may be able to offer. A feedback form was also shared with attendees, who shared their thoughts on the closures. One respondent described feeling, "utterly heartbroken at the demise of the Feltham satellite."

The clinical team reviewed the list of attendees to identify those most affected by the closure of the satellites, using criteria such as individuals not attending other sessions at INS in Twickenham, online, or by home visit. Around 30 people were identified as high-priority for outreach, and they have been contacted by the team with alternative solutions for support, including in-person and online exercise, communication, and social groups.

Our Premises

As part of our Strategic plan, we have been evaluating options for a future, sustainable service delivery model, which includes extending our lease and upgrading facilities with a capital fundraising campaign or relocating to different premises within Richmond borough.

Last year, we achieved the following in developing our premises strategy:

- Action on key repairs and maintenance at INS, including upgrading fire protection and drainage.

- Recruitment of an Operations Lead in February 2025 to take change of all aspects of the building and its management. The role has focused on understanding building usage and costs of running the premises including future maintenance costs.

- Understanding the financial climate and future affordability of suitable premises.

- Communication with our landlord regarding longer-term opportunities in our current property. In 2025-26, this information will be used to create short- and longer-term plans.

Events

Heritage Walkathon

In June 2024 INS staff, supporters, and volunteers took part in a Heritage Walkathon, to celebrate 30 years of INS and raise money to support our services.

The walk started close to where INS was founded in Kew, and participants walked in two teams 'through our history' to our satellite venues in Brentford, Feltham, and Barnes in a celebration of our work across the boroughs. The walkathon raised over £3,200 including Gift Aid.

Bridge Drive

In April 2024 we held our Bridge Drive at Priory Park club in Kew. The event was attended by more than 40 people and raised £1,113.

We would like to thank Ellie, Sara, Frankie, Mark, Alan, and Beatrice for supporting and helping to organise the event and for hosting the Drive at the Priory Park Club.

We would also like to thank Squire's Garden Centres, and Newen's The Original Maids of Honour for generously donating raffle prizes.

Quiz Night

In November we held our annual Quiz Night, which was attended by around 80 supporters. The evening raised £1,900 for INS.

Thank you to Keith, Alan, Chris, Nicola, Debbie, and Michael for their exceptional support on the night.

Thank you to the businesses and individuals who generously donated prizes to our raffle, including The Maids of Honour, The Orange Tree Theatre, Twickenham Ales, Squire's Garden Centres, Syon Park, and EMPWRD Consultancy.

Fundraising

We are grateful to residents of Grove Park Terrace in Chiswick, who selected INS as the beneficiary of their summer street party, which raised £624 in donations.

In December 2024 we ran our first Big Give Christmas Challenge fundraising appeal, which was the first public match-funding appeal we have participated in. The appeal raised a total of £11,487 for our counselling service. The success of this appeal appeal created increased engagement with our donors and the confidence to increase the target for following year.

We are very grateful to our private match-fund pledgers, and to The Reed Foundation for acting as our match funding Champion. In January 2025 we won The Big Give's Supporter Engagement award, which included a prize of £1,000 in unrestricted funding.

Trusts and Foundations

The greatest success of last year was the securing of multiple multi-year grants enabling INS to look further ahead. Innovation and development helped secure a successful award from Motability Foundation to deliver a new area of service to INS clients and carers.

We are always trying to build our longer-term funding, as this helps us plan ahead in areas like recruitment, and we are so grateful to a number of generous Trusts and Foundations who continue to support us.

As part of this sustainable funding, in June 2024 we were given a wonderful 5-year endowment of £150,000 by the Edward Gostling Foundation, as part of their plan to wind up by 20230, with an amount to be drawn down annually.

We are also extremely grateful for the generous, ongoing support of two local grant makers, Hampton Fund and Richmond Foundation; in September 2024 we were awarded a 3-year core funding grant from Richmond Foundation.

In December 2024, we were delighted to be awarded a 2-year core funding grant of £70,000 from Garfield Weston.

Starting in June 2025, we have a fantastic 3-year project grant of £202,000 from the Motability Foundation to support our service users with neuro conditions and their carers to 'Travel with Confidence'.

Thank you also for the amazing support from: John Horseman Trust; Lambert Charitable Trust; Sir Jules Thorn Charitable Trust; National Lottery Awards for All England; Bruce Wake Charitable Trust; Ashcroft Charitable Trust; Girdlers Company Charity; Barnes Fund; Souter Charitable Trust; Dyers Company Charitable Trust; Marsh Charitable Trust; Percy Bilton Charitable Trust; Civic Pride Fund; British Aphasiology Society; P F Charitable Trust; Lower Hall Charitable Trust; William Allen Young Charitable Trust; February Foundation; Green Hall Foundation.

FINANCIAL REVIEW

Financial position

Review of Financial Results

INS made a deficit for the year of £22,550 (2023/24 £21,681). The decline on last year reflects an increase in income of £3,712 offset by an increase in costs of £4,581.

Income

INS receives most of its income from grants, donations and from contract income. The environment for fundraising and grants continues to be very competitive. We are grateful for the continued support from a number of generous donors including the Richmond Foundation, Hampton Fund and the Edward Gostling Foundation. Overall, the income from grants was lower this year which reflects the fact that some grant makers were not able to continue their funding due to factors such as changing priorities.

The income includes £52,189 in donations, which is slightly down on last year. We are delighted to have a number of supporters who have organised fundraising events for INS, such as marathons, sponsored walks and social activities. Some examples of these are set out earlier in the report. We were also fortunate to receive some large legacies with a total of over £20,000 received in the year.

Income from charitable activities includes income from contracts and teaching income. Overall income from charitable activities increased to £297,448 in the year, with increases in both contract income and teaching income.

Staffing and expenditure

INS continues to manage its expenditure carefully and seeks to minimise costs wherever possible. Total costs were in line with last year. Payroll costs for the year were held to £397,705 which is slightly lower than the previous year.

Non payroll costs were slightly higher in 2024/25 reflecting higher maintenance and repair costs on the premises as well as additional costs incurred in upgrading our digital infrastructure.

As noted above, INS depends upon grants and donations and we are very grateful to all our supporters and donors. Fundraising is a very important part of our business and we continue to focus our resources on pursuing appropriate opportunities. This helps us to maximise our effectiveness and the amount of funding which is directed to our charitable activities. Overall fundraising costs were held at 7% of income.

Reserves policy

The Trustees have reviewed the charity's reserves policy, taking account of the current uncertain economic circumstances and the funding challenges within the charitable sector.

They have agreed a policy to build towards holding six months' expenditure in unrestricted reserves This will help INS plan prudently for the future and strengthen its sustainability.

The level of unrestricted reserves at 31 March 2025 was £162,785 (2023/24 - £185,335).

FUTURE PLANS

Looking Ahead - Strategic aims for 2025/26

We have developed our Strategic Operational Plan, with key priorities to ensure sustainable growth for INS within achievable resources and funding. This strategic plan builds on the ongoing priorities for 2024/25 which we continue to work on along with our updated strategic aims.

In 2025/26 we will:

- Manage demand, capacity and funding planning by developing a new service model that reflects funding available in Richmond and Hounslow boroughs.

- Develop a long-term premises strategy to ensure sustainable, accessible service delivery. This includes continuing our locality approach to reach more people and remove barriers to engaging with INS.

- Continue to pilot and implement outcome measures across all our services, to show the difference our support makes to service users, and evaluate the best approach to assess these, depending on factors relating to people's neuro conditions.

STRUCTURE, GOVERNANCE AND MANAGEMENT

Governing document

The charity is controlled by its governing document, a deed of trust, and constitutes a limited company, limited by guarantee, as defined by the Companies Act 2006.

REFERENCE AND ADMINISTRATIVE DETAILS

Registered Company number

05292539 (England and Wales)

Registered Charity number

1107273

Registered office

82 Hampton Road

Twickenham

Middlesex

TW2 5QS

Trustees

Ms A Gowan Chair

L H Gray

Ms T P James

T D G Millar

G Norman

Ms K M Pearce

P A Rogers

Dr C Vyas

Ms J M Walmsley

S Williams

Company Secretary

Ms S Vines

Independent Examiner

Mary E Ryan FCCA

Ark Accountancy Limited

Chartered Certified Accountant

56-58 High Street

Ewell

Epsom

Surrey

KT17 1RW

Approved by order of the board of trustees on 12 November 2025 and signed on its behalf by:

S Williams - Trustee

Independent examiner's report to the trustees of Integrated Neurological Services ('the Company')

I report to the charity trustees on my examination of the accounts of the Company for the year ended 31 March 2025.

Responsibilities and basis of report

As the charity's trustees of the Company (and also its directors for the purposes of company law) you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 2006 ('the 2006 Act').

Having satisfied myself that the accounts of the Company are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of your charity's accounts as carried out under Section 145 of the Charities Act 2011 ('the 2011 Act'). In carrying out my examination I have followed the Directions given by the Charity Commission under Section 145(5) (b) of the 2011 Act.

Independent examiner's statement

Since your charity's gross income exceeded £250,000 your examiner must be a member of a listed body. I can confirm that I am qualified to undertake the examination because I am a member of the Association of Chartered Certified Accountants, which is one of the listed bodies.

I have completed my examination. I confirm that no matters have come to my attention in connection with the examination giving me cause to believe:

1.	accounting records were not kept in respect of the Company as required by Section 386 of the 2006 Act; or

2.	the accounts do not accord with those records; or

3.	the accounts do not comply with the accounting requirements of Section 396 of the 2006 Act other than any requirement that the accounts give a true and fair view which is not a matter considered as part of an independent examination; or

4.

the accounts have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice for accounting and reporting by charities (applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)).

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

Mary E Ryan FCCA

The Association of Chartered Certified Accountants

Ark Accountancy Limited

Chartered Certified Accountant

56-58 High Street

Ewell

Epsom

Surrey

KT17 1RW

12 November 2025

31.3.25

31.3.24

Unrestricted

Restricted

Total

Total

funds

funds

funds

funds

Notes

£

£

£

£

INCOME AND ENDOWMENTS FROM

Donations and legacies

2

227,334

86,613

313,947

314,183

Charitable activities

5

Charitable Activities

171,586

125,862

297,448

277,166

Other trading activities

3

3,108

-

3,108

18,102

Investment income

4

16,700

-

16,700

18,040

Total

418,728

212,475

631,203

627,491

EXPENDITURE ON

Charitable activities

6

Charitable Activities

441,278

212,475

653,753

649,172

NET INCOME/(EXPENDITURE)

(22,550

)

-

(22,550

)

(21,681

)

RECONCILIATION OF FUNDS

Total funds brought forward

185,335

-

185,335

207,016

TOTAL FUNDS CARRIED FORWARD

162,785

-

162,785

185,335

31.3.25

31.3.24

Unrestricted

Restricted

Total

Total

funds

funds

funds

funds

Notes

£

£

£

£

FIXED ASSETS

Tangible assets

12

8,734

-

8,734

11,170

CURRENT ASSETS

Debtors

13

25,698

24,698

50,396

22,672

Cash at bank and in hand

271,873

9,785

281,658

180,689

297,571

34,483

332,054

203,361

CREDITORS

Amounts falling due within one year

14

(143,520

)

(34,483

)

(178,003

)

(29,196

)

NET CURRENT ASSETS

154,051

-

154,051

174,165

TOTAL ASSETS LESS CURRENT LIABILITIES

162,785

-

162,785

185,335

NET ASSETS

162,785

-

162,785

185,335

FUNDS

16

Unrestricted funds

162,785

185,335

TOTAL FUNDS

162,785

185,335

The charitable company is entitled to exemption from audit under Section 477 of the Companies Act 2006 for the year ended 31 March 2025.

The members have not required the company to obtain an audit of its financial statements for the year ended 31 March 2025 in accordance with Section 476 of the Companies Act 2006.

The trustees acknowledge their responsibilities for

(a)	ensuring that the charitable company keeps accounting records that comply with Sections 386 and 387 of the Companies Act 2006 and

(b)

preparing financial statements which give a true and fair view of the state of affairs of the charitable company as at the end of each financial year and of its surplus or deficit for each financial year in accordance with the requirements of Sections 394 and 395 and which otherwise comply with the requirements of the Companies Act 2006 relating to financial statements, so far as applicable to the charitable company.

These financial statements have been prepared in accordance with the provisions applicable to charitable companies subject to the small companies regime.

The financial statements were approved by the Board of Trustees and authorised for issue on 12 November 2025 and were signed on its behalf by:

S Williams - Trustee

Cash flows from operating activities

Cash generated from operations

1

95,369

(68,075

)

Tax paid

1,706

2,108

Net cash provided by/(used in) operating activities

97,075

(65,967

)

Cash flows from investing activities

Purchase of tangible fixed assets

(602

)

(7,560

)

Interest received

4,496

-

Net cash provided by/(used in) investing activities

3,894

(7,560

)

Change in cash and cash equivalents in the reporting period

100,969

(73,527

)

Cash and cash equivalents at the beginning of the reporting period

180,689

254,216

Cash and cash equivalents at the end of the reporting period

281,658

180,689

1.	RECONCILIATION OF NET EXPENDITURE TO NET CASH FLOW FROM OPERATING ACTIVITIES

31.3.25

31.3.24

£

£

Net expenditure for the reporting period (as per the Statement of Financial Activities)

(22,550

)

(21,681

)

Adjustments for:

Depreciation charges

3,038

3,420

Interest received

(4,496

)

-

Increase in debtors

(29,430

)

(15,275

)

Increase/(decrease) in creditors

148,807

(34,539

)

Net cash provided by/(used in) operations

95,369

(68,075

)

2.	ANALYSIS OF CHANGES IN NET FUNDS

At 1.4.24

Cash flow

At 31.3.25

£

£

£

Net cash

Cash at bank and in hand

180,689

100,969

281,658

180,689

100,969

281,658

Total

180,689

100,969

281,658

1.	ACCOUNTING POLICIES

Basis of preparing the financial statements

The financial statements of the charitable company, which is a public benefit entity under FRS 102, have been prepared in accordance with the Charities SORP (FRS 102) 'Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019)', Financial Reporting Standard 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' and the Companies Act 2006. The financial statements have been prepared under the historical cost convention.

Integrated Neurological Services meets the definition of a public benefit entity under FRS102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated on the relevant policy note.

Income

All income is recognised in the Statement of Financial Activities once the charity has entitlement to the funds, it is probable that the income will be received and the amount can be measured reliably.

Expenditure

Liabilities are recognised as expenditure as soon as there is a legal or constructive obligation committing the charity to that expenditure, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all cost related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with the use of resources.

Tangible fixed assets

Depreciation is provided at the following annual rates in order to write off each asset over its estimated useful life.

Furniture & equipment

-

20% on cost

Taxation

The charity is exempt from corporation tax on its charitable activities.

Fund accounting

Unrestricted funds can be used in accordance with the charitable objectives at the discretion of the trustees.

Restricted funds can only be used for particular restricted purposes within the objects of the charity. Restrictions arise when specified by the donor or when funds are raised for particular restricted purposes.

Designated funds have been created to provide for the dilapidation of the leased property.

Further explanation of the nature and purpose of each fund is included in the notes to the financial statements.

Hire purchase and leasing commitments

Rentals paid under operating leases are charged to the Statement of Financial Activities on a straight line basis over the period of the lease.

Pension costs and other post-retirement benefits

The charitable company operates a defined contribution stakeholder pension scheme. Contributions payable to the charitable company's pension scheme are charged to the Statement of Financial Activities in the period to which they relate.

2.	DONATIONS AND LEGACIES

31.3.25

31.3.24

£

£

Donations

52,189

57,215

Gift aid

10,804

6,871

Legacies

20,556

2,030

Grants

230,398

248,067

313,947

314,183

Grants received, included in the above, are as follows:

31.3.25

31.3.24

£

£

Steel Charitable Trust

-

15,000

Richmond Foundation

60,000

56,100

Barnes Fund

6,300

6,300

Other grants

2,290

31,242

Hampton Fund

40,000

29,800

Hounslow Thriving Communities Fund

-

22,800

Sports England

-

2,200

The February Foundation

5,000

5,000

The Bruce Wake Charitable Trust

-

2,000

Heathrow Community Trust

5,320

7,980

Geoff & Fiona Squire Foundation

-

5,000

John Horseman Trust

10,000

15,000

Edward Gostling Foundation

30,000

14,000

Basil Samuel Charitable Trust

-

10,000

Souter Charitable Trust

2,000

3,000

PF Charitable Trust

4,000

3,000

Sir Jules Thorn Charitable Trust

3,500

3,000

Lambert Charitable Trust

2,500

5,001

Vandervell Foundation

-

2,000

National Lottery Community Fund

13,500

9,644

LB Richmond upon Thames

2,988

-

Richmond Carers

450

-

Greenhall Foundation

2,000

-

The Girdlers' Company Charitable Trust

1,550

-

William Allen Young Charitable Trust

2,000

-

Garfield Weston Foundation

35,000

-

The Dyers Company

2,000

-

230,398

248,067