CARE HOMES FOR OLDER PEOPLE
Clarkson House 56 Currier Lane Ashton-under-Lyne Tameside OL6 6TB Lead Inspector
Unannounced Inspection 03:30 2 October 2008
nd X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Clarkson House Address 56 Currier Lane Ashton-under-Lyne Tameside OL6 6TB Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 308 4618 0161 339 9588 Clarkson House Residential Care Home Limited Anand Pooloogadoo Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (28), Physical disability over 65 years of age (24) Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 28 service users to include: *up to 28 service users in the category of DE(E) (Dementia over 65 years of age. *up to 24 service users in the category of PD(E) (Physical disability over 65 years of age). *up to 28 Service users in the category of OP (Old age not falling within any other category). *up to 2 service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 5th September 2006 2. Date of last inspection Brief Description of the Service: Clarkson House is a detached building that has been adapted and extended to provide accommodation for 28 service users, some of who may have dementia or physical disabilities. The accommodation is provided in 24 single rooms, fourteen of which have an en suite facility. There are aids and adaptations to meet the assessed needs of the service users. Level access is provided throughout the building; the exception being rooms on the mezzanine floor where service users have three steps to negotiate, grab rails are provided for their assistance. On the ground floor there are two sitting rooms, one conservatory and dining room. There are gardens to the side and rear of the property. Off road parking is provided at the side of the house. The home is located in a residential area, close to the centre of Ashton, with the associated shops, community resources and public transport links. Fees for the home range from £364.78 to £393.28 extra not covered by the fee include personal clothes newspapers, hairdressing, chiropody, incontinence wear, outings and social fund. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes
This was a key inspection that included a site visit to the home. The manager was not told beforehand that we were coming to inspect, this is called an unannounced inspection. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social Care (CSCI) about the service provided at the home since the last inspection. During the site visit a selection of records, care plans, policies and procedures was examined. Discussions took place with the manager, staff working in the home, and some relatives who were visiting. Several residents living in the home were spoken to during the visit, and discussions took place with them to find out what they thought about the home and what they felt about how the staff supported them. A tour of the home was undertaken and residents were asked for their comments and views about the environment. Before the inspection, we also asked the manager of the service to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This is one of the ways that we get information from the manager of the service, about how they are meeting outcomes for people using their service. Information that was provided in the (AQAA) for this service provided evidence of a service that was committed to focusing on positive outcomes for the people who use the service. Since the last inspection visit, which took place on 5th September 2006, the Commission for Social Care Inspection has not received any concerns about this service. There was evidence during this visit that the manager was managing complaints well, and that procedures were followed appropriately. Over the last twelve months the home’s manager has received 2 complaints, and these were investigated within 28 days. The response made by the home shows that no matter how small the complaint, the home takes all concerns seriously. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 6 What the service does well:
From observations made during this visit, there was evidence that this home continues to work towards improving and developing systems within the home. Staff demonstrated an understanding of good care practice. There was a strong focus on listening to the views of the residents and their relatives, and in providing flexible care and support arrangements. All the residents spoken to were extremely positive about their experiences in the home, and about the way the home was run and managed. From comments made by residents and their relatives and from observations made, this is a home that actively encourages people to express their views, so that the service can use the comments to learn and develop the service. Residents were very complimentary about the way in which staff provided care and support. Some of the comments from residents were as follows: “Staff are very good, they can’t do enough for you”. “Staff are brilliant, nothing is too much trouble”. “I am confident in approaching the staff with any concern, they are so approachable”. “The manager comes round every day, and if you have a complaint he likes to know about it straight away so he can put it right”. “The staff are marvellous. The manager is always interested in us”. Comments from relatives and visitors were also positive, and mirrored the experiences and comments made by residents in the home. One relative said, “There is a real personal touch here, and I am confident that they meets the needs of people here”. The home has a motivated staff team and a supportive management structure. Staff and residents in the home expressed confidence in approaching the manager with any issues of concern. The staff team provided care and support in a caring and sensitive manner. Nothing seemed too much trouble, and during observations made during the site visit there were several examples of good care practice when staff responded into residents in a positive and spontaneous manner. Care plans provided clear details for staff to use when providing care and support. Good systems were in place to review care plans and to encourage residents and families to be involved in the process. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 7 The physical environment both internally and externally was well maintained and provided a pleasant place for residents to live and entertain their family and friends. Good systems were in place to monitor care practices in the home including the safe administration of medication. This helps residents to feel confidant that they will receive care in a professional way and that they will receive medication safely. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are given sufficient information about the home to help them in making a decision about their care arrangement. Residents’ needs are assessed prior to admission to the home so they are confident their needs will be met, and the home is sure it can meet their personal needs. EVIDENCE: The home have a service user guide which is offered to all prospective residents and to anyone making an enquiry about the home. Relatives who were spoken to confirmed that they were given information prior to arranging an admission for their family member. This is good practice and ensures that prospective residents are given sufficient information to help them in making an informed choice about their future care arrangements. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 10 Three care plan files were looked at. There was evidence on the files to show that the home made every effort to ensure that they obtained sufficient information to generate a working care plan. During this visit, the manager and a senior staff member showed us some new documentation which they intend to use for gathering information on new residents. This will form the basis of pre admission documentation. The manager showed us a copy of a letter that he sends out to all people offered a place at Clarkson House. This provides confirmation in writing that the home is able to meet assessed needs. This practice helps prospective residents to be confident that the home is the right place for them before moving there. One resident had recently had a period of stay in hospital. There was evidence to show that the manager had visited the resident in hospital to undertake an assessment. The information obtained was used to develop an interim care plan, which would be used as the basis for the development of a detailed care plan. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8.9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care received by residents is based on individual needs. EVIDENCE: All individual care needs were clearly documented with detailed instructions for staff on how residents wanted to be supported. There is space on the new care plan reviews to include the signature of the resident and relative to demonstrate that they have been involved in the process. Records were in place to monitor nutrition, weight, falls and general risk assessments including moving and handling. There was also a system for staff to monitor falls to identify the patterns. The manager said that the incident of falls had decreased over recent months. Documentation was in place to evidence this.
Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 12 There was documentation to show that regular monthly reviews were taking place, and where changes had taken place in health care needs, these had been updated in the care plan. Relatives who were spoken to said that the staff always kept them updated about any changes in healthcare needs. One relative said, “ I am confident that they look after my father properly. The staff phone me up and keep me informed and they get the doctor out if necessary. There is a real personal touch here”. There was evidence to show that residents were supported to access healthcare services and records were kept of all these visits including visits from the General Practitioner. One resident said, “ If I need to go to an out patient appointment, then one of the staff go with me”. All the residents who were spoken to during this visit were highly complimentary about the staff team. Staff were observed carrying out their duties in a sensitive, polite and caring manner. Residents were supported to maintain their privacy and dignity at all times. One resident said, “ Staff are brilliant, nothing is too much trouble for them”. Another resident said, “I can’t praise the staff enough, they have got to know me and they know if anything is troubling me”. Medication was administered using a monitored dosage system. Medication stock levels balanced with the written records. Records were in place for the receipt and disposal of medication. Controlled medication records were accurate. At the time of this visit none of the residents were self-medicating. Staff who are responsible for the administration of medication receive appropriate training so that residents can be sure that they will receive their medication safely. One of the senior staff is responsible for regular weekly audit of the administration of medication records. This has proved highly effective, and the manager said that practice issues related to the safe handling of medication has improved. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to engage in the social activities, and daily life in the home, and the home supports and encourages residents to maintain links with their family and friends, and to exercise as much choice and control over their lives as they can. EVIDENCE: A part time activities organiser is employed by the home. She is responsible for co-ordinating a range of activities. The activities available were listed in the reception area. All residents spoke to confirm that there was always a wide range of activities available including art and craft, gentle exercise etc. One resident said, “ There are always activities, I love the armchair aerobics”. Information in the AQAA showed that the service was actively looking at ways in which to improve on increasing positive outcomes for residents. The information states that they are being pro-active in opening up options for more outdoor activities and trips for residents.
Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 14 One resident said, “ There are no restrictions here we can come and go as we want, it’s free and easy”. Residents spoken to said they could come and go as they pleased. This was evident during the course of this visit, when staff were seen supporting residents to get on with their daily lives and routines in a way that suited them. Staff responded spontaneously to the requests of residents. The lunchtime was a relaxing and pleasant occasion. The dining room was bright and spacious and consisted of small group seating arrangements. The meal was well presented and residents said they enjoyed their meal. Residents stated that a choice of food is offered on a daily basis. One resident said that the menu was brought into the lounge every morning which was a time when they were individually consulted on their preferences. Two relatives said they had been invited to enjoy a meal with their parent. Both people reported that the meal was of a high standard. Residents seemed to enjoy the mealtime occasion. Staff engaged in meaningful and pleasant conversation and there was a warm ‘homely’ feel generated. All residents spoke highly of the meals in the home. Comments included: “Food is delicious. I have put weight on since I moved in here. The chef does a lovely cheese and onion pie”. “The meals are terrific”. “We have a catering chat line where we discuss menus and choices. You can always have a choice. There’s always alternatives to everything”. During this visit there were numerous visitors. There was an open and welcoming atmosphere. All relatives who were spoken to spoke highly of the warm welcome they received from the manager and staff team.. One relative said, “There are always plenty of staff on duty and they are so approachable. They always make us feel welcome”. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents rights are protected by robust polices and procedures and there is an open transparent approach to managing complaints. EVIDENCE: Clarkson House has a comprehensive complaints procedure, which is made available to existing and prospective residents and their representatives. The complaints procedure is displayed in a prominent position in the reception area of the home. There have been two complaints made to the home in the last 12 months. The response to the complaints was made within 28 days and considered all the points raised by the complainant. The tone of the response was positive and demonstrated that the home takes all complaints seriously, and that they welcome any opportunity to resolve issues of concerns and improve the service. From discussions with residents and relatives it was clear that they felt very relaxed and confident about raising any issue of concern. One relative said, “ This home welcomes any feedback, they are very approachable. We feel confident in going to the manager or staff with any concern”. Another relative
Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 16 said that he could speak to the manager at any time, “ He is so approachable and I know if I have a concern it will be quickly sorted”. Residents were equally confident about raising any issue of concern. One resident said, “The manager comes round to see us every day. If you have a complaint he likes to know about it straight away so that he can put it right”. Many residents made this type of comment during this visit. The Commission has not received any recent complaints about this service. During discussions with the manager and senior staff there was evidence of an open and transparent approach to any complaint and concern. The manager said that he supported staff to be pro-active in responding quickly to concerns raised by residents and their families. This approach ensures that issues of concern can be managed and addressed quickly and efficiently, so that positive outcomes are experienced by any complainant. There was evidence in documentation and in the information provided by the manager in the AQAA document, that safeguarding and adult abuse issues were re-inforced to staff in supervision sessions and staff meetings. The training programme included training in the protection of vulnerable adults. All of the staff who were spoken to had a good understanding of issues around abuse and what to do in the event of an allegation of abuse. Training in safeguarding had been extended to all staff on the team. They had a sound knowledge that social services must be informed and take the lead in allegation of abuse, and that the Commission must be informed. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with a safe, pleasant and hygienic environment. EVIDENCE: All residents who were spoken to expressed satisfaction with their bedrooms, and many had taken the opportunity to personalise them with their own small items of furniture, ornaments and pictures. There was a high standard of hygiene and cleanliness throughout the building and all areas were tidy. Infection control policies were in place and liquid soap and paper towels were provided in bathroom and toilet areas. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 18 Some residents sat in the conservatory, and said they really liked the feeling of being outdoors. They also commented that the outside garden areas had been recently improved and provided a pleasant place to sit in warmer weather. The manager said that there are plans to develop a sensory garden. There was evidence of an ongoing programme of decoration and refurbishment. All rooms are now single and new tastefully decorated en-suite facilities had been provided in a number of rooms. One relative said that he had noted that there were never any unpleasant odours in the home. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment, and training programmes were in place. Residents using the service can be confident that staff receive appropriate support and training, to ensure that they have the right skills to help them to meet the needs of the people they provide care and support to. EVIDENCE: During this visit, there appeared sufficient staff on duty to meet the needs of the residents in the home. One relative said there was always plenty of staff on duty. Another relative said that sometimes he felt there could be more staff so that more one to one time could be spent with residents. Staff were observed engaging in meaningful conversations, and seemed to respond quickly to any resident asking for support. Information provided in the annual quality assessment (AQAA) provides evidence that training is prioritised in the home. Training records showed that the home was making good progress with NVQ training. The home is a member of the local training consortium and as a result they take advantage of
Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 20 any training courses that are offered. Staff who were spoken to confirmed that they had access to training and development opportunities. Training records shoed that staff had competed training in a wide range of care related topics. Induction is linked to skills for care, which ensures that good standards are in place for training new members of staff. Three staff files were examined and contained the appropriate paperwork and documentation as required by regulation. Files examined contained two written references and Criminal Record Bureau (CRB) checks. Staff in the home said they felt that they worked well as a team. One member of staff said that he had noticed recent improvements in the paperwork and the day-to-day practice in the home. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This service is run in the best interests of the residents, and the management ensure that the safety and welfare of residents and staff is promoted. EVIDENCE: Residents, relatives and staff expressed confidence with the way in which the manager carried out managerial duties. All people spoken to said that the manager and senior staff were always approachable. One of the relatives spoken to during this visit said that she had found the manager very
Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 22 responsive to any problems, and that he was approachable and quick to respond to any complaints or concerns. Quality monitoring systems were in place, and there was evidence that the manager consulted with residents and their relative on a formal and informal basis. Regular surveys are completed, and the findings are collated into a report with an action plan to address issues raised. Staff supervision records were in place and reflected the experience of staff. Staff said that they felt well supported and that supervision was used as an opportunity to look at day-to-day work practice and any training and development opportunities. Information in the AQAA provided evidence that good standards were maintained for the maintenance of equipment for health and safety including fire prevention equipment. The findings during this visit provided evidence of a service that is committed to developing the service so that residents experience positive outcomes. Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Clarkson House DS0000065884.V365911.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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