CARE HOMES FOR OLDER PEOPLE
Acorn Nursing Home 125 Newton Drive Blackpool Lancashire FY3 8LZ Lead Inspector
Christopher Bond Unannounced Inspection 11th January 2007 09:30 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 Acorn Nursing Home DS0000068202.V324148.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. Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Acorn Nursing Home Address 125 Newton Drive Blackpool Lancashire FY3 8LZ 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) 01253 392440 01253 305705 awlison.matron@btconnect.com Axelbond Limited Mrs Ann Wilson Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (3) of places Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 40 service users to include:*Up to 37 service users in the category of OP (Old age not falling within any other category). *Up to 3 service users in the category of PD (Physical disability). Date of last inspection Brief Description of the Service: Acorn Nursing Home is a large home situated in a residential part of Blackpool. The home is close to Stanley Park and Victoria Hospital. The town centre is approximately two miles away and can be reached by a bus service, which stops near by. There are some small shops in the local vicinity. There are several parking spaces to the side of the house. The building has three floors and a lift is available for the residents to use. Most of the rooms are on the ground floor and the first floor. There are two dining areas and a separate lounge for the use of residents who smoke. The main lounge is at the rear of the house overlooking an extensive garden. There is plenty of space for the residents to sit out when the weather is warm. Information relating to the home’s Service User Guide and Statement of Purpose is included in the welcome pack, which is given to all prospective residents. This information explains the care service that is offered, who the owner and staff are, and what the resident can expect if he or she decides to live at the home. At the time of this visit, (11/01/07) the information given to the Commission showed that the fees for care at the home are from £450.00 to £455.00 per week, with added expenses for hairdressing and chiropody. Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over a total of 6.5 hours. A tour of the home included bedrooms, lounge and dining areas, and bathrooms. All areas were clean and hygienic. The residents’ personal files and care plans were examined. Care staff records and recruitment records were also looked at. Safety certificates for the home were also examined. Residents, visitors and care staff were spoken to during this inspection. A number of care surveys were returned from the residents at the home. What the service does well: What has improved since the last inspection?
Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 6 New equipment has been installed in the laundry area. This is computer programmed and is able to wash clothes hygienically at a lower temperature. This means that there are fewer problems with clothes being damaged in the washing process. The system also uses less power, water and is more environmentally friendly. Care records are now held on an internal computer system. Care staff can access information from different parts of the building. The home now has Internet access and valuable information and research regarding caring for people can now be accessed. There have been several training events that have assisted the care staff in giving a better service. Most of the care staff now have a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). Better training helps the staff to have a greater knowledge about what they are doing. The manager has achieved a nationally recognised qualification in management (the registered managers award). This has given her more skills that help to ensure that the home is run successfully. There was a good induction process to help ensure that new care staff were competent before commencing their role. This was now in a three -day block instead of being spread out over a period of time. All of the policies and procedures for the home, which guide the staff in the way that they work, have been updated and reviewed. This has helped to make sure that all the information available about how the service operates is current. Residents have been given the opportunity to help select what entertainment they would like to see at the home. One of the residents had chosen a male voice choir to entertain people. What they could do better:
There was little evidence to show that the care staff were receiving proper supervision in their roles. This is structured and dedicated time set -aside for the member of staff to receive support and supervision from their supervisor. This helps the care staff to do their jobs successfully and identify areas where they may need time to improve or need training in. Both the dining areas and the lounge areas were looking a bit ‘tired’. There were stains on the carpets and the decoration needed refreshing. Some of the furniture was old and needed replacing. Good quality surroundings make it better for the people who live in the home. There was some information missing from care staff files. None of the fourteen files that were checked had a photograph of the staff member. There was also
Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 7 very little proof of identification or proof of address. This information is legally required and should be kept on staff personnel files. Good information regarding current staff members is important to help ensure that suitable staff are employed to work at the home. 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. Acorn Nursing Home DS0000068202.V324148.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 Acorn Nursing Home DS0000068202.V324148.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): Standards 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written information provided to prospective residents is good enabling an informed decision about admission to the home to be made. Thorough admittance procedures and careful assessment ensures that the home can meet people’s needs. EVIDENCE: Everyone who chose to live at the Acorn Nursing Home received plenty of information about the home before moving in. A brochure about the home was sent to prospective residents. This brochure contained a copy of the home’s Service User Guide, which also held a copy of the most recent inspection report for the home. All of this information helped the residents and their families to make an informed choice about whether the home was right for them. Three of the residents were able to confirm that they had been given this information. Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 10 Each of the residents had been assessed before coming to live at the home so that a decision could be made as to whether the staff could care for them properly and address their specific needs. There was a copy of this assessment on each of the residents’ personal information files. Acorn Nursing Home DS0000068202.V324148.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): Standards 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 residents health and social care needs are met and well planned. Residents are supported and protected in their daily lives. Prescribed medication is administered appropriately and properly, ensuring that the residents are safe. EVIDENCE: All of the residents had an extensive plan of care that documented all of their daily needs and how the staff would address these needs. This was a Nursing Home and some of the residents had complex needs. The trained nurses and care staff added information to the plans on a daily basis and each plan was reviewed every month so that information could be updated and appropriate action taken. Some of the plans, however, had not been reviewed for two months. The manager said that this was because of the busy Christmas period. The monthly review included updating information on bathing, mobility, nutrition, continence, and moving and handling needs. The inspector looked at fourteen of the care plans and there was enough information in each of these
Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 12 plans to show that the care needs of the residents were being dealt with properly and appropriately. Several visitors were spoken to during the inspection. There were some very good remarks made about the home and the standard of care that was offered. One of the relatives said, “ I think the staff do a good job. We always get a cup of tea and are spoken to nicely. I’m satisfied that he is looked after well.” Most of the residents who were spoken to felt that they were being respected by the care staff and that their dignity was maintained properly. One resident felt that some of the younger staff were occasionally ‘disrespectful’. This needs to be explored by the manager. The home had a call bell system where staff could be summonsed to individual bedrooms by pressing a button if immediate help was required. Another resident commented, “Overall I think the staff do a very good job, they are very quick when answering the call bell.” An accredited assessment tool for the care and prevention of pressure sores was being used at the home, and reviews were held monthly and recorded. This meant that people were less likely to develop pressure sores because the care staff were constantly monitoring their condition. Preventative aids were also available within the home. The home had a separate room where medication was stored safely. The medication record sheets of each resident were looked at and they were completed appropriately. Everyone had a photograph attached to his or her records to help identification. The controlled medication was being stored properly and records were being properly kept regarding its administration. None of the residents were responsible for their own medication. Systems were in place that ensured that all medication was handled correctly and professionally ensuring the safety of service users. There was plenty of evidence on file that showed that health professionals were visiting the home to attend to health matters. This showed that external help was being sought for appropriate health issues that the staff could not deal with. Acorn Nursing Home DS0000068202.V324148.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): Standards 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. Friends and family are made welcome within the home, which helps to maintain positive relationships. Mealtimes are planned and unhurried and residents’ preferences are respected. Activities were regular and were appropriate to residents’ interests. EVIDENCE: There was a range of activities available for people to do during the day. The manager had organised a programme of planned activities for each day. An entertainer came into the home every two weeks and the residents were able to sing along to the old tunes. Other activities included exercises to help keep people supple, and cake making. There had been lots of activities over the Christmas period and a carol service had been arranged. One of the residents had requested that a male voice choir visit the home to entertain the residents. This had been booked and planned by the manager. The manager was aware that some of the residents, who were developing dementia, or other cognitive impairments, did not have as many specialist activities as they should do. The home needs to develop a planned programme of activities for these residents. This should include reminiscence, where
Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 14 people can discuss old photographs from their lives or objects from the past. This helps the residents to maintain an active mind and preserve memories. This also helps the care staff to develop communication with the residents and see them as positive individuals who have had long and interesting lives. The inspector spoke to four people who were visiting their relatives at the home. One gentleman said, “I come every day and I’ve always found the staff polite and helpful. We’re always asked if we want privacy and I’m always offered refreshments.” There were lots of visitors at the home during the inspection, which showed that family contact was positively encouraged. Some of the residents attended meetings where their views on the home could be addressed. There were minutes of these meetings available. The dining areas overlooked the front garden and the dining tables were properly and attractively set. The care plans held evidence that special diets were catered for. One of the visitors said, “My mum is a diabetic and they manage this very well.” Another visitor commented, “ Because my friend has Crohn’s disease they can’t eat dairy products. I think the staff deal with this by the book.” All of the residents that were spoken to said that they thought the food was generally very good and that they mostly looked forward to meal times. All of those who filled out comment cards said that the food was generally to their liking. Two residents commented that they were sometimes upset by the actions and comments made by other residents during meal times. It is important to make sure that all of the residents are able to eat their meals in peaceful surroundings. Mealtimes are a significant part of the day and should be enjoyable to all. The general décor in the dining rooms needed attention. The carpets were stained and the furniture was quite old. It is important that residents should be able to eat their meals in pleasant surroundings. Acorn Nursing Home DS0000068202.V324148.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are treated seriously to ensure that the residents’ rights are protected. Residents were safeguarded from harm by good staff awareness and appropriate training. EVIDENCE: All of the staff that were spoken to said that they knew what to do if someone was unhappy about the service. The complaints procedure was displayed in the home and was part of the Service User Guide. The manager was aware of her role regarding the complaints procedure and how complaints can be used as a quality tool to ensure that the home is run in the best interests of the residents. Three of the residents who were spoken to said that they were aware of the procedure to follow if they were unhappy about anything at the home. All felt confident that their concerns would be dealt with appropriately and fully. There were policy documents for the staff to read about how to ensure that people were safeguarded from harm. All of the staff that were spoken to said that they had a good awareness of this important issue and knew what to do if they were not happy about something they had seen. The manager was aware of her responsibilities and knew whom to contact should abuse be suspected. Recent training had taken place regarding safeguarding adults. Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 16 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): Standards 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are provided with a comfortable, clean and hygienic environment and bedrooms were personalised. This means that residents will feel at home with their belongings around them. EVIDENCE: All of the rooms were fairly large with plenty of room for personal possessions and furniture. All of the bedrooms had personal photographs; ornaments and other items that made each room look homely and individual. All of the residents who were spoken to said that they were happy with their rooms. The home was well maintained throughout. The manager confirmed that maintenance tasks were generally dealt with quickly so as not to inconvenience residents. Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 17 On the day of the inspection the home was clean, hygienic and fresh smelling. There had been new laundry equipment installed which ensured that clothes were washed properly, hygienically, and at the correct temperatures. The communal areas were quite large. Both the dining areas and the lounge areas were looking a bit ‘tired’. There were stains on the carpets and the decoration needed refreshing. Some of the furniture was old and needed replacing. Generally, however, the home was well decorated, comfortable and pleasant. Several residents and visitors spoke of how at home they felt. The furniture and fittings were generally of good quality and there was plenty of natural light throughout the building. There were decorators in the home at the time of the inspection. Some of the bedrooms were being refurbished. One of the residents commented, “ I think my room is lovely, not like my old home but almost as good!” Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 18 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. Good recruitment practices meant that residents were protected from unsuitable staff working in the home. Staff were caring and competent in their roles. Regular training meant that staff were better prepared to do their jobs effectively. EVIDENCE: There were enough trained staff and care staff on duty during the inspection to ensure that the assessed needs of the residents were adequately dealt with. The staff rotas showed that staffing was good and that there were plenty of staff on each shift to ensure that people were being properly looked after. All of the questionnaires received said that there was always or usually staff available when they were needed. Three of the staff were spoken to at length. All said that they had had training in important areas since the last inspection. These areas included mandatory training in fire safety, moving and handling, infection control, and food hygiene. There had also been training courses in Dementia awareness and Abuse awareness. Some of the staff were attending a numeric and literacy course. Good training means that the care staff are better prepared to do their jobs successfully. Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 19 Most of the care staff had achieved a national qualification in care (National Vocational Qualification level 2 or 3). Proof of this training was found on records within the home. Staff records showed that new carers had been properly checked before starting their jobs, including obtaining Criminal Records Bureau checks. This helped to make sure that the residents were safer by ensuring that suitable staff are employed. There was some information missing from care staff files. None of the fourteen files that were checked had a photograph of the staff member. There was also very little proof of identification or proof of address. This information is legally required and should be kept on staff personnel files. There was a good induction process to help ensure that new care staff were competent before commencing their role. This was now in a three -day block instead of being spread out over a period of time. Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 20 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): Standards 31, 32, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are protected and safeguarded by good management practice and a well maintained home. EVIDENCE: Good records were being kept of safety checks within the home. These showed that professionals were checking the lift, electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. Trained maintenance people were also checking the lifting equipment in the home on a regular basis. The home had recently had an inspection by the fire service and had achieved all of the requirements expected for a home of this size.
Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 21 Staff were being instructed in safety aspects within the service. They were being shown how to move those residents, who had difficulty in supporting their own weight, safely and respectfully. Other safety training included fire safety awareness, food hygiene and health and safety. All of the care staff that were spoken to were able to confirm that they had received safety training. Some of the residents had small amounts of money held by the service. This was held very securely and was safeguarded by good recording and checking. The home had an office manager who looked after the administration of the service and helped to make sure that the residents’ money was safe. She also helped to take some of the administrative duties away from the manager. This gave the manager more time to concentrate on ensuring that people were getting a good service. All of the residents and care staff that were spoken to during the inspection were complimentary about the style of management within the home. One resident said, “The manager is always available for a chat and she really cares about how the staff work.” The manager confirmed that she liked to spend some of her time out of the office and helping to care for the residents. This helped her monitor the quality of care provided by the care staff. The resident were asked for their views on a regular basis. Questionnaires had been handed out and the results had been collected and written up. This helped the manager to find out what the home was doing right and where improvements could be made. The inspector saw an example of this. Some of the care records for the service were now available on the homes own computer system. This meant that information could be obtained quickly without staff having to visit the office on the ground floor. There was little evidence to show that the care staff were receiving proper supervision in their roles. This is structured and dedicated time set -aside for the member of staff to receive support and supervision from their supervisor. Supervision could take different forms: for example, individual one to one meetings with staff; a group supervision session or perhaps observation of professional practice. This helps the care staff to do their jobs successfully and identify areas where they may need time to improve or need training in. Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 22 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 N/A 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 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X 2 3 3 Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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. 1 Standard OP29 Regulation Schedule 2. Requirement Staff files must contain all of the information set down in schedule 2 of the Care Home Regulations. This includes a photograph of the carer and proof of their identification. Timescale for action 28/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP36 OP25 Good Practice Recommendations All care staff must receive regular recorded supervision. The furniture and décor of the dining rooms and lounges should be upgraded. Acorn Nursing Home DS0000068202.V324148.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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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