CARE HOME ADULTS 18-65
Blackburn Drive, 13 13 Blackburn Drive Halewood Liverpool Merseyside L25 0QF Lead Inspector
Ms Lorraine Farrar Unannounced Inspection 24th July 2007 11:50 Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 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 Blackburn Drive, 13 DS0000021459.V333642.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 Adults 18-65. 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. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Blackburn Drive, 13 Address 13 Blackburn Drive Halewood Liverpool Merseyside L25 0QF 0151-486-2054 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) www.c-i-c.co.uk. Community Integrated Care Mrs Mary McGibbon Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service User to Include up to 2 LD Date of last inspection 22nd May 2006 Brief Description of the Service: 13 Blackburn Drive is a detached bungalow in a residential area of Halewood, with local shops, transport and facilities nearby. The house provides two single bedrooms, an office, lounge, dining room, one bathroom and kitchen, there is also a small extension at the back, which is used for some storage and laundry facilities. The home has some adaptations, including, a walk in shower, hoist and ramps fitted to the front and back of the house. Outside there is a small front garden with some parking and to the back a large enclosed garden with seating area. The service provides support and accommodation for two adults who have learning and physical disabilities. Staff are available twenty four hours a day to provide support. The service is operated by Community Integrated Care (CIC) who provide staff, budgets and support. CIC are a national organisation who provide support services to people across the country. The House itself is owned by Liverpool Housing Trust who are responsible for maintaining the structure of the premises. It costs £367.50 each week to live at 13 Blackburn Drive. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Information for this inspection was gathered in a number of different ways. A site visit was made on 24/7/07, with a further visit made on 2/8/07 to meet with the manager and examine staff files. Case tracking’ was used as part of the site visit. This involves looking at the support a person gets with their care plans, medication, money and bedroom, time is also spent meeting with the people living there and with staff about how they meet the persons needs. During the site visits the inspector met with both of the people living there and three members of staff including the manager. Discussions also took place with a relative of one of the people living there. Any information the Commission for Social Care Inspection (CSCI) has received since the last big inspection of the service is also taken into account. This includes any smaller site visits that have been carried out. The manager contributed information prior to the site visit by completing a questionnaire regarding the service provided. An easy to understand summary of this inspection report is available. If you would like to see a copy please ask staff working at 13 Blackburn Drive. What the service does well:
The people living at 13 Blackburn Drive are supported by a staff team who are able to understand and respond to their non verbal communication and their choices. When at home people are supported to engage in activities of their choice and staff spend time sitting with people and socialising as well as providing the support they require with their health and personal care. Staff support people to maintain contact with their families and involve them in planning the persons care. Any concerns that people have about the service are listened to and acted upon and relatives are confident in the staff team and the service they provide Information about the persons support needs and their choices is clearly written down in their care plans along with information about how staff should meet these. This helps to ensure that people are supported in the way that they prefer. The house is domestic in size and feels homely and inviting inside. There are aids and adaptations provided to help people with getting around more easily.
Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 6 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. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Sufficient information is provided to and obtained about, new people to ensure that 13 Blackburn Drive can meet their needs and choices. EVIDENCE: Both of the people who live at 13 Blackburn Drive have lived there for many years, therefore the support offered to people considering moving into the house could not be practically assessed. There is however a policy in place from the organisation for introducing new people. This states that a full assessment of the persons needs and choices must be carried out and that they will be offered the opportunity to visit the house, meet with staff and the people living there and stay overnight if they wish. An information brochure about the service is also available to inform people about the services and support they can expect. This helps everyone to decide if 13 Blackburn Drive is the right place for them to live and if it can meet their needs and choices. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The individual needs and choices of the people living at 13 Blackburn Drive are identified and met within the service. EVIDENCE: A relative of one of the people living at 13 Blackburn Drive said that, “The needs of each individual are always taken into account. To be honest the very best is provided and given to the residents”. Individual care plans are in place for both of the people living at 13 Blackburn Drive. These provide information and guidance for staff on how to support the person. Clear information is recorded about the persons support needs, the things they do and don’t like and their health and personal care. Plans are written in plain English with some use of pictures. This helps to give the person as much opportunity as possible to understand their plan and the contents. The relatives of the people living at 13 Blackburn Drive are also involved in providing information for the care plan.
Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 10 Information is included about the ways that the person communicates nonverbally and how staff should respond to this. During the site visit staff were able to discuss this information and explain how people showed their choices about the things they did and did not want to do. For example one plan explained that if the person wanted quiet time alone they will go into their bedroom and staff should put their music on. This support was seen to be offered during the site visit. As the people who live at 13 Blackburn Drive do not communicate verbally the level of detail in the plan helps to ensure that everyone is aware of and can respond to the persons non verbal requests and ensure their support needs are met. Plans also contain information about possible risks to the person from their environment, whilst out and about and whilst receiving support. The level of risk is identified along with guidelines reduce it. This helps to ensure that people can live their daily lives as they wish whilst remaining safe. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living at 13 Blackburn Drive receive support to live a lifestyle of their choice. However further development of opportunities within the community would benefit them. EVIDENCE: A relative of one of the people living at 13 Blackburn Drive said that, “They know (my relative) and ensure that (their) likes and dislikes are catered for”. During the site visit staff were seen to sit and chat with the people living there and offer them activities within their home that they enjoyed. One person was spending some time in their bedroom listening to music whilst another was in the lounge playing a musical instrument. Both of these activities are documented in the persons plan as things they enjoy doing and staff provided support for people to access them. Staff were able to discuss the things that people enjoy doing and explained that future plans include, separate holidays for the people living there based
Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 12 on the things they enjoy. The manager also explained that she is exploring opportunities for one person to attend college part time in September and a member of staff explained they are exploring opportunities for one person to join a local social group. The service has supported people to obtain an adapted vehicle, which makes it easier for them to get out and about. Daily records for one person showed that they had been supported with the things they enjoy such as visiting a local sensory room and going out for a drive. Records for the other person showed that they enjoy ‘hustle and bustle’ and being out and about. Although they had been supported to go out shopping and to enjoy activities at home there was no evidence that they had been or plans are in place to, support them with other community activities they may enjoy. A member of staff explained that the person enjoys going to concerts and to local theatres, however this has not occurred for some time. A relative explained that, “I have a good relationship with the home manager and this enables us to communicate effectively”, and “ the manager and the staff are excellent at providing updates””. Records showed that people are supported and encouraged to maintain contact with their families and that staff will support this by ensuring families are welcome to visit and are kept informed about how the person is. Records of menus showed that people are offered a variety of meals including plenty of fruit and vegetables. A member of staff explained that they have obtained a book on healthy eating which they use to ensure that a healthy diet is offered to people. Staff were able to discuss the support they offer to people, including the way in which they supported one person following a recent hospital stay to ensure that they could eat safely and begin to enjoy their meals again. Shopping for food is carried out at local supermarkets and a farm shop with one of the people living there regularly accompanying staff in this household task. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 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 needs and choices of the people living at 13 Blackburn Drive are recognised and support provided to meet these. EVIDENCE: A relative of one of the people living at 13 Blackburn Drive said that, “They are very protective of (my relative) and I really appreciate that. (They are) loved and protected. Who could ask for more”. Explaining that their relative had been unwell recently they explained, “ They have done their best to keep staff with (my relative) around the clock….. (my relative) is in the best possible place to live out (their) life”. Care plans for the people living at 13 Blackburn Drive contain clear information about the persons support needs with their health and personal care. Information was up to date and included guidance on supporting the person with their mobility, their medication and how to stay healthy. Records showed that people receive support from staff to attend regular health appointments and that guidelines given to the person by health professionals are followed.
Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 14 Recording of how to support people are detailed and discussions with staff evidenced that this support is provided. For example one plan advises that the person likes a cup of tea and their medication before getting up in a morning and staff confirmed this is offered. Staff working at 13 Blackburn Drive have received training in dealing with medication. This helps to lessen the risk of mistakes occurring. Medication was stored correctly with information about each persons medication recorded in their care plan for staff to refer to. During the first site visit there were two sheets in place for recording the medication people are prescribed and given. One of these was handwritten by staff and the other printed by the chemist. Staff explained that they were in the process of trialling the printed sheet and this was why both sheets were in use. However the instructions for one medication were different on both sheets, this could, along with the use of a dual system lead to mistakes occurring. Good practice was noted in that staff had obtained written confirmation of a Consultants instructions to alter medication given to one of the people living there. This helps to ensure everyone is aware of changes and no confusion can arise. During the second site visit the manager had taken action to ensure that only one recording sheet was in place and that all instructions were recorded as prescribed by the GP. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Concerns and complaints are welcomed within the service and dealt with. However peoples finances are not always dealt with in a way that ensures they are safeguarded. EVIDENCE: No complaints about 13 Blackburn Drive have been received since the last key inspection. There is a policy in place for dealing with any complaints or concerns that arise and a member of staff was able to explain the actions she would take to deal with these. Staff receive training in recognising and dealing with any adult protection issues that arise and have a copy of the local authority procedure available to guide them. This helps to ensure that any issues that may arise would be dealt with swiftly. The relative of one of the people living at the house said that the service has always responded to any concerns raised, explaining that, “They have been brilliant. They aren’t scared of constructive criticism and will try suggestions. Really approachable”. An assessment of how peoples money is managed by the organisation is recorded on file. This includes how decisions are reached as to whether people will contribute to a mobility vehicle or not. This is good practice as it provides clear information about the support the persons needs and a clear audit trail as to why decisions have been reached on their behalf.
Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 16 Records and discussions with the manager regarding the financing of the mobility car indicated that an agreement was reached that the cost of this would be shared. However records indicated that so far only one person has paid the majority of costs with the other person owing them a considerable amount of money towards this. As the organisation act as appointee it is their responsibility to ensure that peoples financial interests are safeguarded. This does not appear to have occurred. Records and amounts of money held within the house for the people living there were checked and were correct. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 13 Blackburn Drive provides a warm, comfortable and safe place for people to live in that meets their needs and choices. EVIDENCE: 13 Blackburn Drive is a three bedroom bungalow, based in a residential area of Halewood, it is well placed for accessing local amenities. Shared space within the home consists of a lounge, separate dining room, kitchen, office, laundry and enclosed back garden. These rooms are comfortably furnished and decorated and have a homely atmosphere. Outside there is a large back garden with patio. Parking is available on the front drive or on the road outside. Throughout the house there is sufficient space for the people living there, staff and visitors. The people living there have their own bedrooms, which provide enough space for them to get about and have their personal possession around them.
Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 18 There are a number of aids and adaptations available to support people with their mobility, this includes, ramps, shower chairs, grab rails and a hoist. The bathroom has been recently refurbished with a walk in shower that is easier for people to use. During the site visit the house was clean and warm with a homely atmosphere. Some of the paintwork is beginning to chip, however the manager explained she was meeting with the Housing Association in the near future as the whole house is due to be re-decorated in 2008. Suitable equipment and facilities are provided to enable staff to prevent or quickly deal with any outbreak of infection. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at 13 Blackburn Drive are supported by an experienced staff team who are able to meet their support needs and choices. EVIDENCE: A relative of one of the people living at Blackburn Drive said that, “My experiences have taught me that (the manager) and staff are absolutely excellent. I trust them implicitly and rely on them completely.” Staff files had been recently audited by the manager to ensure they contain all required information to ensure the member of staffs suitability. Prior to anyone being appointed to work in the house a series of checks are carried out, these include obtaining two written references, a Criminal Records Bureau Check (CRB) and checking the protection of vulnerable adults register. These checks help to ensure that anyone employed to work with the people at 13 Blackburn Drive is suitable to work with vulnerable people. During the site visit staff displayed a good knowledge of the people living there and their support needs and choices. They were able to explain how people communicate non-verbally and make their needs and choices known. Staff
Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 20 spent time with the people living there chatting and offering activities that they enjoy. When they begin work with the organisation new staff undertake an induction programme that covers basic areas of health and safety such as moving and handling people, training on dealing with medication and protection of vulnerable adults and how to communicate with people effectively. Staff who have worked in the house for some time also undertake regular training to update their knowledge and skills. The majority of staff in the house have achieved a recognised qualification in care (NVQ) with others planning to undertake this. This training helps to ensure that staff are aware of how to support people safely and in line with current good practise. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 13 Blackburn Drive is safely and well managed for the benefit of the people living there. EVIDENCE: Mrs Mary McGibbon is the Registered Manager of 13 Blackburn Drive. She has many years experience of working with adults with a learning disability and has worked at 13 Blackburn Drive since the people living there first moved in. Mrs McGibbon holds a care and management qualification and through reading records and discussion it was evident that she attends training events to maintain and increase her knowledge. There are a number of systems in place within the house to check on the quality of the service they provide. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 22 This includes regular updating of care plans and checks on staff files and medication. A senior manager from the organisation visits monthly and looks at a number of areas including the support offered to the people living there and the environment. Following this visit a report is prepared and any issues identified are listed along with the actions needed. Survey forms were sent to the families of the people living at 13 Blackburn Drive in March 2007. These asked their views of the service provided along with any concerns they may have. The results were positive with no areas of concern identified. These regular checks help to ensure that the people living at 13 Blackburn Drive receive a good service and that any areas for improvement are quickly identified and addressed. Records and certificates evidenced that regular checks are carried out on the building and equipment to ensure these are safe. This includes checking electrical appliances, the gas supply and regular fire checks. Blackburn Drive, 13 DS0000021459.V333642.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 Adults 18-65 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 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 X 3 X 3 X X 3 X Blackburn Drive, 13 DS0000021459.V333642.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. 1. Standard YA23 Regulation 13(6) Requirement An audit of how peoples mobility money is managed must be carried out. This will ensure that peoples money is safeguarded. Timescale for action 30/09/07 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. Refer to Standard YA14 Good Practice Recommendations A review of community activities offered in line with peoples identified likes and dislikes should be undertaken. This will ensure that people are offered the opportunity to undertake activities of their choice. Blackburn Drive, 13 DS0000021459.V333642.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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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