CARE HOMES FOR OLDER PEOPLE
Bluebell Lodge Ashfield Street Sutton in Ashfield Nottinghamshire NG17 3BE Lead Inspector
Stephen Benson Key Unannounced Inspection 5th December 2006 9:30 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 Bluebell Lodge DS0000068402.V322667.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. Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Bluebell Lodge Address Ashfield Street Sutton in Ashfield Nottinghamshire NG17 3BE 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) 01623 440188 Bank House Care Homes Ltd Mrs Siobhan Carmichael Care Home 36 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (36) of places Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Bluebell Lodge Residential Home is registered to provide accommodation and care to people whose primary care needs fall within the following categories: Old Age - not falling within any other category (36). Within the total number of beds (36) a maximum of 10 beds may be used to accommodate people, aged 55 years and over whose primary care need is Dementia (DE). New service 2. Date of last inspection Brief Description of the Service: Bluebell Lodge Care Home (formally known as Ashfield Care Home) is a care home providing personal care and accommodation for 36 older people, up to 15 of whom may have dementia and 10 be aged 55 or over with dementia. The home provides short and long term, long term care. The home is owned by Bank House Care Homes Limited, who purchased the home in October 2006 and is run as a family business. The home is located close to shops, pubs, the post office and other amenities. The home was opened in 1987 and consists of a purpose built building which has been extended. All of the homes bedrooms are single, and 5 of the bedrooms have en-suite facilities. Bedrooms are located on 2 floors and there is a passenger lift. The home has a garden to the rear of the property and ample car parking space. The manager said on 08/12/2006 that the fees for the service range from £283 - £326 per week depending on dependency needs. There are additional charges for hairdressing and chiropody. Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first visit to the home since 1st April 2006 by The Commission for Social Care Inspection. Prior to the visit an analysis of the home was undertaken from information gathered since registration. The site visit lasted for 3 ½ hours and the main method of inspection used was called case tracking which involved selecting 3 residents and tracking the care they receive through the checking of their records and discussing this with them. Other residents were spoken with and additional records were seen. A discussion was had with the provider, the manager, staff on duty and care practices were observed. A visitor and district nurse were spoken with during the visit. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. The inspection included a thematic enquiry. This consisted of asking a number of standardised questions to a sample of the residents. The manager was informed and the agreement of residents was sought before asking a set of questions about the care they received. What the service does well:
There have not been nay new residents move to the home since the change in ownership, however there are some current referrals being considered and this included an assessment of their needs to establish if they can be met within the home. The evidence shows that new residents are assessed before they come to live at the home. The home has a medical room where all drugs are kept. Medicine Administration Records were fully completed and residents confirmed that staff gave them their medicine as they need it. Only staff trained in the safe handling and administration of medicines give out medication. The evidence shows that residents are protected by the homes procedures for dealing with medicines. There is information about promoting residents privacy and dignity available and staff were able to say how they do this. Residents were happy with the personal care they receive. The evidence shows that residents’ privacy and dignity are promoted. There are two part time activities coordinators employed in the home and a record is made of all activities provided. Residents were pleased with the arrangements and particularly like some recent craftwork they have done. The evidence shows that resident’s lifestyle matches their expectations. Staff showed they are able to vary the level of choice offered to residents depending upon their abilities. Residents spoke of flexibility over such things Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 6 as when they get up and go to bed. The evidence shows that residents have control over their lives. Food is now purchased from a local supermarket and there is a choice provided at each meal. When the menu is changed residents are asked for their views. Residents spoke of getting the type of food they prefer. The evidence shows that residents receive a wholesome appealing balanced diet. Residents said they knew about the complaints procedure. The evidence shows that residents are confident that their complaints will be listened to. Staff have recently had protection of Vulnerable Adults training and knew where to find the home’s procedures. Residents said they are treated well at the home. The evidence shows that measures are in place to protect residents from abuse. Protective clothing is provided for staff and safe practices were seen to prevent the spread of infection. Then home was clean and resident thought the cleaners worked well. The evidence shows that the home is clean, pleasant and hygienic. Staff felt there are enough staff on duty to carry out their work and residents said they were seen to promptly. The evidence shows that residents’ needs are met by the numbers and skill mix of staff. The evidence shows that residents are in safe hands at all times. There is a room created for staff training ands a training programme for the next few months has been prepared. Staff spoken of recent and future training. The evidence shows that staff are trained to do their jobs. The manager has been employed in the home for a number of years and is currently enrolled on National Vocational Qualification level 4. The evidence shows that there is a suitable manager employed to run the home. A survey of residents’ views on the home was carried out a year ago and the manager and provider intend to repeat this. The evidence shows that residents express their views on how the home is run. The home will help residents with their personal allowances if wanted and a record is made of any expenditure made. This is signed by two people and receipts are kept where provided. The evidence shows that residents’ financial interests are being safeguarded. Regular safety checks and tests are carried out and there are contracts in place for servicing equipment. The evidence shows that the health, safety and welfare of residents are protected. What has improved since the last inspection?
They new provider has started a programme of decoration and making some alterations to the home, including the location of the front door. Residents were choosing new carpets for their rooms, which are then to be ordered. Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 7 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. Bluebell Lodge DS0000068402.V322667.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 Bluebell Lodge DS0000068402.V322667.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): 3 and 6 Quality in this outcome area is good. New residents are fully assessed prior to moving into the home to ensure that their needs can be met. The home does not offer an intermediate care service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has not been anyone admitted to the home since the change of ownership, however there have been some referrals and a pre admission assessment was seen for these. The manager was seen arranging to visit another prospective referral and asking for the Community Care Assessment to be sent to the home. The manager said that she goes to assess any prospective new resident and the new provider is changing the assessment forms to ones used in his other homes. Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 10 Staff said that they are told about new admissions in handover meetings and are able to see the assessments. Assessments included details of any specialist assistance a resident requires. The manager said that anyone is welcome to apply for a place providing they fall within the registration category for the home. There is no arrangement made for the home to provide an intermediate care service. The following questions were asked as part of the thematic enquiry: 1) Do you have an up to date copy of the service user guide? Two residents answered no and one resident answered yes. A service user guide was seen in the reception area. 2) Since coming to the home have you had any information about any changes to the cost of your care? Two residents answered no and one resident answered yes, who said this had been done by letter. 3) Do you have a written contract or statement of terms and conditions? Two residents answered no and one resident answered yes. There was not a copy of a contract seen in residents’ files. 4) Has the contract changed since you came to live here? One resident answered no and two residents answered don’t know. The new provider has not issued any new contracts. 5) Before you came to live here, did anyone talk with you to find out what your care needs were? Two residents answered no and one resident answered yes. Pre admission assessments were seen on each resident’s file. Bluebell Lodge DS0000068402.V322667.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. Residents’ health, personal and social needs are set out in an individual plan of care. Residents’ health care needs are fully met. Residents are protected by the homes procedures for dealing with medicines. Residents are treated with respect and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said the new provider is changing the care plans to ones used in his other homes and training has been arranged to show staff how these will work. Care plans seen contained relevant information but tended to be lacking in detail, for example under social needs there was an entry saying ‘liked watching television’ but did not say which programmes were liked. Care plans had been regularly reviewed and there were entries showing these had been discussed with residents and/or their relatives.
Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 12 Staff said if they want to know anything they will look it up in the care plans. A resident said, “I think the manager discussed my plan with me, I am happy with the care I get, this is the best home I have been to”. Care plans include details of resident’s gender, ethnic origin, religious beliefs and any disability. There is a section in the care plan for recording any contact with a doctor and entries seen included staff seeking advice. Information about contact with other healthcare professionals is recorded in the daily notes, although this did not appear to be always done. This made it difficult to check back to see all healthcare residents have had making it more difficult to monitor their well being. The manager showed a separate opticians file and agreed that it would be better to record all healthcare appointments in one record. Staff were seen using appropriate moving and handling equipment and footplates were in use on all wheelchairs seen. The hairdresser said that residents are always clean when they come to have their hair done. Staff said that they pass on any healthcare concerns to a senior and they discuss and assess whether it is necessary to call a doctor. A resident said, “If you want a doctor staff send for one straight away. I have seen the District Nurse and had a flu jab recently”. The resident also said the chiropodist and optician have recently been. There is a designated medical room and medicines are appropriately stored. The Medicine Administration Records were fully completed and a sample of drugs were checked and these were correct. The manager said that only trained staff are allowed to give out medication. Staff said that they have had training this year in the safe handling of medicines. Staff said one resident is given his medication to take himself, but this was not recorded in the care plan. A resident described being given medication by staff and said, “They always get more medicine when it is needed”. There was information about promoting residents privacy and dignity seen in residents care plans and the manager said that information about promoting residents’ privacy and dignity is included in the Statement of Purpose and the Code of Conduct for care staff. Staff described good practices for promoting the privacy and dignity of residents, including keeping doors closed and not leaving them in an undignified manner when getting undressed. Staff were seen knocking on residents doors before entering. A resident said, “Carers help me shower, they are very good”. Bluebell Lodge DS0000068402.V322667.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. Residents find the lifestyle experienced in the home matches their expectations. Residents maintain contact with family and friends and the local community. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota showed that there are two activities coordinators employed and there is someone to carry out activities five days a week. A record is made of all activities taking place and includes details where a resident chooses not to take part. The manager said that the new provider had made additional funds available for activities and this has made a big difference to the amount of activities provided. Staff said that residents have been making Christmas decorations to decorate the home. A relative said he had phoned to ask staff to put a film on for a resident as it was one he liked and this was done. The relative also said that
Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 14 he had been asked not to visit when activities were on as the resident enjoyed taking part in them. A resident said, “We have made some cards with our names on for our doors with one of the ladies, they are lovely” and “A man comes to do exercises with us”. The manager said all Christian festivals are celebrated There are details of resident’s families in the care plans, but these do not include visiting and contact arrangements. The manager said that a local choir visits monthly and residents are able to follow their religion if they wish. Staff said some residents go out with their families and the activities coordinators take some residents out for a walk. One resident is able to go out on their own to the paper shop. A resident said, “I have kept my own manicurist who comes to se me” and “Visitors are able to come to the home and if they don’t arrive staff will phone up to find out why”. A selection of carpet books were delivered to the home and residents were being asked to choose a new carpet for their room. The manager said that it is stated in the home’s documents that residents will have autonomy and choice. Staff said that residents are able to make choices about what they do, in including what they are going to wear. Staff described differing ways of offering residents choices depending upon their abilities and understanding. A resident said, “If you want to stop in bed you tell staff, I get up early but others don’t get up till 9 or 10”. The manager said that the menu is going to be reviewed soon and residents will be involved in this. New dishes have been tried including curries and lasagne, which some residents liked. Staff said there is choice of meal provided and food shopping is now done at a local supermarket. A resident said, “The food is lovely, I like salads which we get”. The manager said that any special diet for personal choice, religious or health reasons will be accommodated. Bluebell Lodge DS0000068402.V322667.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. Residents are confident that their complaints will be listened to. Measures are in place to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have not been any complaints since the change of ownership of the home. Staff said they were aware of the complaints procedure and would pass any complaint on to the manager. A resident said, “I haven’t got any complaints but I have seen the complaints procedure”. Staff said they had Protection of Vulnerable Adults training a week ago and knew where the procedures were in the office. A resident said, “I have never been treated badly here”. The manager said there have not been any reported incidents of abuse and that any form of abuse or discrimination would not be accepted and would be dealt with by following the Adult Protection Procedures. The following questions were asked as part of the thematic enquiry: 1) Have you received any written information that tells you how you can make a complaint?
Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 16 Two residents answered no and one resident answered yes. 2) Do you feel you have all the information you need to raise any concerns you have about your care? Two residents answered yes and one resident answered no. Bluebell Lodge DS0000068402.V322667.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. Residents live in a safe, well-maintained environment. The home is clean, pleasant and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are a number of changes to the building being made by the new provider. The home is currently having a number of areas decorated and some new carpets are being ordered. The front entrance is being moved and the name of the home has been changed. A relative suggested the new name and the manager said that residents were asked what they thought and said they liked it. The home is well laid out and has wide corridors and everywhere is accessible to wheelchair users. Repairs are recorded in a maintenance book and dealt with by a handyman. Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 18 Staff said they have and use protective clothing and are given a hand wash gel to carry. A resident said, “They are always cleaning, my room has not been done yet but they will be coming, they do it when it is convenient. I have a high regard for the cleaners”. Bluebell Lodge DS0000068402.V322667.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. Residents’ needs are met by the numbers and skill mix of staff. Residents are in safe hands at all times. Residents are not fully supported and protected by the home’s recruitment policy and practices. Staff are trained to do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota showed the home provides 1 senior care and 2 care staff during the day and 2 waking care staff at night. There is a full time manager and the home employs a cook, kitchen assistant, handyman and cleaners. Staff said there is always at least three staff on duty during the day and two overnight and this is sufficient for them to be able to carry out their duties. A resident said, “There are always enough staff on, they always come when I press the button. The manager said that eight staff have completed National Vocational Qualification level 2 and three staff have completed level 3. Staff files seen showed that the correct recruitment practices had not been followed, as there were two staff working with Criminal Records Bureau checks carried out at their last employment rather than at this home, as required. An
Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 20 immediate requirement notice was left concerning this. One staff file only had one reference, the manager said that she had seen the other reference but was unable to find it. There was a notice of forthcoming training on the notice board in the office and the provider said he is ensuring that all staff have the required training. An unused lounge is being converted into a staff training room. Staff said the provider had discussed training with them and they had attended a course on the Protection of Vulnerable Adults the previous week and a fire safety course was planned for the next week. Bluebell Lodge DS0000068402.V322667.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. There is a suitable manager employed to run the home. Residents express their views on how the home is run. Residents’ financial interests are being safeguarded. The health, safety and welfare of residents are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has not been any change of manager as a result of the change in ownership of the home. The manager has worked at the home for a number of years and is currently working towards National Vocational Qualification level 4 in management. Staff said they were happy with how the home is managed.
Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 22 The manager carried out a survey of residents’ views on the home a year ago and intends to speak to the new provider about how this should be done in future. The provider said he intends to discuss this with the manager in the near future. The home will hold money for residents to pay for hairdressing, chiropody and other incidentals. A record is made of each transaction and signed and witnessed. Receipts are kept when available. The manager said that all the required health and safety checks are carried out at the required frequency and there are service contracts in place for servicing all the equipment. Dates of tests were recorded in the pre inspection questionnaire showing they are regularly carried out. A sample of these were looked at and found to be correct. Bluebell Lodge DS0000068402.V322667.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 X 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 X X X X X X 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 X 3 X X 3 X 3 Bluebell Lodge DS0000068402.V322667.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 OP29 Regulation 19 Requirement The registered person must ensure that all staff working in the home have a current Criminal Records Bureau or Protection of vulnerable Adults check carried out for this employment. Timescale for action 06/12/06 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 Bluebell Lodge DS0000068402.V322667.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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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