CARE HOMES FOR OLDER PEOPLE
Bredon View 24-26 Libertus Road Cheltenham Gloucestershire GL51 7EL Lead Inspector
Ruth Wilcox Unannounced 17 October 2005, 09:30 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 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. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Bredon View Address 24-26 Libertus Road Cheltenham Gloucestershire GL51 7EL 01242 525087 01242 525087 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) CTCH Ltd Mrs Katrina Mitchell Care Home 26 Category(ies) of OP Old Age (26) registration, with number of places Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 25 April 2005 Brief Description of the Service: Bredon View is a care home converted from two semi-detached older properties. It provides personal care for 26 older people, and is located in a residential area of Cheltenham, close to the railway station and local bus routes. It is part of the CTCH Ltd group of homes. Accommodation is on two floors, the first floor being accessed by a shaft lift and stair lift. All bedrooms have en-suite facilities; some have the addition of a bath or shower. The communal area consists of 2 lounges, dining room and a conservatory at the front of the property. There is a level access to the landscaped gardens at the rear of the home via a patio door from the lounges. Care staff are on duty 24 hours each day, and there are waking night staff. If nursing services are required, these are accessed from the community, and residents can register with the local General Practitioner of their choice. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced inspection on one day in October, over a period of 6 hours. A check was made against the requirements that were issued following the last inspection, in order to ascertain that the home had ensured compliance in the relevant areas. Care records were inspected, with the care of three residents being closely looked at in particular. Eleven residents and one visitor were spoken to directly in order to gauge their views and experiences of the services and care provided at Bredon View. The arrangements for visitors and the options for residents to exercise choice in their daily lives were looked at. The home’s policies for ensuring the protection and rights for residents were looked at, including the arrangements for those choosing to place money and valuables with the home for safekeeping. A tour of the premises took place, with particular attention to health and safety issues, the maintenance and the cleanliness of the premises. The arrangements for the recruitment, training and supervision of staff were inspected, as were Bredon View’s own systems for monitoring and reviewing the quality and standards of their service. The manager was present throughout the inspection providing help where requested, and the company’s group care manager also attended for the afternoon. Staff were welcoming and helpful, and were observed going about their duties with the residents. What the service does well:
Bredon View provides a pleasant and welcoming atmosphere, which is homely and informal. The home provides a clean and satisfactorily maintained environment for the residents in the main. Residents are admitted to Bredon View on the basis of a full assessment of their needs, which the manager carries out ahead of admission, so as to ensure the home will be able to meet the person’s needs satisfactorily.
Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 6 The relatively recently appointed manager has made a positive impact on the standards in the home, and relationships between her, the staff and residents appear positive, inclusive and mindful of residents’ rights to privacy and choice. Residents speak overwhelmingly of ‘good, kind and caring staff’, with all indicating their satisfaction with the care they receive, including the manner in which their privacy is maintained. They are fully able to maintain their close links with their families and friends, with visitors made to feel welcome here, and permitted to participate in the life of the home if they so wish. There are also satisfactory systems for monitoring the quality of the service provided at the home, with residents and their families having opportunities to give feedback on their views and ideas. Residents are able to place personal money and valuables with the home for safekeeping, and arrangements to manage this are thorough and transparent, ensuring appropriate safeguards for them. Staff are trained for their roles, and receive regular training updates to ensure their continued professional development; however another tier of initial training has been recommended following this inspection. There is access to the NVQ training programme for all care staff. What has improved since the last inspection?
The home has ensured that it has addressed the requirements that were issued following the last inspection. The overall standard of care plan documentation has greatly improved over recent months, with individual documents becoming more reflective and instructive to staff regarding the health and personal needs for each person. The manager has introduced a regular medication check, so that in the management of medications staff consistently observe a better standard of practice, particularly around record keeping. The staff team is recruited after a range of appropriate pre-employment checks, to ensure appropriate people are employed to work with the residents. The staff team is evolving under the improved management guidance and supervision, and a more cohesive way of working has been established for the benefit of the residents. Further adult protection training has increased staff awareness of the importance of ensuring and upholding the rights of the residents, so that they can be protected from abusive practice.
Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 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. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 All residents are admitted to the home on the basis of a full assessment of their needs, ensuring that they can receive the care that they require. EVIDENCE: Assessments for prospective residents are performed by the home, prior to admission. The pre-admission assessments for two recently admitted residents were inspected, and both were comprehensively recorded. One of these residents said that she had settled well, with staff supporting her very well since she had been in the home. Bredon View does not provide intermediate care. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 & 10. There is a reasonably consistent care planning system in place, which in the main provides staff with the information they need to meet residents’ health and personal needs. The systems for the administration of medications are good, with clear arrangements in place to ensure residents’ medication needs are met. Care and support is offered in such a way as to promote the privacy and dignity of the individual. EVIDENCE: Each resident has an individual plan of care, which is based on an assessment of all their needs, including risk assessments. Three were selected as part of the case tracking exercise, and in the main were well written, were done so in consultation with the resident concerned, and were regularly reviewed. The home has made very good progress with the standard of care planning documentation in recent months, and each plan that formed the case tracking exercise contained clear instructions as to how each individual’s health and personal needs are to be met, with visual evidence confirming that this is carried out. In one case the care being delivered on the basis of an identified
Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 11 risk of developing pressure sores was not adequately recorded in a designated care plan. The home has plans to replace its current care plan documentation, with a more comprehensively detailed assessment completed prior to a more accessible form of care planning being devised. Although standard 9 was not inspected in full on this occasion, it was confirmed that the home have ensured compliance with previously issued requirements for improvements. The manager has introduced a regular weekly audit of medication charts and storage in order to monitor and achieve good practice levels. Although the author has signed handwritten entries on medication charts, there was no second signatory to witness the entry, as would be good practice. Residents’ comments about the staff and the care they receive were overwhelmingly positive. All of those spoken to said that staff were kind, caring, helpful and supportive. One person said that the staff are ‘super and sensible’, another said that ‘you couldn’t wish for better’. Residents indicated that staff were mindful of their privacy, and that they showed respect to them. One person was particularly glad that staff were very respectful towards her desire for more independence, and that her privacy was very much respected. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 & 14. Respect is shown to residents’ personal choices, in order that they can maintain close social links with family and friends, and can maintain some control over their lives wherever possible. EVIDENCE: Visitors are free to visit residents at any time of theirs or their relative’s choice. One visitor, who was visiting his relative in complete privacy, confirmed that he felt very welcome in the home, and that it had a nice atmosphere; he felt that the staff were helpful. Information displayed in the entrance hall showed that visitors are invited to participate in the life of the home with their relative, according to their wishes. It was reported that there are few links with the local community, but that this was less to do with the home, which has tried to source opportunities to forge local links. Residents have been out on local bus rides with residents from another closely situated care home, and the home has regular visits from the local parish priest. There are two lounges and a conservatory for residents to choose from, and residents were seen in various locations around the home, apparently spending their time how and where they chose; two were even sitting in the comfortable hall, listening to some classical music.
Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 13 Some residents confirmed that staff are respectful of their choices, with two people grateful that their level of independence is respected. Residents are clearly able to exercise choice in their own rooms, with many introducing personal items, and are also able to exercise a degree of choice with food. Two people commented that they would like to see a bit more choice with the range of food available, and three said that in their opinion there was little to choose from in the way of organised social activities, and that they would like to see more from which to choose. This was relayed to the manager, who has endeavoured to gauge individual’s ideas and preferences for such things in a variety of ways, and confirms she will continue to do so. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Staff’s knowledge of adult protection issues provides a safe environment to protect residents from abuse. EVIDENCE: The home has written policies and procedures for the protection of vulnerable residents. Staff have received in-house instruction in recognising any abusive practice, and regarding the whistle blowing procedure to follow in the event. At the conclusion of the training exercise, staff were given a questionnaire to complete, in order to assess their subsequent knowledge. Three staff confirmed their knowledge, though one of these appeared slightly uncertain when questioned regarding different types of abuse, but was able to recount the home’s policy regarding this issue. The manager has recently organised an appropriate protection strategy with other relevant agencies regarding one particularly vulnerable resident. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26. Bredon View provides a well maintained and comfortable home for the residents, but the failure by staff to observe appropriate infection control procedures consistently could compromise the residents’ health and welfare. EVIDENCE: Bredon View provides a generally safe, pleasant, well-maintained and decorated home for the residents. Maintenance records show the range of cyclical checks that are carried out, with the company’s own peripatetic maintenance person, and outside contractors. Work to address a damp problem in a ground floor room was completed some months ago, and though it continues to be aesthetically satisfactory, a damp odour remains in there. There are also isolated areas of damaged woodwork paint, due to excessive wear and tear. The home is cleaned to a good standard, and is largely free of unpleasant odours. An unpleasant odour was detected in one location, though the source of this is identified, and staff do adopt certain control measures to address it.
Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 16 There are appropriate infection control procedures in the case of one person, with the provision of personal protective equipment for staff to use in the room, including a sanitising hand scrub. The laundry facilities are small, but appeared tidy and organised. It was clear that an appropriate disinfection procedure for handling foul laundry was not being observed, with such items being ‘soaked’ in a bucket, prior to washing at an inadequate temperature to disinfect them. The home does not have a contract for the collection of clinical waste, and incontinence waste is double-bagged and disposed of by the council with other household waste. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 & 30. Improvements to recruitment procedures will provide assurances that suitable staff are employed for the protection of residents. The arrangements for the induction and training of staff are satisfactory, with the staff able to demonstrate an understanding of their roles. EVIDENCE: The records for three recently recruited staff were inspected. Each record contained application forms, including a full employment history, although it had been necessary to verify one of these histories at interview due to it being incomplete on submission. Records of interviews were seen. Full and complete evidence of the required pre-employment checks was seen in each file, with the exception of CRB and POVA clearances, as these are kept at the company head office; a selection of these has been seen at that location on a previous occasion. The manager is advised by facsimile transmission of receipt of individual’s disclosures at head office, though could not find evidence of this at the time of this inspection. CTCH Ltd has devised a new recruitment policy, which has yet to be seen fully in operation. Revised reference request forms ask that the referee give written verification of why the person left their last place of employment, specifically in cases where it involved the care of vulnerable adults. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 18 New staff receive a structured induction training within the first six weeks of employment with additional in-house training. Training records show that there are regular opportunities for staff to have a range of mandatory and optional training, in order that they have the necessary skills for their work. The home is making good progress with the NVQ programme, and is currently working towards having at least 50 of its care staff qualified to this standard. Foundation standard training is not being pursued by the home, as staff are encouraged to go straight onto the NVQ training. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36 & 38. There are some satisfactory management systems in place that will help to ensure that the welfare, health and safety of the residents is safeguarded, however these must be employed more rigorously in certain areas. The home reviews aspects of its performance through a programme of selfreview and consultations, which includes seeking the views of residents and their relatives. EVIDENCE: Since the last inspection, the manager has been registered by the CSCI. She is qualified to NVQ level 4 standard, and has the Registered Manager’s Award. She is currently seeking options for ensuring her continued professional development. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 20 A brief resident survey has recently been carried out, which focussed on the ‘daily timetable’, in comparison to individual’s choices and preferences. The results of this, including any points for further consideration or action, are published in the information folder in the hallway. It was reported that visitors to the home are also included in any satisfaction surveys, with forms left for their attention; direct evidence was not seen on this occasion. The information folder also contains the reported outcomes of a variety of inspection processes, in an effort to keep people informed about the quality of the service provided. A range of internal quality standards audit tools are being introduced, which will cover ten separate areas of the National Minimum Standards, which the manager will complete each month on a rotational basis; this is at a very early stage at this time. The manager has organised meetings for residents to discuss their views of the home, thought to date this has not been entirely successful. She now intends to organise something less formal, such as a coffee morning, with relatives also invited, so that peoples’ views may be more forthcoming. Some residents have placed personal money and valuables with the home for safekeeping. Thorough records for each person, which include transaction details, running totals, and receipts, are kept. Residents or their representative can sign to acknowledge transactions, but where this has not been possible in the majority of cases, two staff members sign the record to witness on behalf of the resident. The manager has drafted a staff supervision matrix, in order to monitor the progress of the programme. Samples of staff supervision records were seen; in addition to this, staff also have the option to request additional supervision from the manager in areas of their choice. The manager confirmed that she has yet to incorporate an annual appraisal for staff as part of the supervision programme. The manager referred to new staff working supervised for the ‘first few shifts’, and not rigorously for the duration of their induction, or pending receipt of their CRB disclosure if applicable. There was evidence that health and safety issues are addressed satisfactorily in many areas, with written policies, procedures and risk assessments, provision of necessary equipment and staff training. However, no evidence was provided to confirm that the electrical installation had been checked for safety, and the stairlift and the portable electrical appliances were overdue by nearly four months for their annual safety check and service; the manager resolved to chase this up with the people concerned.
Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 21 Other safety checks and maintenance of equipment had been undertaken in a timely fashion. Despite this, there was some evidence that hot taps are running at too high a temperature to ensure the safety of residents, despite regular monitoring. There are five members of staff currently qualified to provide First Aid. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x 3 x 3 2 x 2 Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? 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 7 Regulation 15(1) Requirement The Registered Manager must ensure that staff devise written care plans on the basis of an assessment identifying a risk of the resident developing a pressure sore. The Registered Manager must ensure that appropriate infection control measures are observed by staff in the laundry room. The Registered Manager must ensure that: An appropriately qualified and experienced member of staff is appointed to supervise a new worker for the duration of their induction training; As far as is practicable the ‘staff member’ must be on duty as the same time as the new worker; The new worker must not escort any resident away from the care home premises unless accompanied by the ‘staff member’. 4. 36 19 In circumstances where new staff commence employment pursuant to the receipt of a
D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Timescale for action 30/11/05 2. 26 13(3) 30/11/05 3. 36 18(2) 30/11/05 30/11/05 Bredon View Version 1.40 Page 24 Criminal Records Bureau disclosure: The home must appoint an appropriately qualified and experienced ‘staff member’ to supervise the new worker, pending receipt of a satisfactory disclosure; So far as is possible, ensure that the ‘staff member’ is on duty at the same time as the new worker; and Ensure that the new worker does not escort residents away from the care home premises unless accompanied by the ‘staff member’. The Registered Person must send certifcated confirmation of the electrical installation safety check to the CSCI. The Registered Provider must ensure that appropriate corrective actions are taken to ensure that the hot water at outlets accessible to residents remains at a safe temperature. 5. 38 23(2.b) 31/12/05 6. 38 13(4.a) 31/12/05 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. 3. Refer to Standard 9 26 30 Good Practice Recommendations A second person should sign as a witness to any hand written entries on medication administration charts. The Registered Manager should devise and display a detailed infection control procedure in the laundry room. Staff should receive training at foundation level, if they are not progressing to NVQ training. Bredon View D51_D03_16387_Bredon View_ v247015_171005_UI_stage4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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