CARE HOME ADULTS 18-65 Carlton House Dispersed Scheme 24 Wakefield Road Rothwell Haigh Leeds West Yorkshire LS26 0SF
Lead Inspector Karen Westhead Unannounced 12th April 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Carlton House Dispersed Scheme Version 1.10 Page 3 SERVICE INFORMATION
Name of service Carlton House Dispersed Scheme Address 24 Wakefield Road Rothwell Haigh Leeds West Yorkshire LS26 0SF 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) 0113 2827110 0113 2887523 J C Care Ltd Robin Staincliffe Care Home Only 21 Category(ies) of LD Learning Disabilities 21 registration, with number of places Carlton House Dispersed Scheme Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: None applicable. Date of last inspection 03 August 2004 Brief Description of the Service: Carlton House is owned by J C Care, which is a subsidiary of Craegmoor Health Care. The home is managed by Robin Staincliffe. The service is registered to provide care and accommodation for up to twenty-one adults with a learning disability and is spread over three properties. Carlton House has facilities for ten service users, an annexe within close proximity in the same grounds, provides additional accommodation for five service users and Woodhouse Cottage is registered for six adults. The one double bedroom, at Carlton House, is used as a single room thus admitting to a maximum of nine residents. Woodhouse Cottage is located three miles away. It is a satellite facility, which is staffed seperately, with Robin Staincliffe retaining oversight as manager. Carlton House and the annexe are situated in large grounds, a perimeter wall encloses these and the main gates are electronically secured. At the time of this visit extensive refurbishment was being carried out to improve the facilities and provide additional living space. Woodhouse Cottage accommodates service users who are more independent. Access is not restricted. The cottage has gardens to the front and rear of the property. Both care homes are well served by public transport. Both sites provide car parking for visitors. The annexe is purpose built, Carlton House and Woodhouse Cottage were previously family homes, which have been adapted. Carlton House Dispersed Scheme Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took just over six hours to complete and was unannounced. The reason for the inspection was to check if any progress had been made with requirements and recommendations made at the last visit, and assess a number of standards. In recent months there have been three meetings with senior managers from the organisation and other agencies to review the conduct of the home following an adult protection issue and another subsequent incident. The meetings have now concluded and it is evident that the staff in the home, and senior managers have co-operated with the CSCI and have amended procedures and policies in light of the outcome. The inspector carried out a brief inspection of all three sites. Resident records and supporting documentation was examined and cross-referenced. Six staff, eight residents and the manager overseeing the three sites were spoken with. What the service does well:
The level of care and support for residents is good. Residents spoken with confirmed their satisfaction with the way of life in the homes and spoke positively and frankly about their experience to date. Residents have access to a range of groups and individuals who are able to provide advocacy and third party assistance as appropriate. Staff take a common sense approach to risk taking and enable residents to fulfil their wishes as appropriate. The level of involvement in the community, whether residents access this through independent means or not, fulfils their individual wishes. In view of the complex nature of some of the resident needs, staff are able to manage well in accessing educational placements and recreational pastimes and incorporate the type of supervision required. The atmosphere in each of the homes is relaxed and staff approach daily activities flexibly. The staff team were observed to deal with situations in a calm and competent manner. However, the manager and senior team need to continue to monitor the use of restraint as detailed in the body of the report. Residents said they were happy with the staff looking after them. Residents spoke frankly about their relationships with staff and felt they got enough guidance and support. The manager operates the home in an open and transparent way, he encourages staff to take on responsibility and help with any decisions affecting the lives of residents.
Carlton House Dispersed Scheme Version 1.10 Page 6 What has improved since the last inspection? What they could do better:
There were three requirements outstanding from ten highlighted at the last inspection. The two recommendations have now been addressed. As a result of this visit an additional eight requirements and one recommendation was noted. The home did not address the requirement to provide a contract for residents, keep adequate medication records (Woodhouse Cottage) or develop the policy relating to care of the dying. In addition to these outstanding requirements there were issues referring to the care plans, records and care delivery, the premises and fire safety arrangements. Residents said they were not interested in what records were being kept about them, as long as they felt safe and well cared for. Residents, at Carlton House, said they thought the improvements would make life easier. It is envisaged that some redecoration and re-carpeting will also take place, which will drastically improve areas, which at the present time remain institutional and unwelcoming. There needs to be a focus on improving care documentation to ensure this meets the required standard. The areas needing improvement were discussed with the manager who agreed there had been a lapse in the quality of the recording being done. Carlton House Dispersed Scheme Version 1.10 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Carlton House Dispersed Scheme Version 1.10 Page 8 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 Standards Statutory Requirements Identified During the Inspection Carlton House Dispersed Scheme Version 1.10 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 and 5. The level of care and support for residents living at the three sites was noted as good, despite the lack of contracts or statements of terms and conditions. EVIDENCE: A random selection of resident files were looked at. None contained a signed contract or statement of terms and conditions. This was highlighted at the last inspection and therefore remains outstanding. The manager said that these had been produced but not signed due to the limited understanding and issues of capacity for residents. Residents were assessed prior to being admitted to the home. Written evidence demonstrated the alternative forms of assessment used. Of the records seen the methods of assessment were appropriate. Written evidence supported the view by residents that they felt the home provided the support and care they needed. A number of residents had aspirations about their future. It was evident that they were supported appropriately. Where issues arise, staff are skilful in their approaches and deal with residents in a practical and realistic manner. Residents confirmed they had contact with other agencies, advocacy groups and where necessary social workers were visiting them on an ongoing basis. Carlton House Dispersed Scheme Version 1.10 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 There needs to be a focus on ensuring residents personal files and supporting documentation is maintained appropriately and reflects the care and attention required. Staff take a reasonable and commonsense approach to risk taking. EVIDENCE: A random selection of care plans were looked at during the course of the inspection. At Carlton House, the most recently admitted residents were looked at to review the progress made with their plans of care, treatment and the evaluations made. The records were not complete. The manager made the assumption that staff were working on the content of the file, however he was unable to locate the records and until he had spoken to key staff members he was unable to explain the absence of the records. The inspector discussed the implications of accurate record keeping and the use of factual evidence and appropriate use of language in daily records. The manager acknowledged that some work was required to ensure staff were given guidance and support in this area. This is detailed as a recommendation. Carlton House Dispersed Scheme Version 1.10 Page 11 It was evident when talking to residents and subsequently to staff, that risk assessments were in place and that a common sense approach was used when determining the level of supervision and support residents required when trying new initiatives. This was seen during the visit when an organised event was reviewed following an incident. The manager gave clear guidance to staff and the matter was dealt with in a calm and professional manner. Carlton House Dispersed Scheme Version 1.10 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14. Residents have appropriate support from staff, outside agencies and other professionals in order for them to lead a fulfilling lifestyle inside and outside the care home. EVIDENCE: Over the three sites, a total of five residents access community facilities unescorted. This includes services locally and out of area. All other residents are escorted. Staff were proactive in their efforts to ensure residents attend leisure activities, educational placements and therapeutic recreation. Overall there is good organisation around leisure. At Woodhouse Cottage the emphasis is on residents taking control of this. Residents are enabled to research and choose their individual activities. During the course of the visit residents were seen interacting with staff about their days activities. Appropriate support was being offered and the inspector gained the impression that this practice was the norm.
Carlton House Dispersed Scheme Version 1.10 Page 13 Residents with specific and complex needs are provided with specialist support from other agencies. On the day of the inspection a review was being held to discuss and evaluate the care being provided for one individual. The resident, members of family, key members of staff and a social worker were in attendance. Residents, who were able to share their experiences, confirmed they were satisfied with the levels of activity provided/organised. Those residents with limited understanding and speech were supported appropriately and systems were in place to monitor their involvement in organised and ad hoc events. Carlton House Dispersed Scheme Version 1.10 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 and 21 There is a flexible approach to daily routines, which supports residents with their personal care needs and health care support. Residents receive appropriate medical treatment for short and long term conditions. The records in the home were not being maintained appropriately. Particular attention was required to personal records and care plans at Carlton House, medication records at Woodhouse Cottage and the policy on care of the dying. EVIDENCE: The policy in the home, which relates to care of the dying, needs to be developed to include all the necessary information. This requirement was highlighted at the last inspection. A random selection of care plans were seen during the course of the visit. As stated in the previous section, additional work is required to ensure records reflect the care and attention provided and that a structured plan of care is in place, particularly at Carlton House. It was evident that the medical records at Woodhouse Cottage were not being maintained properly. Omissions were still evident in the record being kept, however the medication held in the home indicated the medication had been
Carlton House Dispersed Scheme Version 1.10 Page 15 given. This requirement was highlighted at the last inspection and remains an issue. The policy in the home, which related to care of the dying, needed to be developed to include all the necessary information. This requirement was highlighted at the last inspection. There was a flexible approach to daily routines. Residents described a ‘typical’ day, which involved a choice about getting up, if they were not having to attend an appointment or prearranged event, and going to bed when they wanted. Staff offered suitable advice and guidance about personal hygiene and matters, which could affect others in the home. Records showed residents were being offered appropriate treatment from doctors, hospital consultants and other professionals. Residents, during conversation, referred to their visits to the doctor’s surgery. They were able to see the doctor in private, receive treatment and had their medication reviewed regularly. Carlton House Dispersed Scheme Version 1.10 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 A significant number of incidents, resulting in a form of restraint being used, is an ongoing matter for the manager and organisation to consider. This issue must be continually monitored to ensure the use of restraint is reserved as a last resort and used appropriately. Despite this concerns and complaints are dealt with promptly and appropriate action taken to ensure the welfare and protection of residents. EVIDENCE: Records were examined to check the number of times restraint has been used. All incidents were recorded in full and any subsequent injuries noted. There had been two incidents where a serious injury had been sustained. These were referred to the Adult Protection Team and an investigation was carried out. This resulted in there being a review of the home by the CSCI, the police authority, social services departments and senior managers from the registered organisation. At the time of the visit there had been no formal complaints made at any of the homes. Carlton House Dispersed Scheme Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 29 and 30 At Woodhouse Cottage the premises were well maintained with attention given to detail. The staff must remain mindful about the use of door wedges and not compromise the health and safety of residents. The home was found to be clean and tidy. At Carlton House and the annexe there is extensive refurbishment and alterations. Apart from the need to provide adequate facilities for those who smoke and address the issues with the newly fitted shower room the home is generally maintained to the minimum standard. There was much redecoration, refurbishment and re-carpeting required. However this will be completed in the programme of improvements planned. Improvements must be made to the frequency of fire safety checks and the records being kept. EVIDENCE: Building work had started to enhance existing facilities. There is no intention to reduce the number of registered beds.
Carlton House Dispersed Scheme Version 1.10 Page 18 Carlton House is a non-smoking building. Facilities have been provided to the rear of the building. However, attention should be given to how litter and discarded cigarette butts are disposed of. No clear guidance was available for when the weather is poor. A resident to showed the inspector around the building. The extension was not completed, but was visible from the existing kitchen area. The proposals have been well planned and residents had had some input. It was envisaged that once the construction work is finished, redecoration will start in the remainder of the house. A shower room has now been provided in Carlton House. This had been well received by residents, who confirmed they had benefited from this and had a choice of a bath or shower. There was however an offensive odour evident, which appeared to be coming from the waste pipe. A resident also pointed out that the water had been cold when he took a shower earlier in the day. The manager agreed to have this investigated and rectified. Some of the resident bedrooms were seen. At Woodhouse Cottage a brief walk around the building took place. Despite there being magnetic self closing devices fitted to all fire doors in the communal areas, which means they will automatically close should the fire alarm be activated, one was found to be wedged open. This is unacceptable as it places residents at risk. At Carlton House, the annexe and Woodhouse Cottage fire drills were being completed but need to include the initials of who took part. Weekly checks of the fire system were not being carried out at Carlton House or the annexe but had been done at Woodhouse Cottage. The manager agreed to carry out a thorough evaluation of the fire system, at Carlton House, immediately following the inspection. This must be repeated at the required frequency. Carlton House Dispersed Scheme Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33,34 and 36. The number of staff shortages is having an impact on the deployment of staff, particularly at Carlton House. Staffing levels are at times, inadequate to meet the needs of residents. There was no consistency with the amount of supervision being provided for all designations of staff, thus leaving staff without the opportunity to discuss work and training requirements. Despite this residents said they were happy with the staff working in the home where they lived. They described the relationships they had with staff and acknowledged the support and guidance provided. EVIDENCE: Since the last visit there had been significant changes in the staff group. One member of staff had moved to ‘bank’ work in preference to their permanent position; one full time member of senior staff and the deputy manager have transferred to another care home, within the organisation. This has impacted on the vacancy situation, which was in total eight posts, including three senior posts. Carlton House Dispersed Scheme Version 1.10 Page 20 The manager acknowledged this did cause some difficulties when providing sufficient cover in all three homes. There had been three appointments made in the weeks before the inspection, however, until the necessary personnel checks had been completed the applicants had not been given start dates. Staff spoken with in private and in groups said that staffing shortages were of significance. However, staff were working additional hours to cover the shortfall and in some instances bank workers were being utilised from other homes within the organisation. Staff comments suggested there had been difficulties in ensuring residents were offered ample quality time in addition to their basic care needs. The manager confirmed this was an issue, which needed addressing, particularly at Carlton House. However, once the new staff were in post, there should be better flexibility within the rota to allow for maximise deployment of staff. The manager said that supervision sessions had been organised for staff on a one to one basis over the three sites. Some staff were not able to recall when they were last seen in this capacity. Staff talked about the training they had received to enable them to provide a good standard of care. Records demonstrated a wide range of mandatory training courses had been attended by staff. All staff across the three homes had a criminal records bureau check. All new staff were subject to a robust recruitment and selection process prior to their appointment. As stated above, staff are awaiting the necessary checks prior to starting work. Staff were observed carrying out their respective duties in a patient and competent manner. One potentially serious incident at Carlton House was dealt with in a calm and professional manner. Residents spoken with appeared happy with the staff. Each resident was able to say who the staff were and what their roles were. Two residents talked about their experiences of the home in detail and gave the impression that they understood why they were living at the home and what their personal expectations were. Many of the residents were aware of their plan of care and had some understanding of the support they required for them to live as independent a life as possible. Carlton House Dispersed Scheme Version 1.10 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 41 and 42 The manager runs the home in an open, positive and inclusive manner. The health and safety of residents is compromised and improvements must be made. EVIDENCE: On looking at records and cross-referencing key documents with supporting information it was evident that records were inadequate and do not reflect the care and attention provided. These are itemised in the corresponding sections. A number of health and safety issues were highlighted and are listed as requirements with a specific timescale for appropriate action to be taken. Carlton House Dispersed Scheme Version 1.10 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 2 x 1 Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 x x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x 3 2 x 3 2 Standard No 11 12 13 14 15
Carlton House Dispersed Scheme x 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 x 3 3 x 2 Version 1.10 Page 23 16 17 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 2 Standard No 37 38 39 40 41 42 43 Score x 3 x x 2 2 x Carlton House Dispersed Scheme Version 1.10 Page 24 YES 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 2 Regulation 14 Requirement All residents must have an individula plan of care which is based on the pre-admission assessment. The home must be able to demonstrate that it can meet the individual needs of the individuals admitted to the home through evaluation and review. All residents must have a signed contract/statement of terms and conditions. Where issues of capacity are evident, suitable arrangements must be put in place to safeguard residents. (Previous timescale of 23 August 2004 not met.) All residents must have their assessed and changing needs and personal goals reflected in their plan of care. All medication records must be completed in full and accurately reflect the drugs administered to each resident. (Previous timescale of 21 October 2004 not met.) The documentation relating to the procedure for caring for the dying needs to be developed to include all the required
Version 1.10 Timescale for action 30 May 2004 30 May 2004 2. 3 15 3. 5 5(1)(b) 19 June 2004 4. 6 15 30 May 2004 9 May 2004 5. 20 13(2) 6. 21 12 30 May 2004 Carlton House Dispersed Scheme Page 25 7. 27 23(2)(d), 23(2)(j), 8. 9. 10. 11. 30 36 41 42 23(2)(j) 18(2) 17(1)(a) Schedule 3 23(4) information. (Previous timescale of 14 October 2004 not met.) The lack of hot water in the shower room must be investigated and resolved. Suitable arrangements must be put in place to cater for the needs of those who wish to smoke, including the disposal of discarded cigarrette butts and litter. All areas of the home must be kept free from offensive odours and hygienic. Staff of all designations must be well supported and supervised at least six times per year. All records must be maintained in an up to date manner and be accurate. The home must be kept as far as reasonably practicable free from hazards. Fire safety records must indicate those involved in training. 9 May 2004 9 May 2004 30 May 2004 9 May 2004 9 May 2004 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 41 Good Practice Recommendations The manager should ensure that staff have the information and necessary skills to be able to complete records. Particular attention should be given to the language used when describing incidents. Carlton House Dispersed Scheme Version 1.10 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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