CARE HOMES FOR OLDER PEOPLE
Castelayn 2 Leighton Drive Sheffield South Yorkshire S14 1ST Lead Inspector
Shirley Samuels Key Unannounced Inspection 23rd January 2007 09:00 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 Castelayn DS0000002946.V324981.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. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Castelayn Address 2 Leighton Drive Sheffield South Yorkshire S14 1ST 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) 0114 239 8429 0114 239 8216 none www.sheffcare.co.uk Sheffcare Limited Mrs Diana Oak Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability (4), Physical disability of places over 65 years of age (4) Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The 4 PD beds can also be for people who are PD (E) and are situated in a separate wing. 14th March 2006 Date of last inspection Brief Description of the Service: Castelayn is a purpose built 40 bed home. The home offers personal care for 36 older people and personal care for 4 people with physical disabilities. It is in a residential area of Sheffield with good access to public services and amenities (e.g. bus services, shops, pubs, etc). It is over three floors all serviced by a lift. All the bedrooms are single and there are a suitable number of lounges and dining rooms. The gardens are landscaped and it has a small car park. Information about the service is provided to service users on admission and displayed on each of the four units. The inspection report is displayed and made available on request. The fees range from £315:00- £348:00. Further information about fees can be obtained from the service. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced site visit carried out over eight hours from 9:00am5:00pm. Fifteen service user questionnaires were sent out. Nine questionnaires were completed by service users and given to the inspector on the day of the site visit. Fifteen questionnaires were sent out to relatives Fourteen were returned. Seven service users, four staff two relatives and one professional visitor and the manager was spoken to on the day of the inspection. The manager provided written information about the building, policies and procedures, service users and staff. An inspection of the building was made records were examined including three service user files, two staff recruitment documents, training records, staff rotas, minutes of meetings complaints, activities programme and quality assurance documentation. Observation was made of the interaction between staff and service users. What the service does well:
Service users did not move into the home without having there needs assessed. Each service user had a plan of care that detailed there needs and what action the staff needed to take to meet those needs. Health care needs were met and service users said “the staff always requested a visit from the doctor whenever it is necessary”. Although some issues were found, in the main the medication system was safe and staff received training on medication procedures and how to administer medication safely. Staff were able to give examples of how they promoted service users rights and dignity. With the exception of one member of staff, staff were observed being friendly cheerful and attentive to service users. Service users said they felt that in the main the staff were polite and respectful. There was a programme of activity, which the service users were positive about. It was clear from observations that the need for activity and stimulation was recognised as being important to promote service users general overall wellbeing. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 6 Service users were encouraged to keep in touch with family and friend. Relatives spoken to said, “the staff are very hospitable and always make us feel welcome”. Policies and procedures were in place to protect service users from harm and staff were able to verbalise the action they would take if an allegation was reported to them. Appropriate procedures were in place to control the spread of infection. A number of staff who had worked at the home for many years have recently left the home due to retirement and other opportunities. This has been unsettling for some of the service users. Who have had to get used to new staff. However in he main the required staffing level had been maintained by using agency staff and the lone of staff from other homes within the organisation. Service users spoke positively about the staff and described them as being “kind” and “helpful”. The recruitment procedures included all the required checks and new staff were employed with a probationary period. New staff received induction training and “buddied” up with experienced staff for the first few weeks in the job. Ongoing training was provided for all staff to make sure they maintained the skills and knowledge to do their job and develop new skills to respond to changing needs and new challenges. Since the last inspection the manager has been registered with the Commission For Social Care Inspection. Service users, staff and relatives spoke positively about the manager and there was evidence to show that she was able to carry out her responsibilities fully. There is a quality assurance system, which seeks the views of service user, relatives and other people involved with the home. There were procedures in place to make sure the service users financial interest was safeguarded. The health safety and welfare of service users and staff were promoted and staff understood their responsibility for maintaining a safe environment. What has improved since the last inspection?
Service users information is no longer displayed publicly. An uneven floor surface has been made even. The manager said that staffing levels and the needs of the service users are constantly kept under review. Staff said they were receiving regular supervision. Castelayn DS0000002946.V324981.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. Castelayn DS0000002946.V324981.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 Castelayn DS0000002946.V324981.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 & 6 Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. Service users did not move into the home without having their needs assessed. The home did not provide intermediate care. EVIDENCE: Assessments were on each of the files checked. Staff said that information was given to the home, which allowed them to make a judgement about whether they could meet the needs of any potential service user. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. Each service user had a care plan which detailed their health, personal and social care needs. Health care needs were met and in the main the medication procedures met the standards. Service users were treated with respect and their right to privacy was upheld. EVIDENCE: Three service user files were checked they contained details of service users personal care needs, bathing oral hygiene, Continence medication and dietary needs. Service users medical needs were recorded and details of any medical or professional intervention. Social interest likes and dislikes were recorded. The plan of care was revived monthly. There was evidence to show that service users and their families contributed to the plan of care and to the reviews. The service user and relatives spoken to confirmed that they were consulted. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 11 Service users were registered with a GP and said that the staff always requested a GP for them if they were ill. The home did consult with the continence service on behalf of individual service users. Individual service users were receiving input with regard to falls prevention. The records showed that service users received visits from other health care professionals such as dentist, chiropodist and opticians. Medication was appropriately stored. Staff received training on the administration of medication and received periodic supervised drug rounds to monitor competence. Controlled drugs were stored separately in line with requirements and records of administration were kept. There were procedures in place to monitor the management of medication and action was taken where discrepancies or failings were found. However gaps were found on medication administration sheets. The application of creams was not recorded. One service user said they did not always receive their medication at the time prescribed. This was confirmed by a member of staff and supported by the records. Staff were able to verbalise in what way they promoted service users privacy and dignity on a daily basis. By sharing information, giving choices, valuing service users opinions, offering privacy and considering dignity during personal care tasks. Service users said the staff were “polite” and “caring”. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is (adequate). This judgement has been made using available evidence including a visit to this service. A variety of activities took place, which met the social and cultural needs of service users and were able to maintain contact with friends and family. Service users are encouraged and help to exercise control over their live. Service user did not always receive a meal that was appealing to them at a time that was convenient to them. EVIDENCE: There was a programme of activity in place. Service users said there was plenty of opportunity to take part if they wished. Activities were arranged for most mornings and afternoons. Trips outside of the home were also arranged. Service users said, “I enjoy my own company but I can join in if I wish”, “ I watch television and listen to my radio”, “ I go and stay overnight with my friends at weekends”. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 13 Relatives said they were able “to visit at anytime” and “were always made welcome and kept in formed of any changes concerning their relative”. Service users said they were able to spend their time as they wished, choose when to go to bed and get up and were given choices about the gender of the person providing personal care to them. This promoted autonomy and a sense of control over their lives. Service users were keen to talk about the food provided. The comments ranged from “it’s alright”, “always a choice”, “always hot”, “always enough” to “It’s awful”, “overcooked” “undercooked”, “the meat tough as old boots”, “not as good as it used to be”. One relative said via the questionnaire “I am not yet convinced that the central kitchen is condusive with regard to “home” cooking”. It was clear from minutes of meetings and discussion with the staff that service users in the main were not satisfied with the standard of the food. Food is prepared for five homes from the kitchen at this home. Lunch, which is the main meal of the day, is cooked by 10:30am. Special containers have been purchased for the storage and transportation of the food from this home to the others. The food for the service users at this home is stored in a hot trolley and then plated up prior to being served and covered with cling film. The meal on the day of the inspection was meat potato white cabbage, cauliflower and yorkshire pudding. On arrival to the dining room the food had started to sweat under the cling film and the heat had caused the cling film to stick to the plates. Some service users said they enjoyed the meal but were observed to leave some of it others did not eat any of the main course but ate some of the dessert. Service users described the pastry on the apple pie as “soggy”; this to had been covered with cling film. Service users were observed only eating the apple from the middle. One service user who was not well and had only eaten a slice of toast for breakfast had a large potion of food placed in front of her, which she refused to eat. She did however enjoy the milk pudding. I asked the staff if there was anymore and was told that there was no more to offer from the trolley. There were 12 service users in the dining area one member of staff and one service user who needed prompting/assisting. Assistance with eating was provided by a member of staff standing over the service user they were not attentive and food was offered in-between clearing the tables and filling the dishwasher. Tasks could have been managed better to allow the service user to be assisted in a more dignified way. The staff said that service users who go to the day centre take sandwiches for their lunch. A cooked meal is not provided for them on their return. This means that on some days those service users are not receiving a cooked meal all day. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. Complaints were taken seriously and acted upon; there were procedures in place to protect service users from harm. EVIDENCE: Service users said they had someone to talk to if they were unhappy. The complaints procedure was displayed in the entrance to the home and copies were also seen in some of the bedrooms. Staff had knowledge of the complaints procedure and knew what to expect if a complaint was made. This ensured that service users complaints were taken seriously. Fourteen questionnaires were received from relatives; five said they were not aware of the complaints procedure. Twelve said they had never had to make a complaint. The manager said that the home had received six complaints since the last inspection, four of these being about the food provided at the home. Records of these complaints were recorded but did not record sufficient information about the complaint and the action taken. Since the last inspection one complaint has been made to the Commission For Social Care Inspection, this to was about the food provided. The complaint was passed back to the organisation to investigate. The issues have not yet been fully resolved as complaints are still being revived about food.
Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 15 Staff said they had received training in adult protection. They were able to verbalise the action they would take if an allegation were made to them. Service users said they felt safe and there were clear written procedures in place. This ensued that service uses were protected from harm. There have been no allegations of abuse since the last inspection. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 and 26 Quality in this outcome area is (adequate). This judgement has been made using available evidence including a visit to this service. Service users live in a safe clean and reasonably maintained environment. The call system was not in full working order. EVIDENCE: In the main service users said they were satisfied with their bedrooms. Bedrooms were personalised and service users were able to bring personal possessions into the home with them. Some communal areas were reasonable decorated however in some areas wallpaper was damaged. Some parts of the home was noted to be very drafty, some of the windows were ill-fitting, during windy and rainy weather water came in, in a number of places including corridor areas and service users bedrooms. Water damage was also noted to the ceiling and ceiling tiles were damaged and bowing. The carpet on one of the corridors was faded.
Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 17 One-service users said that staff did not always come quickly when they called. Observation was made of one service user waiting eight minutes for the buzzer to be answered. It was established that equipment (the “bleep” carried on the staffs person) was missing and had not been replaced. The manager was required to address this immediately. The manager notified the Commission For Social Care Inspection on the 25/1/07 that a risk assessment had been completed and action taken to provide extra monitoring of service users. 26/1/07 confirmation received that “bleeps” had been replaced. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. In the main the number and skill mix of the staff meets service users needs. Staff were appropriately qualified and received the training they needed to help them do their job. The recruitment procedure was thorough and protected service users. EVIDENCE: The rotas showed that on the majority of shifts the minimum staffing levels were maintained. The service users and relatives pointed out in their questionnaires and during discussion that there had been a lot of change in the staff at he home. The manager confirmed this. The manager said that due to the possible redeployment of staff from other homes within the organisation; recruitment to vacant posts had not taken place. The use of agency staff (some of whom were familiar with the home) has been unsettling for the service users. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 19 Some of the comments received from relatives and service users included, “the care is not as good as a year ago, e.g. personal hygiene, no jug or cup to drink from in the bedroom, no paper towels in the dispensers in the toilets”. “I think that they should have more staff on duty”, “A number of staff have left recently the ones now do not seem as friendly, sometimes have to go looking for staff, there used to be always someone around”. “ We are noticing at certain times i.e. mealtimes, the staffing levels are insufficient”, “I am most grateful to all the staff for all the care they give to my mother”. The staff files checked did contain all the information and checks required by the regulations. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38 Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. The manager is qualified, experienced and able to discharge her duties responsibly. There is a quality assurance system in place, which seeks the views of service users, and others involved with the home. There are procedures in place to ensure the safe management of service users finances. The health safety and welfare of service users and staff is promoted and protected. EVIDENCE: The service users spoke positively about the manager. The staff said she was approachable and they had confidence in her management of the home.
Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 21 Service users were surveyed and asked to comment on the service. Service user meetings were held and a forum was in place. There was evidence that changes had been made following service user comments and that service users were able to effect change. A person delegated by the Responsible Person visited the home monthly. During this visit service users and staff were spoken to and observations made about the conduct of the home. A report was completed and a copy submitted to the Commission For social care Inspection. The trustees and executives also visited the home. Service users said they were satisfied with the arrangement in place for their finances. Three service users accounts were checked. They were accurate and receipts were kept of all transactions. All staff received core training including health and safety, moving and handling, first aid, food hygiene and fire safety. Hazardous substances were appropriately stored and the manager said safety checks had been carried out on all equipment in line with safety requirements. Accidents were appropriately recorded. The records showed a high level of falls. Consultation was ongoing with the falls intervention team who was already working with individual service users to try and reduce the incidents of falls and injuries to service users. Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 2 x x 2 x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13 Requirement All prescribed medication including creams and eye drops must be signed for immediately following administration/ application. All medication must be administered at the time stated on the prescription label. Food must be presented in a manner, which is attractive and appealing in terms of texture, flavour and appearance in order to maintain appetite and nutrition. Service users must not be over faced by large potions of food if thy only have small appetites. Consideration must also be given to food potions when service users are feeling unwell, off their food and staff want to encourage them to eat a little. Assistance with eating must be offered in a discreet and sensitive manner. Service users must be provided with three meals a day one of which must be cooked.
DS0000002946.V324981.R01.S.doc Timescale for action 10/02/07 2 3 OP9 OP15 13 16 10/02/07 10/02/07 4 OP15 16 10/02/07 5 6 OP15 OP15 16 16 10/02/07 10/02/07 Castelayn Version 5.2 Page 24 7 OP15 16 8 OP16 Schedule 4 9 OP19 23 The manager must continue to 10/02/07 establish whether the catering services are meeting the needs of service users. Records of complaints must 10/02/07 include sufficient detail about the content of the complaint, the findings following investigations, the action taken and whether the complainant was satisfied with the outcome. All areas of the home used by 01/05/07 service users must be kept reasonably maintained and decorated. Action must be taken to ensure that drafts are excluded. Windows must be repaired are replaced as necessary. Maintenance and repair of the building must take place to prevent leaks during bad weather. The faded carpet on the corridor identified must be replaced. The call system must be maintained in good working order to ensure that staff are immediately alerted to service users call for assistance. Staff must respond promptly to service users calls for assistance. There must be at all times staff in sufficient numbers to met the needs of service users. Consideration should be given to providing additional staff at peak times e.g. mealtimes. The employment of staff on a temporary basis must not prevent service users from receiving continuity of care.
DS0000002946.V324981.R01.S.doc 10 OP22 23 27/01/07 11 OP27 18 10/02/07 12 OP27 18 10/02/07 Castelayn Version 5.2 Page 25 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 Castelayn DS0000002946.V324981.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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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