CARE HOMES FOR OLDER PEOPLE
Fazakerley House Residential Care Home Park Road Prescot Knowsley Merseyside L34 3IN Lead Inspector
Danny Hamilton Unannounced Inspection 18th October 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 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. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Fazakerley House Residential Care Home Address Park Road Prescot Knowsley Merseyside L34 3IN 0151 289 9203 0151 477 9208 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) Meridian Healthcare Ltd Mrs Cathrine Joan Atkinson Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24), Physical disability over 65 years of age of places (24) Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced Manager who is registered with the CSCI. Variation to admit one named service user under pensionable age Date of last inspection 27th April 2005 Brief Description of the Service: Fazakerley House is a care home that is registered to provide personal care and support for up to 24 older people, including older people with a physical disability. The home is a purpose built building that is currently undergoing major building / refurbishment work to increase the number of bedrooms from 24 to 30 and to improve the overall environment for residents. It is located in the Prescot area of Liverpool and is easily accessible from the M57. Local shops, bank and public transport are situated approximately half a mile away. Presently, the home offers a large amount of communal space as well as bedrooms. A smoking lounge is provided on the ground floor along with the offices, kitchen area, dining room and a selection of bedrooms. The upper floor, which can be accessed by a lift, comprises of the rest of the bedrooms. The more dependent service users are located in this area. Toileting and bathing facilities are located throughout. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 9 hours. A partial tour of the premises took place and observations were made. A selection of care, staff and service records were also viewed. The manager, care coordinator, two staff on duty, seven of the twenty-one residents and three relatives were spoken to during the visit. Leaflets were also left in the home to enable residents and others to comment on the service provided. What the service does well:
Sufficient numbers of staff were on duty to meet the needs of the people living in the home and residents spoken with complimented the care provided. Comments from two residents included; “The staff are brilliant” and “There are plenty of staff on duty. They look after you very well.” Likewise, a relative expressed a view that his relative; “Couldn’t get better care.” Health care was well managed and appointments were arranged with health care practitioners as required. A resident spoken with said; “They look after our physical health very well.” Daily life and routines with the home were flexible and determined by the people using the service. A resident reported; “The staff ask you what you would like to do, not tell you what to do.” The home had an open door approach to visiting. A resident spoken with said; “Visitors can come any time they want.” The home’s manager was suitably experienced in the management of a care home for older people and was registered with the Commission for Social Care Inspection. A staff member spoken with said; “The manager is really supportive.” Likewise, a resident said; “Catherine [Manager] is OK. She listens to us.” Suitable arrangements were in place to monitor the quality of care provided in the home and to ensure the home was run in the best interests of residents. Likewise, residents’ financial interests were safeguarded. Records of all transactions and receipts were available for personal money entrusted to the home for safekeeping by residents or their representatives. Although building work was in progress, the home was generally clean and tidy. A resident interviewed said; “Everyday, they clean my room.” Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better:
A pre-admission assessment viewed during the visit had not been completed in full. The home must undertake a full assessment of each resident’s needs prior to admission, to ensure all the needs of residents are identified. Medication administration records were not being appropriately maintained. All medication entering the home must be checked, dated and signed for and the date that medication is administered must be recorded on medication administration records. Furthermore, the home should re-establish a system to verify the identity of residents, prior to administering medication. Residents expressed mixed views about the range and frequency of activities provided. In order to provide a range of activities that meet the preferences and expectations of the people using the service, a new programme of activities should be developed in consultation with residents. Likewise, the alternative choice of meals on the menu should be reviewed, taking into consideration the wishes of residents. The home’s recruitment process did not fully protect the people living in the home. A member of staff had commenced employment, before all the
Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 7 necessary checks had been completed. The results of a Protection of Vulnerable Adults (POVA) check must be obtained, before staff are confirmed in post. Despite a requirement at the last inspection, some staff training records had still not been updated. Furthermore, records showed that some staff had not completed all safe practice training. These issues must be addressed, to confirm that staff are sufficiently trained and competent to undertake their roles. In order to ensure the health and safety of residents, staff and visitors to the home, a gas safety and a lift service record / certificate must be obtained. Furthermore, the hot water temperatures should be monitored and records maintained. 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. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 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 Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 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 the following standard(s): 3 Some pre-admission assessments had not been completed in full and lacked key information. Unless a full assessment is completed, there is no assurance that care needs will be met. EVIDENCE: Three files were viewed during the visit. Two were for residents who had recently moved into the home and one was for a resident who had lived in the home for over 5 years. Each file contained an assessment. Assessments had been completed for each of the two new residents prior to admission however one of the assessments was incomplete as pages were missing. The home had introduced new assessment documentation, which was well constructed and enabled a thorough assessment of needs to be undertaken when completed in full. Information gained from the assessment process was used to develop a plan of care for each resident. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 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 the following standard(s): 7,8 and 9 Care plans had been completed, which reflected changing needs and personal goals. Residents had access to health care services, subject to individual requirements. Medication administration records were not being appropriately maintained. This has the potential to place the welfare of residents at risk. EVIDENCE: Three resident files were viewed. Each file contained a plan of care, which identified the individual needs of residents, the support required from staff to ensure all identified needs were met and personal objectives. Records showed that care plans were kept under monthly review and had been signed by residents or their representatives. Supporting documentation including risk assessments for; falls, moving and handling, environmental hazards, nutritional and individual risks and weight and daily report records had been completed. Since the last inspection, the manager had introduced an audit system, to monitor the home’s care plan system and documentation. Medical intervention records viewed showed that residents had access to health care practitioners subject to need. There were records of recent visits to and from; doctors, opticians, district nurses, dentists, community psychiatric nurses, chiropodists and hospital appointments on the files viewed. Residents interviewed described how the staff supported them with their routine health
Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 11 care needs. One resident said; “I have seen my doctor and the nurse visited today” and another reported; “They look after our physical health very well”. The home had a corporate medication policy in place and a local medication handling policy had been produced by the manager, to provide additional guidance for staff. Risk assessments had been completed for three service users who self-administered their medication. A record of the staff designated with responsibility to administer medication and their sample signatures was in place, however the home’s system for verifying the identity of residents, prior to administering medication, was not in place at the time of the visit. Furthermore, medication administration records viewed had not been dated and there was no record of the medication being checked, signed for and dated upon entering the home. All medication including controlled drugs was suitably stored. The administration of controlled drugs was appropriately recorded and balances were correct. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14 and15 Some residents felt that the range of activities within the home was limited and did not provide much variation and interest. Residents retained control of their daily lives in order to maintain their independence, relationships and preferred lifestyles. Residents were offered a nutritious and wholesome diet. Although menus had been updated to show a choice of meal for each sitting, some residents felt the alternative meal options were limited. EVIDENCE: Residents interviewed expressed concerns about the range and frequency of activities available, both inside and outside the home. One resident reported; “It’s rather difficult with activities. Not many people choose to participate.” Other residents felt there had been fewer activities of late, due to the refurbishment work. Comments from four residents included: “There are not many activities on offer”; “We could do with some more activities”; “There are very little activities here” and “I miss some of the activities. We used to have a programme and staff took us out more.” The home maintained a record of activities provided. The activities record did not detail the names of participants however it showed that a limited range of activities was provided on a regular basis. Recent activities included; dominoes, hairdressing, nail care, communion, church services and occasional trips into the community. There was no activities programme in place. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 13 Residents spoken with confirmed that the home had a flexible approach to visiting and that they could receive visitors and maintain contact with family and friends as they wished. Comments included: “Visitors can come anytime they want”; “I have visitors everyday and they don’t say anything”; “My daughter and son come here everyday to see me. There are no restrictions on visiting times.” Residents were observed to receive visitors during the visit and relatives interviewed expressed satisfaction with the service provided. One visitor stated that his relative; “Couldn’t get better care.” The routines of daily living were determined by the people using the service and residents spoken to reported that they were able to make their own choices and decisions regarding their personal lives. The views of three residents included: “You can do what you want here”; “We make our own decisions” and “The staff ask you what you would like to do, not tell you what to do.” The home had a three-week rolling menu in place. A residents meeting had been coordinated on 29th July 2005, to consult residents about their views of the menus. Menus viewed showed that a range of nutritious and wholesome meals was provided, with a set alternative for dinner and tea. Meals were served in the home’s dining room at set times, however arrangements were flexible to accommodate individual needs. The home’s dining room was undergoing refurbishment work at the time of the visit. Overall, residents were satisfied with the meals provided however the majority of residents felt the choices available lacked variation. Comments from three residents included: “The food is very good but the choices are limited”; “We don’t get a good choice of food. There is limited variety” and “The food is quite nice, but you don’t get many alternatives.” Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 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 the following standard(s): 16 There had been no complaints since the last inspection and residents were confident that if they needed to make a complaint, their concerns would be listened to and acted upon. EVIDENCE: The home had a complaints procedure and a record of complaints. The complaint record showed that no complaints had been received since the last inspection. Residents spoken with had no complaints about the home, however some people expressed concern about the building work, which was near to completion. Despite having concerns, residents did not wish to complain as they could see the home was benefiting from the refurbishment. One resident said; “The home is improving for the better. I have my own toilet now.” Residents were confident that the home would address any complaints / issues should they arise. One resident said; “I have nothing to complain about but if I did, they would get it sorted.” Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 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 the following standard(s): 19,21 and 26 Major refurbishment work was in progress, to ensure residents benefited from a modern, well-maintained and comfortable environment. Although building work was ongoing, areas viewed were generally clean and hygienic. EVIDENCE: A major building programme had been commissioned, to create six new bedrooms and to refurbish the entire building, including the replacement of all furniture and fittings. At the time of the visit, this work was near to completion. Some areas of the home had been affected by the building work and were in the process of being repaired / redecorated and residents were awaiting the delivery of new furniture. Despite the building work being in progress, areas viewed were generally clean and tidy. The home had infection control policies and procedures in place and the laundry was appropriately sited away from food preparation areas. Residents spoken with considered that the home was kept clean and tidy. One resident reported; “The home is clean, they are good that way” and another said; “Everyday they clean my room.”
Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 16 A previous requirement had been issued by the Commission to repair the floor in the hairdressing room. This requirement has been retracted, as the former hairdressing room has been re-developed to create a new bedroom. Likewise, a requirement was issued at the last inspection, as there were insufficient communal toilet facilities available for residents to use in some parts of the building. This issue had been rectified. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29 and 30 Sufficient staff were on duty to meet the needs of the people living in the home. There were gaps in the home’s recruitment process, which did not fully safeguard the welfare of residents. Training records were not up-to-date and some staff had not received the necessary training to ensure competency in their role. EVIDENCE: Inspection of rotas and direct observation confirmed that staffing levels remained the same as at the last inspection. Three care staff (including a senior) were on duty at all times through the day and night. Since the last inspection, the manager had received authorisation to recruit a new 20-hour domestic, to ensure the home was maintained in a clean and hygienic state. Application forms had been received and the manager had arranged to interview applicants. The home employed a good skill mix of staff and was due to also recruit a new handyperson and a day and night care assistant to cover vacancies. Residents spoke highly of the staff team and confirmed there were sufficient staff on duty to meet their needs. Comments included: “There are enough staff in my opinion”; “If you press your buzzer they are soon here”; The staff are brilliant” and “There are plenty of staff on duty. They look after you very well.” Only one new staff member had commenced employment since the last inspection. Records showed that the employee had commenced employment at the home before the results of a Protection of Vulnerable Adult (POVA) check
Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 18 had been completed. All other records required under the Care Home Regulations were in place. Discussion with staff and examination of induction records confirmed that new staff received appropriate induction and ongoing training. The home’s training matrix was not up-to-date and showed that some staff had not completed all safe practice training. Furthermore, some staff did not have an individual record of training completed. The home was making good progress in supporting staff to complete National Vocational Qualification (NVQ) training. Six staff had completed a NVQ at level 2, four staff were working towards the award and funding had been secured for an additional six staff to complete the training. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Suitable arrangements were in place to ensure the home was run in the best interests of residents and systems had been developed, to protect the financial interests of residents who required support with personal allowances. Some important records were not in place, to safeguard the health, safety and welfare of residents and staff. EVIDENCE: The home was managed by a suitably experienced manager, who was fit to be in charge and who was registered with the Commission for Social Care Inspection. Staff and residents interviewed spoke highly of the manager. A staff member spoken with said; “The manager is really supportive.” Likewise, a resident said; “Catherine [Manager] is OK. She listens to us.” The Registered Provider completed monthly reports in accordance with Regulation 26, to monitor the standard of care provided in the home. A residents meeting had been facilitated during June 2005. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 20 The organisations’ quality monitoring form was distributed to residents and their representatives during September 2005, the results of which were in the process of being collated by head office. A residents / representatives satisfaction survey report was available for June 2005. This identified two areas of concern (food and social activities). The findings were well presented and provided useful information for current and prospective users, their representatives and other interested parties. The manager was not an appointee for any of the residents. The majority of residents received assistance with financial matters from family members or a chosen representative. One service user received support from a solicitor who had Power of Attorney. The manager looked after the personal allowances of 12 residents. Records of all transactions and receipts were available. Balances were checked and found to be correct. Personal money was not pooled. Since the last visit, the home had produced a fire risk assessment and a fire certificate was in place. Records showed that staff were receiving fire training at the recommended intervals. All service / maintenance certificates were in place and up-to-date except for gas safety and the lift. Water temperature checks were still not being undertaken. Health and Safety policies and procedures were available and a range of environmental risk assessments had been completed. Records showed that the fire alarm system was tested on a weekly basis. Furthermore, the emergency lights were checked on a weekly basis and the fire extinguishers on a monthly basis. Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 21 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 22 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. 2. 3. Standard OP3 OP9 OP9 Regulation 14 13 13 Requirement A full assessment of need must be completed for each resident, prior to moving into the home. Medication administration records must be dated. All medication entering the home must be checked, signed in and dated on the medication administration record Staff must only be confirmed in post if full and satisfactory information has been obtained via a POVA check. The Registered Manager must ensure that all staff are updated in mandatory training areas and that training records are kept up to date. (Previous timescale of 1/03/05 not met). A gas safety certificate must be obtained and a copy forwarded to the Commission. A lift service record / certificate must be obtained and a copy forwarded to the Commission Timescale for action 18/11/05 18/11/05 18/11/05 4. OP29 19 (4) 18/11/05 5. OP30 18(1)(C) (i) 18/01/06 6. 7. OP38 OP38 23 (2) 23 (2) 18/11/05 18/11/05 Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 23 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. 4. Refer to Standard OP9 OP12 OP15 OP38 Good Practice Recommendations The home should re-establish a system to verify the identity of residents prior to administering medication. A new programme of activities should be developed in consultation with residents, in order to provide a wider range of person-centred activities. The alternative choice of meals should be reviewed in consultation with residents. Water temperature records should be maintained Fazakerley House Residential Care Home DS0000062027.V262639.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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