CARE HOMES FOR OLDER PEOPLE
Highnam Hall Residential Home Park Avenue Hartlepool TS26 0DZ Lead Inspector
Mr Paul Emmerson Unannounced Inspection 9:30 21st June 2007 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 Highnam Hall Residential Home DS0000065270.V342342.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. Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Highnam Hall Residential Home Address Park Avenue Hartlepool TS26 0DZ 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) 01429 232068 01429 233715 Mr Matt Matharu Mrs Christine Noble Care Home 45 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (17), Mental disorder, excluding learning of places disability or dementia (5), Old age, not falling within any other category (45), Physical disability (5) Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Five persons in the category DE above the age of 55 may be accommodated in accordance with the home`s Statement of Purpose Five persons in the category PD above the age of 55 may be accommodated in accordance with the home`s Statement of Purpose. Five persons in the category MD above the age of 55 may be accommodated in accordance with the homes`s Statement of Purpose 22nd June 2006 Date of last inspection Brief Description of the Service: Highnam Hall Residential Care Home is registered to accommodate up to 45 older people, including people with mental health needs. On the day of the inspection there were 29 people living in the home. Highnam Hall is a grade 2 listed building, which retains many of its original features. The home is situated in a quiet road overlooking a popular park and has lawned areas to the side and private car parking to the front. The home is owned by Mr. Matt Matharu, who also runs a number of other care homes in the area. From information provided by the manager of Highnam Hall, fees charged by the home range from £354 to £358 per week. Additional charges include those for hairdressing, chiropody and newspapers. Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7½ hours, on the morning and afternoon of Thursday 21st June 2007. In line with current CSCI policy on ‘Proportionality’, the inspection focused upon a number of key standard outcomes for the people who use the service. The inspector looked around the building and a number of records were examined. 6 people who live at Highnam Hall, 3 relatives / visitors, a visiting nurse, a visiting hairdresser, the home’s manager, deputy manager and 8 members of staff were spoken to. What the service does well: What has improved since the last inspection?
Management and staffing arrangements are much more settled. Administrative arrangements are better organised. Care planning arrangements in the home have been revised. Care reviews are being carried out. Substantial building work has been carried out to improve the home. Externally the property has been repaired and repainted. The front driveway has been extended to provide additional car parking. Garden areas have been tidied up. Although still ongoing, internal building work has improved the layout of the home, which feels more open and brighter. Additional en-suite facilities are being created. To date, 6 bedrooms now have en-suite facilities. Much of the home has been redecorated and refurbished. Communal areas look attractive, feel comfortable and are pleasant places to sit. A number of people spoken to on the day of the inspection commented that the home is looking much better. A full-time activities co-ordinator is now employed. Although the post is shared with another home, people’s social / activity needs are being met better.
Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 6 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. Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 7 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 Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 8 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): 1 & 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home are well managed. People’s needs are assessed prior to admission. However, people could be better informed about the home and the services available. EVIDENCE: Some of the people spoken to during the inspection had moved in to Highnam Hall recently. They spoke positively about the home and how they have been made to feel welcome. One person said, “My daughter looked around for me when I was in hospital. She liked it here and thought I would too. I can only speak as I find, but it’s smashing and the staff are always nice and pleasant”. A visitor said, “The staff are very dedicated”. A recently admitted person’s care plan documents were examined. These showed a pre-admission assessment had been carried out, which was being developed to inform the delivery of the person’s care. Assessment / care plan
Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 9 information was also obtained from the local authority social services department and hospital discharge team. People who are thinking about moving into Highnam Hall are welcome to visit with relatives, have a meal and stay overnight if necessary. In this way people can get to know the home. Any move into Highnam Hall is on a six-week trial basis. At the six-week stage a formal review meeting is held to consider permanency. Since the last inspection, ‘Statement of Purpose’, ‘Service Users Guide’ and ‘Contract’ documents have been developed to provide information about the home. However, the home’s ‘Statement of Purpose’ and ‘Service Users Guide’ lack some essential information about the home’s management and the services / facilities available. These documents must be reviewed to ensure that they contain all of the information required by Regulations 4, 5 and Schedule 1 of The Care Homes Regulations 2001 and the home’s own policies and procedures relating to these documents. ‘Service User Guides’ also need to be made available to all of the people living in the home. Highnam Hall Residential Home DS0000065270.V342342.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. Personal and healthcare needs are met. Appropriate care plans are prepared. Medicines are dealt with correctly. EVIDENCE: The inspector spoke to, and spent time in the company of, the people who live at Highnam Hall. These people are well cared for and comfortable in their home. The management and staff of Highnam Hall are ensuring that people’s health care needs are met. Where specialist intervention is required it is sought. Records confirm that contact with GPs and other health professionals is maintained. For example, a pharmacist from the local ‘Older Persons Integrated Needs Team’ has visited and carried out medication reviews. A district nurse visiting people in the home on the day of the inspection provided positive feedback. A person who lives at Highnam Hall said, “I’m fine here, they’re good lasses. They treat me right, I’m well looked after”. Another person said, “I get plenty
Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 11 of help”. A relative spoken to on the day of the inspection said: “I like the staff, they’ve helped a lot, he’s well looked after here”. The inspector looked at 4 care plans, which were all generated from initial assessments. Care plans are clear about people’s physical and emotional needs and describe the care required and being provided to meet such needs. People who use the service and/or their relatives are involved in formulating the care plan and wherever possible they sign to agree it. Since the last inspection of Highnam Hall, care plans have been reviewed and developed. They are much better and are more complete records of care. Care plans consider a range of needs, including equality and diversity matters, mental health and nutritional needs. However, although most people are weighed regularly, it is recommended that the home should acquire, or access, weigh scales suitable for people who need to use a wheelchair, so their weight can also be monitored better. The inspector observed, through the actions and responses of staff, that staff respect the privacy and dignity of the people who live at Highnam Hall. For example, staff were seen to knock before entering people’s bedrooms. People spoken to expressed general satisfaction with the manner and attitude of staff. The home uses a monitored dosage system to administer medicines. Policies, procedures and systems in place relating to the receipt, recording, storage, handling, administration and disposal of medicines are satisfactory. As stated above, a pharmacist from the local ‘Older Persons Integrated Needs Team’ has visited to check medicines in the home and carry out medication reviews. Highnam Hall Residential Home DS0000065270.V342342.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 good. This judgement has been made using available evidence including a visit to this service. Social needs are recognised and activities are being provided by the home. There are open visiting arrangements. The rights of people who use the service are respected and choice is provided. Although meal choices are limited, meals are of a good standard. EVIDENCE: An activities co-ordinator (shared with another home run by the provider) is now employed and works 2 days a week at Highnam Hall. Outside entertainment is also arranged. For example, 2 musicians visited the home the week before the inspection and played medleys of Scottish music. Care staff also provide activities wherever possible, and staff were seen to engage with the people who live at Highnam Hall in social interaction. Highnam Hall has open visiting arrangements. The inspector spoke to 3 visitors who provided positive feedback. A visitor said, “I’m always made to feel welcome and am offered tea or coffee and biscuits”. People spoken to said they were satisfied with the food provided. Food served was seen to be of a good standard. One person spoken to said, “I get plenty of
Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 13 good food here”. Another person said, “I don’t know what’s for dinner, but it’s always quite nice”. To ensure that meals served meet people’s preferences, kitchen-staff said that they speak to the people who live at Highnam Hall on a daily basis to obtain their meal preferences / alternatives for the day. However, to ensure that food provided is to people’s liking, and to improve the choice of meals available when they are offered, it is recommended that menus and alternatives be reviewed in consultation with the people who live at Highnam Hall. Highnam Hall Residential Home DS0000065270.V342342.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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems in place to respond to complaints and safeguard people who use the service. EVIDENCE: Information about complaints, how and who to make them to, is made available through information placed in people’s bedrooms and (although not yet fully circulated) in the home’s ‘Service Users Guide’. Any complaints or concerns are appropriately dealt with and are adequately recorded. People’s views are obtained through regular contact and an ‘open door policy’. Comments received are recorded for quality assurance purposes. Staff have received ‘No Secrets / Protection of Vulnerable Adults’ training. Procedures are in place to safeguard from abuse, the people who use the service. These procedures also protect people’s financial affairs. The home has a copy of the local authority’s ‘No Secrets’ guidance on abuse and the protection of vulnerable adults, and has its own related policy and procedure to follow in the event of an adult protection issue. Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Highnam Hall is well maintained. The home is clean and tidy. Action is being taken to reduce offensive odours. EVIDENCE: Highnam Hall Residential Care Home is registered to accommodate up to 45 older people, including people with mental health needs. On the day of the inspection there were 29 people living in the home. Highnam Hall is a grade 2 listed building, which retains many of its original features. The home is situated in a quiet road overlooking a popular park and has lawned areas to the side and private car parking to the front. The inspector looked around the building and saw that some people have personalised their bedrooms. The home has a number of communal areas that are well used by the people who use the service. There is a smokers’ lounge
Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 16 and other quieter areas should privacy be required. Although the home is situated over a number of levels, a lift gives access to all floors. On the day of the inspection, the home was seen to be tidy and safe. Action is being taken to reduce odours in some areas of the home; where necessary carpets, and sometimes the floorboards beneath them, have been lifted, discarded and replaced. All radiators have been guarded or have low surface temperatures. Where specialist equipment, such as pressure relieving mattresses, is required, it is obtained. However, some people spoken to commented about the lack of ramped access to the home at the front, and the gradient of the ramp to the side of the home being steep. One of the people spoken to said, “I can get out, the ramp’s a bit steep, but it’s good exercise”. The provision of ramped access to the home should be reviewed. Since the last inspection of Highnam Hall, the home has been extensively refurbished. Substantial building work has been carried out. Externally the property has been repaired and repainted. The front driveway has been extended to provide additional car parking. Garden areas have been tidied up. Although still ongoing, internal building work has improved the layout of the home, which feels more open and brighter. Additional en-suite facilities are being created. To date, 6 bedrooms now have en-suite facilities. Much of the home has been redecorated and refurbished. Communal areas look attractive, feel comfortable and are pleasant places to sit. A number of people spoken to on the day of the inspection commented that the home is looking much better. The work that has been done, and the significant and much needed financial investment into the home, is acknowledged. Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient staff are employed. The home has a settled, well-trained and well-led staff team. EVIDENCE: From discussions with management and staff, and from an examination of duty rosters, sufficient staff are employed within the home. There is a settled staff team. Staff know the people who live there well. Agreed staffing levels for Highnam Hall are, in addition to the manager, deputy manager and ancillary staff: a senior care assistant and 2 care assistants throughout the day and 2 staff at night. A member of staff spoken to said, “There’s always plenty of staff to cover”. These staffing levels are considered to be appropriate to meet the needs of the people currently accommodated. However, it is recommended that additional domestic staff should be employed so that the home can be kept clean, tidy and odour free. Further, overall staffing levels should be kept under review as occupancy levels rise. Highnam Hall has a number of floor levels and extension wings. When the home is full, and dependency levels are high, additional staff will be required. Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 18 Recruitment procedures within the home are generally safe. CRB (Criminal Records Bureau) disclosure checks have been carried out for most staff. A copy of each person’s birth certificate and a photograph is kept in their personnel file; these documents are copied when completing the Criminal Records Bureau disclosure. However, it was noted that a member of staff has started work recently without a CRB check having been carried out. Whilst it is accepted that this person has a CRB disclosure from her previous employer, and that this is less than 12 months old, another CRB disclosure check is required. Attention is drawn to CRB Guidance produced by the Criminal Records Bureau, CSCI and the Department of Health. Applicants for employment complete an application form and 2 references are requested. A reference from the last employer is requested, plus another; any gaps in employment are explored. Each member of staff receives a contract of employment and a job description. Staff training is given a high priority. All but 1 member of staff has, or has nearly completed, NVQ (National Vocational Qualification) training at level 2 or above. Core training such as in First Aid and Moving and Handling is arranged. Other courses are also held. On the day of the inspection a staff training course had been arranged relating to skin, wound and pressure care. Activity in this area is commended. Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Highnam Hall is a well-run care home. Appropriate quality assurance systems are in place to identify and rectify any concerns. EVIDENCE: The registered manager is well qualified and has almost completed a ‘Registered Managers Award’ training course. People spoken to on the day of the inspection spoke about lots of change in the last 18 months or so. However, they also said that things are settling down and are much better. People also spoke highly of the manager. For example, a person who lives at Highnam Hall said. “It’s well run. If there’s a problem you see the head lass, who’ll get it sorted and help you out”. A relative spoken to on the day of the
Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 20 inspection said, “It’s a lot better now. From the management side there’s always someone about to talk to if there’s a problem”. The home has a range of a policies and procedures. Appropriate systems are in place to ensure people’s health and safety is protected. For example, risk assessments are completed; about which staff have received related training. People’s views are also obtained through regular contact and an ‘open door policy’. The manager is aware that it is important to provide an opportunity to people to make their views known. The manager said residents meetings have so far proved unsuccessful, but that she has found regular 1-1 chats with people who use the service and their relatives more productive. People spoken to on the day of the inspection confirmed this. The owner of Highnam Hall visits regularly. He talks to staff and the people who live in the home. He also meets with the manager. Reports required under Regulation 26 of the Care Homes Regulations 2001 are now being completed and are available in the home. Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 22 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 OP1 Regulation 4, 5 & Schedule 1 Requirement So that people who use the service are fully informed about the home and the services it provides, Highnam Hall’s ‘Statement of Purpose’ and ‘Service Users Guide’ must be reviewed to ensure that they contain all of the information required by Regulations 4, 5 and Schedule 1 of The Care Homes Regulations 2001 and the home’s own policies and procedures relating to these documents. ‘Service User Guides’ must then be made available to all of the people living in the home. To ensure the safe recruitment of people coming to work at Highnam Hall, CRB (Criminal Records Bureau) disclosure checks must be carried out for all new staff. Timescale for action 30/09/07 2. OP29 19 30/09/07 Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 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. Refer to Standard OP7 OP15 Good Practice Recommendations The home should acquire, or access, weigh scales suitable for people who need to use a wheelchair. This is so their weight can be monitored better. To ensure that food provided is to people’s liking, and to improve the choice of meals available when they are offered, it is recommended that menus and alternatives be reviewed in consultation with the people who live at Highnam Hall. To ensure that people can get in and out of the home, the provision of ramped access to the home should be reviewed. Overall staffing levels should be kept under review as occupancy levels rise. Highnam Hall has a number of floor levels and extension wings. When the home is full, and dependency levels are high, additional staff will be required. Additional domestic staff should be employed so that the home can be kept clean, tidy and odour free. 3. 4. OP22 OP27 Highnam Hall Residential Home DS0000065270.V342342.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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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