CARE HOMES FOR OLDER PEOPLE
Lapal House & Lodge Lapal Lane South Halesowen West Midlands B62 OES Lead Inspector
Mrs Jean Edwards Unannounced Inspection 19th January 2006 09:45 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 Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 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. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Lapal House & Lodge Address Lapal Lane South Halesowen West Midlands B62 OES 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) 0121 503 0326 0121 550 1562 Mr Anthony Billingham Mrs Pamela Billingham Mrs Michelle Upperdine Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability over 65 years of age (5) of places Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 11/07/2005 Brief Description of the Service: Lapal House & Lodge is located in an attractive area of Halesowen. Although it is not far from the A456 from Birmingham to Kidderminster, it can only be accessed via a minor road. A link to the M5 motorway is nearby. The home is set in acres of land, giving picturesque views from most windows. There is a farm to the rear. Service users who have bedrooms at the back of the home have the benefit of views of the farm and surrounding countryside. All the grounds are maintained to a high standard. The home is operated in two sections, the House and The Lodge. There is a registered Manager who has overall responsibility for the two areas. There are lift facilities in The House and a stair lift in The Lodge. There are separate dining and lounge facilities in both areas. The home operates a no-smoking policy for residents. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection visit was undertaken by the inspector from the Commission for Social Care Inspection, over one day, using the following methods to obtain evidence and make judgements: information supplied by the home such as the action plan response from the home to the announced inspection in July 2005, monthly reports from the proprietor relating to the conduct of the home, and records held at the home. During the visit the inspector has spoken to the majority of the 40 residents who are currently living at the home. Longer discussions have taken place with the residents and relatives whose care was looked at in depth. The Registered Manager, senior staff and the homes administrator have taken an active part in the inspection process. Comments from residents, relatives and members of the Friends of Lapal House are very positive. Comments commend the social events, catering, the environment and caring management and staff team. A tour of the building has taken place, looking at the general environment, bathing facilities, communal areas of the home and a sample of residents’ bedrooms, with their permission. What the service does well:
The registered manager, supported by the proprietor, has responded to the previous inspection report with a comprehensive action plan, giving dates for the required improvements to be put into place. The majority of required improvements from the last inspection visit are now in place. Information about the home and the service it provides is readily available on the premises and on its Internet site. People visiting the home have made very positive comments about the information about the home and the facilities provided. The relatives of a new resident are very satisfied, commenting that, its wonderful here, there are quality aspects to the bedroom and staff are welcoming, happy and cheerful. The manager and staff make sure that each resident and if appropriate their relatives, are involved in the plan of how care is to be provided. The home continues to have excellent relationships with the local GP and district nursing services, which provide support for the residents at the home. Residents are encouraged by staff to treat Lapal House & Lodge as their own home and to be as independent as possible. Residents are able to make their Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 6 own choices and can take an active part in meetings and surveys. Views are freely aired about the running of the home. People are encouraged to spend some of their time with a range of stimulating activities supported by the activities co-ordinator and staff. There are organised activities and outings, such as shopping trips and pub lunches. The home continues to have a small active dedicated group of Friends of Lapal House & Lodge. A monthly newsletter is produced to advertise forthcoming events. There is an in house shop stocked with attractive goods reasonably priced, supported and partly serviced by members of The Friends of Lapal House & Lodge. There are fund - raising activities such as the Christmas Fayre, which raised a significant amount of money to be used to provide additional activities for the residents. People commented about their enjoyment of the illuminated Christmas sleigh towed through the grounds by the proprietors Landover on Christmas Eve. Some people may choose not to be involved in organised activities; these decisions are respected and fully supported. One person likes to write poetry and plays the mouth organ as pastimes. Each persons rights as citizens are protected by the home and processes are in place to make sure residents can exercise their rights to vote in local and national elections as they wish. The meals are thoughtfully and well prepared, and the menus, displayed on each table, offer a range of options for each meal. Appetising and innovate recipes are tried, for example lamb and apricots. Members of staff ask residents what they prefer at each mealtime and staff offer sensitive help and assistance, according to each persons needs. The dining rooms provide attractive environments in which to eat, though people can choose to have meals served in their own rooms if they wish. The food is of an exceptionally high standard and the home has been given the gold award by Environmental Services and NHS. Lapal House & Lodge continues to have a stable staff group, the majority of whom have worked at the home for many years and know the residents well. They are caring, committed and flexible, often willing to work extra shifts, especially to support residents with outings in trips away from the home. Residents and visitors describe the home as ‘friendly, cheerful, well run and staff as good as gold.’’ Other comments are that staff take a pride in the look of the home, for example cleaning and tidying communal areas after meals. One person states he particularly values the sense of humour shown by members of staff and enjoys the banter. A member of staff says, its wonderful working here. The home follows a rigorous system to select and recruit new staff. They are keen to share views and answered any questions in an open and honest manner. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 7 Lapal House & Lodge maintains excellent standards of cleanliness. The home is tidy, homely and comfortable. People commented that they are very impressed with the standards of hygiene. The home has achieved the Investors in People Award and has implemented its own surveys to obtain the views of residents, relatives, and visitors as to how they think the home is performing. This inspection was conducted with full co-operation of the Registered Manager, staff and residents. The atmosphere through out the inspection was relaxed and friendly. The Inspector would like to thank staff, and residents for their hospitality during this inspection visit. What has improved since the last inspection?
The manager has plans to introduce a supper club for residents living in the lodge, in the near future, as a social occasion. A number of residents bedrooms have been refurbished and redecorated including the provision of classic new biscuit coloured carpets since the last inspection visit in July 2005. The colour schemes chosen in bedrooms such as 14, 18, and 19 are attractive, subtle shades of creams, coffee and beiges. In addition attractive new carpeting has been fitted throughout the communal areas of the Lodge. Comments about the new carpet are that, it is lovely and lifts the look of the rooms. The proprietor has plans to extend the existing building to upgrade the access to the first floor in the Lodge, replacing the stair lifts with a passenger lift; and to provide additional en suite bedrooms. In the interim a new stair lift has been installed in the lodge. The manager has sought advice from the continence service and improvements have made to continence aids supplied for each person. For example the old style draw sheets have been replaced with more modern draw sheets, which are kinder to the skin. The manager has improved the safety measures in place for the resident needing oxygen, with officially approved compressed gas warning signs for oxygen in use obtained and displayed. In addition information about the oxygen has been notified the West Midland Fire Service and included in the homes fire risk assessment and fire plan. Improvements have been made to the organisation of staff personnel files, with the use of indexes and dividers. This makes auditing and monitoring records easier and makes sure that staff are kept up to date with training and development. The home is now keeping track of the receipt of individual copies of the General Social Care Council Code of Practice and Conduct, which has
Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 8 been added to the induction checklist, which is signed by each member of staff. A further improvement has been made to recruitment processes and as a matter of good practice interview questions and answers are now retained on staff personnel files. 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. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 9 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 Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 10 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): These standards have been assessed at the inspection visit on 11 July 2005 and were satisfactory. EVIDENCE: Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 11 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, 11 There is a clear and consistent care planning system in place to provide staff with the information they need to satisfactorily meet residents needs. The evidence of good multi disciplinary working taking place on a regular basis continues to be good and the health needs of residents are generally being satisfactorily met EVIDENCE: There is a detailed care plan in place for each person, based on assessed and identified needs. Discussion with relatives and a resident recently admitted to the home provided good evidence that care plans are developed in conjunction with the resident and their relatives, with signatures in place to indicate agreement. On the sample of residents’ care plans assessed there are records of the persons preferences for their daily routine, for example rising, retiring, and bathing. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 12 On one persons plan there was insufficient guidance for staff regarding the administration of PRN medicate, used as a means to calm, however this has been improved during the visit, with additional documentation. There are good risk assessments in place and generally appropriately recorded health care screening assessment tools completed for each person. There is evidence that residents are weighed on admission and that their weight is monitored each month. However one person (KB) has experienced deterioration in her health and has returned to the home from a hospital admission in a more frail condition. From examination of her care plan, case file and from discussion with the manager and staff there is no evidence that the Waterlow score has been reviewed following the deterioration in her condition. There is evidence of her poor appetite and continuing weight loss, however there is no documented nutritional screening assessment in place and to date the home has not made a referral to the GP and community dietician advice and support. There are daily food and fluid intake charts in place, however there are currently more than one days entrys on one sheet and some records are not fully completed, dated or signed. The home has comprehensive policies and procedures relating to dying and death. There is evidence from discussions about the care of the residents who are currently unwell that members of staff understand how to sensitively care for and support each person and their family. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 13 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): 14 Good contact is maintained with family and friends for the majority of residents and there is evidence that residents are supported to exercise control and make decisions about their lives. EVIDENCE: There is evidence that the home encourages residents, wherever possible to retain their independence to manage their own financial affairs, there are a small number current residents who wish to do so. Decisions regarding the management of residents financial arrangements are documented as formal agreements. Additionally the home proactively provides information about independent advocacy services, this can be found in the foyer. There is evidence from the tour of the premises and assessment of residents case files that people are encouraged to bring their personal possessions into the home if they wish, subject to health and safety considerations. These decisions are generally documented as part of the admission process, there are completed inventories held on the sample of individuals files assessed. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 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): 16,17 The home has a satisfactory complaints system with good evidence that residents and relatives feel that their views are listened to and acted upon. There is evidence that residents are supported to exercise their rights as citizens. EVIDENCE: The home has a comprehensive complaints procedure, which is displayed in the reception area and is also contained in the service user guide. The home has not received any complaints since the last inspection visit in July 2005. Residents and visitors consulted feel able to raise any concerns with members of staff, the manager or proprietor who visits the home very regularly. Any minor issues are dealt with immediately. Assessment of residents case files and discussions have provided evidence that the manager proactively facilitates each persons right to vote if they wish. There is evidence that residents are enrolled on the electoral register and have a proxy or postal vote to allow them to vote in elections. The Home has a copy of the Local Authority multi-agency Protection of Vulnerable Adults policy and procedure, Safeguard & Protect. The home has developed its own policies and procedures relating to the protection of vulnerable adults, dealing with aggression, use of physical / non-physical intervention; whistle blowing, dealing with residents finances and there is a copy of the Public Disclosure Act available. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 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): 19,25 The majority of these standards have been assessed at the inspection visit on 11 July 2005 and were satisfactory. The standard of the décor within this home is very good with evidence of improvement through continuous maintenance. This is a very attractive and comfortable environment for residents. EVIDENCE: A brief tour of the interior of the premises has taken place at this visit. There are attractive views from communal rooms and many of the bedrooms over the grounds and surrounding countryside. There are outline plans, discussed with the CSCI satellite office, Halesowen for proposed extensions to the home. These include improvements to facilities in the Lodge and remedial work to some window frames in the main house, mainly to the rear of the property. There is a rolling programme of redecoration and renewal. This includes the on-going re-decoration of identified bedrooms and some communal areas.
Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 16 Some of the redecorated bedrooms have been viewed; these are tastefully refurbished to the obvious pleasure of the residents. New carpeting has been laid throughout the Lodge, improving the ambience for the residents benefit. The décor, fixtures and furniture continue to be maintained to high standards. The bathing and toilet facilities, including four assisted bathrooms and 6 communal toilets and en suite bedrooms viewed are clean, attractive and well maintained. The bathroom on the first floor of Lapal house was in the process of being redecorated during this visit. The programme of work to provide radiator covers is continuing each cover has to be custom-made due to the size, age and type of the radiators. During discussions with the manager and administrator it has been stated that the suppliers are not able to give a date for completion. However pro-active strategies need to be implemented to make sure that the customised radiator covers are completed as a priority. During the tour of the premises on this visit, it is evident that high standards of cleanliness continue to be maintained and there are no discernable malodours. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 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 The majority of these standards have been assessed at the inspection visit on 11 July 2005 and were satisfactory. This home continues to maintain stable substantive staffing levels and residents receive good and consistent care. EVIDENCE: Assessment of staffing rotas at this visit demonstrates that the home continues to maintain satisfactory staffing levels. The registered manager reviews staffing levels on a regular basis, using Department of Health Residential Forum Staffing Tool, taking account of the occupancy and dependency levels of residents accommodated, this is good practice. A copy of documentation has been given to the Inspector during this visit. The Home has a very stable staff team of 39 people including 30 care staff, 2 catering staff,) 2 domestic staff, 1 activities co-ordinator, 3 gardeners, 1 maintenance staff, 1 administration staff, the Registered Manager. One member of staff has left the home’s employ since the last inspection visit in July 2005, for family reasons. There are currently no staff vacancies - the home is fully staffed. Random samples of staff files examined are satisfactory. Interview questions and answers are now retained on staff personnel files as a matter of good practice. The manager is making progress to obtain evidence of the hairdressers CRB clearance for her file at the home.
Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 18 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): 32,36,38 The registered manager and the senior staff are effective in providing leadership and good clear communication systems throughout the home and staff demonstrate a good awareness of their roles and responsibilities. EVIDENCE: Residents, staff and visitors feel that the management team are approachable, supportive and everyone consulted feels that they are able to air their views in an open manner. There are clear lines of accountability within the home, with Michelle Upperdine, the Registered Manager in day-to-day control of the home and Mr Billingham, the Registered Proprietor and Responsible Individual, providing supervision, support and monitoring through monthly unannounced Regulation 26 visits and reports.
Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 19 A sample of fire safety and maintenance documentation examined is satisfactory. The Manager ensures that all staff receive mandatory training commensurate with their roles; fire training, drills twice each year, moving and handling, first aid, food hygiene, health and safety and infection control training, commensurate with duties undertaken. There is a structured formal supervision system for all staff. Supervision sessions are used to identify training needs, personal development. The registered manager receives regular supervision and support for her professional development from the proprietor. Record keeping at the home continues to improve, achieving high standards, with only very minor improvements required at this visit. All personal information continues to be held, stored and disposed of in accordance with the Data Protection Act 1998. The accident records examined are satisfactory. The Manager undertakes a regular documented accident analysis each month, which is used to identify trends and any additional control measures as needed. One health and safety issue raised relates to the lack of a documented asbestos risk assessment; this must be undertaken by a competent person, with any recommendations actioned to comply with recent health and safety legislation. Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 20 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 2 X X X X 3 2 X STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X X 3 X 3 Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP8 Regulation 13(1) Requirement 1) To review the Waterlow score for KB following the deterioration in her condition 2) To undertake a nutritional assessment and review regularly for KB 3) To ensure a referral is made to GP and community dietician for KB for advice and support relating to poor appetite and weight loss 4) To ensure that daily food and fluid intake charts are fully completed, dated and signed for KB and any resident with poor appetite or significant weight loss To obtain evidence of the hairdressers and any other therapists CRB clearance. (Timescale of 31/08/05 - Not Fully Met) The Registered Provider must complete the provision of low surface radiators or radiator covers to reduce the risk of burns. This must now be
DS0000024965.V277449.R01.S.doc Timescale for action 01/02/06 2. OP29 17(2) Schedules 2&4 13(4) 01/03/06 3. OP38OP25 01/04/06 Lapal House & Lodge Version 5.1 Page 22 4. OP38 13(4) prioritised. (Timescale of 31/10/04 and 31/10/05 Not Fully Met) To arrange a documented asbestos risk assessment by a competent person, with any recommendations actioned 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP37 Good Practice Recommendations That key worker notes are retained on individual residents case files Lapal House & Lodge DS0000024965.V277449.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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