CARE HOMES FOR OLDER PEOPLE
Manor Farm House Residential Home Church Road Kessingland Lowestoft Suffolk NR33 7SJ Lead Inspector
John Goodship Key Unannounced Inspection 23rd May 2007 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 Manor Farm House Residential Home DS0000024440.V342324.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. Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Manor Farm House Residential Home Address Church Road Kessingland Lowestoft Suffolk NR33 7SJ 01502 740161 01502 740756 hector.jackson@btconnect.com 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) Mr Hector Jackson Mrs Alison Palmer Care Home 25 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 26th July 2006 Brief Description of the Service: Manor Farm House is a residential care home registered under the provisions of the Care Standards Act 2000 to accommodate 25 older persons. It is privately owned by Mr and Mrs Jackson. Located in the village of Kessingland, Manor Farm House is close to main amenities although transport would be required to access them. Manor Farm House was first registered in 1983 and consists of a two storey main building with a bungalow extension that is linked to the main building. The Home provides 17 single bedrooms and four double bedrooms that are all provided with a wash hand basin. There is a choice of areas for service users to sit, either in the large lounge in the extension, a smaller seating area, or the conservatory. The dining room is situated at the front of the home and provides views of the open countryside. There is a stair-lift fitted to assist service users to access the first floor. At the time of this inspection the fees ranged from £341.00 to £412.00 per week. Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key inspection visit was unannounced and covered the key standards which are listed under each outcome group overleaf. This report includes evidence gathered during the visit together with information already held by the Commission. The inspection took place on a weekday and lasted four and three-quarter hours. The manager was present throughout, together with staff on the morning shift and, later, those on the late shift. The owner was also present for the first part of the visit. The inspector toured the home, and spoke to some of the residents, and the staff, both individually and in a group. The inspector also examined care plans, staff records, maintenance records and training records. A questionnaire survey was sent out by the Commission to residents and to relatives. Thirteen residents responded and thirteen relatives. Their answers to the questions and any additional comments have been included in the appropriate sections of this report. What the service does well:
The home employs caring and attentive staff who are much appreciated by the residents. “The staff are very caring and always on call” said one, and “you only have to ask and its done” said another. “The staff are friendly and caring at all times. They treat everyone individually.” “I am very happy here.” The home asks new residents for their views on how the home managed their admission. This is good practice and part of the quality assurance policy to continually improve the home. The home has put staff through a comprehensive dementia care training programme which enables staff to provide the most appropriate care for those with that condition. Residents and the home are well supported by the doctors and nurses of the local practice and by the hospital consultant responsible for dementia patients. The home provides a varied traditional menu of well-cooked food, which on the day of the visit was pleasing and looked appetising.
Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Manor Farm House Residential Home DS0000024440.V342324.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 Manor Farm House Residential Home DS0000024440.V342324.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): 1,2,3,4,5. Standard 6 is not relevant to this home. Quality in this outcome area is good. Prospective residents can be assured that they will have sufficient information to decide if this home is where they wish to live. The home will also collect information to assure the person that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service Users’ Guide were examined. The home refers to them as part of their Welcome Pack, which also includes the contract, a questionnaire on how the admission was dealt with and, when completed, the pre-admission assessment. The owner explained that the initial fee information to a new resident could not always include details of how the payment of fees was to be divided between
Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 9 the parties, until the funding local authority had confirmed to the home their financial commitment for a resident. The home had applied to the Commission to vary its registration to allow the home to care for people with diagnosed dementia up to the total number of places registered in the home. This had been approved and the home was waiting to receive the revised Certificate of Registration. All places in the home were filled at the time of inspection including all ten places previously authorised for people with dementia. All the residents who replied to the questionnaire confirmed that they had received a contract, and enough prior information about the home. Prospective residents were offered opportunities to visit the home. One resident had said at a previous inspection: “I came and viewed the home, and spoke to the manager about my needs.” New residents were asked to complete a post-admission questionnaire which covered all aspects of admission including understanding the paperwork and the manner in which they were welcomed into the home. One completed questionnaire was seen in the file of the newest resident. All items were assessed as satisfactory. Manor Farm House Residential Home DS0000024440.V342324.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): 7,8,9,10,11. Quality in this outcome area is good. Needs are assessed and reviewed regularly to ensure that residents are properly cared for. Medication procedures ensure that residents are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were examined. The format continued to be comprehensive, with initial assessments of care needs and monthly reviews by a senior carer of all activities of daily living. They also included a list of each person’s medication, with a description of the purpose of each drug. The care plan for a resident admitted with dementia contained detailed daily notes about the behaviour of this person from the day of admission. The information had been used at the first review to provide a proper care plan with instructions for the staff on providing the most appropriate care.
Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 11 A recent resident had been found after admission to be a vegetarian. The home had discussed what this person liked to eat and were trying out different choices for them. This was detailed in the care plan. The person confirmed to the inspector that they were being given food they preferred. A diet sheet for the week had been drawn up. Care plans included records of visits by health professionals to the home including the chiropodist. The manager reported that the home had good links with the local psycho-geriatrician who responded quickly to calls from the home. She said that the local GP practice was also quick to visit if asked. This was confirmed by two residents on their comment cards. All relatives said that residents received the medical support they needed. All plans included moving and handling risk assessments. These were confirmed, by observation and by discussing with carers, to be up-to-date and understood by the staff. One resident’s plan identified that the person was able to choose their own clothes each day, and liked listening to music. Carers knew residents well and were able to tell the inspector about each resident and their varying abilities. They explained how they supported residents to look after themselves as much as they were able and how they supported those who needed assistance with, for example, eating their meals. This support was observed at lunchtime. Plenty of fluids were seen to be available within reach for residents in different parts of the home. In discussion with staff, it was clear that they were aware of the importance of fluid intake for older people. The quantity of continence aids delivered to the home every eight weeks by the NHS had given the home a storage problem. This had now been solved by storing the aids in an outside shed, with a low level of stock kept in a person’s room, usually on top of a cupboard. A carer was tasked with regularly checking and reviewing the aids in each room and topping them up where necessary. The inspector observed the lunchtime drug round. Most recipients were in the dining room but a few were in their rooms. The correct procedure was followed for those in their rooms. The trolley was used in the dining room and was used securely. Medicines were observed to be taken before the senior carer signed the sheet. The MAR sheets were examined and there were no gaps in signatures. The stock levels tallied with the quantity of drugs delivered from the supplier and administered. All bottles had been dated on opening and were within the allowed timescale. The pharmacy supplier visited quarterly to do an audit of the medication procedures. Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 12 The care plan proforma included a section on “Expressed wishes on death.” Not all were completed as, according to the manager, some residents or their relatives found it difficult to address this sensitive area. Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. Residents can choose how they interact with other residents, and can maintain contact with their friends and relatives. They can be assured that their nutritional needs will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Several relatives commented how well the home kept them in touch with anything of importance about their relative. “I get a phone call when they are under the weather so that I can choose to spend more time with them.” One visitor came regularly to talk to a resident and take them out. Many residents had lived locally so had contacts with the community in the village. One relative said: “ They always tell me about any change in my relative’s health.” There were photos in one of the sitting rooms of the visit by a local school who came to sing songs to the residents. The day before the inspection, a duo had
Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 14 performed old songs, with residents playing some musical instruments, and wearing appropriate hats. One of the oldest residents told the manager during the tour of the home how much they had enjoyed it. A bingo game was being played in the sitting room during the morning. Other activities were listed on the notice board, including cards, dominoes, exercises to music, and skittles. Staff commented that reminiscence quizzes had proved popular. These had been rented from a local source. These had provided a particularly interesting activity for those with early onset dementia. Some residents could also go out for a walk with support. Two residents had put in their questionnaire that they chose not to take part in any activities. Residents who participated in an activity had this recorded in their daily record. There was a four-week rolling menu, which was varied, and it was seen that there were sufficient fresh vegetables and fruit available in the dry store. One resident said: “There is always plenty of choices and the food is excellent and plenty of it.” On the day of the inspection, the choice of main course was roast chicken or fish fingers. The lunch was plated up in the kitchen, and taken to each resident by two carers. There were two more carers in the dining room supporting residents. The atmosphere was calm, with friendly chatting between staff and residents. The room was in a sunny position overlooking the garden. Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 15 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. Residents are protected by the home’s prompt action if things go wrong, and from staff trained to recognise and report any abusive actions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a complaints procedure that was given to residents, or their relatives when admitted, and was displayed on a notice board in the home. The procedure met the requirements. The home’s complaints book was available to visitors to the home. It listed a number of matters, mostly comments from relatives rather than official complaints. Recent matters recorded included, for example, that a bedroom radiator was not working, that some laundry was missing, and that a resident did not understand that their fluid intake was restricted due to their medical treatment. A visiting relative had informed the inspector on a previous visit that the manager and owner were “very approachable and seemed to do their utmost in sorting out any problems”. All respondents to the questionnaire said that they knew how to make a complaint. Although relatives said that the home responded appropriately if
Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 16 they had any concerns, several made the point that it had never been necessary to raise a concern. All residents said that they knew who to speak to if they had a concern, and all said they knew how to make a complaint. Two residents said that if they had a concern, they would speak to the manager, although they had never needed to. The Commission for Social Care Inspection had received an anonymous complaint in 2006 direct from a relative. This had not been raised through the home’s complaints policy. The issues were investigated and all regulations were found to be met. All staff received training on the protection of vulnerable adults from the manager. This usually took place during a staff meeting, and was recorded in the minutes. Staff were able to describe what action they would take if they witnessed any occurrence. Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 17 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): 19,20,22,24,26. Quality in this outcome area is good. Residents live in a safe and comfortable environment that is well maintained, with rooms which they can make their own by their own possessions, and space to receive visitors. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were no names on most of the doors of each resident’s room. The manager explained that names were only put on at the request of the resident. Although there were no residents who had difficulty finding their own room, the manager said that they were considering putting pictures on some doors which had a meaning for that room’s resident.
Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 18 The residents could access the enclosed garden and there was a small conservatory off the main sitting room. No one was using either of these during the inspection. The hot water was tested in the hand washbasin of room 4 and the new bath with an integral hoist. Both were at a safe temperature. The laundry was in a separate unit outside the back door. It had an impermeable floor and was clean and tidy. The sluice was provided in a separate room away from residents, WCs and bathing facilities. Overall residents’ rooms were seen to be clean, well decorated and full of their personal possessions. One visitor asked staff to remind their relative to water the flowers in their room. A ground floor bathroom had been upgraded and redecorated after the last inspection. An enclosed cupboard had been built in it, and at the end of the adjacent room for the storage of towels and linen. This area had also been cleared of combustible material following a visit from the Fire Officer. There was a stair lift to the first floor. All residents were supported by staff when using this. Although there was a small sitting room on the first floor, no one was using it, and the manager said it was only used occasionally by visitors when talking to residents. The Fire Officer had visited on 11 October 2006 and made a number of requirements. These had been actioned and this was verified during this inspection. The absence of a shaft lift meant that only residents who were safe to use the stair lift could take a room on the first floor. A relative commented that there had been several improvements to the home recently. Several visitors commented that the home was very clean. There was a hand-cleansing gel dispenser opposite the front door which visitors were asked to use to protect the home from cross-infection. A tour of the home showed it to be clean with no unpleasant odours. The tiling in the wet room was being repaired during the inspection. Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 19 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. Residents and relatives can be assured that residents’ needs will be met by the numbers and skill mix of staff and that the home will provide training to ensure that the staff are competent to do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The personnel files for a number of staff were examined. All of them showed that proper recruitment procedures had been followed. In particular, none had started until the first level of criminal record check had been obtained. Other identification checks had also been made. Staff were able to confirm the recruitment procedure, and the training that they had undertaken. The home had no vacancies at the time of inspection. It did not use agency staff as it was able to rely on the permanent staff to cover any gaps through holidays and sickness.
Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 20 At the time of the visit there were 4 care staff and the senior carer on duty. There were three staff on the afternoon and evening shift and two staff at night. The inspector noted that staff were able to go about their work and respond to residents needs in a calm and unhurried manner. Residents were seen to be receiving individual attention as was required. Staff behaved in a courteous manner. At lunch, residents who required support were mainly seated at one table so that staff assisting them were always at hand. One resident said: “I am very well looked after. Everyone is very kind and caring”. A visitor said:” Staff will do anything if asked, and always politely.” Training records for different grades of staff confirmed that training was ongoing and up-to-date. Five staff had completed the NVQ Level 2 and four were currently studying for it. The cook had just started their NVQ Level 3 in Hospitality. Twenty-two staff had completed a distance-learning course in Dementia Awareness. Staff who were spoken to confirmed that they had undertaken training, either as part of their NVQ, in-house refreshers or external courses, in moving and handling, food hygiene, infection control, health and safety, adult protection, dementia care and safe administration of medication. The latter was undertaken by senior carers, who were the only care staff responsible for the administration of medication. The manager and senior carer were accredited trainers in moving and handling, and the manager was also a trainer in adult protection. Fire awareness training was taking place on the afternoon of the inspection. Eight staff were attending. The trainer had the group outside demonstrating the use of fire extinguishers. Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 21 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): 31,32,33,35,36,37,38. Quality in this outcome area is good. Residents and relatives can expect the home to be well run, by competent staff. Their safety is assured by the home’s health and safety practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager had worked at the home for many years and continued to strengthen her experience and knowledge by developing her knowledge of providing services to people who experience dementia. She had completed the
Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 22 Registered Managers Award. She was an accredited trainer in Moving and Handling, and had done a four month dementia care course. Records of the regular supervision of staff were shown to the inspector, together with the annual appraisal record. The home had had a visit from a safety officer from the County Council in March 2007 to check that the premises were safe for work placements. This was confirmed as a safe placement. The records of the monthly testing of hot water temperatures were seen. Room checks were done monthly by the manager or a senior carer to audit cleanliness, check door closers, and to ensure that all equipment in the room was working, and that the resident was in a safe environment. Maintenance contracts for the fire alarms and other fire protection equipment, and for the hoists were seen. The fire alarms and the fire extinguishers were also checked weekly. No doors were seen to be wedged open. The entrances to the home were protected by keypad entry systems, except the one to the internal secure garden. The manager was not an appointee for handling the financial affairs of any resident. These were the responsibility of their relatives or legal representative. The home kept a cash float for each resident which was topped up by families as necessary. Cashbook records and receipts were available for each person. Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Manor Farm House Residential Home DS0000024440.V342324.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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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