CARE HOME ADULTS 18-65
Meadow View 2 The Lawns Bempton Lane Bridlington East Yorkshire YO16 6FQ Lead Inspector
David Blackburn Key Unannounced Inspection 16th November 2006 09:00 Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 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 Meadow View 2 DS0000056629.V319251.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 Adults 18-65. 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. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Meadow View 2 Address The Lawns Bempton Lane Bridlington East Yorkshire YO16 6FQ 01262 400955 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) H4037@mencap.org.uk Royal Mencap Society Mrs Linda Jane Gregory Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 15th December 2005 Brief Description of the Service: 2 Meadow View is a purpose built semi detached bungalow owned and maintained by New Dimensions Housing Association. The care input is organised and managed by the Royal Mencap Society. The home is situated in a residential area of the town. An adapted motor vehicle is provided for service users. Public transport to the town passes nearby. The home offers long term accommodation for adults with a learning disability and associated health and behavioural problems including some challenging behaviour. The staff seek to provide a holistic regime offering personal care, help, advice and guidance with daily living skills and activities, a catering service, a laundry service and domestic and cleaning services. Activities are offered both on and off site. Nursing care is not given but can be provided on a short-term basis by community healthcare services. There is a garden accessible to those service users who have mobility problems. The four bedrooms are of a good size and take into account service users’ physical needs. There is a bathroom provided with specialist bathing facilities. Specialist equipment is provided as necessary. Communal space consists of a lounge and dining room. A Statement of Purpose and Service User Guide are available in the home. The fee level advised at the time of the inspection was from £846 to £889 per week depending on assessed needs. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection upon which this report is based comprised a review of the evidence held by the Commission including written information given by the registered provider and a site visit. Relatives, general medical practitioners and care managers had been contacted for their written views. The comments and observations made are included within the relevant sections of this report. An unannounced site visit was carried out, by one inspector, over one day, with a total time at the home of approximately 3.5 hours. A number of bedrooms, communal areas and services, for example the laundry facilities and kitchen were inspected. An examination was made of some service users’ care records, the home’s policies and procedures and other documents, for example staff records. Conversations were held with a number of service users. Responses varied according to the individual’s communication skills. Observation of service users’ normal routines was undertaken throughout the site visit. The registered manager, two staff on duty and an outreach worker (a person working with people with disabilities to ensure their access to community facilities activities) were spoken with in confidence. Feedback to the registered manager was made at the end of the visit. 2 Meadow View is one of four similar properties located in a small cul-de-sac owned by the housing association and managed by the society. What the service does well:
The staff team had achieved the overall aim of the home in providing service users with, as far as is possible, a normal and meaningful lifestyle. The focus of all activity in the home whether care, domestic services or planned social activities was firmly upon the assessed needs of service users. A care manager said “The staff in the bungalows provide a caring and effective service. The paperwork is always excellent, being detailed and informative. If they have concerns they are not afraid to seek advice.” A relative said “The service provided in the home is of the highest standard. The facilities are excellent and the work done by the staff is much appreciated.” Another relative commented “The overall care is excellent.” Good information was available about the home enabling any prospective service user to make an informed decision about admission. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 6 Good care plans were in place. They were detailed, clear and precise in giving staff the necessary information to enable them to offer the required care in the most appropriate manner. All service users were involved and integrated into the local community ensuring they had a wide and varied range of different life experiences. Personal care was offered in a discrete manner with the accent firmly on the maintenance of service users’ privacy, dignity and independence. Proper procedures were in place to ensure service users’ protection from harm. One relative had raised concerns with the manager which she felt were being properly addressed. The home was domestic in style and was a pleasant and comfortable place in which to live. The provision of the necessary specialised equipment enabled service users to take full advantage of all available facilities. Staff appeared enthusiastic, committed and well trained. Their continued hard work, attention to detail and provision of individualised care meant each service user’s assessed needs were met in a manner most suited to them. The registered manager was competent and able ensuring service users could live in a well-managed environment. 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.
Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users had the information available to make an informed decision about admission to the home and had confidence their needs would be properly assessed. EVIDENCE: A Statement of Purpose and Service User Guide were available. They had been produced in a large type print with good use made of pictures and symbols. Together they gave a clear indication of the care, services and facilities on offer in the home. They were supported by other documents including the Aims and Objectives and Quality Care Statement. The available information affirmed that all service users, irrespective of disability, would be afforded full adult rights and responsibilities as far as each individual was able. The majority of the service users were admitted to the home a number of years ago. They had assessments undertaken as part of their admission process. The criteria for admission were shown in the Statement of Purpose and various policies and procedures of the registered provider. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 9 The file of the last service user to be admitted was examined. This contained a very comprehensive set of assessment and admission documentation ensuring the person’s needs were fully known, understood and with the confidence they could be met appropriately and competently. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a clear and consistent care planning system in place that provided staff with the information needed to appropriately meet service users’ needs. EVIDENCE: A number of case files were examined. Each service user had four files, one containing the care plan, one the record of daily events, the third a variety of risk assessments and the fourth other relevant and specific information. Care plans had been developed in partnership with the service users, families, health and social care professionals and other interested parties. They clearly set out how requirements would be met through positive and planned interventions. Cultural and spiritual needs were recorded. Care plans had been regularly reviewed, updated and signed. Service users were not able to provide their own comments and views on the plans. The registered manager said all care plans were to be reviewed and revised to follow the principles of person-centred-planning, a system where much of the information is recorded in the first person.
Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 11 A separate file contained a number of risk assessments based on the daily activities of living. The assessments indicated the anticipated risk and how it was to be managed. None of the service users was denied an activity because a risk could be identified. Rather staff were pro-active in arranging many activities but with clear evidence they had researched the risks involved and taken the appropriate action to minimise or eliminate them. The profound nature of service users’ disabilities did affect their ability to make day-to-day choices. However staff were observed to continually consult with service users and involve them in decisions about daily life, the environment, staff issues and service development. Observation throughout the site visit showed staff’s good attention to detail and the understanding of each service user’s needs. They were able to discuss the meaning of gestures, movements, facial expressions and changes in demeanour of the service users. Staff responded quickly and appropriately to these indicators and were seen and heard to consult with service users at every opportunity. Service users appeared relaxed and comfortable in staff’s presence. The registered manager handled the personal money for service users in accordance with the signed personal financial agreements. Proper procedures were in place to ensure all money was correctly accounted for. Bankbooks were in service users’ names. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users were provided with every opportunity to establish and maintain good links with the community thereby enriching and stimulating their lives and developing their social skills. Service users were offered meals that met their likes and choices and catered for any special dietary needs. EVIDENCE: All service users suffered from a learning difficulty often with associated physical disabilities. None was able to undertake any form of employment. Similar none had been assessed as being able to benefit from further education services. The registered manager and her staff demonstrated an awareness of the importance of enabling service users to achieve their goals, follow their interests and be fully integrated into community and leisure activities.
Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 13 Service users were able to enjoy a full and stimulating lifestyle with a number of options available to them. They were able to access numerous activities in the home and at outside locations. Good use was made of the local Outreach Service, designed to give people with disabilities the opportunity to access community facilities and take part in community activities. The location of the home gave good access to local facilities and amenities. The use of the minibus ensured service users were able to make full use of wider community facilities and amenities. Staff had encouraged and maintained family contact where this was appropriate and possible. The level of contact depended upon the location of relatives, their ability to travel to the home or have home visits from the service user and their willingness to maintain contact. The service users’ personal care plans showed how care was to be provided and by whom. Despite their multi and differing needs staff were able to maintain individual choice and maximise independence. Routines in the home were designed around service users and the meeting of their needs. Staff were observed throughout the site visit to interact with service users and an obvious and positive rapport had been developed between the two. The menus were devised by the staff based on the known likes, dislikes, preferences and choices of service users. Observation by staff of a service user’s reaction to additions to the menu gave a clear indication as to whether or not a particular item was liked. A variety of food was offered and the staff felt they catered for every need. The registered manager was confident any dietary needs could be met. Staff were observed to assist with breakfast. Any assistance was given in a quiet, dignified and unobtrusive way. Special crockery and cutlery were readily available. Service users were involved in shopping for food. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ personal and health care needs, including medication, were met with good evidence of multi disciplinary working taking place on a regular basis to the benefit of service users. EVIDENCE: The case files examined detailed each service user’s personal and health care needs and how they were to be met. There was a clear accent on the maintenance of the individual’s privacy, dignity and independence. Male and female staff of differing ages were employed so service users could choose their preference when receiving personal care. All personal care was given behind closed doors. Bathroom doors had suitable privacy locks. Service users went shopping for clothes and personal items assisted as necessary by staff. A number of personal services for example hairdressing were provided in the town. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 15 An excellent liaison and relationship was maintained with a variety of health care professionals including physiotherapists, occupational therapists, speech and language therapists and tissue viability nurses. The extent of their involvement was fully recorded. Specialist equipment had been provided where necessary to ensure service users could access and use all the facilities in the home. A medication policy and procedure were available. Discussion with and observation of staff carrying out medication administration and recording showed these procedures were being properly followed. All staff who administered and recorded medication had completed suitable training at induction and from an external trainer. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were provided with information in an appropriate form to enable them to express their concerns and to have the confidence they would be properly investigated. EVIDENCE: The formal complaints procedure was in the registered provider’s Operational Manual. Copies were also found in the Statement of Purpose and Service User Guide. These had been produced in pictorial form using pictures and symbols and therefore more easily understood by the service user group. For those with little on no understanding staff acted as advocates or there was a reliance on the involvement of professionals outside the home. No complaints had been recorded since the last inspection. The registered provider’s Operational Manual had a detailed and comprehensive adult protection policy and procedure. A simplified but relevant version was in the Service User Guide. A copy of the Multi-Agency Agreement on the Protection of Vulnerable Adults was available together with updated staff information leaflets on safeguarding procedures. Staff confirmed further training in safeguarding had been arranged for the near future. It was felt the home had an open culture that enabled service users to express their views and concerns in the knowledge they would be handled quickly and appropriately. Those who responded through the comment cards raised no concerns about any aspect of the service.
Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 17 The registered provider’s recruitment and selection procedure ensured the protection of service users through the obtaining of written references and enhanced disclosures from the Criminal Records Bureau. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were provided with a homely and attractive place in which to live, adapted to meet their individual assessed needs and that enable them to take full advantage of all facilities in the home. EVIDENCE: 2 Meadow View is a large purpose built bungalow situated in a quiet location on a large residential development. It is convenient for access to all local facilities and amenities. The bungalow shares a small cul-de-sac with three other similar properties. All facilities for service users were on the ground floor. There was level access to and from all external doors. There was a private and secluded garden that could be accessed by service users in wheelchairs. Outdoor furniture had been provided. The property appeared in good structural and decorative condition internally and externally. It is owned by a housing association.
Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 19 Four single bedrooms were available. Non had an en-suite facility. All bedrooms were of a good size and spacious. They were provided with suitable furniture and all were well personalised. There was one bathroom with specialist bath. Sufficient toilets were available. The communal areas consisted of a sitting room and dining room. All parts of the property were spacious, with wide corridors and door openings. Furniture, fixtures and fittings were strategically placed so they did not cause an obstruction or impede the progress or movement of any service user. There was a small laundry adequate for the needs of the home. Good systems were in place for the laundering of bedding, linen, towels and personal clothing. The premises were clean, tidy and free from unpleasant odours. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. An enthusiastic, competent, able and well-trained staff team was working positively with service users to improve their whole quality of life. EVIDENCE: The numbers and skill mix of the staff group met service users’ needs. The staffing complement in the home consisted of the registered manager and eight support workers. They was one vacancy. Staff were of differing ages and from a variety of backgrounds. Male and female staff were employed. Responsibility was not only taken by staff for personal care of service users but also catering and domestic duties. There was a core group who had worked at the home for a number of years. Any gaps in the rota were filled by existing staff or peripatetic staff employed by the registered provider. This gave a consistency of care for service users. Of the seven current support workers four had a National Vocational Qualification to at least level 2. Other staff were working towards this award. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 21 All staff recruitment and selection was done through the published procedures of the registered provider. Two staff files were examined including that of the last permanent staff to be employed. They contained an application form, two references and the necessary clearances required prior to employment, for example enhanced disclosures from the Criminal Records Bureau. Staff received the necessary induction, foundation and on-going training to enable them to carry out their duties in the most appropriate manner. The relevant induction and foundation training material were examined. A number of training certificates were also seen. Staff confirmed they had received induction training. They said they had undertaken courses to refresh their knowledge and skills, for example first aid, fire safety and moving and handling and to increase their knowledge, for example autism. Supervision was offered to staff and records were seen. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provided clear and competent leadership throughout the home ensuring service users lived in a well-managed environment. EVIDENCE: The registered manager had been in post for over 12 years. She had secured registration as manager with the Commission. She had achieved the registered managers (Adults) NVQ4 award and a National Vocational Qualification in care to level 4. She undertook the relevant training to update and increase her knowledge. The registered manager impressed as knowledgeable about the service users in her care, staffing needs and managerial responsibilities. Staff spoke of her abilities to promote the best care for the service users in the home. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 23 Quality assurance and quality monitoring systems were in place known as the annual service review. This was carried out by two managers from another part of the registered provider’s service and with no direct knowledge of the home and care on offer. The level of care, services and facilities were thoroughly and rigorously assessed with a final rating (from one to five) being offered to the home based on the findings. The last review of 2004 was seen and the home and staff had regularly achieved scores of 4, seen as very good. No review had been undertaken since 2004. The registered manager said that following a reorganisation of the registered provider’s senior management reviews would recommence in the New Year. Proper attention was being given to matters of health and safety. A number of safety reports and certificates were examined. All were relevant and up-todate. Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Meadow View 2 DS0000056629.V319251.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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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