CARE HOMES FOR OLDER PEOPLE
Neilston 47 Woodway Road Teignmouth Devon TQ14 8QB Lead Inspector
Judy Hill Announced Inspection 17th January 2006 10:00 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 Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Neilston Address 47 Woodway Road Teignmouth Devon TQ14 8QB 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) 01626 774221 01626 879395 Mr John Bryant Wescott Mrs Joy Wescott Care Home 22 Category(ies) of Dementia (22), Old age, not falling within any registration, with number other category (22) of places Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: Neilston is registered to provide accommodation and care for a maximum of twenty-two people who are elderly and people who have dementia. The registered service providers are Mr John Wescott and Mrs Joy Wescott. Mrs Wescott manages the home on a day-to-day basis while her husband takes responsibility for the upkeep of the house and garden. Neilston is situated in a quiet residential area of Teignmouth and is approximately one mile from the town centre and beach. The house is detached and set in well-landscaped gardens. All but two of the bedrooms are registered as single rooms and all of them have en-suite toilet facilities. There is a large lounge and a large dining room, which has recently been extended by the addition of a conservatory. Trained care staff are employed to provide twenty-four hour care, but the care staff and Mrs Wescott also do most of the cleaning and prepare meals. Only one member of staff is employed on a waking basis to provide care from 8pm to 8am, however registered persons and some of the care staff live on the premises and are available on call. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and was carried out by one inspector on Tuesday 17th January 2006. The information contained in this report was gained in conversation with Mrs Joy Wescott, one senior care assistants and two care assistants (all of whom were interviewed in private) and with several residents. Additional information was gained through direct and indirect observation, from a tour of the premises and from documentary records including, a pre-inspection questionnaire that had been completed by Mrs Wescott, comment cards that had been completed by relatives of the residents, staff rotas, staff records, service user assessments and care plans. What the service does well: What has improved since the last inspection?
The Statement of Purpose and Service Users’ Guides have been rewritten and now meet the required standards. Since the last inspection a conservatory has been built onto the dining room and this provides a very pleasant additional sitting are for the residents. In addition to this a covered patio has been built to provide an additional sheltered outdoor area for the residents. Specialist training has recently been provided for Mrs Wescott and her staff on the provision of person centred care for people with dementia. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 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 Neilston DS0000003759.V263047.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 4 The Statement of Purpose and Service Users’ Guides are well written and provide prospective service users and their representatives with information about what they should expect from the service. The homes initial needs and risk assessment practices are poor and do not include enough information to enable the service providers to give prospective service users and their carers an assurance that the home will be able to meet their needs. EVIDENCE: Since the last inspection both the Statement of Purpose and Service User’s Guide have been updated and both documents now include all of the information required and recommended in the Care Home Regulations and National Minimum Standards and provide information for current and prospective service users and their representatives about how the service should be provided. Samples of service users case files were inspected. Assessments that had been carried out by Social Service Case Managers are kept on file. Mrs
Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 9 Wescott uses commercially produced forms, which provide clear guidance on all of the information that should be included in the homes internal assessment. A sample inspection of the service users assessments showed that the assessment forms are not being fully completed and do not provide sufficient information about individual service users to enable detailed needs assessments to be drawn up. Standards 2 and 5 were not inspected on this occasion and standard 6 is not applicable because the home does not offer intermediate care. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10 The residents individual care plans do not set out in detail how their health, personal and social care needs can be met and this, coupled with low staffing levels, does not enable the service to provide person centred care. EVIDENCE: A sample inspection of residents care plans was carried out. As with the needs assessments, commercially produced care planning forms are used but again essential information about the residents assessed needs and how the service should be provided to meet the service users individual needs was missing. In addition to this there was no evidence that the service users and their representatives are actively involved in the assessment process, or in developing care plans and reviews. Mrs Wescott is a qualified nurse (trained in the Philippines) and is able to identify when the service users require professional health care support and to ensure that such support is provided in a timely fashion. Concerns were discussed with Mrs Wescott about the quality of care that the home provides for the more dependent service users, and in particular the need to ensure that these service users receive regular attention from the staff and that, where necessary, their fluid intake is monitored.
Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 11 It was clear from meeting the service users that their personal and oral hygiene needs are being met. No evidence was seen to demonstrate that individual assessments are being carried out with the service users to identify situations or actions that may place a service user at risk and to provide guidance for the care staff on how to reduce identified risks. Some armchair exercises are carried out with the service users but more could be done to ensure that the service users engage in appropriate exercise and physical activities on a more regular basis. All of the current service users have dementia and would benefit from a higher level of one to one support from the care staff than they are currently receiving. This is no reflection on the abilities of the staff, as they have recently received training on how to provide person centred care for people with dementia, but on the care staffing levels. Standards 9 and 11 were not inspected on this occasion but standard 9 was assessed as met at the last inspection. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 14 The residents are able to make choices with regard to some of their daily routines, more detailed assessments and more care staff input is needed to provide the service users with a service that is based on their individual needs. EVIDENCE: An inspection of a sample of individual needs assessments, care plans and reviews demonstrated that insufficient attention is being given to understanding the residents personal backgrounds and identifying their likes and dislikes, preferences and capabilities. Arrangements are being made to engage the residents in games and activities, including bingo, cards, sing-a-longs and armchair exercises and entertainer comes into the home very two weeks. Mrs Wescott said that she sometimes takes three of the residents out. One of the residents regularly attends Church services and vicar and a priest visit the home monthly. The menu plans demonstrated that the residents are offered a choice of food at breakfast and teatime. No choices are offered at lunchtime but Mrs Wescott said that alternative meals would be provided if any of the residents did not want the set meal. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 13 Mrs Wescott said that the residents are free to choose when they go to bed and when they get up in the mornings. Feedback from Comment Cards completed and returned by the relatives of service users indicated that visitors are always made welcome. The new conservatory provides an attractive, comfortable and fairly private area for the residents to receive their visitors in if they do not wish to use their bedrooms for this purpose. Standard 15 was not inspected on this occasion but was assessed as met at the last inspection. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Complaints are not systematically recorded and the service users and their representatives cannot be confident that their complaints will be taken seriously and dealt with appropriately. EVIDENCE: A summary of the homes complaints procedure is included in the Statement of Purpose and the Service Users’ Guides and displayed in the hallway at the home. Within the last twelve months two complaints have been made to the Commission for Social Care Inspection about the service provided at Neilston and both complaints were partially substantiated. In addition to this Mrs Wescott identified two complaints, which had not been substantiated, in her completed pre-inspection questionnaire. No recent entries had been made in the complaints book. Standards 17 and 18 were not inspected on this occasion but standard 18 was assessed as met at the last inspection. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 22 The house and gardens are well maintained and the residents live in an attractive and comfortable home. The home does not have suitable hoist facilities and so the staff and service user who require lifting are being placed at risk. EVIDENCE: Neilston is situated in a pleasant residential area on the outskirts of Teignmouth and is approximately one mile from the town centre and beach. The home is well maintained, attractively decorated, comfortably furnished and clean throughout. Since the last inspection a conservatory and covered patio have been built and these provide attractive additional communal areas for the residents. The gardens are well maintained and attractive. A qualified occupational therapist has carried out an inspection of the premises and the report is favourable. It was however identified in the report that a mobile hoist was needed to enable residents who require lifting to be moved safely. Mrs Wescott and a care assistant were observed having to lift a service user who had slouched down into an uncomfortable position in her chair. Mrs
Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 16 Wescott and her care staff have received training in manual handling and therefore are aware that this practice is not safe. A letter has been sent to Mr & Mrs Wescott advising them that their failure to provide a suitable hoist is a matter of serious concern which must be dealt with immediately. Standards 20, 21, 23, 24, 25 and 26 were inspected on this occasion but standards 23, 24, 25 and 26 were assessed as met at the last inspection. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The care staff are well qualified and well trained but there are not enough staff hours to meet the needs of the residents. The recruitment practices are not sufficiently robust to ensure that only suitable staff will be employed to work with the residents. EVIDENCE: Mrs Wescott and some of the staff have recently received specialist training on the caring for people with dementia and Mrs Wescott was able to demonstrate she understood the need to adopt a more person centred approach. However, the staffing levels are too low to enable the care staff to put their specialist training to good use. In addition to the low care staffing levels insufficient ancillary staff employed and Mrs Wescott and the care staff much of their time cleaning and cooking. A letter of immediate concern has been sent to Mr & Mrs Wescott regarding the low level of care staff hours that are being devoted to care duties. An inspection of staff records demonstrated that the staff are well qualified and that they regular training in health and safety related topics, including First Aid, Basic Hygiene, Fire Safety, Medication (‘Boots’), Manual Handling, Protection of the Elderly from Abuse, Continence Control, Infection Control and Health & Safety. The two senior care assistants are qualified nurses (trained in the Philippines). One care assistant has an NVQ in Care at Level 2 and two of them have gained their NVQ at Level 3. A further 2 Care Assistants are currently working towards gaining their NVQ in Care at Level 2.
Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 18 The procedures used for recruiting new staff were inspected using the records of the most recently recruited member of staff, who had been in post for three weeks. A CRB check had not been applied for and although the applicant had completed an application form and provided the home with the names and addresses of two referees, these had not been sent for. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 The manager is well qualified, well trained and experienced but needs to focus on bring the service into line with the stated purpose, aims and objectives recorded in the Statement of Purpose. EVIDENCE: The registered persons are Mr John Wescott and Mrs Joy Wescott. Mrs Wescott is a nurse who was trained and qualified in the Philippines and she takes responsibility for the day-to-day running of the home while her husband takes responsibility for the maintenance of the house and gardens. Mrs Wescott has completed her Registered Managers Award (NVQ Level 4), is a qualified NVQ assessor (D32/33) and has undertaken periodic training to update her skills and knowledge. However, she does need to focus on the management of the home to ensure that the service meets its stated purpose, aims and objectives. The stated purpose, aims and objective of the service are included in the Statement of Purpose and summarised in the Service Users Guide, however it
Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 20 was evident during this inspection that low staffing levels, poor assessment and care planning are not enabling these aims and objectives to be met. A quality assurance/quality monitoring system is in place to gain feedback from service users and their representatives but a more thorough and systematic approach needs to be taken to enable the service providers to measure their success at meeting the aims and objectives of the home, as recorded in the Statement of Purpose, and to review the homes care practices where they fall short of their stated aims and objectives. None of the current service users manage their own financial affairs and most of them have assistance to do so from their families or a legal representative. Mrs Wescott acts as appointee for one resident and records demonstrated that he is given, and signs for his personal allowance weekly. Mrs Wescott had recently received a large check from Social Services for a resident and had put this money into the homes bank account for safekeeping. This is not an acceptable practice and a letter of serious concern has been sent to the service providers requiring them to take immediate action to deal with this matter. The care staff receive formal one to one supervision from the registered person and are supervised informally on a day to day basis. The frequency of formal supervision needs to be increased to six times a year and records should be kept to demonstrate that the supervision has included all aspects of practice, the philosophy of care in the home and career development needs. The Statement of Purpose and records relating to the general upkeep of the premises are satisfactory but both the staff and service users records were seen to be incomplete. Records of staff training demonstrated that the care staff have received training in safe working practices. However the registered person and care assistant were observed lifting a service user to make her more comfortable in her chair and this practice is not safe for the staff. The registered provider recognised that she need a mobile hoist to care for the resident safely but said that the cost was prohibitive. Maintenance and associated records and a physical inspection demonstrated that the premises are safe and well maintained and that appliances are serviced regularly. The staff are receiving training in health and safety related topics but safe working practices are not always being carried out. This was demonstrated by the findings of a report of an inspection by a qualified occupational therapist, which concluded that the premises were suitable for people with dementia, but that the home needed a mobile hoist to ensure that the staff and residents were not put at risk when moving residents. Standard 34 was not inspected on this occasion. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 21 Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 22 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 X 2 1 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 X X 2 X X X X STAFFING Standard No Score 27 1 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X 2 2 2 2 Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 23 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 OP3 Regulation 14 & 15 Requirement The resident’s assessment forms must be fully completed prior to admission. Previous timescales 1.12.04 and 7.8.05 not met. Following a detailed assessment prospective service users and their representatives must be given written confirmation that the home can meet their needs. Previous timescales 1.12.04 and 7.8.05 not met. The resident’s care plans must set out in detail the action that needs to be taken by the staff to meet the residents individual health, personal and social care needs. Previous timescales 1.12.04 & 7.8.02 not met. Individual personal risk assessments must be carried out with each of the residents and detailed written guidance must be provided for the staff on how to reduce identified risks.
DS0000003759.V263047.R01.S.doc Timescale for action 18/01/06 2 OP4 12, 14 & 16 18/01/06 3 OP7 12, 13 & 15 17/03/06 4 OP8 13, 14 & 15 17/03/06 Neilston Version 5.0 Page 24 5 OP10 18 6 OP12 12, 14 & 15 Sufficient care staff must be employed to ensure that the needs of the residents can be properly assessed and met. The assessment of residents’ needs and care plans must be reviewed with the service users and their representatives to take into account their social needs and preferences as well as their physical needs and capabilities. Previous timescales 1.12.04 & 7.8.05 not met. The residents’ individual assessments and care plans must demonstrate that their individual wishes and preferences are identified and taken into account. Previous timescales 1.12.04 & 7.8.05 not met All complaints must be taken seriously, dealt with appropriately and recorded. To ensure the safety of the staff and residents, suitable lifting devises must be provided and the staff must be trained to use them appropriately. A letter has been sent to the registered service providers advising them that this is a matter of serious concern that must be dealt with immediately. The registered persons must be able to demonstrate that the care staffing levels are based on the assessed needs of the residents and that they are high enough to meet their health, personal and social care needs. A letter has been sent to Mr & Mrs Wescott advising them that this is a matter of serious concern that must be dealt with 17/03/06 17/03/06 7 OP14 12 17/03/06 8 9 OP16 OP22 17 13 17/02/06 18/01/06 10 OP27 18 18/01/06 Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 25 immediately. Previous timescales 1.11.2004 and 7.8.2005 not met. Safe recruitment practices, including commissioning enhanced CRB checks and taking up references must be used. The quality of care provided must be raised to accurately reflect the purpose, aims and objectives as stated in the Statement of Purpose. As above. The service providers must identify and record the name and address or any person entrusted by each of the residents to assist them in handling their personal financial affairs and must not deposit any money belonging to a resident in their own or the homes bank account. A letter has been sent to the registered providers advising them that this is a matter of serious concern that they must deal with immediately. 15 OP37 17 All of the records listed in Schedules 2 and 3 of the Care Homes Regulations, which relate to records required in respect of each member of staff and each service user, must be kept. The registered persons must ensure that the staff and residents are not placed at risk by ensuring that working practice are assessed and that suitable equipment and training is provided where a risk has been identified. This refers specifically to unsafe lifting practice and the failure of the service providers to provide a suitable hoist.
DS0000003759.V263047.R01.S.doc 11 OP29 17 & 19 18/01/06 12 OP31 4 & 17 17/04/06 13 14 OP32 OP35 4 & 17 20 17/04/06 18/01/06 17/01/06 16 OP38 12 & 13 17/01/06 Neilston Version 5.0 Page 26 A letter of has been sent to the service providers as this represents a serious concern that must be dealt with immediately. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP33 OP36 Good Practice Recommendations A systematic quality assurance/quality monitoring system should be introduced to enable the service providers to evaluate and develop the service. All care staff should receive formal supervision at least six times a year. Neilston DS0000003759.V263047.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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