CARE HOMES FOR OLDER PEOPLE
Oak Lodge Nursing Home Rectory Road Oakley Basingstoke Hampshire RG23 7EL Lead Inspector
Nick Morrison Unannounced Inspection 5th December 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 Oak Lodge Nursing Home DS0000011655.V319850.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. Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Oak Lodge Nursing Home Address Rectory Road Oakley Basingstoke Hampshire RG23 7EL 01256 780222 01256 782377 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) Forest Care Limited Mrs Sarah Maureen McColl Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability over 65 years of age of places (10) Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: Oak Lodge is a care home providing nursing care for forty one persons over sixty five years of age and those of that age who have physical disabilities. The home is one of two homes owned and operated by Forest Care Limited. Oak Lodge was opened in 1995 and the establishment forms part of a large Georgian Manor House with conference facilities. It stands in extensive grounds in Oakley, on the outskirts of Basingstoke, Hampshire. Residents are accommodated in thirty-five single rooms and three double rooms sited over three floors. Two passenger lifts and stairs allow access to all areas of the home, including a large lounge, small lounge for smokers and a conservatory. Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 5th December 2006 and lasted six hours. During this time the Inspector toured the premises, looked at a sample of five service users’ files and met with four of those people. All records and relevant documentation referred to in the report was seen on the day of inspection. The Inspector spoke with the Matron and Manager, as well as a sample of staff, other service users and a visiting doctor. Current charges in the home are between £700 and £1000 per month. What the service does well: What has improved since the last inspection? What they could do better: Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 6 The Registered Manager has identified that written records need to be kept to demonstrate that care plans are reviewed on a regular basis and also to demonstrate that staff are receiving regular supervision. 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. Oak Lodge Nursing Home DS0000011655.V319850.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 Oak Lodge Nursing Home DS0000011655.V319850.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 and 6 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Service users benefit from having the information they need about the home and from having their needs assessed prior to moving in. They also benefit from having a clear statement of Terms & Conditions. EVIDENCE: Service users’ files showed that they all had a written assessment of needs that had been completed prior to them moving into the home. Assessments were comprehensive and included an initial risk assessment. Health needs were assessed in detail along with social needs and a personal history profile was completed. There was written evidence that service users and their families had been involved in the assessment process. Service users spoken with confirmed they had been involved in an assessment prior to moving into
Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 9 the home and that the Registered Manager had visited them in their previous residence to undertake the assessment. All service users were given a copy of the Service User Guide before moving into the home. The home has an information pack that is sent out to all prospective service users whenever an enquiry is made. The pack also contains the Statement of Purpose, a brochure, advice on finances and a sample statement of Terms & Conditions. Service users spoken with confirmed they and their families had received this information and that they each had a written and signed copy of the Terms & Conditions of their stay in the home. The home does not provide intermediate care. Oak Lodge Nursing Home DS0000011655.V319850.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 and 10 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Service users benefit from having a clear care plan and are protected by the home’s medication policies and practices. They also benefit from being treated with respect and from having their healthcare needs addressed. EVIDENCE: Records showed that each service user had their own care plan in place. Care plans were comprehensive and there were individual plans for different need areas. The plans were written clearly and were specific about what staff needed to do in order to address the person’s needs. Records showed that each care plan was updated on a regular basis as the needs of service users changed. Although the care plans were considered and reviewed very regularly, there were no written records to state that they had been formally reviewed on a monthly basis. This was discussed with the Registered Manager who will introduce a system to ensure that this information is clearly recorded.
Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 11 Service users spoken with were clear about their own care plans and said they had been involved in devising them and were involved in reviewing them. Service users’ healthcare needs were monitored closely. There were records of monitoring of general health needs for all service users as well as specific monitoring for individual conditions. Clear records were kept of all medical interventions within the home and of input from other health professionals. The GP spoken with on the day of the inspection visit was complimentary about the standard of health care provided in the home. She said that staff were well trained and competent and that some had specific skills that were beneficial to people living in the home. She said that the home was particularly good in responding to physiotherapy needs as well as in the care of wounds. The GP was confident in the way the home was run and said that the Registered Manager and other staff were good at liaising and working with other healthcare professionals. The home is about to begin introducing calcium and vitamin D supplements for service users in an effort to strengthen bones. Service users spoken with felt that the standard of healthcare within the home was extremely good. One service user said that, thanks to the treatment from staff at the home, the ulcers on her legs had been treated very well and she and her family were surprised at how much they had improved in the relatively short space of time she had been at the home. The home had a clear medication policy in place to protect service users. Only trained nursing staff administered medication and records showed that they had ongoing training and updates in administering medication. On the day of the inspection visit, the midday medication was administered during the lunchtime period and the nurse administering the medication demonstrated an understanding of the policy and an awareness of the need to administer medication in a safe and sensitive manner. Each service user was given their medication discreetly the member of staff observed that it had been taken before signing it off. The medication was stored in a methodical and safe manner in the medication cupboard and was all clearly labelled. A colour coding system was used to ensure decrease the likelihood of mistakes being made. The medication records were clear, up-to-date and accurate. Service users spoken with said they felt the medication system was safe and that they always received the medication they needed and said staff administered medication well. Observation throughout the inspection visit showed that staff were respectful to service users at all times and this was confirmed in conversation with service users who said they received care according to their own preferences. The home’s policies, in-house training and the approach of the manager emphasised the need to support people in a respectful manner. Each service user had a telephone in their room that was connected through a central exchange in the office. Service users were able to make calls in private from their own rooms whenever they wanted to and there was no cost to them for the calls. The way the telephone system was set up meant that all incoming calls went through the office and were then put through to the relevant service user. Service users spoken with did not feel this was a problem.
Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Service users benefited from access to a range of activities and were supported to maintain contact with their friends and families. They were supported to exercise control over their own lives and had the benefit of a balanced and nutritional diet. EVIDENCE: The home has a regular programme of activities on offer for service users. An Activities Coordinator was employed on three days of the week and care staff were involved in running activities on the other days. The activities for each day were posted on notice boards around the building. During the service users’ meeting on the day of the inspection visit, one service user mentioned that it was difficult to read the notice boards for people who used wheelchairs. The manager responded immediately to this saying that individual copies of the programme of activities would be given to all service users who wanted them so that they could easily read what activities were on offer.
Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 13 Service users spoken with felt that the range of activities on offer was good and that the activities themselves were always interesting and stimulating. One service user spoken with said she did not spend much time watching films on the television because there was always something else to do. Each service user had a personal history profile completed with them when they moved into the home. This recorded information about the kind of activities the person had been involved in prior to coming into the home and also asked what new activities they might be interested in undertaking. The Activities Coordinator used this information in planning the activities in the home. Additional activities were also planned throughout the year. These included seasonal activities like Christmas shopping trips, carol services and visits to pantomimes. Some activities, such as summer fetes, raised funds for the home and this money was put into the service users’ fund. During the service users’ meeting on the day of inspection people had the opportunity to put forward ideas about the how the money in the fund could be used. Service users were involved deciding and planning activities and part of the meeting was used to encourage service users to think of activities and outings they would like over the coming months. The home had a visitors’ policy that was clear and encouraged service users to have visitors at any time convenient to them. Service users said their visitors were always made to feel welcome by the staff in the home. There was a small lounge upstairs that service users could use to meet with their guests in private if they did not want to do so in their own room. Service users’ care plans contained information on members of their family they liked to keep in touch with, along with contact details so that staff could assist them to contact their relatives if necessary. The home’s policies emphasised the importance of helping service users to keep in touch with their friends and families. The need for service users to exercise control over their own lives was also emphasised through policies and staff training. Service users spoken with felt that they were in control of their own lives as much as they could be within a care home. They said they were supported and enabled to make decisions for themselves about things that were important to them like when they got up and when they went to bed, what they wore, how they were supported and what things they did with their time. The food in the home was of good quality. The home shares a kitchen with the conference centre that is on the same site and which is owned by the same company. Service users’ nutritional needs were assessed on admission and kept under review. The lunchtime on the day of the inspection was a sociable occasion and service users appeared to enjoy the atmosphere as well as the food. Discreet support with eating was available for those people who needed it and service users were able to eat in their own room if they preferred. The food was nicely presented and was served to service users by members of staff. In the kitchen there was clear information about each service user’s dietary needs and this was kept up-to-date and corresponded with the information in the care plan. Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 14 Service users spoken with had mixed views about the food. Some said it was very good and others felt that the quality varied. Everyone felt that the food was varied and nutritious. Service users were able to comment on the food and make suggestions through the service users’ meetings. Issues that had been raised at previous meetings had been addressed. The Registered Manager always involved herself in serving the food so that she could monitor what meals were enjoyed and which meals did not get as much approval. Changes were made to the menus where service users clearly did not particularly like certain meals. Oak Lodge Nursing Home DS0000011655.V319850.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 and 18 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Service users were protected by the home’s abuse policies and practices and were confident that any complaints they had would be responded to. EVIDENCE: All service users spoken with were aware of the complaints procedure and of how to use it. They each had their own copy of the procedure, which was given to them with their initial information about the service. There was also a copy of the procedure placed in the front entrance of the building. Along with the procedure there was a complaints form so that service users could record their complaints in writing and so that they could be easily tracked. The procedure including a system for recording and responding to complaints and using the information gained from complaints to make improvements to the service. There had been no complaints in the past two years. Discussion with service users suggested that there was little need for them to use the formal complaints procedure because the service was very responsive to their needs and wishes. The Registered Manager made a point of talking to each service user each day. She did this by doing the morning medication round and/or by completing the menu choices with each person each morning. During this time she would ask service users about the service and about how they were and would use this information to address any issues that arose. People living in
Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 16 the home also had the opportunity to express views during service user meetings and the management team responded to any issues raised. There was also a Suggestions Box in the reception area of the home, although the Registered Manager reported that this was not widely used. The home has adult protection procedures in place. The procedures are clear and all staff have received training in identifying and responding to instances of suspected abuse. The procedures and the training were very clear and explicit about the kinds of abuse older people might experience. Staff spoken with were clear about the procedures and of their responsibilities within them. Service users spoken with said they felt safe within the home and that the service and the staff treated them very well. No service users spoken with expressed any concerns about there being any kind of abuse within the home. Oak Lodge Nursing Home DS0000011655.V319850.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 and 26 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Service users benefit form living in safe, clean and pleasant surroundings. EVIDENCE: The home was well laid out and provided a homely atmosphere. Records showed that the maintenance of the building was regularly monitored and that any maintenance issues were responded to as quickly as possible. The home is set in a large, rural area that it shares with the conference facilities attached to the building. The grounds provided very attractive spaces for service users to access or to just look out onto. The gardens were maintained to a high standard and service users spoken with appreciated the views they had from the home.
Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 18 Hygiene in the home was well managed. The management team were keen to ensure that the building felt comfortable and clean and that no unpleasant odours were present. At the time of the inspection visit the home was exceptionally clean and service users spoken with said the home was always kept very clean. Although the cleanliness of the home was a high priority, it did not detract from the comfortable and homely atmosphere. The laundry area was well equipped and clean as were the sluice areas. Liquid soap and paper towels were available in all areas throughout the building. Infection control procedures wee in place and staff had received training on these. There were copies of procedures and other instructions in the bathroom and sluice areas so that staff had the information to hand when they needed it. Oak Lodge Nursing Home DS0000011655.V319850.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 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 benefited from being supported by well trained and supported staff and were protected by the home’s recruitment policies and practices. EVIDENCE: Rotas showed that sufficient staff were on duty at all times during the week. The number of staff on duty at the time of the inspection visit corresponded with the numbers shown on the rota. Staff spoken with said that there were usually enough staff on duty to ensure that the needs of service users were met. Service users spoken with confirmed that staffing levels were adequate in their opinion. The home did not use any agency staff. Staff received a comprehensive induction programme on beginning work in the home and good, clear records were kept of each person’s induction. All staff had regular appraisals and supervision which were linked to personal development and identifying training issues. The Registered Manager has identified that records of support and supervision sessions to be clear and dated to demonstrate how regularly supervision is taking place. Staff were receiving training in a wide range of areas related to the needs of service users
Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 20 and domestic staff were encouraged and supported to take advantage of training opportunities in understanding the needs of service users. Recruitment records demonstrated that all necessary pre-employment checks were undertaken prior to staff beginning work in the home. These included Criminal Records Bureau checks, references and work permits for non-EU staff. There had been a requirement at the previous inspection that the home must ensure that all staff have a Protection of Vulnerable Adults list check prior to beginning work in the home. The recruitment records of the most recently appointed staff demonstrated that this requirement has now been met. Oak Lodge Nursing Home DS0000011655.V319850.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, 33, 35 and 38 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well managed home where their views and best interests inform service development. Health and safety issues are well managed and the financial interests of service users is safeguarded. EVIDENCE: The Manager of the home is registered and has demonstrated that she has the skills, experience and qualifications to manage the home. She is supported by a management team and staff group who were very positive about the way the home was managed. Service users spoken with were complimentary about the way the home was managed and commented on the dedication and attention to detail of the Registered Manager.
Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 22 The views of service users are taken into account in the day-to-day management of the home as well as in the development of the service. The Registered Manager seeks individual views on a daily basis and service users have an opportunity to express their views as a group in service user meetings that occur every two months. As observed on the day of the inspection visit, these meetings were well structured and gave service users an opportunity to raise issues about the service and to have a response from the management team. At a recent meeting some service users asked if there was a possibility of getting Sky TV in the home. The management team have explored the possibilities and responded at this meeting by explaining that Sky TV will be in place in the rooms of all service users who want it by the end of December at no charge to individual service users. Minutes were kept of each meeting and were issued to those present. The service also sought and recorded the views of service users, relatives and other professionals through the use of questionnaires. A development plan for the service was in place and reflected the views expressed by service users and others. The home does not manage service users’ finances but does hold small amounts of money for some service users who are unable, or prefer not, to do so for themselves. Families of service users manage finances for service users who do not do it themselves and the families ensure that that the service user has an amount of money in the home for day-to-day expenses. The home manages this money well and keeps good, clear, accurate records of each transaction along with receipts, which are then available for families if they want to keep track of the expenditure. Records demonstrated that health and safety in the home is consistently monitored and managed. Records were kept of all servicing of equipment and good fire records were also kept. A workplace health and safety risk assessment was in place and was regularly reviewed. Information was kept on all substances that are potentially hazardous to health and copies of this information was kept in bathrooms, sluices and other areas where staff might need to refer to it. All potentially harmful substances were kept locked away. The building has handrails throughout and an effective call alarm system which service users said staff responded to promptly. Oak Lodge Nursing Home DS0000011655.V319850.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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 X 3 X 3 X X 3 Oak Lodge Nursing Home DS0000011655.V319850.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 Oak Lodge Nursing Home DS0000011655.V319850.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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