CARE HOME ADULTS 18-65
Oakmead 19 Worlds End Lane Weston Turville Bucks HP22 5SA Lead Inspector
Christine Sidwell Unannounced Inspection 20th August 2007 14:00 Oakmead DS0000023075.V344541.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 Oakmead DS0000023075.V344541.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. Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Oakmead Address 19 Worlds End Lane Weston Turville Bucks HP22 5SA 01296 615578 N/A michelleread@parkside.org.uk 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) Turnstone Support Limited Michelle Elaine Read Care Home 5 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 5 residents between 18 - 65 with a learning disability and/or physical disability 30th August 2006 Date of last inspection Brief Description of the Service: Oakmead is a small home providing care and accommodation for up to five residents with physical and learning disabilities. The home works with residents to ensure that they are as independent as their abilities enable them to be. At the time of this unannounced inspection, there were five residents, who all happened to be male, living at Oakmead. The home is in the village of Weston Turville, close to the market towns of Wendover and Aylesbury. Residents use the locally based amenities and are within a short journey of Aylesbury itself. Oakmead is a large detached dormer-bungalow, which has five single rooms and communal space situated on the ground floor. There is a dormer area to the bungalow where the office and sleeping-in accommodation for staff is situated. The home has its own vehicle to transport residents and there are ample parking facilities for approximately a further three vehicles at the front of the property. From the driveway there is easy access into the home and there is an enclosed garden to the rear of the property. The current scale of charges is £1,443.00 to £1505.00. Additional costs are incurred for personal items, travel and holidays. Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over three days and included an unannounced visit to the home. Prior to visit the manager was asked to complete an annual quality assurance self-assessment, which she did and returned on time. Surveys were sent to the residents in a format appropriate to their needs and to families and healthcare professionals. Two family members and two healthcare professionals returned the surveys. Four residents completed the questionnaires, with some help. Information received by the Commission for Social Care Inspection since the last inspection was considered in the planning of this inspection. The residents, manager and staff were spoken to on the day of the unannounced visit. Records were examined and a tour of the building undertaken. The way in which the organisation promotes equality and diversity was considered throughout. What the service does well:
There is a thorough assessment procedure and residents have the opportunity to stay at the home, prior to moving, to help them and those who are supporting them to assess whether the home can meet their needs. The assessment process takes into account resident’s religious, cultural and diverse support needs. Information is available to residents in a format that they can understand. Information about their terms and conditions and finances are also available in a format that is accessible to residents and takes account of their disabilities. There are detailed care plans in place, which document service users’ needs and how these are to be met, within a risk assessment framework. Residents and their families have been involved in developing these care plans which reflect their wishes. They are updated regularly and reflect the individuality of the residents. One family member commented that the ability of the home to meet the diverse needs of residents was a strength. The home is in contact with a local advocacy group. Residents have a varied and active lifestyle, which reflects their interests and abilities. Their rooms are personalised and reflected their individual hobbies and interests. Meals are varied and residents have the opportunity to choose meals for the menus. There was no one requiring special meals on cultural grounds at the time of the inspection although the manager said that these could be arranged if necessary. Residents are encouraged and supported to remain in contact with their families, which they enjoy. Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 6 The health and personal care needs of people living at the home are met, promoting their health and well being and ensuring that they receive medication in a safe and consistent manner. Residents are registered with the local general practitioner and have regular check ups. Illnesses are responded to promptly. Medication is managed well and staff have received medication administration training. Complaints and adult protection are effectively managed. The views of people who live at the home are listened to. Resident friendly versions of the complaints procedure and what abuse is and what to do about it are in the Resident’s Guide. The Commission for Social Care Inspection has not been notified of any complaints or safeguarding allegations, which are being investigated by the local authority. The home is a comfortable, homely and safe place for residents to live in. Resident’s rooms and the communal areas are personalised and create a family atmosphere. Residents’ individuality is recognised and supported. There is a programme of on going redecoration and residents are able to participate in this. There are good staffing levels. Staff have had training to enable them to meet residents’ needs in a supportive way. Seventy five percent of staff hold National Vocational Qualifications in Care at level 2 and there are plans for the remaining staff to achieve this by early 2008. The records showed that staff have had basic training in safe working practices. Recruitment procedures are thorough, involve residents and protect residents from unsuitable carers. Residents are involved in interviewing new staff, which is good practice. The management arrangements are satisfactory. The manager is experienced and is currently applying for registration with the Commission for Social Care Inspection. There is a quality assurance system in place to ensure that the service continuously improves and is responsive to residents and families needs. What has improved since the last inspection?
The overall level of care to residents has improved. There have been improvements in care planning, enabling residents to participate in activities through effective risk assessments. Medication management has improved. The organisation’s staff induction programme has been implemented and training programmes for staff have been systematically implemented. If agency staff are needed, staff who are known to the residents are used. Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 7 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. Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 8 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 Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 9 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, 2 and 5 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a thorough assessment procedure and residents have the opportunity to stay at the home, prior to moving in, to help them and those who are supporting them to assess whether the home can meet their needs. EVIDENCE: No new residents have moved to the home since the last inspection. The organisation has comprehensive policies and procedures in place to guide managers on the steps that they should take should a vacancy arise at the home. The manager explained this process, which would entail an initial assessment and frequent visits to the home, progressing to longer stays. During this period the home, the potential resident, their family and appropriate care managers would make an assessment as to whether the home could meet the potential residents needs. There was documentation in resident’s files to verify that this process had been undertaken for the existing residents. The Statement of Purpose had been updated in July 2007 and was available to residents in their rooms in a pictorial format. Each resident had a licence agreement, which was also in pictorial form and contained information about fees and the complaints policy. The documentation used for the assessment has cues, which prompt staff to consider potential resident’s diverse needs and cultural backgrounds.
Oakmead DS0000023075.V344541.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are detailed care plans in place, which document service users’ needs and how these are to be met, within a risk assessment framework. Residents and their families have been involved in developing these care plans which reflect their wishes. EVIDENCE: The care plans are comprehensive and updated regularly. The care plans are ‘person centred’ and staff work with residents and their families to agree them. Two plans were looked at in detail. They contained evidence that residents’ choices are taken into account and that residents’ days are structured to help them achieve their goals. Care plans are reviewed regularly. There was evidence in the files that residents and families are involved in the reviews. The atmosphere in the home was relaxed and caring and there was evidence that residents are involved in decisions about their care and how they spend their day. The residents who returned the questionnaires indicated that they had a choice as to how they spend their day and residents were observed during the inspection to be undertaking a variety of projects and activities. Each resident has a pictorial calendar on their wall, which reminds them which staff members are on duty and what they are doing on that day. The staffing
Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 11 levels in the home allow for individual programmes to be put into place, which reflect resident’s diverse interests and needs. Individual risk assessments are in place to enable residents to participate safely in the activities that they wish to participate in. There is a missing persons policy in place. The home helps residents to manage their own money and each resident has a ‘my money file’, containing comprehensive records of income and expenditure. These are audited regularly by the home and the organisation. A local advocacy group has visited the home regularly and is available to support residents if necessary. Oakmead DS0000023075.V344541.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have a varied and active lifestyle, which reflects their interests and abilities. Meals are varied and residents have the opportunity to choose meals for the menus. Residents are encouraged and supported to remain in contact with their families, which they enjoy. EVIDENCE: All the residents were at home on the day of the unannounced visit. From care plans, daily notes and discussion with service users, there was evidence that service users go out most days usually in small groups. Each had their own preference. Some had work or college placements although given their disability this was not always possible to achieve. The manager was working hard to help one resident continue his life skills college courses. The residents spoken to said that they enjoyed going out in the home’s car, which brought interest and diversion to the day. All residents had a holiday planned. One is planning an overseas visit, which he has wanted to do for a long time. Two carers will go with him. Residents who wish to can make use of churches in the area and their spiritual needs are noted in care plans. A number attend a
Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 13 local church coffee morning. Receipts of expenditure showed that service users use the local shops for clothes shopping, leisure activities and buying items such as toiletries and magazines. Residents are supported to take responsibility for keeping their rooms clean and tidy and participating in the general tidiness of the home. There is a choice of entertainment in the home and residents have their own hobbies. Their rooms reflect these. Residents are encouraged to keep in contact with families. Two family members returned the questionnaire and said that they were happy with the care that their son received. One said that ‘as far as my son is concerned they are very caring and he is happy which is the main thing’. There is a varied menu and residents contribute to the weekly menu planning. Fresh fruit is available in the dining room for residents to help themselves when they wish. There was no one requiring special meals on cultural grounds at the time of the inspection, although the manager said that these could be arranged if necessary. Oakmead DS0000023075.V344541.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of people living at the home are met, promoting their health and well being and ensuring that they receive medication in a safe and consistent manner. EVIDENCE: There was evidence in the care files that resident’s healthcare needs are met. All residents are registered with a local general practitioner and visit when necessary. The local consultant specialist and learning disability team monitors their overall care. There was evidence in the files that residents have regular dental check ups and optician visits and also attend the local ‘well man’ clinic for regular checkups. Residents hold their own ‘my health appointment’ records which helps them to understand the health interventions that are necessary to promote their well-being. There are medication management policies and procedures in place. Records showed that all staff who administer medication have received training. The home uses a dosette system which is overseen by the pharmacist. Medication entering and leaving the home is recorded. The medication administration charts were completed accurately. The home does not hold any stocks of controlled drugs. No residents self medicate, although there are policies and procedures in place should anyone wish to and be able to do so. There are
Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 15 protocols in place to guide staff when caring for people with epilepsy and staff have received training in the administration of rectal valium, should this be necessary. There are protocols in place to govern the actions that staff should take if a resident refused medication and staff said that medication was never administered covertly. Oakmead DS0000023075.V344541.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints and adult protection are effectively managed. The views of people who live at the home are listened to reducing the risk of harm to them. EVIDENCE: There is a complaints procedure in place, which contains the contact details of the Commission for Social Care Inspection. Both family members who returned the questionnaire said that they were aware of how to make a complaint. The residents said in the questionnaires and on the day of the visit that they knew who to talk to if they were unhappy. The atmosphere was very relaxed. Families felt that the new manager was responsive to concerns and addressed them promptly which one family member felt was an improvement on past practice. The Commission for Social Care Inspection has not been notified about nor received any complaints since the last inspection. The home has policies in place to respond to safeguarding allegations and staff have received Protection of Vulnerable Adults training. The Commission for Social Care Inspection has not been notified of any allegations, which are being investigated by the local authority. Service user-friendly versions of the complaints procedure and what abuse is and what to do about it are in the service users guide. Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 17 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is a comfortable, homely and safe place for residents to live in. EVIDENCE: The home is comfortable and homely. It is in a good state of repair and there is good disabled access to the building. The furnishings and fittings are of good quality and domestic in style. Residents have personalised their rooms and can choose the colour of the walls and paintwork and decorations. The home was clean and tidy on the day of the unannounced visit and there were no offensive odours. There are infection control policies and procedures in place although, according to the annual quality assurance assessment sent in by the home, these have not been updated since July 2002. The organisation should review its control of infection policies and procedures to ensure that they are in line with new guidance published by the Department of Health in June 2006 and available on their website www.dh.gov. Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 18 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 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are sufficient staff, who have had good levels of training to enable them to meet residents’ needs in a supportive way. Recruitment procedures are thorough, involve residents and protect residents from unsuitable carers. EVIDENCE: The staffing levels in the home are good. There are always two carers on duty and sometimes three to enable residents to participate in different activities. There was evidence that of the twelve carers, nine hold the National Vocational Qualifications in Care at level 2 and two hold it at level 3. The home is aiming for all carers to hold this qualification by early 2008. There are recruitment policies and procedures in place. All new staff undergo two interviews, one by the organisation and a second interview with residents to ensure that they are happy with the carers who will be supporting them. This is good practice. The recruitment files of two recruited members of staff were examined. They contained documentation to verify that staff had completed an application form, which showed their work history. All staff had been interviewed and interview records had been kept. Two references and a Criminal Records
Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 19 Bureau disclosure had been sought before the staff member had started work. Staff had a contract with the organisation and had been given copies of the codes of conduct and practice set by the General Social Care Council. In addition to the National Vocational Qualifications training staff have the opportunity to undertake further training in specialties relevant to the care of the residents. One had undertaken autism training and all had undertaken training in the care of people with epilepsy. The records showed that mandatory staff training in safe working practices was up to date. Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 20 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, 40 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management arrangements are satisfactory. There is a quality assurance system in place to ensure that the service continuously improves and is responsive to residents and families needs. EVIDENCE: The manager was appointed in June 2007. She has experience of caring for people with learning difficulties and is in the process of registering with The Commission for Social Care Inspection. She holds the National Vocational Qualifications (NVQ) in Care at level 4 in Management and Health and Social Care. She has a job description and the lines of accountability are clear within the home and within the organisation. She is supported by an operational manager who visits the home regularly. There are quality assurance systems in place to regularly review the quality of care. The manager said that she had an open door policy and this was confirmed by the families and residents who were seen to be happy to
Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 21 approach her at all times. There is a resident’s satisfaction survey in pictorial form and regular surveys are sent to families. An operational manager visits the home on a monthly basis and reports of these visits are kept on file. Action has been taken to address the requirement of previous inspection reports in a timely manner. The information gained from regular surveys, operational manager visits and inspection reports is collated on a computerised continuous improvement plan, against which improvements are monitored. There are policies and procedures in place to govern the management of the home. The annual quality assurance assessment submitted before the inspection showed that the organisation had equal opportunities, diversity and anti oppressive policies in place, which were last updated in 2000. These should be updated to ensure that they reflect current best practice in the area. There are health and safety policies and procedures in place. Fire safety records are maintained with evidence of regular checks being undertaken and a satisfactory fire officer’s report in January 2006. Residents have been assessed as to their likely individual response to a fire alarm. Staff were upto-date with health and safety related training such as moving and handling, first aid and food handling. The accident records showed a very low incidence of injury at the home. Records were in place to show that equipment is routinely serviced and certificates were available to verify that gas and electrical checks are undertaken regularly. Staff were routinely checking fridge and freezer temperatures and hot water temperatures. Thermostatically controlled valves are fitted to all water outlets. Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 22 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 3 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 4 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 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 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 2 X 3 X Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 23 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. 1 Refer to Standard YA30 Good Practice Recommendations 2 YA40 Oakmead DS0000023075.V344541.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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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