CARE HOMES FOR OLDER PEOPLE
Royd Hill Nursing Home Royd Hill Nursing Home Sutton Lane Sutton in Craven Keighley West Yorkshire BD20 7AJ Lead Inspector
John McGarva Key Unannounced Inspection 9th May 2007 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 Royd Hill Nursing Home DS0000064544.V335930.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. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Royd Hill Nursing Home Address Royd Hill Nursing Home Sutton Lane Sutton in Craven Keighley West Yorkshire BD20 7AJ 01535 633499 01535 636668 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) www.roydhill.co.uk Royd Hill Nursing Homes Ltd ****Post Vacant**** Care Home 46 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10), Old age, not falling within any other category (36), Terminally ill (4) Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 29th June 2006 Brief Description of the Service: Royd Hill is a care home providing nursing care for up to 46 service users who have general nursing care needs, dementia and mental illness and those who are terminally ill. The original building, which is in stone, circa 1900 was a Mill owners dwelling and an extension was built on about fifteen years ago. The accommodation is on three floors, including the basement and there is a vertical lift to facilitate level transfer to all of them and a stair lift from the ground to first floor is also provided. The home is located in Sutton-in-Craven and is situated in well-laid out private grounds with ample parking facilities for visitors and staff. The fees charged at 09/05/07 are between £375.50p - £498.95p per week. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection, which took place on Wednesday 9th May 2007 and Mrs Barbara Corney the manager who has been in post since April 2006 was available to assist throughout the inspection. Mrs Susan Funnell, a senior registered nurse, was also available. The inspection commenced at 10.00hrs and finished at 14:30 hrs. Three hours of preparation time was deployed and information from the Regulation Inspector’s inspection record, which included a detailed history of the home and relevant information about what had been happening in the home since the previous inspection visit was also used. A pre-inspection questionnaire was also prepared by the manager and given to the inspector on the day of inspection. Discussions took place with the Manager, nurses, care staff and residents. What the service does well: What has improved since the last inspection?
There has been some refurbishment, including: New carpeting corridors, lounges and 38 individual rooms. Non-slip surfaces for bathrooms, toilets and staff room. Six ‘fire-guards’ have been provided for the fire doors. Sixteen new bed tables provided for the resident’s rooms. Sixteen new hoist slings and handling belts. Three additional adjustable ‘profiling beds’, which enable the position and therefore the comfort of the resident’s to be enabled.
Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 6 At the last inspection water temperatures to two baths were greater than 43 degrees centigrade. Mixer valves have now been fitted to these thereby helping to ensure a safer environment for the residents. A plumber is at present fitting mixer valves to the sinks in the resident’s rooms. A new ‘Stand-Aid’ has now been provided and this helps facilitate the transfer of the residents to different surfaces without needing to be hoisted up in a sling. Three new sluice disinfectors have been purchased, and two have yet to be installed. Liquid soap and disposable towel dispensers have now been provided for each of the bedrooms, bathrooms, sluice rooms and laundry. The care staff deploy bactericidal pure alcohol rub, which they carry about in their pockets to help reduce risk from cross infection. All these measures help ensure a safer environment for the residents insofar as infection control is concerned. There is a focus on staff training and there are records to see for each member of staff. NVQ training is ongoing and twelve of the care staff have undergone this, making the total numbers so qualified 48 , an increase of 10 since the last inspection. The care plans have now been more particularised to the individual residents in line with recommended practice. They address issues relating to all the activities of daily living and this will help ensure that identified needs are met. The weight of the residents is now routinely recorded on a monthly basis, as there have been new sit down scales provided. This will help in monitoring the resident’s health. What they could do better:
The care staff does not have sufficient time to fully address the social needs of the residents and an activities organiser would be of great help with this. Secretarial / clerical support would assist the manager with her significant managerial tasks helping her to focus her skills and time on the care of the residents. There are six bathrooms and ten toilets, but not all of the bathrooms are in use as there are problems with the water pressure, hot water temperatures and lack of hoisting equipment. Bringing all the bathrooms into use will enable the residents to be bathed nearer to where their bedrooms are located. The provision of hoist tracking systems would be of great assistance for the bathrooms, which do not have sufficient space for floor standing hoists to be deployed.
Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 7 This was discussed with the manager who agreed to look into this. Improvements are required to the ventilation in the laundry. 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. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 8 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 Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 9 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): 3&6 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 records to evidence that the residents’ needs are sufficiently assessed so that their care plans can be developed. EVIDENCE: Evidence from the case tracked residents records confirmed that pre-admission assessment sheets are completed prior to admission. The manager usually undertakes these either in hospital or the resident’s place of residence prior to admission. Intermediate Care (Standard 6) is not provided in this home. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 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. A good standard of care is being provided by staff that is well-motivated in what they do. Improvements have been made to particularise the care plans, and monthly reviews are taking place which will help in ensuring identified needs are met. EVIDENCE: Individual plastic covered folders are available for each of the home’s residents into which all information relating to their care plan and needs are kept. There is an additional folder into which the social history, interests, likes and dislikes are recorded. The care staff rather than the nursing staff are involved in this aspect of documentation. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 11 The care plans have now been more particularised to the individual residents in line with recommended practice. They address issues relating to all the activities of daily living and this will help ensure that identified needs are met. The weight of the residents is now routinely recorded on a monthly basis; as there have been new sit down scales provided. This will help in monitoring the resident’s health. The care staff is being encouraged to participate in the recording of the care they provide rather than just the nurses as was previously the case. There is a nurse allocation system being introduced whereby individual named nurses have responsibility for the care plans and care of a cohort of residents. Each of the residents rooms are provided with lockable space so that they may store their valuables or medication in safety should they so wish. The residents spoken to appear happy and said they were very pleased with the care they received in the home and it was evident that the staff had a good rapport with them. All looked clean and well dressed and there was no raised voices or evidence of distress, which can sometimes occur in homes that care for the EMI client group. The storage and administration of medications is managed in accordance with recommended practice. The medications are stored in two locations, one downstairs and the other on the first floor of the dementia unit. A 28-day blister pack system (Manrex) is in use and seems to be working well and all medications are faithfully recorded in line with recommended practice. The management of the disposal of drugs is done in accordance with recommended practice and there is a special container with chemicals which, when mixed with water render the drugs unusable. Royd Hill Nursing Home DS0000064544.V335930.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 & 15 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 care staff endeavours to meet the residents social needs but an activities person would improve their quality of life. The quality of the meals provided is good, with fresh vegetables and meat being routinely available. EVIDENCE: The care plans gave information about the resident’s family and friends and how they could be contacted. A folder has been developed which includes the social histories and leisure preferences of all the residents and is in the main completed by the care staff rather than the nurses. There is a programme of activities posted on a monthly basis with various quizzes, clothes parties, bingo, baking, concerts and shopping trips arranged.
Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 13 The care staff does not have a lot of time to fully address the needs of the residents in regard to activities and an activities organiser would be of great help. The post of activities organisers has not yet been filled and this gap in provision is one in which the care staff are aware of and wish to see addressed. This was a matter raised at the last inspection and for which a recommendation to address it was made, but so far no action has been taken. The home’s visiting arrangements are flexible so that the residents are able to see relatives and friends whenever they wish,day or night. A physiotherapist visits the home and provides group armchair exercise classes for the residents. There is a menu board and the resident’s can chose their main courses prior to it being served. Choices at breakfast, lunch, tea and supper are provided on the day as proffering choices the day before was found not to be impractical given the frail mental state of many. The residents spoke very favourably about the quality of the meals. Fresh vegetables are always provided and that butter and cream were also readily available. Full cream milk is provided as well as semi-skimmed. Most of the residents require help or supervision with their meals and staff are trained on how best this is to be done. Where liquidised food is indicated, this is done in accordance with good practice in that the individual elements are treated separately thereby providing attractive and flavoursome meals. Bowls and guards are deployed to help enable the residents to feed themselves where indicated. The dining room on the Cricket Wing (EMI unit) is not big enough to accommodate all the nine residents located there but many prefer to eat in their own rooms. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 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 has a relevant complaints procedure and the staff have received abuse awareness training. EVIDENCE: The complaints procedure of the home meets the required standard. Care staff are aware of how to respond to any complaints made by either the residents or their representatives. There have been no complaints made about the service either to the home or the CSCI since the last inspection. There are records to show that there has been recent training of the care staff in abuse issues and their responsibilities in this regard. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The environment is comfortable, and improvements have been made to address some of ssues raised at the last inspection. Improvements are required to the bathing facilities to ensure that they are all available for use. EVIDENCE: The home meets the standards for homes registered before 2002. There are 32 single and 2-shared rooms. Only five of the single rooms have benefit of en-suite toilet facilities with the resultant need for commodes to be deployed.
Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 16 The home is registered for 46 residents, however 5 of the shared rooms have only one resident in occupation at present and the home is planning to expand the building at some point to provide more single en-suite accommodation. There has been some improvements made in the home in recent times and these include: New carpeting has been provided for corridors, lounges and 38 individual rooms. Non-slip surfaces for bathrooms, toilets and staff room. Six ‘fire-guards’ have been provided for the fire doors. Sixteen new bed tables for the resident’s rooms. Sixteen new hoist slings and handling belts. Cleaning staff trolley Laundry trolley. Radio call system. Three additional adjustable ‘profiling beds’, which enable the position and therefore the comfort of the resident’s to be enabled. Each of the resident’s rooms has a lockable drawer where they can keep their private things. There is a member of staff employed who is responsible for the routine maintenance of the premises and facilities. There are six bathrooms and ten toilets but not all of the bathrooms are in use as there are problems with the water pressure, hot water temperatures and lack of hoisting equipment. The provision of hoist tracking systems would be of great assistance for the bathrooms, which do not have sufficient space for floor standing hoists to be deployed. This was discussed with the manager who agreed to look into this. At the last inspection water temperatures to two baths were greater than 43 degrees centigrade. Mixer valves have now been fitted to these. Bringing all the bathrooms into use will enable the residents to be bathed nearer to where their bedrooms are located. The temperature of the water to many of the sinks in the resident’s rooms is not controlled and is subsequently greater than 43 degrees. A plumber is at present fitting mixer valves so that the temperature will not exceed 43 degrees centigrade. There are a range of power assisted hoists provided and a new ‘Stand-Aid’ has now been provided and this helps facilitate the transfer of the residents to different surfaces without needing to be hoisted up in a sling. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 17 Three new sluice disinfectors have been purchased, and two have yet to be installed. Liquid soap and disposable towel dispensers have now been provided for each of the bedrooms, bathrooms and sluice rooms. The care staff deploy bactericidal pure alcohol rub, which they carry about in their pockets to help reduce risk from cross infection. These measures help ensure a safer environment for the residents insofar as infection control is concerned. The laundry is located in the basement floor and is equipped with up-to-date washing and drying machines as well as a roller press. The laundry lady keeps the room immaculately clean and tidy. There is a large window, which can open, but too large to be opened to any significant degree due to obstructions in the room and in consequence the room is uncomfortably hot. Additionally there is a large hot water tank located in the room adding to the temperature problem. A two-way fan is recommended and as there is already an open-air vent in the wall this would seem to be technically easy option to consider. This was recommended at the last inspection, but so far no action has been taken. There is now a liquid soap dispenser and disposable paper towels available in this area in keeping with best-recommended practice to reduce risks from cross infection. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 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. Satisfactory recruitment practices are followed ensuring that appropriately screened staff are provided to care for the residents. EVIDENCE: The staff felt that they were able to provide a good level of personal care but that a dedicated activities person would provide more time spent with the residents and give them more local trips to the local village etc. Staff spoken to say that they enjoyed working in the home and were supported in the work they do by means of training and other support. NVQ training is ongoing and twelve of the care staff have undergone this making the total numbers so qualified 48 and increase of 10 since the last inspection. One of the care staff has commenced NVQ Level 3 and two have embarked upon NVQ Level 2 training. All staff have received training in Health & Safety, First aid, Moving & Handling, Fire Safety,and Abuse awareness. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 19 A member of staff who has a Certificate in Education helps to deliver the mandatory training. Some staff had recently had training in Palliative care and Infection control and this helps ensure that the staff have the skills necessary for these vulnerable residents. There are six members of staff trained to First Aid at Work level.(FAW) Health & Safety training had been given to the kitchen and cleaning staff. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 20 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. 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 caring ethos, which is evident in the quiet ambience of the home. Some clerical / secretarial assistance is required to help the manager in her work. EVIDENCE: A manager has been in post since April 2006 and has submitted an application for registration to the CSCI. She is a registered general nurse with some years spent in research and is at the present time embarked upon a doctoral in public management. She has a
Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 21 BSc in nursing studies and a postgraduate diploma in advanced nursing practice. There is a need for some clerical/ secretarial assistance to help the manager in her work and enable her time to be focussed in the care of the residents. The staff spoken to confirm that the manager is approachable and that there had been meetings convened with the care staff to keep them informed about matters relating to the management of the home. Some of the care staff have worked in the home for many years and very much liked the ambience and philosophy of the home. The care staff spoken to say they had received individual supervision, which helps identify their training and support, needs. All policies are now dated and staff sign to evidence that they have seen and understood them. There is now a written policy for bathing which identifies all recognised risks. A quality assurance survey had been undertaken in recent times with good response and results reported about the quality of the care the residents receive. The home is not involved in any of the finances of the residents. The lack of hot water control in bathrooms and residents rooms is now being addressed by the installation of mixer valves so that the temperature in resident areas does not exceed 43 degrees centigrade. The records of servicing records of the hoists, gas appliances, lifts etc were seen and were satisfactory. There was an electrician present on the day of inspection attending to the issuing of a wiring certificate, which will be issued in the next few days. A fax of the new certificate has been received in the CSCI office and is dated 16/05/07 and is valid for twelve months. Royd Hill Nursing Home DS0000064544.V335930.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 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 X X 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 1 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 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 OP21 Regulation 16 & 23 Requirement All bathrooms must be made safe and in usable conditions. (Previous timescale of 30/03/06 not met). Timescale for action 01/10/07 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 3 4 Refer to Standard OP12 OP21 OP26 OP31 Good Practice Recommendations An activities organiser should be appointed to help the residents with their social needs. Consideration should be given to installation of hoist tracking systems so that all the bathrooms can be used. A two-way fan should be provided in the laundry to make the environment more tolerable for the staff. Secretarial / clerical support should be provided to assist the manager with her significant managerial tasks. Royd Hill Nursing Home DS0000064544.V335930.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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