CARE HOMES FOR OLDER PEOPLE
Ryecourt Nursing Home Ryecourt Nursing Home 264/266 Queens Promenade Bispham Blackpool Lancashire FY2 9HD Lead Inspector
Mrs Jackie Riley Unannounced Inspection 4th January 2007 09:30 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 Ryecourt Nursing Home DS0000006078.V312323.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. Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Ryecourt Nursing Home Address Ryecourt Nursing Home 264/266 Queens Promenade Bispham Blackpool Lancashire FY2 9HD 01253 592905 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) Ryecourt Limited Mrs Jean Hepburn Wilson Care Home 35 Category(ies) of Dementia (13), Old age, not falling within any registration, with number other category (22) of places Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 35 service users to include: Up to 22 service users in the category of OP (Older People over 65 years of age) Up to 13 service users in the category of DE (Dementia) Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the CSCI. All staff working in the home must have dementia awareness and dementia care training, which equips them to meet the assessed needs of the service users accommodated, as defined in the individual plan of care. 21st November 2005 2. 3. Date of last inspection Brief Description of the Service: Ryecourt care home provides residential and nursing care for 22 older people and 13 people with dementia. The home is situated on the Promenade, overlooking the sea in Bispham and is close to local amenities. The home is within easy access to the beach, local shops, banks, the library, public houses and bus and tram routes. Accommodation within the home includes four day rooms and two dining areas. Thirty-one single bedrooms of which twentyseven have en-suite facilities. There are also two double bedrooms. There are two individual units in the home, one for residents who are elderly and one for residents who have dementia. Both units provide a high standard of facilities, including specialist bathing and mobility equipment. The home has a Statement of Purpose and user guide providing information about the services the home will provide to residents and their families whilst living there. A copy of the Service User Guide is issued to all prospective residents and/or their families or representatives to help them make an informed choice whether to move into the home. At the time of the inspection the range of fees was £357.33 to £500.00 per week. Additional variable charges are made for Chiropody, hairdressing and additional toiletries. Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on 4th January 2007 over a period of six hours. The inspector spoke to the registered manager and four staff members including the homes cook. The inspection was carried out with the inspector spending time in both lounge areas of the home, speaking to a number of residents both individually and as a group, in order to gain an insight into how they felt about living at the home. Some residents have various levels of dementia therefore; their ability to communicate was limited. However observation of how staff and residents communicated was observed. As part of the inspection process the inspector used case tracking as a means of assessing a number of National Minimum Standards. The process allows the inspector to focus upon a small number of people who live at the home. Records relating to these persons are examined to show how they live at the home and what level of care they receive. In addition they are spoken to and their individual rooms are looked at. Any other comments or opinions are sought from other residents living at the home to give an overall picture. The response from surveys sent to residents and relatives for their views on how the home is run was good. Six completed questionnaires were returned commenting positively about how their relatives receive care at the home. A tour of the home was undertaken. Two staff records were examined and some of the homes policies and procedures were examined. This process formed the basis of the inspection. What the service does well:
The homes manager and staff team are highly motivated in providing a good service to people who live at the home. A number of residents were very positive in their comments, which included “all the staff are very good and care for everyone really well”, “They are all very caring for everyone here”. The homes environment is maintained to a high standard with a range of adaptations and facilities for people with poor mobility or those who need nursing care. This makes sure residents are comfortable and have the facilities they need for their personal or nursing care. One resident said “I get a lift in the special bath when I want one, I couldn’t do that at home”. Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 6 The home takes nutrition and choice of meals seriously. Comments included, “they always make nice meals here”, “they know what I like and don’t like”. The meals as seen, are of a high standard and attractively served, with the home using fresh produce whenever possible to make sure the diet is nutritious and well balanced. Staff spoken to had a good knowledge of special diets so that residents are receiving meals based upon nutritional assessment, which were seen following examination of some of the individual records made by the home. Staff comments included “ we get to know who likes what, and what they can eat and cant eat”. “ Some residents like to eat when it suits them and that’s no problem to us”. Six completed surveys and comments received during the inspection confirmed users of the service are aware of how to make complaints and were confident the manager would be supportive should a complaint or concern be raised. One comment included, “ If I’m not happy with something I know who to go to and know it will get sorted out” What has improved since the last inspection? What they could do better:
The Statement of Purpose does not provide information about the current staffing structure in the home and also needs to make sure the appropriate name of the Commission for Social Care and Inspection (CSCI) is included. In addition any reference to legislation must relate to Care Standards Act 2000 and Care Homes regulations 2001 and not the Registered Care Homes legislation of 1984. This information is necessary for people to know who the staff team are and for all other information to reflect the current legislation being used to regulate the home. Resident’s rooms in the dementia unit and rooms 16,17,18 in the older person unit were cool and would not be comfortable for residents to use. This was
Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 7 discussed with the manager and was found to caused by the high winds on the day and a temperature control which was to low. This was addressed at the time of the inspection but must be maintained so that the home can be used by residents at any time and be warm enough for them to be comfortable. 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. Ryecourt Nursing Home DS0000006078.V312323.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 Ryecourt Nursing Home DS0000006078.V312323.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): 1,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are not provided with sufficient information about the home to make an informed decision about living at the home. The admission and assessment procedures are clear to make sure the care needs of residents are met. EVIDENCE: The home has a written Statement of Purpose and Service User Guide. This information is provided to prospective residents and their families prior to and during the admission process so that they know what services are going to be provided to meet their individual needs. Six completed surveys confirmed the home has provided information about the home prior to admission. However observation of the document showed a number of areas need to be reviewed including the current staffing structure and reference to the Commission for
Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 10 Social Care Inspection (CSCI). Also the document needs to refer to current legislation so that people reading the document are fully informed using appropriate information. The records of three residents were looked at and included a full assessment of need, so that the home knows what and how the needs of the individual resident can be met. The manager confirmed that all residents are fully assessed by social workers or the homes manager prior to admission to the home, “so we know we can manage their needs”. One resident said “they came and had a chat with me, and told me all about how I was going to be looked after”. The home does not provide intermediate care. Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are identified and met. Residents feel their right to Privacy is upheld and is respected by the staff team. EVIDENCE: The records of three residents living at the home were examined. They included people receiving three levels of care, one requiring personal care and two residents who are provided with nursing care including one resident with dementia. The records accurately reflected the individual’s health and social care needs. Care plans were up to date even though they are currently being changed to a new system. There was evidence regular reviews are taking place, to reflect
Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 12 any changing needs in the health and personal care of the resident and how these were being actioned. The records showed the level of care being provided makes sure the welfare and general wellbeing of residents is continuously monitored. Staff members spoken to say, “we know it’s important to record everything”. Another said, “The key worker system is good because we know the specific needs of the residents we care for”. Records examined confirmed risk assessments have been completed and are constantly reviewed and updated reflecting any changes that have occurred individually and in the environment ensuring the resident’s needs are being met. Significant events had been recorded and daily entries by key workers made, demonstrating the care given. Some of the residents spoken to commented, “The staff are a good bunch, they can’t do enough for you”. “They know what you want”. The six completed surveys showed residents and families felt staff are available when needed. In respect of the care and support one comment included “they are all very caring in this home for everyone”. Care plan records confirm the home is promoting equality by treating residents as individuals and ensuring people with diverse needs are having these met. Discussion with one resident confirmed the support being provided by the home helps them to pursue their own choice of lifestyle and maintain a level of independence, which was important to them. Medication practices observed at lunchtime appeared to be safe, with the manager administering all medication to individual residents. Records including administration of medication and a controlled drugs record were seen to be completed for the people being tracked as part of the inspection process, and showed the current practices are safe. The manager spoken to about medication said, “Only qualified staff administer and manage medication so that it is safe”. It was recommended staff responsible for administration and management of medication attend refresher training in this area at intervals, so that they know about any procedural guidance, which may have changed. Staff spoken to about issues of privacy and dignity were knowledgeable about making sure all residents rights are protected. One staff member said “its really important to make sure we protect privacy and dignity especially with the residents living here with dementia”. Staff receive training in this area as part of the induction and in house training programme so that they know this area is respected for all residents. A resident spoken to said “they always knock and give a shout before coming into my room”. The home makes sure any medical alert advice from the department of health is always taken seriously with evidence of this being passed onto all nursing Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 13 and care staff so that it follows the advice given thereby protecting residents living at the home. Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are helped to exercise choice in their day-to-day lives and meals are wholesome and provide daily variation and interest for people living in the home. EVIDENCE: Residents have a good choice in meals provided by the home. Staff spoken to including the homes cook, commented on how residents can choose what they want to eat on a daily basis. Staff said, “we know the likes and dislikes of individual residents so that they eat what they like”. Food is prepared using fresh produce wherever possible and the lunchtime meal was seen to be attractive and balanced. One resident said, “I really liked that lunch it’s my favourite”. Surveys provided evidence families and residents are happy with the meals at the home. Discussion with staff confirmed there is a good understanding of special diets and how different cultures and religious faiths can have their nutritional needs met. Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 15 Activities are centred on the preferences of residents living in the home, so that they are flexible with residents enjoying their own particular interests. Care plans seen record specific interests so that staff know what they are. One resident spoken to enjoys going out every day and staff assist with this. Another resident spoke of enjoying playing cards with other residents and staff. There were seen to be arrangements for activities in the dementia unit, where staff spoken to said, “we like to do group activities which residents seem to get enjoyment with”. Visitors are welcome in the home at any time, and three groups of visitors were at the home during the inspection process. Comments received included “we can visit anytime”. Residents spoken to said they were happy with arrangements in place for receiving visitors. Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for recording and reporting complaints are good so that people feel listened to. The Management team and staff have a good knowledge and understanding of safeguarding adult issues, which protect residents from abuse. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents and relatives on admission and is included in the homes brochure ensuring the residents feel protected. Staff spoken to are aware of the complaint and abuse procedures. One member of staff said, “we all have training in complaints and abuse issues, in fact there’s training going on in this area in the next few months”. Comments seen in surveys from relatives and residents confirmed they know who to speak to should they wish to make a complaint. One resident spoken to said, “If I’m not happy with something I tell em, and know it will get sorted out”. Ryecourt Nursing Home DS0000006078.V312323.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, 25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment and building is safe cleaned and well maintained providing comfortable surrounding for residents, Heating was insufficient in some parts of the home having the potential to make it uncomfortable for residents to use these areas. EVIDENCE: A tour of the building found the home to be clean and tidy. The home is maintained to a good standard and maintenance records confirmed there is a programme of general repairs and renewal of the premises ensuring the comfort and safety of the residents is maintained. The manager said, “there is always maintenance available if anything needs doing in the home”. Comments from residents about the environment confirmed the home is well looked after
Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 18 and included, “ they’re always cleaning here”. “I like the way my room is kept”. When touring the dementia unit it was found to be cool throughout, however no residents were in their rooms at the time. The manager, who said, “it’s a really windy day, we need to turn up the control”, noted this. The home must have a consistent temperature throughout so that residents can use their rooms at any time. Low room temperatures were also recorded in rooms 16,17,18. The temperature was adjusted by the time the inspection was completed. All communal areas of the home were warm and residents spoken to said they never felt cold. There are policies and guidance for laundry processes and for the control of infection ensuring the home is kept clean, pleasant and hygienic. Ryecourt Nursing Home DS0000006078.V312323.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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The policies and procedures for the recruitment of staff are good ensuring the safety and protection of residents. Training for staff is good ensuring they have the skills and competences to carry out their roles. EVIDENCE: There has been little change in the staff team since the previous inspection. Staff records seen include, application and interview forms, individual identification and Criminal Records Bureau (CRB) disclosures. These completed documents ensure recruitment procedures are safe. Staff comments included, “ I didn’t start work until I had all the checks”. It is recommended staff who have had a criminal record disclosure for more than three years have new disclosures in place for the protection of users of the service. References were in place to ensure the residents are protected. The registered manager is aware of the recruitment procedures and checks required by legislation, so that safe practices are in place. The manager said “ All new staff go through all the necessary checks before they work in the
Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 20 home”. One staff member said, “I had to wait for my checks to come back before I could start work”. Examination of staffing rotas showed staffing levels were sufficient for the number of residents living at the home and on duty at the time of the inspection. Residents said they were happy with the care they receive from the staff and management team and were well treated. A number of residents spoken to said, “I really like living here”. “The staff can’t do enough”. Through observations made during the inspection there was evidence of good interaction between staff and residents, which showed how relaxed and comfortable they are living in the home. Training records seen and discussion with the manager confirm the home has over 50 of care staff who have completed NVQ (National Vocational Qualification) level 2 in care, which ensure staff have the skills and competencies to provide care and support for the residents. Staff spoken to said “we can go on training whenever courses come up, there are three coming up in the next few months which we can go on”. The courses include, safeguarding adults, First Aid, Dementia and Health and Safety, which all benefit both residents and staff. Ryecourt Nursing Home DS0000006078.V312323.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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and systems in place for the protection of staff and residents are good. EVIDENCE: The registered manager demonstrated she has the knowledge, skills and competencies to provide the support to staff and care to the residents. Residents and staff members were very positive in their comments about the homes owners and manager. Residents found the manager to be approachable, supportive and helpful. Residents comments included, “the managers always there when you need her”. “If I need anything from the
Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 22 office there’s always someone there to help”. Staff comments included, “the manager is very supportive”. “We can always go and get advice whenever we need to”. Examination of policies, records and information received from the home prior to the inspection confirmed regular tests to emergency lighting, fire procedures and extinguishers had been carried out ensuring the safety and protection of residents and staff is maintained. The home has an annual development plan in place in order to continue to develop the home to ensure the safety and comfort of the residents. Regular staff and resident meetings are held and recorded and suggestions are carried out if agreed by both parties. One resident spoken to said, “The staff are always willing to listen”. Inspection of records for residents were comprehensive, well written and up to date ensuring staff are aware of residents needs. Ryecourt Nursing Home DS0000006078.V312323.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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 N/A 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 2 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 Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 24 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 OP25 Regulation 23(2)(p) Requirement All areas of the home must be adequately heated at all times for the comfort of people living and working at the home. The inspection noted that in the dementia unit individual rooms were cool and rooms 16,17,18 on the older persons unit were also cool. The temperature was improved by the end of the inspection but this must be consistent. Timescale for action 04/01/07 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. Refer to Standard OP29 OP9 Good Practice Recommendations All staff who have been in post for over three years should have a renewed criminal records disclosure for the protection of users of the service. All staff responsible for drug administration would benefit from attending refresher courses medication so that they are up to date with current guidance and procedures.
DS0000006078.V312323.R01.S.doc Version 5.2 Page 25 Ryecourt Nursing Home Ryecourt Nursing Home DS0000006078.V312323.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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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