CARE HOMES FOR OLDER PEOPLE
Seathorne Court Winthorpe Avenue Skegness Lincolnshire PE25 1RW Lead Inspector
Vanessa Gent Unannounced Inspection 9th January 2008 09:15 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 Seathorne Court DS0000070081.V356564.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. Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Seathorne Court Address Winthorpe Avenue Skegness Lincolnshire PE25 1RW 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) 01754 765225 Gungah Care Limited Sadesh Gungah Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC To people of the following gender: Both Whose primary needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP 2. The maximum number of people who can be accommodated is: 18 Date of last inspection This is a new service. Brief Description of the Service: Seathorne Court has had new owners since August 2007. It is a care home providing personal care for up to eighteen older people of both sexes. The home is situated in a side street, at the north end of Skegness, close to the beach. It is within 500 metres of pubs and amusements and within half a mile of the town centre where there are many facilities for shopping, entertainment and refreshment. The accommodation is made up of single rooms on two storeys, with a bathroom shared between each two bedrooms. Three of the baths have assistance facilities. A passenger lift gives access for residents with restricted mobility to the first floor. Communally, there is a large lounge, casually sectioned into three smaller areas to create a more relaxed, intimate atmosphere. There is one dining room. Both the lounge and the dining room are south facing so are “bright and ‘catch’ the sun”. There is a small kitchenette on the ground floor where visitors and residents can make drinks during the day. The home has a secure garden at the rear of the property and off-road car parking at the front of the home. A large proportion of the garden is gravel but there is a small area of lawn and shrubs for residents to sit in. The home’s philosophy of care is to provide the residents with a place that they feel is their own home and makes them feel comfortable and safe.
Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 5 The provider keeps a printed copy of the latest inspection report at the home, which is available for people using or enquiring about the service. The fees range from £348 for low to £391 for high dependency residents. Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes.
An unannounced visit was made to the home as part of a key inspection. It started at 09.15 and lasted six hours. We took into account previous information held by The Commission for Social Care Inspection (CSCI) including the home’s service history and information received anonymously since the new owners took over the home. Prior to the visit the providers had returned their Annual Quality Assurance Assessment (AQAA) and this will be referred to throughout this report. Six surveys were received back from residents. One had very positive comments about the level and quality of care given; two had ticked all sections as always good or complied with. One survey had ticked in all sections that everything was usually satisfactory. One said that activities were only sometimes available for them to join in. Three staff had returned surveys. Two said that almost everything about the service is positive and good; the other survey had several sections ticked as usually reasonable. The site visit focused on whether key standards and requirements from previous inspections had been met and how the residents feel about the service provided. Three residents’ assessments and care plans were examined to ensure the health, safety and welfare of the residents is checked and that residents are allowed dignity, autonomy and choice. A partial tour of the home was made and a sample of other records examined. Two staff on duty, twelve of the sixteen residents and several visitors, including relatives, spoke with the inspector. The provider-manager was present throughout this inspection visit. What the service does well:
The home provides a clean, comfortable, homely place for the residents to live in. The provider/manager and staff make the residents feel safe and content. Residents and relatives said that the staff provide good care and treat the residents with respect and dignity.
Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 7 One staff, commenting in the staff survey, said, “[the home] promotes care, equality, dignity, respect, religion, diversity”. What has improved since the last inspection? 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. Seathorne Court DS0000070081.V356564.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 Seathorne Court DS0000070081.V356564.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, 2, 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with enough information to enable them to make an informed decision about moving into the home. The pre-admission assessment is detailed to enable the home to know enough about the resident to identify that they can meet the needs of the resident once they move in. EVIDENCE: A copy of the current statement of purpose and service user guide has been prepared and was displayed in the foyer. It informs prospective residents and visitors about what the home provides in the way of care, facilities and service. The provider said its review is ongoing as they improve the service provided. Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 10 A copy of the terms and conditions contract has been prepared but not yet distributed to residents. It gives the number of the room to be occupied and will be signed and dated by both the manager and the resident or their representative. Care plans showed that a comprehensive pre-admission assessment is done by the manager for all prospective residents to ensure that the home knows they can meet the resident’s needs. These are then used by the manager as the basis of the resident’s care plans once they move in. One resident said they were visited in their own home and the provider filled in a form, before they moved into the care home. Residents and families said they are welcomed and encouraged to visit the home at any time before they make up their mind. Seathorne Court DS0000070081.V356564.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 adequate. This judgement has been made using available evidence including a visit to this service. Although residents have care plan documents in place, their needs may not be met fully if the staff and residents are not routinely involved in the creation and review of the care plans. There is good liaison with other professionals and safe medication practices. The residents’ dignity is respected by conscientious and caring staff. EVIDENCE: Roughly half of the residents had new care plans in place. These were improved on the previous care plans but the manager said that he is aware that there is still room for further development and involvement of the residents. Residents said they would like this and look forward to having input into their own care plans. Before the inspection visit, concerns were raised that there was no communication between staff and the manager.
Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 12 During the visit staff said they do not always fully participate in the creation and reviews of the care plans; however, they said they have good ‘handovers’ and there is very good communication between them, and with the manager, to ensure they know how to care safely and efficiently for the residents at all times. The communication book was well-filled and showed signs of plenty of wear and use. It was used by the morning staff handing over to the afternoon staff. The care plans demonstrate that there is good liaison between the manager and healthcare professionals who visit the home. Residents said that the staff call in doctors and district nurses when they are poorly and they get visits from the chiropodist, dentist and other healthcare people as necessary. Relatives said they are confident that the residents’ health needs are attended to and that the staff and manager will contact them if the resident is ill. The supplying pharmacist visits the home regularly, inspects and reports on their practices and trains senior staff to administer the medicines safely. A staff member said that they are due to have training in the safe administration of medicines to ensure their practice continues to protect the residents at all times. All residents gave a resounding “Yes!” when asked if staff treat them in a respectful and dignified manner. One resident with special dietary needs said food is served in a dignified manner, which they appreciate. A visitor said their relative is very happy at the home and that the staff are lovely, very friendly, courteous and respectful to the residents whenever they visit, which is often. One staff member said “we are a listening staff. We do as the residents wish and all are pleasant to them.” This was confirmed by relatives and visitors as well as the residents. Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. An insufficient variety and quantity of activities means that some residents are not always as occupied as they would like to be. Residents have choice in all other aspects of their lives, including the food provided, and are content and comfortable living at the home. EVIDENCE: Residents, relatives, staff and the provider all agree there is not enough variety or quantity of activities. Residents all voted to have weekly bingo, a session of which took place during the inspection visit. This was obviously enjoyed by the residents and visitors who joined in. There was a very happy atmosphere in the lounge. Because of the low dependency needs of some residents and because some are able to go out on their own into the town or to attend local events or activities, these residents say they are not too affected by the limited activity provision; it does not have too much an impact on them. Others, who are not so mobile, say they are looking forward to having more activities provided.
Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 14 One relative says “there wasn’t enough before for them to do but this is getting better”. The job of activity organiser has been advertised, along with those for caring staff, cook and cleaner. At least ten people phoned the provider during the inspection visit, enquiring about the job vacancies advertised. Some relatives say they are happy and willing to help in providing activities and keeping the residents occupied and busy. Visitors and relatives say they feel very welcome at any time. Residents say they are given autonomy and choice in all aspects of their lives. They say they enjoy the food, and that the provider and cook have discussed with them what they would like. The cook tries to tempt them with a wide variety of foods, some of which the residents want to keep on the menu, some they are not so keen about. One resident says in their survey response, “There is always a good variety in the meals. Well cooked and served.” Although a concern came to our attention before the inspection about a lack of choice and quantity in food, it was confirmed that all residents have choice at breakfast, one person wishing to have, and getting, a boiled egg every day. A choice of cereals, tinned breakfast fruit and fruit juice plus toast are offered daily. We ate lunch with the residents. It was a tasty three-course meal with soup, the entrée with potato and two vegetables and pudding. The residents chatted during the meal and staff interacted well with them. Residents agree it is a pleasant experience for them and they enjoy the food. A choice of cold drinks is available in the lounge all day and residents can ask for hot drinks at any time. Visitors say they are always offered refreshment or can make themselves a drink when they arrive. Visitors sometimes stay for meals with the residents. Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by knowing they can always voice any concerns, will be taken notice of and that concerns will be responded to, and by staff who are trained to prevent abuse and who are conscientious and caring to the residents at all times. EVIDENCE: A copy of the complaints policy is displayed in the entrance foyer. In their survey responses, and in conversation with them, residents say they know who to go to if they are not happy with any aspect of their lives in the home. Relatives also say they would be happy to take any concerns or issues to the providers or to staff and that they are sure they would be listened to. One resident says, in their survey response, “If I wish to know anything I speak to the managers who always listen to me.” None of the residents or visitors voiced any concerns during the inspection visit and all residents say they feel safe and well-cared for by the staff and providers. However, there has been a need for Social Services to investigate two concerns made known to them about the welfare and dignity of residents. The
Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 16 providers have responded to these appropriately and are assisting in the process of resolving the concerns raised, putting measures in place to address the issues. During the visit he was able to show records to illustrate how he has responded to the issues. See also the section on ‘Staffing’. Staff training was undertaken on 5th December 2007 for all staff in how to protect residents and prevent abuse or neglect. Residents say staff are “very kind”, “thoughtful” and “lovely”. Seathorne Court DS0000070081.V356564.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, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provider and staff provide a safe, comfortable and clean environment to ensure the residents are well cared for and feel ‘at home’. EVIDENCE: The home is clean, tidy and fresh smelling. A resident says, in their survey, “The rooms are cleaned every day fresh towels and linen and dirty garments washed and returned in excellent condition.” This was confirmed in the rooms of the residents we case-tracked and by chatting to all the residents in the lounge. Residents, relatives and visitors say they feel the home is safe, relaxing and homely. Many residents have personalised their rooms with their own furniture and ornaments. Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 18 Several residents have mobility scooters in which they visit friends, go shopping and attend local events. These scooters are kept and re-charged in a lockable garage at the back of the premises. The laundry, bathrooms and toilets are all clean areas. Hygiene practices are in place to prevent infection. Cleaning staff are employed five days a week. We discussed with the provider about ensuring cleaning staff work each day to ensure that caring staff do not have to leave their work to attend to cleaning needs in the home. The provider has advertised for more staff and received enquiries about the post during the inspection visit. Seathorne Court DS0000070081.V356564.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 adequate. This judgement has been made using available evidence including a visit to this service. The residents are cared for safely by staff who are well-trained, conscientious and concerned about them. Staffing levels need to be increased to ensure there are enough staff members available to care for residents safely at all times. EVIDENCE: Prior to the inspection visit, we received some concerns that there were not enough staff to care for all residents safely and without “rushed” care. During the visit we looked at the staffing levels. The staff duty rotas show that two staff are on duty on all shifts, but in addition to these, the owners are on the premises almost every weekday morning and most afternoons. The owners say they are also ‘on call’ and live not far from the home, so can be asked to come to the home at short notice, if needed. Staff members said they have been happy to cover any shortfall in staffing with overtime but are looking forward to having more staff to work with. One staff member, in the staff survey, said, “We are short-staffed but manage well. We are a dedicated team that thinks a lot of the residents and new owners”.
Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 20 The provider said he realises that the staffing levels could be improved and during the inspection visit, at least ten phone-calls were received from people enquiring about the job vacancies being currently advertised. Caring, catering, cleaning and activity jobs are to be filled. Residents said they are not rushed, that call bells are answered “quite quickly” and that they feel well-cared for by “lovely girls”. One resident in their survey stated, “I find the care and attention more than adequate. If you need attention at night the carers are always there to help.” When asked about the staff attitude, one resident says “I have no complaints about any of them. They bend over backwards to help. The ones here now are good staff.” One relative says, “I can’t fault them [staff].” They did also comment that they don’t feel there are enough staff on duty sometimes though. Senior staff say they are happy to take the new staff under their wing and help with their induction. The manager told us that new staff will have a sufficiently long induction period to ensure they are well trained and experienced enough to meet the needs of all the residents. Documents are in place to check this takes place. The providers have put together new staff files that show that recruitment checks are done to safeguard the residents and records are kept of training, discipline and all other necessary documents. Staff say that the amount of training has greatly improved since the new owners took over and that they feel supported by the providers in this. The providers use an external trainer for most training and certificates are issued when the training is completed. We saw a list of training subjects and dates that are planned for 2008, including compulsory training for the new staff and update training for established staff. Seathorne Court DS0000070081.V356564.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, 32, 35, 36, 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 run by a provider-manager who is appreciated by the residents, who supports the staff with good training and communication and who is aware of what he still needs to put in place for good practice. Residents feel safe, happy and enjoy living at the home. EVIDENCE: Both providers are trained nurses and have left the NHS to work in the private sector. Residents say “they are friendly and smile and talk to us whenever they are around”. “You can go to them. They will help you if you need it.” Staff say “The manager listens and takes things on board”.
Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 22 According to the Annual Quality Assurance Assessment form (AQAA) the providers completed prior to the inspection visit, the providers stated they have commenced residents’ meetings. Residents confirmed that the providers speak with them and ask for their opinions, wishes and choices. The providers have a large number of ideas they want to put into practice in the home, including establishing resident and relative satisfaction surveys. Residents take care of their own personal allowances but do not have lockable facilities. Providing this would make sure they could be confident that their personal belongings are safe. Some staff have complained that they did not have regular supervisions with the manager. In the two staff surveys we received, they said the manager meets regularly with them to support and discuss how they are working. Staff said he is supportive of them in their work. The manager said he is shortly going to establish regular one-to-one contact sessions with staff to discuss all aspects of their work, to make sure the care they provide is what the residents want and need. All aspects of health and safety are in place, including testing of portable equipment, keeping of maintenance records and maintaining fire safety and hygienic practices throughout the home. One resident, in their survey, echoed the opinions of other residents I spoke with, “I find the home very comforting. I never wanted to be in a home. But am more settled and would not like to be anywhere else.” Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 2 2 X 3 Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 15 Requirement Residents must be consulted on the creation of their own care plans, to ensure their needs and wishes are recorded and met. Activities must be provided in sufficient quantity and variety to meet the needs and wishes of the residents. The staffing levels and a suitable mix of skills must meet the needs of all the residents at all times. Staff must be appropriately supervised in their working practices to safeguard the residents. Timescale for action 09/03/08 2 OP12 16(2)(n) 09/04/08 3 OP27 18(1) 09/03/08 4 OP36 18(2) 09/04/08 Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 25 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 OP7 OP35 Good Practice Recommendations Staff should be knowledgeable of what is in the care plans to ensure that care of the residents is given safely and efficiently at all times. Residents should have individual lockable facilities in their own rooms in case they have charge of their own personal allowances, may have valuables and may wish to control taking their own medicines. Seathorne Court DS0000070081.V356564.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Midland Regional Office Edgeley House Tottle Road Riverside Business Park Nottingham NG2 1RT 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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