CARE HOMES FOR OLDER PEOPLE
Shaftesbury Rest Home 49 Shaftesbury Avenue Highfield Southampton Hampshire SO17 1SE Lead Inspector
Mr Roy Bega Unannounced Inspection 13th March 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 Shaftesbury Rest Home DS0000011848.V329457.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. Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Shaftesbury Rest Home Address 49 Shaftesbury Avenue Highfield Southampton Hampshire SO17 1SE 023 8058 4478 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) northoverresthomes@tiscali.co.uk Mr Roy Clive Northover Mrs Heather Northover Ms Paula Smith Care Home 17 Category(ies) of Dementia - over 65 years of age (17), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (17), Old age, not falling within any other category (17) Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. A maximum of 3 service users in the categories DE and MD may be accommodated between the age of 55-64 years at any one time 24th January 2006 Date of last inspection Brief Description of the Service: Shaftesbury Rest Home is a care home providing care and support for 17 older people with care and support needs associated with old age, dementia and mental health. Mr and Mrs Northover have owned the home for the past eighteen years. Ms Paula Smith oversees the day-to-day management of the home. The home is situated in the residential area of Highfield and within walking distance of Portswood shopping centre. Accommodation is spread over two floors and comprises of nine single bedrooms and four shared rooms. Current weekly fees are £335 per week with additional costs being made for hairdressing, chiropody, toiletries and news papers. Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report is an assessment of how the National Minimum Key Standards for Care Homes for Older Persons were being met. Evidence has been collated from the service’s history file a returned pre inspection questionnaire and this site visit. This visit took place on 13 March 2007 between the hours of 9-30 a.m. and 4 p.m., a total of six and a half hours. Opportunity was taken to look around the home view records, observe the working environment and speak with management, staff, residents and relatives. One requirement was raised from the previous site visit. There were none raised resulting from this visit. What the service does well: What has improved since the last inspection?
The one requirement raised resulting from the previous inspection has been assessed as being met. Where the home is looking after service users money, conformation has been received from care managers to do so. Subsequent to the last inspection visit the lounge and dining areas have been redecorated and new chairs purchased. A new sink unit has been installed in the laundry.
Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 6 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. Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standard 3 was assessed on this occasion. This service does not provide intermediate care as defined by key standard 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information they need to make an informed choice with regards to moving into the home. EVIDENCE: A sample of two comprehensive assessment records was seen for most recently admitted residents. Admissions are not made to the home until a full needs assessment has been undertaken. Detailed documentation was seen for example which included residents needs with regards to dependencies, moving and handling, psychological, mobility, falls, personal hygiene and activities. Written evidence and discussions with management and relatives indicated that the assessment is conducted professionally and sensitively and has involved the family or representative of the resident.
Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 9 Relatives spoken with stated they were fully involved in the assessment process and management and staff were so kind and helpful before, during and after the move. They were provided with an information pack which included the service’s statement of purpose; objectives and philosophy of the service; a detailed account of the quality of the accommodation, qualifications and experience of staff, how to make a complaint and recent inspection findings of the Commission. They were also given a statement of terms and conditions prior to moving to the home, which sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the resident. Before making a decision they had opportunities to visit the home. Staff spoken with informed the inspector that they are made aware of prospective new residents and their needs prior to them moving into the home. Shaftesbury Rest Home DS0000011848.V329457.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): Key Standards 7, 8, 9 and 10 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are good and personal to each resident. They are written in plain language, easy to understand and consider all areas of individual’s lives including health, personal and social care needs. Personal support within the home is offered in such a way as to promote and protect residents’ privacy and dignity. Residents are supported by appropriately trained staff, who follow the homes policies and procedures for the management of medicines. EVIDENCE: A sample of four resident care plans was seen. Information recorded was written in plain language setting out personal care needs for each resident generated from their assessment. Seen documentation and discussions with staff and relatives indicated residents’ health care forms an integral part of their care plans.
Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 11 Documentation seen and discussions with staff indicated the management of risk takes into account the needs of residents and their rights for independence and choice. Records seen showed the service ensures each resident’s plan is reviewed monthly and the necessary action taken to respond to any changes. Discussions indicated residents and family members are asked to be involved. Observations, discussions and available training records indicate staff have the skills and experience to deliver care effectively. Members of staff spoken with regard care plans as working tools and respecting residents’ privacy and dignity when delivering health and personal care is a key principle of the service’s aims and objectives. Staff were observed to inform residents what they were going to do with regards to care before carrying it out ensuring dignity was maintained. Comments from residents and relatives spoken with and seen relative and visiting professionals questionnaires included, “Staff are always courteous”, “Staff are reliable”, “They know what they are doing”, “They are super”, “Staff treat my mother with respect”, “Aunt’s needs have been well looked after”, “Staff are sensitive to the needs of individual residents” and “Instructions have been attended to well”. Medication within the home is administered primarily through a monitored dosage system. The inspector was informed that any resident who has the capacity are encouraged to keep and take their own medication but currently there are not any who have been assessed as able to. Evidence was seen that staff who administer medication have completed appropriate training. Records seen were well maintained an up to date. Procedures for medication to be taken as required were in place. The staff member who assisted the inspector with the auditing of this standard was able to demonstrate an understanding of the medication currently being used and appropriate storage. Shaftesbury Rest Home DS0000011848.V329457.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): Key Standards 12, 13, 14 and 15 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to enjoy a full and stimulating life style with a variety of options to choose from. Visitors are made to feel welcome and know they can visit the home at any time. The home is conducted to maximise residents’ capacity to exercise personal autonomy and choice. Residents receive a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: Residents are able to enjoy a full and stimulating life style with a variety of options to choose from. A varied programme of activities both for groups and individuals is in place. A plan of activities provided was displayed on a notice board that included a sing along, board games, bingo and pub luncheons. Some of the residents spoken with told the inspector they choose not to take part in activities but prefer to have a “Good chin wag” with staff. This was reflected in discussions with management and staff. Throughout the day it was noted staff spent time sitting down and talking with residents in-between
Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 13 their duties. Observations and discussions with relatives and staff indicated the routines of the home are planned around residents’ needs and wishes. Systems enable the service to be flexible and changed to meet individual wishes. For example, when the inspector arrived a 9-30 a.m. there were residents (through choice) still in bed. Throughout the day it was seen where able, residents moved freely around the home independently or with the use of various walking aids. When required staff were observed to assist residents in moving around the home when they (residents) wanted to and at their pace. Records seen and discussions showed two residents make their own hot drinks, one goes out to maintain friends gardens and another likes to do their own laundry and ironing. Comments made by residents, visitors and seen relatives questionnaires included, “It is so relaxed here”, “They are friendly and helpful”, “I can do what I want when I want”, “I decide when I get up. I had a lie in this morning”, “The staff are always helpful and polite”, “Mum is free to move around” and “Staff spend quality time with mum”. Visitors informed the inspector they feel welcome and know they can visit the home at any time. Observations and discussions indicated staff always make time to talk with visitors. The layout of the home provides areas where residents can entertain their visitors, in addition to the privacy of their own room. Comments received from visitors included, “We are always made to feel welcome”, “Management and staff are so obliging”, and “They explain if there are any concerns about mum”. Food is considered to be highly important and meal times considered a social occasion. Discussions and records seen showed the dietary and cultural needs of each resident are being met. The menu is varied, balanced and nutritious. Observations showed food is served to meet the need of all residents including those who have swallowing or chewing difficulty. Staff were seen to give assistance in a discrete and sensitive manner to those residents who need help to eat. The mealtime witnessed by the inspector was relaxed. Staff were patient and helpful, enabling residents the time they needed to finish their meal whilst encouraging them to serve themselves. Shaftesbury Rest Home DS0000011848.V329457.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): Key Standards 16 and 18 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives have access to an effective complaints procedure. Staff have good awareness of policies and procedures to protect residents from abuse. EVIDENCE: The service has developed a clear complaints procedure that highlights the importance of complaining or making suggestions for improvement. The complaints procedure is provided to residents and relatives. Visitors informed the inspector they have been provided with a copy of the home’s complaints procedure, know what action to take but have not had the need to do so. The Commission has not received any concerns in respect of the service in the preceding year. Policies and procedures are in a place with regards to the protection of vulnerable adults. Staff spoken with portrayed a good knowledge and understanding of what action to take if they had any concern. Evidence was seen to show staff have completed an adult protection course as part of the service’s training programme. Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 15 Discussion with management indicated through training and supervision, care staff are supported to comply with the policies and procedures in relation to protecting and safeguarding the rights of residents. Staff spoken with portrayed good knowledge and understanding of what action to take if they had any concerns regarding adult protection matters. Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 16 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): Key Standards 19 and 26 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is accessible, safe, clean and well maintained. It meets residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: To ensure good management of routine problems, the organisation employs a maintenance/handy man to cover all it’s homes. A daily maintenance book was seen where any “snags” are recorded that require attention. Domestic staff are also employed to ensure good housekeeping management. The inspector toured the building with the home’s manager. At the time of the visit it was accessible, safe and well maintained and providing aids and equipment to meet the care needs of the residents. It was well lit, warm, clean, tidy and free of offensive odours.
Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 17 Management informed the inspector there is a rolling programme to replace existing window frames with double glazed units. Subsequent to the last inspection visit the lounge and dining areas have been redecorated and new chairs purchased. The management has a good infection control policy. They seek advice from external specialists, e.g. infection control, and encourage their own staff to work to the service’s policy to reduce the risk of infection. Staff spoken with told the inspector they have received training in respect of infection control and are provided with appropriate protective clothing and were seen to wear it during the visit. The most recent inspection report of the environmental health agency was seen dated 23 November 2006. It was noted through observations and discussions with management that requirements raised appear to have been completed. Shaftesbury Rest Home DS0000011848.V329457.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): Key Standards 27, 28, 29 and 30 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. The registered person operates a thorough recruitment procedure based on equal opportunities and ensuring the protection of residents. Staff are well trained, skilled and in sufficient numbers to meet the aims of the service and changing needs of residents. EVIDENCE: Rotas seen show the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. This was confirmed in discussions with residents and care staff. The service clearly defines the roles and responsibilities of staff through accurate job descriptions and specifications. A good recruitment procedure is in place that clearly defines the process to be followed. Records seen and discussions indicated this procedure is followed in practice. The service views induction and probationary period as being an extension of recruitment. A sample of two records was seen for the most recently appointed staff. They included all the required information and completed “Skills for Care” inductionShaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 19 training programmes. Members of staff spoken with told the inspector they have been fully supported by management on joining the team. Residents reported that staff working with them are very helpful, kind and seem to know what they are doing. This was reflected in discussions with visitors. Comments seen in relatives’ questionnaires include – “Staff have always got time to talk”, “Aunt’s needs have been well met”, “They are professional people”, “They are very proficient”, and “The staff are always helpful and polite. The service ensures all staff within its organisation receives relevant training that is targeted and focussed on improving outcomes for residents. The service uses external providers to deliver this training if they have not got the appropriate skills within the organisation. This training can be small scale and individualised if necessary in order to promote the delivery of person centred services. Discussions and records indicated management encourage staff to undertake external qualifications beyond the basic requirements, and recognise the benefits of a skilled, trained workforce. On the day of this visit staff were in receipt of first aid training. Evidence was seen with regards to the following qualification training – One member of care staff has completed the National Vocation Qualification (NVQ) level three in care. Seven care staff have completed the NVQ level two in care. Evidence seen and discussions showed short courses completed in the preceding year has included, adult protection; moving and handling; infection control; needs of the service user; health and safety; effective communication; food hygiene; care of substances hazardous to health (COSHH); managing challenging behaviour; death, dying and bereavement and fire prevention. The service is to be commended regarding having a positive attitude of providing appropriate staff training in promoting the fulfilment of its aims and meeting changing needs of residents. Staff spoken with stated that they feel well supported by management and the training provided is very helpful in assisting them to understand and carry out their work. Shaftesbury Rest Home DS0000011848.V329457.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): Key Standards 31, 33, 35, and 38 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is experienced and competent to run the home. Management and administration of the home is based on openness and respect. An effective quality assurance system is in place. Safeguards are in place to protect the interests of the residents. As is reasonably practicable the health, safety and welfare of residents and staff are promoted. EVIDENCE: The manager has been in post for twelve years, has the required qualifications and experience to run the home. Discussions and records show she works continuously to improve services and provide an increased quality of life for
Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 21 residents. Staff informed the inspector management has a strong ethos of being open in all areas of running the home and is resident focused. Relatives spoken with commented management are always approachable and available. Records and observations showed management leads and supports a strong staff team who have been recruited and trained to a good standard. Discussions indicated management is aware of current developments both nationally and by the Commission and plans the service accordingly. The service has sound policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. Discussions with staff and observations showed there are clear lines of accountability within the home. They told the inspector, management approach of the home creates an open, positive and inclusive atmosphere. Minutes of staff meetings were available. Residents and relatives spoken with commented that the management team are very approachable, always make themselves available and readily help with any problems. Good relationships between staff on duty and staff and residents’ was evident. Staff portrayed a strong loyalty towards their work and management. A quality assurance and monitoring system based on seeking the views of residents, relatives and professionals is in place. Dated and signed completed surveys were seen which included both positive and negative comments, the following of which are examples. “All staff are very pleasant and approachable”, “More trips and activities could be tried”, “Could do with another downstairs toilet”, “Carers do an excellent job”, “ Senior staff are always ready to answer any concerns” and “Staff are very open and honest”. Discussions indicated management have taken note of and rectified problems that have been in their ability to do so. The service works to a clear health and safety policy, all staff are given a copy, and regular random checks take place to ensure they are working to it. The service has a good record of meeting relevant health and safety requirements and legislation. Records are of a good standard and are routinely completed. Service records for systems and equipment were seen and are up to date. No unsafe practices were observed during the inspection. Records seen and discussions showed the service has very efficient systems to ensure effective safeguarding and management of resident’s money. Invoices/receipts were seen where the home had purchased goods on behalf of residents and requested the money from relatives/representatives. Shaftesbury Rest Home DS0000011848.V329457.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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Shaftesbury Rest Home DS0000011848.V329457.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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