CARE HOME ADULTS 18-65
Silverdene 709 Moston Lane Moston Manchester M40 5QD Lead Inspector
Helen Dempster Unannounced Inspection 21st November 2006 11:30 Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Silverdene Address 709 Moston Lane Moston Manchester M40 5QD 0161 682 4901 F/P 0161 682 4901 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) Mrs Maria Hughes Mrs Maria Hughes Care Home 7 Category(ies) of Learning disability (7), Physical disability (1) registration, with number of places Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. A maximum of 7 service users can be accommodated at any one time. One named service user is physically disabled (PD). Should this service user no longer be accommodated then the place shall revert to Learning Disability (LD). 5th January 2006 Date of last inspection Brief Description of the Service: Silverdene is a privately owned residential home which is registered to provide 24 hours personal care and accommodation for six people with a learning disability and one person with a physical disability. The accommodation is also part of the registered providers family home and residents are treated as part of the family. The property is a large dorma bungalow with a separate detached property, which has been recently built to the rear of the main house. The main house can accommodate 5 residents in ground floor single rooms and the detached external extension building can accommodate a further 2 residents. All bedrooms are single and are furnished to a very high standard. One room has a purpose built en-suite shower room to meet the needs of the individual resident. One large lounge area was available for residents to use. A wellfitted kitchen and dining area was available which led out to a separate utility area to accommodate the laundry facilities. The range of fees charged by the home are between £500:00 per week and £750:00 per week. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was conducted by gathering lots of information about how well the home was meeting the National Minimum Standards. This included the manager filling in a questionnaire about the home, which gave information about the residents, the staff and the building. Questionnaires about the service were sent to the home prior to the inspection and all 4 residents completed questionnaires. The inspection also included carrying out an unannounced visit to the home on 21st November 2006 from 11:30am to 5:30pm. During this visit, lots of information about the way that the home was run was gathered and time was taken in talking with the residents and the staff team about the day-to-day care and what living at the home was like for the residents. Other information was also used to produce this report. This included reports about events affecting residents that the home had informed the Commission about. The main focus of the inspection was to understand how the home was meeting the needs of the residents and how well the staff were themselves supported by the home to make sure that they had the skills, training and support to meet the needs of the residents. What the service does well:
There are many things that the service does well. These include the following: The home gives residents lots of information, which was easy to understand and included pictures, about the services offered. This helped them to make a choice. Residents’ needs are assessed, talking account of their wishes, before they move into the home. Assessments talked about what the resident “liked” to have and do. This is good for the residents. Care plans talked about residents’ “strengths”, “needs” and “wishes”, so they explained what residents could do independently and what they needed help with. It is good that resident’s individual needs were clearly written down and respected in this way. Reviews of each resident’s care plan were held every 2 months, which included a discussion with residents about their preferred hobbies and interests and any changes in their needs and wants. Residents were helped and encouraged to take part in social and leisure activities e.g. going to the shops and the pictures and were given the food that they preferred to eat.
Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 6 Residents said that they “liked” the food and the things they liked and disliked were recorded on their files. Residents were supported by staff in a way that maximised their dignity and independence. This included choosing their own clothes and hairstyle and which staff helped them. The home has a clear complaints procedure and all residents have a copy of this and knew who to talk to if anything was bothering them. Staff spoken to had a good understanding of adult protection issues and had received training, in November 2005, in abuse awareness. Residents live in a warm, comfortable, well maintained home, which they were happy with. Residents said that they liked their rooms and chose to spend a lot of time there doing activities they enjoyed. Staff said that they were well trained and well supported and supervised by the manager. Staff liked being a keyworker to residents because this meant that they “knew all about” that particular resident. What has improved since the last inspection? What they could do better:
While care plans were clear and detailed they were not backed up with clear risk assessments about residents’ daily life and support. Advice was given on linking risk assessments to the care plans and a requirement was made about this. Residents’ confidential files were stored on open shelving in the hallway. This may lead to a breach of confidentiality and Data Protection Legislation and a requirement was made about this. The storage and recording of some medication was not safe and a requirement was made about this. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 7 Liquid soap and paper towels were not provided at the home to reduce the risk of cross infection when staff were dealing with bodily fluids. A recommendation was made about this. Residents’ had access to a shower room and also to one bathroom, which was accessed through the owner’s private room and did not have non-slip flooring to minimise risks. It was strongly recommended that if residents continued to use this bathroom, these issues were addressed. 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. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with information about the services offered by the home and residents’ needs are assessed, talking account of their wishes, before they move into the home. EVIDENCE: No new residents had been admitted to the home since the last inspection. Each of the 4 residents had a personal copy of the Statement of Purpose and Service User Guide, which would be offered to any person wishing to use the service. The documents had been reviewed to make them more ‘user-friendly’, by including pictures and explanations in plain English to meet the needs of the residents in the home. All 4 files looked at during the inspection contained a detailed assessment of need and the care management assessment of the Local Authority who were purchasing the care. The home’s own assessment of needs were detailed and talked about what the residents choices and preferences were. One example was a resident who was said to “like a lot of pillows”. Assessments talked about what the resident “liked” to have and do. This is good for the residents. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 10 The information in needs assessments was used to develop the care plan and to provide staff with information and guidance about how to provide care to each individual resident. The home’s admission policy states that all prospective residents would be offered the opportunity to visit the service and spend a trial period in the home prior to making any major decisions about their future. One resident’s questionnaire talked about the initial visit to the home with a family member. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall, residents’ choices about their support and care continued to be respected and were recorded clearly in care plans. However, this good practice needs to be extended to completing risk assessments about all aspects of residents’ care to maintain residents’ and staffs’ health and safety. EVIDENCE: Each of the 4 residents had an individual plan of care. Care plans contained a lot of information about the daily routines of residents and what staff needed to do to support and care for residents in the way they wanted to be supported. The care plans and daily routine information was cross-referenced to make the residents’ needs and choices clear to staff. Care plans focused on residents’ “strengths”, “needs” and “wishes”, so they talked about what residents could do independently and what they needed help with. There was a good mix of information about health and social needs and,
Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 12 like the needs assessments, the residents’ choices were made clear. Guidance for staff was very clear including the example where a resident was said to “take between 1 and 2 hours for (the resident) to eat breakfast”. This information reflected the information contained in the Care Manager’s needs assessment and the home’s own needs assessment. It is good that resident’s individual needs were clearly written down and respected in this way. Reviews of each resident’s care plan was held every 2 months and a report about the review was written by the resident’s keyworker. These reviews included a discussion with residents about their preferred hobbies and interests and any changes in their needs and wants. While care plans were clear and detailed they were not backed up with clear risk assessments about aspects of daily life and support. One service user had particularly extensive medical needs, including the use of a suction device to prevent choking and a peg feed. This resident also required complex moving and handling techniques involving 4 staff at any one time. Despite this, there were no risk assessments in place to explain control measures to reduce the risks. For example, one resident when assisted to move had involuntary movements, which could cause staff to be kicked in the head and face. Advice was given on linking risk assessments to the care plans and a requirement was made about this. Residents’ confidential files were stored on open shelving in the hallway. This may lead to a breach of confidentiality and Data Protection Legislation. The staff agreed that the files should be secured when this issue was discussed and a requirement was made about this. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents continued to be supported and encouraged to participate in community based social and leisure activities and were given the food that they preferred to eat. EVIDENCE: Non of the residents had jobs, but all residents were encouraged to have hobbies and activities that they enjoyed. One resident visits a day centre twice each week and another resident visits a local gym, as this resident is interested in boxing. Residents visit the shops on a regular basis and enjoyed trips out including going for meals, going to the local cinema, pantomimes and day trips to local attractions. One resident was encouraged to maintain regular weekend visits to a relative, and another resident participated in daily visits to a day centre.
Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 14 One resident who had previously experienced difficulty in going outside the home had been supported to go out on short shopping trips with careful observation of any signs of anxiety. This is good for the residents. Residents preferred daily routines were recorded and were based on their choices. The needs and routines of residents were reviewed and any changes in need were discussed with the resident and recorded at the reviews. The food which each resident ate each day was recorded on their file. Residents said they liked the food and the things they liked and disliked were recorded on their files. Residents were asked each day what they wanted to eat and their preferred routines were recorded. This included one resident whose care plan stated that this person’s “table must be set with meal, dessert and cold drink before they sit down”. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents were supported by staff in a way that maximised their dignity and independence, and their healthcare needs were well met. However, some aspects of medication storage and recording were not safe. EVIDENCE: From talking to residents and staff and from looking at the residents file it was found that residents received the support from staff they needed in a way that respected their privacy and dignity. Residents were choosing how they dressed and wore their hair and as the staff group was small, they were usually able to choose who helped them. Staff were familiar with residents’ favourite colours and styles of clothes. One example was a resident who was happy to show bright pyjamas they had chosen to the inspector and preferred to wear a baseball cap. Residents’ healthcare needs were met by a range of heath care professionals. One resident was receiving regular visits from a community nurse. Residents
Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 16 usually attended healthcare appointments in the community with their keyworkers. Records were held about the outcomes of these visits. At the time of inspection, medication for 2 of the residents, including controlled drugs, was held in a cupboard inside the wardrobe of one resident. This cupboard was not secured to a wall. The fact that this storage method was not safe and meant that staff had to enter this residents room to obtain medication for the other resident was discussed. Staff said that they believed that another cupboard had been purchased, to be fitted in the other resident’s room. Some controlled drugs were entered in the controlled drugs book, but Temazepam was not. Staff had signed the medication records to indicate receipt of one resident’s medication, but had not done this for the other resident. A requirement was made about these issues. Medication, including paracetamol, was also stored in an unlocked kitchen cupboard. This practice must stop because it could put residents at risk and a requirement was made about this. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had information about how to make complaints and knew who to speak to. Policies and procedures were in place to protect residents from abuse and staff training in the protection of adults from abuse safeguarded residents. EVIDENCE: The home has a clear complaints procedure and all residents have a copy of this and knew who to talk to if anything was bothering them. Staff spoken to had a good understanding of adult protection issues and had received training, in November 2005, in abuse awareness. The home had an ‘in house’ policy on Adult Protection, but staff were unable to locate the Local Authority Multi Agency Policy including the Department of Health guidelines ‘No Secrets’. It was recommended that this is readily available to staff. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a warm, comfortable, well maintained home, which they were happy with. EVIDENCE: The home was found to be warm, comfortable, clean and homely. Residents said that they liked their rooms and chose to spend a lot of time there doing activities they enjoyed. At the previous inspection, a conservatory, built onto the rear of the premises, impacted on the privacy of residents in two of the existing bedrooms. This had been addressed by fitting ‘one way glass’, so that residents could see into the conservatory but nobody could see into their room from the conservatory. At the previous inspection, the home failed to consult the Commission for Social Care Inspection about the proposals to extend the premises. They had since put this in writing and sought planning department and local fire department approval to confirm that the building complied with building
Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 19 regulations and fire regulations. The registered manager was required at that time to give written notice of to any proposals to alter or extend the premises. During this inspection, a further extension was being made to the external building to the rear of the home. A requirement was made about this as it must be established that any additions to the building do not impact on residents’ wellbeing, e.g. when the building works are taking place. Liquid soap and paper towels were not provided at the home to minimise the risk of cross infection when staff were dealing with bodily fluids. A recommendation was made about this. Residents’ had access to a shower room and also to one bathroom, which was accessed through the owner’s private room and did not have non slip flooring to minimise risks. It was strongly recommended that if residents continued to use this bathroom, these issues were addressed. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staffing levels were sufficient to give residents one- to –one attention most of the time. Staff were well trained and supervised and residents were very happy with the staff and the way staff supported them. EVIDENCE: At the time of the inspection, the manager was on holiday and 3 staff were on duty to care for 4 residents. The staffing levels meant that residents were able to have lots of one-to-one attention and care from the staff, including activities, being taken out and just being able to talk to the staff. This is good for the residents. Two staff files were seen and recruitment was appropriate, with CRB checks being made. Job descriptions and contracts and a photograph of staff was held on their files. Staff were having 2 monthly supervision, where the needs of the residents for whom they were the keyworker were discussed. Staff said that they found this helpful because the keyworker “knew all about” that particular resident. Staff said that they also attended staff meetings.
Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 21 Staff had good access to training and 4 of the 5 care staff held NVQ Level 2. One member of staff said that she “loved working at the home” and the others agreed. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continued to review systems in place to ensure people’s safety. EVIDENCE: The manager was on holiday at the time of inspection, but one of the staff was providing management cover to the home, including sleeping in at the premises on call. The manager has NVQ Level 4 and was about to complete the Registered Managers Award. Staff and residents said that the manager was “good” and one member of staff said that the manager always told staff directly if she “had a problem” with any aspect their work, which staff found helpful. The home had a quality assurance system which included gaining the views of residents from questionnaires and through talking to them.
Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 23 The manager provided a pre-inspection questionnaire, which detailed necessary safety checks of the premises and equipment. The fire officer had found that fire precautions were satisfactory at a recent visit to the home. Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 x 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 2 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 2 x Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 25 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation 13. (4) Requirement Risk assessments must be in place about aspects of residents’ daily lives and support, which provide staff with guidance on how to minimise risks to residents and staff. Residents’ confidential files must be stored in a safe place in order to protect and promote the residents’ privacy and confidentiality. The home must consistently have suitable arrangements for the storage and recording of drugs, including controlled drugs. Timescale for action 21/12/06 2. YA10 17. (1)(b) 21/12/06 3. YA19 13. (2) 21/12/06 Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA23 Good Practice Recommendations It is strongly recommended that the Local Authority Multi Agency Policy including the Department of Health guidelines ‘No Secrets’ is readily available to staff. It is strongly recommended that residents’ access to one of the bathrooms is reviewed and that if residents could be at risk from the tiled floor in this bathroom, non slip flooring is fitted to minimise risks. It was strongly recommended that these issues were addressed. It is strongly recommended that liquid soap and paper towels are provided at the home to minimise the risk of cross infection when staff were dealing with bodily fluids. The registered manager should give written notice of to any proposals to alter or extend the premises. 2. YA24 3. YA30 4. YA42 Silverdene DS0000021710.V319325.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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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