CARE HOMES FOR OLDER PEOPLE
Silverways Silver Way Highcliffe Christchurch BH23 4LJ
Lead Inspector Jo Palmer Unannounced 3 June 2005 10:00 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 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. Silverways Version 1.10 Page 3 SERVICE INFORMATION
Name of service Silverways Address Silver Way, Highcliffe, Christchurch, Dorset, BH23 4LJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01425 272919 01425 277981 Christchurch Housing Society Mrs Marie Madders Care Home with Nursing (N) 73 Category(ies) of OP - 73 registration, with number of places Silverways Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: One named person (as known by the CSCI) under the age of 65 may be accommodated to receive care. Date of last inspection 06 September 2004 Brief Description of the Service: Silverways Nursing Home was purpose built in 1985 and is situated in a quiet residential area of Highcliffe. It is set in one and a half acres of gardens and provides facilities for 73 service users.The home is owned and managed by Christchurch Housing Society, a voluntary organisation registered with charitable status. The society was founded in 1946 to provide accommodation and care services for older people. Silverways has accommodation on the ground and first floors. The premises are divided into four wings which comprise of single and shared rooms, assisted bathrooms, showers and toilets, and a hairdressing salon. Each wing has a communal lounge /dining area although dining space is limited. The home also has two 8 bedded bays, one of which is currently vacant and is being used as an activities and exercise room. Christchurch Housing Society are considering up-grading and refurbishment of the home to create better use of available space. The home is managed by Mrs M Madders. Silverways Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection on 3rd June lasted for six hours. Marie Madders, the registered manager was present throughout. Mr Hickish, Responsible Individual for Silverways’ provider company attended briefly. The last inspection of Silverways identified a number of requirements; the purpose of this inspection visit was to monitor progress in addressing those requirements and to review practices in relation to some of the National Minimum Standards and this inspection concentrated on the outcomes of care and services for residents. The inspector spoke with five residents, three relatives, two members of staff, the manager and briefly with Mr Hickish; took a tour of the home and examined relevant records. Although registered to accommodate 73 people, there were 68 residents living at the home at the time of inspection. What the service does well:
Prior to admission, people are provided with sufficient information about the home; they are assessed to determine if the home can meet their needs and they are issued with a contract detailing their rights regarding their time at the home. The right to complain is outlined in the Service User Guide and residents are assured their complaints and concerns will be listened to. Care needs are met through good planning and organisation and there was some indication of resident consultation although this needs to be more consistent. Residents spoken with confirmed that they feel they are respected and their right to privacy is supported and relatives spoken with also confirmed that staff are very respectful and courteous. The home provides certain activities which a group of residents’ was seen to be enjoying, other residents confirmed they are able to determine their own level of activity and social life as far as their general health allows. Currently some areas of the home provide a comfortable environment for residents, all parts of the home seen were clean and there are sufficient numbers of bathroom and toilet facilities. Resident’s confirmed that their bedrooms were comfortable and suitably furnished and equipped. There are sufficient staff to meet the needs of the residents and the needs of the home in relation to catering and domestic duties. Staff training opportunities are good and all staff are regularly supervised. Silverways Version 1.10 Page 6 The manager showed a commitment to the development and improvement of the service as well as showing a good understanding of the resident’s needs, and having a good relationship with residents and staff. What has improved since the last inspection? What they could do better:
This inspection has identified some areas where practice can be improved with regard to resident consultation and identifying how and from where information is obtained for assessment. Recommendation has also been made with regard to re-evaluating some of the care records to ensure they remain useful. Some areas of the home would benefit from decoration although Ms Madders confirmed that communal areas were to be decorated shortly, other areas requiring attention would be considered as part of the overall refurbishment programme. However, despite the plans to improve, the day to day management of the environment must not be overlooked, the cleaning programme of some of the bathroom areas needs to be reviewed and risk assessments are needed to ensure appropriate action is taken against the risk of accidental scalding. There is no designated dining space in the home; again, Ms Madders confirmed that this would be planned for as part of the development and refurbishment. Staff recruitment and employment practices require attention to minimise the risk of unsuitable staff being employed and staff fire training needs to be regularly provided. For the safety and welfare of residents, testing of the home’s emergency lighting must be carried out at the specified intervals. The manager should
Silverways Version 1.10 Page 7 undertake spot checks to ensure records relating to this testing are maintained appropriately and fire training must be carried out in accordance with Fire Authority guidance. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Silverways Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Silverways Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 & 4. Standard 6 is not applicable The home’s Statement of Purpose and Service User Guide provide detailed information about the care and services provided at Silverways. Residents are issued with a contract describing Terms and Conditions of occupancy, including the fees, at the point of admission to the home. Prior to admission, the needs of each prospective resident are assessed to ensure the home will be able to properly meet them. The home then writes to the prospective resident confirming the ability to properly care for them EVIDENCE: Residents and relatives spoken with who were newly admitted to the home, confirmed they had sufficient information about the services to enable them to make an informed choice about moving to Silverways. A copy of the home’s Service User Guide, which contains a summary of the Statement of Purpose was available to residents in the entrance of the home. Ms Madders confirmed that all new residents and their representatives are given a copy of the guide. Silverways Version 1.10 Page 10 Contracts, or Terms and Conditions of Residency documents were seen on residents files and demonstrated that all relevant information had been provided regarding the terms of their stay. Where residents are assisted with their funding by a local authority, contracts are issued that are signed by all parties. Examination of resident’s care files demonstrated that prior to admission, an assessment of need is undertaken to ensure the resident is suited to a placement at Silverways. Of the files examined, there was no evidence of the resident’s participation in the assessment process or of the source of the information obtained. For example, an assessment may be made regarding a particular aspect of a person’s need although it had not been recorded how that need had been identified or who had informed the assessor of it. Assessments did identify where they had taken place, for example, in hospital, but did not refer to who had provided the information. Silverways Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 There is a comprehensive and reliable care planning system in place to effectively provide staff with the information they need to satisfactorily meet resident’s needs. Resident’s health needs are met through visits with doctors and other health professionals as required. Systems for resident consultation and participation in the assessment and care planning process are inconsistent Residents are respected and their right to privacy is supported. EVIDENCE: Care files examined evidenced that care plans are drawn up following assessment. It was evident that staff at Silverways carry out assessments using prescribed recording formats, the inspector questioned the need for some of the paperwork as it was apparent that some areas of assessment were repeated on different forms, excessive completion of such forms does not make best use of staff resources. Similarly, a ‘general care plan’ is drawn up as well as specific care plans identifying in more detail how needs are to be met. This general care plan is also unnecessary and a time consuming activity to
Silverways Version 1.10 Page 12 complete. The inspector and Ms Madders discussed a review of the assessment and care planning paperwork. Care plans provide necessary information to the staff regarding how needs are to be met. Some care plans were more detailed than others although in all cases seen, all personal care, health and welfare needs had been addressed. Residents spoken with confirmed that they are treated respectfully, one resident stating that staff were always kind and attentive. This resident also confirmed that she is able to make choices with regard to her everyday routine and activities and is assisted with the purchase of items for her leisure interests. One relative spoken with confirmed that staff were ‘always courteous and willing to help’ and that as a regular visitor the relative confirmed that staff always offer hospitality including cups of tea and occasional meals. Silverways Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14 Residents are able to enjoy self-determined activity as far as their health and general abilities allow, they are supported in maintaining contact with their friends, family and the local community and in making decisions about their lives in the home although this is not always documented. An activities programme enables residents to participate in craft and social activities and enjoy each other’s company. EVIDENCE: Daily care records demonstrate to some extent social activities that each resident participates in; a separate record held in the activities area demonstrates more, the specific activity. Different groups of residents who are able to do so, come together daily in the activities area, an area that has been created in one of the unused, eight bedded bays, to join in arts, crafts, games and social activities. Some care staff have been given a specific role in activities planning and organisation away from their care duties; for this purpose, they are not on the care rota and wear a separate uniform to identify their role and purpose. Three relatives confirmed that they are able to visit whenever they choose and that there were no restrictions, relatives stated they were always made to feel welcome in the home.
Silverways Version 1.10 Page 14 Meal provision was not specifically examined although residents spoken with confirmed that the food was good, relatives who had seen meals served and sometimes joined the resident for a meal confirmed this. Silverways Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Complaints are managed properly and residents are confident their concerns are listened to and taken seriously. Procedures for responding to suspicions of abuse are held in accordance with Department of Health guidance, therefore, any allegations of abuse will be managed effectively. EVIDENCE: The home’s complaints procedure is contained in the Service User Guide and in contractual information provided for residents. Ms Madders confirmed that information has recently been revised and includes methods of complaining to the local authority for residents who have assistance with their funding, all residents are assured that they can complain to the Commission should they need to. Two complaints have been received by the Commission, these have been investigated, one has been resolved, one is waiting to be resolved depending on further information. Ms Madders confirmed that one complaint was received by the home, records relating to this demonstrated that the complaint was appropriately and sensitively managed to the satisfaction of the complainant. Procedures are in place for staff guidance providing information on what to do if they suspect a resident is being abused or harmed in any way. There have been no reported incidents. Silverways Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 23, 24, 25 and 26. Some of the interior décor and use of space in the home needs improvement through maintenance or future planning. Currently some areas of the home provide a comfortable environment for residents all areas were clean although some bathrooms would benefit from deep cleaning. There are sufficient numbers of bathroom and toilet facilities, communal dining space is limited, each wing of the home has sufficient lounge space. Resident’s bedrooms vary in size and design, single and shared rooms provide adequate facilities, an eight-bedded bay does not meet recommended standards. Facilities for staff to ensure against the spread of infection are appropriate. EVIDENCE: Discussion with Ms Madders and Mr Hickish was informative; it was evident that consideration is being given to refurbishment and reorganisation of internal space in the home. Plans are currently being discussed with Silverways’ management committee regarding the best use of available space. Mr Hickish and Ms Madders confirmed that residents and their
Silverways Version 1.10 Page 17 relatives/representatives would be kept up to date with developments once proposals had been agreed. Plans for development are a positive step to bring Silverways in line with expected standards of care home accommodation. The home currently provides accommodation to some residents in an eight-bedded bay. One of these style bays has already been closed and the space is temporarily being used as an activities and exercise room for the benefit of residents. Ms Madders confirmed that the remaining eight bedded bay would be finally closed when it is no longer occupied by residents. Whilst accommodating people in this area is not satisfactory, the recommendation made in previous reports has been removed as it is evident that Christchurch Housing Society are making positive moves to improve the home’s environment. There was evidence of redecoration in some resident’s rooms and Ms Madders confirmed that a company has been recently contracted to redecorate the communal areas of the home. Resident’s rooms were appropriately furnished and residents are able to bring various personal items into the home including small items of furniture, ornaments, pictures etc. One resident has small caged bird as a pet that is looked after on her behalf by staff. The home was suitably lit, ventilated and at a satisfactory temperature for the time of year and weather conditions. Bathrooms and toilets are suitably sited around the home with easy access for residents; there are no en-suite facilities. One bath was noted to be heavily lime-scale stained and the area of flooring around the toilet was also stained. Hot water in baths is regulated to a temperature around 43°C prevent accidental scalding; hot water from basins is not regulated and was very hot to the touch. There were no risk assessments in relation to the potential for accidental scalding. Anti-bacterial soap and disposable towels are available for staff hand washing to prevent the spread of infection, sluices are sited appropriately were clean and the areas well ventilated. Silverways Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The deployment and number of available staff is sufficient to meet the needs of the residents. Recruitment and employment practices require attention to minimise the risk of unsuitable staff being employed. Staff training is a priority and there is good communication about available learning opportunities and the statutory obligations of staff to undertake mandatory courses EVIDENCE: Two weeks staffing rotas were examined that demonstrated that sufficient numbers of staff are on duty in suitable roles to meet the needs of residents. The home is divided into four wings; each wing has a trained nurse on duty daily with between three and four health care assistants on each wing depending on workload and resident’s needs. During the night shifts there are two trained nurses on the ground floor and one on the first floor; three health care assistants work the night shift on each floor. There are some staff vacancies that were being filled by agency staff although Ms Madders confirmed that the use of agency staff has reduced considerably since the last inspection, Ms Madders also confirmed that those agency staff that are used are consistent meaning there is minimal change and disruption to residents. In addition to nursing and care staff, general assistants, domestics and kitchen staff are employed in sufficient numbers. Residents spoken with confirmed that
Silverways Version 1.10 Page 19 there are sufficient numbers of staff and that they are answered promptly if they need to use their call bells. Staff records examined for two newly appointed health care assistants demonstrated some omissions. One file held only one reference and the application form indicated a five-month gap in employment history; the second application examined also had gaps in employment history. Ms Madders confirmed that she was aware of both applicants’ periods of unemployment although had not recorded them. Both these new staff had been sent an offer of employment letter detailing their start date and other relevant information, the letters stated that employment was on a three month trial basis and subject to satisfactory police checks and references being received; neither member of staff had a contract of employment on file. Copies of the applications made to the Criminal Records Bureau were held. Both new staff were working through a period of induction, the induction record followed the five units of the Skills for Care (formerly TOPSS) training targets. Both new staff were supernumerary to the care rota for the first week of their induction. Ms Madders confirmed that she has the learning materials for the staff to undertake Foundation training when their induction is complete. The staff rota shows the capacity in which staff are working and indicates their qualification. From this, it was evident that 17 health care assistants have attained NVQ level 2. All staff undertake mandatory training in moving and handling, infection control, first aid, food hygiene, health and safety and elder abuse. Ms Madders confirmed that staff have been issued with a copy of the General Social Care Council Code of Conduct. Silverways Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34, 36, 37 and 38 The manager has a good understanding of the areas in which the home needs to improve and has a clear development plan and vision for the home, which has been effectively communicated to the registered providers for consideration. Records in the home are generally well maintained but would benefit from regular reviews and auditing to ensure their effectiveness. Staff receive regular, formal and confidential supervision and management practices promote and safeguard the health, safety and welfare of residents. The Health and Safety working practices are satisfactory and staff fire training is not provided in accordance with Fire Authority guidance Silverways Version 1.10 Page 21 EVIDENCE: Ms Madders demonstrated at this inspection her understanding of the needs of residents, the needs of the service to move forward and improve and the needs of the organisation in relation to its registered and charitable status. Ms Madders and Mr Hickish confirmed that there is not an annual development plan for the home or a financial and business plan. Ms Madders and Mr Hickish are advised to ensure the at quality monitoring system is in place to secure the views of the residents, relatives, staff and others with an interest in the home in order that an annual development plan can be established, a financial plan would be needed in support of this; this would be particularly prudent at a time when plans for up-grading the premises are being considered. Records required by regulation are up to date and accurate although attention is needed to ensure that where the home’s maintenance person holds records, they are transcribed to the appropriate recording log to ensure they are available for access. Records relating to testing and maintenance of fire alarms, emergency lighting and equipment were out of date although the maintenance person’s records later confirmed a qualified person had carried out these checks with the exception of the six monthly testing of the emergency lighting. Certificates of maintenance of the electrical installation, the lift, the gas installation and heating, and the nursing equipment (hoists, beds etc) were seen and demonstrate regular servicing. Fire training has been provided six monthly for all staff although records seen indicated that six day staff had not received the training at the appropriate intervals. Silverways Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 x 3 x 2 3 1 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x 2 x 3 2 1 Silverways Version 1.10 Page 23 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 26 Regulation 18(1) Requirement Timescale for action 31.08.2005 2. 25 13 3. 29 18 4. 38 23 The registered persons must ensure that domestic staff maintain the bathroom areas in a clean and hygienic state and that appropriate cleaning materials are used to remove stains from baths and floors. Risk assessments must be 31.07.2005 undertaken in relation to excessivley hot water from wash basins. Staff must only be employed 31.07.2005 following receipt of two satisfactory references. Any gaps in employment history must be explored at interveiw. Staff must be issued with a contract of employment which states that are to work in a supernumerary capacity and supervised during induction and until such time as references and CRB checks have been received. Where possible, new staff must work under supervision of a named, senior person. The registered persons must 31.07.2005 ensure that is regular six monthly testing of the homes emergency lighting system by competent person.
Version 1.10 Page 24 Silverways 5. 6. 38 34 23 25 & 26 All staff must receive fire training 31.07.2005 twice within each 12 month period. A development plan supported 31.08.2005 by financial and business planning must be produced to demonstrate the homes intentions for improvement and development; the development plan must be based on the views of service users, staff and relatives. The responsible individual must visit the home, unannounced and inspect the service provided, a report of the responsible individuals inspection visit must be made available to the registered provider company, the manager and the Commission. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 3 7 3&7 37 Good Practice Recommendations When assessing a persons needs for consideration to admit them to Silverways, a record should be held relating to the source of the information obtained. Records should be consistent to demonstrate that service users have been consulted with regard to the care planning process. Care documentation should be reviewed to reduce the need to repeat information on different records. The registered person should undertake spot checks of all records in order to establish are being approrpiately maintained. Silverways Version 1.10 Page 25 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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