CARE HOMES FOR OLDER PEOPLE
Sue Ryder Care Birchley Hall Birchley Road Billinge Wigan WN5 7QJ Lead Inspector
Mrs Lynn Paterson Key Unannounced Inspection 10:00 8th January 2007 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 Sue Ryder Care Birchley Hall DS0000022399.V295374.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. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Sue Ryder Care Birchley Hall Address Birchley Road Billinge Wigan WN5 7QJ 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) 01744 894893 01744 895430 birchleyhall@fsmail.net None Sue Ryder Care Care Home 30 Category(ies) of Dementia (2), Old age, not falling within any registration, with number other category (30), Physical disability (30) of places Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service users to include up to 30 (OP); 30 (PD) over the age of 55 years; 2 (DE). That staff are provided in sufficient numbers and skill mix to meet the assessed needs of all service users. Date of last inspection Brief Description of the Service: Birchley Hall Care Home is registered to accommodate up to 30 older persons who are in need of assistance with their personal and social care. The home forms part of The Sue Ryder organisation and is situated in a residential area, close to shops and local amenities and is set within extensive grounds affording views over open countryside. The premises comprise 24 single and 3 double bedrooms, most of which have en-suite facility. Accommodation is provided over three floors with upper floors being accessible via a passenger lift. Communal rooms include 3 lounge areas, spacious dining room and a conservatory. Fees currently range between £351--£376 per week. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection of Birchley Hall Care Home took place on 8th January 2007 and was carried out over a six- hour period. The inspector met with the, senior officer, five care staff members, cook and kitchen staff and 21 of the 30 residents living in the home. Records care files, policies procedures and other documentation was examined and a tour of the premises was carried out. Fieldwork included case tracking five residents, which involved reading all documentation relating to the residents daily living and speaking with the residents and staff who were associated with their care. Several resident’s representatives were also spoken with to gain their perceptions of the standards of care provided by the home. What the service does well:
Staff, work well together as a team and present as being well trained and totally committed to the provision of needs led care for all the residents. Residents said they were very well looked after and comments included: “The staff are so good to us, they seem to know exactly what we want”; “Staff are kind and caring and they try very hard to make sure we are happy”,
Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 6 “I have been here quite some time and the staff have always been good to me. They help me to wash and dress and support me in almost everything”. Staff training records confirmed that staff, are provided with ongoing training to ensure they can provide care that is appropriate to residents changing needs. Residents spoken with said the food was excellent, the menu very varied with choices being available at all times. Residents said that meal times were also flexible to suit the needs of all individuals living in the home. Comments from resident’s included-; “The food here is always lovely, look at today’s menu it is so good”. “ All the food is good no matter what is on the menu it is appetising, well cooked and nicely presented. The premises were very clean and comfortable and residents said they felt very much at home in Birchley Hall. What has improved since the last inspection?
Records show that the activities programme has improved since the last inspection and the activities notice identified that sing-along, outings, exercise classes and quizzes are arranged on a weekly basis. Monthly quality improvement plans have been introduced and monthly quality assurance groups have been implemented to include discussions re complaints, compliments, incidents, and policies, staff feed back. Monthly residents meetings have been resurrected to ensure they can discuss forthcoming events and activities and have choices of menu preparation. All staff now has access to the Internet to enable them to take control of their own personal development and e-mails are used to ensure effective communication between staff. Sue `Ryder provide an education lead officer who attends Birchley hall on a weekly basis to provide all mandatory training in-house. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 7 What they could do better:
The manager’s office has been moved to the ground floor and the staff office moved to the first floor and residents families/representatives commented that they felt this impacted unfavourably upon communication systems. It was said that prior to the changes visitors to the home would always be able to speak with staff about general concerns or everyday issue’s as the staff office was “never empty”. However it appears that the office now has a closed door and resident’s representatives said they now felt unable to have a general chat as staffs was no longer around. Comments included: “Before the change of offices we were able to see staff when we arrived at the home and were able to chat about general issues and feel reassured. Now we never see anyone unless we go looking as the staff office is based upstairs out of the way”. “The managers office has a closed door and we don’t feel we should intrude”. “General communication was great when the staff were down here as we were able to talk to them without making a big thing of it. This helped us to feel a part of the home. The changes of office have affected this open communication as we now come and go from the home without passing the staff office and therefore miss out on “our chats”. Observational practices revealed that residents wandered around the home entrance area and were able to open the outer door un-noticed. Discussions were held with the manager after the inspection had taken place and she advised that she had changed offices from upstairs to downstairs to enable her to “be available”. However she expressed concerns about the feedback and agreed to review the situation to ensure that communication between residents representatives and staff is maximised and the safety and security of residents is well managed. It is recommended that ground floor office space be utilised to ensure the safety and communication needs of the residents and their representative and the security of the premises. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 8 Care plans viewed did not hold signatures of the residents or their representatives to show they had been involved in the compilation of the plan. It is essential that signatures of all who are involved in the drawing up of the care plan are recorded to ensure that choice and care needs are correctly recorded to make sure that care is delivered as appropriate. 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. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 9 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 Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 10 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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provides clear information to enable people to make an informed choice about living in the home. Staff; ensure that all prospective residents are subject to an assessment of need prior to admission to make sure that the home has the facilities to meet all assessed need prior to admission. EVIDENCE: Care files examined held information to show that pre admission assessments had been carried out prior to the resident being offered a placement in the home. The assessment documents were clear and the information recorded showed that all daily living tasks had been discussed with the resident and their representative and all care and support needs had been addressed.
Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 11 Residents spoken with were unclear about the pre assessment process however all care files looked at held information to confirm that a pre admission homed/hospital visit had been carried out. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9.10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans have been reviewed and amended and generally hold details of social and heath care need and of how this need will be met. Medication is well managed by people who have full knowledge and understanding of all aspects of medication. However some care plans did not hold signatures of those who were involved in the care planning process. EVIDENCE: Care plans were looked at in general and five care plans examined in detail. Care plans held details of assessed need and of how this need would be managed by care staff. However none of the five care plans examined held signatures of the resident or their representative to show they had been
Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 13 consulted about or agreed to the care plan. It is essential care plans are signed by all who have involvement in their compilation to ensure that the care delivery is an agreed process and choices have been provided re all aspects of daily living. It was noted also that residents changing need in respect of dementia/ confusion/short term memory loss had not been fully identified on the care plan, although in discussion staff identified they had full knowledge and understanding of all residents current care needs. Discussions with the home manager the day after the visit identified that she is in the process of implementing a system to ensure that dementia needs are clearly recorded on care plans and appropriate care practices introduced to meet changing need. Care plans in general were well managed with clear details being recorded about care and support needs. Daily reports about all aspects of the residents daily living were thorough and provided all the necessary information to show how the residents spent their time and how all care and support was delivered. Residents spoken with were high in their praise of staff and comments included: “The staff are so kind to us all, nothing is too much trouble for them”. “Staff are always happy and friendly and provide us with the care we need”. “They work so very hard to ensure we are all well looked after”. Resident’s representatives said that the staff were all professional in their approach and provided an excellent service for the residents of Birchley hall. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14.15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffs ensure that residents have choices in all aspects of daily life to include choice of activity and menu. EVIDENCE: Notifications placed around the home show that activities are arranged on a regular basis to include Bingo, outings, quizzes, and entertainment. At the time of the visit five residents had been taken out to the Pemberton area of Wigan for lunch and other residents said that outings were arranged on a regular basis and everyone who wished to participate was given the opportunity as only a few could go at a time they all “took turns to go out”. Residents were observed watching television, listening to music and taking part in a quiz and all appeared to be enjoying their particular interest. Residents spoken with said the food was very good and most enjoyable and comments included: “The food here is excellent, we get choices, and everything we get is well cooked and good to eat”,
Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 15 “We have a menu and can pick what we want. The food is very nice indeed”, “I think the food here is so good, just look at what we are having today don’t you think it looks good”. Residents were observed eating their lunch and enjoying various menu choices. Menus were in position on each table, crockery and cutlery was suitable for use and the meals were well presented. Staff, were seen to offer discrete assistance to residents to ensure they were able to fully enjoy their meals. Discussion with the kitchen staff revealed that they are able to provide choices of nutritious meals and snacks for the residents. The kitchen was seen to be well managed and most hygienic at the time of the visit. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16.18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The organisation has policies and procedures to make sure staff are trained and competent to assist residents to express their feelings about the standards of service provision in the home. Staffs have received training in adult protection and understand how to protect residents from abuse. EVIDENCE: The organisation has a complaints policy that explains the procedures residents and their representatives can follow in the event of concern. This policy was seen to be clear and explicit. However none of the residents spoken with were able to give information about the policy. Staff said that all residents were provided with this information on admittance to the home and revealed that they continue to prompt residents to let staff know if they had any complaints or concerns about the care, support and accommodation provided. Residents spoken with said they had no need to complain as everything was always good and resident’s families revealed that they were aware of the complaints policy although none spoken with had ever had the need to use it. However, whilst this is not seen to be a shortfall of the service, it is recommended that all residents be provided with another copy of the complaints procedure to make sure they are fully aware of their rights.
Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 17 Staff spoken with, were clear about all aspects of adult protection and staff training records reveal that adult protection training is an ongoing process in the home. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19.26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The premises presented as clean, hygienic and well maintained and general maintenance records show that work is carried out as an ongoing process to make sure the building is safe and fit for purpose. EVIDENCE: The home presented as clean, well maintained and most hygienic at the time of the unannounced visit and all rooms were comfortable and homely. Staff advised that the organisation employs a deputy manager who has overall responsibility for health and safety and building and ground maintenance and records show that all essential services are tested and serviced as appropriate. It was noted that a glass panel had been removed from a door leading from the dining room to the conservatory and staff advised that the glass had
Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 19 cracked due to a heater above the door and the glass had been removed for safety reasons. Staff said a daily risk assessment was carried out in the home to ensure the building was maintained to a high standard of safety. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27.28.29.30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are adequate to meet the current assessed needs of the residents and staff present as being well trained, motivated and hard working and totally committed to providing quality care for the residents. EVIDENCE: Staff, were seen to be very busy carrying out their duties and it was noted that they held responsibility for the provision of care to up to four extra residents each day who were provided with day care facility in the home. Residents care plans revealed that many had a high degree of care needs to include mobility, anxiety and mental health need. Observation of staff carrying out their duties revealed they were very busy and it was noted that the call alarm system was in constant use and on occasions staff were not readily available to answer the call. Staffing levels appeared to be barely adequate to enable staff to spend any time with residents who appeared to be anxious or upset and wanted reassurance by way of chat. Staff advised that they tried their best to spend some quality time with residents but agreed that it was not possible most of the time.
Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 21 Staff spoken with demonstrated they were trained and supported to provide a good quality of care for the residents and those observed carrying out their duties were seen to be professional in their approach and worked as a team to provide support and assistance to residents. Staff and residents displayed mutual respect and interactions were excellent. The home utilise a consistency of staff due to very low staff turnover and staff said they feel valued and respected as individuals. Staff said they receive regular supervision and are provided with a high level of training to ensure they are able to provide good quality care. The recruitment and selection policies of the organisation are fair and equal and prospective employees are subject to rigorous checks prior to being offered employment to ensure residents safe-care. All staff now has access to the Internet to enable them to take control of their own personal development and e-mails are used to ensure effective communication between staff. Sue `Ryder provide an education lead officer who attends Birchley hall on a weekly basis to provide all mandatory training Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31.33.35.38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is respected by staff and residents and runs the home in the best interests of the service users. EVIDENCE: The management team has changed since the last inspection and the management team comprise of a care manager and deputy manager who holds responsibility for all aspects of health and safety. Staffs say this appears to work well. Service users said they think the home continues to be well managed and they are happy and content with all aspects of the home. They said they feel able to
Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 23 take and make decisions about what they feel would benefit daily life and were constantly consulted by staff as to how they felt about the services provided. Monthly residents meetings have been resurrected to ensure residents can discuss forthcoming events and activities and have choices of menu preparation. Quality monitoring groups have been introduced and take place on a monthly basis to discuss all the management issues of the home. The home has system’s in place to make sure that residents financial interests are `safeguarded and maintains clear records to ensure moneys and possessions are protected. However it was noted that the manager’s office has been moved to the ground floor and the staff office moved to the first floor and residents families/representatives commented that they felt this impacted unfavourably upon communication systems. It was said that prior to the changes visitors to the home would always be able to speak with staff about general concerns or everyday issue’s as the staff office was “never empty”. However it appears that the office now has a closed door and resident’s representatives said they now felt unable to have a general chat, as staff were no longer around. Comments included: “Before the change of offices we were able to see staff when we arrived at the home and were able to chat about general issues and feel reassured. Now we never see anyone unless we go looking as the staff office is based upstairs out of the way”. “The managers office has a closed door and we don’t feel we should intrude”. “General communication was great when the staff were down here as we were able to talk to them without making a big thing of it. This helped us to feel a part of the home. The changes of office have affected this open communication as we now come and go from the home without passing the staff office and therefore miss out on “our chats”. Observational practices revealed that residents wandered around the home entrance area and were able to open the outer door un-noticed. Discussions were held with the manager after the inspection had taken place and she advised that she had changed offices from upstairs to downstairs to enable her to “be available”. However she expressed concerns about the feedback and agreed to review the situation to ensure that communication Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 24 between residents representatives and staff is maximised and the safety and security of residents is well managed. It is recommended that ground floor office space be utilised to ensure the safety and communication needs of the residents and their representative and the security of the premises. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 25 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 2 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 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 26 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. 1 Standard OP7 Regulation 12 Requirement The manager must ensure that care plans hold all details of assessed need to include dementia care. The manager must ensure that care plans hold signatures of all who are involved in their compilation. Timescale for action 15/03/07 2 OP7 12 15/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 Refer to Standard OP16 OP33 Good Practice Recommendations It is recommended that copies of the complaints procedures be provided to all the current residents. It is recommended that the manager/staff office accommodation be situated in a position, which is accessible to residents and their representatives and ensures that people are able to enjoy effective communication in a secure environment. Sue Ryder Care Birchley Hall DS0000022399.V295374.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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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