CARE HOMES FOR OLDER PEOPLE
Trelawney House Polladras Carleen Helston Cornwall TR13 9NT Lead Inspector
Diana Martin Announced 17 May 2005 09:30 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. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Trelawney House Address Polladras Carleen Helston Cornwall TR13 9NT 01736 763334 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) c.gatzianidis@ntlworld.com Christine Anne Gatzianidis Rigas Gatzianidis Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 04/11/04 Brief Description of the Service: Trelawney Care Home is situated in the village of Polladras, about five miles from the town of Helston. The property used to be a hotel until about five years ago. The home is set in it’s own spacious grounds and has gardens with seating provided for service users. There is sufficient car parking space at the front of the home. The home offers residential care for up to eleven elderly people. Day-care is provided for three people. Accommodation is on two floors; the first floor can be accessed by a shaft lift. There is one large lounge with another smaller lounge. There is also a games room with pool tables, this is the room designated for those who wish to smoke. Meals are cooked in a large kitchen and served in the dining room. Trelawney provide a ’meals on wheels’ facility and supply between ten and twenty meals to people in the community each day.The homeowners live on site in a mobile home and are actively involved in the day-to-day running of the home. Care staff provide personal care within a happy, friendly, atmosphere. There are opportunities for socialising and visitors are openly encouraged. Service users gave very positive views of the home. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector visited Trelawney on the 17 May 2005 and spent the day at the home. This was an announced visit. On the day of inspection 8 service users were resident in the home, one was leaving to go to a care home providing nursing care. This home provides day care for two service users and meals on wheels to people in the community. The inspector met with 5 service users, 1 visitor, a number of staff and the Registered Providers to gain their views on the service Trelawney provides. Several positive comment cards were received from visitors to the home. In addition the inspector examined records, policies and procedures and toured the building. This report summarises the findings of this inspection and includes the findings of a complaint received since the last inspection. What the service does well:
The home provides a warm, clean homely environment and service users said they were contented and happy living there. All parts of the home and grounds were accessible to the service users. New service users have a needs assessment before any decision can be made to move into the home. The assessment enables the staff to decide if they can meet the needs of the service user. Admission to the home is done in stages with separate contracts for each stage this allows the home and the service user time to fully decide if the home is really suitable. When admitted each service user has a care plan devised from the initial assessment with relevant risk assessments included. The District Nurses advise the staff if service users have any special needs and they provide equipment for pressure relief and so on. The home has some moving and handling equipment, suitable for the service users accommodated. There is a suitable system for medicines in the home and a written policy to guide the staff. Staff administering medicines have received appropriate training. Medicines are stored securely in a locked cupboard. Service users said their privacy and dignity are always respected and this was observed throughout the inspection. Service users said they receive visitors when they wish and are free to go out with their relatives and friends. The daily routines are flexible, service users said they get up and go to bed when they like. There is a menu with choices available and service users were generally happy with the food provided. A great deal of refurbishment has taken place in the home and there is an ongoing programme of work to be done. The grounds are tidy and there are plans to build a fishpond. The staffing situation has improved and service users were aware of the changes. New staff were due to commence including one for night work. All employees are issued with a job description and terms and conditions of
Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 6 employment. Staff have received more training recently which was very necessary they were very pleased with this. The Registered Providers run the home together; Mrs Gatzianidis is undertaking the NVQ level 4 management course and has found the dementia awareness course very valuable. Quality assurance monitoring takes place annually in the form of a questionnaire for service users and their relatives to complete. All service users control their own money and have their own bank accounts. A lockable facility is provided in the bedrooms for the safe storage of money and valuables. Statutory training takes place with records kept. All service and equipment checks are undertaken regularly and accidents are recorded and reported appropriately. What has improved since the last inspection? What has improved since the last inspection?
The last inspection was undertaken during unforeseen circumstances, which meant that Mrs Gatzianidis was not at the home. There have been substantial improvements on this occasion in many areas. Each service user now has a written care plan with relevant risk assessments and day and night records are maintained. The bathroom carpet has been replaced with flooring that can be washed and the walls have been tiled, the whole room looks cleaner and brighter. The laundry ceiling has been repaired and new flooring fitted. The Registered Providers are hoping to hire a washer disinfector to clean the commode pots and urinals. Thermostatic valves are being fitted to ensure the water temperature in all areas accessed by service users is regulated to 43ºC. The cats no longer have free access inside the home and other pets are kept out. Fly screens are now fitted to the kitchen window and external door. Doors that must be locked were locked during the inspection. The recruitment process has improved and CRB checks have been applied for. The fire risk assessment has been undertaken and approved by the fire officer. What they could do better:
Some service users said they would like more homemade food and cakes rather than those bought from the supermarket. Transcribing of medicines onto the MAR charts must be witnessed with two signatures recorded The Adult Protection policy must be fully updated and all staff must attend appropriate training in the protection of vulnerable adults. A satisfactory explanation for gaps in employment must be sought when interviewing prospective employees.
Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 7 A report of the Quality Assurance results must be compiled annually and a copy sent to the Commission. There should be evidence in the home that the animals do not pose a risk of spreading infection in the form of veterinary care records. There must also be a risk assessment for the presence of animals in the home and grounds, with particular reference to falls and Infection Control. Paper towels must be supplied in the kitchen by the hand washbasin rather than a cotton towel. 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. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 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 Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 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) 3 and 5 Service users are assessed prior to moving into the home to ensure their needs can be met. Prospective service users and their family can visit the home to assess the service prior to a decision being made to move in. EVIDENCE: The Registered Provider said she tries to visit prospective service users before admission to the home. There is a specific form for recording the initial assessment, which forms the start of the care plan. Reports are obtained from other health-care professionals whenever possible, for example District Nurses, Social Workers and Hospital Nurses. The Registered Provider said that relatives are also involved. The Registered Provider said that service users and their family are encouraged to visit and spend time in the home prior to admission. Admission to the home is in stages with separate contracts for each stage. The first two weeks enable a thorough assessment of needs to be undertaken. A four-week temporary residence is then undertaken before a full time contract is negotiated. The only emergency admissions are those receiving respite care. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Each service user has an individual care plan setting out their health, personal and social care needs; these are detailed to guide and direct the staff providing care. Service users have access to health care services as necessary to ensure their assessed needs are met. There are suitable policies in place for dealing with service users medicines, however the recording procedures need some minor improvement to safeguard service users from the risk of harm. EVIDENCE: Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 11 Service users health, personal and social care needs are set out in individual care plans. The Registered Provider said the plans are reviewed annually or as a change in need is noted. Day and night records have been implemented; these now need to get established into comprehensive care records, as they are legal documents. Relevant risk assessments are carried out for all service users and include the risk of falls, moving and handling and Waterlow scoring. There are charts and body maps for pressure area treatment. The service user or their representative have signed the care plan whenever possible. The Registered Provider said that all service users were registered with a General Practitioner. Pressure relieving mattresses are supplied by the District Nurses when needed. There was one service user with a pressure sore. District Nurses advise on continence, pressure relief and any other specialist need. The home has a hoist, a bath hoist and walking aids for service users. Service users said they had access to specialist medical, nursing, dental and other services according to their needs. Service users are offered a walk outside each day and some went out during the inspection. The nomad medication system was used in the home. There were no Controlled Drugs, Schedule 3 medicines or medications requiring storage in a fridge and there were no service users on oxygen therapy. Medicines were stored securely in a locked cupboard. Patient Information Leaflets were provided. Transcribing of medicines onto the MAR charts must be witnessed with two signatures recorded. Staff had received medication training. The homes had a policy and a copy of the ‘The Royal Pharmaceutical guidelines for the administration of medicines in care homes’. Service users privacy and dignity were respected throughout the inspection and service users said this is the normal procedure. Service users were addressed by their preferred name and this was recorded. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14 and 15 The home ensures that service users have the opportunity to maintain contact with their family and friends as they wish. Service users are helped to exercise choice and control over their lives to maintain their independence for as long as possible. Service users dietary needs are catered for with a selection of nutritious meals on offer. EVIDENCE: There is a record of visitors to the home. All service users spoken with said they could receive visitors at any time and they could go out when they wished. Service users have a telephone line in their room if they wish and there is also a cordless phone available. Service users said they had choice in how they lived their lives. Daily routines were flexible. Individual rooms were personalised and homely. The Registered Manager stated that service users handle their own personal affairs for as long as possible. She also stated that service users could access their personal records on request and there was a policy for this with a form to sign. All furniture brought into the home by service users was recorded. Service users were positive, on the whole, about the food provided. Some said they would like more homemade food, including cakes. There was a menu that showed that choices were available. The Registered Provider said that service
Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 13 users order their meals weekly, however they are free to change their minds. Service users said that drinks and snacks are available throughout the day. All staff have attended a course in Food Hygiene. Service users comments include “The food is really very good”, “We tell them what we like”, “I would prefer more homemade food and less Tesco food” and “I never know what I am having for lunch”. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Service users will be better protected from abuse when the policy is completed and all staff have received appropriate training. EVIDENCE: The adult protection policy is being updated; some minor adjustments were made during the inspection. This document must be fully updated. There is an appropriate whistle-blowing policy in the home. Some staff have been booked on an adult protection training course; all staff must undergo appropriate training in respect of Adult Protection. The Registered Provider said she goes through the home’s Adult Protection policy with all staff. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 15 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, 20, 25 and 26 The home and grounds are well maintained providing a safe environment for service users, staff and visitors. The decoration and furnishings are to a good standard creating a comfortable home. Service users have access to communal areas that are spacious and safe both indoors and outside. The home is clean and pleasant and controls are in place to reduce the risk of infection. EVIDENCE: The home is safe, clean, warm and comfortable. Service users said they liked their home and were happy living there. They could access the garden and service users said they liked to go outside. There is an ongoing programme of maintenance and refurbishment. The bathroom has been completed since the last inspection and is a big improvement. One bedroom was in the process of being totally refurbished and the floorboards are being replaced. There have been no changes to the layout of the home. No cupboards with fire doors were unlocked on this occasion. The water temperature is controlled in most areas; there are only a few washbasins left to do. The Registered Providers’ cats are now kept outside and fly screens are in place on the kitchen
Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 16 windows and external door. A tank with tropical fish has been provided in the main lounge and service users showed a keen interest in this addition. The laundry was clean and tidy, the ceiling has been repaired and the leak fixed. The Registered Providers are looking to hire a washer disinfector to clean commode pots and urinals. Alcohol hand gel is provided for staff and protective clothing is also used. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 17 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 and 29 The number of staff available is sufficient to meet the needs of the service users. Recruitment procedures have improved but must be maintained to offer protection to the service users. EVIDENCE: The Registered Provider said the staffing situation has improved and new staff were to start soon, two with NVQ qualifications. There are two care staff on duty during the day and a part time cleaner. At night there is one waking and one sleeper. The Registered Providers have been doing some of the night shifts as they have had difficulties employing care staff for night duties. As they live in a mobile home alongside the Care Home one sleeps there while the other stays awake in the home with the service users. They have a radio system for contacting each other. Service users said the arrangements work; some said they would rather not be tended by a man at night. This was fed back to the Registered Provider. Staff spoken with were happy with the shift times and generally satisfied in their work. Prospective employees complete an application form and a health questionnaire prior to an interview with the Registered Provider. A satisfactory explanation for gaps in employment must be sought. References are sought prior to employment and available on the files inspected. CRB and POVA checks have been applied for for all staff. These must be evidenced on each inspection. The Registered Provider stated that staff are being supervised until satisfactory checks are received, however staff were seen to be working alone.
Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 18 Employees are given a job description and a statement of terms and conditions of employment. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 19 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) 31,33,35 and 38 The management of the home has improved since the last inspection and service users benefit from the leadership provided. Quality Assurance monitoring takes place so that service users and their families can air their views. Service users manage their own money and their financial interests are safeguarded. Appropriate training and safety checks are undertaken to ensure the health, safety and welfare of service users and staff. EVIDENCE: The Registered Providers run the home together, Mrs Gatzianidis is responsible for the care of the service users, staffing and policies while Mr Gatzianidis deals with the building, maintenance and catering. Mrs Gatzianidis said she keeps up to date on issues regarding the elderly; she is undertaking the NVQ level 4 in Management and a course in dementia awareness. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 20 A Quality Assurance survey is undertaken annually, service users tend to complete the form with their relatives. A report of the results must be compiled annually and a copy sent to the Commission. All service users control their own money, they have their own bank accounts and they all have a secure facility in their rooms. Some money was held in the safe for one service user as she had accrued a large sum, there were records of her expenditure and receipts were kept. Statutory training takes place. Firewatch will be undertaking fire training in future. The fire risk assessment has been completed. All staff have done first aid training. All necessary service and equipment checks are undertaken regularly. Accidents are recorded and reported appropriately. The homes environmental risk assessment must be completed. There should be evidence in the home that the animals do not pose a risk of spreading infection in the form of veterinary care records. There must also be a risk assessment for the presence of animals in the home and grounds, with particular reference to falls and Infection Control. Paper towels must be supplied in the kitchen by the hand washbasin. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 x x x x 3 3 STAFFING Standard No Score 27 x 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 x 2 x 3 x x 2 Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 22 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 9 Regulation 13(2)(4)( c) Requirement Transcribing of medicines onto the MAR charts must be witnessed with two signatures recorded (Previous timescale of 04/11/04 not met) The adult protection policy must be fully updated. All staff must attend appropriate training in respect of Adult Protection. Staff must work under supervision at all times until a satisfactory CRB check has been received . Paper towels must be supplied in the kitchen by the hand washbasin for infection control purposes. . A satisfactory explanation for gaps in employment must be sought. There must be evidence that CRB and POVA checks have been undertaken for staff available at each inspection A report of the quality assurance results must be compiled annually and a copy sent to the Commission. Timescale for action 17/05/05 2. 3. 4. 18 18 18 13(6)12(1 ) (a) 13(6)12(1 ) (a) 18(2) 19(11) 13(3)(4)( c) 18/07/05 18/07/05 17/05/05 5. 26 20/06/05 6. 7. 27 27 19(1) 19(1) Sch 2 24 (2) 17/05/05 17/05/05 8. 33 18/07/05 Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 23 9. 10. 38 38 13(4) 13(3) (4)(a) 14(4)(c) 23 (2)(o) 17 (2) 11. 37 12. 37 .12(1)(a) (b) 17(1)(a) The homes environmental risk assessment must be completed There must also be a risk assessment for the presence of animals in the home and grounds, with particular reference to falls and Infection Control. .There must be records of food provided to service users in sufficient detail to enable inspectors to determine whether the diet is satisfactory in relation to nutrition and any special diets prepared for individual service users. Recording systems, with particular reference to daily care records must be improved. 18/07/05 18/07/05 18/07/05 18/07/05 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 38 28 Good Practice Recommendations There should be evidence in the home that the animals do not pose a risk of spreading infection in the form of veterinary care records There should be a minimum ratio of 50 trained members of care staff (NVQ 2 or above) excluding the registered provider. Trelawney House D52-D04 S53715 Trelawney House V215873 170505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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