Inspection on 16/05/07 for Isabella Court

This inspection was carried out on 16th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Isabella Court 29/11/05

Isabella Court 25/07/05

Isabella Court 13/10/04

Isabella Court 29/06/04

Similar services:

Whitwood House

Whitwood Hall

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Isabella Court 72a Westgate Pickering North Yorkshire YO18 8AU Lead Inspector Pauline O`Rourke Key Unannounced Inspection 16th May 2007 10:30 DS0000007833.V333206.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000007833.V333206.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000007833.V333206.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Isabella Court Address 72a Westgate Pickering North Yorkshire YO18 8AU 01751 475787 01751 477116 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) www.wilfward.org.uk The Wilf Ward Family Trust Mr Paul Spencer Holbrook Care Home 10 Category(ies) of Learning disability (10) registration, with number of places DS0000007833.V333206.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 10 residents with Learning Disabilities some or all of whom may have Physical Disabilities Date of last inspection 29th November 2005 Brief Description of the Service: Isabella Court is registered to provide accommodation to 10 younger adults who have a learning disability and/or a physical disability. Paul Holbrook is the Registered Manager and it is owned by the Wilf Ward Family Trust, a registered charity who also provide the care. Isabella Court is a purpose built centre situated on the outskirts of Pickering. The site offers three facilities: Isabella Court itself giving respite care to a maximum of six guests at any one time, a day care centre within this building and Woodside, an adapted property, offering permanent accommodation to four residents. Isabella Court and Woodside cater for adults with a learning disability and associated health and behavioural problems including some challenging behaviour. There are 6 places available at Isabella Court and 4 places at Woodside. Both properties offer accessible accommodation and are set in grounds that are available to all users of the service. All the bedrooms are single occupancy. No bedroom has ensuite facilities although one room can directly access bathing facilities. Each building has communal areas and these are also used for dining areas. Information about the service is available on request and it can be provided in a variety of formats. On the 16th May 2007 the cost to the residents was between £108.95 and £143.60 per week, this is determined through a financial assessment. This covers the accommodation costs, the local health authority and social services departments meet the cost of the personal care. They and their carer are informed of this cost prior to their admission. DS0000007833.V333206.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on information gathered from the provider, service users and relatives. A site visit to the home was carried out on 16th May 2007. It focused on the key standards. An inspection of some of the premises was undertaken. A number of records were also examined. Discussions were held with the three members of staff on duty. The manager in the form of a pre-inspection questionnaire supplied information and surveys were sent out to relatives. Feedback was received from 20 relatives and 3 care managers. Time was also spent observing the interactions between the staff and residents. What the service does well: What has improved since the last inspection? Since the last inspection all the people who use the services have had a risk assessment this allows them to participate in activities whilst staff are mindful of possible risks. DS0000007833.V333206.R01.S.doc Version 5.2 Page 6 The registered manager has obtained a copy of the revised multi-agency protocol on adult protection. Staff spoken with were aware of this document. All staff have received training in the administration of medicines. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000007833.V333206.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000007833.V333206.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who decide to use this service have the information needed to ensure their needs can be met. EVIDENCE: People who access the respite facilities at Isabella Court undergo a comprehensive, multidisciplinary assessment prior to commencing the service. Any respite available is part of a larger package of care and this is reviewed annually with all involved parties. Everyone who wants to use the service is able to visit the home and to spend as much ‘settling in time’ as they need. Information about the service is provided in a variety of formats. There have been no admissions to Woodside since the last inspection, but a discussion was held with the Registered Manager about how a new admission would take place. The Wilf Ward Family Trust has a proven admissions policy and this ensures that a multi disciplinary assessment is undertaken prior to any admission. The home usually receives an assessment and makes as initial decision about suitability before the person who requires support and their family are contacted. The process then becomes a series of visits and short stays to determine whether the placement is suitable. A trial period is then DS0000007833.V333206.R01.S.doc Version 5.2 Page 9 planned and the length of this trial is dependent on the needs of the individual. As part of the assessment process the wishes of the established residents are taken in to account. The case files seen of current residents contained comprehensive assessments and evidence of regular reviews of the care plans. DS0000007833.V333206.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are able to make decisions on a day-to-day basis about their lives and this allows them to remain as independent as possible. EVIDENCE: All the people using Woodlands have a comprehensive care plan and there is evidence to show these are reviewed when necessary. Other health professionals indicated that the staff are good at requesting reviews of specialist services and asking for help when the residents needs change. The staff spoken with were knowledgeable about the care plans and they involve the residents and their relatives, where appropriate, in all reviews. The residents were seen during the visit making their own choices about what they wanted staff to do for them. The staff have developed an understanding of the communication methods used by them and these are clearly identified in DS0000007833.V333206.R01.S.doc Version 5.2 Page 11 the care plans. A daily diary is maintained for each resident so that all staff can be involved in the review process. The people who use Isabella Court have a care plan but also a daily routine sheet that outlines how they like to be supported with their personal care. These sheets are used on a daily basis and are kept in the persons’ bedroom and in a file accessible by staff. This information is reviewed at each visit. After each visit a brief description of what activities they have been involved in during their stay is sent to their carers. This allows supporters to see what they have done during their stay and gives them an opportunity to suggest alternative activities the person they support may enjoy. Feedback received from relatives said: ‘The staff work well together and understand the needs of the service users’ and ‘‘I feel the care home do well at looking after each individual’s needs keeping everyone occupied’ The people in both services were seen during the visit to make choices about their routine or their interaction with the staff. Methods of communicating their choices were described in their care plans. Staff were fully aware of the differing styles of the people who use the service and were able to explain the differences in communication styles during the site visit. All of the people who use the service had up to date risk assessments in place in relation to their individual needs and their differing daily living abilities. These documents are reviewed regularly incorporating specialist assistance when necessary. The staff accommodate the variety of needs very well and endeavour to make all areas of the home, garden and community accessible to all. DS0000007833.V333206.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are encouraged to make decisions about their daily life and staff provide appropriate support and encouragement for them to remain independent. EVIDENCE: People who use the service have an activity folder outlining a personal profile of likes and dislikes. A daily calendar is kept showing what they do each day. The activities available are pertinent to the individual and during the visit it was clear that the staff demonstrated, a clear understanding of the service users needs. The activity files show that the ability of the individuals to take part in a lot of external activities has changed along with their changing needs. The key workers know their likes and dislikes and activities planned are based on this knowledge. The manager recognises that there hasn’t always been a proper programme of activities and he has introduced an expectation amongst DS0000007833.V333206.R01.S.doc Version 5.2 Page 13 the staff that there is at least one main activity with each person each day, more if possible. This also applies to a weekend in response to concerns raised by relatives about the lack of activities available. Relatives are now kept informed of what happens whilst they are resident. ‘I always feel welcome staff listen to any problems my son may have they write a diary of what and where my son has done so we can talk about it when he comes home’. There is a visitor’s policy in place and this is included in the information available to potential residents and their families. Questionnaires received from relatives indicated that they are kept informed of any changes to their situation. This information is contained in their personal plans and staff were fully conversant with these documents. Relatives said that the staff keep them informed of what happens with each stay and through a monthly newsletter. ‘Information to the relatives is provided through a newsletter and regular meetings’ The people who use either Isabella Court or Woodlands enjoy a varied and balanced diet. 4-week menus are in place but the staff, are flexible enough to change it around to take in to account trips out, what the residents want and what is available. Where necessary people are assisted with their meals and they have specialist equipment if it is needed. All the people are encouraged to be as independent as possible during their meals. The mealtime observed at Isabella Court during the visit was relaxed. All the staff on duty eat with the residents this allows for appropriate assistance in a relaxed and respectful way. One resident was able to choose how and when they ate their meal and staff observed but did not interfere. DS0000007833.V333206.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of the people who use the service are met on an individual basis. The staff employ the principles of respect, dignity and privacy in all interactions with the residents. EVIDENCE: Care plans seen were pertinent to the individual concerned. They are detailed and evidence was available to show they are reviewed on a regular basis. Feedback received from other professionals indicated that the staff were particularly good at dealing with people who had complex needs. Staff were observed treating the residents with respect and endeavoured to maintain their dignity at all times. Evidence was available to show that the care plans for those people who live at Woodside are reviewed every two months. Key workers maintain daily diaries to show what an individual has participated in. This information is used during the reviews. The people who use the respite service are registered with their own doctors and only access the local surgery as an emergency patient. Their carers DS0000007833.V333206.R01.S.doc Version 5.2 Page 15 continue to organise any health related appointments. The people who live in Woodside are all registered with the local surgery and evidence was available that they access this service when necessary. Evidence was also available in their file to show that they attend a range of health services such as chiropody, dentist, learning disability support services and assessments from speech therapists and psychologists. The medication is stored in an individual locked cupboard. Medication is dispensed directly from the original packaging and the records kept were accurate and up-to-date. There is a stock control record and two members of staff sign all medication records. All staff have completed a learning distance course in The Safe Handling of Medicines, they also cover the topic on the Learning Disability Award Framework-accredited training. (LDAF) National Vocational Qualification level 2 training. The Wilf Ward Family Trust has also provided supplement training for the staff to ensure they continue to manage the medication appropriately. Staff encourage the residents to take their medication and are aware that they are allowed to refuse it. On the day that people are admitted to the respite unit the medication brought in for their stay is counted and audited by two members of staff. It is then entered on the administration sheets and checked each day. DS0000007833.V333206.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected. EVIDENCE: There is a robust complaints procedure in place, a copy of which is available in the residents file. They are in large print and picture format. The Wilf Ward Family Trust also has a resident Group, which meets to discuss how residents might like to improve the services available. A representative is named and contact details are displayed in the hallway of the home. The Wilf Ward Family Trust or the Commission has received no complaints. Following a period of respite the manager contacts relatives of people who have been at respite to see if there were any concerns connected with the stay Feedback received from relatives indicated that they could raise any areas of concern at any time and the staff listened to what they had to say. ‘I always feel welcome staff listen to any problems my son may have’ An Adult Protection protocol is in place and staff were aware of their responsibilities under this procedure. Staff have received training through Nation Vocational Qualification and their induction and foundation training. The manager also reinforces the training in the monthly staff meetings. DS0000007833.V333206.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a well-maintained, clean property that allows them to access all areas, promoting their independence. EVIDENCE: Isabella Court is purpose built and allows access throughout the building for everyone visiting. There are 6 single bedrooms and one large communal area, there is a separate communal area but this is used for day care. The home was clean and odour free and the general maintenance is kept up to date. They have been able to install a ceiling track hoist in one of the bedrooms, which allows easy access to the bathroom for one resident. The bedrooms were functional but very bare in their décor. The rooms are painted, carpeted and supplied with a bed. A discussion was held with the manager to see if there was a way that the rooms could be accessorized and made to feel more homely. He was in the process of collecting a ‘shoe-box’ for each resident who used this service and in this box would be personal photos and items important DS0000007833.V333206.R01.S.doc Version 5.2 Page 18 to the visiting resident. This would then form part of the admissions process with staff personalising the bedroom. He is looking in to the possibility of adding further decorations to the rooms. Woodlands is a purpose built bungalow with four bedrooms and a communal and dining room. The whole building was well decorated and maintained and it was odour free. The residents’ bedrooms were highly personalised and reflected the character of the occupant. All staff were aware of the infection control policy and laundry facilities were appropriate to the service. DS0000007833.V333206.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents in both Isabella Court and Woodside are supported by welltrained staff in sufficient numbers that they are seen as individuals and the care provided id pertinent to their needs. EVIDENCE: The Wilf Ward Family Trust has a well established and robust recruitment process and all necessary checks would be carried out prior to anyone being deployed in the home. The rota’s received prior to the inspection indicated that the home is staffed appropriately. During the site visit the residents plans provided the staff with clear instruction including where two members of staff were required for one resident. The staff spoken with said that they felt the staffing was adequate and that they had time to spend with the residents on a one-to-one basis. The whole routine during the visit was relaxed and staff were seen interacting positively with the residents. The pre-inspection questionnaire showed that the staff have received training in Safe Handling of medicines, fire training, first aid, food hygiene and use of DS0000007833.V333206.R01.S.doc Version 5.2 Page 20 wheelchairs in a mini bus. Staff spoken with said that they had access to training on a regular basis. Staff have monthly supervision where they are expected to set their own learning goals and identify training needs. Team meetings are an opportunity to ensure everyone is aware of any changes to the residents’ plans and to put forward ideas for future activity plans. Surveys were sent to carers and some of their response included: • Staff care for the service users with respect and kindness. • The staff are excellent very kind and caring. I would like you to know how much we both appreciate the respite care we get at Isabella. This was echoed by the visiting professionals who said: ‘Staff can meet complex needs of service users. Staff administer medication appropriately. Privacy and dignity of service users is respected’ ‘Staff seem to cope particularly well with more severely disabled clients and the manager is very clear on what staff can and cannot offer’ DS0000007833.V333206.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a well managed home where the administration of the home is based on openness and respect. This allows the residents to retain their individuality and independence. EVIDENCE: The Registered Manager is an experienced manager. The staff said that he operates and open door policy and he works with the staff. The staff said that he asks for their ideas and opinions on issues and listens to what they say, but they also said that if he needs to make a decision he does. He works closely with his assistant managers and tries to make time for the users of the respite service as well as the residents at Woodlands. DS0000007833.V333206.R01.S.doc Version 5.2 Page 22 The Wilf Ward Family Trust has a thorough quality assurance programme within the trust and where possible involves residents as much as possible. The individual homes carry out small quality checks and a visiting service manager carries these out. The records seen during the site visit were maintained to high standard and contained detailed and pertinent information. They were stored securely and the staff could access them when necessary. The records for the residents’ monies were found to be accurate and up-to-date. Someone from outside the home but from the Wilf Ward Family Trust checks the accounts on a regular basis. All the working practices within the home are safe and staff keep accurate accident records, this information is used to inform the care plan and in requesting specialist input. Staff have received training in the health and safety procedures and all the policies are read by the staff. The records relating to health and safety issues that were seen during the visit were up to date DS0000007833.V333206.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X DS0000007833.V333206.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000007833.V333206.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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