Inspection on 06/02/06 for Rookwood Residential Care Home

This inspection was carried out on 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rookwood Residential Care Home 15/11/06

Rookwood Residential Care Home 31/10/05

Rookwood Residential Care Home 24/02/05

Rookwood Residential Care Home 08/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Rookwood Residential Care Home 219 Walmersley Road Bury Lancs BL9 5DF Lead Inspector Lucy Burgess Unannounced Inspection 6th February 2006 09:30 Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 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 Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 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. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rookwood Residential Care Home Address 219 Walmersley Road Bury Lancs BL9 5DF 0161 761 7952 0161 761 7952 antric@tiscali.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Anna Geraldine Ellis Mr Colin Bruce Ellis Mrs Collette Mary Richmond Care Home 17 Category(ies) of Learning disability (17), Mental disorder, registration, with number excluding learning disability or dementia (17) of places Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the maximum registered numbers there can be up to 17 MD and up to 17 LD The service should at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection 31st October 2005 Date of last inspection Brief Description of the Service: Rookwood provides residential care and support for up to seventeen people who are recovering from a mental illness. The home is owned by Mrs A Ellis and managed by Mrs C Richmond. The property is a large converted house that is sited on a main road about a mile from Bury town centre. Accommodation is on three levels and comprises of three lounges, a dining room, eleven single bedrooms and 3 double rooms. There are also four bathrooms and eight separate toilets. The home is spacious, homely and well maintained. Service users have access to local shops, pubs and other amenities situated nearby and there is easy access to bus services. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over one day for a period of 5½ hours. The inspector took the opportunity to look round the home, view records as well as talk with a number of residents. Discussion and feedback was also held with the Manager and Owner. The home is registered to provide accommodation for up to 17 people. At the time of the inspection there were no vacancies. One of the residents was receiving respite. Not all the standards were looked at during this inspection. Those not looked during this visit were looked at during the last inspection on the 31 October 2005. What the service does well: What has improved since the last inspection? Policies have been developed in relation to protecting residents. These have included the recruitment process when taking on new staff and how residents are supported with finances. These policies set out what should be done so that the residents are protected . As stated above the home is very settled with a stable staff team and group of residents. The home is maintained to a good standard, where work is needed this is dealt with. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 6 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. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 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 Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 The system of assessing prospective residents as well as spending time with them prior to admission gives an assurance that a resident will only be admitted if the home can meet their needs. EVIDENCE: On the day of the visit one individual was moving into the home for a period of respite. This had been arranged with the social worker. The service user along with a family member had previously visited the home so see if it was suitable. This enabled information to be gathered with regards to the needs of the individual and if the placement would be suitable. Assessment information was also being requested from the social worker with regards to the assessed needs including background information in relation to the mental health history. The home encourages prospective residents to visit the home. This enables residents and staff to meet with each other as well as enabling information to be gathered about their particular support needs. Information gathered is used to inform the development of the care plan. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 Minor amendments were needed to the care plans and risk assessments so that information fully reflects the support needed ensuring the health and safety of residents is maintained. EVIDENCE: Detailed information is held for each of the residents. Separate files are held and include a current working file with an up to date care plan risk assessments, health information diary notes. Whilst further information consists of assessments by health professionals, minutes from formal reviews, old notes and correspondence. Daily diary notes are completed by staff on each shift and outline individual routines, appointments etc. These are also used for monitoring purposes so that should there be any changes in the health and well-being of individuals the appropriate action can be taken. Through discussion with the manager, it was noted that the needs of one individual had changed. Recent incidents had occurred outside of the home, resulting in the resident being injured. The home become concerned about the resident being away from the home alone. Details of the incidents had not Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 10 been recorded with the accident book, it is advised that this is done for monitoring purposes. Information held within the care plan and individual risk assessments also needed to be expanded upon to reflect the recent concerns and intervention had been agreed. So that support offered by staff was consistent and where possible reduced any further risk to the resident. Risk assessments are completed in all areas identified. Assessment had improved with regards to residents smoking in their rooms however these needed to be further expanded upon to include how staff monitor this and ensure the risk is minimised and individuals are protected. Each of the plans had been reviewed on an annual basis. Further reviews also take place with health and social care professionals as part of the resettlement programme. Minutes to meetings had been provided and copies held on file. Formal reviews were said to be carried out annually, however should an earlier meeting be required this would be arranged. The Community Psychiatric Nurses (CPN) and hospital consultants continue to provide on-going support and advice to the team. From feedback received and through observations made residents are happy with the support they receive. Interactions with staff were seen to be open and friendly. Staff were found to have a good awareness of individual needs. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14 and 15 Routines vary depending on individual choices and preferences. Residents access the local and wider community enabling them to lead valued lives, develop skills and increase their independence. Support is offered where required. Residents maintain contact with family and friends and open visiting is encouraged. EVIDENCE: The home is a large detached property situated on a main road leading to Bury town centre, with easy access to public transport. The home is indistinguishable from those around it. Routines at the home vary depending on individual wishes and motivational levels with individuals rising and retiring as they wish. Residents pursue activities both in and away from the home and staff offer encouragement in maintaining their independent living skills. Activities are supported for those who require additional support. Residents use local public transport and have the use of a bus pass. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 12 Individuals continue to have regular access to local and wider community facilities accessing local shops, town centre shops, park etc. A few of the residents also attend the local college, a social club and drop-in centre. Courses have included computers and maths. Whilst at the centres or social groups activities have included DVD’s, museum trips, cookery sessions, swimming, football and visits to places of interest. Residents also have a variety of items such as televisions, videos and stereos, which they can relax and listen to. At present residents generally choose not to pursue formal courses or therapeutic employment. Staff continue the practice of giving mail to the residents unopened, however support is offered with those items needing a response etc. Residents are routinely offered a key for their own room, however some prefer for this to be held by the staff. Keys to the front door are not given out as generally the house is always occupied. Residents continue to maintain contact with family and friends. Visits take place both at the home or with residents visiting family members. Contact is made on a regular basis. Both residents and staff make visitors very welcome. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Residents’ mental health needs are consistently met. Relationships with mental health professionals are effective and provide positive support networks for the residents ensuring their health needs are promoted. The medication system was found to be safe and staff have completed training ensuring residents are protected and practice is safe, minor improvements were needed to the records. EVIDENCE: Information is held in relation to the mental and physical health needs of residents. Health care professionals are accessed for additional support and advise ensuring sufficient support and monitoring is provided in meeting the needs of residents. The home has established effective working relationships with the mental health professionals involved with residents. Formal reviews as required under the discharge programmes are held and discussion includes the residents’ stability, progress or concerns in relation to their mental health. Further information is also recorded within the care plans outlining the specific support needs of individuals and how they are to be met providing staff with the necessary information when offering support. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 14 Records are made of all professional visits and appointments, which include community psychiatric nurses, GP, hospital etc. Each resident has access to all NHS entitlements as and when they are needed. Support is offered for appointments. Where additional intervention has been identified with regards to maintaining the physical well-being of a resident, staff will access the support of the district nurse team ensuring that the necessary care and support is provided. Staff provide personal care support where agreed. This is very much dependent on individual needs. In the main residents are prompted in maintaining their own personal care and appearance. Support and encouragement is offered from staff in developing this area. Additional records are also held with regards to individual weights. These are completed for monitoring purposes, should any concerns be identified additional support and advice would be accessed. The medication system was looked at. The supplying pharmacist had carried out an audit of the system in October 2005. This identified that a procedure was needed with regards to homely remedies. Medication held within the home is stored safely along with individual records. Minor improvements were needed to the records with regards to changes made to any prescribed medication stating date of change, by whom and then signed. At present the home does not hold any controlled drugs. Any returns are recorded and signed for by the driver. Existing staff have received the relevant training required, further training is to be planned for the newest members of the team. Residents’ medication is also regularly reviewed with health professionals ensuring the stability of their mental health. At present residents are supported with their medication other than eye drops and hand creams. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Systems are in place with regards to the investigation of complaints and adult protection issues, ensuring that residents are listened to and protected. EVIDENCE: Policies and procedures are in place covering complaints and the protection of vulnerable adults. The home also has a copy of the Local Authorities Vulnerable Adults procedure. No issues have been raised at the home or with CSCI. The majority of staff have received training in this area, further training is being planned for the newest members of the team. Further policies and procedures in relation to adult protection have been implemented. These include dealing with whistle blowing, confidentiality, recruitment and selection of staff, the management of residents’ finances and a POVA referral procedure. Suitable arrangements are in place with regards to the management of residents’ finances. Residents continue to receive their full personal allowance each week and records are made of all transactions. The Proprietor remains the appointee for 9 of the residents. Additional accounts i.e. saving accounts these are registered in the names of those individuals. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Rookwood provides comfortable, clean, homely accommodation, which meets the needs of those living there. EVIDENCE: Rookwood continues to provide a good standard of accommodation for the individuals living there. The home is a large property that is in keeping with those around it. Communal space comprises of 3 lounges, one of which is the designated smoking area, a dining room and kitchen. There are also 11 single bedrooms and 3 double rooms. None of the bedrooms have en-suite. Three bathrooms and 8 separate toilets are available on each floor as well as a basement laundry and staff office. The home is spacious, well-maintained, decorated and furnished, providing comfortable accommodation. Rooms were seen of those residents spoken with. These had been personalised with pictures, photographs and personal belongings. Residents spoken with were very happy and settled at the home. Each of the rooms have a sink and are fitted with suitable door locks. Residents have keys for their own rooms. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 17 The Proprietor has identified future redecoration/refurbishment work within the kitchen, hall, stairs and landings. The home continues to employs a domestic who carries out the majority of the domestic tasks. The support staff also carry out additional tasks. As already identified the home has a separate laundry, which also has hand-washing facilities to prevent any cross infection. The environment was seen to be clean, tidy and odour free. The home also has a gardener who ensures that the grounds are well maintained. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Sufficient staffing is provided to meet the needs of residents. On going training is planned to equip staff with the knowledge and skills needed in meeting the needs of service users. In the main recruitment and selection procedures are followed ensuring the residents are protected. EVIDENCE: Staffing at the home consists of 9 day staff and 4 night staff, however one night carer is soon to leave the home. Two staff members will provide support between the hours of 8am and 10pm each day with wake-in night cover at night. The home also employs a domestic. In addition both the manager and the owner also provide cover at the home during week-days, supporting both staff and the residents. Sufficient staffing is provided to meet the needs of residents. Since the last visit 2 new staff have been employed. Records were examined for the new staff. Information included an application form, copies of identification, references and training certificates. The manager must ensure that references are provided from those referees named and that where information states ‘to whom it may concern’ the authenticity of such documents should be checked. Information contained on the application should also include a detailed employment. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 19 All staff have also been recently been issued with new contracts. These are currently being signed by staff and copies places on file. Discussion also took place with regards to the process of Criminal Record Checks (CRB’s) and Pova 1st checks. The manager was advised on how to access the Pova 1st checks ensuring that information is held on file prior to new staff commencing employment. In relation to staff training, courses have been identified for the newest members of the team as well as updates for existing staff. These include an induction, medication, vulnerable adults, moving and handling and 1st aid. The home also has training video, which are utilised as part of the induction process. These cover infection control, health and safety, moving and handling, medication and adult abuse. Videos are used in addition to the formal courses ensuring staff have the knowledge required as well as ensuring the safety of residents. All new staff complete an induction. The manager is arranging for new staff to complete an on-line induction covering the principles of care, needs of service users, health and safety, role of a carer and providing services. This will be completed in conjunction with the ‘skills for care’ induction process. New staff also complete a period of ‘shadowing’, which enables them to learn their role. Of the 9 care staff 5 have or are currently completing the NVQ training. Three staff have achieved the level 2, of which 2 have gone on to do further training with the Level 3. Two other staff are currently completing the Level 2 course. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42 The overall management of the home is consistent and reliable for the people living there. Satisfactory arrangements are in place with regards to providing a safe, well maintained home so that residents and staff are safe from harm. EVIDENCE: The Manager has worked at the home for approximately 10 years, becoming the registered manager in 2005. The Registered Manager is responsible for the day-to-day management of the home. Training with regards to the Registered Managers Award and NVQ level 4 have previously been completed. Other training courses related to the needs of service users have also been completed ensuring that her practice is up-todate. The owner supports the manager in her role. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 21 Checks are carried out in relation to the safety of the home and equipment. Up to date certificates were seen. These included; • a 5-year electric checks • gas • fire appliances and alarm • emergency lighting • small appliances Further in-house checks are also made with regards to the fire alarms, mean of escape and fire drill, however information had not been updated since November 2005. Records are also held in relation to water temperature, these too need to be updated to reflect that checks are made regularly. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 22 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 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X X X X 3 x Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA7 Regulation 15 Requirement That the care plans reflect current issues/concerns identified for individuals residents. That risk assessments outline action being taken by staff to minimise the identified risks. That staff files contain all information required under the regulation and schedule. Timescale for action 03/03/06 2. 3. YA9 YA34 13 19 schedule 2 03/03/06 03/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA9 YA20 YA20 YA42 Good Practice Recommendations That information in relation to recent accidents involving one resident is recorded within the accident book. That where changes have been made to the medication record sheets information is dated and signed to confirm when and by whom it was agreed. That a procedure is introduced in relation to homely remedies. That records in relation to the water temperature and in house fire checks are brought up to date. Rookwood Residential Care Home DS0000008425.V282171.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 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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