Setting

Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 1 RESIDENTIAL SPECIAL SCHOOL

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CO6 3QL

Lead Inspector Jenny Elliott Announced Inspection 6th March 2006 10:00 Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 2 The Commission for Social Care Inspection aims to:

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CO6 3QL

• 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

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CO6 3QL

Reader Information Document Purpose Inspection Report Author CSCI Audience General Public Further copies from 0870 240 7535 (telephone order line) Copyright 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 Internet address www.csci.org.uk Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 3 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 Residential Special Schools. 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

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CO6 3QL

Every Child Matters, outlined the government’s vision for children’s services and formed the basis of the Children Act 2004. It provides a framework for inspection so that children’s services should be judged on their contribution to the outcomes considered essential to wellbeing in childhood and later life. Those outcomes are: • Being healthy • Staying safe • Enjoying and achieving • Making a contribution; and • Achieving economic wellbeing.

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CO6 3QL

In response, the Commission for Social Care Inspection has re-ordered the national minimum standards for children’s services under the five outcomes, for reporting purposes. A further section has been created under ‘Management’ to cover those issues that will potentially impact on all the outcomes above.

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CO6 3QL

Copies of Every Child Matters and The Children Act 2004 are available from The Stationery Office as above. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 4

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Name of school

Address Abbotts Lane Eight Ash Green Colchester Essex CO6 3QL

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Name of school

Provider Web address www.essexautistic.org.uk

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inspection

11 th October 2004 Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 5

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Brief Description of the School:

Doucecroft School is an independent special school, owned and operated by the Essex Autistic Society, catering for children and young people affected by autism spectrum disorder.

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Brief Description of the School:

At the time of the inspection the school was providing places for 20 boarding pupils aged between 8 and 19 years.

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Brief Description of the School:

Since the last inspection, the main school has moved to a purpose built site on the outskirts of Colchester. The new site has separate teaching, office and boarding areas. Boarding is divided into four units, all pupils have their own bedroom and each unit has a lounge and kitchen area. All of the accommodation and recreational areas are a great improvement on the old school.

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Brief Description of the School:

The school’s Further Education department has remained in Kelvedon, about 8 miles from the main school. Accommodation here is provided in single rooms. There is a large garden at the rear of the building with vegetable patches and fruit trees. The conversion of an outbuilding for additional teaching and meeting space, had been completed since the last inspection. The FE department continues to access nearby community facilities, in addition to social events in nearby towns. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 6

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SUMMARY

This is an overview of what the inspector found during the inspection.

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SUMMARY

This inspection was carried out between the 6 th and 24 th March 2006. Two days were spent at the main school. During this time, breakfast and lunch were taken with pupils, staff and pupils gave a tour of the teaching and boarding areas, morning and evening routines were observed, discussions held with a range of staff, and records were inspected. A visit was also made to the FE department, where tea was taken with staff and pupils and a meeting was held with the Head of that department. Questionnaires were sent to parents and staff, extending the end of the inspection to allow for the return of these. Due to the nature of the children’s special needs, questionnaires were not completed with children, however opportunities were taken to observe children at school, and talk with those who were able to communicate verbally.

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SUMMARY

Children and staff were helpful and accommodating throughout the inspection, and the inspector would like to thank everybody for contributing to the inspection process.

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What the school does well:

Staff at both sites continue to have good professional relationships with children and young people, and respond in a consistent manner to their needs.

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What the school does well:

The school and FE department continue to use a range of communication methods, suitable to the needs of individual children and young people.

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What the school does well:

There was a high level of positive interaction with children and young people, encouraging the use and development, of communication and social skills.

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What the school does well:

Communication with parents was good, one parent stated in a questionnaire ‘Home/school links are good and we have been able to deal with any problems with trust and openness’.

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What the school does well:

The management and promotion of health issues was generally good, including the management and administration of medication.

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What the school does well:

The induction of new staff was good, and included familiarisation of individual care plans, staff had a good understanding of the needs of individual pupils.

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What the school does well:

The school’s residential provision actively supports educational progress. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 7

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What has improved since the last inspection?

The new purpose built school is a great improvement, and has had a positive impact on the well being of pupils.

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What has improved since the last inspection?

Interaction between staff and pupils was consistently good.

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What has improved since the last inspection?

The school’s residential staff teams are structured to reflect the new boarding units. There are clear lines of accountability, supervision (of staff in residential units), and shared understanding and knowledge in respect of children’s needs in each unit.

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What has improved since the last inspection?

The FE department has introduced real choices in menus that has led to some students extending the range of foods they will eat.

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What they could do better:

It is of some concern that the issues that have been identified as requiring attention reflect those raised at the last inspection.

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What they could do better:

The vetting of staff employed by the school did not, at this inspection, meet national minimum standards.

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What they could do better:

The school’s recording of sanctions and restraints still require improvement.

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What they could do better:

The school must ensure that it takes appropriate action, and keeps clear records of action taken, in respect of any concerns about the welfare of children and young people.

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What they could do better:

The senior management team were still not receiving supervision.

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What they could do better:

Please contact the Head 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. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 8

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CONTENTS

Recommended Actions identified during the inspection Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 9

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The intended outcomes for these standards are:

• Children live in a healthy environment and the health and intimate care needs of each child are identified and promoted.(NMS 14) • Children are provided with healthy, nutritious meals that meet their dietary needs.(NMS 15)

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JUDGEMENT – we looked at outcomes for the following standard(s):

The school environment is healthy, and the health and intimate care needs of pupils were generally well met.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The school caters well for each pupil’s specific dietary requirements.

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EVIDENCE:

Pupils at the main school have benefited from the new environment. Pupils are cared for in small groups by staff who have a good understanding of their needs. New staff were carefully instructed to follow the school’s intimate care policy, and always observed before carrying out these tasks unsupervised. Medication was stored safely in each boarding area, and the records sampled were complete in respect of the amount of medication stored and administered. The administration of medication to two pupils was observed. The practice seen was very good. Each child was encouraged to take a level of control, appropriate to their ability, in the administration process. The school was experiencing on-going difficulties with the receipt of medication for one child, despite a protocol being agreed between the school and the children’s home, where the child lived. The school had and was continuing to take all

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EVIDENCE:

reasonable action to address this. One pupil will only take their medication in food. A clear risk assessment, with appropriate action identified was in place and had been reviewed.

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EVIDENCE:

The school must ensure that appropriate risk assessments and protocols are in place for all specific health needs and not rely on staff being aware of verbal agreements.

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EVIDENCE:

Pupils at the main school had a wide range of diets and food tolerances. These were clearly recorded and adhered to. Within the restraints of these, pupils were encouraged to try a variety of foods at the mealtimes attended. During the lunch attended by the inspector, two children had particular difficulties that Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 10 resulted in episodes of challenging behaviour. Staff provided reassurance and support to other children in the dining room to reduce anxieties and enable them, where possible, to continue with their meal. During lunch one pupil went to pick up a metal vegetable dish, but had to let go quickly because it was so hot. Staff advised that there were not sufficient warmers in the kitchen, so that some dishes came straight from the oven, resulting in a risk of burning.

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EVIDENCE:

Breakfast was taken in the boarding units. The atmosphere during breakfast was homely, chatty and relaxed. Pupils were encouraged to maximise use of communication, whether verbal or through ‘picture exchange’ and were consistently praised for their efforts.

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EVIDENCE:

Tea was taken at the FE department, again the atmosphere was relaxed and homely. Students were encouraged to communicate, participate in the mealtime routine and to eat well. The FE department now use photos of food to enable all students to make a choice about their meal. Comments in home- school communication books included ‘[student] says she is eating salad at school. I have always prepared salad at home which [student] has always declined’, and in respect of another student ‘first normal Christmas we’ve had [student] ate turkey.’

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EVIDENCE:

The catering staff at the main school had not had any training in respect of special diets, in light of pupil needs it is recommended that this should be sought. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 11

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The intended outcomes for these standards are:

• Children’s privacy is respected and information about them is confidentially handled.(NMS 3) • Children’s complaints are addressed without delay and children are kept informed of progress in their consideration.(NMS 4) • The welfare of children is promoted, children are protected from abuse, and an appropriate response is made to any allegation or suspicion of abuse.(NMS 5) • Children are protected from bullying by others.(NMS 6) • All significant events relating to the protection of children in the school are notified by the Head of the school or designated person to the appropriate authorities.(NMS 7) • Children who are absent without authority are protected in accordance with written guidance and responded to positively on return.(NMS 8) • Children are assisted to develop appropriate behaviour through the encouragement of acceptable behaviour and constructive staff responses to inappropriate behaviour.(NMS 10)

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The intended outcomes for these standards are:

• Children live in schools that provide physical safety and security.(NMS 26) • There is careful selection and vetting of all staff, volunteers, and monitoring of visitors to the school to prevent children being exposed to potential abusers.(NMS 27)

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JUDGEMENT – we looked at outcomes for the following standard(s):

The privacy of children and young people is respected.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The school did not respond satisfactorily to incidents involving children, that were, potentially, of concern.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Staff were consistent and positive with children and young people when promoting acceptable standards of behaviour.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The physical environment at the school and FE department were safe and secure for the numbers of children and young people in residence.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The vetting of staff was not satisfactory. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 12

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EVIDENCE:

As described in the previous section the school has a comprehensive intimate care policy, implemented by staff, that promotes the privacy and dignity of pupils. All students and pupils now have their own bedrooms, and the morning routine observed at the main school allowed for each pupil to have one to one support from staff. The administration of medication observed during the inspection also served to promote the privacy and dignity of pupils. Records were held securely.

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EVIDENCE:

The school keeps comprehensive records of activities, behaviours and incidents relating to all pupils. In the records sampled there were examples of incidents and records of bruising/marks about which the school should have consulted other professionals. The records associated with these did not evidence that appropriate action had been taken. The issue of thresholds for reporting concerns, or seeking further advice, was raised at the last inspection. One member of staff told the inspector ‘children with autism can do odd things’. Whilst this is acknowledged, it must not become a reason for raising thresholds in respect of potential issues of concern.

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EVIDENCE:

Interaction between staff and young people was positive throughout the inspection. Children and young people were encouraged to maximise the use of their individual communication methods, and to behave in an appropriate way, with constant praise and encouragement. Apart from incidents of the most challenging behaviour, unacceptable behaviour was dealt with calmly and discreetly, with prompts about what behaviour was acceptable. Behaviour targets were consistently applied in boarding and teaching areas. One parent commented ‘the transfer to a boarding place has been a pleasant experience and I can see improvements in his behaviour and progress already in just a short period.’

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EVIDENCE:

Records of physical intervention did not meet national minimum standards and were not in a format that allowed them to be robustly reviewed. Staff were appropriately trained in restraint techniques, however one restraint observed during the inspection was not recognised as such by the school, and it was not clear whether the restraint used had been agreed with trainers.

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EVIDENCE:

The physical environment was safe and secure. The new school had been inspected and approved by the appropriate regulatory bodies. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 13

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The intended outcomes for these standards are:

• The school’s residential provision actively supports children’s educational progress at the school.(NMS 12) • Children have ample opportunity to engage in purposeful and enjoyable activities both within the school and in the local community.(NMS 13) • Children receive individual support when they need it.(NMS 22)

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JUDGEMENT – we looked at outcomes for the following standard(s):

The school’s residential provision supports educational progress.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The school provides opportunities for children and young people to engage in a range of appropriate activities.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Children and young people receive individual support as they need it.

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EVIDENCE:

Although teaching and residential staff do not formally meet to discuss the educational needs of pupils, there is a daily written handover from the school to the residential staff. Children’s educational targets include targets related to behaviour and communication and these are addressed on a 24 hour basis. The regime at the school is highly structured to meet the special needs of pupils. Residential staff collect children at the end of the school day and bring them into school in the morning. Older children at the main school are encouraged to develop their independence in preparation for moving on from the school.

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EVIDENCE:

The FE department has a smaller staff team, who work together regularly. There is a greater emphasis on the development of independence and social skills that is addressed during teaching and residential time.

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EVIDENCE:

The main school has taken advantage of the new site to develop the range of out of school activities available. Children participate in these in small groups. An evening music session was observed during the inspection, where pupils were given lots of encouragement and praise to try out a range of percussion instruments and sing along to a tape. The school also makes use of its rural Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 14 location for short walks in the evening. The school has its own swimming pool, allowing children who could not manage a public pool to enjoy this activity. Whilst the new site benefits from much a larger outside recreational area, there is no fixed equipment in place for the children to use. The school is currently fundraising for this.

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EVIDENCE:

The FE department continues to use local facilities such as restaurants, library and public house. On the evening spent at this part of the school during the inspection, students were getting ready to attend a youth club at a nearby town.

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EVIDENCE:

The main school and FE Department have a high staff/pupil ratio, allowing individual support to be provided where necessary. Due to a particularly high level of challenging behaviour by one pupil, the number of staff in one unit was higher than the number of pupils, ensuring that periods of challenging behaviour did not impact negatively on the support to other pupils in the unit. The school does not operate a key-worker system, all staff in a unit share the care of all children in that unit. This ensures that staff are not constantly working with the most demanding children. It was evident from observation that children were comfortable with staff, jokes verbal and non-verbal were shared, and a high level of communication obtained through picture exchange. One pupil told the inspector ‘I really like [member of staff] she always checks on me at night and wakes me up in the morning’. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 15

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The intended outcomes for these standards are:

• Children are encouraged and supported to make decisions about their lives and to influence the way the school is run. No child should be assumed to be unable to communicate their views.(NMS 2) • Children have sound relationships with staff based on honesty and mutual respect.(NMS 9) • Children experience planned and sensitively handled admission and leaving processes.(NMS 11) • Children have their needs assessed and written plans outline how these needs will be met while at school.(NMS 17) • In accordance with their wishes children are able and encouraged to maintain contact with their parents and families while living away from home at school.(NMS 20)

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JUDGEMENT – we looked at outcomes for the following standard(s):

The school works to maximise each child’s ability to make decisions.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The relationships observed between staff, children and young people were good.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The plans of care for pupils were generally good.

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EVIDENCE:

As has already been described, most children accommodated by the school have limited, or no verbal communication. A variety of communication methods (including the interpretation of behaviour) were in consistent use by staff with these pupils, enabling them to make basic choices about, eg, food and recreational activities. A small number of children had good verbal communication and this was developed through conversation. At the FE department more complex conversations were held with students who had the most developed verbal skills, but all students were engaged in making basic choices. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 16 As the (albeit small) group of children with verbal skills has increased at the main school, consideration should be given to how meaningful consultation can be carried out.

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EVIDENCE:

Communication between staff at both sites of the school and pupils’ main carers was good.

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EVIDENCE:

As has already been described, the observed relationships between staff and pupils were consistently good.

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EVIDENCE:

The plans of care sampled during the inspection were generally good, providing clear direction for staff about how to care for individual pupils. It was evident from the consistency observed between staff, and the understanding of pupils’ needs expressed by staff in discussion, that these plans were in use. However there were some specific gaps noted in plans of care, such as protocols for health needs and clear guidance in respect of restraints for particular children. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 17

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The intended outcomes for these standards are:

• Children can wear their own clothing outside school time, can secure personal requisites and stationery while at school, and are helped to look after their own money.(NMS 16) • Children about to leave care are prepared for the transition into independent living.(NMS 21) • Children live in well designed and pleasant premises, providing sufficient space and facilities to meet their needs.(NMS 23) • Children live in accommodation which is appropriately decorated, furnished and maintained to a high standard, providing adequate facilities for their use.(NMS 24) • Children are able to carry out their personal care in privacy and with dignity.(NMS 25)

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JUDGEMENT – we looked at outcomes for the following standard(s):

Accommodation provided by the school was of a satisfactory to high standard.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Children and young people were able to carry out personal care with privacy and dignity.

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EVIDENCE:

The new school, on the outskirts of Colchester, generally provides a very good standard of residential accommodation. There are four boarding areas, each with single bedrooms, sufficient bathroom and toilet facilities, a kitchen-diner and lounge. The space available was sufficient for the numbers of children accommodated. However, it was felt that should units be full some areas, specifically the kitchen-diner would not be sufficient, bearing in mind the needs and behaviours of some children and the number of staff required to meet those needs. Walls at the new site were generally bare, although pictures drawn by the children were on display on cupboard doors in the living room. Notice boards were in all of the bedrooms seen, and some of these held photos, cards and posters. Generally however the school could make better use of available wall space to improve the homeliness of the accommodation.

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EVIDENCE:

It was unfortunate that the only windows in the living and dining areas of residential units were skylights, which were too high for children to see out of. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 18 The FE department is located in an older building. All students have single bedrooms and there is a satisfactory number of bathrooms and toilets. Two lounges are situated near the boarding area. There is only one dining room, but this has a homely feel, and is of sufficient size to enable all boarders to sit at one large table.

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EVIDENCE:

Many of the children and young people need help in respect of personal care. This is either in the form of verbal, pictorial prompts or physical help. Policies, care plans and the induction of staff ensures that whatever help is required is provided in a manner that promotes the dignity of individuals.

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EVIDENCE:

One parent said they [staff] ‘always treat [child] with respect and as an individual. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 19

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The intended outcomes for these standards are:

• Children, parents, staff and placing authorities have access to a clear statement of the school’s care principles and practice for boarding pupils.(NMS 1) • Children’s needs, development and progress is recorded to reflect their individuality and their group interactions.(NMS 18) • There are adequate records of both the staff and child groups of the school.(NMS 19) • Children are looked after by staff who understand their needs and are able to meet them consistently.(NMS 28) • Children are looked after by staff who are trained to meet their needs.(NMS 29) • Children are looked after by staff who are themselves supported and guided in safeguarding and promoting the children’s welfare.(NMS 30) • Children receive the care and services they need from competent staff.(NMS 31) • Children and staff enjoy the stability of efficiently run schools.(NMS 32) • The governing body, trustees, local authority, proprietor or other

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The intended outcomes for these standards are:

responsible body monitors the welfare of the children in the school.(NMS 33)

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JUDGEMENT – we looked at outcomes for the following standard(s):

Records relating to needs, development and progress of pupils were good.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Staff had a good understanding of the needs of pupils.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Residential staff were supported and supervised well, there was no supervision in place for the senior management team.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The care received by pupils at the school and FE department was good.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The school has an active governing body, although not all areas were monitored sufficiently. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 20

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EVIDENCE:

Full records were kept relating to the progress of children. Records were maintained in daily logs, care plans and home-school books. Records were signed and dated and reflected the plans of care in place. Staff used the records on a daily basis and were familiar with the current needs of pupils.

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EVIDENCE:

Regular supervision was held with staff in residential units, records were kept and provided evidence of a child centred approach to those sessions. The senior management team did not receive supervision; it is of concern that this has been an issue raised at the previous two inspections.

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EVIDENCE:

The school has an active governing body, who participate in training and carry out regular visits. Visits take place during the day and evening, to both school sites on an announced and unannounced basis. Reports were provided following those visits. There was no evidence from these reports that records were checked during visits, and as has already been mentioned, records in respect of restraint were not held in a manner that afforded easy scrutiny. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 21

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SCORING OF OUTCOMES

This page summarises the assessment of the extent to which the National Minimum Standards for Residential Special Schools have been met and uses the following scale.

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SCORING OF OUTCOMES

4 Standard Exceeded (Commendable) 3 Standard Met (No Shortfalls) 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (Major Shortfalls)

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SCORING OF OUTCOMES

“X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable

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SCORING OF OUTCOMES

BEING HEALTHY MAKING A POSITIVE Standard No Score CONTRIBUTION 14 2 Standard No Score 15 3 2 3 9 4 STAYING SAFE 11 X Standard No Score 17 3 3 3 20 X 4 X 5 1 ACHIEVING ECONOMIC 6 X WELLBEING 7 1 Standard No Score 8 X 16 X 10 2 21 N/A 26 3 23 3 27 2 24 3 25 3 ENJOYING AND ACHIEVING Standard No Score MANAGEMENT 12 4 Standard No Score 13 3 1 X 22 4 18 3 19 X 28 4 29 3 30 2 31 4 32 3 33 2 Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 22 Are there any outstanding recommendations from the last inspection? Yes

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RECOMMENDED ACTIONS

This section sets out the actions that must be taken so that the proprietor meets the Children Act 1989, Inspection of Schools and Colleges Regulations 2002 and the National Minimum Standards.

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RECOMMENDED ACTIONS

No. Standard Recommendation Timescale for action (Serious welfare concerns only) 1 RS14 The school must ensure that all of the health and care needs of pupils are adequately recorded. 2 RS7RS5 The school must ensure that appropriate action is taken, and recorded, in respect of concerns in respect of children and young people. And that thresholds of reporting concerns are appropriate.

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Previous timescale of 31/01/05 not

met. 3 RS27 The school must ensure that satisfactory recruitment checks are carried out on all new staff. 30/04/06

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Previous timescale of 31/01/05 not

4 RS30 The school must ensure that supervision is in place for all staff. Previous timescale of 31/03/05 not met. 5 RS10RS5RS33 The school must ensure that it adequately records incidents of restraint and that those records are monitored by the governing body and senior management team.

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Previous timescale of 31/01/05 not

met. Doucecroft School DS0000018010.V277552.R02.S.doc Version 5.1 Page 23

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Commission for Social Care Inspection

Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ

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Commission for Social Care Inspection

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. Extracts may not be used or reproduced without the express permission of CSCI.

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