Inspection on 17/07/06 for Pembroke Rest Home

This inspection was carried out on 17th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

Pembroke Rest Home 12/07/07

Pembroke Rest Home 07/11/05

Pembroke Rest Home 07/07/05

Pembroke Rest Home 07/02/05

Pembroke Rest Home 08/07/04

Pembroke Rest Home 06/02/04

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

CARE HOMES FOR OLDER PEOPLE Pembroke Rest Home 2 Pembroke Avenue Walkergate Newcastle Upon Tyne Tyne & Wear NE6 4QU Lead Inspector Deborah Haugh Key Unannounced Inspection 17th July 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pembroke Rest Home Address 2 Pembroke Avenue Walkergate Newcastle Upon Tyne Tyne & Wear NE6 4QU 0191 224 0862 0191 224 5803 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 Jennifer Houghton Care Home 21 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (15) of places Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 Brief Description of the Service: Pembroke House provides care and support for 21 older people who require residential care. Six of the 21 places available are specialist beds for older people with dementia care needs. The Home is situated in a residential area of Walkergate. The accommodation is spread over two floors and offers the following facilities - nineteen single bedrooms, including two with en-suite, and a double bedroom; a central kitchen and laundry; a large lounge and a dining area; a conservatory. A pleasant garden area is available to the side of the building and there is a yard to the rear of the Home. The Home has good access to local facilities and transport systems. On-road parking is available to the front of the building. The current fees charged by the home are £355 £425 per week. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The un-announced inspection took place on 17/07/06 from 9.30am until 3.45pm. There were 16 service users living at the home. The home does not have a Registered Manager but the acting manager Neil Stewart was on duty during the visit. Time was spent looking around the home to check the cleanliness, maintenance and decoration during the visit. Time was also spent observing the contact between the service users and staff. Visitors were seen to freely come and go. Questionnaires were sent to service users, visitors and professionals who have contact with the home. Service users and staff were spoken with. Three Care Plans were examined. Arrangements for the administration and management of medication were checked. Health and safety arrangements were examined as well as the catering, recruitment, protection of vulnerable adults (POVA) service users finances, fire instruction, training and complaints. What the service does well: Some of the service users shared their views of the home and these included. - ‘I have no problems with the staff.’ - ‘The girls are good.’ Visitors also shared their views. - ‘ There is not enough for those who are able to do.’ - ‘The staff are good.’ Staff knowledge of the needs of service users. The garden. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home ensures that it can meet the needs of the service users as their needs are assessed prior to admission. But social assessments must be consistently completed. EVIDENCE: Three service user care plans were examined and assessments are completed which look at a range of the needs of the service users. However a social assessment, which looks at interests, hobbies and personal preferences, has not been completed for one service user. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users have care plans and risk assessments, which enable them to have their needs met. But activities must be developed more. Service users good health is promoted but one record must improve. Service users receive the medication they require. Service users feel their privacy is respected and they are treated well. EVIDENCE: Care plans identify a range of needs and assessments. These include mobility, nutrition, skin care and personal hygiene. Improvements have been made regarding nutrition. It is recommended that the cook keep a copy of nutritional care plans. Staff spoke in detail of the needs of service users particularly nutrition. Records show that service users who are nutritionally vulnerable have gained weight. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 10 One service user does not have a social assessment and the daily social records are blank. The service user would like to receive the Evening Chronicle and prefers to eat alone, likes to smoke, enjoys visits from family and prefers to spend time in their bedroom. This is not documented in an activity care plan. One service user’s social care plan states that they have total bed rest and only gets up for meals. The daily activity record was last completed 06/02/06. The service user has regular visits from a relative, likes to have the newspaper read to them, loves cricket and sport but none of this is recorded in the care plan. The home has a general record, which records activities in the home. The activities range from skittles, watching TV, movies sing-a-longs, chair exercises, quizzes. But some service users do not want to join in group activities and these activities may not be suitable. Person centred care and meaningful occupation for people is seen as good practice. The inspector has provided information to the Company regarding meaningful occupation. Service users have access to a range of health professionals such as GP’s, District Nurses, Community Psychiatric Nurses, Chiropodists, Opticians and Dentists. One care plan regarding continence was discussed with the manager and must be developed to consider preventative measures. A full audit of the medication arrangements was completed and arrangements are good. Good progress has been made to address the requirements and recommendation made at the last inspection. Staff are trained and care staff have received training in administering ointments. Service users said that they felt that staff respected them and treated them well. Service users are called by their preferred name and this is recorded in their care plans. The laundry arrangements are good which ensures that clothes are returned to the right person. However the manager was asked to consider providing delicate bags for hosiery laundry for service users. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 -15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users expectations, choice and preferences are not always provided by the home (activities). Service users are provided with autonomy and choice. Service users maintain contact with family and friends. Service users receive an adequate nutritional diet. EVIDENCE: Two care plans examined are not addressing the preferences of the service users and developing their social interests. (See NMS 7). Another care plan identifies music and sing-a-longs for the person who has confusion which they enjoy. Staff provide group activities and a recent BBQ 28/06/06 was enjoyed by those who attended. The manager has applied for a grant to fund a bus trip to the coast with fish and chips. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 12 During the very hot day staff facilitated a singsong, asked people if they wanted to sing or watch TV. Ice cream cornets were offered in the afternoon which people enjoyed including a visitor. Two visitors confirmed that they are made welcome and staff contact with relatives is positive. People are able to bring their own possessions and keepsakes with them when they move into the home. Service users are able to handle their finances for as long as they are able. The lunchtime meal was ham and egg pie or fish cakes, chips and beans. The sweet was a trifle or yoghurt. Teatime was cheese on toast, a selection of sandwiches, tuna, cheese, corned beef and beetroot. Cheese and fruit scones to follow with butter, jam and cream. The presentation was good. Staff encouraged service users to eat, offered assistance and alternatives. The meal was relaxed and unrushed. Drinks were available during the meal. The cook described the foods used to fortify food such as full fat milk, cream and butter. These foods are used in cooking to raise the calorific value. The cook would benefit from having copies of the nutritional care plans for service users. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The Registered Provider takes complaints seriously and visitors feel they can share concerns and make complaints to the home. Poor arrangements for the recruitment, supervision of staff may compromise service users being protected from abuse. EVIDENCE: The Registered Provider has a complaints policy and procedure. CSCI and the Registered Provider have investigated complaints in the last 12 months. Elements of the complaints have been substantiated and appropriate action taken by the Provider. Staff are clear about how they would deal with a complaint, which includes informing the management and making a record. Visitors said they would feel able to go to staff and make their concerns known. Staff spoken with are clear about reporting poor practice under the homes Whistle Blowing Policy. According to training records and the manager 5 out of 18 staff (including the manager) have received POVA training. All staff must Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 14 receive this. Following the inspection the manager said that all staff have now been registered to complete a 13 week POVA course the following week. Recruitment arrangements are not satisfactory (see NMS 29) and this may compromise the safety of service users. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Service users live in a home, which is maintained, clean and decorated. But domestic/laundry staffing levels have been reduced which may compromise infection control and cleaning. EVIDENCE: The manager accompanied the inspector around the home to check the cleanliness, maintenance and decoration. The cleanliness and lack of cleaning schedules were not adequate in the kitchen. The Environmental Health Officer (EHO) arrived unannounced at the home during this inspection and will issue a report and requirements regarding the kitchen. The cleanliness, decoration and maintenance of the home was acceptable on the day of the inspection. However domestic and laundry hours have been reduced without CSCI agreement and care staff are expected to clean when there is no ancillary staff. (See NMS 27) Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 16 Four out of six requirements have been completed regarding the premises, which is good progress. - Emergency pull cords now reach the floor. - A label is now on the domestic’s disinfectant spray in accordance to Control of Substances Hazardous to Health (COSHH). - The shower room has been refurbished to replace tiles, replaced the fixed rusty shower chair and repainted the flooring. - Non-functioning Extractors have been repaired - An audit of the lockable storage facilities has been must be undertaken to ensure that service users (who are able) have keys. - Liquid soap and paper towels have been provided in the sluice & laundry. Two requirements remain outstanding - A hand-washing sink must be provided in the laundry. Plumbing is in place and according to the manager the sink is due to be installed. - Steps must be taken to reduce the hot temperature (30oC) in the sluice room. The temperature in the sluice remains high. Service users bedrooms are personalised with their own keepsakes and possessions. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 Quality in this outcome area is poor. This judgment has been made using available evidence including a visit to this service. Staffing numbers are not appropriate to the assessed needs of the service users, size and layout and purpose of the home at all times. Staff are trained and obtain qualifications but POVA training must be provided to all staff to protect service users. Recruitment arrangements are not robust which may put service users at risk. EVIDENCE: The home does not maintain the level of domestic/laundry staffing in accordance with previous agreements with the local authority and this reflects the size and layout of the building and the needs of the service users currently living in the home. Staffing levels No of beds 8am –2pm 2pm – 5pm 5pm – 9pm 9pm – 8am 4 –9 2 2 2 1 back up 10-12 2 2 2 2 13-15 3 2 2 2 16-19 3 3 3 2 20-23 4 3 3 2 Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 18 Domestic Laundry 15 residents 21 residents Cook 15 20 55.5hours/week 74 hours/week 43.5 47 Using the calculations there must be 55.5 hours a week domestic and laundry in place. According to staff rotas for June and July 2006 the following hours are allocated Laundry Domestic 16 18 The Registered Provider has not advertised or recruited 21.5 hours vacant domestic/laundry hours. This short fall has occurred before during the inspection in November 2005 but was addressed by the Registered Provider by the additional visit in March 2006. CSCI have contacted the Operations Manager regarding this repeated shortfall following the inspection. The Registered Provider and manager must ensure that ancillary hours are adequate hours. Staff vacancies must be filled and reductions in staffing must not occur without prior agreement with CSCI. Staff training records were examined and staff have received training in Medication, Manual Handling, Fire Safety, Food Hygiene, Infection Control First Aid, Nutrition and Decontamination/disinfection. As mentioned in NMS 18, 5 out of 18 staff including the manager have received training in POVA. All staff must receive this. 60 of care staff have NVQ level 2 or above which exceeds the standard of 50 by 2005. Staff spoke with confidence regarding their roles and duties. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 19 A training plan was forwarded to CSCI by the Operations Manager which indicated that staff will receive further training in Protection of Vulnerable Adults, Six care staff have NVQ Level 2 and seven are to commence. One staff member has NVQ Level 3 and three are to start. From a sample of staff records one person does not have Criminal Records Bureau clearance and is working under a POVA check. Staff in this situation must be supervised and accompanied by a staff member who is appropriately qualified and experienced until clearance is received. The manager confirmed that is has not occurred as he was unaware of this regulation. The manager is required to arrange supervision of the staff member. Two staff recruitment records had only 1 reference. Two references are required one of which being the previous employer in a caring capacity. Staff photographs were not available for three people. The Registered Provider must ensure that recruitement arrangements are robust to protect service users. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The home does not have a Registered Manager who is legally responsible for the care of the service users. The Registered Provider works with CSCI and has measures to ensure that service users are provided with a quality service. The home ensures that service users finances, which are looked after by them are protected. Records are not in place to safeguard service users. Routine servicing and maintenance checks are completed apart from 2 items. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 21 EVIDENCE: The acting manager Mr Neil Stewart is not registered under the Care Standards Act 2000. He came to Pembroke Care Home at the end of February 2006. Mr Stewart has recently completed the Registered Managers Award and NVQ level 4 in Care. The Registered Provider must submit Mr Stewart’s application to be the Registered Manager without further delay. The Registered Provider has a Quality Assurance System where audits are undertaken periodically. The Operations Manager completes regulation 26 monthly visits and reports and CSCI receive copies. A check of finances looked after on behalf of service users were checked in the presence of the manager. Arrangements were satisfactory but a discrepancy was looked into by the manager and resolved. Records regarding recruitment and staff are incomplete (See NMS 18 & 29) The manager undertakes weekly and monthly maintenance checks but records provided showed that the fire alarms and hot water temperatures have not been checked each week. Staff are expected to test water temperatures of baths/showers before service users bathe. The servicing of equipment is in place such as fire checks, chlorination, lift and heating appliances. Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X 2 2 Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 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 Provider/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 OP27 Regulation 18(1) Requirement The Registered Provider shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health ands welfare of service users. (Domestic/laundry). Reductions in staffing must not occur without prior agreement with CSCI. 2 OP29 19, 17 schedule 2 The Registered Provider shall ensure that recruitement arrangements are robust – 2 references for staff must be obtained. - New staff without CRB clearance but who have POVA First checks must be supervised and accompanied by a staff member who is appropriately qualified and experienced. - A recent photograph of staff must be obtained. The Registered Provider shall ensure that all staff receive POVA training. DS0000000451.V295581.R01.S.doc Timescale for action 31/07/06 17/07/06 3 OP30 18(1) 31/08/06 Pembroke Rest Home Version 5.2 Page 24 4. OP7 12(1) 15 The Registered Provider shall ensure that care plans for occupation and activity are based on assessments and reflect personal preferences. Review identified care plan regarding the promotion of continence. 31/08/06 5. OP26 16(2) The Registered Provider shall ensure that steps are taken to reduce the hot temperature (30oC) in the sluice room. OUTSTANDING 30/04/06 The Registered Provider shall ensure that weekly fire alarm and hot water temperatures checks are completed and recorded. A hand-washing sink must be provided in the laundry. OUTSTANDING 30/04/06 The Registered Provider shall appoint an individual to manage the care home where there is no Registered Manager. 30/11/06 6. OP38 16(2) 23(4) 17/07/06 7. OP26 16(2) 31/08/06 8. OP31 8 31/08/06 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 Refer to Standard OP10 OP15 Good Practice Recommendations Consider providing delicate bags for hosiery laundry for service users. Provide copies of nutritional care plans in the kitchen (high calorie) Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Pembroke Rest Home DS0000000451.V295581.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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