Aim To explore the impact of policy changes on care homes and the provision of nursing in care homes.

Method Eight hundred Royal College of Nursing (RCN) members working in nursing care homes were surveyed by postal questionnaire in 2004.

Results A 37 per cent response rate (n=296) was achieved. Of these, 274 worked in homes registered to provide care for older people and/or those with dementia. Although the majority of respondents were happy in their posts, they said that they were not always able to meet residents’ needs. They voiced concerns about inappropriate admissions, the assessment process and the need to fill beds to maintain income. Although 65 per cent of residents were state-funded, almost 75 per cent of the homes charged these residents a top-up fee.

Conclusion Care homes should be given enough resources to ensure that the needs of residents are met. The RCN is developing a programme to lobby government for adequate resources for care home placements.