Long-term care. Unknown quantities.

A small study of nursing home owners, managers, residents and relatives found effective management depended on strong leadership skills, high bed occupancy, enthusiastic staff and low staff turnover. Funding problems were a key issue for homes, creating massive insecurity for residents, relatives and staff. There was a feeling that nursing homes could be used more effectively by the NHS, but there were concerns about capacity and competence. The viability of homes would be improved by annual block booking by the NHS. This would also facilitate the development of intermediate care. A national development programme for nursing home managers is needed.