The Royal College of Nursing (RCN) care homes survey 2010 was undertaken to get a snapshot view of the current situation in England’s care homes sector, specifically focusing on capacity, workforce, meeting resident’s needs and quality of care. We surveyed registered nurses and health care assistants. Results show that complex care needs of residents are increasing. The staffing levels in these homes are unable to respond efficiently to meet resident needs. This policy report outlines the results of the RCN 2010 care homes survey and identifies policy responses on improving care outcomes.