The findings of the 2011 RCN care home survey paint a worrying picture of the many daily challenges that care home staff strive to overcome to deliver quality care in care homes. Many of these challenges are not new, with RCN members identifying some of the concerns in the 2004 and 2010 RCN care homes surveys. However, the scale of these challenges is new. Following years of neglect, these issues have significantly worsened. In particular, the challenges facing care homes and their staff have resulted in the continued depletion of workforce morale to further compound the issues relating to staffing shortages and patient safety and care quality. With wholesale reform of both care systems planned, there is a clear opportunity for the Government to address these issues that for too long have been overlooked.