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This report looks at the training, support and resources care home staff need to do their jobs well, based on feedback from 13 care home managers in East Kent.
It builds on the same set of interviews as our wider system working report and focuses on the day-to-day challenges staff face when supporting people with complex needs.
You can also read our companion report looking at how care homes are working with hospitals and community services, which helps explain some of the wider pressures behind these findings.
Supporting increasingly complex needs
Managers were very clear that residents’ needs are becoming more complex—and support hasn’t always kept pace.
Some of the most common areas where extra help is needed include:
Dementia care
Continence support
Frailty and long-term conditions
Distressed behaviour
For example:
10 managers raised issues around continence, including delays and not enough supplies
10 also highlighted dementia support, particularly around training and access to mental health teams
Managers also spoke about long waits for specialist services, such as speech and language therapy, and challenges accessing the right support at the right time.
Training: a consistent theme
Across both nursing and residential homes, one message came through clearly—staff need more training.
Managers talked about wanting:
Practical, hands-on learning
Training that’s easy to access
More in-person sessions in some cases
They also highlighted gaps in areas like:
Falls prevention
Managing distressed behaviour
Long-term conditions
What makes training hard to access?
Even where training is available, it’s not always easy to take part.
The biggest barrier was staff availability:
Releasing staff from shifts is difficult
Long working hours (like 12-hour shifts) make training harder to attend
Other challenges included:
Cost, especially for smaller homes
Travel and logistics for in-person training
Some managers said they were well supported internally, but this varied a lot depending on the organisation.
Infection control and day-to-day support
Most managers felt confident in their infection control training and knew where to get help if needed.
However, they also pointed out that:
Newer staff may lack hands-on experience
Knowledge isn’t always consistent across teams
Support for managers
Managers also reflected on their own roles, which many described as demanding and sometimes isolating.
They highlighted a need for:
More support with HR and people management
Opportunities to connect with other managers
Greater understanding of the pressures they face
Working with the wider system
Experiences of support from health and care partners were mixed. Some managers described regular contact and helpful relationships, while others said they had very little interaction or had to chase support themselves.
Related report
This report is part of a wider piece of work on care homes in East Kent. Read our report on system working to see how these workforce challenges link to issues like hospital discharge, access to services, and continuity of care.
