This overview of life in United Kingdom (UK) care homes is edited by the three conveners of the National Care Home Research and Development Forum who were commissioned by the charity Help the Aged to prepare a review of the literature as well as an accessible report about the quality of life in care homes. The resulting report, My Home Life, which at the time received considerable attention from the national press, constituted a comprehensive description of life in a UK care home, from the resident's admission through to, in most cases, death.

The book reviewed here presents some of the research upon which My Home Life was partly based, and although it is targeted at a wide audience including policy makers, several chapters focus on practice issues particular to nurses and social workers. It commences with a scene-setting chapter in which the editors explain the fundamental premise of the book: ‘an emphasis on participatory engagement and collaborative working, both within care homes and between care homes and external agencies’ (p. 18). The editors identify four primary principles of these relationships: equity, engagement, mutual learning, and honesty, and they suggest that the research and development examples in the book show how these principles can be incorporated into practice to enhance the experiences of all the players in care home life.

The book has three sections although, as the editors note, there are overlaps among them. The first section focuses on the individual, and commences with a description of the challenges faced in an action research project that was undertaken by the lead author to introduce person-centred care into a long-term care setting. It concludes that the imperative to engage in person-centred care, which is central to the National Service Framework for Older People, ignores the relationship dimensions of the care exchanges between staff and residents. This is followed by another chapter on an action research project that focused on care planning for care-home residents with dementia. One interesting aspect of this was the challenge of getting residents to tolerate the behaviour of fellow residents with dementia, particularly where there was a low staff-to-resident ratio. Although exact figures are hard to access nationally, it is apparent that the majority of care-home residents have dementia to some degree, and that this impacts on many aspects of care. The presented findings suggest that reappraising roles and building upon existing resources in care homes could improve the experiences of all involved. Christine Brown-Wilson, Glenda Cook and Denise Forte illustrate how narrative can be used to help residents maintain existing relationships with relatives and friends as well as develop new friendships within the care setting. Robert Jenkins highlights the particular issues faced by older people with learning difficulties, and in common with many other authors in this volume makes a strong case for developing environments appropriate to the needs of the specific population as well as employing specially trained staff.

Part 2 focuses on ‘organisation’ and commences with an overview of three projects undertaken by Garuth Chalfont. He describes how, through conversation, he helped care-home residents with dementia to engage with nature in order to help them to reinforce their sense of self. He emphasises the need to value residents' identities and explore ways, even within the practical limitations imposed by poorly-designed premises, to enable residents to commune with nature and maintain aspects of their identities. A social work perspective was used by Furness and Tory to undertake a small study of ‘Friends of Care Homes’ in two locations, to ascertain whether these influenced the quality assurance and quality monitoring systems enshrined in the National Minimum Standards for Care Homes for Older People of 2003. They conclude that such organisations have the potential to make an important input into ensuring improved quality of life for residents as long as managers not only listen to their views but also operationalise useful suggestions.

The last section is entitled ‘The wider perspective’ and explores different networks and ways of working in care homes, including those that might change the existing culture, and others that might combat the isolation that some staff experience in care homes. Improvements in care in relation to specific conditions suffered by residents, as well as improvements in care workers' skills and confidence, can be enhanced by strengthening relationships; with, for example, higher education (Tina Fear) and district nurses (Claire Goodman, Sue Davies, Stephen Leyshon, Mandy Fader, Chris Norton, Heather Gage and Jackie Morris). This book should be essential reading for policy makers, directors of care-home organisations, care-home staff, and others working at the coal face providing all elements of support to care-home residents and staff. The book shows how a commitment to improve the care-home experience for residents, relatives, professional carers and providers can lead to innovative and exploratory projects, which in themselves could feed into policy and practice.