Well-educated nursing staff are needed in care and nursing homes to provide high-quality care because comprehensive and advanced nurse competence is required to meet the needs of older people.

such as care and nursing homes) have a high prevalence of dependency, multimorbidity, polypharmacy, cognitive impairment and behavioural symptoms resulting in complex care needs (Gordon et al., 2014;Onder et al., 2012). When providing care in care and nursing Abstract Background: The need for older people nursing expertise is increasing, and every effort is required to ensure that personnel taking care of older people are capable of providing high-quality care. Aims:To explore care home nursing professionals' self-rated competence in older people nursing and to identify predictors of this competence. Design: A cross-sectional survey design.Method: Data were collected in August-September 2017 via an electronic questionnaire using the newly developed Nurse Competence in Care Home Scale (NCCHS).Participants (n = 781) were recruited via nurses' associations and social media. They were working in care homes either as licensed practical nurses (n = 680) or as registered nurse and/or in managerial position (n = 101).Findings: Approximately 65% of the respondents had "adequate competence," and 35% had "inadequate competence" in older people nursing based on self-assessed overall competence. Respondents rated their competence highest in "observation, communication, interaction" and lowest in "group guidance and activities" subscale.Age and further training were predictors of licensed practical nurses' competence, and length of work experience predicted registered nurses' competence. Conclusions:Self-assessments revealed the need for competence development especially in relation to holistic support of a person's well-being. It is recommended that care home nurses, managers, educators and curriculum developers all strive to develop care home staff's ability to support residents' well-being holistically. Implications for practice:Nursing personnel should consider all aspects of older people's well-being holistically. In care homes, it is essential to assess nursing staff competence and to provide possibilities for competence development for personnel. K E Y W O R D Scare home, competence, licensed practical nurses, nursing, older people, registered nurses, self-assessment

Family members' expectations reflect the need for ethical and interactional competence in the care home. In addition, evidence-based practice competencies are required to provide high-quality care. Nurses' ability to provide person-centred, individual and holistic care is vital to ensure care home residents' well-being.

Nurses need versatile competence to care for older people in care home settings. A modified Delphi study was conducted to identify competencies registered nurses and licensed practical nurses need to care for older people in care homes. A total of 38 panelists consisting of experienced professionals in clinical and managerial roles were recruited to identify types of competencies these nurses require. In total, 80 competencies for licensed practical nurses and 81 competencies for registered nurses were identified as necessary. This study has shown that licensed practical nurses are required to have similar competencies to registered nurses in care homes. Nurse managers, nurse educators, and policy makers should pay more attention, to nurses' work requirements, especially for licensed practical nurses, and support nurses to meet the needs of older people living in care homes.

AimThe aim of this study was to investigate the prevalence of frailty and identify the demographical and clinical factors associated with frailty among older family caregivers.MethodThe participants of this cross‐sectional study were older family caregivers (n = 125) living in Eastern Finland. Data on functional and cognitive status, depressive symptoms, nutritional status, medication, chronic diseases, stroke, and oral health were obtained. The Mini Nutritional Assessment (MNA) was used to evaluate nutritional status. Frailty status was evaluated using the abbreviated comprehensive geriatric assessment (aCGA) scale.ResultsSeventy‐three percent of caregivers were identified as frail. According to multivariable logistic regression, cataract, glaucoma, or macular degeneration and the MNA score were predictors of frailty. After adjusting for age, gender, and number of own teeth, the MNA score remained a significant predictor of frailty (adjusted OR = 1.22, 95% CI = 1.06, 1.41). As the MNA scores decreased (meaning poorer nutritional status), the risk of frailty increased.ConclusionsThe present study showed that frailty is prevalent among older family caregivers. Recognising older family caregivers with frailty or at risk of frailty is vital. It is essential to acknowledge vision problems' role in frailty and to monitor and support the nutritional status of family caregivers regularly to prevent frailty development.

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