“…In addition to limited resources, efforts to ensure a well educated and motivated workforce are inhibited by several staff-related factors including: the limited financial rewards and low vocational image of the sector (Ron and Lowenstein, 2002); the low ratio of care staff to residents that compounds the difficulties of releasing staff Lindeman, et al, 2003;Lopez, 2006); high staff turnover, making it difficult to ensure that the majority of staff in employment have received appropriate education and training (Simons, et al, 2000;Ron and Lowenstein, 2002;Rosen, et al, 2005;Castle, 2006); low levels of literacy and, more widely, a background of poor educational achievement and few learning skills amongst staff (Huda, 1996;Walker and Osgood, 2000); low self-confidence and lack of motivation to attend seminars (Huda, 1996;Ross, et al, 2001;Aoki and Davies, 2002;Ron and Lowenstein, 2002), compounded by the limited incentives for staff to attend, especially if this is expected in their own time (Huda, 1996;Simons, et al, 2000;Ron and Lowenstein, 2002;Jones, 2006). The challenge is even greater for certain groups of staff, for example, those on night duty (Aoki and Davies, 2002).…”