Care home staff described how hospital staff did not understand the nature and challenges that are faced by care homes. In the following quote, a care home manager points to ethical and procedural differences between residential care and hospital care, suggesting that residential care is negatively vilified. Again, such feelings are likely to result in further demoralisation in this sector and reduce integration of care.When they go to the hospital from here, they always have a UTI, they’re always dehydrated, they have faecal impaction … And it’s ALWAYS, look that’s what’s happened, dehydrated. But none of this is true. What they [hospital staff] don’t understand is that we don’t force care here on anyone, for any reason whatsoever. We don’t restrain, we don’t restrain physically, chemically, we don’t put people in recliners that they can’t get up out of, that’s a restraint, we don’t open people’s mouths and give medication if they’re spitting it out, we don’t put fluids in people’s mouths if they don’t want to drink, the same thing with food, ok, and we have a balance that we, this is one of the stresses of the job in that when we admit somebody, and decide that we’re going to care for that person, we have a duty of care. We also on the other hand have to balance that with the person’s right to refuse … and I think, not just the hospital but I believe, social workers need to come in to care homes and I think they need to see for themselves what happens in care homes (Care Home Manager).