The physical layout of the care home may hinder the provision of good quality care. Many care homes are arranged so that people with different levels of need are housed on different floors of the building. Staff are required to work across these settings and the focus of their tasks may vary. Having staff consistently assigned to one floor was seen as promoting continuous care both to people with dementia and their families and enabled professional carers to adopt a more personalised approach.I don’t know how confident the care home staff would have been to do it [make referrals] and also they changed on a daily basis, that was the biggest,… not the staff in the home but the floor that they worked on, yeah. So like you’d go do a ward round with (Doctor) and you’d sit there and you’d say ‘so how’s blah, blah been this week?’ and they’ll say ‘well I worked downstairs for the last five days then I had two days off’ and it would be like well what, you know we did say ‘please can you try and keep the same staff on the same floors’ and then you’d have RMN’s (Registered Mental Nurse) that worked on the middle floor which was more sort of general nursing and you would have an RGN (Registered General Nurse) on the bottom floor which was more psychiatric. There didn’t seem to be any consistency to be honest (Clinical Manager).