The aim of this article is to share with a wider audience a quality enhancement approach from a nationally funded project which used peer review to benchmark practice standards as a basis for enhancing the care of older people within acute inpatient settings. The study involved the development and implementation of clinical practice review systems, and provision of mentoring, peer review and critical refection for staff nurse and health care assistant grades. A review of the nursing care in 43 ward areas and departments was undertaken, along with analysis of the peer review feedback sheets. Analysis revealed that examples of good practice predominated. There were, however, important areas where practice could be improved. For example, many staff needed to improve their communication skills, and some health care assistant grades needed particularly to improve their patient-centred approaches. It was also found that many staff had unmet educational needs.