Background: Establishing and maintaining a professional nurse–patient relationship is a core dimension of the Fundamentals of Care Framework¹, encompassing trust-building, being present and focused, getting to know the individual, anticipating needs, and collaborative evaluation of the relation. Such a relationship is widely recognised as essential for addressing fundamental care needs through a person-centred approach. However, despite clear conceptual definitions, the consistent integration of these relational elements into everyday nursing practice—particularly in home-based care—remains uncertain. Aim: To explore nurses’ activities related to how the nurse–patient relationship is established and maintained in home-based care for older people. Methods: This study is part of a larger project exploring nursing practice, Fundamentals of Care and quality of care. A structured observation protocol based on the Fundamentals of Care Framework was used to support direct observations (N=230) of nurses’ home-visits at four home-based care settings in Sweden (Table 1). Data was analysed with descriptive statistics. Results: The most frequently observed activity was nurses engaging in trust-building, which occurred in nearly every observation (Figure 1). This was followed by activities reflecting focus, knowing the older people, and anticipation of their needs. However, nurses’ engagement in anticipating care needs and developing familiarity with older peoples varied across sites. Notably, evaluation of the nurse–patient relationship was observed only once (0,7% of the observations). Conclusion: Nurses predominantly established and maintained the nurse–patient relationship through trust-building, being focused, getting to know the older people, and anticipating their needs. However, the degree of engagement in familiarity and anticipating varied across sites. The near absence of mutual evaluation of the nurse–patient relationship reveals a critical gap in person-centred care and highlights an opportunity for strengthening reflective and collaborative practices in home-based care settings.