Building on the author's previous research on sustained shared thinking (SST) in early years' settings, this study investigates challenges for nannies of fostering quality interactions (Qi) within a family home. Data were collected through a focus group and semi-structured interviews with London-based nannies. Analysis of the rich, qualitative data revealed the nannies' conceptualisation of Qi, the skills required and the fact that interactions in the home can be especially effective in supporting development. Relationships with employers and the child's mood were significant challenges for nannies. Implications of findings for students, for educators and for employers have been outlined.