This paper describes the leadership and management competencies of head nurses and directors of nursing in social and health care. In the nursing profession, studies have tended to describe the role of the nurse manager, or to provide lists of competencies, talents and traits which can be found in successful managers. However, nursing managers’ leadership and management competencies lack any depth of research knowledge. Data were gathered by electronic questionnaire. Respondents (n = 1025) were head nurses and directors of nursing. The data were statistically analysed. Both groups evaluated their leadership and management competencies to be quite good and their general competence to be better than their special competence. Overall, directors of nursing rated their general competence and special competence better than head nurses. However, the head nurses had a stronger expertise in general competence areas, professional competence and credibility, and also in the special competence areas of substance knowledge than the directors of nursing. While the overall leadership and management competencies were good for both groups, each has identified areas which can be further developed.