Introduction

The focus of this chapter is on the development of services for and professional practice with unpaid carers, primarily in social care. The chapter will continue to explore the themes identified in the previous chapter, by exploring developments in the organisation of services and professional practice at the local level. Key points of discussion involve the tensions and challenges that have arisen in practice since the 1990s, related to professionals’ perceptions of carers, the experiences of carers within the social care system as well as their roles in service planning and provision. As discussed, the framework of practice has shifted significantly over the period under discussion. For example, in the early 1990s, professionals and service managers were being urged to take account of unpaid carers’ needs when they assessed the needs of service users but since then the focus has moved towards demands to engage directly with carers in their own right. This change in emphasis has generated organisational changes in local authority social services and in their relationships with the voluntary sector, particularly with organisations representing unpaid carers’ interests. A focus on the outcomes that carers wished to achieve became a dominant theme in policies and was encouraged as a priority for professional practice with a view to stimulating innovations in support.

Innovative approaches have been a challenge to envisage in practice, however, in the context of resource shortages, and the effects of contradictory policy strands are experienced by practitioners as part of their normal working lives. During the early part of the 21st century the development of specific services for carers was boosted through the allocation of ring-fenced funds to local authorities. When the ring-fence was removed, resources were allocated specifically for work with carers, but the more resources in general were cut, the harder it became to earmark funds in this way. Far from encouraging innovations, therefore, resource shortages have had the effect of reducing the overall level of support significantly. Cuts over the past decade especially have been distributed unequally, leading to additional resource problems for some local authorities, especially those in socioeconomically deprived areas (Yeandle 2016). In addition, the organisational context of provision has been an enduring challenge, as health and social care services have been in a state of almost constant reorganisation, and this has absorbed the time and energy of local authority managers.