Anatomy of a care manager

The article considers the impact of the NHS and Community Care Act (1990), and the redefined role of 'care manager', upon social work. It draws from a three-year ethnographic study of five area teams; one based in inner London and the others, including a hospital team, based in the north of England. Particularly it uncovers the considerable impact of intense bureaucracy, circumscribed budgets and the consequential removal of the care manager from the community. The article also questions any 'seamless service' in work with other professionals and raises doubts as to whether need is even being partially met Care managers are rarely able to utilize the skills that they develop during the Diploma in Social Work course. Frustration is felt on behalf of staff in the area office, who are new working under considerable strain, with little recognition, within what resembles a new emergency service. It is hoped the article is able to draw attention to the consequences of the continued deskilling of social work and retrenchment of what little remains of welfare.