Critical Thinking – For a new role and function of Care rooted in citizenship
To know the role and function of Residential Child Care you need to know the role and function of children’s services and you need to have a definition of Care.
The Care Review, and what has followed, has been described many times as ‘transformational’ for children’s social care.
In not going to first principles it can be seen that what has been decided as a policy programme is but a reset of Children’s Services, not of Care. The distinction is important, and needs a thorough working through.
The Care Review acknowledged that ‘National government has a unique and vital role in setting out the goals and values for children’s social care’ and recommended a National Children’s Social Care Framework. Couched in assumptions regarding ‘relationships’ and ‘family’ the closest it comes to defining care is in 1.1 The purpose of children’s social care page 34 with these 2 paragraphs
‘Where children cannot live with their birth parents, the state should support wider family networks to care for these children instead. Where those networks are not strong or safe enough, care from the state should surround children with loving, stable and safe relationships so that they can flourish. A central aim of care should be to strengthen lifelong relationships. The care experience should help to heal trauma, realise identity and achieve potential’ Elsewhere it says services should be ‘clear about concerns, compassionate in their response and decisive in their actions’
The Care Review did not address ‘Care’ as something we do and something that we are
Read on for: ‘Care: A Critical Review of Theory, Policy and Practice’
Care as an ethic of care, of relationships, a practice rather than a set of rules of principles Tronto conceptualises care as ‘a practice rather than a set of rules of principles …It involves both particular acts of caring and a ‘general habit of mind’ to care that should inform all aspects of a practitioner’s life (1994 0126-7).
Care as something we do has 4 elements: attentiveness, responsibility, competence, responsiveness.
Caring for: Caring about: Caring with
Tronto explains
- ‘caring for’ includes hands-on care;
- ‘caring about’ describes our emotional investment in and attachment to others;
- ‘caring with’ describes how we act together to transform our world
The DfE have been requested by the parliamentary Public Accounts Committee to come back to them with the departmental view of the role and function of Residential Child Care.
NCERCC have provided a detailed summary of the evidence. In this we make the point that this task has to start from stating the role and function of care, then we can state the role and function of children’s services, and only then residential child care.
It is clear that a lengthy period of critical thinking is necessary. Now is not the time to accelerate to an unknown place.
Learning from history, the 1946 Curtis Committee, then Report, had very public debates about care and the services needed.
The 1989 Children Act lead in period was lengthy, the last decade increasingly intense.
This is what is needed now. It is not what we have had, and so the foundation for the policy programme is not secure.
NCERCC has set out upon the series of Critical Thinking postings to our website to bring perspectives not raised in recent years.
In this second posting we are using the work of Kirstein Rummery, in particular ‘Care: A Critical Review of Theory, Policy and Practice’ also drawing from her wider work.
We have aimed for a detailed, structured, movement‑useful summary
Core Takeaway
Rummery argues that contemporary care systems are shaped by deep tensions between care theory, care policy, and care practice, and that these tensions systematically disempower both carers and care‑receivers. She calls for a citizenship‑based model of care that rejects paternalism, challenges marketisation, and embeds care as a matter of justice, rights, and democratic participation.
- Why Care Is a Site of Theoretical Tension
Rummery begins by showing that “care” is not a neutral concept. It sits at the crossroads of:
- Feminist ethics of care (Gilligan, Tronto, Sevenhuijsen)
- Social policy and welfare state theory
- Disability studies and independent living movements
- Political theory on citizenship and justice
These fields often pull in different directions:
- Ethics of care emphasises relationality, dependency, and moral responsibility.
- Disability rights emphasise autonomy, independence, and control.
- Welfare regimes emphasise cost‑containment, risk management, and bureaucratic accountability.
Rummery argues that these tensions produce contradictory expectations of carers and care‑receivers, which then shape policy and practice in problematic ways.
- The Policy Landscape: Comparative Welfare Regimes
Drawing on comparative social policy, Rummery analyses how different welfare states organise long‑term care for disabled and older adults. The read across as a lens on care more generally is possible as she highlights for example, the countries where care is
- marketised, means‑tested, fragmented, or
- universal, publicly funded, professionalised, or
- family‑centred, cash‑benefit heavy, or
- familialistic, low formal provision
Note how different they are, making generalisation and comparisons difficult to achieve with accuracy. We might learn lessons but these have to be at a cultural and whole system level. Recent attempted translations of certain aspects from one country and culture of care have fallen short.
Across all regimes, she identifies common structural problems:
- Care is undervalued and feminised
- Marketisation increases inequality
- Cash‑for‑care schemes can reproduce exploitation
- Professionalisation can disempower both workers and service users
- Austerity erodes quality and access
Her conclusion: no regime has resolved the fundamental justice questions of care.
- The Practice Gap: How Policy Fails on the Ground
Rummery uses case studies to show how policy shapes practice in care and identifies several recurring failures:
- Paternalism and Disempowerment
Care systems often assume:
- professionals know best
- passive recipients
- carers (paid or unpaid) are infinitely flexible
This produces dependency, not empowerment.
- Fragmentation and Incoherence
Because care is split across health, social care, welfare, and labour markets, people experience:
- inconsistent assessments
- gaps in provision
- contradictory eligibility rules
- poor coordination
- Marketisation and Inequality
Introducing markets into care leads to:
- variable quality
- workforce precarity
- profit extraction from human need
- hierarchies amongst those working in the sector
- The Invisible Labour of Care
Both paid and unpaid carers experience:
- low pay
- low status
- limited training
- emotional strain
- lack of recognition
Rummery argues that these are not accidental.
They are structural outcomes of how societies conceptualise care.
- Theoretical Contribution: Care as Citizenship
Rummery’s most important intervention is her argument for a citizenship‑based model of care.
She proposes that care should be understood as:
- a right (to receive care)
- a responsibility (to contribute to care)
- a social good (necessary for democratic participation)
- a collective practice (not a private burden)
This reframes care away from:
- individualised “dependency”
- paternalistic professional control
- marketised service delivery
And toward:
- co‑production
- participatory decision‑making
- rights‑based entitlements
- democratic accountability
This aligns her with Tronto’s caring democracy and Fraser’s social reproduction critique, but with a more policy‑focused, pragmatic orientation.
- Rummery’s Critique of Existing Approaches
She identifies several weaknesses in dominant frameworks:
Ethics of Care
- Too focused on interpersonal morality
- Not enough attention to institutions, rights, and power
Rights / Independent / Autonomy
- Important in the practice and understanding and of relational and interdependent nature of care
Welfare State Policy
- Overly technocratic
- Ignores lived experience
- Reinforces gendered inequalities
New Public Management
- Turns care into a commodity
- Prioritises efficiency over relationships
- Produces audit cultures that distort practice
Her synthesis: we need a model that integrates ethics, rights, and political economy.
- What a Citizenship‑Based Care System Would Look Like
Rummery sketches the contours of a transformed care system:
- Universal entitlement to long term care (differentiated, needs-led delivery)
- Publicly funded, democratically governed services
- Co‑produced care planning with service users
- Recognition and fair pay for care workers
- Support and rights for unpaid carers
- Integrated services across health, social care, education, and community sectors
- Anti‑paternalistic practice grounded in autonomy and interdependence
- Gender‑equal and anti‑racist labour policies
This amounts not to just a policy shift—it is a redefinition of citizenship itself.
- Why This Matters for Movements for care, children’s services, residential child care
Rummery’s analysis offers:
- a theoretical justification for democratic, worker‑led care
- a critique of marketisation that supports cooperative alternatives
- a framework for rights‑based, participatory care planning
- care as a public good, not a commodity
Her work strengthens the case that care must be reorganised around democracy, equality, and collective responsibility.
