Health and care professionals are starting to recognise that, in the words of one director of adult services, "we don't deliver social care in this country. Carers do." Councils now receive more than £0.25bn a year to support carers and there are many examples of encouraging practice.
The National Carers Strategy envisioned a changed world for carers. The commission for social care inspectorate, now part of the Care Quality Commission, has reformed the inspection process, to take the agenda for carers far beyond its traditional social care sphere. But when the inspectors call, will councils be prepared?
Putting People First, the concordat on personalisation published by the government in December 2007, made it clear that choice and control over services should be offered to carers as well as to those they support. It introduced a universal offer of advice and information for all service users and carers, regardless of their level of need or means.
The concordat did less to recognise that carers not only receive care and support, but are also its largest provider. Councils continue to issue policies on carer assessment and support designed to gatekeep (in some cases unlawfully), rather than to recognise unpaid caring as a resource that needs nurturing if the delivery of care and support is to be sustainable.
We would not limit the induction and training of professionals to those demonstrably suffering stress or ill-health. Similarly, leaving families with unsustainable, unrecognised caring roles proves a false economy when those carers lose their jobs, their health and, ultimately, their ability to care.
The best councils balance commissioning specialist support for vulnerable carers with investment in services that can identify and include hidden carers, give all carers tailored information and put carers at the heart of local decision making. Every area needs a centre of carers' expertise to help the area's health, social care, education, leisure and employment services become carer-friendly.
The new performance assessment guide for council adult services will make life difficult for councils that do not take an enlightened approach. Many interventions now considered cutting edge will soon be required by councils merely to be assessed as "adequate".
For instance, carers will need to be treated as expert care partners by all services, with specific opportunities given to carers to shape local services. Support for disabled parents to ensure children do not have to take on inappropriate caring roles is now mandatory and will require new joint working protocols across children and adult services.
To perform "well", councils will need to demonstrate that carers are supported to pursue employment alongside caring and that there are a range of carer-friendly employers in an area, including the council itself.
Supporting carers as both consumers and providers of support is complex, but no more complex than the challenges carers face every day in juggling their caring role with any kind of life of their own.
Getting it right will reward not just those families but councils' and health trusts' hard-pressed budgets.
Alex Fox is director of policy and communications, The Princess Royal Trust for Carers
Putting people first without putting carers second, carers.org/professionals
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