This thesis is the result of research that investigated the views of residential care workers (RCWs) working with people with dementia about their perceptions of training for their dementia care role with older people. Using a constructivist ontology and an interpretivist epistemology, the research investigates how care workers perceive their training and how they feel it can be applied to their working environment. RCWs were asked what they saw as the specific needs of residents with dementia, what training they had received, how useful they perceived the training to be, and what training they felt was still needed. Previous studies had put forward topics for inclusion into dementia care training, but very little research had asked RCWs themselves about their dementia training needs. Nineteen semi-structured interviews were carried out across three care home organisations during the summer of 2013 in the East of England. Findings from thematic analysis showed that the care workers interviewed had very limited or no dementia training or assessment they could remember, and that training had generally been a negative experience. Dementia care trainers were not considered helpful or knowledgeable enough and RCWs identified that their learning needs had not been taken into consideration. The learning environment was viewed as unsuitable, usually a lounge or a bedroom where it was very cramped and RCWs were pulled out of training when there were limited staff numbers. Many challenges specific to caring with people with dementia were also identified: challenging behaviour, lack of time and resources, poor teamwork and communication and lack of organisational support all inhibited the development of person-centred care and training transfer into practice. A conceptual model of the training and learning cycle is proposed as a way forward for dementia training. This model illustrates the training process from course creation through to satisfactory completion. Learning into practice is measured by care workers' knowledge, confidence, and competence. This assessment is a two-way process between the learner and the mentor to ensure RCWs feel fully supported and recognised. Although this conceptual model has not been tested empirically, such a process is seen as a possible next step.

My thesis examines the journey made by myself and others from paid employment, usually with a local authority, to self-employed status within an independent practice. I have tried throughout, as far as possible, to uncover the many meanings and essential elements of the experience: both my own, and those of others. Fully integrated within my thesis are the detailed experiences of my research respondents who have travelled a similar journey. I have used a heuristic methodology, first established and pioneered by Clark Moustakas. This demands that the researcher and his or her respondents must have lived through the experience being described. The methodology is congruent with my own positioning as a researcher and also provides a suitable, flexible but rigorous framework within which the emerging story (and stories) can be told. This approach has also been of the utmost value in structuring my research. Moustakas defines the heuristic approach as: A process of internal search through which one discovers the nature and meaning of experience and develops methods and procedures for further investigation and analysis. The self of the researcher is present throughout the process and, while understanding the phenomenon with increasing depth, the researcher also experiences growing self-awareness and self-knowledge. Heuristic processes incorporate creative self-processes and self-discoveries' (1990:9). I have used other approaches for data analysis as Moustakas does not give detailed guidance in this area. I have principally used the approach pioneered by Max Van Manen which can be described as an evolved phenomenological approach. My thesis therefore describes and explores the experience of setting up my independent practice from its very first manifestations through to the present. Integrated within that narrative are the detailed and rich ‘borrowed' experiences of my research respondents captured through 11 in-depth interviews and a consideration of the similarities and differences of the individual experiences. I have let the individual voices speak fully which draws out the themes of the experience of becoming independent in terms of motivation, preparation, the moment of independence and finally, the experience of independence. In the succeeding chapter I have analysed the findings with reference to the literature on the nature of modern day social care organisations, organisational theory and motivation, and have also explored in some depth underlying issues concerning the nature of identity and selfhood and the autonomy of individuals. I conclude that there is a core of selfhood and that, within defined limits, individuals are free to choose their own path. A final creative synthesis draws the research project to a close by considering how all that has been learned fits together. My research strategy has essentially been an exploratory one which aims to “generate knowledge about a relatively under researched or newly emerging subject” (D'Cruz and Jones 2003:17). The under-researched and emerging subject here is about the experience of establishing an independent consultancy in the social care field. My contribution to knowledge on this subject falls into several areas, including what I see as the necessary and gradual liberalisation of the social care field which allowed independent practices to evolve. I also contend that my research respondents had a particular and specific motivational profile which explains why these particular individuals made the move to independence when others did not. A further finding is that my research group exchanged a constricting organisation for a more comfortable one: that of the informal network. I also find that making the move to independence is a near irrevocable step and that, in effect, the research group went through an important identity shift in their transition to independence.

Concerns have been raised about the quality of care provided by professional caregivers to vulnerable older adults. However, little is known about the psychological mechanisms that may affect professional caregivers' ability to provide good care. This thesis presents four papers which sought to address this gap in our knowledge. The first paper reports a proposed quantitative multilevel study, investigating the effects of nursing home manager-level and care assistant-level variables on psychosocial caregiving among care assistants. There were no effects of manager-level variables. However, structural equation modelling (SEM) analyses found care assistants' community aspirations and basic need satisfaction at work positively predicted the autonomy and relatedness support care assistants showed towards service users. No indirect effects were found. The second paper presents a new measure of autonomy, relatedness, and competence satisfaction, which had improved construct validity compared to an existing measure and good external validity, being related to measures of well-being and ill-being in expected ways. The third paper reports the relationships between autonomy, relatedness, and competence satisfaction and prosocial behaviour. SEM analyses showed that a higher order factor of basic need satisfaction explained a small but significant amount of variance in prosocial behaviour, but that autonomy, competence, and relatedness satisfaction were not independent predictors. The final paper presents a grounded theory analysis of semi-structured interviews with a range of individuals associated with nursing homes for the elderly. The findings highlight the role of a person-centred perspective at all levels of caregiving, with positive management practices interacting with the qualities and approaches of individual caregivers to support the provision of good care. Overall, this body of research provides a preliminary understanding of the interplay between the personal qualities of professional caregivers and socio-environmental factors in the provision of good care. In addition, it has contributed meaningfully to the SDT literature and its application to real-world settings. These findings pave the way for future research to provide further beneficial insights for policy and practice in professional caregiving.

Family members are themselves affected by the impact of Acquired Brain Injury (ABI) upon their relatives and they play an important role in the rehabilitation and long term support required. The study aims to understand how families are impacted and their views on the formal and informal support received directly or indirectly as a consequence of the ABI. To date there has been very little research undertaken by social workers in relation to ABI and/or the experience of family members. A mixed methods research design was employed to capture the lived experience of family members of people with ABI. The results of the quantitative and qualitative data were triangulated against the literature. An online survey was completed by 110 relatives of people with an ABI, seeking their experience of the condition, its impact upon their lives and their views of services. The results of the survey were collated and organised in SPSS (version 24). Non-parametric Spearman's Rho Correlations (non-parametric test) were performed upon the results. In-depth, semi-structured interviews were conducted with 16 family members of people with severe ABI to ascertain the family members' experience of their relatives' condition, its impact upon them and their views of the associated formal and informal support received. Inductive thematic analysis of the transcribed interview data was undertaken to identify themes. The quantitative element of the research identified strong correlations between the relative's assessment of the invisible impairments suffered by those with an ABI (cognitive, executive, behavioural and emotional difficulties) and lack of insight. This correlation was not present in relation to physical impairment. It was observed that increased loss of insight and behavioural difficulties were strongly correlated with loss of friendships by the non-injured family member. The results of the inductive thematic analysis identified 7 themes which were: 1: The Context 2: The All-Encompassing Challenge 3: Family Loss and Grief 4: The Unavoidable Burden 5: The Poor Experience of Support 6: Positive Support and Change 7: The Curator of Narrative The research identified that family members' experience is complex and enduring, encompassing most aspects of life, and is affected by the context in which it occurs as well as by formal and informal support structures. The particular nature of the grief and loss experienced by families is ambiguous, develops over time and leads to ambivalent feelings for family members who perceive no option but to remain involved. Informal and formal support frequently fails to take account of the reality and complexity of the condition and fails to integrate the relative by recognising their own losses and trauma. Relatives' views on the services received identified significant gaps in practitioner knowledge, most especially of those aspects of life that were of most concern to them, the invisible impairments and issues with insight. Practitioners that were valued were more likely to be specialists in the condition and practiced as “expert companions” supporting the relative to develop a new “neuro-narrative” to reconstruct their identity in the face of their ongoing grief. The specific nature of the condition requires such an approach if input is to be effective. Greater understanding of the complex lived experience of family members may support more effective responses to both them and the individual with ABI, integrating services and families to improve quality-of-life. As ABI is a process with changes to functioning developing over time, the information and knowledge required by loving and supportive relatives needs to be created with them, being person-, family-, injury-and-context-specific.

The relationship between the statutory registration of a workforce and impact upon practice and practitioners is unclear. Little empirical research in relation to the efficacy of existing professional registers has been undertaken. No research has so far been undertaken in relation to the impact of UK legislated registration upon social work practice. A number of high profile cases in health care such as the Bristol, Shipman, Ayling and Allit inquiries (DH, 1994; Crown Office, 2001 & 2005) have drawn attention to the inadequacies of workforce registration systems. Regulatory approaches to modifying the behaviours of the regulated are widely viewed as problematic in a broad range of theoretical literature from diverse disciplinary bases and methodologies. Literatures caution that just as ‘markets' may behave imperfectly, so may regulatory mechanisms such as workforce registration systems (Ayres & Braithwaite, 1992; Baldwin, Scott & Hood, 1998; Haines, 1999; Sparrow, 2000; Ashworth & Boyne, 2002; Johnstone & Sarre, 2004; Haines & Gurney, 2004; Walshe & Boyd, 2007). The UK Better Regulation Task Force cautions that some regulatory interventions can make a situation worse (2003b). The potential of professional registers generally and the social work register specifically to impact upon quality and improve protection has been questioned since 1982 when the first meetings about the development of a national social work regulatory council were held (Malherbe, 1982). The regulatory body for social work in England, the General Social Care Council (GSCC) came into being in 2002. The first UK register of social workers came into force in 2005 with protection of title implemented shortly after. The first three conduct cases applying sanctions to registrants were heard within a year of the social work register opening. Using a grounded theory approach, in the context of the first three conduct case outcomes, this study sought to elicit the perceptions of qualified social workers on the positive and negative impact(s) of the statutory requirement to register, for both the individuals and the organisations in which they work. This study finds that the first registration conduct case outcomes triggered a reframing of the concept of conduct and that as a consequence, respondents in this study re-positioned their allegiance to registration, and engagement with conduct matters in the workplace. The study considers the relevance of research findings in the context of a changing policy and political landscape.

The aim of this research, set in two schools in Malmö, Sweden, was to examine the outcomes of a combined approach of a behavioural modification program and a biofeedback intervention for students, aged 7 to 12, with behavioural and concentration difficulties. Biofeedback is the use of technology to measure physiological changes in the body (such as heart rate and breathing) and gives this information back to the user. The behavioural modification program was an intervention known as Family Class, whereby students (and their parents) attended for 12 weeks to work on classroom issues identified by the teacher. It is accepted that students with behavioural and concentration difficulties are at risk of going on to develop more severe problems such as ADHD, if early intervention programs are not implemented (Barkley, 1996). In addition, the Swedish education system is under increasing political pressure given poor international results (PISA, 2013) and poor high school graduation rates (Cederberg et al, 2011). Working as a social worker across two schools, I was ideally placed to assess the current intervention provision, adapt it and subsequently carry out the research to evaluate the outcomes. The research drew on a pragmatist epistemology (Hall, 2013) that supported the semi-experimental design used in the study. A mixed methods approach to gathering the data from parents, teachers and the students was used. Qualitative data collected before and after the intervention, were sought through interviews with students in which vignettes were used to identify their ideas on self-regulation of behaviour, whilst quantitative data on the impact of the combined intervention were gathered through pre/post measures using The Strengths and Difficulties Questionnaire, Biofeedback software and behavioural sheets. The thesis also traces the author's changing identity from a practitioner to a researcher-practitioner. The experience of doing the research was interwoven into the fabric of the study, helping to ensure that the study is rooted in practice. In that respect, a key social work value, empowerment, was critically discussed by referring to the theories of Michel Foucault and John Dewey. A view that self-regulation can be seen as an act of empowerment was the resulting outcome of this theoretical discussion. This position supported the author's personal practice and the intention behind the intervention was the focus of the research. The key findings from the qualitative data suggested that the majority of the sample of 13 students (most of whom had experienced difficulties for more than a year) had learnt self-regulation skills and understood self-regulation ideas; from their responses to the vignettes, it appeared students had moved from a position of reliance on teachers and other adults when managing behaviour and concentration difficulties to a position that encouraged a balance between the students' self understanding on how to manage classroom challenges and the role the teacher can play in this. This was backed up by SDQ feedback from the parents and teachers on the changes in the students' own behaviour in relation to the following categories: hyperactivity and attention, peer interaction and pro-social behaviour, conduct behaviour, emotional difficulties, impact on relationships and perceptions of the problem. The biofeedback data also showed that the group as a whole had learnt how to regulate their breathing and heart rate. The key implications for social work practice are that the combination of a behavioural modification approach such as Family Class with biofeedback has potential in helping students with behavioural and concentration difficulties in a school setting. The methods and methodology used in this research proved to be a suitable approach to identifying the impacts of an innovative intervention and could be considered by other social workers carrying out research in similar settings.

Drawing on principles from systems theory, critical health psychology and narrative analysis, this research sought to examine the relationships between environments that facilitate creative arts-based group work, and notions of self-governance and self-determination that they may give rise to; exploring whether such processes are discernible in speech, language and narrative formation. The research constituted an eleven month, qualitative community-university project that examined ways in which the 'Centre user and volunteer led' organisational ethos of the Brighton Unemployed Centre Families Project (BUCFP) - a charity working to relieve poverty and hardship based in the south of England - related to the forming of a creatively working and self-managing group. This sought to better understand the emergence of the group; the ways in which participation was experienced; and what (if any) effects participation may have had on sense-making and narrative formation surrounding the topic of food poverty. Using arts-based and participatory methods, the research was carried out with a group of twenty Centre users with experience of food poverty. It culminated in the production and display of an art exhibition on this topic as part of the Brighton Festival in May 2015. The research suggests that using participatory and arts-based approaches in the exploration of food poverty in the facilitative environment of the BUCFP enabled participants to examine and contest societal discourses surrounding poverty. The research describes how, through a complex interplay between group discussion and the material and semiosis of art-making, participants developed and symbolised a counter narrative that deflected stigmatising narratives surrounding food poverty, instead developing a collectivised narrative of resistance. The ability to 're-narrativise' forms of social discourse and to signify the taking of a position in the socio-cultural and political landscape through creative methods may be tied to notions of wellbeing that are important to consider within a community health milieu.

This research considers the hypothesis that eugenic ideology still influences social work practice in contemporary Britain. Exploring the issues through a feminist perspective by utilizing a narrative approach with individuals with learning disabilities. For many people with learning disabilities access to 'Human Rights' is rather elusive and this work seeks to examine this through the lens of eugenic ideology and a Bourdieusian approach to social work. The purpose being to ascertain if eugenic ideology is still present, if only through the Bourdieusian concept of "doxa", if so how does this affect the life choices and human rights of the people in the research. Based on the 'lived experiences' of a number of individuals with learning disabilities, all of whom were members of a self-advocacy group in England. All participants had previously been involved as service users in the selection of Social Work students for a London university and were contributors to the programme in this capacity over a period of several years. Involvement of participants in the research with the self-advocacy group was by open invitation to the group members, and individual 'life stories ' were documented through recorded interviews by the researcher over a period of several months. Utilizing a narrative approach to the life stories from a feminist perspective the experiences were examined against the historical backdrop of eugenics, articles of the Human Rights Act and Bourdieu's theory of practice. The findings show oppression, inequality and a lack of 'Human Rights' experienced by the participants, this against a policy background of 'Valuing People' and 'Personalisation' which both set out to promote strategies of social inclusion and real opportunities for people with learning disabilities. The 'caring ' professions including social work are implicated in the continuing and ongoing oppression and symbolic violence of people with learning disabilities. Whilst the terminology of 'eugenics' is no longer an acceptable topic of conversation, the impact of the ideology continues to permeate the ‘collective unconsciousness' (doxa) of many including those who are involved in the decision making processes of individuals identified as learning disabled. The implications for practice is that awareness of the pernicious effects of the eugenic movement need to be taught as part of the history of social work and included in the curriculum, if we are to avoid repeating the horrors of the history of the eugenic movement. By utilizing Bourdieu's concepts of habitus, capital and field, together with doxa and hysteresis it is possible to arrive at a new model of Social Work practice to address discrimination and to promote anti oppressive practice. The "Hysteresis Wheel', is a model developed as a result of this research.

The research study focuses on how social work Approved Mental Health Professionals (AMHPs) use the law in practice. AMHPs in England and Wales have statutory powers under the Mental Health Act 1983 (MHA) to detain people in hospital for assessment and/or treatment. The stakes in this area of law and social work are high: practitioners deal with important issues concerning individual liberty that have profound implications in relation to the power of the state to intervene in the lives of citizens, where notions of autonomy, protection, coercion and care sit in tension. The study explores the relationship between law and social work practice by interpreting meanings contained in case stories told by social work AMHPs about recent Mental Health Act assessments that they undertook. Eleven social work AMHPs, purposively selected from three different local authorities in England, participated in the study, which used qualitative in-depth interviews to collect data about using the law in circumstances where compulsory admission to hospital was a possibility. The use of case stories encouraged participants to provide a rich description of events as they unfolded over time. The data were analysed using Framework analysis (Ritchie and Spencer 1994). Computer Assisted Qualitative Data Analysis in the form of NVIVO was utilized to manage the data, and to support data analysis. Five themes are presented in the findings chapter: understanding the referral situation; understanding the individual; understanding the situation causing concern; community versus containment, and relationships and resources. The study contributes to knowledge by illuminating how the use of law in practice is an inherently socio-relational undertaking, involving embodied practice. Bourdieu's (1977) concept of habitus is used to make sense of participants' accounts of the action that unfolds when they use the law. A further contribution is made to knowledge on legal literacy in social work, where there is little empirical research focusing on how social workers use the law, and still less on how mental health social workers use the law to consider compulsory powers under mental health legislation. The organisational factors impacting on how participants relate to the law are outlined and discussed drawing on legal consciousness theory (Ewick and Sibley 1998; Sibley 2005), together with an account of how participants adapt to this, drawing on street level bureaucracy (Lipsky 1990). The thesis explores the distinction in practice between medical and social perspectives occupied by AMHPs when they use the law in circumstances where compulsory admission to psychiatric hospital is a possibility. The study findings suggest that AMHPs' perspectives are holistic and social and can be understood as occupying a socio-medical-juridical perspective. The most important factor in the decision to use compulsory powers in mental health law to detain a person involves the AMHP taking a wide perspective in terms of their understanding of the individual that is relational to the understanding of others, and understanding the person in their environment in relation to how they relate to others. The thesis outlines that the social and family situation of the person assessed, combined with views of others, and particularly the impact of risk on others, is the most influential factor in the decision to detain. This leads to the further argument that notwithstanding a holistic and social perspective, this does not necessarily lead to less coercive interventions. Medical and social perspectives thus often lead to the same conclusions in relation to decisions to use the law to detain.

This thesis provides a description and analysis of contemporary policy and practice in kinship care within three local authorities in England. The aim is to examine the extent to which government policy principles and available research evidence have translated into professional practice on the ground in different agency settings and to consider the implications of these findings for future management planning in this field. This is approached through considering UK research on kinship and examining the relationship between the statutory principles driving policies and the way the three local authorities have responded. This is with a view to questioning how kinship locally has influenced social work practice at a case level and compares local policies and practice against wider research evidence. Proposals are made about the modelling of a more effective approach to social work practice and management in kinship care planning. This study of different authorities and their approaches to kinship explores some of the challenges by which policy principles and research findings get translated into social work practice in a field of practice and theory that is itself contested. The study was undertaken in four stages: 1. A review of the extent to which local authority policies are compliant and consistent with statutory rules and contemporary research findings on kinship care. 2. A comparative analysis of the similarities and differences between policies and their formation in three studied authorities. 3. An analysis of the extent to which local management and social work practice, as reported, is consistent with policy and research. 4. The modelling of a Kinship care Definition and Policy Model could be proposed that is compliant with the principles of the Children Act 1989 and responsive to the research findings. The challenge set out in this research is to bridge academic research, policy formulation and operational practice. This research does not seek to evidence best practice in its own right but to recognise the variance of kinship in practice and approach and, from knowledge gained, set out a proposed model of good practice, one that is responsive to the findings and could be adopted within local authorities in England.