Thursday, 22 October 2015

Origins 8: My First Caseload: Margaret and her Cats

This post contains lots of cats. But not in a good way
Part 8 in an occasional series about my early years as a social worker in the 1970’s and 1980’s.

Since my last post, I’ve been continuing to reminisce about my past as a social worker. Social work has changed a lot since I started in the mid 1970’s, in some ways for the better, in other ways for the worse.

When I started, our local social services office would receive a request for assistance, the case would be allocated to a social worker – and, er, that was about it. Unless there were very clear identified needs, for example a need for residential care, for aids to daily living, or a child subject to some form of abuse, the social worker would just tend to, sort of, bumble along, visiting the client, as they were referred to back then, developing a relationship, maybe sometimes doing something practical, like helping them claim benefits.
Most clients did not have any sort of formal care plan. Occasionally, in supervision, your team leader would ask you what you were doing with a particular client. Then you had to think hard and say something that sounded worthy and useful.
My first caseload was very mixed. I had a few children and family cases, some elderly people, some people with physical disabilities, a few people with learning difficulties or mental health problems, and one or two who defied categorisation.
Margaret was one of the latter. She was in her early sixties, and lived alone in a local authority house in a small village a few miles outside Charwood.
I was never clear about how she ended up a client of the social services department. It may have been a referral from the local housing authority, who was certainly concerned about her ability to manage her tenancy. It may have been because of complaints from neighbours.
It’s possible she may have had mild learning difficulties, although she had no formal diagnosis. She had lived all her life in that house, taking over the tenancy when her parents had died over twenty years previously, and perhaps they had been her carers. She certainly had no obvious mental illness. But she was deemed to be a vulnerable person, and hence worthy of having a social worker, even if that social worker was unqualified and completely inexperienced.
Or maybe it was because she was a witch.
She certainly looked like a witch. She had snaggle teeth, a long nose with a wart on the end, and matted hair. It was thought that the last time her hair had been washed was over 20 years ago, when she had had to go into hospital when she’d had a fall. I could believe it; her hair had become felted. She had probably also not had a bath for twenty years, and her face and hands were black with dirt.
And she had cats. I never knew how many cats she had, and I don’t think she knew either, but there must have been somewhere between 20 and 40. They lived in the house, never leaving it, and freely interbreeding. She seemed to have no arrangements for their toileting, with the result that they defecated anywhere and everywhere.
See if you can imagine the experience of visiting her house.
I always went in through the back door, which was never locked. The hallway was comparatively free of cat faeces, as she tended to keep them in the living room and kitchen area. But she made up for this omission by having piles of newspapers at least 4 feet high lining both walls of the hall. As she lived and slept in the living room, she never went upstairs. I have no idea what the bedrooms were like, as it was impossible to go up the stairs because each step was piled high with old newspapers.
I was told that a previous social worker had attempted to clear the house of newspapers by diligently putting them into an outhouse, but Margaret had then brought them all back in because she was afraid they’d get damp outside.
Festoons of ancient cobwebs hung from the ceiling, some hanging so low you risked getting them in your hair unless you ducked.
Having negotiated the hallway, you finally entered the living room. Winter or summer, Margaret never opened the windows, so the temperature in there could get quite high during the summer months. But not as high as the stench.
It was impossible to tell what the original floor covering in the living room was, as it was completely covered with cat faeces to an unknown depth. My shoes tended to stick to the floor as I walked through. There was an audible noise as I picked my feet up step by cautious step.
The smell was almost unbearable. In those days I smoked a pipe, and used to smoke furiously throughout my visits in a futile effort to mask the ghastly smell.
Margaret would be sitting at the head of a table covered with old papers and cats. Her matted and filthy hair was partly covered with an equally filthy headscarf. She generally ate white bread straight from a bag during my visits, tearing it into smaller pieces with her black hands before putting it into her mouth. Sometimes she would offer me a biscuit. I always declined.
During the summer months she would be surrounded by a halo of flies.
I never sat down in her house. This was partly because any seats were always covered with cats, but mainly because they were so filthy that I would have needed a change of clothes afterwards.
So what social work tasks was I undertaking with Margaret?
Did I try to improve her living conditions? Not really. Her file catalogued the efforts previous social workers had made, all of which were futile. Margaret did not want to change.
Did I support her within her community? I guess so; people seemed reassured that a social worker was visiting her. But if they hoped that it would effect any perceptible change, they were sadly disappointed.
Issues of capacity were barely talked about back then. Apart from her appalling living conditions, I never had any feeling that Margaret was not mentally able to make decisions about her lifestyle. Nowadays I could explicitly assess her capacity, and conclude that she had the right to make unwise decisions, but there was no legislation that covered Margaret’s situation in the 1970’s.
She appreciated my visits, and liked to talk to me, so I suppose I fulfilled some welfare purpose. Again, nowadays that befriending role could either be provided by a voluntary organisation or supplied via a personal budget under the Care Act. But back then, the main resource was social workers.
One thing I learned from Margaret was not to be phased by extreme housing conditions. In later years, when people complained of patients living in squalor, I set Margaret as the benchmark. That was squalor.
During the two years Margaret was on my caseload, I achieved one traditional social work task; I arranged for a neighbour to be paid as a home help in order to do her shopping once a week. So I suppose I did do something to improve her life.

Friday, 2 October 2015

No Happy Endings: Stories from an Out-of-Hours Social Worker

There’s been quite a lot of discussion lately about the nature of social work and the social work task, and this has got me thinking about my years as a social worker, which has covered 5 decades.

I started as a generic social worker in 1976, and continued to hold a generic caseload, consisting of a mixture of mental health, elderly, child protection and children and families, until my local authority elected to operate with specialist teams in 1988. It was then that I became a specialist mental health social worker, working in a multidisciplinary community mental health team (one of the first in the country).

In addition, throughout the 1980’s and 1990’s, I also worked one or two shifts a week on the out-of-hours standby duty team. This team dealt exclusively with emergencies and crises that arose outside normal working hours.

This seemed to me to be the essence of social work: working in crisis, having to make independent executive assessments and decisions on the hoof with hardly any backup, and having to be prepared to live with the consequences of those decisions.

It was during this time that I encountered similar issues to those reported in Rotherham.

The child protection failures in Rotherham were by no means unique; there were a few occasions when I was called out to the city police station to act as an appropriate adult under the Police and Criminal Evidence Act (PACE) for teenage girls who had been picked up for soliciting.

I recall one occasion in the early 1990’s when I was called out during the evening to deal with two 14 year old girls. They had been arrested following a tip off from a much older prostitute to the vice squad.

She had reported them, not because they were taking business from her, but because she was rightly concerned that such young girls should not be attempting to solicit. She was primarily concerned for their safety.

But the police did not really see it like that. They did not see it as a child protection issue. That was not why they wanted a social worker. They regarded these girls as juvenile offenders. They simply wanted to process their cases by giving them a caution and then getting them out of the station as quickly as possible. So they needed a social worker, in the role of appropriate adult, to be present while the formal procedure was conducted. And so that I would then be officially responsible for their disposal once released.

Tracey and Tanya were waiting in the custody area when I arrived. They looked as if they were going to a “tarts and vicars” fancy dress party, with ridiculously short skirts and exaggerated makeup.

But they also looked like children rather than adults, and like children, they seemed to have a startlingly naive picture of the reality of prostitution, and were actually grossly unprepared, both practically (no condoms or other protection) and emotionally (they appeared to think that they would get spending money in return for little more than a kiss and a cuddle.)

They were reluctant to talk to me about their motivation or the circumstances that had led them to take to the streets (this was the first time they had tried it), and actually seemed to regard it as a bit of a laugh. The custody officer told me that the mother of one of the girls was a known prostitute, but it was unknown whether the mother knew what they had been trying to do, or indeed if she had actually encouraged them.

They were duly given a caution in my presence, and then released to me. I was unhappy about taking them home, as none of their parents could be contacted, and eventually obtained agreement to place them in a local children’s home, at least until the day time children’s services could assess the situation.

As so often when working out of hours, I never heard what happened toTracey and Tanya.

But I did find out what eventually happened to another lost girl I had involvement with, called Naomi.

Naomi was 16 and over school leaving age. She was on a Care Order to the local authority, and had been in a children’s home for a considerable time, until she had decided to leave the home and move in with someone she described as her boyfriend, a man in his twenties. She had been picked up for soliciting, and I was again called out to act as an appropriate adult.

As she was actually on a Care Order, I felt that I had to ensure that she had a safe place to stay tonight, and arranged for her to have one of the leaving care beds at the local YWCA.

I went to the police station. Naomi was an intelligent, likeable girl. But she had the manner of someone much, much older than 16. She came across as weary and hopeless, and had no interest in what I might be able to do to help her, other than to get her released from police custody.

Once the police had cautioned her, I told her that I was going to take her to the YWCA.

“I’m not going,” she said. “Just take me home. Take me back to my boyfriend.”

I had the strong suspicion that her “boyfriend” was actually her pimp. I was very reluctant to take her there.

“Look,” I said. “It’s just for tonight. I’d just like to feel you were in a safe place.”

She looked at me with 1,000 year old eyes.

“No,” she said finally. “I know you’re just trying to help. But I don’t need any help. Just take me home.”

Although she was on a care order, I had no powers to compel her to live in any particular place, so I reluctantly took her to her stated home address.

Two weeks later her dead body was found on wasteland on the edge of town.

To this day, her murder remains unsolved.