Social Work, Covid-19 and Being Human

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Social Workers have our own version of the old joke – how many social workers does it take to change a light bulb? The answer is, and always will be, ‘one, you’. We change the light bulb, we don’t refer on for someone else to sort. We need to be there when everyone else has gone home.  When we need to, we come to work in our scruffy clothes to help someone clean their flat before moving, to help them get their bond back. We get stuck in, on our hands and knees with the person, scrubbing, chatting, laughing. Doing. That’s what brought many us into social work in the first place. We are good at it. We get stuck in where and when it’s needed.  Like now.

There is of course the statutory side of Social Work. We have to do that. The regulations, statutory guidance, Court applications, legal safeguards with confusing names (CoP3, CoP10, DoLS Form 6) and of course there is the glare of the pinkest of papers and the ruminations of the latest Jones. That’s vital. But if you are reading this blog, it’s likely that you know in your heart that isn’t really fully you, that you are awkward in the role of administrators,  not really feeling comfortable in your skin, it’s time to don the scruffy clothes.

Social workers instinctively know what LJ Munby meant when he said the Local Authority is ‘a servant, not a master’. We are steeped in public service. Our interest in community led social work is because we are proud that it means going back to our roots and being of the communities we serve. We don’t want assessment forms. We are creating our own paperwork which records good conversations we have with people and reflects values and respects their wishes, feelings and beliefs. We enable people to be supported to understand risk, retain the relevant information, weigh up what being safe means to them, and communicate what they want to do as a result. Social Workers know in our hearts that the shift back in recent years to social workers being community practitioners, not simple brokers of care packages, is right.  Community led social work is our social work values, our social work ethics and our moral purpose made real.

Like most of the Country, we have been watching our news feeds and TVs and listening to our radios as they filling up with the spread of the Covid-19 virus.  But we are also human, we have families too and it is important to rest, have fun and spend time with the people we love and it is important for us that our families feel safe.  So thinking about Covid-19 is not easy because it doesn’t make us feel safe.  As Social Workers, an academic discipline grounded in social theory and the social model, we are worried about what will it mean for society over the coming months.  As practitioners in a profession which is activist by nature, we are thinking about what we can do to be helpful (yes, it is a professionally taken for granted assumption here that we can be helpful…).   The next few months will be a time when community led social work could really make a positive difference.

A lot of social work attention in the coming months will be on supporting our NHS colleagues, working collaboratively and collectively to ensure that clinically skilled nurses and Doctors are able to prioritise and concentrate on those who most need their care and it’s right that we do that. Social work has a long tradition of supporting people to stay well at home, or when they do need a stay in hospital, to help them get home with support and services.  Here at Social Work Cats the Blog, we will be supporting our commissioning colleagues to understand what support people need to do this, and whether any of the needs we see when we meet people are changing and different to what they might have usually needed.

So, we are starting to mobilise and work out how we can do our bit on a professional and a personal level.  Here’s a few things we here at Social Work Cats the Blog Site will be doing over the next few weeks at work and in our own communities, please let us know if you have other suggestions to add to this list:

  1. Visibility – People may need to see, speak to and hear from social workers more than usual over the coming months. We are planning to be much more visible to the people we support than we have ever been in the next few weeks.  Now is a good time to get up to date with advice about how to minimise the risk to yourself and the people you support from Covid-19.  BASW have really helpfully collated the national advice into a single site which we will be checking daily as the situation is changing on almost a daily basis –  https://www.basw.co.uk/media/news/2020/mar/covid-19-guidance  If we cannot be physically visible for some people we must ensure contact. For us it means ensuring communication with the people in our communities who we know and have supported to live lifestyles that are on the edge, often outside of social care, the people who other often think we are doing nothing for (when in supporting them to live their lives we are doing lots). Our conversations could be vital.
  2. Contact between families and friends.  Article 8 ECHR is the right to a private and family life with a circle of good friends.  This is the heart of social work. There are lots of ways to make sure that if best interest decisions are being made by providers such as care homes about protecting people’s Article 2 right to life by restricting access to the setting, there are lots of ways to cheaply work with the provider to ensure they take action to keep families connected and prevent the well documented impact of social isolation. There are loads of modern technologies out there that can help do this – Skype, Facetime, Whatsapp are all easily accessible and we are encouraging Care Home providers to get these set up now.  As more people are taking social distancing action, self-isolating, including our own parents and grand parents, we will keep talking about how we support non personal contact using new technologies than ever before. We have our own family Whatsapp groups and we are planning to visit our family members, taking sensible precautions.  We are reviewing care and support plans over the next 2 weeks to ensure that how families are supported to stay in contact with loved ones is documented and agreed where the least restrictive option is for a setting to restrict access.
  3. Shopping and Food Banks. We have contributed to food banks through fund raising, sleep outs and on a weekly basis donated to in our weekly shop as we walk past the trolly in our local supermarket.  In our offices we keep small boxes of enough stuff to help people get home from hospital, or set up their first home, with a couple of meals of stuff in the cupboard. We help families access local food banks.  For right or wrong, food banks are part of our lives and provide essential items to people regardless of income, disability, access. This is ensuring social justice, our central mission as a profession which is encoded into the international definition of Social Work.  So it is not a surprise that this week our social work colleagues have been telling us that they have been out to see their neighbours and ask do they need any help with shopping, and giving them their personal numbers inviting neighbours to contact them if they need help with this in the next few months.  We will be talking to the people and families we support over the next few weeks about shopping. Is there something they haven’t got?  Have they the resources to be able to stockpile a fortnight worth of resources.  If someone only eats garlic bread, or ice cream or drinks Cherry fizzy pop, we have gone out to make sure that they have a supply of these in at a time when supermarket shelves are emptying faster than they can be filled by the stores. Many of the families we support won’t be able to afford this so we will be looking to see if the food banks can cope with the pressure and agitating for resources to be made available to help.
  4. Our local area has already set up facebook community action groups which we have joined so we can help support our neighbours.  We are talking to people and families we are support over the next few weeks about whether they have something similar they can connect to, and do they have a good neighbour to help them from becoming isolated.  Local community centres, Mosques, churches, synagogues, temples, parish or town councils all have positive contributions to make and social workers are pooling what we know about the communities we are part of and how we can access these resources to support people who are worried, self-isolating and may need some help.  We are asking ourselves a challenging question – social work assumes it is helpful, but we only know who we know. Most people don’t choose to invite social workers into their lives.  We are thinking about who do the corner shops know? Who does the library know? What about the bookies and the local cafe? We are making sure that they know us and feel that they have a relationship which means they would pick up the phone and ring us if they think someone needs our help over the next few months.
  5. We will be speaking to people and families who manage their own support and use a Direct Payment to arrange for Personal Assistants about their contingency plans over the next few months.  Would they and their PAs be interested in talking to other families who live near them, or whose children attend the same school, about whether they might be interested in pooling their PA support as part of planning for cover.  We will be encouraging PAs and families to keep up to date with government guidance about personal protective equipment https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-controland to sign up to webinars being arranged by organisations set up to support self directed support such as this one

We are, of course, taking care of ourselves too!  We are human, we have family members we are worried about, we can’t always be as reassuring as we would like to be (we get worried too). We will be using our professional supervision, our friendship groups and our family networks to talk about the personal, about how we feel and about what is happening so that we also get the support we need if and when we need it.

Social Workers will be led by their employers and national guidance as it becomes available. We all have plans to follow and there are good reasons for this.  We aren’t a blue light service. But we will get into our scruffs, we are down into the hole with the people we serve helping give each other leg up.  We are human, not care managers.

Nice ‘n’ Sleazy does it every time

nice n sleazy

By @briantheroomie

When one considers representation and inclusion within the arts then it seems there is a huge omission in relation to people with a learning disability. Goddard (2014) argues that people have very little or indeed no say in the in the development of the inclusion agenda when considering the professional arts from a UK perspective. The lack of any real and meaningful engagement with the arts would undermine any notion of being taken seriously as a starting point. The field is highly competitive and success is often based on existing relationships. Menger (2006) asserts that any work or opportunity is generally ‘piecemeal’ this then links to reputation or standing within the immediate community or group. Accordingly this then serves to magnify the power of differences in talent and work opportunity to increase inequality.

When considering people with a learning disability as a “professional artist” then one could argue that identity and the ability to grow and understand self are the prerequisite within “creative learning” but if as Menger offers the field is limited then how are people going to access the chance to perform on their own terms and equally develop a sense of self value as an artist? Fundamentally if access is the issue then where are the spaces where people can access the arts and contribute on equitable terms?

I was introduced to the “Nice n Sleazy” festival four years ago and it has been overwhelming watch it grow and develop. The festival is named after The Stranglers hit song from 1978 and has been part of the live music scene for fifteen years. I initially I thought it was a ‘punk’ festival though defining that term is virtually impossible. Tait Coles (2014) refers to punk as a state of mind” and attitudinal. Danny Baker writing in 1977 in the D.I.Y magazine ‘Sniffing Glue’ argued it is “something new” and furthermore that confusion is all part of the underlying philosophy of the movement and therefore “f*ck it, you go and figure it out” Baker (2104)

With this in mind then what has been created by the organisers is a music festival – Nice ‘n’ Sleazy.

https://www.nicensleazy.info/

The difference here however is that it is evident that the team have adopted an approach to support equality, diversity and inclusion through their own understanding and definition of punk. If ‘actions speak louder than words’ then one can see the huge push to creating a space that is safe for all. It equally provides opportunities for employment and performance and then sets the scene for four days of music and entertainment.

In 2019 the festival was awarded ‘Disability Confident’ status. The tangible reality of this is that people with learning disabilities both perform and work on site For the full duration of the event. The Disability Confident scheme claims to support employers “to make the most of the talents disabled people can bring to the workplace” (on-line 2020) Moreover the scheme is seen as a way of addressing how employers engage with people with a disability.

According to the web-site there are 8.1 million people in the UK that have some form of disability. Defining disability can be problematic however Shakespeare and Watson (2001) perceive the term as complex and assert that one cannot reduce a definition to just biological circumstances. Equally important are psychological and socio-political factors”. This seems to capture the idea that a disability could be a social construct, Hiranandani (2005) and here in is the overriding philosophy of the Festival.

When viewed through this prism ‘disability confident’ argues that by adopting more inclusive strategies for support then an organisation can change behaviour and cultures within “businesses, networks and communities “on line (2020) The reach is measured way beyond the immediate employer. By embracing inclusivity and by people having a visible and valued presence the potency of the message is magnified.

Running parallel with this is the notion that whilst exploring and having access to arts people with learning disability have a very real chance to “express themselves through different creative opportunities and media. According to idonline.org (2020), people can “gain confidence” in terms of self-development. More importantly though is the idea of the person being seen and valued as an artist or performer in their own right. Creating our own selves through the arts reflects Stuart Hall’s concept of identity being understood as identification, that is an evolving process rather than a fixed identity that is often ascribed to us by society and particularly for people with a learning disability (Hall, 1990).

Whilst trying to steer clear of labels, Becker (1963) and being mindful of respecting how people may want to self-define it is noticeable that “Sleazy” has given a platform and equal standing to the following bands

The latest track by the White Ribbons band is available for download with the funds going towards supporting the EC-Tix to be supported to tour Norway during summer 2020.

It is easy to see why the bands sit well within the festival due to their own punk ethos. Aligned with this therefore one could argue that “Sleazy” is a world away from how other festivals organise and promote what they do. There is no fuss and no huge banner proclaiming and asserting inclusivity. This reflects Beresford and Croft’s ‘democratic / citizenship’ approach to inclusion that emphasises people’s rights as citizens (as artists) to create and set their own agenda and identities, rather than as ‘consumers’ or ‘service users’ to be consulted in an often reactive manner to ‘tick the box of inclusivity’ (Beresford & Croft, 2003).

This philosophy is captured perfectly by Pauline Murray lead singer of Penetration who when asked what is it like being a woman in rock offered she never considered her gender an issue. Murray explains “I just thought I was part of the band” in retrospect however “it seems quite revolutionary, the way women were behaving. Females in bands were breaking down stereotypes” PR Intern (2017) Could the same be said of the bands appearing at Sleazy?

If pushed it is doubtful the bands above would describe themselves as having a learning disability. The idea that a group of musicians would want to be categorised in this way seems wholly at odds with my understanding of the rock persona. Joe Strummer of The Clash in defining ‘self-awareness suggested it has something to do with ‘an ability to trust your own judgement’ and more importantly “an ability think for yourself” as cited in Coles (2014) The chances are the respective bands just want to be musicians, performers and artists and consequently this is how they see themselves.. Doubtless that is exactly how the promoters at “Sleazy” make sense of it all. One is left to ask therefore, is there any other way to see it?

I wanted to do a piece here about inclusivity within the arts and I have focused on this festival as the yard stick by which others could measure their impact. In considering Sleazy I haven’t spoken about the broad range of opportunities it presents for people (with a learning disability) to work as sound engineers, stage managers, lighting technicians, stage runners and the wealth of talent it embraces to do this.

I haven’t discussed how the festival supports and promotes the White Ribbon Campaign which was founded in 2005 and is “part of a global movement concerned with ending male violence against women. “Much of the work we do is concerned with engaging men and boys regarding attitudes and behaviours, raising awareness, influencing change and providing resources to make change happen in relation to domestic violence and abuse of women and girls” White Ribbon.org.uk (2020).

I also would have wanted to raise the work that Sleazy have been doing since 2016 in promoting The Sophie Lancaster Foundation. As part of their developing agenda regarding equality and diversity the organisers have been instrumental in challenging ‘hate crime’. This has allowed a further opportunity to increase and raise awareness and address discrimination and prejudice on an individual basis. Sophie Lancaster was a young woman that was murdered and her death was treated as a Hate Crime by Judge Russell who sentenced the murderers accordingly. Under the current UK Hate Crime Legislation (Section 146), as the motivation behind the murder was hateful, he was able to use his discretion to class it as a “Hate Crime”. The work the foundation does focuses on creating respect for and understanding of subcultures in our communities. Where better to do that than at a punk festival?

It is probably worth mentioning that the team also support Morecambe food bank. There is a donation point in the foyer at the festival where food can be left and once the weekend is over the donations are then transported to the charity. Again this evidences how “Nice n Sleazy” has an alternative perspective when considering how to promote and host a music festival.

The tangible reality of this is not only do people with learning disabilities perform and work on site during the weekend, there is a massive emphasis on inclusion, diversity and equality. This is a world away from how other festivals organise and promote what they do, so in conclusion one could say “Nice and Sleazy does it every time” The Stranglers (1978)

Learning to Fly

learning to fly

My middle son started an MA in Social Work a few months ago. This was a bit of a surprise for me. Although he is ideally suited to the profession (he is very lovely, far less spikey than me, has lots of patience and will be brilliant – I am of course exceptionally biased) I didn’t expect him to choose social work. Chatting to people at work about this, I was asked if I would ‘teach him’ at home to help him with his studies. My reaction was, no which seemed to surprise people who worked with me. They wanted to know why, given that I am a proper social work bore, would not want to do so. Well, the thing is, I don’t know how much of social work you can actually ‘teach’.

I am uncomfortable with the word ‘teach’ in relation to social work. It gives the impression that to be taught there must be a beginning, middle and end to social work interventions. That social work is deterministically pre-set and if we just train people in the right processes with the right tools they will be good social workers. This idea of social work though leaves me cold. I also not sure I am articulating this well. I will try and explain, but in truth this could go horribly wrong so please bear with me.

A few years ago my youngest son, aged 8 at the time, just before getting out of the car as I dropped him at primary school casually said ‘Dad, I know about capacity’ and then without any prompting he rattled off the five principles of the Mental Capacity Act. Pleased by my speechless shocked reaction he finished with a flourish reciting ‘least restrictive summat, bye dad’ and was out of the car and off running to the playground. As I told my colleague when I got to work, I had never felt so proud and yet so ashamed at the same time! Clearly without ever having a direct conversation with my son about the Mental Capacity Act, he had acted on my interest in and probably some of my anxiety about the MCA and found it interesting to memorise it. Whatever the reason, he knew enough at the age of 8 to recite some stuff that was extremely important to me. He hadn’t been taught it but he had somewhere absorbed it, liked it and wanted to show me.

I have never had an easy relationship with teaching now I think about it. When I was choosing my GSCEs/O Levels at school I had a choice between Home Economics (a subject title that even at the age of 14 I recognised as extremely old fashioned and somewhat Thatcherite), Metal and Plastic Work (heaven forbid – I struggle holding cutlery correctly never mind making it) or Art. I chose Art. Part of my thinking was that apart from the abhorrence of being the only boy in a class full of girls doing cooking or the only boy in a class full of blokey-type boys in the ‘workshops’ of the Metal Work department, if I chose art I would be taught how to draw. Despite my huge lack of artistic talent I quite liked the idea of art and happily ticked the options box for it, genuinely excited about the prospect of doing art and improving on my doodles. When I say I quite liked art, I quite liked art to the point where I watched Take Art on TV and not just for Morph. And although I never for one moment believed the kids whose pictures where shown in the Gallery on Take Art had actually produced such masterpieces, ‘aged 8? He’s got his mum to draw that’, was a regular refrain as I waited for Why Don’t You together with my sisters, I did like watching Tony draw (when Mr Bennett gave him any peace) and I did want to replicate his work. As I say, I quite liked art.

It dawned on me relatively quickly in the art classes that I had made a big mistake. The bi-weekly ritual of cooking something truly awful in front of a load of girls I was hugely failing to impress or produce a metal coat hanger than would make the proper lads of metal work fall about laughing, would have been preferable. While the art teacher may spend the first 5 minutes of the lesson talking about art, quickly describing certain techniques and less so actually doing any drawing or painting himself so I could try and follow and learn from him, the rest of the session was devoted to the class and where we were at liberty to draw, paint and create pretty much whatever we wanted or what the art teacher said ‘was our muse’, a term I suppose I quite rightly didn’t understood. It struck me at that early stage of the course that being taught art wasn’t actually something that was going to happen. The classes were to all intents and purposes for the children who had self-identified that they could do art already. They weren’t learning or being taught art or trained as artists – they were essentially artists already. In fact some of my peers were not just artists, it was clear that art was their passion and would undoubtedly be more than likely to be their chosen career in one form or another. My friend Ben, who I sat next to throughout my ordeal was, in my eyes, an artistic genius. 35 years on and he unsurprisingly still is. Back then, aged 14 he could pick up a pencil and well, draw something exceptionally good, using what seemed to me unimaginable combinations of colours across the paper and even more intriguingly for me, they were always accurate. He drew whatever he wanted to draw. I tried to do the same and simply could not. My hand could not do what my brain wanted it to do. As it turned out I could draw a half decent hammer and sickle (bizarrely popular Soviet iconography at the time, which I suppose chimed with my very half-baked political interests) and I would spend the best part of 2 years doing that, drawing the same thing badly, much I think to the amusement of Ben who seemed to enjoy my somewhat comedic presence without it distracting him one bit. My art agony was made only even worse by my artistic sister who I had confided my struggles in, one evening choosing to help me by tackling my backlog of barely started art homework for me and producing pieces in my name that I was wholly incapable of producing myself. The Weetabix box that she drew was that good that the teacher held it up to the rest of the class to demonstrate the level of art he was looking for. Even Ben looked impressed. This episode rendering it impossible for me to actually turn up for my art exam at the end of the two years course for fear of this deception being discovered, which certainly it would have. I would not have known what the word plagiarism meant back then but I knew the consequences of cheating. A disaster from start to finish. I came to the conclusion that art could not be taught to someone like me who essentially could not draw then, could not draw now and could not draw if Tony Hart himself had provided me with free lessons throughout my lifetime or his, whichever is/was the shorter (I haven’t googled*).

I have had a similar relationship with playing football. It’s a sport I love and I play regularly, although I am not good at it at all and never have been. Thankfully I am now at an age where it doesn’t matter that I am no good. Not getting into the school football team at 10 may have felt crushing. Now nearly 40 years later merely doing any exercise at all regardless of skill is something that people compliment you for doing. How bad you are at it seems irrelevant, which is a blessing for me. Standing on a five-aside picture in the freezing cold and rainy Bradford nights, I probably get more joy from seeing my younger, faster and better footballing star colleagues score a great goal between them via running in circles around me than I do from managing to get through 60 minutes and occasionally kicking the bloody thing myself. But the point is that no desire to be better at football or love of the game or advanced thinking about positional play actually would have improved me. I was at a level. Football practice isn’t designed to teach football really, its there to help hone skills that already very much exist just as the art classes did for Ben. Aged 14 I may have possibly improved some technique of football through being taught it well but essentially from an early age whether its drawing fantastical gothic monsters during art sessions, or playing football and hoofing it as far as you can, there are certain skills and attributes where I have found my level. Most things can be taught but some things are intrinsic.

And that’s what brings me somewhat awkwardly back to social work and can it be taught? I don’t think a lot of it can be. We need skills and tools, and need to be shown how to use them, but most if it must be there already in the same way that my art and football skills weren’t at 14 and aren’t at nearly 50. My son needs a good social work education which provides access to information, experience and practice wisdom, the best theorists who can relate application to practice and a wide understanding of society to help him explore how critically reflective he can be if he is to become a become a social worker – and that’s different to being taught, isn’t it? A friend and colleague in social work education told me a while ago that what the best social work educators do is provide a brilliant social work education and experience for their students, and in doing so they do not set out to produce conveyor belt of uniform professional workers, they are seeking to tap into the intrinsic motivation that drives the person to be a social worker. That stuck with me. We aren’t training people or necessarily even teaching people to be social workers; we are educating students in social work. It sounds simple but I think many get that wrong, particularly social work employers. Getting that wrong is where the ‘practice ready’ difficulties starts and which result in far too many new social workers leaving the profession early. Employers are (still far too slowly) coming to terms that when we employ NQSWs we need to invest in an Assessed Supported Year in Employment, but the experience is still too variable across the Country and the impact on confidence of social work students who are now full autonomous professionals leads all too often to employers, services and teams giving up and trying to recruit experienced workers instead. But if we take NQSWs as they are, educated, ready to learn through practice experience with the right support around them, full of the values that brought them into the profession in the first place we get the best of us.

Good social work education provides an academic framework to help those students whose values are in keeping with the values inherent in the profession, which helps them make sense of their unique role and contribution in applying the social model when in practice. But for social work students and NQSWs to translate their values and knowledge frameworks into practice skills, they need a social work employers to value and foster service cultures which also encourage and support experienced social workers to access and participate in on-going critically reflective social work post qualifying education. The best qualified people to judge fitness to practice will always be practicing social workers, not the trainers. There should not be any expectation on the part of social work employers that at the end of the social work education we will have ‘ready made’ social workers who now need no further investment in their continuing education. What we will have instead of that is even better. We have social work graduates who with the right organisational culture wrapped around them in practice will be able to pick the baton up from our HEI colleagues and provide them with an environment to safely, calmly and at their own speed gently learn how to apply their social work education into practice. No training. No quick fix. No chance of turning me into Picasso via a 2 year GCSE Art class. Social work students are there to absorb the first part of the education and get to see and a small taster of what the job is. As qualified social workers and as responsible employers we are all forever training, practicing and honing skills from our first day in University until our last day in employment. With the right support social workers are able to fly and recover from falls. With the right support from the right people and the right people choosing social work and having the right environment we are all able to be naturally talented at what we do. Some even get as good at social work as Ben is at art.

I have now Googled. Tony Hart died in 2009. RIP Tony. Thanks for the memories if not the free lessons. And Ben, now in Los Angeles, still draws http://www.benfellowes.com/

In the Bleak Mid-Winter

cottage

Everyone knew Mary. She had been known since her husband Albert had been admitted to hospital with his heart 6 years earlier. Mary had sat by his bed, refusing to leave, sleeping on the chair. The ward staff had tried to get her to go to the café to get something to eat, but she didn’t want to leave his side, so they’d rung the hospital social work team. The hospital team went through their pack ups and managed to get together some cheese sandwiches which Bob and Lyn from the team took up to Mary on the ward.

Mary was dosing when they found her in the chair next to Albert. Dressed in an old coat, stockings and well worn boots, she was not happy to be woken up. ‘No, I don’t need owt, thanks’ she grunted at the social worker. ‘Me and Albert we are just fine, once he gets better we are going home’. Lyn sorted a mug of tea and left it with her, ‘just in case’. They paused as they were about to leave the ward and waited, watching as Mary’s hand reached out and a sandwich was picked up, sniffed, and then a bite taken from it. A decision was made, they would be back in a couple of hours with more sandwiches.

The phone call came through 2 days later, Albert was not getting better, he had become really quite unwell, he needed moving to intensive care and Mary was kicking off refusing to leave his side. Lyn and Bob went up to the ward.

Mary was inconsolable. She’d not been separated from Albert in over 60 years. She was not having some doctor or nurse tell her that she couldn’t be by his side now. Bob spoke to Matron who told him that they were working on Albert now, it didn’t look good. A nurse appeared, Mary needed to come now. Lyn and Bob went with Mary as she went into a room with bright lights, tubes, machines, and on the bed – Albert. ‘We need your permission to stop’, Mary collapsed into Bob.

The next 24 hours had been a blur, but they’d got her home in Bob’s car. It was a stone cottage right on the edge of the villages in the Pennines. Gritty beauty in any other circumstances Bob thought. Isolated. The cottage was cold, really cold. No central heating. No electricity or white goods. An old cold store for food storage and a wood fired stove the only source of warmth. Lyn offered to make a fire and get a cuppa on. But Mary wouldn’t have any of it, she just wanted them gone. Mary settled into her new life without Albert.

The referral came through from District Nursing to the Locality Social Work Team. Mary’s GP had been out to see her and was extremely worried. She was living in slum like circumstances, hording, piles of stuff everywhere in her house, no central heating, no electricity – she wasn’t safe. District Nurses had been to see her but she was refusing their help. A social worker needed to go out, she needed to be in residential care for her own safety, winter was coming.

Simon and Kirsty from the area social work team went out to see Mary on a cold December morning. The frost was deep and crisp as a cold snap had set it. Everything was sparkling white. The path was pretty icy to Mary’s cottage, Kirsty nearly lost her footing as she slipped on the way, so Simon got to the door first and knocked. No response. They tried again. Still nothing. Kirsty tried to look through the windows. She could see Mary in there, moving around the piles of papers and clothing that had accumulated over the years. They waited and finally Mary made her way to the door but refused to open it. They could hear her there on the other side of the door. ‘Are you alright love?’ asked Simon through the letter box. No reply. ‘People are worried, we just wanted to check on you’. Finally, a response ‘Bugger off’. Kirsty smiled, Mary sounded fine, nothing wrong with her voice. However, having got one response, Mary wouldn’t reply to anything else they asked her. After an hour of trying they paused. Mary was sill there on the other side of the door, but she wouldn’t speak to them. Kirsty stuck her hands in her pocked to warm them up, bonus! She found a couple of quality street she’d grabbed on the way out from the office Christmas tin. She passed one to Simon. As they opened them, the wrappers crinkle sounded louder than usual in the cold, crisp morning. ‘What’s that?’. Mary had heard the wrappers. ‘Quality Street, do you want one?’. Nothing for 10 minutes. Then ‘yes’. Kirsty looked at Simon, OK then, ‘can you open the door’, nothing again, silence. Simon looked at the letter box, they came to an agreement, they reached through the letter box with a sweet. A partially gloved hand snatched the sweet away on the other side of the letter box. Progress. The start of something. In the car on the way back to the office they talked through what to do next.

Kirsty and Simon did the leg work over the next few days. It turned out that Mary had a regular routine that everyone knew as she walked from her house to the farm shop, post office, church and past the local pub every Thursday for her weekly shopping trip. Everyone knew her. They were all really sad about what had happened to her and Albert. They were all unconsciously quietly checking on her, making sure she was OK. The village were up for being there for her, letting Kirsty and Simon know if anything changed. The butcher in the farm shop knew that she liked a sausage sandwich. A plan was reached, Mary wouldn’t speak to the social workers. But she would take food through the letter box. During winter they would stay in contact with Mary and visit once a week to check on her, taking with them a parcel of sausage sandwiches and quality street to post through the letter box.

The first trip went well. Once again it took an hour for Mary to come to the door. Once again, she told them to ‘bugger off’. But she grabbed at the sandwich and ate it on the other side of the door whilst they waited. Over the next three months some days she even began to speak to them a little – ‘oh it’s you again’, ‘you off now?’.

It was March and the first of the daffodils were out on the pathway to Mary’s door. Yellow heads bobbing in the early spring sun. Kirsty and Simon had heard from the village that Mary was following her usual routine but just wanted to check she was OK. Mary was waiting at the door as they arrived, the door opened a crack, they looked at each other and stepped in.

Stay Another Day

winter walk

So, it is a given that we love the Mental Capacity Act. We love the fact that when it is administered properly, it ensures people who lack capacity to make specific decisions benefit from safeguards, which simultaneously enable the person to exercise their rights, such as challenging the assessment/Best Interest decision. As well as ensuring these safeguards, the MCA also enables the state to sign off and sanction proportionate support and protection to mitigate against a particular situation. We also love the fact that when someone has the capacity to make a specific decision (such as whether I have the capacity to choose to write this blog) the MCA doesn’t really apply. If the decision doesn’t break the law or infringe on anyone else’s rights, personal decision making is essentially no-one else’s business. When a decision to act in a certain way does break the law or infringe on others we rely on criminal justice to ensure rights. So whether this blog is good (unlikely) or bad (more likely) it doesn’t matter in terms of whether or not we can make the decision to write it. We have capacity to make the decision and as such we can get on and write pretty much what we choose to.

We were asked a question last week that comes up quite often, particularly around this time of year when its getting close to Christmas, the days are darker and the weather is turning bitterly cold. The question is, whether in assessing that someone has the capacity to make a specific decision to accept or decline care and support, do social workers use the non-rebuttal of principle one (i.e. assume capacity) or use capacity assessments that people are able to make the decision, to justify a lack of action on behalf of the social worker and simply walk away, close the case & move on just because the capacitous person is telling us that they do not want us involved?

We touch on this issue in Social Work, Cats & Rocket Science in most of the case examples in the book. All those of us who were involved with Elsie in ‘Someone To Safeguard’ are mindful of the fact that ignoring rights, or striving to find a lack of capacity through over assessing and/or setting the bar artificially too high or over-medicalising what are seemingly environmental situations in the pursuit of safety, often at the price of happiness such as in Elsie’s case, is simply wrong & needs to be vehemently guarded against by excellent social work practitioners. However that is not to say that a balance doesn’t sometimes need to be struck between turning on our heels, doing an about face and walking out of someone’s life because they have capacity to make a decision that they don’t want help and genuinely working to keep a possible foot in the door for when state support may be required either through the person changing their mind, accepting the consequences of their original decision may have been detrimental or where, in the case of someone going on to lose capacity to make the decision, a best interest decision to put in place treatment and support is necessary. Our answer to the question as to whether we do just walk away if a capacious person who has care and support needs but who is in an extremely risky situation tell us to do so is unequivocally yes and we absolutely and unashamedly work uphold the persons right to reject undue state interference. However that in itself is so very often not the end of our work – its often just the start what Ruth Allen at the British Association of Social Work refers to as ‘the messy stuff’ and this is where the best social work excels rather than disappears.

When the door is slammed in our faces, everything we learnt at university, through our experience, through learning from theory, through working alongside exceptional colleagues (both in social work and in partnership with allied professions) is used to maintain & enhance relationships wherever possible, whilst absolutely keeping the right side of Article 8 ECHR & in upholding our values, becomes critical. For us, in rejecting the notion that adult social workers are merely brokers of care packages, stepping up to the plate and demonstrating our unique skills in trying to ensure a lifeline for people becomes vital, essential even. This is where adult social work is at its most vociferous challenge and where the assumption that social work is inherently helpful, is at its most tested. Can we forge a relationship with a capacious person in a risky situation, who is telling us in no uncertain terms where to go, whilst at the same time not only uphold their right to reject state intervention but be the leading exponent of their demand to reject support within our multi disciplinary settings and where we are under significant pressure from genuinely worried family members and other professionals? The answer is that we can and we do. Only last week, in looking at preparations for Christmas, it was staggering how many people we support who do not accept statutory help in the form of prescribed care or Direct Payments, but where social workers are working to keep channels of engagement open, often in the most difficult of situations.

Every social worker seemingly has a story about a person who made a decision to reject us and what the outcome was. In Elsie’s case we panicked and sought immediate medical intervention before ultimately probably erroneously using mental health legislation and watched her go from the home she had lived happily in for 80 years into hospital & care home & die within months of first slamming the door in our face. With David, a man dying of cancer and battling with alcoholism, we saw him reject all state intervention whilst tipping whisky into his drip feed and choosing the death he clearly advocated. We did what we could for David and we were commended in court afterwards for upholding his rights. However we could not do anything to stop him and his capacatous decision making, all we could do is respectfully uphold his dignity in choosing how his life ended. But Elsie and David are both extremes.  Most people social workers are supporting range between the extremes, and where we are hanging on by our social work fingertips whilst capacious people make a series of decisions that worry, upset, confuse and sometimes scare the lives out of people. Hanging on in there, sometimes to ensure that other agencies adhere to the persons Article 8 rights, is often the only social work intervention possible. Social Workers who understand the inherent power in their role and recognise that legislation is at their fingertips but should not be applied to a situation where a person is free from mental ill health and has the capacity to make the most challenging and worrying decisions, or simply where there is no causal link between the persons impairment and the decision to be made, battle to uphold rights using only their skills as communicators to remain involved in the face of rejection and adversity are the social workers who take our profession to another level. These are the social workers who recognise that the Mental Capacity Act has no get-out clauses for people with particular conditions and the generality of the Act in that it applies to us all in the exact same way. These are the social workers who do not bend the rules and the assessments so that it may act as a bypass for these most painful and seemingly hopeless situations and in doing so they protect all our human rights. Yet crucially these social workers keep the door ajar for the capacious person and their families and remain involved with the state but accept a different kind of involvement. This is social work resilience and keeping the hope alive at its best and it requires the very best of us all. It means we genuinely keep the channels of communication going, make the call to concerned relatives and not to leave it to them to worry about their loved one on their own but we instead share the concern, properly hold the risk whilst also enabling it as it is lawful & understand & uphold the decision someone is making, whilst remaining resilient & positive that things may be better and help may be accepted. These are the social workers who have the connectivity to families and communities and networks of support, if not to the person themselves. Its social work but its often three, four, five times removed from the person.

So this is to all the social workers out there who are somehow managing to do this work, particularly over Christmas and in the winter. We know this stuff is not rocket science but upholding rights whilst holding risk is really bloody hard. The pressure to misapply legislation, agree that ‘something must be done’, buckle and dodge the complaint that is going to be made about you for doing your job correctly and go on to find a lack of capacity to relieve everyone of the burden of autonomous decisions that scare us rigid is real.

So for all the social workers who are worried about people over the winter and who are out about doing things like posting cooked food through letterboxes of the unkempt house in the terrace block, with the hole in the roof and where we know there’s no electric or water in there but there is a person, who at this moment in time isn’t prepared to speak to you but might, just might accept the food parcel – thank you for hanging on in there. For all the social workers out there using resources to buy things like mobile phones for people and hoping someone will accept it as a lifeline to ask for support whilst accepting that they might not and that this may lead to more risk – thank you, you are doing exactly what you are educated to do and paid to do. For all the social workers who are hanging on, staying involved, living with the complaints and accusations of doing nothing whilst actually doing the exact opposite, or those picking up the phone or visiting the concerned family members to see how things are progressing and look at where, if anywhere, we can collectively make a difference to the person that they love – thank you, that’s often all anyone can do and your involvement despite the obvious frustrations of those who love the person, is what you need to do. And for all the social workers who use every skill they have to keep the light on and keep whatever contact in place they can and can pull off the seemingly impossible of being the best exponent of human rights on one hand in enabling the persons decision to be heard, whilst not disappearing, not using capacitous decisions as an excuse to disappear but as the start of something really very skilled – thank you.

Many thanks for reading our blogs throughout the year and for those who bought the book. We are privileged to work with some amazing people, including social workers, both in our Local Authority and nationally, other professionals, providers of support, academics, students and especially the inspirational community of people who follow the blog. Many thanks also to our wonderful guest bloggers.

On behalf of Last Quango in Halifax may we wish everyone a peaceful, joyful Christmas and a wonderful 2020.

Walk out to winter, swear I’ll be there
Chance is buried just below the blinding snow

 

Special not Special

I'm Special

A guest blog by student social worker @RShirtliffe

Social Workers = Special type of person, aren’t they?

I am currently embarking on my second year at University to one day become a qualified Social Worker. To myself, becoming a Social Worker would be a ‘dream transfer’, as the footballers would say, into a career I have long been striving for. However, should I drop this information onto others around me I seem to get a similar response:

“A Social Worker? You’re brave” – (puffs out cheeks and raises eyebrows)

“Really?” – (confused face)

“Rather you than me” – (relieved someone else wants to do it, as if they could be called upon to become a social worker themselves like jury service)

Then there is the most common but uncomfortable response of all….“Couldn’t do it me, taking people’s kids off them. Not for me that” – (accompanied with a scrunched up facial expression and upper lip movement that says social work is disapproved of nationwide).

Is social work really removing children from families? Surely that’s not right.  What is the role of a social worker? Will I be hated before I’ve even become a social worker? These are just a few of the many questions that I thought about, but I could not answer until I finally made the decision to enroll at University. Meeting different social workers with various amounts of experience and knowledge has really helped to clear my mind. But has it erased the nagging thought that I will still be disliked by many before they get to know me? No. If anything, it has made me worry that it will be a common re-occurrence.

The most powerful response I have had the privilege of trying to compute is “takes a special type of person to want to do that”.

Does it? Why do people have to be ‘special’ to want to help people find purpose. Or to offer to help somebody battle a situation that they maybe don’t fully understand. Or to simply have someone check on them every now and again. What is so special about ringing or visiting someone to check that they are happy with their life, or not in some cases. I don’t have to be a social worker to do those things, nobody does. It’s worrying to think that the public see someone as special for wanting to make a difference to others lives.

Before starting university, I was very naïve to the sheer size and scope of areas that social workers are expected to work to and within. To me a social worker did it all, children, adults, older people, families. Now I’m a little more up to date with the different types of social work and social work employers, I can see why so many people don’t fully understand what a social worker does or can do. I will hold my hand up and admit that I myself once had a very simplistic opinion as to why I wanted to be a social worker. Simply because I wanted to help people. That was it. How ideal that would be if that was my job role. There would be much less disapproval.

Social work is planning, meetings, specific work taking place every day to protect and safeguard, years of training and practice. These unspoken aspects are the heartbeat of the social work role and I for one cannot wait to be managing my caseloads using all the tools out there available.

So as my first placement of my social work training draws closer and closer and I feel the build up of nerves and excitement, I keep questioning how I will be seen by the people I will be working with.

“Student social worker, you know nothing!”

“You’re just another one of them”

Or maybe, and it seems a little far fetched, but I might be liked…..

After all, I am special right?

Age Speaks

On 19th September, we launched the book version of our blogs, Social Work, Cats and Rocket Science. The launch was at the brilliant Bread and Roses pub in Clapham,a cooperative venue steeped in history.The wonderful Mervyn Eastman from Age Speaks was there to capture the atmosphere for his podcast which we hope you can find time to listen to over a cuppa – https://m.mixcloud.com/EastLondonRadio/age-speaks-social-workcatsrocket-science-book-launch-aug19/The book sold out in a week which has blown us away as the author royalties are going to Stay Up Late. A new batch comes out this week so hopefully we can raise a bit more and support #nobedtimes being the norm everywhere.