The best assessments are the ones that don’t happen

There are people who change your career without ever intending to. Twenty-five years later, I still get a Christmas card from one of them.

His name was Ken. Her name is Alice. And, to borrow Billy Bragg once again, somewhere between Marx and marzipan in the dictionary, there was Mary.

I met Ken as a newly qualified social worker (before the title existed!) on an older people’s psychiatric ward. His admission wasn’t really the story. His marriage was.

Alice had reached the end. Not because she had stopped loving Ken, but because she never had. Decades of living alongside his severe mental ill health had simply exhausted her. She wasn’t angry. She was broken.

At the ward round, everyone seemed to know what needed to happen. Ken’s long-standing psychiatrist arrived with the Community Mental Health Team manager (who I privately called Rambo because every story he told about mental health sounded like an action film). They wanted Ken transferred to older people’s services and into a care home as quickly as possible. The older person’s psychiatrist nodded thoughtfully. “It’s over to social services now. Rob, find him a care home.” Everyone nodded. Job done.

Except, for once, it wasn’t.

Around that time I was wondering whether social work was really for me. Every week I took five or six people to the panel for permanent care home placements. Assessment. Recommendation. Placement. Repeat. I loved the older people and their families. I just wasn’t sure I was actually helping them. I remember saying to my manager, Mary, “I think I’m helping bed managers more than people.”

She listened. Then she completely wrong-footed me. “Stop assessing Ken.”

I assumed she’d lost faith in me. Instead she said, “Rob, you always talk about how much you loved being a care assistant. So go and be one again. Don’t rush him out of hospital. Spend time with him. Really get to know Ken. And while you’re doing that, get to know Alice too. Not just as Ken’s wife. Get to know Alice.”

It remains one of the best pieces of supervision I’ve ever received. Mary wasn’t reducing social work. She was reminding me what it actually was. The ward wanted progress. Mary gave me permission to slow down.

So I occasionally employed what could generously be described as creative care planning. “I’m taking Ken to look at care homes”, I told the ward. Technically true. Eventually. But for now, we went to the pub.

Every time he saw me he’d grin. “Bob, lad, we escaping again?” Over cups of tea and the occasional pint, I learnt about his first job, the music he loved, his children and, somehow, every conversation came back to Alice. He never described himself as mentally ill. He described himself as a husband.

That turned out to matter far more.

Alice thought I’d completely lost my mind. The psychiatrist had promised her a care home. I was taking her husband for drinks. Trust took time. It grew through dozens of ordinary conversations, helped enormously by an experienced colleague who understood the quiet magic of kitchen-table conversations. Nothing dramatic happened. People simply began believing that we meant what we said.

Gradually Alice stopped seeing me as the person delaying a placement. We all began to understand that she didn’t really want Ken in residential care. She wanted the man she’d spent her life with. She wanted life to become liveable again. She needed room to breathe. So did Ken. And conversely, in a much less important way, so did I. 

Eventually we found a care home, not as an ending but as part of a recovery. The real work wasn’t finding a placement. It was helping Ken and Alice rediscover each other. There was no miracle. Just hundreds of ordinary conversations. Staff who understood the couple, not just the diagnosis. Remembering what helped. Letting go of what didn’t. Even deciding together that some medication wasn’t helping.

Eighteen months later, Ken went home. Not for a visit. Home home.

Every Christmas afterwards a card arrived. “We’re doing fine.” “Another grandchild.” Small sentences. Enormous meaning.

Ken died around fifteen years ago. Alice still sends me a Christmas card every year.

People sometimes ask where I really learnt to be a social worker. It wasn’t at the panel. It wasn’t in an assessment. It wasn’t even at university. It was in a supervision where a manager told me to stop trying so hard to be a social worker. Slow down. Have a cuppa. Listen. Go to the pub if that’s where the conversation needs to happen. See the husband before the diagnosis. See the wife before the carer.

Because assessments don’t change lives. Relationships do.

So thank you, Ken and Alice. I don’t think I’d have stayed in social work if our paths hadn’t crossed. And thank you, Mary. You probably thought you were helping one older couple. In truth, you were rescuing a newly qualified social worker who wasn’t sure he belonged in the profession.

Twenty-five years later, I’m still here. Still making mistakes. Still doubting myself. Still wondering. Still needing all the Mary’s. 

https://youtu.be/7x–rv-uheU?is=vHLT8otdxsP2kKnm