Social work has changed a lot
since I started in 1976, in many ways for the better, in some ways for the
worse.
Back in 1976 the 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, 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 person. 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 town.
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 uneven and discoloured 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 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 quite many cats she had, and I don’t think she knew either, but there
must have been as many as 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.
Let me describe 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 make an explicit assessment of her capacity, and would
probably 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.
