My First Caseload in 1976: Margaret & her 40 cats

 

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.