Why did I become a social worker?

The Masked AMHP when he was a hippy

As I approach retirement from the job I have been doing for the last 42 years, I’ve started to think more about what led me into social work in the first place.

Several years ago I wrote in the Guardian about how I ended up becoming a social worker. It was almost accidental. No child has it in their mind that they want to go into social work; for one thing, it is not generally a high visibility profession, unless something goes wrong, and then social workers always seem to be identified as the guilty parties.

But there were a couple of incidents in my adolescence, long before I actually applied for, and got, the job of social worker, that with hindsight first put the idea of being able to help people into my mind.

The old lady

The first incident was when I was 16, when I was still at school studying for A Levels. The Post Office were wanting temporary assistant postmen to cover the pre-Christmas period. I managed to get one of these jobs, to earn some pocket money.

I was assigned to assist Bill, one of the permanent postmen, on his round. This involved carrying a huge bag of post around a housing estate, while he went here and there in his van.

But part of his round involved having to drive to more remote houses. He went to a rather dilapidated looking bungalow and then asked me to deliver a small bundle of what appeared to be Christmas Cards and a couple of parcels. He said that he didn’t want to do it himself as the occupant would keep him in conversation for hours.

I knocked on the door and after a while the door opened. An elderly and frail looking lady was standing there. I noticed that she had dried food attached to the whiskers on her chin.

The bungalow beyond was dirty and ill cared for, with random piles of newspapers and cobwebs hanging from the ceiling.

 An almost overwhelming sadness gripped me as I gave her the cards and parcels.

She seemed desperately disappointed.

“Isn’t Bill delivering today? Such a nice man. We always have such a nice chat.”

“No,” I replied. “He’s … busy, what with the Christmas rush and everything.”

“Oh, well, never mind.” Her voice petered out, and she closed the door.

I felt for the lady’s loneliness, and her disappointment at not being able to have a conversation with the postman. How many people did she see in a week? The experience haunted me.

Surely there must be services that could help someone like her, I remember thinking.

The driver

The second incident taught me something else.

I was 17 years old, and trying to be a hippy, with long hair, a beard, bell bottomed jeans, and sandals. (Give me a break. This was the early 1970’s.)

It was the summer, and I was hitch-hiking in England. I don’t remember where I was going to. It may have been a pop festival. (Weeley?)I had a rucksack, and a sleeping bag, and was hoping for some sort of adventure.

A very upmarket car stopped to give me a lift. When I got in, I was surprised to see the driver was an immaculately dressed woman in her 40’s. Women never usually stopped for a young male hitch-hiker who looked a bit like a hippy.

I couldn’t help noticing that her face and bare arms were covered in a blotchy rash.

We drove off. Looking straight ahead at the road, she said, “I expect you’re wondering what’s wrong with my skin.”

She didn’t wait for a reply.

“It was my husband. The person I love most in my life. He went to the doctor one day because of a pain in his head. The doctor sent him for tests.

“My husband had a brain tumour. It was inoperable. Within 6 weeks he was dead.

“The funeral was 2 months ago.

“I thought I was doing fine. I thought I was managing. But a couple of weeks later I woke up one morning and saw that my whole body was covered in this rash.

“The doctor told me it was nothing to worry about. It was a reaction to the stress.

“Nothing to worry about.

“I‘ve lost my husband, the love of my life.

“Nothing to worry about.”

She continued to tell me her story for the rest of the journey. When it came time to drop me off, she looked at me and said, “You don’t know who I am. I don’t know who you are. We’ll never see each other again. Thank you.” She smiled for the first time during the trip.

Even though I was only a 17 year old self-absorbed teenager, I realised that something significant had happened.

She needed to tell someone how she was feeling, someone she did not know, who was nothing to do with her family or social circle, someone who would not judge her, who would not argue with her, who would just listen. She just needed to talk.

So simply by being there in the car with her, and sharing that journey, I had helped her in some way to come to terms with her bereavement.

I realised that making a difference to people might not be so difficult after all. And it was oddly satisfying to realise I had helped in some way.

Death and Fire Bunnies: Another Story from an Out-of-hours Social Worker

I’ve mentioned before on this blog that in addition to my day job, I did shifts in the local out-of-hours social work team for about 14 years, throughout the 1980’s and 1990’s.

You were very much on your own: there were two social workers on duty covering a county that was 75 miles from west to east, and 50 miles from north to south. A deputising service took calls and passed them on to these two workers, who then dealt with the referral as they saw fit, whether it was a Mental Health Act assessment, an allegation of child abuse, a frail elderly person needing a night sitter – or anything else at all that could conceivably fall within the remit of social services.

We were pretty much allowed to make our own decisions without interference. Often it was as much about what you decided not to do as what you did.

One winter’s evening, I received a call from a medical ward in a hospital. The Sister was concerned about Erica, a woman in her 70’s who had been present at her terminally ill husband’s bedside when he had finally died.

“I’m very worried about her,” the Sister said. “She won’t stop crying. We’ve got her in a side room, and one of my staff is with her, but we’re worried she might do something silly if she goes home. She might need to be admitted to a psychiatric hospital.”

I couldn’t help feeling that the quality of the referral was dubious. After all, isn’t someone entitled to cry when a loved one has died? Isn’t it something that nurses on a medical ward come across frequently, and ought to know how to deal with such events?

However, the Sister maintained that this wasn’t normal, and that Erica needed to be assessed.

In the end, I decided I had to go out and see Erica, although I was not going to treat it as a formal request for a Mental Health Act assessment, which seemed disproportionate in the circumstances.

The county being so geographically large, it was about an hour before I got to the hospital. Erica was in a side room. She was no longer crying, and seemed quite composed.

“I’m very sorry you’ve been bothered,” she said. “As you can see, I’m quite all right now. But Jimmy and I have been married nearly 50 years, you see, and I’m going to miss him.”

A tear sprang into her eye, although she did not sob.

“Do you have any relatives nearby? Any children?” I asked gently.

“Jimmy and I never had children. I’ve got a sister, but she lives 200 miles away. I don’t want to bother her. I promise, I’ll be all right.”

“What would you like to happen right now?”

“I’ve paid my respects, I’ve said my goodbye. I don’t want to stay here any longer – Jimmy isn’t here now. He’s somewhere else. I’m tired. I’d like to go home.”

“Would you like me to take you home?” I asked.

“I don’t want to put you to any trouble.”

“It’s no trouble.”

Her home wasn’t far away, and we were soon at her dark cottage. She unlocked the door and I followed her inside. The house was clean and tidy, displaying the love she had had for their home, but it was cold. She did not have any central heating.

I noticed a tiled 30’s fireplace, with a grate and a bucket of coal on the grate.

“Shall I light the fire for you?” I asked her. “Have you got any firelighters?”

“I don’t use firelighters,” she said. “I just make some fire bunnies.”

“Fire bunnies? What are fire bunnies?”

“Don’t you know what fire bunnies are?”

I shook my head. “Can you show me?”

“Come and watch me,” she said, getting a newspaper and kneeling down by the fire.

I observed as she took a sheet of newspaper and rolled it into a long tube. Then she tied it into a loose knot and popped it into the grate. She continued to do this until she had used up the newspaper. Then she laid a few pieces of kindling wood on top, and finally added a few lumps of coal.

Once she was satisfied, she struck a match and lit one of the fire bunnies.

The fire very soon flared up, the fire bunnies providing a rapid and efficient source of heat, catching the kindling, and soon the fire was blazing away and bringing warmth into the room.

“That’s amazing,” I said, genuinely impressed. “I’ve never heard of fire bunnies before. What a good idea. I’ve got a woodburner at home. I’ll have to try that next time I’m lighting a fire.”

Her face lit up with pleasure. “Oh, I’ve known how to do that since I was a little girl. My mother taught me. Would you like a cup of tea?”

She made us a cup of tea and we sat in front of the fire while she told me about her mother, and her father, and even her grandmother. And about Jimmy, of course.

By the time I left, I was satisfied she was safe to be alone. She was best at home. I knew she had a long journey ahead of her, and it wouldn’t be easy. But she was already beginning to process her grief. She would make it.

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.

Origins 5: Death in Charwood

 

Part 5 of an occasional series about my early years as a social worker in the 1970’s.

Within a few months of starting as an unqualified social worker in Charwood Area Social Services Department it was decided that I could take part in the Area on call rota.

Charwood provided a local out of hours emergency service. Every social worker in the team had to be on the rota. This meant that about once a fortnight I was on call during a week night. About every three months I had to cover a whole weekend, from the end of the day on Friday until the following Monday morning. Being the late 1970’s, there was no such thing as a mobile phone or even a pager, so your home number was placed on the office answer phone and you could not leave home as long as you were on duty – unless, of course, you had to respond to an emergency.

I was on call one cold February Saturday when Robina phoned.

Robina was an elderly woman who was well known to Charwood Social Services Dept. When her husband died, she fell to pieces and her behaviour became disinhibited and erratic. She developed a somewhat cavalier attitude to continence, and was frequently incontinent of urine and faeces. I had on one occasion had to visit her at home, and discovered that, if she was taken short while in bed, she would simply scoop up the excrement and place it on the windowsill. The windowsill consequently contained a neat line of turds in varying stages of decomposition.

Robina lived in a village a few miles out of Charwood, and liked to go to Charwood market on a Saturday. However, she was banned from using the local bus because of her incontinence. Her solution to this was to hitchhike into Charwood. She had a unique method of doing this, which consisted of lying in the middle of the road with her voluminous dress over her head. When a concerned driver stopped to investigate, she would leap up and ask for a lift into town.

When I look back at what I have just written, it seems apparent to me that if a social services department was confronted with this situation in the present day, Robina would probably end up either being detained under the Mental Health Act, or being placed in residential care using the Mental Capacity Act.

However, back then, it seemed quite natural to tolerate this sort of behaviour, and although Charwood SSD was involved with her, intervention was focused on keeping her in the cottage in which she had lived for the previous 50 years, and she had a home help who would keep an eye on her and ensure that she had regular meals.

Charwood SSD had a number of clients, especially in the outlying villages, who could probably best be described as eccentric, but who were generally tolerated within their community. The main object of intervention was to preserve them in their own homes for as long as was feasible.

“Hello, it’s Robina here. I’ve just been to see Cyril. He’s awful ill. I don’t know what to do.” Robina went on to tell me that Cyril lived in Charwood. He was an elderly man who lived alone. I decided that I would have to go out and investigate. Robina couldn’t be left to handle this on her own.

I found Cyril’s address. It was at the end of a terrace of ancient cottages in the older part of Charwood. The door wasn’t locked so I went straight in. It was like walking into a Dickens novel. The cottage was quite literally a “2 up, 2 down”. The front door opened directly into what might have been a living room, except that it had no furniture. The only things in the room was a wooden stump with an axe, and a pile of split logs. A rickety staircase led up from the corner of the room.

I went through into the next room, which was a kitchen/parlour. This contained a stone sink with a cold tap above it. Beside it was the back door into the small garden. There was an ancient Victorian kitchen range which appeared to provide the only source of heating and cooking for the cottage. It had gone out, and the room was bitterly cold. In a corner was a small table with a wooden chair on which Robina was sitting.

It was very dim in the room, but when I looked around for a light switch, I realised that Cyril had no electricity in the house, and never had had. I could not even find a candle or an oil lamp.

The only other furniture in the room was a battered armchair in which Cyril was slumped. He was only partially clothed. It was apparent to me from a single glance that he was in a bad way. He appeared to be conscious, with his eyes staring, and was breathing shallowly. However, he was quite unable to respond to any questions.

I looked around for something to cover him up with. There was nothing in the kitchen, so I went upstairs. There was no furniture at all in the landing bedroom. In what must be Cyril’s bedroom there was only an old brass bedstead with a bare mattress, which was piled high with old coats. I took one of the coats and attempted to cover him up with it.

“Is he all right?” Robina asked me.

“No, he isn’t, Robina. I’ll call the doctor and get him to have a look at him. You wait here while I go to a phone box.”

I went down to the nearest phone box and rang the on call doctor, who was one of the surgery’s GP’s. This was back in the days when GP practices covered their own patients with a rota of GP’s attached to the practice. He said he’d come right out.

I returned to Cyril’s house and told Robina what I had done. Then I waited for the GP, confident that he would examine him and then probably arrange for an ambulance to admit him to hospital.

The doctor arrived, looking rather grumpy. He gave Cyril a very cursory examination, which did not even appear to include checking his pulse, heart or temperature.

Then he stood up and said to me, “There’s nothing much wrong with this chap. He just needs feeding up in the local old people’s home.”

I was aghast. Cyril was clearly immobile, and to my eyes appeared to have had a stroke or some similar serious health crisis. No care home would have him in this condition. I told the GP this.

“That’s not my problem,” the GP replied when I pointed this out. “There are no hospital beds, and he can’t stay here, can he? With that, he left.

“What’s going to happen now?” Robina asked me.

“I don’t know, Robina. I don’t know. I’m going to have to leave now and try and sort something out. Can you keep an eye on him?”

This was way out of my experience zone. I went to the local authority old people’s home in Charwood and spoke to the manager. She confirmed that Cyril was in no condition to be admitted to them. I used their phone to ring my own manager. She did her best to reassure me, and said she make a few calls and get it sorted.

I waited at the home for half an hour or so until my manager rang me back.

“I’ve spoken to a doctor on the geriatric ward at Charwood Hospital and he’s happy to admit him. I’ve called an ambulance and they’ll be there any minute.”

Much relieved, I returned to Cyril’s house.

Robina was still sitting beside Cyril with his hand in hers.

“Hello, Robina, it’s all sorted out. Cyril’s going to hospital. The ambulance will be here any minute. How is he?”

She looked up at me.

“I think he’s dead,” she said.

I had a close look at Cyril. His eyes were staring sightlessly. He was not breathing. She was right.

The ambulance arrived.

The crew took one look at Cyril.

“He’s dead,” one of them said.

“I know that,” I replied.

“He’s not one for us,” he said. “I’ll call the police and let them know.” They left.

Everyone was leaving.

I went back to the phone box and called the GP again.

“Oh, it’s you again, is it?” he said. “What is it now?”

“You know that old man who you said just needed feeding up in an old people’s home?”

“Yes, what about him?”

“Well, he’s dead.”

There was a brief silence. Then: “Oh shit,” the doctor said. “I’ll come straight out.”

 When I got back to Cyril’s house, the police and a police hearse had arrived. The GP came soon after and formally certified Cyril as dead. He studiously avoided eye contact with me and left rather quickly.

As the hearse crew zipped Cyril into a body bag and carried him out to the hearse, I comforted Robina, who was crying.

“He was a good friend, Cyril was,” she said. Then she looked around the room, Spying a box of eggs on the table, she took a few out of the box and put them into her shopping bag.

“Cyril won’t miss these, will he?” she asked me.

“No, he won’t, Robina. You may as well have them.”

She saw a pile of split logs ready to go on the fire, and slipped a few of them into her shopping bag too, with predictable results.

“Let me take you home,” I said.

“A lift, oh good, with such a nice young man,” Robina replied, and smiled at me.

Origins 4: My First Caseload

Part 4 of an occasional series

Within a couple of weeks of starting as an unqualified generic social worker in Charwood in the Autumn of 1976, I began to acquire a caseload. It was quite a mixture. Being a complete novice, I did not question their histories, assuming they were “normal for Charwood”, but when I look back now, I realise how extraordinary some of these people and their life experiences were.

First, there was Benjamin. Private Benjamin. He was my very first mental health client. Benjamin had been a young man during the 2nd World War, and had been called up to serve in the Army. He had previously spent his life in a village in the Charwood area, living with his parents and family in a large timber frame farmhouse, and working on the family farm. He had a fiancée, whom he had to leave behind when he was called up. She promised to wait for him until his triumphal return.

While in the Army, Benjamin was badly injured. It was not in active service. A munitions lorry backed into him in the Army depot, crushing him against a wall and damaging his legs and spine. He was medically discharged, returning to his village permanently disabled, and only able to walk with the aid of sticks. His fiancée, on seeing his injuries, promptly left him, and married another.

Broken in heart and body, and no longer able to work on the land, he retreated to the family farmhouse, where his parents still lived with his sister and her son. He took over the attic rooms, and became a complete recluse. His mother would leave food and the daily local newspaper at the top of the steep attic stairs, he would take it once she had left, and return the empty plates to the landing when he had finished.

He continued to live like this for the next 20 or more years. No-one in the household ever saw him, although they would hear noises emanating from the attic from time to time, so they knew he was alive.

It is unclear how social services came to be involved with him. Perhaps the noises in the attic became more disturbing. Perhaps his family began to get concerned that they had allowed this crippled ex-serviceman to isolate himself in this way. Whatever the trigger, in the mid 1960’s an assessment was carried out under the Mental Health Act 1959.

The Mental Welfare Officer, his GP and a Psychiatrist climbed the steep stairs to the attic and entered the attic room in which he had lived unseen for over 20 years. The entire space was taken up with a warren made of old newspapers. They picked their way through these narrow corridors until they eventually discovered him, huddled in a nest of old newspaper. His hair and beard had grown down to his waist, his fingernails were several centimetres long, and worst of all, they discovered that, because he had not used his legs for decades, and had instead negotiated his warren by shuffling along on his bottom, his legs had atrophied under him and were completely immovable.

He was detained under Sec.25 of the 1959 Act, which was the equivalent of Sec.2, and admitted to the local Victorian asylum for assessment. He was diagnosed with paranoid schizophrenia and detained under Sec.26 (the equivalent of Sec.3), for the next 10 years.

When I took Benjamin on, it was with the specific purpose of facilitating his move out of hospital and back into the community. Although still physically disabled, physiotherapy had restored use to his legs, and he was again able to walk with the aid of sticks. His mental illness was in remission, and there was a project under way to decant the long stay patients from the hospital and back into the community.

It was not considered a good idea for Benjamin to return to the family farmhouse, where his elderly and frail mother now lived alone, and there was nowhere else in his village where he could live, but I did find a place for him in a hostel in Charwood, where he had his own room, his meals were provided, and he had company.

He was content with this for a year or so, until his elderly mother died, and the farmhouse was sold. He received a considerable share of the proceeds, and decided to leave the hostel and travel around the county, looking for a suitable place to buy a bungalow and settle down. As he was mentally capable, I could not stop him. He bade farewell, and left Charwood, and my caseload.

I thought I would never see him again.

However...

One day nearly 30 years later, I was asked to assess an inpatient on the older people’s psychiatric ward. He had been detained under Sec.2 and they wanted to further detain him under Sec.3.

It was Benjamin.

Since I last saw him in the late 1970’s he had spent over 10 years wandering around the county, staying in bed and breakfast accommodation, until being allocated a local authority flat in Charwood about 10 years previously. He had had no involvement with mental health services for 30 years.

I was the only professional who actually knew his history.

Over the previous few months, he had been refusing food, and had become emaciated and very frail. When assessed at home, they found him living in a warren of newspapers.

When I interviewed Benjamin in his room on the ward, I found a very elderly and frail man. He was by now in his 90’s. I asked him if he remembered me from the best part of 30 years ago. He did.

There were no significant signs of dementia, but he was displaying clear symptoms of psychosis. He was paranoid about food, and objected to the ward staff forcing him to eat. He thought they were poisoning him with food and medication. He wanted to go back home so that he did not have to eat or take any more medication.

There was no option. He needed to be detained under Sec.3.

He recovered. His nephew, his sister’s son, who had known him as “the mad man in the attic”, when he had been a child, and who had reconnected with him when he had settled again in Charwood, offered to accommodate him in his own home. Benjamin was his last living relative.

Benjamin agreed to this, and he was discharged.

Next time: more choice cases from my rooky caseload.

Origins of the Masked AMHP 3: Social Work in the 1970’s

Social work was very different in the 1970’s -- even the concept of “social work” as a single profession was novel. The social work task certainly seemed more straightforward back then – generic social work implied that you could be equally competent to practise with all service users, whatever their problems.

Some processes were certainly much simpler than they are now. If you visited an elderly or disabled person and thought that they needed home care, all you had to do was talk to the “Home Help Organiser” in the team. She would then undertake her own assessment of need, decide how many hours and what sort of care was required, then arrange for an in-house “Home Help” to go in. The service user paid for this service, if necessary, by buying stamps from the local post office.

Is that really less cost effective than conducting an assessment for a personal budget (our local authority has 140 steps in the process of assessing and setting up personal budgets), then arranging for an account to be set up for an individual so that they could then hire their own carer – with the assistance of the (separate) independent living team?

There was undoubtedly a sense of optimism, especially among the hordes of new social workers who were appointed then (as well as a naivety that would be quickly dispelled). There was quite a lot of money going into social work – local authorities then, far from having to cut back year on year, were actually going through a period of immense budgetary growth.

New services were being created: “Intermediate Treatment” was being mooted as a way of tackling juvenile crime, social workers were getting involved in dealing with young offenders; family centres were being set up in their dozens, based on the philosophy of tackling the problem of teenage alienation by targeting early deprivation and working with families where children were considered to be at risk of future offending.

Some social problems were really rather rare, particularly out in the rural parts of the Charwood area; far from there being the extensive drug and alcohol problems, and associated services, that there are now, I can remember that in Charwood back then, the numbers of registered heroin addicts could be counted on the fingers of one hand.

Other problems, however, especially in Charwood and its surrounding area, were very common. Isolation and difficulties accessing services were serious issues for the people in the outlying villages. Having said that, even the smallest hamlet had a post office; this was extremely important when trying to find “Dingley Cottage, Golden Corner, Hempland St Giles”, as comparatively few people had telephones and the local sub post master or mistress could always give you directions (“Oh, you’ll be wanting Edna Boggis – her arthritis has been playing her up terrible, you know.”)

Charwood itself contrasted markedly with the surrounding countryside, having a bizarre preponderance of inner city type problems. This was because of its status as a London Overspill town. People moving up from London brought their London problems with them as well as finding new problems when they arrived. It never ceased to amaze me how many Charwood people had been associates of the Krays; some of them, I suspected, were laying low in the town to avoid possible “unpleasantness”, and might even have had assumed names.

Many of those who moved to Charwood from London found it very difficult to adjust. While I was delighted that I could walk out of the back gate of my house on a GLC estate and immediately find myself walking down a path beside a river teeming with fish into the middle of a wood full of deer, woodpeckers, and edible fungi, many of the people I started to see could not get over the lack of any significant night life, the dearth of takeaways, and the absence of any leisure activities at all apart from bingo at the local cinema, not to mention the difficulty of finding public transport that would take you anywhere more cosmopolitan.

Our threshold for services was rather different then, and some of our social work tasks would seem completely alien now. One example was the arrangement we had with the public utilities companies (water, gas, electricity). If they were planning to disconnect someone and had reason to believe they were vulnerable, for example, if they had young children or a disability, they would write to us to give us notice. We would then go out to visit them, and if necessary would loan them a calor gas heater or cooker. We had a store room at the office full of such equipment.

We also used to get sent out on trivial errands – I can remember driving 10 or more miles simply to deliver a bendy straw or a non slip placemat to someone with a physical disability!

In those days one of the perks of being a social worker was that you were designated an “essential user” and therefore entitled to quick installation of a telephone. You have to remember that British Telecom back then hadn’t been privatised and had a monopoly for provision of phone lines and equipment. They were in short supply, and ordinary members of the public often had to wait 6 months to have a phone connected. As well as jumping the queue, you had your quarterly standing charge paid for.

There was no countywide out of hours emergency service; emergencies outside normal working hours were dealt with by the local area. This meant being on a duty rota for evenings and weekends. Your home phone number was put on the answer-phone message at the office, and police, doctors, or members of the public could ring you directly at home. Being on duty over the weekend meant that you could not be out of ear shot of your phone at any time over the entire 48 hour period.

Our filing system consisted of huge cabinets full of paper files, into which all our visits and contacts were recorded. We had a large typing pool whose job it was to type up our handwritten notes and insert them in the files.

It must have been an onerous job, although the typists never complained. Some social workers were into “process recording” – this entailed not just writing down the bare facts of a visit, but also including your thoughts and opinions, and even your speculation as to what the service user might be thinking.

I was particularly struck by the notes I found in one child’s file by the previous social worker.

“Little Lorna was nervous about meeting her new foster parents. She gazed up at me, her lip trembling, an apprehensive tear in her eye, and held my hand tightly as we walked up the flower bordered path towards the Jones’ front door. The green painted door opened as we approached, and Sally Jones knelt down on the doorstep, her arms held wide in welcome. Lorna looked up at me again, spotted the doll in Sally’s hand, and gingerly reached out to it... As I drove away, I looked into my rear view mirror, and saw Lorna waving with one hand, the doll clutched firmly under her arm. She will settle in well, here, I thought, and felt a lump in my throat.”

I decided that I would attempt to be more concise in my own recording.

Origins of the Masked AMHP Ep. 2: Seebohm, London Overspill – and Quaint Country Pubs

Part Two of an occasional series

One Monday morning in the early autumn of 1976 I turned up for work at Charwood Social Services Department, along with 3 other people who had also succeeded in getting jobs as unqualified social workers in Charwood.

This post may turn into something of a history lesson for my younger readers, as social services provision was very different 35 years ago. In 1974, only two years before I started work as a social worker, there had been a huge national reorganisation of social care provision, precipitated by the Local Authority Social Services Act 1970. This in turn had been inspired by the Seebohm Report, published in July 1968, which had proposed the integration of disparate social care services into single, generic departments overseen by local authority social services departments.

Until then, social care had been administered in a range of guises. For example, mental health had Mental Welfare Officers, defined by the Mental Health Act 1959. Services for children and families had Children’s Officers. Hospital social work was done by Hospital Almoners. In 1974, all these people were moved into these generic departments, and all became known as “social workers”.

Most of the people already working in Charwood area office had come from these areas. Most of them either had no formal qualifications, or had qualifications in their specialist areas. When I started there were only one or two staff in the entire team of more than 20 who had actually formally trained and qualified as social workers.

The area office dealt with everybody in the community who had a social care need: children and families, the mentally ill, people with learning difficulties (who were then known as “mentally handicapped”), people with physical disabilities, the elderly, and people with sensory impairment (although they were then formally known as blind, partially sighted or deaf).

As a generic social worker, I was expected to have a caseload with a mixture of all these people.

We had comparatively little to do in the first couple of days: we had a brief induction process, to explain administrative procedures: the filing system, methods of recording, and so on. The expectation was that all contacts with service users would be written by hand and then given to the large team of typists, who would then type it onto contact sheets, which would then be filed.

Within a couple of days, however, I was sitting in with the duty officer, whose job it was to take any calls relating to enquiries or requests for services from any source, and to see and interview anyone who walked into the department requesting help. After a morning of this, during which I sat in on several interviews, ranging from a request to have a home help for an elderly relative, to a young mother saying that she couldn’t cope any more and wanted her children “taken into care”, the social worker decided I had accumulated enough experience to field a call, and the next time the phone rang she told me to answer it.

My bowels immediately turned to water. I broke into a sweat as my shaking hand reached for the ringing phone. Everything suddenly seemed to go into slow motion.

“Hello, can I help you?” I asked with a quavering voice.

Thankfully, it wasn’t a service user. It was a doctor, asking for one of his elderly patients to be assessed for Part III accommodation. I had picked up in the previous couple of days that “Part III accommodation” meant a local authority old people’s home, so that didn’t phase me. I took down the details of the person and told the doctor we would arrange to see her. I had successfully managed my first duty call!

Charwood social services catchment was very varied. It covered a geographical area about 20 miles in diameter, which included Charwood, as well as a couple of small market towns and a lot of villages. About half the population lived in the villages and small towns, and the rest lived in Charwood. The main problems for people outside Charwood related to age and infirmity. Charwood itself, however, was quite different.

In the 1960’s through until the late 1970’s, the Greater London Council embarked on a massive social housing building programme in existing towns outside London, as well as encouraging the creation of new towns such as Milton Keynes. Businesses were encouraged to relocate to these towns, taking their employees with them. Charwood was one of these London Overspill towns.

It meant that Charwood had a very unusual demography for the county in which it lay. Charwood had increased in size from a population of about 4,000 in the 1950’s, to approaching 20,000 by the mid 1970’s. Most of this increase consisted of families with children, who had all moved from the London area, and who all had jobs in the relocated light industries, since the requirements for obtaining one of the new GLC houses was that you had to live in a London borough, and you had to have a job in Charwood.

Since I met these requirements, I was entitled to one of these houses, and for the first year I lived on one of the largest of the new GLC housing estates. As Charwood Social Services Department was in the old site office of that estate, I did not have far to go to get to work.

We four rooky social workers were sent on a three day residential induction course. The course took place in a convent in a very rural area of the county, where the nuns provided home grown and home cooked food, a venue and sleeping quarters. There were around 40 on the course, as the county had been engaging in a massive recruitment programme.

(Back in those days training departments had reasonable budgets, and courses were frequently regarded as a perk of the job. Residential courses, often in very pleasant country hotels, were not unusual. Nowadays, you’re lucky if a course provides free coffee.)

During the course we learned about the organisation in which we were employed, the nature and philosophy relating to generic social work, and the basics of the different client groups we would be serving.

However, the main thing about the course that I remember now was the vast difference between life in the London Borough I had moved from and life in the rural county in which I now lived. This was exemplified by the pub a group of us found in the nearby village one evening.

The village itself was charming, consisting mainly of thatched cottages around a large village green. We had been told there was a pub in the village, but we could not immediately identify where it was. There was no inn sign to be seen anywhere. We trooped past one charming cottage after another, none of which looked remotely like pubs, until we came to a double fronted detached farmhouse. We noticed above its unremarkable 30’s style front door that there was a statement saying that Miss Enid Abbs and Miss Hilda Abbs were licensed to sell alcoholic beverages for consumption on or off the premises.

We tried the door, and it opened onto a narrow corridor, lit by dim ceiling lights covered by ancient lampshades, at the end of which was a half door with a small counter attached to it. There were doors on either side down the corridor. We looked in one, and found an entire extended family, ranging from elderly grandparents to small infants, all sitting round a large table containing several glasses containing alcoholic beverages which took up most of the room, watching a TV perched high up in the corner on top of a cabinet. Another door opened into a room where several men were playing a range of pub games, including dominoes, darts and shove ha'penny. They all stopped what they were doing and stared at us in silence until we closed the door again.

We eventually reached the half door at the end and realised that this was what passed for the bar. Beyond was basically a kitchen, with a stone sink in one corner, a row of beer and cider barrels ranged along the back wall, and a counter in another corner containing a range of bottles of spirits. An elderly lady, who must have been one of the Miss Abbs, smiled at us and asked us what we would like to drink.

Once our orders had been taken, she told us to go through another door, and that she would bring us our drinks. The small room was unoccupied. Ancient bench seats were ranged around the walls, and the middle of the room was again occupied by a large table. A small coal fire burned in a grate. Once we were seated, she brought through our glasses, along with several large jugs of beer freshly drawn from the barrel.

We got a kitty going in the middle of the table, and then set to work on transferring the contents of the jugs into our glasses. The old lady periodically checked the jugs, removed the empty ones and replaced them with brimming ones, taking the appropriate amount of money from our kitty as she did so. What a splendid arrangement.

I decided that I was going to enjoy working at Charwood.

Next time: Learning the ropes as a generic social worker: my first home visit. I get a caseload!

Origins of the Masked AMHP: Episode 1

An occasional series

The Beginning
I think no-one has ever asked a child or even a teenager what they’d like to be when they grew up and the answer has been: “social worker”. A fireman. An engine driver. An astronaut. Maybe even a nurse. But never a social worker.

I was no exception. When I was a teenager I wanted to be either a poet or a professional actor. Preferably both. Consequently, I wrote vast quantities of incredibly bad and embarrassing poetry, and was a member of various drama groups.

In the very early ‘70’s, when I was 16, I attended a careers evening at secondary school. I went straight for the desk where the local authority’s head of drama education was sitting to ask about pursuing a career as a professional actor. He knew me, as I had been involved in various drama activities both in and out of school, some of which he had organised. He gave me the following advice:

“The best thing to do is to enrol on a teacher training course and specialise in Drama. That way, you will always have teaching to fall back on if you have difficulty finding employment as a professional actor.”

I could see the sense behind this advice. I was not so naïve as to be unaware that it was very difficult to make a living in the theatre, and the rate of unemployment among actors was very high. So I took his advice, and applied for several teacher training colleges that offered Drama as a main subject. In particular, I decided to go for courses that offered a combined option of Drama and English Literature, so that I could combine my love of the Theatre with my love of poetry.

It really wasn’t very difficult. The course I opted for, which was in the London area, only required 1 A Level (in those days the standard qualification was a Certificate in Education, which wasn’t actually a graduate qualification, so you didn’t even need 3 A Levels). Knowing I didn’t have to work too hard, I frittered away the rest of my 6th form acting in amateur productions and writing terrible poetry. I consequently only managed to get 2 A Levels.

But that was enough to get me on the course, and at the age of 18 I left home and went to college.

The course mainly succeeded in extinguishing any desire or ambition I may have had to be a professional actor. With hindsight, I suspect that the drama adviser knew I had no real talent to make a go at acting. I think if he had thought I had any real dramatic spark he would have advised me to go to Drama School.

I wouldn’t say that going on the course was a total waste of time. I did at least learn how to live independently on a small budget (my grant – yes, students had grants in those days – was £13 per week). However, the main thing I learned was that I didn’t want to be a teacher, or at least, not in any conventional sense.

So I looked around for a job I might like to do. Being an inveterate Guardian reader even back then, I fancied the idea of a career in journalism, so I wrote letters to all the local papers in the Greater London area asking to be considered for a post as a trainee journalist. I figured my training in English and Drama would stand me in good stead.

I did not even get a single interview. So I set my sights lower and started applying for jobs as a trainee building society manager, which seemed incredibly sensible, especially as I’d just got married, even though my heart sank at the prospect.

Then I saw a job advertised in the local paper for a “junior houseparent” in a children’s home. This involved looking after children in a 24 bed children’s “reception and observation centre”. I liked the sound of it. I would get to work with children, one of the few things I had enjoyed about the teacher training course, and I would be involved in managing and supporting their care and development. I got an interview, for once my Certificate in Education and experience of working with children was relevant, and I was given the job.

The home, being a “reception and observation centre”, took children, usually in emergency, anywhere between the ages of 4 and 16, although the oldest we had there was a young man of 18 with learning difficulties, whose social worker could not find anywhere else for him.

Children would arrive at the home at any time of the day or night, usually with the minimum of information. I remember one morning arriving at the start of an early shift (which started at 7.30 a.m.) to find a family of three young children asleep under a pile of blankets in a space under the stairs. Aged between 4 and 9, they had been brought in on a Place of Safety Order (as Child Protection Orders were then called) in the early hours of the morning, and the night staff, not wanting to disturb the other children, who slept in dormitories, had put them there.

One of my first tasks, within a week of starting there with no previous experience, was to take a group of children to the local fireworks display. This entailed walking with a dozen children, the youngest of whom was 6, and the oldest of whom was 15, along a busy road, in the dark, until we reached the park where the firework display was being held. It was terrifying – being entirely responsible for the safety of 12 children in the care of the local authority, all of whom were erratic or unreliable in some way, in a park full of hundreds of people, in the dark, with a large pile of explosives separated from the crowd by nothing more than a rope.

I found myself being led by the excited children, who pushed through the crowd in order to get as close as they could to the firework display. I ignored the fact that all the older children (that is, aged 12 or over) were taking the opportunity of being in a large crowd in the dark to smoke, and concentrated on the 3 children under 10, who were beside themselves with excitement. I tried to hold the hands of all of them at once, but it was futile. One of the young children was so entranced by a Catherine wheel that he pulled away from me and dodged under the rope, heading straight for it. I found myself diving after him, and managed to manhandle him to the ground just before he reached out to grab the conflagration with both outstretched hands.

“Can’t you keep your children under control?” the organiser shouted at me. No, I couldn’t.

I learned a lot, fast. I learned never to enter the girls’ dormitories without a female member of staff; I was told that a previous male member of staff had once been enticed into a compromising situation by responding to a request from a teenage girl to help her in her room. I learned to be careful how you admonished a pugilistic teenage boy, when he punched me in the face, breaking one of my front teeth. I learned to avoid distressed children when they were close to the cutlery box in the dining room, when I was showered with knives by a provoked and desperate young boy who had realised that his parents didn’t love him.

We took in abused children, young offenders, children whose foster placements had broken down, children in emergencies. The average stay was about 3 months before their social workers managed to find them a more appropriate placement. This was my first contact with social workers. On the social care career ladder I was the lowest of the low. I was not even a “residential social worker”, I wasn’t even a “house parent” (some of the younger children would actually call us “uncle” or “aunty”), I was just a “junior” house parent.

The children’s social workers would turn up from time to time, have a brief chat with their child and a brief chat with the officer in charge, and then leave again, maybe not visiting again for a month or two. They would never bother to talk to the junior house parent, the one who had spent many bedtimes telling stories to a sad and abandoned little boy, but who probably knew more about him than anyone else in the home.

Nevertheless, they were in charge of each child’s care and destiny, they made the plans that could affect a child for the rest of their life. And they only worked a five day, 9-5 week. And they were paid a lot more than a junior house parent.

I began to be drawn to the idea of becoming a social worker – not just because of the pay and conditions, but because you had more of a chance of influencing a child’s fate for the good, because you could also follow through and see a child growing up and hopefully begin to heal.

However, the Summer of 1976 made up my mind to apply for a post as a field social worker.

Those of my readers who are old enough to have lived through the British Summer of 1976 will not need reminding how extraordinary it was. For months it didn’t rain. Drought was declared. Some people were reduced to getting water from standpipes. And it was hot. I remember spending that whole summer wearing nothing more than a pair of flared jeans (come on, it was the 70’s), a T-shirt and sandals.
It was too hot for the children in the home. They couldn’t settle in the evening. As it got hotter and hotter, the children became more and more restless. One evening, at 10.30 pm, when all the children, of whatever age, should have been tucked up in bed, half of our residents had been officially reported missing, and the other half were running around in the grounds of the home throwing stones at the windows.

I arrived at work one afternoon for a late shift to find the morning staff barricaded in the office, waiting for the police to arrive, as there had been a riot during breakfast over an inadequate supply of Sugar Puffs.

My wife and I decided that it was no fun living in a London borough. I decided to apply for social worker jobs in the surrounding shire counties, in particular, the ones where it was possible to afford to buy a house.

I was offered an interview at Charwood area social services office. It was a blisteringly hot day. I drove up wearing jeans and T-shirt, then stopped in a quiet woodland area a few miles outside Charwood and changed into my only suit. Nevertheless, by the time I reached the office for the interview, I was drenched in sweat. I was then ushered into a waiting room with the 16 other applicants, who would be competing for 4 posts. We were all unqualified. In those days it was not a condition of employment, and few social workers were qualified.

The area officer was a kind man. He allowed the male applicants to take off their jackets for the interview, and even tolerated us loosening our ties.

I must have done fairly well in the interview (by this time I was beginning to have a reasonable CV), because I got a job.

To be continued…