With friends like these…

Case notes 

Practitioner: Alison Daly, social worker. 

Field: Learning difficulties. 

Location: Wakefield, West Yorkshire. 

Client: Maureen Jennings, 38. She has a twin sister, Rosemary. Both have mild learning difficulties and were brought up in care after becoming orphans at an early age.  

Case history: Unlike Rosemary, Maureen wasn’t known to social services as an adult. But it was Rosemary’s social worker who raised concerns about Maureen who had been living for about a year with the family of Chloe Davies, a friend of Maureen’s extended family. Maureen had told Rosemary that she was not being given food and was hungry and unhappy. The concerns were referred to Daly who, with her manager, visited Maureen. Despite unease about Maureen’s circumstances, Maureen said she was fine and there were no problems. Davies said she looked after Maureen well and treated her as if she were part of the family. “Given this information we couldn’t take it any further – we had to leave it there,” says Daly. 

Dilemma: Despite strong suspicion to the contrary Maureen was saying that everything was fine. 

Risk factor: Although suspecting that something was not right, Maureen was saying she was OK and had to be left in the potentially abusive environment. 

Outcome: Maureen was removed from her abusive environment and now lives independently in warden-controlled accommodation and is thriving.

An instinctive gut feeling can be a valuable weapon in a social care worker’s armoury. On the surface everything may seem fine, people say they are OK and happy. But there’s something bothering you; something not quite right.

Although decisions cannot be made safely on instinct alone, it does alert you to explore further, dig deeper and watch developments to collect evidence. Those working in adult protection have learned the benefits of not relying on first impressions.

And it was this gut feeling that caused social worker Alison Daly to monitor the situation of Maureen Jennings, a 38-year-old woman with learning difficulties.

Unlike her twin sister, Rosemary, Maureen had not been known to social services. And it was through Rosemary’s social worker that concerns were raised about Maureen’s treatment by Chloe Davies, a family friend, in whose house Maureen had been living for a year.

Daly and her manager visited Maureen who said she was “fine”. And in the world of adult protection, if an adult with ability to consent says they are happy where they are, then they are happy where they are.

“Something didn’t seem right, but we couldn’t proceed with the adult procedures. But we still had that link with Maureen’s sister and her social worker so we knew that any future concerns would find their way to us and so left it there,” says Daly.

Two months later Daly received a telephone call from Maureen’s neighbour, who happened also to be a relative of Davies. Daly says: “She said she had concerns in the past but had never alerted social services. But she reported that the night before there had been a lot of banging, screaming and shouting from the house. Disturbed by this she went around in the morning and found Maureen distressed, frightened and unsure what to do. She had been suffering neglect because she was not allowed to have food – she had to wait to be given food and was kept hungry. She told the neighbour that she wanted to move out.”

Acting on this information and taking into account Maureen’s fear, Daly waited until Davies went out. “With Maureen’s agreement, we just took her away,” Daly says. “With Maureen in a place of safety we could keep her warm, give her food to build her up a bit and do an initial assessment.”

Now safe, Maureen felt able to disclose the abuse she had suffered. Daly says: “She was emotionally abused and made to do all the housework and shopping, look after Davies’s child and made to clean other family members’ homes for £2 a day. She said she sometimes was not allowed to sleep in her bedroom and had to sleep on the floor.”

And there was the financial abuse. Daly says: “Davies also took all Maureen’s benefits off her – and apart from what she received back for cleaning she had no money of her own. Davies also physically attacked Maureen, hitting her.” The latest episode was the cause of the commotion that the neighbour had heard.

A case conference, attended by Maureen, agreed a clear protection plan. “This was to make sure that she was safe from the abuser, and that the incident was reported to the police,” says Daly. “They investigated the case but did not pursue it. We looked at some accommodation options because her place of safety was only a short-term measure.”

Maureen moved into an adult placement scheme (a sort of adult fostering) where she lived with a carer in their home. It proved successful. Daly says: “The carer did a really good assessment on Maureen’s living skills and got her back on her feet. She was able to take care of her own personal care, started cooking and shopping, and began socialising with other people. It set her on the road to moving into her own independent accommodation.”

At the four-week review meeting, it was clear that Maureen was still frightened of Davies finding her. Daly says: “We had already moved her some distance from her previous home but thought about sheltered accommodation where there is a secure lock on the outside door and a warden but where she has her own flat.”

A council-run therapy service, which trains people with learning difficulties in meal preparation and personal care, provides continuing support. Daly says: “We looked at how to integrate her back into society because she had been so isolated. She started going out, and she’s looking at starting college. She loves where she lives and says she feels really safe and happy. She’s enjoying her independence.”

Arguments for risk

• Because of Maureen’s ability to consent, Daly and her colleagues could not intervene without Maureen’s expressed agreement. And Maureen was saying clearly that she was happy living where she was. Therefore, despite their uneasiness after a referral from Maureen’s sister’s social worker, Daly was powerless to do anything other than continue to monitor the situation.
• Although Maureen did not have an allocated social worker, Daly knew that, because her sister Rosemary did have a social worker, there was a likelihood that if things continued to deteriorate this information would find its way through.
• Having learning difficulties made Maureen vulnerable to manipulation by Davies. It was possible that she was scared to say anything against her – certainly in her presence. It would be imperative that should Maureen have indicated a willingness to disclose information it should be done away from Davies.

Arguments against risk

• The laws on adult protection are not so clear cut as those around child protection. However, there is plenty of guidance available (for example, the Department of Health’s No Secrets) and practitioners are becoming more confident in working within agreed procedures. There is also a national organisation, Pava (Practitioner Alliance Against Abuse of Vulnerable Adults), which is building up a directory of good practice-based interventions to generate positive outcomes in working with the abuse of vulnerable adults. These should allow a more proactive way of working than just waiting for something else to happen.
• No Secrets defines a vulnerable adult as a person over 18, “…who is or maybe unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation”. This clearly applies to Jennings and it could be argued that it was fortunate that action could happen before it became too late.

Independent comment

The outcome of this case is positive, writes Kathryn Stone. Alison Daly has worked hard to make sure Maureen has been involved in all decision-making about her future. Thankfully, things are on the up.

However, there are a few things about this case that are worrying. What if the neighbour hadn’t rung? Or what if she hadn’t rung for two years and not two months? At Voice UK we felt that if Daly had had a gut feeling that something wasn’t quite right she should have worked more quickly to find out what was going on. Two months is a long time to wait if you are hungry and frightened. The recent civil case brought by the survivors of the Longcare scandal is a stark reminder of the outcomes of not acting quickly.

We at Voice UK know that people with learning difficulties find it very hard to disclose abuse. They think people won’t believe them; they think they will get into trouble; and sometimes they are too frightened as they have been threatened with worse if they tell anyone. I

t’s not surprising the police won’t take action. Voice UK is currently campaigning for changes to the law to increase awareness of neglect of people with learning difficulties and to increase the sentences for those who are convicted. Maureen has also been physically assaulted and had her money taken away. These are crimes and should be treated as such, using special measures to support Maureen to make her statements and give evidence.

Kathryn Stone is director of Voice UK – a national charity working with people with learning difficulties who have been abused.