Diary of a social worker

Monday
 
I come into the office first thing to check the ICS case management system for any referrals over the weekend. One has come in about a teenage girl who has severe behavioural difficulties. She has been in a specialist fostering programme but three placements have broken down due to extreme verbal abuse and physical threats as well as regular absconding, drug taking and alcohol use. 
 
I had managed to get agreement for funding for a specialist residential unit but after three days there she has assaulted a member of staff, smashed up property, had a 'sit in' all night and absconded with two others.  I put my head in my hands and wonder what the future holds for this girl and what abuse I will face when I see her.
 
Tuesday
 
I meet with a father who is currently being assessed for sole care of his son. He has convictions for sexual offences against children and also seems quite controlling of his ex partner.
 
Wednesday
 
I see one of my young mums who has been in a relationship with a violent partner. She has recently disclosed how he stabbed her in the leg but she tells me he didn't mean it. I have spent several weeks trying to engage her in parenting programmes and to do some work around domestic abuse but she feels she doesn't need help and I fear the case is heading for a public law case as she continues to have contact with him.
 
Thursday
 
I attend court for an issues resolution hearing where the parents both have learning difficulties.  The case was referred in when baby was born as mum dropped the baby on the floor but didn't call for help. The local authority paid for a residential assessment but parents have limited ability and struggle to accept concerns.  Luckily, maternal grandparents have been approved as baby's carers and she is placed there long term.  Paternal grandmother however is not happy and tells me she has written to David Cameron to complain.
 
Friday
 
I meet with a young boy who has recently been placed in care. His parents are both drug users and his father is very violent to his mother. Dad has several spells a year in custody and has missed contact for two weeks as he has been remanded yet again. Parents have always told him that 'dad works away'. Now we are in proceedings, I decide that the truth will out and refuse to partake in an obvious lie. Mum and I tell him together that his father is in prison. The poor boy merely nods and asks: "will I see dad next week?"
 
Finally, the end of the week arrives...a good old moan with a few social work mates tonight and work-free weekend puts the smile back on my face!

Monday.

It's our monthly team meeting. Stress is high. I'm a manager and know we have a number of policies to put forward which are going to mean more work for people. The atmosphere is hostile. What do we do?  We need to pass on the organisational demands, but staff also desperately need affirmation and encouragement. The cuts have hit us severely, colleagues have been made redundant, our office has been closed and we are now working remotely. Yet more uncertainty around jobs has just been indicated in a recent consultation paper. It's hard for staff to provide a supportive service to a demanding client group when they are worrying about their own security.
 
Wednesday

I go into our local office where some of my mobile workers gather for a small meeting. There's a lot of anger about Monday's meeting. I try to support them, but it's difficult to know where to draw the line between listening to people's concerns and facilitating discontent.  

I tell them they are doing an amazing job despite the circumstances. The problem is no-one likes mobile working. They feel unsafe and unsupported without the physical closeness of their team and managers. I don't really blame them. My sense is that social work is best done as a team sport with important reflection and accountability assisted by the natural comings and goings of a social work office. However these are not ideal times, we are lucky to have jobs, perhaps people do just need to get on with the work and keep their heads down.

Thursday

I have a training day. We've been told to come with a 'can do' attitude. I really want to be 'can do' and am always interested in ways to improve practice. However, the increased management supervision of work being talked about seems impossibly time consuming. I'm a working mother and I can't see where my extra time can come from. 

Being 'can do' at work could mean being 'can't do' at home, and I'm not prepared to go this distance when my children are small. I try to count my blessings. I've got a supportive manager, great colleagues, and the people I supervise are excellent committed workers who have stayed with the team through the changes.

An hour later my mobile rings. One of my workers has decided to leave. She's been with the team for over a decade but the move to mobile working doesn't suit her and she hates feeling angry and frustrated rather than concentrating on the job. I am absolutely gutted. I know no-one is indispensable and it's probably right for her to move on, but each colleague feels so vital in these difficult times. It's another knock and yet another leaving do.

Friday

It's my day off, but it's difficult to restrict my work worries to my part time hours. Six months ago I wrote a diary article as the news of our cuts was just coming through. It was about trying to stay optimistic in the face of the cuts and was entitled 'Keeping the Faith as the Cuts Bite'. Can't help but think this one is about losing my faith. Last time I'd quoted the service manager who'd said 'Don't blame me, blame the government' when challenged about the redundancies. It remains a fair point.

Monday

Safeguarding adults training (level 2) all day.  As a locum, I cannot participate in the duty rota until I have completed this training in each local authority I work in.  This is often a source of tension - I have been in my current role for 2 months yet am only now covering duty.

Tuesday

Team meeting in the morning.  Manager advises that health staff will be reshuffled next year and moved out of current building. Social care staff will remain. Lots of downbeat faces as a result - there is real concern that the lack of integrated teams is going to critically affect the learning disabilities service, particularly around information sharing.

Funding panel in the afternoon. Ongoing 'discussion' between two local authorities about ordinary residence and Fair Access to Care Services criteria for my service user. Senior managers are reluctant to make decisions and meanwhile the individual is left in a state of confusion and anxiety. Leave work in a frustrated mood.

Wednesday

Drop-in visit to check on a new care package. Staff were not expecting me and did not have care plans or risk assessments up to date. Speak to the service manager who is not happy that I had arrived without warning. Give specific deadline for paperwork (end of the week) and spend twenty minutes with the service user, having a cup of tea and talking about their benefit worries.  Agree to write a supporting letter to the Department of Work and Pensions. 

Start a reassessment in the afternoon with an individual who has previously experienced financial abuse.  Complete a mental capacity assessment and conclude that he is able to manage his own finances. 

Thursday

Complete a 28-day review in the afternoon for a service user who has recently moved to supported living from residential care.   did not organise his move, and his current social worker is off on long-term sick. Very difficult review as the family, provider and service user wanted the allocated worker there. I have never seen such attachment to a social worker. It turns out, upon further investigation, that my colleague was the first social worker they'd had as a family who had kept their promises.

Friday

Spend the day out-of-county, doing two reviews for service users.  Sun is shining, placements are positive, families are supportive and the individuals concerned want to be involved. Lots of person-centred skills being used by the provider which is good to see. 

Concerns raised by the families about future benefits reassessments. Advise them (in line with local authority policy) to seek support from Citizen's Advice when it arrives. It feels good to not have to complete the benefits forms myself (having done dozens before), but I worry that the families who try to take it all on themselves will miss out simply because they do not know the rhetoric.

(Pic: WestEnd61/Rex Features)

 

(Pic model released: Jon Santa Cruz/Rex Features) 

Monday

Monday again? I walk over to the youth offending team to see a young person on a supervision order who is smoking a lot of skunk every day.  We discuss how his skunk use is making his anxiety worse and not helping him chill out.  I do a DNA drug test to see if the skunk is mixed with anything he doesn't know about.  I see a young person at school, then get completely lost doing a home visit.  Ah yes, the map is upside down.

Tuesday

I practice a mindfulness meditation before work.  I try and use some mindfulness techniques to help young people manage cravings.  I have a young person miss an appointment with me this morning, then go to a looked-after children review.  He's smoking less skunk and doing really well, and I'll soon transfer him back to his referrer.  We have our team meeting, and I'm filmed by an ex-service user for a film about ketamine she's making.  No doubt I'll soon be famous!  Back to the office for paperwork, and after work I meet with a friend I trained with who also works in CAMHS.  We discuss the importance of maintaining a social work identity outside of social services.

Wednesday

Start with a CAMHS meeting, and then a few hours of paperwork.  I see a young person at school, who is drinking large amounts of vodka several times a week mixed with energy drinks.  We explore risks together; particularly the added risks of mixing alcohol and energy drinks.  We discuss harm reduction techniques, and look at the cycle of change together.  The young person is sporadically self harming by cutting, and we discuss wound care, and managing triggers and cravings. 

Thursday

I'm training post-graduate mental health students at a local university this morning in substance misuse education and treatment.  What I wasn't told is that it's a huge lecture theatre and the screen for my PowerPoint is as big as a cinema screen!  After the initial shock it goes well and we have some good discussions.  I see a young person this afternoon whose substance use has increased after the transfer from a LAC team to a leaving care team.  He binged on ketamine and MDMA over the weekend, and doesn't understand why he now feels low and depressed.  He has been smoking more skunk to help deal with the come down, but has spent his entire food budget on it.  

Friday

I go to the YOT for an appointment, but the young person doesn't show.  We talk on the phone, and he says that he's feeling ill.  We re-arrange.  I go on a home visit.  He can't come and see me in the office because it means crossing a postcode which he can't due to gang tensions.  His last drug test tested positive for benzodiazepines, which he admits he's been buying off the street and using when he can't afford skunk.  We spend the session on tranquilizer education and risks, and afterwards I stop off at the office to update his risk assessment.  Now I'm off to the pub to unwind with some non-social work mates- no work talk tonight please!

Monday to Wednesday

Economic crisis cutbacks mean that, newly reallocated from a learning disabilities team, I embark on my first week in a reassembled multi-disciplinary rehabilitation and reablement team. 

A "glass half full" approach is called for, so I am diversifying and upskilling. In a blur of shadowing and induction, I marvel at how different the processes and systems are from my former team's.  A fellow new starter announces helpfully, "I speak geek!" and effortlessly steers me through parts of the client record system I never knew existed.

My head spins with newly crammed knowledge. Panel forms, experimentally, must now be emailed to our service manager for instant agreement or negotiation. Our dedicated short stay home caters for older patients newly discharged from our local super hospital, helping them regain independence before going home. I attempt to understand the subtle differences between its health-funded reablement beds, and the social care funded rehabilitation and reablement beds, coexisting with sought after respite beds.

Our community rehabilitation centre supports adults with physical or sensory disabilities, but there are rumours of closure in the second round of cutbacks due next year. I must book a visit.

Thursday

Within our multi-disciplinary team there are rehabilitation and reablement assistants (RRAs), occupational therapists, nurses (community and twilight), physiotherapists, a community matron, footcare specialists... and more, all sporting different, startling, tunic colours. 

Team support is time limited, so today, with his RRA, I visit a 50 year old man who has miraculously survived the loss of a large part of his skull in an accident. He has made an astonishing recovery, and is now managing basic cooking, personal care, and crossing the road, despite brain injury related sight loss.  Hot, plated haute cuisine comes from an industrious neighbour daily (and more often when his flatmate is away). We offer information on sources of future support, and having urged him to keep his community alarm pendant handy (his wry smile suggests he has no intention of wearing it), we discharge him.  

Friday

I visit an 85-year-old woman who has recovered well from a fall at home, and is walking again with a frame. Her vascular dementia leads her to believe she has eaten heartily when she has barely nibbled her sandwich. I assess her for ongoing care, including someone to offer meals and tempt her to eat. One look at her pot-bellied dog clearly shows where most of her food is going.

New to my team, I have been temporarily allocated straightforward cases, where people have supportive families and good quality housing where adaptations are possible, and some independence can be maintained. In the months ahead, I expect other aspects of city life to be revealed, with more complex issues.  I make my routine check-in call to my "buddy" at the office, then head home.

Monday

I attend county court for the final hearing in a case where the baby suffered severe non-accidental injuries during the first four weeks of his life. The child is now a year old and everyone is happy with the progress that the mother and child are making since he was returned to her care. 

I also meet with a social worker at another family's home to discuss the lack of progress being made in the home conditions. Mother is a long term alcohol user and her husband has recently died due to an alcohol related illness. Mother is progressing well in reducing her alcohol to a safe level and it is felt that mother and I now need to make the home conditions the priority.

Tuesday

Team meeting this morning - we are a small team of four crisis intervention workers and a team manager.  We are told that we have had funding agreed for the project to last until early 2012 and there is a possibility of another two workers joining the team.  We also have a discussion about another worker's case where she is wondering about different ways to engage a young person.

I have a signs of safety meeting in the afternoon with colleagues from my team and the other two teams based with us. This is to look at one of my cases and pick it apart to really consider whether we are supporting the family in the right way.

Wednesday

I visit one of the children's social care offices to speak with social workers about our service and discuss any cases that they might want to refer to us.  Social workers (and our team) find that this is the best way for families to be picked up at the right time (when they are in crisis).

I have an introductory meeting with a family who have been referred to the service.  I explain our service to the mother and I use a lot of motivational interviewing during this visit, but the mother does not see her alcohol use impacting on her parenting or family life.  From the referral it is clear that it does, but she has given up on parenting her older daughter or having any sort of relationship with her.

Thursday

Complete child permanence reports for two children that I am allocated social worker for. It has been decided that they cannot return to their mother, but the decision about long term fostering or adoption is yet to be made.

Friday

I attend a core group meeting for a family that I am crisis intervention worker for. The mother is doing well with her reduction in alcohol (it has reduced from 45 units per week to 10 units per week) since I started working with the family six weeks ago. Everyone is pleased with the progress that her children are making and their attendance and presentation in school has improved.

Monday    

Shared Lives schemes recruit, assess and support carers who offer accommodation or support in their own home to people who are unable to live independently.

Today I attend review of woman with early onset dementia. She's having sessions going out with Shared Lives carer then back to their house for tea. This suits her better than the day centre: she used to become very agitated going there. Could look at trying an overnight stay now.

Meeting with finance - they are behind with paying invoices because of new computer programs. They are struggling with restructure and short staffing but we need to keep carers happy.

Tuesday

Take call from carer concerned about service user who started a same sex relationship. He's worried about his family finding out. Discuss issues of consent, and how best to support this - the opportunity for sexual relationships is a positive outcome of living in the community.

Sort out emergency placement for a man whose mum has gone into hospital. His regular Shared Lives carer can have him for a couple of weeks - hopefully this will be long enough or we'll have to find another place.

Visit a carer for supervision - she's doing a fantastic job supporting a man with downs syndrome and insulin dependency.

Wednesday 

Call from woman interested in becoming a Shared Lives carer. Lots of experience and two spare bedrooms! Also thinking about converting her garage so we could have a ground floor room. Just need to convince her to put in a shower and toilet...

A service user's brother feels she should not be encouraged to buy clothes from a high street shop catalogue, but instead to buy cheaper stuff elsewhere. What's wrong with good quality and good looks for her too?

Request for two weeks break for sight impaired middle-aged man with a learning disability for third year running. Parents say it's the first time they've been able to completely relax knowing he'll be well cared for.

Phone call from service user - wants to move in with Shared Lives carer she stayed with. Her social worker is off sick, so will have to wait to find out if it will be funded.

Thursday

Meeting about restructure - thankfully Shared Lives is seen as a good alternative to residential care, so should be expanded. Hope to get some extra workers from those put on redeployment list!

Psychiatric hospital - woman being discharged but doesn't want to go home to nine hours support a week; agreed to find place for two weeks while she recuperates and plans ahead.

Friday 

Meet service user - really excited at having been abroad on holiday with carer for first time. Planning the next one. Me too, as on holiday next week! Just need to make sure everything set up and hope for no last minute emergency.

(Pic: Laurel Fan on Flickr)

Monday

I return from holiday in Egypt but no one wants to hear of my trip; they are all busy working and eating at their desks to save time. I go with a colleague to visit a mother in a care case who has mental health problems - her house smells of urine, decay and cats. Her mood swings from happy to rejecting, so we leave. Her GP tells me it's virtually impossible to get any mental health professional to visit. I wonder how ill someone has to be before they can get through the red tape.

Tuesday

I go to a meeting about a child at a local school, arriving in the middle of its celebrations at becoming an Academy. A Scots piper and an actor dressed as the ghost of Admiral Nelson are mingling with local dignitaries.  As there is no receptionist that day, a kind teacher ushers me into a library and asks me to wait. Twenty minutes later the chair of the meeting arrives and tells me the meeting has already ended. No one told them I had arrived. I leave the school with the strains of the piper playing Scottish reels and jigs ringing in my ears. 

Wednesday

Visit another mother in a care case, who neglected her children for many years. She looks tired and weary and is still in pyjamas in mid afternoon. She appears charming and credible, though, making her neglect sound like an art form.

Later I visit two of her children in foster care - they are now thriving at home and school. It is good to see them doing so well after their terrible start in life. 

Thursday

I attend a child in need meeting about a family whose mother cannot manage her depression and anxiety - she goes around many agencies saying that no one helps her. These meetings seem to be about keeping track of agencies involved since we last met.  It is hard to make sense of what each one does. While I try to limit involvement to a few agencies that are the most effective, this does not go down well with the children's school, which seem to equate quantity with quality.

Friday

The mother I visited on Wednesday arrives at court complete with new hairdo, fake tan and smart outfit. I have noticed that the more neglectful a parent is the more made up and lavish they appear when in court.

In the afternoon I visit an African family where the parents still live a lifestyle of poverty with no aspirations apart from getting through each day. The children have grown up here and are happy, lively and bi lingual. They are good fun to be with. The father thinks I have been sent to help them solve all their problems by giving them money and jobs. Suddenly I feel elevated to the status of a Pharaoh, but realise that on this overcast afternoon in a barren household, we are a long way from the sands of Egypt.

(Pic: jay8085 on flickr) 

Monday

Spend a lot of time catching up from Friday's day off. I have elected to work a 4-day week at the moment. The downside is that it takes half a day to answer all the e-mails and queries from the previous week. Today, we hold a quarterly meeting to monitor a quality of life action plan for older people, which I am leading on. It is great to look at some of the really good work that is happening in the county across the other departments. Even in these times of financial constraint, we are still developing new services such as extra care housing and an integrated model with the library service, day-care and supported living.

Tuesday

The council is going through a "lean" process, which means that we are beginning to look at all areas to ensure continuous improvement, while reducing waste, improving speed and customer value. This morning we start with looking at how we can "lean" our equality impact assessments.  Being quite cynical at first, it appeared to me that it would be very difficult to apply this business model to the service-user led work we do. However, early indications are proving to be positive and I realise that if you really do sit down and analyse each process, some of what we do is unnecessary and pointless.

Wednesday

I have supervision today and we both acknowledge that suddenly we are really busy. There are lots of consultations starting to be planned as well as the everyday work that we must do. The consolation is that we would rather be busy than twiddling our thumbs and it is recognition for the team that we are needed and can support officers in their roles.
I and a colleague are working on a sustainable model of engagement for the future. I talk to a couple of commissioners today to gain their views on what they are doing, what they would like to see and any innovative ideas for the future. I meet up with my colleague to share our early findings. We have a long way to go and it feels as though the task is getting bigger and bigger!

Thursday

I attend various meetings today on how we are collating user satisfaction. We want to improve the information we collate so that managers can really use this as a robust management tool to improve service delivery. We are trying anyway! Next week we are moving across the room (around 30 feet away). I realise I have a lot of paper and documents that I don't want to move across with me. I spend most of the afternoon having a good clear out and it makes me feel better as I wind down for my day off tomorrow.

Friday

Hurrah, it is my day off. I make the most of it while I can, as I go back to 5 days soon.

(Pic: WestEnd61/Rex Features)

Monday

Monday mornings are generally very busy, family members making "that call" they've been building up to all weekend and this is no different. A hospital social worker calls about a client with dementia who needs to move from sheltered housing to residential care. This will involve a referral to our community support and social work team.

After lunch the Monday rush eases up and I'm able to finish off the various referrals I started this morning. My job is about multi-tasking and being able to switch my focus at rapid speed.

Tuesday

The recession has seen a rise in the number of people concerned about burial costs and my manager has sent out some information about this that I am able to pass on to a worried caller. We have lots of reading to do to keep up to date with changes in health and social care and fitting this in around the ringing phone is an ongoing challenge.

In the afternoon I take a referral for a woman whose husband has dementia. She feels she cannot cope any more and needs a break. She'd like him to go into one of our homes for a week or so. This is a very typical call for us, but nevertheless still affects me every time.

Wednesday

Team meeting day. We need a new out-of-hours helpline message and everyone has a go at writing it. It's harder than it sounds and our manager takes all of our ideas away with her to try and come up with the best possible combination. The rest of the meeting is updates, news and our weekly case study discussion.

In the afternoon I spend some time working on some reports and documents I need to prepare for my NVQ in advice and guidance which is due for completion this month.
 
Thursday

I get on the phone and straight away take two detailed enquiries. These are challenging calls because the caller generally does not have consent from the person they're calling about. We give as much support as we can and ask them to come back to us when they have consent for us to get fully involved.

We often get calls from sons and daughters who are frustrated and anxious because their parents are fiercely independent and will not accept help. We give advice and signpost them to other agencies who may also be able to provide support in a less formal way.

This afternoon I spoke to a lady who was calling about her husband who had the onset of dementia. After our 25 minute conversation she said "I feel better already for talking to you." This made me feel good, but I'm sure her relief was more about taking that difficult and painful first step rather than anything specific I'd said on the phone.

Friday

A large percentage of the people we help are older adults, but today I take a call from a young woman who has recently been rendered almost immobile by a condition that even her GP had never heard of. This sets the tone for the day and the calls keep coming. What feels like five minutes later I look at the clock and realise that my working week is almost over - a glass of wine later methinks.