My practice

 Jackie King* used to phone the social worker
of her daughter, Carla,* up to three times a day, every day. She
also used to write regularly to her council’s director of social
care, her councillor, local voluntary groups, the learning
difficulties team manager, the manager of the home where her
daughter lives, the day service, me and anyone else she could think
of. Her letters and calls were always about a new and slightly
different problem with her daughter’s care. And, of course, there
were protests that her complaints had not been answered. King was
as fed up with talking to staff as staff were with talking to
her.

Although there were elements of Carla’s care which could have been
improved, those working with her believed that, overall, King’s
complaints were unjustified. Staff found her intimidating and they
perceived that Carla, too, was sometimes frightened of her mother.
She refused to accept that Carla was able to make any decisions of
her own and criticised staff for “allowing someone with the mind of
a child” to decide for herself what she wanted.

We tried many ways to manage the volume of letters and calls. I
suggested that it would help to co-ordinate speedier responses if
she just wrote to me. She told me in no uncertain terms that she
would write to whomever she wanted. We tried only responding to
each point once and then referring her back to our previous
answers. We tried “rationing” her to one phone call or letter a
week, but these tactics just gave her something else to complain
about.

A group of us met and agreed to:

  • Recognise King’s role as a carer and maintain our respect for
    her. We might disagree with the way she tried to achieve her aims
    but we knew she loved her daughter and was trying to do her best
    for her.
  • Not let King’s complaints act as a “smokescreen” to concerns
    that had been expressed about her use of Carla’s money and about
    Carla’s fear of her mother.
  • Be consistent with King, ensuring that she was not treated
    differently just because she “shouted loudest”.
  • Record all decisions and provide King with good written
    information. This saved a lot of arguments.
  • Introduce an advocate so that Carla’s wishes could be separated
    from King’s, and she could start to tell her mother what she
    wanted.
  • Support and train front-line staff, and acknowledge that
    sometimes service users and carers do behave unreasonably and how
    to respond to this. It was important to give staff permission to
    say “no” to King; to put the phone down if she swore at them; and
    to put a limit on the number of letters or phone calls that could
    be responded to.

    I would be lying if I said that we now have no problems
    communicating with King. But at least we have all been honest, and
    we all know where we are.

    *Not their real names

    Sarah Baalham is customer care manager, Suffolk
    Council

 

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