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