Social workers must be vigilant in how they wield their power

A social worker comments on a case involving a vulnerable woman with dementia

elderly lady, emergency alarm
Photo: Gary Brigden

Barbara* is an 81-year-old woman who has lived alone in a privately rented house for many years. She has no family but for the past four years has relied heavily on the help of two dear friends (A and B) and neighbours. I also know Barbara as a friend and have witnessed her severe decline in functioning over the last year due to her dementia.

Barbara came out of hospital in 2012 and was given a care package of two visits a day which was, until a few weeks ago, reduced to only one morning call, despite her dementia worsening.

Friends and neighbours

This care was intended to take some of the load off her two close friends, both older women with their own health and/or family issues.

Shopping, laundering, bill paying and general love and care continued to be provided by A and B. Other neighbours helped with practical tasks and their time. Three friends held keys to her home as she would not answer the door.

The state of her house can be seen in this news report by BBC London. Her incontinence and wariness meant that one care visit a day was simply not enough to help Barbara live in dignity. She accepted some level of personal care from A and B but the increasingly soiled clothing and furniture could not be their responsibility. They complained to the care agency over many months as that was their only point of contact with the care system.

Giving up caring responsibilities

Just before the BBC piece went to air the care was increased to four visits a day. Immediately afterwards Barbara took ill and was hospitalised.  A and B said then that they wished to give up all care responsibility and relate to Barbara as her friends only. They explained they were simply not able to provide the intensive levels of care which Barbara needed.

They felt she needed a placement in a residential setting with 24-hour supervision. Barbara goes to bed at 6pm and consequently is up in the early morning hours. When she falls she does not use her alarm pendant.  It is A and B who find her in the morning if she has fallen.

The Care Act and the Mental Capacity Act govern how Barbara’s needs are to be met. One of the duties of the social workers in these cases is to promote Barbara’s wellbeing and, as part of this, consider her personal relationships.

Demanded keys be returned

For Barbara, who has no family, that means A and B and her other caring neighbours. Yet when A and B stated their intention to withdraw from being unpaid carers, a social worker demanded that they return the house keys to them.

They declined as they wish to remain good friends and continue visiting Barbara and to do this they need keys to gain access. The council then changed Barbara’s locks and refused to give keys to A, B and another neighbour.

When challenged, the council said they had the right to restrict their access in Barbara’s best interests.

The council holds a different view of Barbara’s capacity to that of A and B. They state that she does have the capacity to decide to return home, which is what she wants, and so they will provide care at home to her.

Changing locks

It is clear that under section 47 of the Care Act social workers may protect the person’s moveable property. But any action they take must be with her consent, unless she lacks capacity and they are acting in her best interests.

Would she consent to lock her only friends out of her life? It’s hard to imagine the answer is yes.

In which case the council must believe that “there is a danger of loss or damage” to her property. They have to believe therefore that her friends and neighbours present a danger to her property and this must be stopped by a change of locks. The implication therefore is that Barbara’s friends are likely to be criminals.


Is there evidence her friends are criminals? Given they have been helping to clean up Barbara’s faeces and soiled bedding for many, many months this would be surprising and certainly no such evidence has been presented by the council.

In this case it is hard not to feel a service user is being punished for her friends’ concerns and actions in taking her story to the BBC. They are shattering working relationships with the people closest to Barbara irrespective of the effect it might have on her already deteriorating mental health.

It reduces the client to an object of state-only intervention, where her only relationships are with professionals. It effectively divorces Barbara from her community.

Because she is old and powerless social work is enabled to do this but we must constantly be wary that social work does not become a tool of oppression simply because others are worried about ‘damage control’ to the reputation of an organisation.

*Not her real name

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6 Responses to Social workers must be vigilant in how they wield their power

  1. Popeye February 22, 2016 at 11:14 am #

    About as much subtlety of a brick. The social worker in question just undermined all this older lady’s support and did not monitor the case as well as could have done (My view)

    No anticipation of housing needs i.e explore sheltered accommodation, no respect for the older lady- or I suspect a proper discussion held to explore the resilience of the 2 friends whom had their own difficulties… Prevention is better than cure.

    Its embarrassing to read that the social worker was not able to execute any autonomy or creativity in thinking and had to rely on local authority guiding the decision making which as we know errs on the side of caution and not understanding.

  2. anon February 23, 2016 at 1:09 am #

    On the basis of the information given in the article I would totally agree with the conclusion that this is an action that is not being taken in the best interests of the lady. Reading between the lines it would appear the council wishes to prevent her friends having further access to her so that there is nobody who will raise concerns if the council neglects her. Clearly, apart from her friends, this lady has not been receiving sufficient support despite her friends advocating for her. What is the likelihood the council will meet her needs when those friends are struggling to have access to her and the council is left to self-monitor the care it ought to be providing.

  3. Elizabeth February 23, 2016 at 6:03 pm #

    Amen! I believe that any helping professionals’ role includes the facilitation and encouragement of natural and loving relationships in a person’s life. Let’s all work together!

  4. Lizzie February 23, 2016 at 7:35 pm #

    I am a bit dissapointed by Popeye’s comments only in so much as you seem to be laying the blame at the door of the Social Worker. I would have hoped that this case would have been discussed in either informal or formal supervision and therefore he/she would have been possibly guided by his/her line manager.

    My question for the Social Worker and her line supervisor is where is the MCA? Where is the Best Interest Decision? These friends recognise their own limitations and the effect this is having on their relationship. Emotional support is so important to our Elders and A and B have been doing this as well as providing practical support. Surely this should be respected?

    • Planet Autism February 24, 2016 at 2:32 pm #

      I’m a bit disappointed Lizzie that you seem to be absolving the social worker of all responsibility. Even if management wanted to make decisions or pressured the SW into certain avenues that differed from the SWs, it is the duty of the SW to ensure the person’s needs and rights are not ridden roughshod over.

      Had the BBC not got hold of the story no doubt this old lady would have ended up dying neglected by social care. Then everyone is up in arms saying how terrible it is and social care is defending their actions due to x, y, z and it all gets forgotten about until the next elderly person suffers the same fate.

      How is it that the friends were not considered a risk to her whilst they were doing unpaid caring? It’s proof that the LA were being vindictive and hiding their actions.

  5. Carol Selva February 23, 2016 at 8:36 pm #

    From my point of view there wasn’t that much involvement or support from the local Council in the earlier stages, when the situation should have been supported in more structured manner.
    A and B should not have reached the point where they could no longer cope with the care their friend required.
    It is indeed a sad outcome that services were not properly set up and managed in order to evidence that Barbara was able to remain in the Community with the support of carers1
    I do feel that ‘the system’ has let her down and also let down her friends A and B.
    Social workers have a legal framework to adhere to, Departmental guidelines, as well as the spirit of the Act of Parliament they are using! There is such an asset as professional integrity, compassion and an understanding of best interest which are vital in decision making. Unfortunately it seems to have had little presence in this situation!
    Let there be a lesson learnt!
    Ex duty Social worker CQSW