‘Social work without the social’: the heartbreaking impact of separation on care home residents

    A best interests assessor says social workers need regular Covid-19 testing to enable them to uphold the rights of those in care homes and reconnect them to loved ones

    Older_man_at_care home window
    Photo: Milos/Adobe Stock

    The past nine months have been an emotional rollercoaster both personally and professionally.  As a social worker, working as a best interests assessor, I wasn’t furloughed but I also wasn’t working on the ‘front line’ as it’s quite often termed.  I felt a bit stuck in limbo.

    I was still expected to work my usual hours (albeit flexibly around home schooling commitments) and work through assessments at my normal rate or even faster, given that I didn’t have to factor in travel time anymore.

    I was used to meeting people, which is what social work is all about. It’s the cliché but I went into social work to help people, I like meeting people and hearing their stories. So to carry on doing assessments and making big decisions in relation to people’s lives without even meeting them felt awful. It was certainly social work without the ‘social’.

    New ways of working

    We were advised not to visit care homes due to the risk of spreading coronavirus, advice that was given at the start of the first lockdown.  I had, however, already made some adjustments to my working pattern and had stopped visiting a couple of weeks earlier as I felt I shouldn’t be risking people’s health.  I never thought then that nine months on I still wouldn’t have set foot in a care home or met the people I was being asked to assess.

    Covid’s impact on social work

    Increasing need and workload and worse mental health – read about the impact Covid has had on social work in England, from Community Care’s latest survey.

    The guidance we received from the government in relation to Deprivation of Liberty Safeguards (DoLS) was to complete our assessments via video or phone call and to rely on information provided by the staff at the care homes and by family or friends.

    Trying to assess someone’s mental capacity over video call (sometimes with freezing picture and poor sound quality) seemed impossible and very impersonal.”

    I soon found new ways of working that helped and managed to set up a space at home where I could work with some privacy. Things ticked along in this new way, the first lockdown ended and family were able to visit their loved ones from a distance in the garden or outside the window. It felt ok for a short while.

    Challenges of the second wave

    Then things turned and the figures started rising again. The more assessments I completed and the more care home staff and family members I spoke to, the worse things seemed.

    One man told me that, although his 86-year-old mother with dementia was doing ok and hadn’t had Covid-19, the other five people she would sit with at meal times had all died. I was heartbroken, not only for the lady who was now sitting alone at her dinner table but for the other five families who had lost loved ones.

    Deaths in care homes have also had a huge impact on the care home staff. They have all worked so hard, under such impossible conditions, and are terrified of catching it and passing on to their residents.

    They are tested weekly, (which isn’t the nicest experience), they then have to attempt to test the residents (monthly), which isn’t an easy task when the person they are trying to test doesn’t understand what they are doing and why they are doing it.

    Relatives ‘in tears’ on the phone

    As part of my assessments, I always phone family members (or friend or advocate) and these phone calls were getting tougher. Relatives would be in tears on the phone to me, telling me how much they missed their family member.

    One daughter told me that she used to visit her 83-year-old dad every other day.  She used to go in at meal times to help him (he preferred her help to a staff member). She would always take him the newspaper and sit with him and read the sport. He had suffered from depression in the past, and now, with his dementia diagnosis, he would struggle to remember where he was living and why. His daughter would offer reassurance and he would settle down and feel happier about things.

    The son of another lady I was asked to assess said when restrictions were relaxed he visited his mother in the garden but that his mum didn’t recognise him, partly due to wearing a mask (she was frightened) and partly due to the fact that she hadn’t seen him for over three months and her mental health (dementia) had declined. Initially, she thought her son was her husband. He had sadly passed away seven years ago. Her son hasn’t visited since as it was too upsetting for both of them.

    Regular testing of social workers needed

    The impact on people living in care homes has been devastating, not only for the people who live there but for their families and for the care home staff. I do a hard job and I’ve always had challenging days, but the experience of this will stay with me forever.

    The first lockdown was difficult, however, the past six months have got harder and harder and I feel the full extent of the damage that has been caused, not only by the virus, but by the restrictions on seeing loved ones is yet to be seen.”

    Right now, we need more from our MPs and public bodies. We need them, and the public, to better understand the role of social workers. A good start would be to support campaigns like Test, Safe Access, Promote Rights from the British Association of Social Workers, which calls for social workers to be regularly tested for Covid-19 so they can get past blanket restrictions put on by many care homes, in order to safely access and promote the rights of the vulnerable.

    The writer is a mental health social worker and best interests assessor, who has chosen to remain anonymous. 

    4 Responses to ‘Social work without the social’: the heartbreaking impact of separation on care home residents

    1. Angela December 15, 2020 at 9:46 am #

      Ofcourse if social workers saw care workers as allies in the good times, we would be better able to get the support, the testing and the safe working conditions we need now. For many a support staff like me, social workers are not deserving of our solidarity, you have disparaged and undermined us too many times. When you stop waltzing in, telling us off and leaving after 20 minutes because you are “so busy” to listen, we will be colleagues.

    2. Diane Hidayet Taylor December 15, 2020 at 4:18 pm #

      Hi Angela, I have been a Social Worker for 18 years and worked in public service for 44 years in total, and have never treated care workers as you describe, and have always worked in collaboration with carers and support workers at every opportunity and there has been mutual respect.

    3. Stuart December 16, 2020 at 9:33 am #

      Both Angela and Diane make points that resonate with me. However on my placements as a recent student, I was really dismayed to hear qualified social workers make really deragotary remarks about care homes. Social workers might beleive they work collaboratively but they are also highly judgemental and opinionated about other workers. We have a lot of deficits when it comes to self criticism.

    4. Adam December 16, 2020 at 9:41 am #

      Kudos for your respectful approach Diane but it does not ofcourse negate Angelas own experiences. My partner is a registered manager and on the whole her experience of social workers is fairly similar to Angelas. I think some of this is due to misunderstanding of our role as social workers though.