Earlier this year the prime minister of Great Britain told everyone to only go into work if they couldn’t work from home. That day saw my office building resemble a haunted monument where people dared not enter. Many adjusted our personal spaces at home to accommodate confidential working, not knowing when things would ever go back to normal and when we could again inhabit and breathe life into our office spaces.
As a social worker and a team manager in Adult social care, I have noticed that currently the Covid19 situation has bought with it many challenges for all front line staff which need to be at the very least recognised. This includes things like finding a suitable and confidential space to work at home, juggling work with home schooling young children, feeling guilt a not working at the pace accustomed to. Dealing with death at an unprecedented rate and that as well, alone, without a colleague sitting next to you. For some it has included a close family member being hospitalised and relying on that one phone call a day to get an update and for others losing someone close and not being able to attend the funeral or get the support they themselves need due to rules around social distancing. A story that shook my core this week was a staff member sharing that her neighbour living with Dementia was found very confused and distressed as her main carer, her son had taken his life by hanging himself in their home.
I myself with 22 years’ experience in social care have never encountered so many sad stories in one week alone. Just because we work with the elderly and their carers the premise of our work is not all gloom and doom and is certainly not our expectation or aspiration for those we work alongside. However, these are unprecedented extraordinary times, requiring therefore unprecedented and extraordinary action. So, as managers who supervise staff potentially experiencing the situations described above, what can we do? Do we need to consider supporting in a different way, and if so, what is that different way?
I am suggesting that one way is through compassionate supervision. Whilst compassion should be an integral feature of supervision in the human services profession anyway, I am arguing for this to be at enhanced levels during the pandemic. Firstly, very simply this might be by offering more frequent supervision to those that need it. Bearing in mind that currently all meetings are virtual, enhanced compassion can be shown through making sure supervision takes place with your video on. The visual enables us to extend our tone complimenting it with facial expressions and gestures.
Secondly it is important to create the space and time for feelings to be named, allowing emotions safely back into social work practice is something I feel very strongly about and do not see this happening enough. A number of tools are helpful in enabling this. One I have recently been using is the wheel of emotions first developed by the psychologist Robert Plutchick.
Why, I have found this tool extremely helpful is because the very British response to the question “How are you” is usually “I’m fine thanks”. This tool enables, if of course supervisees are willing to engage in this way, to move beyond this stage to acknowledging personal feelings at a deeper level and discuss the impact and support a person might need. I have found that it has helped particularly those individuals, who usually find it more difficult to verbalize feelings and open up in a different way through identifying the intensity of the feeling.
Finally enhanced compassionate supervision moves beyond just listening and recording some of the difficult stuff to taking some action if that is what is required. It involves us Doing and Changing the way we do things and leads us to challenge the status quo. An example of this at the simplest level is making an adjustment to working hours for those that are juggling home schooling with work. On another level it may be redeploying someone to increase their wellbeing and sense of purpose. Adjustments to existing policies around bereavement leave and special leave is also something this situation is highlighting for us as managers.
At the core of compassionate supervision are the basic human essential requirements of connection, acceptance and engagement. All three relational ways of existence are much needed during this pandemic.
Furthermore as I wrote in a previous article in edition one of this magazine, perhaps the new ways of working we adopt during Covid19shift us away from the rule books when we return to the new normal andmake us more human and intentional In engaging with and thinking about how to practice enhanced compassionate supervision, I have certainly evolved and can relate to Foucault’s description of “The act of becoming”.
“I don’t feel that it is necessary to know exactly what I am. The main interest in life and work is to become someone else that you were not in the beginning” (Michel Foucault)
You may also find interesting a recent podcast I was involved in on the topic of supervision
My little sister has COPD, which affects the lungs, so I’m very worried about her at the moment with the coronavirus crisis going on.
I’d like to be able to check in on her but I don’t know where she lives at the moment – if anywhere. I’ve tried a dozen homeless organisations as well as Her Majesty’s Prisons, but no joy.
Her lifestyle is what professionals call chaotic and, as a result, we’ve had sporadic contact over the past 10 or so years. That’s always been the way it is, as she drops in and out of our lives depending on what’s going on for her. But with the coronavirus I realised I’m not comfortable not knowing where she is or how she’s doing at any given time. Ever the big sister: worrying like a border collie about all my younger siblings and their children.
At the beginning of the crisis I reached out to the charity Missing People who agreed to take on my case. There is no guarantee my sister will want to resume contact with me, they said. Yes, but at least you’ll be able to tell her I love her and miss her and am worrying about her, I said. I can think of little worse than being in hospital with this virus and not knowing if anyone cares about you or is thinking about you.
And it’s not just me who cares. Her daughters are worried about her too. They know about her lifestyle and her mental and physical health challenges. They know those things are part of the reason they were adopted or placed into kinship care. They, like me, just want to know she is ok. They, like me, wonder if she is dead. They, like me, wonder if any of us would count as her next of kin in such a situation.
While I wait to hear back from Missing People I thank everyone who has been helpful and empathetic to me during my searches for my sister over the years. From the man at the Newport hostel who said she’s a nice person and “quite funny, when you get to know her”, to the woman from Craig’s Coffee in Manchester who said she knows only too well what it’s like to have a sibling who struggles with addiction and homelessness. To everyone who said, I shouldn’t really be telling you this, but I saw her just yesterday and she’s safe and well. To everyone who agreed that when a little sister comes into your life through adoption, she’ll always be your little sister – no matter what.
You think you’ve tamed it, the wondering and not knowing, but it’s a wild beast, there’s no controlling it, as much as you might fool yourself you have. My most recent experience of the beast roaring to life was a few weeks ago and started with a friend request on Instagram. A photo of a girl with long blonde hair and her face covered, with a name very similar to my birth mothers. I immediately thought it was one of my birth sisters, finally making contact with me. This is it I thought, she’s curious, she wants to know more. The fantasy ran away with its self and triggered a vivid dream about a beautiful reunion where ALL of me was accepted. The dream did what most dreams do and hazily faded, but the feelings stuck for a lot longer leaving me with an uncertain desire to be seen. Do I make contact again? Do I be less guarded? Do I let them know about my growing family and the highs and lows I’ve been through. Are they wondering whether to contact me and share their gains & loses?
Ultimately I don’t make contact, I put the wondering back in its box. With a failed reunion, one of my only hopes is that they will make contact with me one day. It is a fantasy of course, but its mine and I want to keep it.
What it does leave me wondering though is how different this could have been, would a more open adoption with letterbox, photos and contact have reduced the shame, the wondering, the longing, the insecurity and the secrecy? Would we now all be able to sit in a room like adults and not deny each other’s feelings?
As I support teenage adoptees what I notice is the silence of the wondering. The secrecy of the wondering. How it’s not safe to wonder because the wider world doesn’t understand their wondering. ‘I can’t talk to my friends because they don’t get it.’ ‘ I can’t talk to my parents because I’m scared they will think I’m not grateful, or I don’t love them.’ Being able to own your curiosity about your adoption is no easy feat. It’s all so personal, all very emotive.
In my short time of supporting birth parents & first families what I’ve noticed is the rawness of the not knowing. The question I’ve been asked the most is ‘will I be informed if my child dies?’
Birth parents talk to me about what they want their children to grow up knowing, the nuances of life that often get missed in social work reports. They don’t want to be known only for their mistakes and struggles, but the bits that makes them whole. They don’t want their child wondering if they loved them, because I’m yet to meet a sociopath birth parent. It’s almost never about a lack of love.
In a time where many are grappling for the first time with the loss of control over seeing their loved ones and the anxious wondering about what the future holds for them, for those affected by adoption this is all too familiar territory. It’s a little sharper than usual during COVID-19, but this is our norm. We wonder if this time might provide a space for the wider world to gain some unexpected insight into our world of coping with the wondering & not knowing.
Tanya Killick, adoptee & adoption support worker
I feel a little fraudulent to be writing under this heading, as I am adopted person who has been in reunion with my birth relatives for over half my life, but perhaps the wondering never stops, and the unknown things remains. I can wonder how my life would have been if my birth mother had not given me up for adoption. I fully understand why as an unmarried mother in 1951 who believed herself deserted by my birth father, and from a family whose support was conditional on her being able ‘to put this behind us’, she felt she had no choice. Could we have made it on our own – just the two of us? It would have been tough, probably too tough for her and I may have ended up ‘in care’ so perhaps I can wonder if it was for the best that I was placed with loving, indeed devoted, adoptive parents when I was just 10 days old if the alternative may have been a residential nursery, foster care and potentially adoption as a toddler or older….and with the multiple moves and trauma that would have involved for me, and the isolation and despair that my birth mother, Mary, would have faced.
Mary told me that she was devastated at parting with me, and this was corroborated for me by her closest friend, at that time, 45 years later, but did acknowledge that she came to terms with her loss as society maintained the standards that forced her hand for decades. We both wondered how much tougher it must have been for women in the late 60s and beyond who parted with babies only to see society quickly reverse its attitudes – as one birth mother said to me ‘I was an unmarried mother just before single parents were invented’.
I can wonder how different things may have been if my mother had been able to talk to my father once she discovered she was pregnant. Their communication in cryptic letters for fear their respective mothers might read them, gave little opportunity for problem solving. My mother said she wrote that she was pregnant and he wrote back asking for her share of the rent. My father says she wrote and told him she thought she was pregnant but was terrified her mother would guess, so he wrote back about the rent as a cover to try to find out when she would return to London after Christmas at home in Lincolnshire. He presumed when he heard nothing further that it was a false alarm but enough to have scared her and put her off their cohabitation. When I questioned him about his ‘responsibility’ to follow up, his answer was that this was 1951. When his sister was in a similar position, his father went to see the boy’s father and sorted things out; surely Mary’s father would have been after him with the proverbial shotgun. Mary says her father never knew – her mother said it would have destroyed his position, she made all the arrangements and created the smoke screen that kept Mary …and me …hidden from family and friends. So I will never know if one version is right and another is wrong, or perhaps both were correct in telling from their own perspective, I can wonder if my adoption was a result of class differences in how to handle a pregnancy out of wedlock at that time?
I can wonder endlessly how my life would have turned out if Mary and Roy had been my parents….I doubt their relationship would have survived long; what if Mary had kept me, married and I had grown up with two half sisters instead of finding them when we were all adults? But I know that would not have happened, the ‘good marriage’ Mary made would not have happened if she had her illegitimate child in tow. Mary’s brother and his wife were shocked to learn I existed and welcome me with open arms, they insisted had they known they would willingly have raised me. They went on to have 5 ‘born to’ children and adopted 3 more. One more would not have been a problem… but I would not be here. I would have lived in Canada from when I was 8, so would have to give up all the great things I have enjoyed in the life I have known, to embrace the potential unknown one.
There is so much that is unknown and I could wonder endlessly, as probably every adopted person does occasionally or frequently but perhaps every life, whether touched by adoption or not, is full of unknowns, of ‘what if’s and even ‘if only’. The current lockdown has given me plenty of time to wonder, but also many reminders of how much tougher issues of life and death are for so many other people. I am just thankful that, so far everyone of both my birth and adoptive families has remained safe and well.
Like the rest of the world Covid-19 has changed our landscape and the impact has been felt globally. Closer to home paid work for me ceased, schools and colleges closed, Artifacts, my newly set up business put on hold and as a family we’re no longer able to see our older children or close friends. We’re supporting home schooling for our youngest two whilst also fostering two unrelated children with very different needs. The only thing not to dry up is my art work, and when you’re impatient to crack on, it can be a bit of a tough gig.
However I’d like to speak about fostering during these unusual times. We’re looking after two children, one a toddler who has just accomplished the art of walking and thus is creating merry havoc as he can get into even more mischief. The other is an older child with much more complexity and unknowns, who has little confidence, very low self-esteem, hasn’t engaged or been involved with education and believes everything around them will either kill or poison them.
All the children’s social workers operate differently, one still comes to see their child, the other speaks via a video link. A positive result of Covid-19, has been that a technical dinosaur like me has learned to set up and operate Zoom, Skype & Microsoft Teams! Our own support social worker operates via text or telephone. Bearing in mind all three social workers operate from the same authority, it sends out conflicting and confusing messages as they all have interpreted ‘social distancing’ differently. As adults we can deal with these frustrations, but imagine how it may feel from a child’s perspective.
Foster carers, like most parents in the country, are feeling the strain of managing children of varying ages and needs at home every day. We all agree that children, perhaps more so than adults, need structure and routine to their days and weeks and maintaining old routines at this current time feels like a juggling act. For all our children the landscape has changed so that school, breakfast and after-school clubs, sports, parties or simply playing with friends now look very different. As foster carers we are having to take on new roles including managing, overseeing and supporting all schoolwork sent from schools. For many of us and our children this maintains routines and learning, but for some carers it will undoubtedly be a great source of tension and stress in the home.
The most striking challenge faced by our children, their families and us as foster carers at this time of Covid-19 crisis is the disruption caused to the child’s ability to maintain contact with their family. Many family time arrangements have been severely disrupted or ceased because of the crisis. In the beginning of the crisis, when initial measures such as recommendations for ‘social distancing’ and reducing contact with vulnerable people were made, many foster carers expressed concern about how these measures were incompatible with existing contact arrangements. Some of us raised concerns around having people with underlying health conditions within the family home and how a child maintaining a previously existing contact arrangement put those vulnerable people at increased risk of contracting Covid-19. In some cases, members of the children’s family are working in healthcare settings and we expressed concern around these individuals carrying the virus and transferring it during contact. We understand that social workers and their managers assess each case individually to assess the reasonableness of the concerns, the potential impact on the child of a disruption in contact and the alternative means of maintaining some form of contact. However, it can feel that in this scenario that while all professionals are equal, and their voices are considered, some professionals are more equal than others!
As foster carers we recognise and support the child’s right to remain connected to their families and we know that this is supported and encouraged by social workers. I think we all ‘get’ the need to help rebuild interrupted relationships between children and their birth family so even for someone like me, a technical dinosaur, we have had to look creatively at how we can remain engaged and support our children. Due to the different needs and ages of our children we have instigated mini-video clips of our younger child, who wouldn’t be able to gain anything meaningful from a video chat. We have also suggested their family videos themselves reading a bedtime story which we could play back. We already know from the messages we receive from their birth family how seeing such footage has reassured them.
Our older child has weekly video chats and we have encouraged their parents to become involved in reading during these chats. We copy the pages to read and send across to parents and exchange letters and pictures. Again it offers reassurance from the child’s perspective as they can see their parents are okay, it allows the parents to be actively involved too. Our child also gets to speak with their older adult siblings, again this helps to preserve and strengthen that part of a child’s identity.
The disruption and distress caused by the Covid-19 crisis for children in care, presents both the children and the caring adults in their lives with new opportunities to explore methods of staying connected that may previously have been unexplored. As foster carers we do sometimes have valid reasons and concerns around maintaining appropriate boundaries with birth parents and do not wish to give parents our personal phone details or social media platform details. This shouldn’t be viewed negatively, it presents an opportunity to work more creatively. A free SIM card could be topped up to enable WhatsApp to be deployed and allow texting, small video clips and voice messaging. Social workers could work with foster cares to develop appropriate boundaries, whilst still monitoring and satisfying themselves with regards to the child’s well- being and experience.
For some children using video contact could be a positive safe form of ‘family time’ as it may provide an experience which is not n as emotionally charged, or as intense an experience for the child, as a face to face meeting can be. It may be a method which potentially serves towards building a structure that works better for the child.
As foster carers I would expect us to be best placed to judge how the child reacts and responds to this form of communication. We should monitor our children’s baseline behaviour and presentation against their behaviour in the lead up, during and after the video contact. We have had to recognise that, for our older child, their anxiety levels and certainly the number of questions increase as does the level of ‘fidgeting’. We know the signs when the restlessness means time for the call to end and we have to step in, allowing our child to leave the room and we will finish off the conversations, usually filling in some of the gaps that they haven’t mentioned. Fortunately the rapport we have built with our children’s parents is positive and we can share concerns and alleviate some of their worries. Success will always look different due to the uniqueness of our children and will depend on several factors. Different children have differing interests and temperaments and engage to varying degrees. Trying to understand the nature of the relationship and attachment the child had with their parent/family prior to coming into care is crucial especially if the child is having to adapt to a previously unexplored or used method of communication. Just talking face to face for any length of time may be a whole new experience.
Our youngest is blissfully unaware what all the fuss is about. Every day they get to eat, play, experience and explore the world around them and deservingly relish being spoilt with lots of cuddles and hugs, plus they still get to see their birth family twice a week…what is there not to like about that.
On the other hand, Covid-19 has increased our older child’s anxieties and worries. This means an increase in questions. They are conscious of the current situation and struggle with their anxieties even more, as it has increased their additional worries about their birth family, teachers, us, even our cat. Maintaining routines, wherever possible, has been the way forward. School hours have been reduced. They continue to attend, so as to maintain a level of structure, which is important as they had been out of school since 2019.
Typically each day is full of questions. They start first thing in the morning and can be quite random such as “If I use body wash will that kill off bacteria?” “Can the cat catch it?” “Will the virus land on my curtains if I leave the window open?” to “I heard more children in care will die, will I be dying soon?”, and “Can it land on tyres and live on roads and pavements?”
We don’t have all the answers but try to offer reassurance by talking through each scenario to try and get understanding of where they are coming from. It can be tiresome but it’s clearly important. Every morning they insist on watching the news (national, as local news would be too close to home) which means we can discuss and address some of their concerns, and that’s even before they start the school journey.
“Will they have wiped the taxi down when it comes to collect me?” “Will the driver be wearing a mask?” “Will the teachers pass the disease to me?” We try and talk through each one getting the young person to draw out the most rational response. It satisfies them until the next day and we play out the same ritual again. Fresh towel and bacterial soap is packed so they don’t have to share with anyone else, and off they go.
On return, clothes are put for washing, a shower or good wash is taken and we have a hot drink discussing how the day has been. Conversation then centres around family, why can’t I go back and when can I see them again? Due to the current situation physical contact with birth family is every three weeks. In between as I’ve already highlighted we’ve arranged video weekly chats. For this particular child they struggle with the idea that the younger child still gets family time twice a week and they can only see their family for two hours every three weeks. We agree that it doesn’t feel fair, especially when both children are under the same Local Authority. Naturally we have raised these concerns and issues, seeking a degree of reassurance, whilst trying to be supportive of our children.
I think we all have learned to do things differently and creatively. I feel it has meant a much more child-centred approach. That has to be a good thing! The Covid-19 crisis continues to be an unprecedented event in our lifetime. Social workers haven’t had time to prepare strategies around keeping children safe to the greatest degree possible, whilst minimising the upset and disruption caused to the children we all work with. What I believe is it highlights the importance of relationships. It is important that social workers become a significant person in the child’s life. Recognising that this may have been a frightening and confusing time for many children in care, means acknowledging they will be ever-more reliant on the safe, familiar and consistent people in their lives to guide them through it.
Decisions made in relation to the child’s lived experience of this time may have effects that will last well beyond Covid-19. The type of communication and relationship the child is able to have with the most significant people in their lives is therefore of crucial importance. Social workers need to proactively and creatively protect the relationships the child has and incorporate the maintenance of these relationships in to the strategies for guiding and supporting the child through this crisis. As always, the child’s welfare must be placed at the centre of all we do, and the role of the social worker is to manage, support and encourage all to work towards what is best for the child. These principles apply generally to all aspects of the life of a child in care, but are acutely highlighted at this time of unprecedented and unpredictable challenges.
Two weeks ago, I submitted my final assignment for the second year of my social work degree. It was a reflective piece, asking me to give an insight into my ‘Personal and Professional development as a result of my 80-day Practice Learning Opportunity’(PLO). You would think I would be elated – running to the fridge for that prized bottle of bubbly, organising a night out or rewarding myself with a binge session of some box-set or other on Netflix. Strangely, although prosecco was chilling in the fridge, friends were on hand to chat to at the end of a phone and there were new seasons of pretty much everything on tv at the click of a button – I quietly went into my garden. To reflect some more.
You see, being a student undertaking a social work degree during a worldwide pandemic is quite a surreal thing to experience. By the time lockdown was announced to the nation, I had just finished my placement and was due to return to university lectures and academic life for the first time since November. Despite really enjoying my PLO, I was tired of writing reflective pieces; of planning direct observations and was looking forward to getting back to my ‘normal’ routine for a bit. I was excited about the prospect of returning to University and surrounding myself in an academic setting once more to hit my internal ‘reset’ button – it would give me the personal recognition that I’d successfully completed my placement and was now returning to a formal learning environment; looking ahead towards my final year. I’m fairly methodical like that where this degree is concerned – one assignment at a time – complete one task then move on to the next. It makes sense to me; it helps me process what I’ve learnt along the way.
Yet University was now closed. (That wasn’t part of my plan, what about my methodical approach?!) There would be no more face to face learning and life as we knew it was about to change in a way I had not seen before. It all felt very flat, very unnerving, and not a return to my ‘normal’ routine at all.
That was 9 weeks ago. These past 9 weeks have been a ‘corona-coaster’ of emotions and experiences. Up and down I go, around and around, sometimes closing my eyes because I don’t want to see what might happen next, other times committing to everything with eyes wide open. I reflect daily, about everything, just to try and make sense of a surreal situation. I could write about the ways in which this pandemic has had a negative effect on me as a social work student, but I’m choosing to take a different perspective because I actually feel like this experience could benefit my future practice. What if the Covid pandemic created a deeper understanding in me towards the lived experiences of others? What if I developed a different kind of approach that was hope-focused in the individuals I support? Wouldn’t that be a thing to keep in my toolkit?
I’ve learnt about many approaches in the past two years. Strength based, person centred, outcome focused, solution focused…the list goes on. I’ve learnt to look at different approaches in the same way as I view cake recipes, in that I’ve got a recipe book, written by a professional baker, giving me a list of ingredients – but to really make it work I need to add a bit of myself to the mix – and I’ve found that if I just add a little dash of hope here and there it can create a completely unique end result – a cake formed out of my own professional curiosity, learning and experiences! I think this is because when you have hope as an ingredient, it can make you think a bit further into the future, it encourages us to have faith in others, it reassures us that things will be ok. That’s not such a bad thing right now.
For once, I am sharing an experience with other people from all over the world. My liberty has been restricted regarding where I can go and what I can do. I have been parted from family members and friends for long periods of time. I’m having to re-think how I go about my daily life. As a community, I am one of many being asked, expected and encouraged to live in a way we are not used to; conforming to a new set of rules imposed on us by others who hold the professional power to make decisions in our best interest. While none of these terms or phrases are new to me within a social work setting, they are completely alien when being delivered directly on my doorstep.
It’s not the way I’d like to have developed a greater awareness of the impact of decisions I might make in the future. Nevertheless, I will use this experience to enhance my ability to empathise and consider the impact of change to an individual’s life. I always imagined that making a decision based on my professional assessment of a person’s situation would sit comfortably with me – I would have the backing of theory, legislation, policy, procedure. I am an empathic, thoughtful person – I can reassure and instil a bit of hope in an individual surely? Wake up call Becky! It’s not as easy as it looks, and you need to check out that recipe again (don’t forget the cake!). It’s not easy living through this at all, despite the guidance; despite my understanding. As students we are taught that being a social worker means we should always be learning, regardless of years in service. Well, if I can’t learn some important lessons from this experience, I never will!
I now have a deeper understanding of how it really feels to be parted from your family members, how tempting it is to break the rules and be with them again. I can empathise with the frustration of grey areas – goalposts changing regarding what is permitted and what is not. Building trust and respect in others that hold the power. That doesn’t come easily at all does it? I’ve learnt how to make it more manageable by thinking creatively around barriers, learning more about what I need to do to make this situation better, making use of resources available to me. If I’ve found it hard, how must it feel for those with support needs? Just because I remain hopeful that this situation will pass, I cannot ever assume that the people I support have an infinite amount of hope regarding their situation – how must that feel? How can I ensure that I change that without dismissing their lived experiences? I am fortunate, I can understand what I might need to make my situation better, but there are those that do not, or cannot. Reflecting on that, and the situation of others right now has been a motivator for my future professional practice. Just because the ingredients in my cake recipe work for me, doesn’t mean that everyone will agree or even like it, so I’ll need to learn how to adapt my recipe and ensure everyone’s personal needs are added to the mix.
All social work students currently living through this pandemic are adapting to the various challenges it has presented. It can easily get you running to the cupboard to comfort eat! I can see how easily it must be to feel overwhelmed and want to give up. Trying to home school our children while we home school ourselves has been testing. Wondering what the new student ‘normal’ will look like come September has been concerning. Thinking about how we can motivate ourselves to submit yet another assignment has been overwhelming. Sharing our experiences has been emotional yet uplifting. All the while remaining hopeful, navigating our way to adapt life as it is now; moving ever closer to achieve our end goal.
Trying, Wondering, Thinking, Sharing. If you popped them into a baking tin I wonder what the secret ingredient would be to achieve that really great bake…a teaspoon of hope perhaps and hey presto – I might just have baked my first professional curiosity cake!
Becky Salter,BSc Social Work Student, University of South Wales
Alongside my day job working in a London local authority, I am also a doctoral student, due to submit my registration in the coming months. My research ideas (before Covid) were growing from the prevailing policy of strengths-based approaches mandated by the Care Act 2014 and my questioning of their tension with attitudes to ageing and institutional care. I was influenced by the largely negative public and political discourse which depicts the care home as ‘the last resort’ when attempts to promote independence have failed (Blood and Guthrie, 2018). My reading further highlighted that the social work role in relation to care homes is limited, largely transactional and often focused on risk and safeguarding (Ray et al, 2015; Manthorpe and Martineau, 2017; Carey, 2016). On the positive side, I was seeing local authorities’ efforts to promote a more strengths-based, personalised and positive risk-taking approach. My research ideas then had begun to crystallise into exploring the social work role in relation to older people in care homes within the context of strengths-based practice (clearly a title that needs work if you get brownie points for snappiness..).
Now, as Covid has overwhelmed the globe and affected our lives and practice in so many ways, I have been musing on what its impact might be on my research area and social work practice with older people in care homes more generally.
In a recent blog, Mervyn Eastman proposes that compassionate ageism (the notion that older people are needy and require special policies to support them) can lead to ‘othering’ of older people and reinforce paternalism. Tim Dartington in his podcast, Thoughts on Dependency, explores how the current crisis is encouraging dependency, a reassuring state in times of fear and anxiety. We have, as a whole society, for the first time in generations, been encouraged to put aside our independence, accept extreme restrictions on our lives, and try to eliminate all risk as far as we can. Rationally we know that it is not possible to eliminate risk entirely, but this narrative dominates when we think about older people in care homes and is most notable currently in the way we are protecting and supporting the most vulnerable people in our society. I am not for one moment underplaying the huge public health crisis, baulking against the idea of lockdown or criticising the imperative to protect others; it is interesting though to consider how the response to Covid will impact on our attitudes to risk and dependency as we move through the crisis. The ‘shielding’ policy conjures up military metaphors and the need to protect from extreme danger. At some point, if we continue to force older people to stay indoors, no longer supporting their independence, but encouraging them to rely on the goodwill of others to keep them safe, we should ask whether we are being influenced by ageist, paternalistic attitudes.
When the crisis began, the doors of care homes were quickly locked to protect their residents at all costs, even if this denied some older people the right to go to hospital if they became ill, or to see their loved ones at the end of their lives. It took away all choice from care home residents. Again, I am not minimising the many complexities of protecting people, in an under-funded and under-resourced situation, but we need to at least ask the question whether we might be warehousing older people under the guise of keeping them safe? The current situation has magnified for me the tension between person-centred, strengths based social work practice and its role in supporting older people in care homes. When we move through the crisis towards the repair and recovery stage, we must apply an ethical lens to the argument and focus on how we can respond to dependency without taking away all autonomy and reverting to paternalism. If we don’t, how will we ever get back to a focus on positive risk-taking, a key tenet of strengths-based practice?
I have been thinking what might happen to the social work role in relation to care homes when we finally come out the other side. Covid has created a barrier by literally closing the doors, requiring social workers to carry out remote DoLS assessments and care reviews, and rely on already burdened care home staff for information. Will the social work role be strengthened, helping to repair the huge losses, and well placed to advocate for older people in care homes and speak out for social justice? Or will it be further marginalised and deepen the divide when called upon to criticise the way in which care homes have managed despite the almost impossible situation? Will future reviews by social workers once things normalise be looked at through a lens of compassion? My hope is that social workers will question and challenge the notions of compassionate ageism and think about what role they can play in supporting staff and older people in care homes to live their lives and be visible in the community.
At the start of the year, I interviewed a social worker as part of the pilot for my research to elicit stories about how social workers see their role in relation to working with older people in care homes. One theme I noticed was how emotional responses in respect of ageing and institutional care might sit in tension with the professional role. I picked up on the social worker’s vulnerability alongside the older person, with a description of an incident that highlighted the difficulty of confronting one’s own ageing and the reality of seeing vulnerable people in care homes. I also detected a sense of uncertainty and not always knowing what to do, suggesting perhaps the conflict between professional and personal self.
This acknowledgement of how our personal experiences are intermingling with our professional roles is a feature of the current situation as the pandemic affects us all in a multitude of ways. Confronting and accepting our emotions and their impact on our work might be something positive to come from this situation and could be relevant to stop us othering older people in care homes. Thinking about the language we use may also help: constructive challenge of the military metaphors so prominent in media coverage, which not only imply that if we fight hard enough we will conquer this virus, but also supports the notion of protection and paternalism. As we start to move into the next phase of the already cliched ‘new normal’, I hope we will remember and re-examine Justice Munby’s well-worn but still highly pertinent comments: “what good is it making someone safer if it merely makes them miserable?” (Re MM, 2007).
Sally Nieman, Professional Social Work Educator and UEL Doctoral Student Twitter: @js_nieman
Blood, I. and Guthrie, L. (2018) Supporting Older People Using Attachment-informed and strengths-based approaches London: Jessica Kingsley
Carey, M. (2016) ‘Journey’s end? From residual service to newer forms of pathology, risk aversion and abandonment in social work with older people’ Journal of Social Work 16(3) pp.344-361
Manthorpe, J. and Martineau, S. (2017) ‘Engaging with the New System of Safeguarding Adults Reviews Concerning Care Homes for Older People’, British Journal of Social Work, 47(7) pp. 2086-2099.
Ray, M., Milne, A., Beech, C., Phillips, J., Richards, S., Sullivan, M.P., Tanner, D, and Lloyd, L. (2015) ‘Gerontological SW: Reflections on its role, purpose and value’, British Journal of Social Work 45(4), pp. 1296-1312
Lockdown partner, Michael Clarke, care leaver and activist shares his vision
In this film, the final of three, Mike talks about his relationship with his cat Mr Whiskers: “He is definitely aware that there is a lot of chaos in the world right now…”
COVID-19 foregrounds a truth for us: that we humans are a species among others in this world, subject to and living in the natural environment; we carry vulnerabilities and can hold trauma caused by instability or transition. So… shielding, guardianship of the world, love of nature and partnerships – including with cats – become essential.
These films are excerpts from a video conversation during lockdown with Michael Clarke who is a care leaver and activist living in London. It is part of a collaboration between Mike, social worker Tim Fisher and artist Trevor Appleson. It is a continuation of Trevor’s work Portable Studio.
Portable Studio started life as an archive document of contemporary British youth culture, made in collaboration with a selection of the young people Appleson met and photographed on the streets of Birmingham for a commission at The Midlands Arts Center in 2015.
Inspired by the way identities are curated online, Portable Studio explores youth identity and experience in an attempt to preserve evidence of a socio-digital landscape that would otherwise pass without physical record.
Can children, young people & their families ‘own’ their records?
“Those that do not have the power over the story that dominates their lives, power to retell it, rethink it, reconstruct it, joke about it and change it as times change, truly are powerless, because they cannot think new thoughts.” (Salman Rushdie)
I think as social workers we should question who ‘owns’ a child’s record. It is my belief that the child owns it, it is theirs, and yet so often they see very little of it. It can seem like reports, assessments and plans are written for managers, professionals and the courts. This becomes painfully obvious when we hear stories of care experienced adults who return to read their “files” later in life to find their story and the ‘soul’ of their experience as they know it missing from the words written about them. Too often, children’s files simply disappear, as painfully highlighted by the experiences of Lemn Sissay, and by Prof Alexandra Jay in the Rochdale child sex abuse report, both stark examples of what Sissay calls ‘disappearing files abuse’.
Before the lockdown, I was given the opportunity to work on a project for my organisation on how we could improve our record keeping and our families access to what is written about them. The MIRRA (Memory – Identity – Rights in Record – Access) project was one of the sources of inspiration for my work on this subject and tells the stories of care experienced adults accessing their files. They are powerful messages and I encourage anyone who writes records for families to watch some of the videos available online.
One of the aims of this project was to throw light on the responsibilities and power we have as professionals, and why we must critically analyse how we write about children and families. Fergus Hogan’s 2001 article, Letter Writing and Collaborative Note Making in Social Work Practice, also served as inspiration in my own journey to discover whether writing letters to families and having these serve as the case record would assist in making files more accessible to families. The project threw up a number of key questions: How can families be empowered to share the “Record Keeping” space? How can young people write their own stories of their time in care? How can we help children in care make memories they’ll want to access when they’re older? Can record keeping be a therapeutic intervention in and of itself?
Relevance to Covid-19
The current crisis has brought about new ways of working: we are using text, email, social media and other virtual methods of staying in touch with the families we support. These media present opportunities to use this material to record the child’s world, in the child’s voice, on their files for their future reference. With this project I was already thinking about how we could add voice recordings and videos to the files of children in care so that they have real, tangible records of their own voices and images, as well as those of their social workers, important professionals, carers and family members, for them to access in adulthood. Due to social distancing measures, a lot of family time (contact) between children and birth family is now done virtually, often with the capability of recording through whatever platform is being used. This presents a potential opportunity to record messages and meetings virtually between family for these children to view in the future.
Another key question was: What are we currently doing? In the fast paced and stressful environment of child protection social work, how often do families see copies of what is written about them, whether that be social work assessments, family plans, child protection plans or records of meetings? Can we be confident that we are doing this all the time? Another question that kept cropping up was, who are social workers writing for? And are we constantly writing as if the child or young person is looking over our shoulder? In my discussions with social workers I found they often forgot about two things: that a family can request to see everything that’s been written about them at any time, and that they aren’t writing for themselves, but are writing the story of someone’s life.
Consider this: Have you ever attended your GP practice to discuss something personal and as you’re talking about an intimate subject they are typing on the computer without eye contact? Did you ever get to see what they’d written? How does that make you feel?
In 2018, the Transparency Project looked at why parents might want to record meetings with social workers. This shed light on the power imbalance involved when social workers write records without the input of the people concerned and how these could be addressed by doing this collaboratively with clients. The project found, among other things, that parents record workers because they don’t want to forget things, don’t want to rely on other people’s recordings of a meeting and because they have previously disagreed with minutes of meetings.
Ethical Dilemmas in Record Keeping – Nothing about me, without me
How can a family know what we expect of them and what we think we are trying to help with, if they never see our thought process, our ‘working out’? How can they agree to what we are trying to achieve if they aren’t part of writing the plan in clear, understandable language with no jargon/acronyms/professional speak? How can we work within the principles of empowerment, equality and dignity if we are writing things about people, without them, and never giving them access?
I think a key factor in getting this right for families is empowering them to choose how they want to interact with their records. Do they want to read them, or comment on them, or are they in a position to assist in writing them? Would they prefer this to be done via phone calls, emails, letters, texts or in another format? Some young people may engage with being recorded and this being placed on their file for the future, and others may not. I think they key here is that we have a number of different approaches and we work with people to record their stories in the best way for them.
What is collaborative case recording and how is it different?
A lot of case recording, especially in busy fast-paced environments, tends to be done after the fact, back at the office and without the person with whom its about. Collaborative case recording is about the worker and the client spending time together agreeing on what has been said and discussed, and jointly recording this on the persons file. Miller & Barrie (2019) suggest that narrative approaches where stories are constructed with and about the client, could be beneficial as clients are able to reflect on and contribute to their own plan.
Shires (2016) suggests that the standards for client-centred recording should be accountability, appropriate language, therapeutic, social inclusive, accessible and confidential. He suggests that co-constructed (collaborative) records include both the client and worker regularly reviewing them, which ensures accuracy and clarity, and maintains a level of transparency. He also suggests that this way of recording “upholds the dignity and rights of the people” that we work with.
The figure below shows how collaborative case recording (with) differs from the professionally-controlled approach (to) and where letter writing sits within the wider approach. This is a table that I created whilst thinking about the different levels of sharing records with families whilst preparing to deliver training in my authority.
The key benefits of letter writing within a collaborative case recording approach are:
The records become produced by families, allowing them to participate in, and own what is written about them
It allows them to write their own story, design their own goals and create their own path
Families immediately have access to their own records, encourages the co-construction of meaningful conversations (Hogan 2001)
Can be a key way of building trust and relationship, becoming part of therapeutic practice (MIRRA)
Why should we care about our clients having access to their records?
For those who are care experienced, having often lived through a myriad of changes and a childhood of trauma, their files are the only place where they can gain understanding and a picture of their childhood. It is well documented in a number of disciplines, including psychology and criminology, that trauma impacts our memories. The MIRRA project and their work talks extensively about how without our stories, our pictures, memories, sense of who we are, and where we come from, we struggle to have an identity. For those who have spent the majority of their childhood in local authority care, their files are often the one place, the only place, where these memories can be found. I believe that it would be so powerful for care experienced adults to be able to come back to their “files” and read words that they wrote, about their situation, at the time, rather than someone else’s interpretation of what happened that they’ve never seen before.
How can we take this forward?
There are already a number of technologies available which could support this work. For example, my nursery use TAPESTRY. Each child has an individual password-protected account where nursery staff and parents can share pictures and stories about the child’s experiences, learning and development. I envisage a similar platform that could be used to share pictures and stories to add to a child’s electronic co-produced file. We are also exploring the ‘Portal’ function within Liquid Logic. Within the Portal there is a way to give parents and families a log on to access a ‘shared’ area of the child’s file containing documents and information the young person and family could access via the internet.
What have practitioners said about it?
Whilst discussing with social workers in the authority where I work about how we can begin to take this approach forward I have encountered several worries. Practitioners sometimes worry this new approach could be time-consuming. My response is that this method replaces the old method rather than being an additional task. So instead of writing a case note, report or assessment AND a letter to a family, the letter IS the assessment/report/case note. I also believe that engaging families in writing their own reports, being more involved in what’s being recorded, and in writing their own goals this has potential positive impact further down the line because we are engaging and empowering families right from the beginning of any intervention, in keeping with Hoyle et al’s (2018) framing of collaborative record-keeping as a rights-based practice. Social workers have reported that they feel the weight of responsibility working in this way, knowing that the child and family are going to immediately read what they have written about them. This constant reminder that we are recording the story of children’s lives, that they may well read as adults, is surely a positive thing for those we support and practitioners should welcome that.
In this new, virtual world, we are moving from the idea of a physical memory box (most often a shoe box or similar containing a life story book and an old teddy or toy) to the idea of recorded messages in the child’s voice so that when they come to review their files as adults, it is their story, told in their words, in a way that they recognise.
Kay Everard, social work team leader (all views my own)
Willis, R. & Holland, S. (2009) Life story work reflections on the experience by looked after young people, Adoption & Fostering 33(4), 44-52.
 See; how trauma and impact four types of memory( www.nicabm.com) How trauma affects the way in which we encode and store memories (www.lscft.nhs.uk), Traumatic stress: effects on the brain (ncbi.nlm.nih.gov).