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David Clarke Special Edition

Letter writing as case notes: Developing narrative in case files of Care Experienced individuals

Background

The significant administrative demands placed on social workers mean that they only spend 20% of their time in direct contact with families, yet must meet strict statutory timescales in respect of how frequently they visit the many children they support. I know from experience that many social workers feel frustrated such demands, particularly those that constrain time to interact with those whom they seek to serve. Therefore, it is without surprise that many social workers see aspects of case recording practices as burdensome, and writing up case notes is commonly done late into the evening, with whatever energy remains. Muirhead’s (2019) scoping review on recording practice outlines:

“records become conduits for decision-making rather than a vessel that retains a person’s narrative”.

While I can understand why social workers may view case notes as an administrative exercise, I argue that more emphasis should be placed on developing a narrative throughout records, particularly for Care Experienced individuals. For this community, accessing care records is known to be a significantly challenging experience (CELCIS, 2019). For some, this can be a therapeutic process whereby gaps in memory are filled, and questions about their childhood are answered. For others, this can compound their traumatic childhood experiences. Outcomes from accessing files are linked to the quality of recording within (Hoyle, 2020). However, research is often negative about this practice:

 “Social work files damn people to a written history of their past mistakes” (Hogan, 2001, p.11);

[Notes are] “written by a succession of professionals and rarely include the perspective of the person they are written about”  (Buchanan, 2014, p.26).

Within, I reflect on my experience of attempting to develop narrative through recording case notes as written letters. This builds on Kay Everard’s (2020) article in this very magazine that asks “Can children, young people & their families ‘own’ their records?”. She advocates for the adoption of a collaborative approach to case recording. Like Kay Everard, I was also inspired by Fergus Hogan’s (2001) article on Letter Writing and Collaborative Note Making in Social Work Practice. This champions writing letters as case notes as a means of building Life Stories, and I contend that this approach achieves this, and much more.

Gravitating towards letter writing as case notes

I was never formally taught how to write case notes. My education came from copying others, which, on reflection, did not serve me well. I learned to write in a formal style, using third-person tense throughout. In written form, I was ‘The writer’:

            “The writer visited Katie today…”

Regretfully, I admit that as a nervous early-career practitioner, I viewed case recording mainly as a means of evidencing competence and defending practice decisions, particularly in the event of a significant incident. I soon grew tired of recording this way and became more confident in practice, to the point that if I did something in practice, I was going to ‘own it’:

            “I visited Katie today…”

Using first-person tense in case notes was like an epiphany for me. I soon blended this style into assessments, and reports, including those intended for review in Children’s Hearings and the Sheriff Court. By being explicit in respect of authorship and attribution of professional judgements, each assessment came with my personal stamp of approval, underpinned by my professional integrity.

My recording then evolved to writing in a letter format after a brave and creative colleague (whom I am eternally grateful to) shared that she was trialling this in respect of two Care Experienced young people’s case files. At the time, I was a foster carer and a child I was supporting was undertaking Life Story work. Narrative was a big deal for him, and for me at this time. Through this, I needed little encouragement to try out this unique form of recording.

‘Doing’ letter writing as case notes

Simply put, this method of recording takes the form of a traditional written letter. Start the letter by addressing the child (although I find it’s helpful to write ‘to’ the care experienced adult of the future):

“Dear Katie, I visited you today…”

The main body of the letter outlines what you might capture in a traditional case note including the description and analysis of the encounter. However, the principle that underpins this method of case note recording is to develop a narrative throughout. This requires social workers to:

  • Make links to the previous and next case note
  • Include soft facts and other observations that might be important to the future adult (even if it is not important for the purpose of assessment or risk management)
  • Acknowledge that they are an active participant in the encounter
  • Pose questions or statements to the future adult to support analysis
  • Be transparent and accountable for their actions and decisions

Read the following letter case note example:

“Dear Katie, I promised you two weeks ago that I would visit you at school instead of home, so I came to Greenview Primary today. I was keen to chat with you before your review meeting (this is where we look over your care plan to see that you’re getting all the supports you need). You’ll see that I wrote the last time that I was a bit worried about how you were sometimes hiding your packed lunch at school. I remember you did this when you were 5 when you were worried about mum and I wonder if might be something you’re thinking about just now?

Your teacher Miss Edgar brought you to see me. You were upset that I had come during your gym time. I’m really sorry about this- I should have checked the timetable as I know you love football and you’re really good at it. In fact, you had your blue and white school football strip on with your name and number 10 on the back- you might remember this? I asked if you preferred to go back to gym and you said you would.

I still hope to get your views about things at home and school before your meeting, so I’m going to pick you up tomorrow and drive you to school and hope we can chat along the way.

Your social worker,

David”

On review, notice how the case note makes links to the previous case note (“two weeks ago…”), and the next one through promises (“I’m going to pick you up…”). This helps to weave a thread through Katie’s busy case file.  

I am fortunate enough that my parents are able to tell me what food I liked when I was 5-years-old, my favourite toys, and songs we would sing in the car. For many Care Experienced individuals, these identity-forming soft facts are often missing, and I would argue that case notes are the ideal place to record these. In the example recording, note the precise descriptions of Katie’s football strip and her talent for the sport. This, of course, would have little bearing on an assessment of risk, but will undoubtedly be important to Katie to read in adulthood.

Whether adults who request files remember their social worker(s) or not, on reading their records, it is obvious that their social worker held a significant amount of power and responsibility over their lives. I therefore contend that social workers should acknowledge the importance of their role, and include their professional selves in case notes, including reflections, their own behaviour, actions and words. In the above example, the social worker is clearly identified as an active participant, going as far to apologise to the future adult.

There is evidence of analysis and reflection within. Posing questions to the person we write about is a more empathetic way of recording concerns we have than coldly listing them in written form.

Lastly, the note ends with a kind sign-off, and acknowledges who is recording and their relationship to Katie.

It may be useful to compare the above example to how I might have recorded the encounter as a newly-qualified social worker:

“Writer visited Katie at school to record views ahead of review meeting and to explore concerns relating to hiding lunches/snacks. Katie upset with writer about arriving during gym time. Katie returned to gym. Writer to pick Katie up for school tomorrow and discuss above along the way”

I invite readers to compare these two notes, and undertake an honest appraisal of each. By doing so, you may identify some of the pros and cons of letter writing as case notes, as follows.

Benefits of letter writing as case notes

I believe that adopting this method supports me to develop Care Experienced individuals’ Life Story whereby reading the case notes alone would offer much in respect of a narrative of their childhood. Further, despite curious colleagues raising concerns to the contrary, I find that letter writing supports analysis. Posing questions and statements throughout e.g. “I wonder if this is because…” or “I think you might have said this because…” is both relational and analytical in nature. Further, this style enables me to report difficult issues, while surrounding them with a more relational and empathetic tone. This enables notes to serve a number of audiences. Next, I cannot overstate how much better I feel recording in this way. Writing as per the first example aligns much more closely to my professional value base, which makes the task more easy to manage, even late at night(!). Last, and importantly, writing letters to the future adult is an effective way of reflecting on, and then moving on from very difficult encounters. In practice, I have written letter-style case notes to children whom I have removed from home on an emergency basis, as a means of documenting what happened, why and acknowledge the trauma experienced by the child:

“Dear James, this was a really, really difficult day for you and you’ll probably remember this”;

“We were all really worried about your safety and…”;

“…You were really upset when I told you this and I absolutely expected you to feel this way…”

Therefore, in a sense, letter writing allows you to emotionally connect with the future adult, documenting difficult encounters sensitively and humanely.

Limitations of letter writing as case notes

The obvious downside to writing letters is that they can take a lot of time, particularly when starting out or recording a significant incident. It takes commitment from social workers and those supervising them to adopt this method of recording. I would suggest to social workers to outline their intentions in supervision, and pilot this approach within their own department as a means of evaluating this method. While I may have persuaded some that this is a worthwhile approach with benefits to service users and professionals alike, as outlined at the start, social workers do not usually have the luxury of spare time. As such, I reserve this style for explaining significant decisions, or documenting personal encounters, rather than recording, for example, brief telephone calls or suchlike. Further, as I reflected earlier, it took me a while in practice to develop enough confidence to write in the first person, and longer to write in a way considered to be unorthodox. It may be difficult, particularly for newly-qualified social workers to fly in the face of established recording cultures within their agency. 

In closing

By sheer coincidence, a former colleague recently sent me a message to tell me they had shared some of my case notes with a young person I used to support:

“how you write your case notes…has really helped a young person…It felt so much more personal they remember the day when reading…there was a mixture of tears and smiles…was so powerful I think for this young person it’s helped go back to those days and their thinking”

In bringing this reflective article to a close, I hope that this inspires others to, at least, consider both how and why they record and the extent to which their recording practice promotes narrative for Care Experienced individuals. As outlined, letter writing as case notes is not without difficulty, but I would invite readers to give this a try and contact me with feedback.

References

Hoyle, V., Shepherd, E., Lomas, E. and Flinn, A. (2020). Recordkeeping and the life-long memory and identity needs of care-experienced children and young people. Child and family social work. [online]. 25(4), pp. 935-945.

David M Clarke

Social Worker

Twitter: @dcSWer