Social work recording: Regular check-up visit
Characters:
- Laura – Social Worker
- Adam – Service user, 23, mild learning disabilities
Location:
Adam’s flat
Laura comes round every 6-8 weeks, to monitor how Adam is managing, in particular with reference to money and keeping the flat in a decent state. Adam has two hours home care support a week, to help with bills and tidying, but often does not let the workers in.
[SCENE: ADAM’S FLAT]
[A DOORBELL. A LONG WAIT. A KNOCK AT THE DOOR, THEN THE DOORBELL AGAIN. EVENTUALLY THE DOOR OPENS.]
Adam: Oh. It’s you. Laura. 11.15, Friday. Yes. Hello.
Laura: Hello, Adam – how are you today?
Adam: Fine thank you. Thank you, fine. Thank you very much for asking.
Laura: Is it all right if I come in?
Adam: Laura can come in, yes. Come in. Yes.
[WE HEAR LAURA FOLLOW ADAM INTO THE HOUSE.]
Adam: (muttering) Rubbish bags. Missed the dustman. Stink of fish.
Laura: We can put that in the outside bin, Adam. You don’t need to have the bin bags in the flat, making the place smell.
Adam: Stink of fish. Fish pie. Frozen fish pie in the microwave.
Laura: Shall we have a seat in the lounge to catch up?
Adam: Yes. Sit. Sit in the lounge. Sit in the lounge. Don’t drink tea
Laura: That’s right, Adam. No I don’t drink tea. No need to make me a cup. I’ve got some water, thanks. You can make one for yourself if you want?
Adam: No milk.
Laura: So, you’ve run out of milk?
Adam: Buy some milk. Buy some ready meals. For the freezer.
Laura: Is it all right to move these clothes, so I can sit on the sofa.
Adam: Move them. Yes. Smelly clothes. Sandeep help me put wash them, make them fresh. Sandeep’s left. Tony now. Don’t like Tony.
Laura: Are Sandeep and Tony care workers from the agency?
Adam: Yes. Come round Tuesdays and Thursdays.
Laura: Okay, em, first off I just want to make sure you know why I’m here.
Adam: Check up on me. Check I’m looking after myself. Check I’m clean. Washing. Shower smells. Not wanting to use it.
Laura: That’s right, I’m here to check that you’re all right and looking after yourself. Just to see if you need any more support from us. Is that okay? I want to see how you’re managing your credits and looking after the flat.
Adam: Clare says talk about credits.
Laura: Have you been talking to Clare a lot recently?
Adam: Lives in Swindon.
Laura: So, you’ve been talking to her on the phone?
Adam: Don’t like her living Swindon. Far away. Don’t see her.
Laura: It’s hard I know. But you’ve been talking to her on the phone? And she’s concerned about your money situation – how you’re spending your credits?
Adam: Too much. Colin says too much. Too much on phone. Can’t call.
Laura: Colin’s your sister’s partner?
Adam: Boyfriend. Clare’s boyfriend. Postman. Don’t like me phoning every day.
Laura: So you’ve been phoning Clare every day? Do you remember we agreed that you would call her once in the week and once at the weekend? She wants to hear from you, but doesn’t really want you calling every day.
Adam: Talked to mum every day. Clare don’t want me to. Colin don’t want me.
Laura: Adam, Clare does want to speak to you, but just not every day. Last time I saw you, you were keeping the phone calls to just twice a week. Can you tell me what’s changed?
Adam: Don’t like winter, makes me sad. Don’t like cold. Too dark. Mum died winter. Sad not talking to Mum. Mum don’t like winter. Don’t like winter. Lonely.
Laura: You’ve been feeling low because you miss your mum, you’ve been feeling lonely.
Adam: Yes. Lonely. Clare don’t never phone me. Don’t care. Always busy. Worried about my credits.
Laura: And you’ve been calling Clare too often. She probably doesn’t feel the need to call you.
Adam: I call her. Never calls me. Don’t care. Makes me sad.
Laura: Shall I talk to Clare, to see if we can reach an agreement? What, if you agree to phone her just twice a week, she might choose to ring you when she’s not busy and can chat for longer.
Adam: Want to chat for longer. Yes. Want chat for longer. Talk about mum.
Laura: Okay, so that’s something you could do then? Go back to only phoning Clare twice a week, and explain that you’d like her to phone you when she has time to chat properly.
Adam: Talk about mum.
Laura: Yes of course you could talk about your mum but also you can also ask Clare about things in her life, couldn’t you?
Adam: She has a new dog. A puppy.
[SOUND OF PAPER’S BEING SHUFFLED ABOUT.]
Adam: Here. Photo of puppy she sent me. Sent me money and a photo of puppy. Puppy called Benji.
Laura: Ah, what a lovely photograph. Adam did you say your sister’s been sending you money?
Adam: Money for shopping. Ran out. Been buying wrong things. Magazines. Forgot to buy shower gel. Washing powder.
Laura: I see you’ve got a lot of unopened bills on the table there. Has the care worker been this week? He can help you deal with the bills and help you with some tidying.
Adam: Don’t like Tony. Sandeep was nicer. Helped me with washing. But he’s left.
Laura: Your new care worker from the agency is called Tony?
Adam: Tony. Yes. Young, beard. Don’t let him in. Don’t like strangers in flat. Don’t like beards.
Laura: Did the agency not introduce Tony to you properly?
Adam: Sandeep gone. Tony come round tell me he’s care worker now. But he don’t know me. Don’t know him.
Laura: You haven’t been letting Tony into the flat. So you haven’t had as much help with managing your money or cleaning.
Adam: He came in once. Not friendly. Not wanting to chat like Sandeep did. Beard.
Laura: Okay, well it concerns me that you’re not getting all the support you need. I’ll talk to the care agency, to see what I can do.
Adam: I miss Sandeep. Miss mum too. Clare cross … Calling too much. Worried not looking after myself. Not washing. Lonely in flat and frozen fish pie, only.
Laura: Oh dear, Adam. You are feeling a bit low at the moment, aren’t you? Ok, let’s see what we can do right now to make you feel a little more in control. First of all, we can make the flat a little less untidy, let’s get rid of the bin bags in the hallway, and then we can see what your money situation is like – and we can make a shopping list.
Adam: Get rid of stinky fish. No more fish pie from corner shop.
[TRANSITION TO INDICATE TIME PASSING.]
Laura: So, Adam, I think the flat’s looking much better don’t you? Why don’t we ask the agency to work with you to keep on top of it?
Adam: Tidy. Yes. Not stinky. Washing too.
Laura: Okay, we can ask the agency to help with the washing of your clothes too. You will stick to the shopping list we’ve made, won’t you? Should last you until your next credit payment. And you’ll let the care worker in to help you with the bills. I’ll talk to the care agency and discuss the reasons why you haven’t been letting Tony into the house.
Adam: Next Tuesday. Tuesdays and Thursdays they come.
Laura: I will talk to the agency today, so we can work something out before Tuesday. Now, I understand it’s a difficult time of year for you, so I’m going to make a note that we should visit you a bit more frequently during the winter months – is that okay with you Adam?
Adam: Don’t like winter, better with more people. More visits.
Laura: Okay then, but you don’t just want to see your social worker, I’m guessing. What about getting out more – doing more stuff?
Adam: No money for café. Don’t want to see people. Stinky. Stay away.
Laura: In the past you’ve enjoyed feeding the ducks in the park.
Adam: Park, yes. Not in winter.
Laura: Are you still going to church occasionally?
Adam: Mum church. Funeral. Makes me sad.
Laura: But you have friends at church.
Adam: Friends, yes. Roger. Ethel. Ethel makes the tea.
Laura: Okay, well we can follow up on this next time I come and see you. You might want to think about going to church to catch up with some of your friends. I am sure they’d like to see you.
Adam: Think about it.
Laura: That’s it. You have to think about it, and we’ll talk about it again. So… you’re going to try to be more careful with money and shopping, and I’m going to talk to the care agency about the care workers who come and visit you. I’m going to talk to Clare about the phone calls, but you’re also going to ask her to phone you when she has time to chat properly – because you’ve been a bit lonely.
Adam: Time for chatting. When Colin not there.
Laura: Good – okay. Well, thank you for your time today – I hope you feel a bit less low soon.
Adam: Thank you. Thank you very much.
Laura: I’ll see you again in about 6 weeks, and I’ll call to make the appointment. And we can talk again about getting out more.
Adam: See you.
Laura: Bye Adam.
[SOUND OF FRONT DOOR BEING SHUT.]
[END OF SCENARIO.]
[SCENE: ADAM’S FLAT]
[A DOORBELL. A LONG WAIT. A KNOCK AT THE DOOR, THEN THE DOORBELL AGAIN. EVENTUALLY THE DOOR OPENS.]
Adam: Oh. It’s you. Laura. 11.15, Friday. Yes. Hello.
Laura: Hello, Adam – how are you today?
Adam: Fine thank you. Thank you, fine. Thank you very much for asking.
Laura: Is it all right if I come in?
Adam: Laura can come in, yes. Come in. Yes.
[WE HEAR LAURA FOLLOW ADAM INTO THE HOUSE.]
Adam: (muttering) Rubbish bags. Missed the dustman. Stink of fish.
Laura: We can put that in the outside bin, Adam. You don’t need to have the bin bags in the flat, making the place smell.
Adam: Stink of fish. Fish pie. Frozen fish pie in the microwave.
Laura: Shall we have a seat in the lounge to catch up?
Adam: Yes. Sit. Sit in the lounge. Sit in the lounge. Don’t drink tea
Laura: That’s right, Adam. No I don’t drink tea. No need to make me a cup. I’ve got some water, thanks. You can make one for yourself if you want?
Adam: No milk.
Laura: So, you’ve run out of milk?
Adam: Buy some milk. Buy some ready meals. For the freezer.
Laura: Is it all right to move these clothes, so I can sit on the sofa.
Adam: Move them. Yes. Smelly clothes. Sandeep help me put wash them, make them fresh. Sandeep’s left. Tony now. Don’t like Tony.
Laura: Are Sandeep and Tony care workers from the agency?
Adam: Yes. Come round Tuesdays and Thursdays.
Laura: Okay, em, first off I just want to make sure you know why I’m here.
Adam: Check up on me. Check I’m looking after myself. Check I’m clean. Washing. Shower smells. Not wanting to use it.
Laura: That’s right, I’m here to check that you’re all right and looking after yourself. Just to see if you need any more support from us. Is that okay? I want to see how you’re managing your credits and looking after the flat.
Adam: Clare says talk about credits.
Laura: Have you been talking to Clare a lot recently?
Adam: Lives in Swindon.
Laura: So, you’ve been talking to her on the phone?
Adam: Don’t like her living Swindon. Far away. Don’t see her.
Laura: It’s hard I know. But you’ve been talking to her on the phone? And she’s concerned about your money situation – how you’re spending your credits?
Adam: Too much. Colin says too much. Too much on phone. Can’t call.
Laura: Colin’s your sister’s partner?
Adam: Boyfriend. Clare’s boyfriend. Postman. Don’t like me phoning every day.
Laura: So you’ve been phoning Clare every day? Do you remember we agreed that you would call her once in the week and once at the weekend? She wants to hear from you, but doesn’t really want you calling every day.
Adam: Talked to mum every day. Clare don’t want me to. Colin don’t want me.
Laura: Adam, Clare does want to speak to you, but just not every day. Last time I saw you, you were keeping the phone calls to just twice a week. Can you tell me what’s changed?
Adam: Don’t like winter, makes me sad. Don’t like cold. Too dark. Mum died winter. Sad not talking to Mum. Mum don’t like winter. Don’t like winter. Lonely.
Laura: You’ve been feeling low because you miss your mum, you’ve been feeling lonely.
Adam: Yes. Lonely. Clare don’t never phone me. Don’t care. Always busy. Worried about my credits.
Laura: And you’ve been calling Clare too often. She probably doesn’t feel the need to call you.
Adam: I call her. Never calls me. Don’t care. Makes me sad.
Laura: Shall I talk to Clare, to see if we can reach an agreement? What, if you agree to phone her just twice a week, she might choose to ring you when she’s not busy and can chat for longer.
Adam: Want to chat for longer. Yes. Want chat for longer. Talk about mum.
Laura: Okay, so that’s something you could do then? Go back to only phoning Clare twice a week, and explain that you’d like her to phone you when she has time to chat properly.
Adam: Talk about mum.
Laura: Yes of course you could talk about your mum but also you can also ask Clare about things in her life, couldn’t you?
Adam: She has a new dog. A puppy.
[SOUND OF PAPER’S BEING SHUFFLED ABOUT.]
Adam: Here. Photo of puppy she sent me. Sent me money and a photo of puppy. Puppy called Benji.
Laura: Ah, what a lovely photograph. Adam did you say your sister’s been sending you money?
Adam: Money for shopping. Ran out. Been buying wrong things. Magazines. Forgot to buy shower gel. Washing powder.
Laura: I see you’ve got a lot of unopened bills on the table there. Has the care worker been this week? He can help you deal with the bills and help you with some tidying.
Adam: Don’t like Tony. Sandeep was nicer. Helped me with washing. But he’s left.
Laura: Your new care worker from the agency is called Tony?
Adam: Tony. Yes. Young, beard. Don’t let him in. Don’t like strangers in flat. Don’t like beards.
Laura: Did the agency not introduce Tony to you properly?
Adam: Sandeep gone. Tony come round tell me he’s care worker now. But he don’t know me. Don’t know him.
Laura: You haven’t been letting Tony into the flat. So you haven’t had as much help with managing your money or cleaning.
Adam: He came in once. Not friendly. Not wanting to chat like Sandeep did. Beard.
Laura: Okay, well it concerns me that you’re not getting all the support you need. I’ll talk to the care agency, to see what I can do.
Adam: I miss Sandeep. Miss mum too. Clare cross … Calling too much. Worried not looking after myself. Not washing. Lonely in flat and frozen fish pie, only.
Laura: Oh dear, Adam. You are feeling a bit low at the moment, aren’t you? Ok, let’s see what we can do right now to make you feel a little more in control. First of all, we can make the flat a little less untidy, let’s get rid of the bin bags in the hallway, and then we can see what your money situation is like – and we can make a shopping list.
Adam: Get rid of stinky fish. No more fish pie from corner shop.
[TRANSITION TO INDICATE TIME PASSING.]
Laura: So, Adam, I think the flat’s looking much better don’t you? Why don’t we ask the agency to work with you to keep on top of it?
Adam: Tidy. Yes. Not stinky. Washing too.
Laura: Okay, we can ask the agency to help with the washing of your clothes too. You will stick to the shopping list we’ve made, won’t you? Should last you until your next credit payment. And you’ll let the care worker in to help you with the bills. I’ll talk to the care agency and discuss the reasons why you haven’t been letting Tony into the house.
Adam: Next Tuesday. Tuesdays and Thursdays they come.
Laura: I will talk to the agency today, so we can work something out before Tuesday. Now, I understand it’s a difficult time of year for you, so I’m going to make a note that we should visit you a bit more frequently during the winter months – is that okay with you Adam?
Adam: Don’t like winter, better with more people. More visits.
Laura: Okay then, but you don’t just want to see your social worker, I’m guessing. What about getting out more – doing more stuff?
Adam: No money for café. Don’t want to see people. Stinky. Stay away.
Laura: In the past you’ve enjoyed feeding the ducks in the park.
Adam: Park, yes. Not in winter.
Laura: Are you still going to church occasionally?
Adam: Mum church. Funeral. Makes me sad.
Laura: But you have friends at church.
Adam: Friends, yes. Roger. Ethel. Ethel makes the tea.
Laura: Okay, well we can follow up on this next time I come and see you. You might want to think about going to church to catch up with some of your friends. I am sure they’d like to see you.
Adam: Think about it.
Laura: That’s it. You have to think about it, and we’ll talk about it again. So… you’re going to try to be more careful with money and shopping, and I’m going to talk to the care agency about the care workers who come and visit you. I’m going to talk to Clare about the phone calls, but you’re also going to ask her to phone you when she has time to chat properly – because you’ve been a bit lonely.
Adam: Time for chatting. When Colin not there.
Laura: Good – okay. Well, thank you for your time today – I hope you feel a bit less low soon.
Adam: Thank you. Thank you very much.
Laura: I’ll see you again in about 6 weeks, and I’ll call to make the appointment. And we can talk again about getting out more.
Adam: See you.
Laura: Bye Adam.
[SOUND OF FRONT DOOR BEING SHUT.]
[END OF SCENARIO.]
How would you record the events?
Care review visit by Laura Jones Social Worker to Adam Fox by appointment at his flat.
The purpose of my visit was to review Adam’s care package.
Adam took 3 mins to answer the door after 2 rings on the bell but he did remember that we had made this appointment and said that he knew why I had come to which he said was to ‘check up on me’.
Adam’s flat was much more untidy then on my previous visit. There were 3 bins bags full of rubbish in the hall and the bin in the kitchen needed emptying. There was a strong smell of fish in the flat. There were clothes on the sofa which I had to move before I could sit down and unopened bills on the table. Adam himself appeared to be unwashed, with dirty clothes and a smell which suggested to me he may not have showered recently. (REAL, ACCURATE)
Adam said that he had run out of milk and needed some meals for the freezer. He said that he had missed the dustman which was why the bags were still in the flat. Also that his care worker, Sandeep, had left and that he did not like his new worker Tony who he described as young and having a beard, and ‘a stranger’ who was ‘not wanting to chat like Sandeep’. Adam acknowledged he was not letting Tony into the flat.
We also talked about Adam’s sister, Clare, who lives in Swindon with her partner, Colin. Adam told me that he had been phoning Clare every day and this was making Colin and his sister cross. Adam told me that his sister is concerned about how he is spending his credits and had sent him some money.
I asked him why he had taking to phoning everyday instead of twice a week as previously agreed and he told me that he was lonely, hated the winter which made him sad, and missed his mother who had died in the winter. (SUCCINCT)
Adam appeared upset by his current situation so I suggested that we make the flat a little less untidy so that we could then sit down and make some plans together. Adam agreed to this. Together we removed the bin bags, put the piles of clean clothes away and dirty clothes in the washing basket and sorted through the post with Adam. Adam was happy and able to help me and towards the end of the session was able to work on the tasks with minimal prompting by me. We talked about another visit, where we could discuss what Adam could do to get out and about more, and possibly see some people from his church.
We then sat down and I discussed with Adam how I could best support him. I summarised what we had discussed today and what Adam has told me is bothering him. He is not managing as well in his flat as he has done previously with his household routines and he says that this is because his carer, Sandeep, has left and he does not like his new carer. Adam is missing his mum who died last winter and who he talked with every day. He telephones his sister but this needs to be managed so that they both have time to enjoy these calls. He says he is feeling ‘sad’ and ‘lonely’. Adam would like the flat to be tidier, he wants help to go shopping to buy food he likes and that is within his budget.
We agreed on the following actions:
- I would speak to the care agency and try to establish a better relationship with Tony. If this could not be achieved then we would explore what other options were available. This might include looking into personal budget so that Adam could appoint his own carer.
- I would book additional visits from the agency to work with Adam to re-establish a routine in relation to, housework, budgeting, shopping, managing his post.
- I will ask the agency to visit tomorrow to go shopping with Adam so that he has sufficient appropriate food.
- I would speak to Adam’s sister Claire and try to establish a routine for phone contact which is acceptable to all parties and can be sustained.
- I will look into other ways for Adam to meet and talk to people especially during the winter months. I will come back in 6 weeks’ time to discuss options with him.
- I would call next week to make another appointment.
I shared my record with Adam who was able to agree the actions and I left him a signed copy. (PERSON-CENTRED)
I will also have a discussion with the home care agency to ask what action they were taking in relation to Adams deterioration in mood and living conditions and to ask them to report any future decline.