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06th January 2016

Books and Covers

Book cityWe all have a past, however, for some people, things that happened a long time ago can still have a bearing on how they are viewed today.

Every day or so, I receive requests via email to consider whether our service can offer a place to some or other individual needing residential care. Usually, a cursory scan of the paperwork can offer enough information to tell me if this is someone we might be able to accommodate. Sometimes, the information is pretty scant, so I respond and ask for more detail. Increasingly, I am seeing this as a very poor way of making an initial assessment.

It is probably jolly difficult for a placing officer to pitch the level of information just right. If you offer too little, providers will be unable to make a decision. Too much and you risk breaching confidentiality. Moreover, many people given the task of requesting expressions of interest have not even met the person they are writing about. The information provided may well be a sample of historical notes.


I was chatting with a colleague today who told me she had once encountered a man in long stay hospital who was described as having a criminal past. Having worked with him for a while, she found this increasingly hard to comprehend. He was a decent tempered chap, with no discernible challenging behaviour and she could find no reason that he was not moved out into community placement. Yet he remained in hospital because his case notes described him as an arsonist, so people were reluctant to take any chances.

On closer scrutiny of the case file, though, it turned out that this fellow’s story was not exactly clear-cut. Apparently, many years before, when he had first been admitted to the hospital, he had asked for something to eat, as he was hungry. When he was told no by the staff, he took it upon himself to go and make himself some toast. Unfortunately, operating the toaster was slightly outside his skill set and there was a minor fire in the kitchen. The subsequent incident report had been re-told many times and in the true spirit of Chinese Whispers, he had become far more of a miscreant that was actually true.


When I consider the reputations of many of the people I knew and worked with who spent large parts of their life in long stay hospital, it is a wonder that we ever managed to safely discharge anyone. Most wards had their notorious residents; the stories were lurid and colourful. You probably know some of these people today as fairly genial older people, with only an occasional grumpy mood to challenge carers. But back in the day they might strike fear in the heart of a raw student nurse.

If there is a moral (there usually is……) then it’s not to judge a book by its cover, or indeed a person by case notes or gossip alone. All of us are a composite of the history we have lived and the experiences we have had, so the only way to learn about someone properly is to know them for a while. This is a challenge when you need to make a decision on whether you can care for them safely, but unless you look at the person in the context of your service, you may not ever really know them well.

Ginny Tyler – QCS Expert Learning Disabilities Contributor

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