And that's Another Story

The Care Quality Commission released their report on homes run by the Castlebeck care homes firm. Following the abuses at their premises as exposed by Panorama, it comes as no surprise that many of the issues are systemic. The report on the home closest to us in Coventry makes especially grim reading: locked doors, visits by appointment, rules and restraint. More than ever, it should show us that hospital style services are an unacceptable model of long term care for people with learning disabilities (for anybody, probably).

Anyway, here's another funny old story I was thinking about:

It was a warm day in the 1990’s. One of those days when the kids are off school and everyone seems to be getting a train out of the midlands. That was what the five of us were doing; me and four people with learning disabilities*. Here we were, in the community, not very long out of the hospital and if we had the ‘care in the community’ look found questionable by some at that time, none of us minded.

 We were going for a day trip to the countryside and we were all excited. I was heady with newfound responsibilities, William was anxious that there should  be cake, Robin hugged himself not liking to be jostled by passers by, Richard wasn’t showing it but we all knew just by the jumper he had picked out he was up for a good time. Every group has a leader though, and ours was Maureen.  She had led the way out of the house, she was first off the bus, and I had held out a protective arm as she edged close to the edge of the platform.

The train pulled in, and our door was opened by a guard. People in front of us got on and I ushered our party together, worried about  Robin’s need for personal space. Maureen strode to the front of the queue, people giving way to the presence of an older lady moving with a sense of entitlement and a red handbag. I was about to board when the door slammed before me. I wasn’t too worried. I explained to the guard that we had become separated and could he let us on? Please? Oh but please?

The train was full and about to depart. No more room. All right then, please could he let Maureen off? Because as he could see, we were travelling together? Please? I was a carer for people with learning disabilities so he could understand…Please?

He blew his whistle, and the train pulled away in slow motion, going in the direction of Penzance carrying a woman who had never been to the corner shop alone, had no money and no verbal communication skills even if she has possessed a mobile phone that hadn’t been invented yet. William, Robin, Richard and Maureen were all waving. I wasn’t.

The station master was very understanding. Maureen was finally located just before Bristol. She had been sitting with two elderly ladies who had shared their flasks of tea and hadn’t thought to inform the guard of the presence of their new traveling companion. Some time later she was returned to us. My relief was overwhelming. ‘Maureen’, I exclaimed, ‘ are you all right? I’m so sorry. You must be hungry.’ She wasn’t listening to me though. She had opened her handbag and was fishing inside. Out came a package wrapped neatly in a serviette. She handed it to William, smiling. He took it, grumpy from waiting, but then beaming with gratitude. ‘Chocolate Cake!’ And so it was that his day at least had gone to plan.

*names and some details have been changed to preserve confidentiality.

Watch it and Weep

 Usually I aim for funnies on this blog, but not today, however good the latest episode of Richard Herring’s AIOTM  is. Today is for thinking about abuse, and how it happens, and even how it can be fed by the best of people. All of this was prompted by the Panorama investigation into a ‘hospital’ for people with learning disabilities, uncovering abuse that looks like torture from my place on the sofa. If you’re in the UK and haven’t seen it, have a look if you can stand it, but not just before bed.

The program raises lots of questions. Who abuses? Why? What about management? Regulators? Training? How to ‘manage people with challenging behaviour’? I don’t have the answers, but I’m ready to tell a story of abuse. It’s true, but names and places are changed for confidentiality.

It was the part of the ‘90’s before we had Brit Pop, football for the middle class, and laddism. No one I knew had a mobile phone or had heard of the internet. It was my first job as a support worker. I was on a challenging behaviour unit working with a group of men who because of their history of ‘severely challenging behaviour’ were the last to be released from hospital to the community. It wasn’t their own place though; it was officially hospital premises, led by nurses who had worked at the hospital. The support workers were local women some with hospital experience but most not, of whom I was the youngest. There was no induction or training, support workers were unqualified, gaining unofficial seniority through length of service or strong personality. We worked to a number of rules and routines that weren’t subject to question. I cleaned skirting boards twice daily and was unable to display the service users’ drawings because the notice board in their kitchen was for staff. Walls were putty coloured and chipped, furniture was vinyl upholstered, and there were no curtains. I had to face early shifts. There was a lot not to like, but from the first day I loved the men and their families and felt I had found my vocation.

Harold was one of the men I worked with. He would have been in his forties at the time, tall slim and muscular he was always active. His chief loves were to be outside scratching in the bushes with his tough fingers, or to follow staff about, joining in with what was going on chiefly by cheekily disrupting it. His speech comprised a few words he had made up, although he understood a bit more. There was a kindness about him, he could tell if someone was upset and would approach and attempt to cheer them up, ‘Awww’ he would coo, and then tug an ear and dart away laughing ‘ekky, ekky’. He exhibited the behaviours of people who lived at the old hospitals: a love of sweet tea and a fear of keys which before my time were brought down on the knuckles of people as punishment. Don’t get me wrong though, Harold was hard on the nerves when he pestered for what he wanted which was often difficult to determine. He was bruisingly rough and when focussed inwardly saw no danger or self-control. One time, he ran into a busy road unexpectedly after a leaf. Three of us couldn’t stop him, or persuade him to get up from his kneeling position as he turned it in his hands, precious as it was to him.

At the time, the senior management were looking for us to be seen to do more activities with ‘the gentlemen’ as they were called. This can be hard in learning disabilities work because people may struggle to concentrate for more than a moment, there can be issues of safety, there are never enough staff to take people out (or if there are, there’s no transport), and what with shift patterns and gossip and notes and meetings, well….. At the time, the patients’ money was tightly controlled to the extent that when the dentist suggested to me that one of them could be more independent in cleaning his teeth if he had an electric toothbrush I had to go to a panel with the dentist’s recommendation in writing and three quotes. Some of us began to cook with people, looked through books, did drawing, and turned things like cutting fingernails into manicures while the old guard watched in astonishment – what about the skirting boards? Some of those old timers, catching on to the new ‘activities thing’ had a brainwave. They revived the unused allotment area on the grounds of the unit. That way, they could get away for a smoke, grow a few potatoes, and need only take the ‘easiest’ of ‘the gentlemen’ with them. If I seem unduly cynical about all this, I will own that at least ‘the gentlemen’ got to eat organic home grown veg when it was only available from health food shops.

It had been a sunny afternoon. I had been working alone in the house while two of the older support workers had been up at the allotment without a service user. Sometimes it’s easier to do things for people, and John, who they might have taken with them, had stretched out on his bed when offered the activity ‘fk-ovv’. I didn’t mind. Harold and I had been cleaning (me the windows and Harold my arms), I had been singing line by line while he made up a chorus in rhythm ‘ee oo eea’. If I stopped he would demand ‘singy singy’ and we would go on.

The staff came back, one of the nurses arrived, there was chatter in the kitchen and tea to drink. A support worker had picked a bunch of cabbage and it lay in its roots and soil on the worktop. There was talk about the crop, and pride at the successful growing season. Harold had been listening in, leaning on the wall, unnoticed. Unexpectedly, he strode across the kitchen, pushing the women aside to reach the cabbage ‘ooo oooo mmm’. He clasped it to himself. At that time, emphasis was placed on teaching people things. Someone had picked manners, partly I suppose to get ‘the gentlemen’ better socialised, but also (and this had been made explicit to me) to get them to acknowledge the authority of staff. They should ask before they had things, thus Harold should have said ‘ple’ which was his word for ‘please’ and have pointed to the cabbage before picking it up. Immediately the shouting started, ‘Harold, Harold you give that back and say please…Harold put that down now…no, you can’t have it’. All three women at once, surrounding him with high pitched sound.

Harold held on to the cabbage that had come from his allotment, picked by his support worker for his dinner. There were no risk assessments then, but if there were, we’re talking a non-harm-causing, non-harm able cabbage. ‘Nah, nah’, Harold shook his head. The nurse assumed charge; she pulled at the cabbage, calling to the other staff to pluck his fingers to release it. Harold was screaming now, backed into the kitchen cupboards. Eventually, he threw the cabbage to the floor, shoving past us and running to the adjacent living room.

Kitchen and lounge were linked by a serving hatch with doors that we normally kept closed. The lounge was the nicest room in the house, it had the TV, vinyl sofas, a coffee table and a dresser. Room length patio windows led on to the grounds that went downhill to a stream and weeping willows in the valley. Harold began to pick things up and tap them, first a book ‘na na na’ in a sing-song voice like Three Blind Mice, tap tap tap. The nurse pursued him telling us to stay where we were as she would ‘make him behave’. Harold went for a brass ornament, banging it louder, still singing, then the end of the coffee table. Things by now were looking risky, and we all knew from past experience that Harold would not now easily be calmed. The nurse, still shouting at him to put things down and behave began to pass things to us through the hatch. It was a room of few knick knacks, soon emptied. Harold rushed about looking for things he could bang ‘nah nah nah’, bang bang bang. Having run out of things, he tried to leave. The nurse barricaded herself and Harold into the room using the sofa.

Still more distressed, spit flying, his head tilted upwards, Harold began to spin on the spot, He was caught up in his rhythm now, oblivious to calls, and to the nurse's attempts to hold him still. I remember his sudden movement, but not what prompted it. He made a last attempt at the blocked door, shifting the sofa a foot then turned and ran at the patio door, punching his hand through the glass.

Time slowed down as it shattered (it wasn’t safety glass), shards holding in place as he pulled his hand back and looked down at it, a six inch cut bleeding heavily . Then, he sank to the floor, holding the hand as he had first held the cabbage ‘ekky, ekky bad ba’.

While Harold was at the hospital getting his stitches, we sat down to write our witness statements. I wrote what I was told to, with the story starting at the door to the lounge and omitting the sofa barricade. It was concluded that ‘that’s Harold and it couldn’t be helped’.

I learnt a lot, but I’ll leave you to your own analysis.

The window was repaired before Harold’s hand, the glazier told me he had been out twice before when patients had put them through and he always replaced the broken ones with safety glass. There were twelve panes in total. I had enough courage to ask the boss if all of them could be replaced to save further injury, but was told they could not and that ‘the gentlemen will learn from their experience’.

Harold healed (slowly because he was forever removing the bandage to look at the cut, bad ba), and I moved on. I kept in touch for some years after as his team changed around him. Before long, all of the staff bar the nurse (who now worked on another ward) were new to me. The place got curtains and fresh paint, better food and carpet. Harold got a holiday photo out of his pocket to show me. One Christmas, a nice member of staff asked me where the scar came from. She held it out to me as she did so. He snatched the hand away , running a thumb across it soothingly ‘bad ba ba’.

3 in 1 Socially Motivated Post

As with busses, you wait for a blogging opportunity and then three come along at once. And here the analogy ends because, I can tap all three into the keyboard. Not much of a common theme, but hang with it because there’s going to be a call-back.


The Mental Health Nursing studies have started to go quite well. I’m getting to grips with the timetable, haven’t been in trouble at the library for a week, and have got myself some people I sit next to in lessons. So far there have been basic practical skills like hospital corners and bed-baths, some social theory around oppression, and more specific Mental Health Nursing discussions on history, roles and the user movement. Today was an introduction on law relating to mental health. I wasn’t expecting to be troubled. The little-bit –dull lecture had been going almost an hour when it happened. The exposition on treatment without consent. The lecturer, in a matter of fact way described several people holding down a patient so that they could be forcibly injected with medication lasting anything from six hours to six weeks. There was an aura of suppressed glee in some areas of the room, lots of questions and comments on the need for people to be made to have the treatment that was good for them, lots of enthusiastic nodding that people who have committed no crime can be detained for up to a year at a time. I should add that there are measures of balance as decisions can be appealed.
Walking home in the near dark afternoon, I thought about my career in learning disabilities. I have been trained several times in the art of ‘restraint’ (the restraint of others, not the self). To build a career quickly, I worked with people regarded as the most challenging, the ones known to assault staff. As a manager, I was called in to help people in crisis. Here’s a confession then: I have never restrained anyone. There were times when I had the option, even times when doing so would have met with the agreed care plan. I never did. I distracted people, placated them, persuaded them, gave them space and gave them time. Sometimes people ran off and were brought back by the police, the sight of the uniform having a calming effect. Why did I opt for personal restraint rather than restraining? Partly because I saw an incident early in my career where a member of staff took issue with a service user over a cabbage (yes, you read right CABBAGE, I’ll tell you about it someday) and I thought her actions distasteful and counterproductive. Partly because I found my other tricks were effective enough. Here’s a confession though: I think it was mostly because I’m a coward.
So now I’m left to question. Could I ever hold someone down so they can be injected? Could I ever give the injection? Answers on a postcard please.....

On a different topic, I’ve fallen heavily for the music of Chris T-T. He strikes me from Twitter and his blog as a clever man who knows his politics so much better than my wishy-washy leftwingyness. Anyway, he has made a remarkable playlist of protest songs on Spotify. A real treat with loads of stuff I haven’t heard before, and stuff that reminded me of former times. In the grim circumstances of anti-social reform in which we find ourselves I find protest songs heartening somehow. They provide a bit of a ‘you’re not alone’ feeling if nothing else.

And finally.......following the Craftivist patch, some of you have asked me about the homeless people who Nina works for and who I sometimes give stuff to. I’m trying to get some things together to make up a little Christmas Parcel for each man (at the moment there are no women coming in). Nothing fancy, just hats, gloves, socks, toothpaste, shower gel, shaving things, biscuits and sweets. The pound-shops have some useful things at the moment. About twenty people are supported so I can’t do this alone. If you would like to offer anything, this would be appreciated. If you want to give money, I will pass this on to the centre so that it will be spent on things people need. Warm used clothing in small to medium men’s sizes, blankets (not duvets thanks due to washability), and serviceable shoes/trainers are always welcome too. I can collect from the Coventry area. Please get in touch if you are able to offer anything. Giving feels good.

Did I mention a call-back? Oh bugger.

As It Occured to Us

Monday 16.11.09

For weeks, I've been hankering to see Richard Herring's As It Occurs To Me live. It aims to have the qualities of a radio show without the censor, is recorded live and goes out as an unedited podcast. I thought he made a disappointing start, but it came on leaps and bounds and I love it. Nina took pity on me, or perhaps got tired of my whinging, and offered to take me to London for my Christmas prezzie to see the show.
We had a good trip down on the coach. I was confident enough about the travel sickness tablets working not to overdose on them as I did last time, although I still slept on the coach and was dozy for an hour afterwards. we were in very good time for the show and killed an hour or so walking about Chinatown and Theatreland looking at the lights, the people, and the fabulously decorated sponge cakes in the window of the Chinese bakery.

I had spotted a homeless man partially hidden in the shadows of a doorway opposite the Leicester Square Theatre and, as we approached him on our second circuit, although he wasn't asking for money, I offered him a couple of pounds. He had some cans lined up but seemed quite sober and sane, telling us in an Eastern European accent that he stayed around here because it was close to the church, telling us about his faith and how he would prey for us. It was a nice interaction, and we said goodbye and walked on. Nina asked me why I stopped in the first place and I tried to explain that although when I was young I would have said that it wasn't right to give to beggars and that the only way was to support charities, I no longer feel this way. I had eaten and thought that the homeless man might like to, but if he wanted to drink, then a couple of quid would make no difference to his addiction and might take the chill off. We talked about the rights and wrongs of this for a while, and came back full circle again, about to go into the venue.
It was then that the homeless man called us over. He began by saying that he had been thinking since we had been gone and had said to himself "Why did I not ask this question?". He asked if we had some time and I said that we needed to get going but would see him when we got out. He kept us talking and said he only needed a minute and would ask now. Nina and I looked towards each-other, both of us thinking he was going to talk to us about religion and that this would be awkward. He took a deep breath, and looked at Nina,
"You, I think, are too young." now looking at me, "But you, I say to you, I am a very sexual man but look for love also".
He went on for a minute or so with both Nina and I too stunned to speak. It was the first time anyone has proposed marriage to me (I proposed to Nick, but that's another story). Here I was on a street around the corner from Leicester Square being proposed to by a virtually sober, almost clean, homeless man. It was awkward, and funny, and sad. Where were my liberal principles now?
"So, what I ask is how you are fix?", he said.
I explained that I was married. He looked crestfallen and was apologetic. I tried to be as nice about it as I could. We said goodbye hurriedly.

As we went into the theatre, Nina pointed out that nothing we heard tonight would be as funny. She was correct. We talked about it and giggled about it. At her suggestion, we put our hands up during the audience participation part of the show, and it got a big laugh from the audience. Clearly, we were only willing to go so.. far in our bid to help the homeless. Had I not have been married, it might have worked though. A genius solution to the problem of vagrancy, well done that tramp. He wasn't there as we came out. It was just as well.

Waiting for the midnight coach at Victoria, a middle-aged besuited Asian man was eyeing Nina up. He moved seats several times so as to get a good all-round view. We resorted to laughing over this too, I asked Nina if she was merely jealous since he hadn't yet proposed.

Here's the podcast, we are 33.5 minutes in to episode 5:
www.comedy.org.uk/podcasts/as_it_occurs_to_me/
but listen to the whole thing and ten subscribe on itunes because it is excellent.

Snogging the Bus Driver

Friday 30.10.09

After I said 'Goodbye' to all that, it felt too sad to talk about the good bits. I'm talking about the twenty or so years that I worked with people with learning disabilities. Irrespective of my eventual disenchantment with the profession, I always loved the people. I don't think about it much now, but every so often, something catches my eye, or someone says something, and it gets me remembering. This time, I've been prompted by Richard Herring's blog entry, and more so by the Collings & Herrin podcast (of which I'm mighty fond, you should try it) in which Richard's cinema experience is altered by the presence of a young man with a learning disability.

There are enough years between then and now to put the person in my true story beyond identification, but I'm changing the name anyway.

We were getting the bus and I'd never got the bus before. I was a new support worker when the term 'support worker' was new. Before then there were 'care assistants' and there were 'nurses'. Care assistants were for hospitals, and we were all in the community now, except that home for John was still a health setting. It was universally agreed he was better off though. He lived in The Bungalow which was attached to an NHS Respite Unit for people with learning disabilities in a small town. He had two housemates. They didn't get on, but had been placed together because before they were admitted to hospital as children, they had lived in that small town. In the hospital, John had lived on a ward with upwards of twenty other men. His mother later told me that he had gone in at the age of eight. He was in his forties when he came out in 1993, that's around my age now.

I came into the profession as the hospitals were closing so although I visited plenty, I never worked in one. A nurse I worked with said at the time that it was a shame I would never have the chance as they provided such good experience, by which she meant training experience that would have me toughened up and got my expectations in order. She liked me and meant it kindly.

Some months later, she asked me to gather some of John's history from his parents. John's mother had sent him to the hospital on the advice of her doctor. All of her children had been affected by the same unidentified genetic condition, John was the youngest and most disabled so with no alternative help available, they had to let him go. The family made the difficult sixty mile round trip to see him once a month. Before he was admitted, his mother bought him new shoes. On her first visit, John wasn't wearing his new shoes, he was wearing worn out boots that were the wrong size, also they were odd ones, two lefts. When she asked about it, she was told it couldn't be helped. All of the shoes were put into a box at the end of the day. The more able patients put on shoes for the less able. If they couldn't identify the correct shoes, then they got what they were given. It didn't matter though, they didn't walk far, just to the dining room or around the wards or to the social centre on site. There was no-one to see. All of this is off the point except to say that knowing about it makes the bus trip seem a bit special.

Previous to this job, I had worked with people with learning disabilities in supported employment. I had interviewed well, and was enthusiastic, but I never asked to look around. Induction day was a big shock. I had no experience with people who couldn't speak, or use the toilet, or who collected spoons in their pockets to put under their pillows at night, or who might move quickly to pick up and swallow a discarded cigarette butt.

By the time of the bus trip, I'd been 'on The Bungalow' a month. I liked John. He had ways of entertaining himself that fascinated me. I got him some felt tipped pens, and he would spend a long time drawing dots and short lines from the centre of the paper outwards in different colours so that it looked like a planet exploding. I would take the lids of the pens off for him as he chose the colours from the old chocolates tin. When he was absorbed, he would make a cooing noise through pursed lips. Once he was finished with the drawing, he would press it into my hands with his very strong fingers, then walk away.

Books were John's other thing. He looked at books in a way I had never seen before, not to see words or pictures, but for the exercise of turning the pages. The staff would get Argos catalogues for him, or help him spend his 'pocket money' on magazines (over the years I was to learn that loads of people with learning disabilities are soothed by Argos catalogues, I often wonder if the company is aware of their charitable act in supplying them for free). If he got cross, it was usually because he couldn't understand what was wanted of him. If he couldn't walk away, he would hit out with the palms of his hands, the kind of slaps girls do to each-other when playing clapping rhymes, using both hands at once with little power behind them, no malice intended. On these occasions, he could be distracted and pacified with the offer of a 'book'.

There was one thing he did to entertain himself that I never got my head around. At first I asked a few people about it, but I don't think anyone else was interested, one worker I asked said she found it 'creepy'. I found her scary, so each to their own. John would kiss. He wouldn't kiss people, although he would hug hard if allowed. His love was for cool, smooth, hard surfaces. He would kiss walls and especially windows. For hours on end, his lips would pucker up and he would press them close. No tongues. The bungalow had big patio doors that were ideal for his purposes. He quite liked to run his cheek along them too, but kissing was best. It was a sensory, maybe sensual thing, but not a sexual act.

The bus then. A nice community activity, using public transport, that could be 'written up' later in the 'notes'. I was a bit nervous, not of how John would be, but of the mechanics of getting a bus in the unfamiliar town. The wait at the bus stop went OK, we got on and I was told the meaning of 'please have exact change ready'. We sat down and John was spellbound by the movement and colour of the day. We got off after some other passengers, I was looking ahead, leading John by the arm. I felt him snag on something, and thinking he might have hold of the handrail, I gave a tug. No movement. I turned around.

John had locked the driver in a one armed embrace and was snogging him. He had caught the man half on the mouth, half on the cheek and was cooing softly. Presumably aware that I was asking him to get off the bus, John was dragging the driver over the door that separated him from the passengers, over which only cash and tickets were supposed to pass. 'S'awright mate, awright' the driver said, white faced and trembling, attempting to disengage. I was profuse in my apologies, but ineffective in getting John away. It was a long moment before John got fed up enough with my interference to give me one of his two handed slaps. I took my chance to pull him off the bus quick. The driver slammed the door with what might have been interpreted by the romantic heart as ungrateful haste.

I carried on supporting John for a couple of years, learning many things from him, not least of which was; if you get the chance of a snog, hold on tight and make the best of it.

Richard Herring's blog is here http://www.richardherring.com/warmingup/warmingup.php?id=2553

And the excellent Collings & Herrin podcast can be downloaded here (or subscribe to itunes)

http://www.comedy.org.uk/podcasts/collingsherrin/

Thursday 30.4.09

Nina and I stopped for a quick tea in McDonalds Birmingham this evening. A man was sitting near to us. He wasn't at a table, but perched on a low wall. Young, with designer stubble and fashionably collar length hair. They were the handsome features that merited a second look, the incongruities about him merited a third. He was wearing a mod-style suit, with worn office shoes, thick grey sports socks showing. He had a bulging box briefcase propped up against a bulging black bin-bag. There was a stillness about his limbs, but his eyes and lips were restless. It was as though he was hanging on to his dignity through those vestiges of a professional life that maybe he once had, or aspired to have.

As we ate, my eyes returned to him. I watched the faces of the customers who noticed him, and thought of my own reaction, the alertness that a little fear brings, the weighing up of threat that happens when we meet madness. He didn't seem to notice anyone, too focused on his inner voices. I thought about inviting him to sit with us, but I didn't. Nina and I were talking about the cold, steady rain and had decided to get a taxi to avoid a ten minute walk. On the way out, I had a fit of concern that the staff would eventually send the man out into the rain. Just about able to communicate over his other voices, we got him some tea, a burger, and left the change to keep him topped up for the evening. He looked relieved, as though the hot drink was a great gift. I suspect that he was beyond ordering for himself, and that the coins may have been useless to him.

Back in the late 1980's I had a good friend who showed me her workplace, a huge mental health hospital in Leeds, then still open, but earmarked for closure. The wards were bare, echoing and cold. Walls the colour of chewed white bread. It was not a good place. I wasn't to know it, but a few years later, I would begin my career working with people with learning disabilities. I would see around a number of similar hospitals, all of which had been made smaller and had been improved by the means of decorative wallpaper borders. I learned about the biggies of mental health: depression, mania, manic-depression (which was renamed bi-polar disorder), and the hearing of voices that is schizophrenia. The learning disabilities hospitals closed after the mental health hospitals, and although they had to wait, people with learning disabilities had and continue to have a better deal.

It was always my contention that the language of the socio-medical professions aside, (and I'm not anti-choice or empowerment or client led services) people often need to be looked after. To have someone around to help us to get clean, eat a good meal, keep house, find things to do, find a place in society, we all need help with this some of the time, and some of us will need it for a long time, or all of the time. This tends to happen for people with a learning disability, perhaps because there is less distrust of them as a group, and greater public sympathy. There is monitoring of people with mental health problems, but a lot less care. Where caring doesn't happen, people sit in dirty ragged clothes, in places they shouldn't, hungry, cold, tired, talking to themselves. Strangers fear them, and because they are hard to get to know, everybody is a stranger. It was a sobering thought to me that the young man we met was just a year or two older that Nina's boyfriend, and looked a little similar to him. It can happen to any one of us.

We got to The Rainbow for Sam Isaac's gig. It's grotty in the way that I'm partial to, and the band area is a lean-to rigged to the back of the pub. The incongruities begun by the man at McDonalds didn't end. One of the support acts had an exceedingly odd country-western style set of songs, sung in a midlands accent. I can't say it was pleasant. Neither was being chatted up by the barman (well, once was Ok, but by his third attempt, I felt the need to run away). Sam Isaac is my favorite of indie performers. The band are really together and look good on stage. Sam's songs are intelligent and interesting. I especially like the chiming quality of the percussion. The turnout tonight was disappointing, and the music was spoilt by the sound engineering which can be summed up as turning everything up to full volume. My ears are still ringing and my sternum has only just stopped vibrating. I look forward to Sam's new album, Bears. Look him up on youtube, you'll like him.

We got back to the station to find that the train had been replaced by a bus. It took a long time to get home, but yes, we did have a home to go to, and I had the arms of someone who loves me to rest in.