Ellie is a clinician with years of experience in hospitals, hospices and the community. Everything she does comes from a simple love of humanity, in all its mess and interest. And like all people skilled in their art, she practises it with a glorious kind of flow, intuitively adapting her stance to events, almost like a dance, making it look effortless and free. I’ve never seen her lose her temper. I’ve never seen her fail.

Which is why I’m glad we’re visiting Mr Coulsdon together.

There are so many exclamations, warning triangles and block caps on Mr Coulsdon’s record, it would be tidier if they simply replaced them all with a picture of a snarling beast and the words Here be dragons. Mr Coulsdon is notoriously, emphatically, tirelessly bad-tempered – a situation exacerbated by ill health, both mental and physical, of course, and his social situation. But it has to be said the starting point was maybe never that propitious.

Mr Coulsdon’s lounge window is just to the right of the entrance to the block. He has a tatty sheet permanently taped across it, bowed down in the middle. The TV is on full volume – Formula One, by the sound of it. We ring the bell a couple of times, but nothing happens.

‘He’s definitely at risk, so we’d better go in and see he’s okay,’ says Ellie. ‘A quick in and out. I’ll do the obs, you do the typing. How’s that?’
‘Fine by me.’
We let ourselves in using the ‘tradesmen’ button. His flat door is always open – taped up, dented, the scars of many forced entries in the past.

‘Hellooo? Mr Coulsdon? It’s Ellie and Jim – from the hospital. Come to see how you are…’

Other than a plain leather sofa in the far corner, the room is surprisingly, resonantly bare. No carpet, shelves or decorations, no pictures or home comforts. Mr Coulsdon is sitting in the middle of the room in an office chair, his bandaged, ulcerated right leg up on a stool. Just beyond it is the TV, cars screaming round a track. His foot is right in the middle of the screen, and you’d think Mr Coulsdon would angle things – the telly or the foot – so he could get a better view. But it’s hard to shake the idea that like a dodgy off-peak boiler, Mr Coulsdon will find a way of keeping the needle in the red.

‘Mind that!’ he snaps. I’m not sure what he means, because there’s really nothing to mind. ‘These people!’ he says, and links his fingers across his belly.

‘We won’t keep you long’ says Ellie, standing where he can see her, tilting her head on one side as if he’s the most fascinating thing she’s seen so far this morning. ‘How’re you feeling?’
‘How d’ya think I’m feeling?’ he says. Then he flicks me a sly glance and waggles his fingers in the air. ‘With my hands!’
‘Oh – that old chestnut’ says Ellie, putting her bag down. ‘Now then Mr Coulsdon. First things first. Can we turn the TV down a touch, please? Only I can’t hear myself think’
‘Who’s taken the bloody remote?’ he says, scratching his enormous beard as if he thinks it might feasibly be in there. He catches me watching him.
‘What’ve you done with it?’ he snaps.
‘Found it!’ says Ellie, picking it off the floor beside him and flourishing it in the air. The furious yowling of the racing cars eases up.
‘There! That’s better!’
‘For you!’ says Mr Coulsdon. ‘How long’s this nonsense going to take?’
‘Oh not long. Of course – you don’t have to have it at all if you don’t want.’
‘Well I don’t want it! All these people coming round here, messing me about. And nothing ever gets done!’
‘About what?’
‘This!’
‘What – the foot or your flat?’
‘The flat! The flat!’
‘What’s the matter with the flat?’
‘It’s a dump. A trash heap. I wouldn’t keep a dog here.’
‘It looks pretty tidy to me. Do you have people come round to help?’
‘If you can call them people.’
‘Well – look. That’s another matter. I can have a word with one of our social workers about it if you’d like?’
‘Social workers? Scum of the earth.’
‘I’m sorry you feel like that. I think they do a great job under difficult circumstances, Mr Coulsdon.’
‘Do you?’
‘Yes. Absolutely. But look – I’m not here for that. I’m here to do your obs and make sure your leg is okay. That’s it. I won’t if you don’t want me to, but I have to know you understand the consequences of saying no before we leave. Do you follow me?’
‘Jesus Christ! Just get on with it, will you? I haven’t got all day.’
‘All right, then. Thank you. Jim’s here to write the facts and figures down.’
‘Hi’ I say, perching on the edge of the sofa and opening the laptop.
‘I did wonder,’ he sniffs, his chair creaking dangerously as he shifts position. ‘I can see it wasn’t for his looks.’
‘No – you see? That’s what they call character lines,’ I tell him.
‘Oh is that right?’ says Mr Coulsdon. ‘I thought it just meant you were old.’