Decision Report 201609200

  • Case ref:
    201609200
  • Date:
    November 2017
  • Body:
    An NHS Board
  • Sector:
    Health
  • Outcome:
    Some upheld, recommendations
  • Subject:
    clinical treatment / diagnosis

Summary

Ms C complained about the support her child (child A) received from the Child and Adolescent Mental Health Service (CAMHS). During a period of absence of child A's regular therapist, child A was transferred to a new therapist who was not trained in the approach that the first therapist had used. The second therapist then left the service, and Ms C was told that, if child A wished to wait for the first therapist to return, they would need to be discharged in the meantime. Ms C also complained that CAMHS did not provide support to child A in response to a recent traumatic event, or in relation to a decision about child A's future schooling.

In response to Ms C's complaint, senior members of staff met with her, and it was agreed that child A would remain a patient with CAMHS, but that support would be provided by phone to Ms C until the first therapist returned. The board sent a written response to Ms C's complaint five months after this meeting, which confirmed these arrangements and apologised for the tone of a phone call with the CAMHS team leader. Ms C was not satisfied with the response, or the board's handling of her complaint, and she brought her complaint to us.

We took independent advice from a psychologist. In relation to the proposal to discharge child A while waiting for the first therapist to return, we found that staff acted reasonably, and so we did not uphold this complaint. However, we noted that it would have been helpful for them to have discussed Ms C's concerns and explored alternative options to discharge at an earlier stage, as we found that this was only done in response to her complaint.

We found that, whilst it was appropriate for the therapist not to raise the subject of a traumatic event with child A, they should have raised this with Ms C separately in order to explore the issues and offer indirect support. We also found that, although CAMHS was not responsible for the schooling decision, they had agreed to provide an assessment to support this decision and that there was an unreasonable delay in providing this. We upheld these aspects of Ms C's complaint.

Whilst the board had already apologised for the delayed complaint response, we were critical that Ms C was not kept updated during this delay, and that the board's response did not address key points of her complaint. We upheld this part of Ms C's complaint.

Recommendations

What we asked the organisation to do in this case:

  • Apologise to Ms C for:
  • not providing support in response to the recent traumatic event
  • not completing the agreed assessment in time
  • failing to update her regularly during their complaint investigation
  • not responding to all of her points of complaint.
  • The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/leaflets-and-guidance.

What we said should change to put things right in future:

  • Where a recent traumatic event is reported in relation to a child currently under the care of CAMHS, the therapist should seek to provide support, for example by raising the issue separately with the parent/carer.
  • Agreed assessments should be carried out timeously.

In relation to complaints handling, we recommended:

  • Where a complaint response takes longer than 20 days, the complainant should be kept updated on progress.
  • Complaints should be responded to in full.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Updated: March 13, 2018