Decision Report 202408152

Summary

C complained about the care and treatment provided to their child (A). A was urgently referred to the Child and Adolescent Mental Health Service (CAMHS) following a crisis in which they absconded from home whilst awaiting an Autism Spectrum Disorder (ASD) assessment. They initially received input from a nurse via video calls, but this stopped when the nurse changed roles.

A was placed on a waiting list for psychological therapies and was prescribed fluoxetine (an antidepressant). An Autism Diagnostic Observation Schedule (ADOS, a tool used to help clinicians assess autism) was carried out but C was not given a copy of the report.

C complained to the board about a lack of therapeutic input and lack of medication review. A was reviewed by a consultant psychiatrist during the investigation of the complaints and C expanded their complaint to include concerns about the brevity and content of this review. The board responded to C’s complaint but their response did not address all the points of complaint and a further response was provided later. C was subsequently given a copy of the ADOS report.

We took independent advice from a consultant child and adolescent psychiatrist. We found that the care and treatment provided to A was not line with national guidelines. A was not offered therapeutic input in the form of psychological therapy concurrent with their medication as they should have been and the reviews of A’s medication were unreasonable, due to their infrequency, brevity and virtual format. We upheld this part of C's complaint.

C complained that the board did not respond to their complaint within a reasonable timescale. We found that the board's initial complaint response was far beyond the 20-working day timescale. Therefore, we upheld this part of C's complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to A for failing to provide them with reasonable care and treatment. The apology should meet the standards set out inthe SPSO guidelines on apology available at www.spso.org.uk/meaningful-apologies.
• Apologise to C and A for the failings in complaint handling. The apology should meet the standards set out in the SPSO guidelines on apologyavailable at www.spso.org.uk/meaningful-apologies.

In relation to complaints handling, we recommended:

• The board should ensure their understanding of the points of complaint at the outset of an investigation are correct and respond to complaints within 20 working days where possible. We offer SPSO accredited Complaints Handling training. Details and registration forms for our online self-guided Good Complaints Handling course (Stage 1) and our online trainer-led Complaints Investigation Skills course (Stage 2) are available at https://www.spso.org.uk/training-courses.

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.