Not upheld, no recommendations

Summary

Mrs C complained about the care and treatment her late husband (Mr C) received from the practice in the final months of his life. Mr C died after a period of illness and Mrs C felt he did not get the level of care he required as his health deteriorated. In particular, she raised concerns that her requests for GPs to attend were ignored despite Mr C having been very ill and in a lot of pain. Mrs C was also unhappy that the practice recorded the cause of Mr C's death as dementia, as she considered that he had shown signs of many other illnesses.

We took independent advice from one of our GP advisers. Our adviser considered that the practice provided a reasonable standard of care and treatment to Mr C. She said there was a good level of multi-disciplinary involvement, particularly in the last 24 days of his life when he had multiple visits from a range of clinicians. She also considered that the recorded cause of death was appropriate, advising that Mr C's deterioration was consistent with the decline exhibited by patients with dementia. She acknowledged that Mr C had other illnesses that could potentially have been listed in part 2 of the death certificate. However, she explained that this part should not be used to list all conditions present at death but rather only those felt to have directly contributed to the death. She noted that this was a matter of clinical judgement and considered that the practice acted reasonably, and in line with national guidance, in this instance. We accepted the advice we received and did not uphold these complaints.

Summary

Mr C complained to us that his medical practice had failed to diagnose his heart condition. We took independent advice on this complaint from one of our medical advisers and found that there was no evidence in the medical notes that indicated that the practice had failed to follow up on the symptoms Mr C had reported. There were no recorded symptoms of possible heart problems and so we did not uphold the complaint.

Mr C then wrote to us to complain that some of his consultations with the practice had not been recorded accurately. In view of this, we decided to reopen the case to investigate his complaint that his medical records were inaccurate. We obtained a full historical print out of Mr C's computer record from the practice and considered this along with the information he provided to us. However, there was no evidence that the practice had altered or deleted any of the records of the consultations that he had referred to. Our adviser also considered that the GPs had acted reasonably in summarising the consultations in the computer records. In view of all of this, we did not uphold this complaint.

Summary

Ms C attended A&E at Borders General Hospital in September 2013 with a painful knee following a fall. She was treated conservatively (a non-surgical approach) and underwent physiotherapy. Ms C fell a further two times and in April 2014, she was referred to a hospital in another board area for specialist advice. The specialist there diagnosed her with an injury to one of her ligaments and performed reconstructive surgery.

Ms C complained that healthcare professionals failed unreasonably to diagnose her condition until she was referred to the specialist. She said this meant she did not receive appropriate treatment within a reasonable time and that corrective surgery should have been undertaken a year earlier. As a result of the board's failures, she told us she had periods of immobility, and financial and social difficulties, all of which had a negative emotional impact on her.

After taking independent advice from our medical adviser, we found that the clinical picture was complex and, in the circumstances, the initial assessment was reasonable. We also found that it was reasonable to manage the injury conservatively and that she was referred to a specialist within a reasonable time.

Summary

Mrs C complained that after her late husband (Mr C) was admitted to Crosshouse Hospital for surgery in October 2013, the care and treatment he was shown were inadequate. In particular, she said that he was discharged too early and with inappropriate follow-up. Later, after he had been admitted again (in January 2014) for further planned surgery to create a stoma (a surgically made pouch outside the body), he was not provided with timely or appropriate treatment. She said that it was as a consequence of these failures in his care that Mr C died.

We took independent medical advice from a consultant general and colorectal (bowel) surgeon and found that on the day of his discharge in October 2013, Mr C was reported as well and that his discharge was reasonable. We also found that arrangements were made to see Mr C again in six weeks' time, which was common practice for follow-up in similar circumstances. Afterwards, when Mr C was admitted again for the creation of a stoma, it was found that part of his small bowel was sticking to a surgical connection which had been formed during his operation the previous year. As soon as this was released there was a leak of faeces which caused a serious infection which required an operation the next day. There had been no evidence of a leak until it became apparent. Despite appropriate and timely treatment, Mr C did not recover from the infection, and he died in March 2014. We did not uphold Mrs C's complaint.

Summary

Miss C was a self-funding postgraduate student who decided to withdraw from her programme after facing some personal difficulties and feeling depressed since moving to the university. She complained that the university had not given her support, had not made the process of withdrawing clear and had not agreed to the refund of tuition fee she requested. We considered the correspondence between Miss C and the university, internal correspondence in the course of the university's investigation, and the policy on tuition fee refunds. We found that the university had thoroughly investigated Miss C's complaints and considered new issues that arose through the course of Miss C's withdrawal and complaints. The university clearly explained why they upheld some complaints and not others, and appropriately identified ways their service and communication could be improved. The decision not to refund the fee was taken in line with the university's policy and reasonable consideration given as to whether her mitigating circumstances were exceptional.

Summary

Ms C complained that Business Stream or Scottish Water had rejected her claim for compensation following damage to her business's property. We explained to her that our role in complaints about compensation claims was very limited. For example, it was not for our office to establish legal liability or decide whether, or how much, compensation was payable. We could solely consider whether her claim had been reasonably considered.

Scottish Water were involved in the issue as they own the public water pipework network. However, Business Stream were also involved as Ms C's licensed water provider. Therefore, we considered the actions of both organisations.

We concluded that both Business Stream and Scottish Water had looked carefully into the issue. For example, Business Stream had put a number of enquiries to Scottish Water about the events and the claim decision. And Scottish Water had considered the circumstances in detail before reaching their decision, which was that they had no legal liability, which meant that they had no requirement to pay compensation. In the circumstances, we did not uphold the complaint.

Summary

Mr C owns a substantial garage, which he used for storage but that was formerly used for a business. It had no toilet or kitchen facilities but there was a stopcock at the entrance. He was charged for drainage of rainwater from the roof but not for water services. However, in 2014 Business Stream sent him a demand for payment for the provision of water there. Mr C said that after Business Stream visited to verify his information about the lack of facilities, he made enquiries about permanent disconnection of the water supply. A few days later, a contractor called and fitted a meter, although Mr C said he explained that what he wanted was disconnection. He told us that he was asked to pay a fee to proceed with disconnection, but Business Stream then sent him an invoice seeking a further, larger, payment for it. Mr C complained that Business Stream failed to give him prior notice before a water meter was fitted and that the proposed charge for disconnection was expensive for what was required.

We found from our investigation that Mr C had initially applied for a reassessment of charges, which is for the installation of a water meter if possible, before he applied for disconnection of the water supply. There was no record of him changing his mind about having a meter fitted before he applied for disconnection, and we did not uphold the complaint as we did not find evidence that Business Stream were required to give prior notice.

Summary

Ms C told us that other houses in a similar or better condition than her own were included by the council on a programme of works and were re-rendered and insulated. She complained that her home was not included in this programme of works and was not upgraded. She told us her home was non-standard construction and was very hard to heat.

The council said the purpose of the improvement programme was to make sure that their housing stock met the Scottish Housing Quality Standard (SHQS). They instructed a surveyor to carry out a visual inspection of all housing stock so they could identify properties which might fail to meet the SHQS. The surveyor found that Ms C's property was not one of those which failed to meet the standard. It was not, therefore, included in the programme of works.

When Ms C raised concerns about the outcome of the survey a member of the council's capital investment team, who were responsible for the upgrade programme, inspected Ms C's property again and reached the same conclusion, that the property needed a few repairs but did not fail the SHQS.

Summary

Mr C complained about the council's role in relation to a housing development in which he had bought a house from a developer who was no longer trading, and with no completion certificate. Mr C complained that the council had not ensured that the access road met the approved plans or building regulations. He also questioned whether a fire engine would be able to access his house, and was unhappy that the council would not survey the road to check its width.

We reviewed the evidence and could see that the relevant building regulations had required a minimum road width of 3.7 metres. In addition, the council had acknowledged to Mr C that the approved drawings specified a width of 4.0 metres. However, the council said the road's adequacy would have been considered when they granted completion certificates to the development's other properties. They said their surveyors would not have needed to measure its width and this was a matter of professional judgment.

The council provided us with copies of Scottish Government guidance relating to the building standards system. We considered the guidance and it indicated that the council do not stand behind a developer's work, nor is it their role to ensure it is done to an owner's satisfaction. The evidence showed that the responsibility for compliance was not the council's and did not point to maladministration by them. Their role was not as extensive as Mr C might have wished it to have been and we did not uphold his complaint.

In terms of Mr C's second complaint, the council told him that the building regulations in place at the time did not require them to consult with the fire authority. Although Mr C felt best practice would have been for the council to have done so anyway, they provided evidence to show they had recently arranged for the fire service to attend the development. The fire service had confirmed they were comfortable with access in the event of an emergency and that they had no concerns. In light of the assurance the council had obtained - and the fact the evidence indicated that the duty to comply with the building regulations was not theirs - we did not uphold this complaint.

Finally, the council confirmed to Mr C that they had checked the size of the refuse vehicles that accessed his property, and their correspondence clearly showed that the fire service had accessed the development and had no concerns. We found no evidence of any administrative failing by the council in terms of checking the width of the road.

Summary

Mr C complained that the council had failed to ensure that a properly accessible manhole cover was installed (in line with the approved drawings) at the development where he had bought a house. He also felt they had failed to confirm that the surface water drainage satisfied the approved plans and that his house's roof construction met the correct standards. Mr C had bought his house without a completion certificate being in place and he was unhappy at the steps the council had taken with the development.

In considering Mr C's complaints, we took account of the extent of the council's role and obligations. The evidence they provided – including Scottish Government guidance on the building standards system - indicated that it was not their role to effectively supervise the development or to ensure compliance with plans or drawings. In addition, the fact that the manhole cover was missing years after the development was completed did not, by extension, mean it was never in place. Although we could not confirm from the paperwork whether the manhole cover was ever in place, the evidence showed that the council's role was clearly less than Mr C had expected.

In terms of Mr C's second complaint, the council said they were not required to test the development's surface water system. They also said that this would not be part of the final inspection following an application for a completion certificate (noting that there had been no such application for Mr C's property). Mr C had indicated that the drainage system had actually been working successfully and the evidence again pointed to the council's limited role. Although his concerns were clear, there was no evidence that the council had done anything wrong.

Finally, the council told Mr C that enclosing the eaves of his roof was neither required under building regulations nor part of a final inspection. Rather, a roof would generally be visually inspected from ground level, with an intrusive inspection possibly following if the council felt it necessary. In light of the council's limited role with the development, we considered it clear they were not responsible for the quality of the builder's workmanship.