Not upheld, no recommendations

Summary

C complained about matters relating to their mail. A letter sent to C was retained by the Scottish Prison Service (SPS) for the purpose of testing because the item of mail was thought to be suspicious. The mail was tested using the rapiscan itemiser (a machine used by the SPS to trace and detect a broad range of illicit substances). C’s mail indicated a positive result for an illicit substance.

C considered the testing procedure was not carried out properly. In particular, they believed that the mail item was cross-contaminated due to inappropriate handling. C also considered the SPS failed to provide an appropriate explanation as to why their item had been identified as being suspicious.

The SPS explained that testing of suspicious incoming mail was in place across the prison estate and was an important process ensuring the safety of both prisoners and staff. The equipment used was the same in all establishments and was calibrated to detect significant amounts of illicit substances. The scan of C’s letter had indicated for a specific illicit substance. It was also noted unlikely the letter would have been cross-contaminated.

We looked at the SPS’s standard operating procedure and we considered the prison rules. We were satisfied that the SPS handled C’s mail appropriately, in line with the relevant standard operating procedure. Whilst recognising C’s concerns about cross-contamination, we considered the SPS’s response on this point reasonable. In relation to C’s complaint that the SPS failed to properly explain why their mail had been retained for testing, they were particularly concerned that the SPS had not given detail as to why the mail was deemed as suspicious. We were satisfied that there were reasonable grounds for the SPS to deem C’s mail as suspicious. Whilst it would have been good practice for the SPS to have explained to C at the time that specific details of their suspicions could not be shared, we accepted that providing C with a detailed explanation could have potentially compromised the security of the process. Therefore, we felt it reasonable the SPS did not fully explain to C why their mail was deemed suspicious. As such, we did not uphold C’s complaints.

Summary

C held Power of Attorney (POA, a legal document appointing someone to act or make decisions for another person) for their parent (A) who moved to a care home. Due to their level of capital, it was determined that A would be self-funding their accommodation. C requested a reassessment for funding towards care home fees as A’s savings had reduced to the required threshold.

C provided the evidence required to show A’s income and expenditure to social work and was informed that A had been overspending on items other than care costs. The council determined that there had been deprivation of capital (where someone has spent or otherwise reduced their capital at least in part to avoid paying that money towards care home fees). This meant they would not contribute towards A’s care costs. By the time C was informed of this, A’s finances reduced significantly and had accrued debt.

C complained to us that the council’s view that A had deprived themselves of capital was unreasonable and also that the council had failed to provide adequate information about reasonable spending and deprivation of capital.

We took independent advice from an appropriately qualified social worker. On reviewing the council’s records, we considered a reasonable approach had been taken to the financial assessment and that the conclusion reached was reasonable, as there was clear evidence that A’s spending had not been consistent with their spending in previous years. We also considered that reasonable information had been provided about deprivation of capital and made clear that it was the responsibility of a POA to understand A’s financial obligations and that the council did not have responsibility to provide financial advice.

As such, we did not uphold C’s complaints.

Summary

C’s sibling (A) was being treated in hospital after being diagnosed with a brain tumour. C complained about social work involvement in planning for A’s discharge from hospital. C believed the home environment was unsafe for A, and thought the council should have made alternative arrangements for A’s accommodation on discharge. C also complained about the communication with C and C’s sibling (B) regarding discharge arrangements for A. C was dissatisfied with the council’s complaint response, and brought their complaint to us.

The council said that they had acted in accordance with the relevant legislation. They noted A consistently expressed a wish to be discharged home to their family, and the council undertook a number of tasks to improve the home condition prior to A’s discharge.

We took independent advice from a social work adviser. We found that the council had provided an appropriate care and support plan for A. We noted C’s concerns about A’s home environment, but considered that the council had worked to minimise the risks to A of returning home. We considered that the council had met their obligations in respect of A and we, therefore, did not uphold this aspect of C's complaint.

With regard to the complaint about communication, the council acknowledged some of their communication with the family could have been better, and apologised for this. We noted that although C said they had Power of Attorney (a legal document appointing someone to act or make decisions for another person), this had not been registered with the Office of the Public Guardian and therefore gave them no authority to act on behalf of A. Although C and B had no legal authority to be involved in decision-making regarding A, we noted that the council had worked to involve them. We recognised this was a complex and difficult situation but we did not uphold this complaint.

Summary

C complained about the care and treatment their parent (A) had received from the board. A had a terminal cancer diagnosis and severe arthritis. C complained about a series of admissions A had to hospital. C said A had been discharged without C being consulted, even though they were A’s main carer. This meant A was discharged to a potentially unsafe environment, and did not receive the necessary levels of care.

C said A was readmitted to hospital. A was then discharged to a care home, but was not provided with oxygen. C said that A had required oxygen in hospital and the failure to accept that A required long term oxygen support or to provide A with oxygen meant that A required a further hospital admission.

C said that when A was readmitted to hospital, they received substandard care. A was put on a busy ward, that did not specialise in palliative care or geriatric medicine (medicine of the elderly) and that this type of care was only provided once C intervened.

We took independent advice from a consultant geriatrician. We found that A’s discharge planning was carried out to a reasonable standard. A had capacity and the board’s actions took into account their wishes and included a reasonable assessment of A’s home environment.

We found A was very ill during their final admission and that at times A was dehydrated and eating very little and that this would have been very distressing for C and other family members to have witnessed. We noted that dehydration and low food intake were a common feature of this stage of A’s illness and were not evidence of neglect on the part of staff. We found, based on the advice we received, that communication with A was of a reasonable standard and that their pain and condition was monitored and acted on appropriately.

In terms of A’s discharge without oxygen support, we found that staff gave appropriate consideration how best to manage A’s low oxygen saturation levels and that on discharge A’s own preference was a factor in the decision to discharge A without an oxygen supply.

We did not uphold C's complaints.

Summary

C complained on behalf of their child (A). A attended their GP practice and A&E at University Hospital Hairmyres on a number of occasions before examination by a physiotherapist led to a referral back to hospital, further x-ray and diagnosis of slipped upper femoral epiphysis of the hip (SUFE, where the growing part of the bone in the hip joint moves). C complained that A was advised to continue walking unaided despite being in severe pain. C believes failings in care contributed to A’s condition worsening to the point where significant surgery was required. C was dissatisfied with the board’s response to their complaint and asked this office to investigate.

In their response to our enquiry, the board confirmed that A’s case had been discussed at a Morbidity and Mortality review, with learning identified. They said that the initial referral letter from the GP to orthopaedics (specialists in the treatment of diseases and injuries of the musculoskeletal system) prompted no red flags from the orthopaedic team and they suggested musculoskeletal physiotherapy in the first instance. A was given an appointment but they attended A&E in the interim.

We took independent clinical advice from a consultant in emergency medicine and a consultant orthopaedic surgeon. We found that SUFE was a difficult condition to diagnose and we did not consider the delay in diagnosis to be unreasonable. We were, however, critical of the decision to discharge A without further investigation, when they were unable to weight-bear. We noted that the board had identified learning but considered they also ought to develop a multidisciplinary pathway for the limping child. We also found that the referral from the GP was assessed appropriately in view of the information it contained. On balance, we did not uphold this complaint but provided the board with feedback in relation to the issues mentioned above.

Summary

C was suffering from swelling and pain in their right knee. C attended an appointment with a consultant vascular surgeon (a specialist in the treatment of diseases affecting the vascular system including diseases of the arteries, veins and lymphatic vessels). The consultant noted that C had varicose veins (swollen and enlarged veins that usually occur on the legs and feet) but believed them to be uncomplicated. The consultant felt the swelling in the right leg was not caused by a problem with the veins and that there were no other symptoms of venous disease. C was not referred for vascular surgery. C had an ultrasound scan which confirmed the lump on the leg and the symptoms were likely caused by a trapped nerve.

C complained that the care and treatment provided were not reasonable and that it was unreasonable not to refer them for varicose vein surgery.

We took independent advice from a consultant adviser. We found that the examination and conclusions of the board were reasonable on the basis of C’s condition at the time. We noted that there were no indications that further vascular investigations/treatments needed to be offered. Additionally, we were satisfied the board had appropriately applied the National Policy NHS Protocol for access to Varicose Vein surgery.

We did not uphold the complaints.

Summary

C complained in relation to their late sibling (A) who was admitted to Glasgow Royal Infirmary following a fall. During their time in hospital, they contracted various infections (latterly pneumonia) and was diagnosed with dementia. A's health deteriorated during their time in hospital and they died.

C said that medical staff failed to take adequate steps to ensure that A received sufficient nutrients to fight the infections they acquired whilst in hospital and this was a contributory factor in their death.

We took independent advice from an appropriately qualified adviser on the care and treatment, specifically the feeding aspect, and found that the care and treatment provided to A was reasonable. We did not uphold the complaint.

Summary

C complained that the board unreasonably carried out a biopsy after a mass was identified in C’s chest. C said due to the type of tumour it shouldn’t have been biopsied.

We took independent advice from a consultant physician and rheumatologist (a specialist in rheumatism, arthritis, and other disorders of the joints, muscles, and ligaments) and a consultant radiologist (a specialist in diagnosing and treating disease and injury through the use of medical imaging techniques such as x-rays and other scans).

We found that while the type of tumour should not have been biopsied, it was not identified as that type of tumour until after the biopsy and that was reasonable. We found that the decision to perform a biopsy was reasonable based on the information available at the time. As such, we did not uphold this complaint.

Summary

C complained to us about the care and treatment their adult child (A) received from the board regarding their mental health over a one-year period. A was an in-patient for part of this time and C complained that it was inappropriate to allow A to make decisions about their care, including time out of the ward. C raised concerns about A’s diagnosis and the medication they were prescribed, as well as the level of support in place for A.

We took independent advice from a psychiatrist. We found that the care and treatment provided to A in relation to their mental health was reasonable and in line with relevant guidance. We also found that the symptoms exhibited by A were consistent with their diagnosis and that the medication put in place for A was reasonable. We did not uphold this complaint.

C also complained that the care and treatment A received regarding their physical health whilst an in-patient had been unreasonable. We found that the approach taken during A’s admission to hospital was reasonable and in line with the expected approach. The focus of clinicians was on A’s psychiatric symptoms and their physical health was treated in line with the arrangements already in place for them in the community. It was reasonable for the referral to rheumatology (specialists in rheumatism, arthritis, and other disorders of the joints, muscles, and ligaments) to be passed to A’s GP on discharge. We did not uphold this complaint.

In addition, C complained that the communication and engagement with them with regards to input into A’s care and treatment had been unreasonable. We found that the communications recorded in A’s medical notes were of an appropriate standard and well recorded. We did not uphold this complaint.

Summary

C complained that the care and treatment they received from the practice was unreasonable. C said that they had developed an intolerance to a number of medications, some of which they had previously tolerated. C sought a referral to pharmacology (the branch of medicine concerned with the uses, effects, and modes of action of drugs) through the practice but complained that they unreasonably failed to facilitate this.

C complained that the GPs at the practice were dismissive of C’s symptoms without reasonable investigations being carried out. C said that their symptoms were inappropriately attributed to anxiety or panic attacks and that GPs provided misleading information in referrals that suited their own presumptions about C’s diagnosis.

We took independent advice from a GP. We found that, whilst the GPs and C disagreed about the likely cause of C’s symptoms, the GPs did not rule out C’s opinion or block their access to specialist investigations. We were satisfied that the practice’s GPs made referrals based on their assessments of C’s symptoms, but put forward C’s opinion for consideration by the receiving specialists.

We were satisfied that the practice’s GPs made appropriate referrals and did not promote their own ideas about C’s likely diagnosis. Whilst we considered that one of the GPs could have communicated more clearly with C about the reasons behind one of the referrals, overall, we found the care and treatment provided by the practice to be reasonable. We did not uphold this complaint.