Not upheld, no recommendations

Summary

C complained about the advice received and actions taken by trading standards in relation to concerns that they had reported about a builder who had undertaken work for two of their relatives. C said that the council did not provide them with adequate information regarding the steps they could take to establish if they had cause to take further action against the builder, and the timescale in which this was required to be done.

We found that the council had reasonably explained the steps taken in reviewing C's complaint. Whilst we recognised that no information had been given in relation to issues which were time barred, we considered it could not be known until completion of the assessment which matters could be progressed. Therefore, we did not uphold this part of C’s complaint.

C complained that the council suggested they obtain an independent report of the work completed at personal cost to them. We found that C had sought advice from other sources, and we considered their decision to commission the report had been informed by their wider research and not just on the advice given by trading standards. We also did not find any evidence to support that C had been told that an independent report would be required before their case could be taken to the procurator fiscal. Therefore, we did not uphold this part of C's complaint.

C also complained that the council provided them with an inconsistent and inadequate response to their complaints. We found that the response was in keeping with the information shared with C by trading standards. Therefore, we did not uphold this part of C's complaint.

Summary

C’s spouse (A) presented to A&E with neck pain. A was discharged home as it was noted that they were on a waiting list for an MRI scan, following an urgent referral by their GP to orthopaedics (area involving the musculoskeletal system). A was admitted to hospital four days later and advised that they were terminally ill with bladder cancer which had spread to the spine. A later died. C complained to the board that A&E did not consult orthopaedics or arrange further testing when A presented with continuing pain despite prescribed medication. The board’s response indicated that A was appropriately assessed by the A&E doctors and as A was waiting on an MRI, the discharge letter to the GP advised to follow up with the hospital where the MRI was being organised. The board said that the GP was best placed to expedite further care with the relevant team.

We took independent advice from a consultant in emergency medicine. We found that A&E carried out an appropriate assessment, including consideration of any red flags which warranted further investigation or onward referral. We found that as A had already been referred to the spinal team and had an MRI ordered it was reasonable not to investigate A further. We found that the board acted in accordance with NICE guidance in how they managed A’s care and treatment, which was reasonable. Therefore, we did not uphold the complaint.

Summary

C complained that the council had unreasonably failed to follow their own enforcement process and relevant planning guidance in response to an alleged breach of planning condition/s in respect of two sites.

In responding to the complaint, the council acknowledged that breaches at the sites had occurred and highlighted the discretionary nature of planning enforcement. As such, the council considered resolution of the breaches through informal negotiation had, in the first instance, been an appropriate approach rather than formal enforcement action.

We took independent advice from a planning adviser. We found that council’s approach to securing compliance with the planning conditions was in line with their usual enforcement process and national guidance, with no evidence of undue delay or inaction on the council’s part at the time of our investigation. We also found that the council’s decision to engage in negotiations to remedy the planning breaches, rather than to pursue formal enforcement action, was a decision that they were entitled to take. For these reasons, we did not uphold C’s complaint.

However, we did draw the council’s attention to their own Enforcement Charter which sets out the principles for effective enforcement action, specifically that: negotiation to remedy a breach should be pursued provided an appropriate solution can be achieved in a timely manner. As some of the breaches had not been remedied at the time of this investigation, we suggested that the council may wish to consider setting a timescale by which formal enforcement action would be taken.

Summary

C complained about delays in ambulance response time after their elderly parent (A) had a fall at their care home. Care home staff called 999 and, following triage, the call generated an emergency but non-life-threatening response. A clinical triage call took place shortly after followed by another 999 call by care home staff. A paramedic response unit arrived at A’s location, followed by an ambulance. A arrived at hospital around 5 and a half hours after the first 999 call.

Scottish Ambulance Service (SAS) acknowledged that the wait for an ambulance was unreasonable and apologised to C for this. They explained that the delay was due to limited resource and very high demand at that time. C was unhappy with this response and brought their complaint to us. C felt that A was not prioritised fairly following the 999 and clinical triage calls. C considered this to be partly due to A’s age. Although SAS had already acknowledged that there was an unreasonable delay, we carried out an investigation to determine whether the assessment and prioritisation of the calls also contributed to that delay.

We took independent advice from a paramedic. We found that the non-clinical call handling was appropriate. We also considered that there was no indication that A was treated differently or unreasonably as a result of their age. Therefore, we did not uphold C’s complaint. However, we did provide feedback to SAS regarding an aspect of the clinical triage call which did not cause or contribute to the delay in an ambulance being provided, but was not in line with relevant national guidance.

Summary

C complained about the care and treatment provided to their parent (A) on two separate admissions to hospital. A was detained on both occasions under the Mental Health (Care and treatment) (Scotland) Act 2003. C had concerns about A being sedated and that staff had restrained A in an inappropriate manner.

In their response to the complaint, the board explained the care provided to A, the reasons for the administration of medication, how this was overseen and adjusted to address A’s levels of sedation, and the process and performance of restraints when they were required. C was dissatisfied with the board’s response and brought their complaint to us.

We took independent advice from a consultant psychiatrist and a mental health nurse. We found that on both admissions, there was appropriate oversight of A’s medication and care was taken to consider sedative effects and find a balanced approach. We found that medications were administered appropriately to manage A’s distress and aggression. Therefore, we did not uphold this part of C’s complaint.

In relation to the use of restraints, we found that these had been performed reasonably and that A’s concerns about pain to their ribs was appropriately assessed. Therefore, we did not uphold this part of C’s complaint. However, we did provide the board with some feedback on the requirements for accurate record keeping.

Summary

C complained about the care and treatment provided to their late spouse (A). A was admitted to hospital with a suspected small bowel incarcerated in the hernia (a part of the intestine that becomes trapped in the sac of a hernia). Following a CT scan and assessment by a surgeon, it was decided to treat A’s condition conservatively and transfer them to a larger hospital in the area. However, there was a delay in the transfer taking place due to a lack of ambulance resource and A’s condition deteriorated further during their admission. A died shortly after admission. C complained about the delay in transferring A to another hospital or operating on them sooner. In C’s view, A did not receive a reasonable standard of treatment or end of life care following their admission to hospital. In addition to this, C complained about the board’s communication with the family during A’s time in hospital.

We took independent advice from an emergency medicine consultant and a general and colorectal surgeon (specialist in conditions of the colon, rectum or anus). We found that the treatment provided by the board was reasonable. In light of A’s presentation, and without the benefit of hindsight, it was reasonable to treat A conservatively and arrange for a transfer to a better resourced centre. We also found that the end-of-life care provided to A was reasonable, given A’s rapid deterioration and the circumstances within the hospital at that time. Therefore, we did not uphold this part of C’s complaint.

In relation to the standard of communication with the family, taking into account A’s rapid deterioration and the circumstances within the hospital at the time, we concluded that communication was reasonable. Therefore, we did not uphold this part of C’s complaint.

Summary

C suffers from chronic pain and had been receiving pain management and musculoskeletal physiotherapy treatment from the board for many years. Changes were made in the board’s approach to pain management which coincided with some experienced consultants retiring. C’s care and treatment was reassessed and a number of treatments previously provided to C were said to no longer be available and an emphasis was placed on self-management. C complained that withdrawing treatments harmed their health and wellbeing, the local pain management service was now limited requiring patients to travel for certain treatments, effective interventions were removed, the board prioritised cost over patient needs, and the transition to self-management relied too heavily on online resources.

The board stated that the changes were evidence based and in line with clinical guidelines.

We took independent advice from an experienced pain management consultant. We found that the board were correct in stating that the current guidance for the management of chronic pain does not support the long-term use of massage, acupuncture or trigger point injections. We noted that the transition away from this approach towards self-management can be very challenging for patients. We considered that C had been offered a person-centred management plan. We also found that it was reasonable for the board to have explained to C that previous therapies offered in an ongoing sense were likely provided because of discretion and goodwill on the part of a now retired physiotherapist. We noted that this is not uncommon for practitioners, however, approaches to treatment change over time. We did not uphold C’s complaint. However we provided feedback about the need to reflect on cases such as this to inform how best to manage similar situations in the future.

Summary

C complained that their housing transfer application had been unreasonably handled by the housing association. In particular, C complained that they had not been offered a transfer when suitable new build housing had become available. C explained that a restriction had been placed on their transfer application without them being informed as they had declined a property with four flights of external stairs, which their partner could not manage due to their health condition. C explained that external stairs were a problem for their partner, however, they could manage one flight of internal stairs as they could control the temperature inside the property. Despite C explaining this, the restriction had remained in place as the association’s allocation policy did not distinguish between internal and external stairs. C considered this to be discriminatory.

The association confirmed that their allocation policy did not distinguish between internal and external stairs, and it remained their view that a property with stairs would not be appropriate for C’s partner, noting that they would still have difficulty managing internal stairs when their health condition flared up.

We found that the association had reasonably considered C’s transfer application request in line with their policy. While we explained to C that this office cannot determine whether equalities legislation has been breached in reference to their concerns of discrimination, we can consider whether an organisation has taken the relevant legislation into account. On review, we considered that the association had reasonably demonstrated having taken their legislative requirements into account, particularly at the point of reviewing their allocation policy. We did not uphold the complaint.

Summary

C complained about the actions taken and treatment provided by the board in respect of their pregnancy. C reported reduced fetal movements and was admitted to hospital with vaginal bleeding. The hospital discharged C as the vaginal bleeding settled and all clinical assessments undertaken were within normal parameters. However, C returned to hospital with significant vaginal bleeding and was diagnosed with placental abruption (a condition in which the placenta starts to come away from the inside of the womb wall). C’s baby was stillborn shortly after.

In C’s view, the board failed to take into account warning signs or carry out an appropriate assessment when they were admitted to hospital. C feels the outcome would had been different if their baby had been delivered at an earlier opportunity. The board acknowledged some failings in respect of delays caused by the hospital triage process, IT issues and signage. However, they concluded that these delays were unlikely to have made a difference to the outcome. The board were also satisfied that the broader treatment provided to C in respect of their pregnancy was appropriate.

We took independent advice from an adviser with an extensive background in obstetrics and gynaecology (a specialist in pregnancy, childbirth and the female reproductive system). We found that the board’s management of C’s pregnancy was reasonable and in line with relevant national guidance. There was no evidence that the board unreasonably failed to take any actions that they should have. Nor did it indicate that they unreasonably missed any warning signs pointing to this outcome. We noted that guidance prioritises the aim of prolonging the pregnancy in the absence of any signs of maternal or fetal compromise. In addition, we considered the staff’s actions to be reasonable when C presented at hospital. We agreed with the board’s conclusion that it was unlikely that the outcome would have been different had C not encountered the delays at the hospital. Therefore, we did not uphold C’s complaints.

Summary

C complained about the way that the council handled the planning process and the building warrant process for a self-build project within an existing development of houses. Planning permission had been granted, and three years later only limited progress had been made and an application was made by the developer to place a static caravan on site, where they would live whilst completing the project. There were several applications relating to the caravan, and some years later an enforcement notice was served by the council. This was appealed by the developer. Two years later, the council served a completion notice on the site, and the case was appealed to the Planning & Environmental Appeals Division (DPEA) by the developer.

C complained to the council. The Scottish Government reporter concluded planning permission had lapsed, because development had not lawfully commenced. The council took legal advice, which suggested that they reluctantly accept the reporter’s findings. The advice noted that should further evidence be submitted, then the council could take this into account if it supported a contrary position on the implementation of the initial planning permission.

C continued to correspond with the council, and brought a number of complaints to the SPSO. We took independent planning advice and we found that the council had the discretion to decide what enforcement action to pursue, if any. The council had followed the legal advice that they had received, serving a notice requiring submission of a new planning application. The developer had chosen to pursue an alternative course of action, by applying for a Certificate of Lawful Proposed Use or Development (CLPUD). This was not the same as being granted planning permission, but was an acceptable course of action by the developer. The decision of the Scottish Government reporter was only directly applicable to the completion notice, which could not be served. The council were entitled to determine whether they were satisfied the development had lawfully commenced. The advice stated that on balance, the council had acted reasonably. We found that whilst the council’s actions were not without criticism, they had exercised their lawful powers when reaching decisions on both planning and building standards matters. We did not uphold the complaint.