Not upheld, no recommendations

Summary

C complained about the partnership's decision in relation to a charging appeal relating to their parent (A). A transferred their property to their children several years ago. Five years after this transfer, A moved to residential care. The partnership undertook a financial assessment of A and took internal legal advice as to whether the transfer of that property should be treated as a deliberate deprivation of capital in order to reduce accommodation charge. The partnership concluded that the transfer was a deliberate deprivation of assets and as such A was regarded as having the notional value of the property as capital in addition to their actual assets.

C appealed the partnership's decision and asserted that A had not intended to deprive themselves of an asset when transferring the property to their children. The partnership did not uphold the appeal and considered that the transfer of the property did constitute a deprivation of an asset and as such A was assessed as having actual and notional capital which exceeded the capital threshold.

C was dissatisfied and brought their complaint to us. While we could not review the decision taken by the partnership or over-turn it, we considered whether the decision taken was made on reasonable grounds.

We found no evidence of any failures in the partnership's decision-making and determined that it appeared that the partnership took all relevant information into account when reaching their original decision and when considering the appeal. We did not uphold C's complaint.

Summary

C complained about the care and treatment they received from the physiotherapy service at a particular appointment. C was concerned that they were asked to walk from the waiting room to the appointment room using crutches, rather than being provided with a wheelchair.

We took independent advice from a physiotherapist. We found that at a previous appointment (three weeks prior to the appointment in question), C reported that they could mobilise with crutches. In the circumstances, we found that it was reasonable for the physiotherapist to ask C to mobilise from the waiting area to the treatment area. We did not uphold C's complaint about the care and treatment they received from the physiotherapy service.

C also complained about the way the partnership handled their complaint. We did not identify any issues regarding the way that the partnership responded to C's complaints. We did not uphold this aspect of C's complaint.

Summary

C, an advocacy and support worker, complained on behalf of their client (A) who was admitted to University Hopsital Hairmyres with delirium which was found to be caused by a urine infection. A was seen by a doctor who firstly detained them for 72 hours under the Mental Health Act. When the time period ended the detention period was extended to 28 days. A was then transferred to another hospital where the staff did not feel that there was a requirement for the detention and it was rescinded. A felt that the decision to detain them was not clinically required and that the hospital failed to carry out an appropriate mental health assessment on their admission to hospital.

We took independent advice from a consultant psychiatrist. We found that an appropriate mental health assessement was carried out based on A's symptoms. We found that although A did have a urine infection which would have caused their delirium, there was sufficient clinical indication that A was suffering from a mental health problem and that there were grounds to detain them under the Mental Health Act.

We did not uphold the complaint.

Summary

C, a support and advocacy worker, complained on behalf of their client (A) who was diagnosed with cervical cancer whilst they were undergoing fertility treatment. C complained that the board failed to investigate A's symptoms which they had been experiencing for a number of months, and that this led to a delay in diagnosis. C also complained that the board failed to carry out a reasonable investigation of the complaint as their response did not demonstrate that any real analysis was undertaken of the care and treatment provided to A.

The board confirmed their view that appropriate investigations were carried out. They explained that A had a type of cancer (endophytic, where there is no obvious cancer as it is within the body of the cervix) which is more difficult to diagnose.

We reviewed the clinical records and took independent advice from a consultant in gynaecologic oncology (a specialist in the diagnosis and treatment of cancers of the female reproductive system). We found that the referrals, tests and assessments were in line with best medical practice and within reasonable timeframes. As such, there was no missed opportunity to diagnose the cancer sooner. We also found evidence that the board's internal investigation of the complaint was thorough and reasonable. We did not uphold C's complaints, however, we did provide feedback on the board's handling of the complaint.

Summary

C attended their GP with shoulder pain and was referred to orthopaedics (specialists in the treatment of diseases and injuries of the musculoskeletal system) who, during the initial consultation, reviewed x-rays and ultrasound imaging and concluded no broken bones were shown. A was diagnosed with muscle patterning (when the pattern of muscle contractions is altered) and referred to the physiotherapy department for treatment.

C had a number of follow-up appointments and was discharged around four months later as it was considered that there was no further treatments they could be offered to alleviate the symptoms. C was then referred to the neurology department (the branch of medicine concerned with the diagnosis and treatment of disorders of the nervous system). Around the same time, after seeing a private doctor, C had an MRI scan and the results showed that C had broken ribs. C considered that medical professionals focused on their disability and other medical conditions, unreasonably delayed in diagnosing the broken bones and that it was only because they instructed a private consultant, that the injuries were diagnosed.

We took independent advice from an appropriately qualified medical professional. We found that the board performed appropriate investigations following C's referral by their GP. There was an appropriate multidisciplinary approach following the initial consultation involving physiotherapy, rheumatology (the branch of medicine that deals with rheumatism, arthritis, and other disorders of the joints, muscles, and ligaments), orthopaedics and neurology. The fractures identified occurred after the initial consultation and investigations carried out following the GPs referral. We considered that there was no unreasonable delay in diagnosing C's broken bones and therefore we did not uphold the complaint.

Summary

C complained on behalf of A who has a terminal cancer diagnosis. A was diagnosed with a metastatic carcinoma (a cancer that grows at sites distant from the primary site of origin) of possible colorectal (colon) or ovarian origin and progress lung nodules. C complained that A was misdiagnosed multiple times and given the wrong treatment.

The board said that A underwent a number of investigations in order to identify the source of the primary cancer. They explained that surgery was not a viable treatment option.

We took independent advice from a consultant clinical oncologist (a doctor who specialises in the diagnosis and treatment of cancer).

We found that the investigations carried out were appropriate and the length of time taken reflected the challenges faced in trying to identify the source of the primary cancer. There was no evidence to suggest that A was misdiagnosed or given the wrong treatment. We identified that there was a delay in completing the colorectal investigations however, on balance, we did not consider that this delay was significant as it did not have a detrimental impact on A's prognosis. As such, we concluded that the care and treatment was reasonable and we did not uphold the complaint.

Summary

C's adult child (A) had anxiety and a functional neurological illness (a condition in which patients experience neurological symptoms such as weakness, movement disorders, sensory symptoms and blackouts). One morning A was found to be anxious and unwell. A's other parent (B) thought that it appeared different to A's previous episodes and called the GP who visited A at home.

The GP believed that A should be admitted to hospital and called 999. An ambulance crew attended the scene. There was some discussion between the GP and the hospital about which department A should be admitted to; the Mental Health Unit or the Clinical Assessment Unit. The ambulance crew transported A to hospital where A was quickly assessed and taken to the Intensive Care Unit. A died later that day.

C complained that the GP had not properly assessed A, they had not taken blood pressure readings or their temperature. C said that the GP assessed A through the prism of mental health and had not properly considered whether there could be another cause to their presentation, which was different from previous ones.

We took independent advice from a GP. We found that it was appropriate for the GP to consider A's prior medical history when assessing their condition. We found that the GP correctly identified that assessment at hospital was needed, recognising the seriousness of A's condition.

On the basis of information available to the GP at the time, their assessment and conclusions were reasonable. Therefore, we did not uphold the complaint.

Summary

C's spouse (A) received care and treatment from the board for a recurrence of bowel cancer. C complained that the communication and actions by the board in relation to that were unreasonable.

C complained that the board failed to provide reasonable treatment to A. We took independent advice from a senior clinical oncologist (a doctor who specialises in the diagnosis and treatment of cancer). We found that the treatment offered to A was reasonable and in line with guidance. We did not uphold the complaint.

C complained that the board failed to provide reasonable care to A. We found that the board had acknowledged there were some failings relating to staff responding to care requests and there were challenges when a procedure was undertaken. Overall we found that while there were failings in specific instances, the care provided over the entire period was reasonable. On balance, we did not uphold the complaint.

C complained that the board failed to reasonably communicate with A and C in relation to A's diagnosis and the potential risks of treatment. We found, based on the written records available, that the communication was reasonable, noting that the written records could not illustrate the level of empathy exhibited by clinicians. The written records did demonstrate that the risks relating to treatment were discussed. We did not uphold the complaint.

Summary

C complained about their urology care (the branch of medicine and physiology concerned with the function and disorders of the urinary system) and treatment at Borders General Hospital. C has a complex past urological and surgical history including a total cystectomy (bladder removal), and was referred to urology with ongoing pain and discomfort around their stoma region (an opening in the abdomen formed during a colostomy procedure). C complained that the urologist did not see them and that they were instead seen by a general surgical registrar who failed to identify symptoms of a kidney stone. C subsequently became very unwell and was admitted to hospital with an obstructed infected kidney.

In their response to C's complaint, the board confirmed that the urologist felt it best for C to be seen by the consultant general surgeon who had carried out their most recent hernia (a weakness in the abdominal wall beside a stoma which allows the bowel to protrude outwards) repair surgery. They noted that, when C was then assessed by the surgical registrar, they did not have any specific symptoms which would have indicated the presence of a kidney stone.

We took independent medical advice from a consultant urological surgeon. We found that it was reasonable for C's clinical assessment to have taken place with either the surgical or urological consultant team. We, therefore, did not uphold C's complaint about a lack of urological review. We considered that C was appropriately assessed by the surgical registrar, and there was no clinical evidence at that time to indicate the presence of a kidney stone. We did not uphold C's complaint about a failure to diagnose their kidney stone. We noted, however, that C should have been seen by the consultant general surgeon, rather than a surgical trainee, in light of their complex history. We fed this back to the board.

Summary

C complained that Scottish Water had failed to respond appropriately to a number of flooding incidents in their property. C said that Scottish Water had not been open or honest about the cause of the flooding and were refusing to take the only action which would guarantee the protection of their property. C said that Scottish Water’s position had changed whenever they were presented with evidence, which suggested they were responsible for the flooding.

Scottish Water denied that they had acted unreasonably, or that they had failed to investigate the causes of the flooding experienced by C’s property. Scottish Water said that they were not responsible for damaged pipework within the property and the public sewerage network had been working properly. They said that there were likely to be different causes for the flooding incidents C had experienced, but that all of them had been investigated. Scottish Water acknowledged that this had taken time, but said there had been a need to liaise with a number of other stakeholders, including the local authority and utility companies.

We found that Scottish Water had investigated the incidents of flooding. Additionally, they had correctly informed C that they were not responsible for flooding which emanated from private pipework. C maintained that the private pipework had been damaged by the failure of the public sewer network, which Scottish Water were responsible for. We did not find evidence which supported this, and it was not the only possible cause of damage to the pipework as C had suggested. Therefore, we did not uphold the complaint.

C also complained that Scottish Water failed to handle their complaint reasonably. We considered that Scottish Water investigated the complaint appropriately. We did not uphold the complaint.