Not upheld, no recommendations

Summary

C complained to us about the actions of the Scottish Environment Protection Agency (SEPA) in relation to a site near their home. They said that SEPA failed to adhere to their guidance in relation to the information required to carry out a risk assessment for the site. We found that SEPA were entitled to reach an initial decision that no further assessment was required on the site based on the information they held at that time. There was no evidence that they did not adhere to their guidance in relation to the matter and we did not uphold the complaint.

C also complained that SEPA failed to ensure that adequate site investigations were carried out for the site and that they took into account unreliable information. We found that the decisions made by SEPA, based on additional information that had been provided to them and on a basis of a site visit, were decisions that they were entitled to take. We did not uphold this complaint. However, we found that SEPA should have informed C that they were unable to open the videos/photos that C submitted. We provided feedback to SEPA about this matter.

Summary

C complained that the council, as planning authority, failed to provide reasonable justification to discharge two conditions relating to an approved planning application of a development of a historic site. C considered that the council discharged the conditions without the applicant providing solid evidence of compliance.

The first condition related to the pre-commencement condition for scheduled monument consent (SMC) (part one) and that the extension could not be used until the restoration of the site had been completed (part two). The council advised, initially, the discharge of part one of the condition was based on the SMC for the first stage of site works. Later the council justified the discharge of part one of the condition as it duplicated the effect of another organisation and therefore should not have been imposed as a pre-commencement condition.

We took independent planning advice. We found that while the council’s communication in relation to the discharge of the first condition could have been clearer and more consistent, their ultimate rationale was reasonable. Therefore we did not uphold this this aspect of the complaint.

The second pre-commencement condition related to the requirement for a full survey of the historic site and grounds to establish whether they were being used by roosting or hibernating bats and any further actions to minimise the disturbance of same if found. We found that the council had already acknowledged that the survey works should have been requested prior to the determination of the planning application rather than as a pre-commencement condition. As the condition had been made, the council considered the information provided by the applicant, including a bat survey report. On receipt of the report from that survey the council contacted Scottish Natural Heritage (SNH) to gain their views. SNH confirmed their acceptance of the report. On the basis of the response from SNH, the condition was discharged. We found that the council provided reasonable justification for the discharge of the condition. Therefore, we did not uphold this aspect of the complaint.

Summary

C complained to us about the actions of the council in relation to a development near their home. They said that the council unreasonably accepted unreliable information from the applicant and failed to ensure that adequate investigations were carried out in relation to drainage from the site and ground water level. We took independent advice from a planning adviser. We found that the council acted reasonably in accepting advice on the matter from the Scottish Environment Protection Agency. They were entitled to reach the decision they did, given that advice. We did not uphold this complaint.

C also complained that the council unreasonably failed to enforce a planning condition in relation to the site entrance. We found that the planning officer had consulted roads officers on the details submitted to discharge the roads conditions. The council’s position in respect of there being no breach of consent was one that they were entitled to take. We did not uphold this complaint.

In addition, C complained that the council unreasonably failed to ensure that a remedial strategy for field drainage was submitted in line with a planning condition. We found that it was a matter for the council to decide what action it is appropriate to take in respect of enforcement, and whether or not information submitted is sufficient to discharge conditions. In this case, the decisions taken by the council were decisions they were entitled to take and we did not uphold the complaint.

Finally, C complained that the council unreasonably failed to ensure that the burial site visibility splay complied with their roads standards. We found that it was reasonable for the planning officer to have accepted advice from roads officers that the visibility splay had been inspected on site and determined to be acceptable, and to have discharged the condition accordingly. The council undertook the correct processes in determining the planning application and the discharge of the conditions, and therefore we did not uphold this complaint.

That said, we considered that the council should have published all of the information submitted to discharge the conditions and their responses at the appropriate time, so that interested parties were able to follow and understand the progress of the application. We provided feedback to the council in relation to this.

Summary

C complained about the care and treatment they received in hospital.

We took independent advice from a consultant psychiatrist. We found that treatment was in line with recognised clinical practice. There were records of C’s medication being reviewed and altered on a number of occasions. There was also written evidence that a discharge plan was in place and discussed with C, although no specific discharge date had been set. We did not uphold C's complaint.

Summary

C made a number of complaints on behalf of their adult child (A) in relation to the service received from the partnership. We took independent advice from a social worker.

C complained about a delay in referring A for a functional assessment. Whilst we recognised the stress caused whilst waiting for the assessment and bathroom adaptations, we found that the process followed and the time taken was in accordance with standard practice.

C complained about the lack of an annual support plan for A. We considered that the partnership should have confirmed to A that the existing plan still applied; however, we noted that they had to comply with government guidance in care planning. This meant there was a high volume of care plans that required to be updated and priority was given to those with urgent critical or substantial need. A’s care needs had not changed substantially or critically and therefore A's care support was not reviewed until their needs changed when they moved to their own home.

C complained that a draft care and support plan prepared did not meet A's needs. We found that the needs documented from discussions were reflected in the draft care and support plan.

C also complained that A was not provided with copies of minutes of meetings. We found that it was not standard practice to provide copies of the particular type of meetings referred to.

Finally, C complained that a record of a home visit was inaccurate in that it was documented that A engaged with the social worker, when this was not the case. We found that it was not possible to establish what occurred on the day in the absence of other evidence.

We did not uphold any of C's complaints.

Summary

Mrs C complained about the care and treatment she received at Ninewells Hospital. Mrs C had previously received treatment for breast cancer and had been monitored over the years following this.

Mrs C complained that a mammogram (an x-ray test of the breasts) was not performed at a review appointment. The board said that Mrs C had already received the last of the planned annual follow-up mammograms and she did not require one when she attended for a review.

We took independent advice from a consultant breast surgeon. We found that Mrs C had received follow-up mammograms in accordance with national and local guidelines. We concluded that it was reasonable that Mrs C was not offered a mammogram at the review. We did not uphold Mrs C’s complaint.

Mrs C also complained that she was not offered an emergency appointment for breast imaging following a consultation with the Lymphoedema Service (a service managing problems with the lymphatic system, a network of vessels and glands spread throughout the body). We found that it was reasonable that Mrs C was not offered emergency breast imaging and we did not uphold this complaint.

Finally, Mrs C considered that the board’s response to her complaint contained inaccurate information. We reviewed the evidence available and we were unable to conclude that the board had provided inaccurate information. We did not uphold this complaint.

Summary

C, who had a history of breast cancer, complained that the board failed to provide them with appropriate care and treatment at the Western General Hospital for a lump on their breast. The lump was investigated but found to be of no concern. Two years later, a clinically suspicious lump was identified and investigations showed evidence of an invasive carcinoma (cancer). C raised a number of issues including why a trainee doctor was allowed to perform a biopsy on the first lump identified on their breast and whether the doctor performed the procedure correctly. C also questioned why the lump in their breast was not removed or investigated further.

We took independent advice from a consultant breast surgeon. We found that it was acceptable for the trainee doctor to perform the procedure under the supervision of the consultant surgeon, as was the case here, and that there was no evidence that the procedure was performed incorrectly. We also considered that the decision taken by the board at that time not to remove the lump or carry out further investigation was reasonable. C’s case went through the correct process and we determined that C’s treatment was reasonable. We did not uphold this part of the complaint.

C also complained that the board failed to provide them with a reasonable response to their complaint. C raised a number of issues, including that the board’s response did not address their specific concerns. We considered that the board’s response generally addressed the questions raised by C and we did not uphold this part of the complaint.

Summary

C complained about the care and treatment their parent (A) received at St John's Hospital. C considered that A did not receive reasonable medical or nursing care and treatment; in particular, that their ward placement on a ward which was only used during the winter period to provide additional medical capacity was inappropriate and resulted in A not receiving continuity of care. C raised concerns about A’s weight management and the board’s response to A’s concerns about their vision.

The board indicated that they considered that A was appropriately placed and received the same standard of care they would have on any other ward. The board acknowledged that one weekly weigh-in had been missed for A but indicated that improvements had been made in the form of more robust processes in this area of patient care.

We took independent advice from a geriatric (medicine of the elderly) and general medical adviser and a nursing adviser.

We noted that the board had missed one weekly weigh-in for A and that there had been a delay in ophthalmologist (a specialist in the branch of medicine concerned with the study and treatment of disorders and diseases of the eye) input. However, we concluded that overall A received reasonable care and treatment. Whilst some shortcomings were identified, A was placed in an appropriate ward that, on the whole, appropriately met their needs and they received the same care and treatment that they would have had they been on a general medical ward. Therefore, we did not uphold C’s complaints.

Summary

C complained about the care and treatment provided to their parent (A). A, who has vascular dementia and Alzheimer’s, suffered from ill health and C sought medical care and treatment from A’s practice on numerous occasions for what they suspected were urinary tract and chest infections.

A had three hospital admissions during this period and C was concerned about the care and treatment provided in particular in the time leading up to each hospital admission. C said that the GPs at the practice focused too much on A’s dementia and unreasonably failed to take C’s concerns about A’s condition seriously. As a result, C said the GPs had failed unreasonably to investigate and treat A’s deteriorating condition including a number of serious infections.

We took independent advice from an adviser who specialises in general practice. We found that GPs at the practice had taken C’s concerns seriously and assessed and treated A in a reasonable way. We did not uphold the complaint.

Summary

C, a Patient Advice and Support Service adviser, brought the complaint on behalf of their client (B) with regard to the care and treatment provided to B’s late spouse (A). A had a compromised immune system and received regular immunoglobulin therapy (a blood-based treatment to increase the number of antibodies in the immune system). A was admitted to hospital with a high temperature and was found to have acute leukaemia. They deteriorated over several weeks and died a short time later. C complained about a number of aspects of A’s care and treatment including a change in their immunoglobulin brand; that A’s reason for admission to hospital was not clearly communicated; that A had cellulitis (a type of skin infection) in their hand; and that A being incorrectly administered a diuretic (a type of medication which increases the passing of urine) indirectly led to their death.

We took independent advice from a consultant haematologist (a specialist in diseases of the blood and bone marrow). We found that the care and treatment provided to A was reasonable. Specifically, we found that there was no indication the change in immunoglobulin brand caused A’s deterioration; there were several terms that could have been used to describe the reason for A’s admission to hospital and the board’s actions in this regard were not unreasonable; it did not appear that A had cellulitis in their hand; and the incorrect administration of a diuretic was not a cause or contributor to A’s death.

Therefore, we did not uphold C’s complaint. However, we noted some feedback for the board with regard to communication about A’s prognosis.