Not upheld, no recommendations

Summary

Ms C complained on behalf of her father (Mr A) that the council unreasonably issued Mr A with a third warning under the council’s anti-social behaviour policy following an altercation between Mr A and his neighbour. Mr A’s neighbour brought an anti-social behaviour complaint against Mr A, which was corroborated by an audio recording taken during the altercation.

Ms C complained that the council’s handling of the anti-social behaviour complaint against Mr A was unreasonable as they went straight to a third warning and should not have relied on the recording from the neighbour as evidence when investigating the neighbour’s complaint. We found that the council’s anti-social behaviour policy allows for escalation directly to a third warning, bypassing first and second warnings, in cases where an adult is involved in serious anti-social behaviour. We found that the council’s handling of the anti-social complaint made against Mr A was in line with their anti-social behaviour policy and as such did not uphold this part of the complaint.

Ms C also complained that Mr A was inappropriately recorded by a council officer and was only made aware when it was referenced by the council in their complaint correspondence. We were unable to find, on the basis of the information and evidence available, that the recording was inappropriate and as such did not uphold this part of the complaint.

Summary

C complained about the care and treatment they received from A&E of St John's Hospital. C has a history of painful skin conditions requiring hospitalisation. C presented at A&E and was triaged by a nurse. The nurse carried out an assessment of C’s condition and discussed it with the a doctor. C was referred to the out-of-hours GP service. C said that they should have been examined by a doctor in light of their symptoms and previous history.

We took independent advice from a senior emergency nurse practitioner. We found that C’s medical history was considered and observations of their temperature, heart rate and blood oxygen were recorded. The notes did not contain details of the physical examination nor the discussion with the doctor. The out-of-hours GP that C was referred to did not refer them back to the doctor, as they could have done, if they thought the referral was not appropriate. We concluded that C had received a reasonable standard of care and treatment and did not uphold the complaint.

Summary

Following open surgery, Miss C’s abdomen was closed. Miss C was unhappy with the stitching of her abdomen as it had a ‘dog eared’ appearance at one end. Miss C considered that the stitching was inadequate and she should have been given corrective surgery. As the board did not consider that this was necessary at the time, Miss C proceeded to have private surgery to change the appearance of the scar.

We took independent advice form a plastic surgeon. We found that the closure of the surgical wound was achieved by an acceptable technique using appropriate materials. We found the stitching was of a reasonable standard. After several months, there was a small ‘dog ear’ at the end of the scar. We found that the scar was immature at this stage and that it was reasonable to state that it should be allowed to heal, rather than performing corrective surgery at that time. We did not uphold the complaint.

Summary

Mrs C, who has power of attorney for her mother (Mrs A) complained about the treatment provided to Mrs A at the eye clinic at Wishaw General Hospital. Mrs C had been referred from her optician with symptoms of distortion in her right eye which had been present for two months. An Optical Coherence Tomography diagnostic test (a non-invasive imaging test which uses light waves to take pictures of the retina) was performed and the result was subsequently reviewed by a consultant ophthalmologist (a specialist in the branch of medicine concerned with the study and treatment of disorders and diseases of the eye). The consultant reviewed the test results and phoned Mrs A to advise her that she had Age Related Macular Degeneration (ARMD, eye disease which can lead to severe loss of vision) and that due to previous scarring, injections would not improve the vision in her right eye. Mrs A’s obtained a second opinion privately. The private opinion was that Mrs A required an injection which would stabilise her condition. Mrs C complained that the consultant relayed the results of the diagnostic test over the phone to Mrs A without seeing her and that as a result she had to obtain a private opinion.

We took independent advice from an ophthalmologist. We found that it was reasonable that the consultant had diagnosed that Mrs A had advanced ARMD which was unlikely to improve with injections and that it was appropriate for the consultant to have called Mrs A with the result and to arrange a follow-up at the clinic. We did not uphold the complaint.

Summary

C complained about the care and treatment provided to them by the board when they presented with a suspected ectopic pregnancy (a pregnancy in which the fetus develops outside the uterus, typically in a fallopian tube). C’s main concern was that they were not scanned on arrival at the hospital as it was outwith scanning hours. C ultimately had surgery to remove the ectopic pregnancy and a fallopian (tubes along which eggs travel from the ovaries to the uterus). C was concerned that had a scan occurred at an earlier point, it may have resulted in a better outcome.

We took independent advice from a consultant obstetrician and gynaecologist (a doctor who specialises in the female reproductive system, pregnancy and childbirth). We found that C was triaged and transferred within a reasonable timescale on arrival to the hospital and that their management was appropriate in the context of being seen outwith the working hours of the early pregnancy assessment scanning service. We did not uphold C’s complaint.

Summary

Mrs C, an advice and support worker, complained to the board on behalf of her client (Mr A) about treatment which Mr A received at Raigmore Hospital. Mr A was diagnosed with bowel cancer following a positive bowel screen and endoscopy. Mr A underwent surgery to remove the tumour. Initially, keyhole surgery was planned but during the procedure the surgeon was unable to locate the tumour and the operation was changed to full surgery. Mr A developed an infection in his abdomen following the surgery and had to be taken back to theatre. Mr A remained in hospital for a number of weeks and was subsequently discharged home with a stoma and wound bag. Mr A wished to know what went wrong with his care and treatment.

We took independent advice from a consultant surgeon. We found that there were no concerns about the standard of treatment which Mr A received. Initially, it was appropriate to consider keyhole surgery based on the scan results but when the surgery commenced it was noticed that the tumour was in a different position. It was then appropriate to proceed to open surgery, which was completed appropriately with no issues. However, Mr A subsequently developed an infection, which is recognised complication of surgery rather than an indication that the surgery was not performed appropriately. We did not uphold the complaint.

Summary

C complained that the board has been unable to provide them with dentures that fit and function. They said that their ill-fitting and ill-functioning dentures have had a significant impact on them and affected many aspects of their life. C felt that staff have not listened to their concerns or treated them appropriately. C also advised that they consider that they require dental implant treatment to assist with denture use.

The board said that C has had intensive support over a number of years regarding their denture use and has exhausted treatment options and assistance within the secondary care setting. They confirmed that C’s concerns have been reviewed by consultants and implants are not an essential requirement of being able to retain dentures. The denture technique which has been used should make adaption to wearing dentures easier for C and whilst it is recognised that this can be challenging initially, persistence is required for success. Furthermore, the board advised that C does not meet the criteria for dental implant treatment.

We took independent advice from a dental adviser. We found that C’s dental records show that consultants at the board had made a lot of effort in providing several sets of dentures to C and there were no other treatment options that the board should have considered or offered. Therefore, it was reasonable for the board to assert that they have exhausted treatment options and assistance in relation to this matter within the secondary care setting. As such, we did not uphold the complaint.

However, we recognised that there had been some concerns regarding communication and provided feedback to the board for future learning and improvement.

Summary

Mr C, an advocacy worker, complained to us on behalf of his client (Mrs B) about the care and treatment the board provided to Mrs B's son (Mr A). Mr A was a patient at a clinic within the board area, when he experienced what appeared to be a seizure. Mr C complained about how the board responded to this, and in particular, that they delayed in taking action and failed to recognise the seriousness of Mr A's condition.

We took independent advice from both an adviser in general medicine and in psychiatry. We found that Mr A's clinical presentation did not suggest it was an emergency situation or that he was at serious risk. We found that the duty doctor assessed Mr A within a reasonable timeframe and managed his condition appropriately. We did not uphold the complaint.

Summary

C complained about the care and treatment provided by the board’s Children and Adolescent Mental Health Service (CAMHS) in respect of their child (A). After a number of referrals, A attended an initial appointment with CAMHS. This was due to A’s challenging behaviour. The outcome of this assessment was that A would be further assessed before a conclusion was reached on how to progress.

Between this initial assessment and the point C made their complaint, CAMHS engaged with C and A in a variety of ways. A left the family home and moved in with their grandparent. C felt that CAMHS did not provide the help that they and A needed during this time. In C's view, they had been involved with CAMHS for years but nothing productive had been done. Overall, C felt CAMHS failed to provide appropriate care and treatment for A.

We took independent advice from a consultant child and adolescent psychiatrist. We found that overall care and treatment provided by CAMHS was reasonable and in line with relevant guidance for this area. We concluded that the actions taken by CAMHS was reasonable and based on an appropriate consideration of the evidence and A’s presentation. We identified that there were some areas where greater clarity in relation to specialist terms may have been helpful and that there was uncertainty around whether the contents of a risk assessment should have been shared with C. However, we did not consider this to mean that the overall care and treatment provided to A was unreasonable. We did not uphold C’s complaint.

Summary

C complained about the care and treatment they received from the board. C said that a ruptured Achilles tendon (the band of tissue that connects calf muscles at the back of the lower leg to the heel bone) was not identified in a timely way.

We took independent advice from an advanced nurse practitioner and from a consultant physiotherapist. We found that the care and treatment provided to C was consistent with the National Institute for Health and Care Excellence (NICE) guidance on when to suspect an Achilles tendon rupture, and with the board’s own pathway. We did not uphold this aspect of the complaint.

C also complained about the way the board handled their complaint. We did not find any failings regarding the way the board handled C’s complaint. Therefore, we did not uphold this aspect of C's complaint.