Not upheld, no recommendations

Summary

Ms C contacted us on behalf of Ms A, as she had concerns that the housing association had failed to respond to their concerns about disrepair in their house. Ms C said there were also concerns about the association failing to respond to complaints about anti-social behaviour and requests for repairs. Ms C told us that Ms A was classed as a vulnerable adult and suffered from poor mental and physical health. These issues were being exacerbated by the association's failures.

We found that some of the repair issues had been addressed and that some of Ms C's complaints had been upheld by the association in respect of a failure to investigate anti-social behaviour complaints. We also found that the responsible housing officer was on long-term leave, and that this had caused difficulties in determining whether issues had been raised with them by Ms C or Ms A.

We found that the association could evidence their response to complaints of disrepair and that investigations and work had been carried out. Additionally, some of the issues being raised by Ms C, such as decoration within the property, were not repair issues. We also found that the association had offered to address any issues which Ms C believed to be outstanding and also to review any emails which Ms C felt she had not received an adequate response to. Therefore, we did not uphold this aspect of Ms C's complaint.

Summary

C complained on behalf of their child (A) who is an adult with incapacity. C complained that the partnership failed to reasonably safeguard A before and after a reported incident involving a support worker. We found that the partnership's commissioning of services for provision of care followed standard practice and that reviews carried out did not indicate A was at any risk from support workers. We also found that, after the reported incident, the support worker was removed from the care package. We considered that the partnership reasonably safeguarded A before and after the reported incident. We did not uphold these aspects of C's complaint.

C also complained that the partnership failed to involve them and their partner in the decision-making process regarding A's welfare and that there was a failure to discuss with them the importance of seeking medical screening after the reported incident.

We found that there was a lack of communication with C and their partner (which the partnership had apologised for), but we did not consider it was usual practice for the partnership to involve them in professional meetings where decisions were made under Adult Support and Protection procedures. We also did not consider that it was the role of the partnership to advise C and their partner to arrange any medical screening. Therefore, we did not uphold these aspects of C's complaint.

Summary

Mr C's mother (Mrs A) was in hospital for an extended period of time after a stroke. He complained that during that time the partnership failed properly to communicate with and include him in discussions about her care. He also said that the partnership unreasonably restricted the times when he could visit Mrs A.

Mr C complained to the partnership that he had been treated poorly by staff who failed to include him in discussions about Mrs A's care. He said that he particularly wanted to discuss the appropriateness of the use of cannabidiol (CBD) in the management of Mrs A's pain but that staff reacted negatively to this and made assumptions about his intent. He said that they unreasonably imposed restrictions on him.

In response, the partnership said that where a person had capacity to make their own decisions, like Mrs A, they were duty bound to allow them to make their own choices. Similarly, they had a legal duty to safeguard patients and to take necessary steps if there were concerns about their safety or wellbeing. With regard to the use of CBD oil, a number of meetings had been arranged with Mr C so that advice and guidance could be given about this but that he could not always attend, despite attempts being made to accommodate him.

We found that CBD oil capsules had been found in Mrs A's bed and an Adult Support and Protection case conference had been convened as a consequence. While Mr C had been invited, he could not attend. A further meeting was held, after being rearranged to suit Mr C to discuss non-prescribed medication and there had been lengthy discussions about the potential harm that could be caused. At this meeting, it was agreed, amongst other things, that Mr C would not bring non-prescribed medication in to the ward, that he would visit at specific times and that his visits would be supervised. These agreed measures would apply for two weeks after which they would be reconsidered. Further meetings were held because Mr C was unhappy and there had been incidents on the ward. After Mrs A's health improved and she became more able to state what she wanted, the issues with Mr C reduced. Mrs A was discharged from hospital.

On the basis of the information above, we did not uphold Mr C's complaint that communication was unreasonable nor did we consider that the partnership had unreasonably imposed visiting restrictions upon him; we did not uphold the complaint.

Summary

Ms C complained to us about the care and treatment she received from her GP practice. She said that staff at the practice had not listened to her and had not provided reasonable care and treatment for her adhesions, diarrhoea and Myalgic Encephalomyelitis (ME; a long-term illness with a wide range of symptoms including extreme tiredness). She also said that the practice seemed fixated by her having depression and that she needed bereavement counselling or antidepressants without understanding her situation.

We took independent advice from a GP. We found that there was no evidence that staff had not listened to Ms C and that they had provided reasonable care and treatment in relation to her adhesions, diarrhoea and ME. It was also reasonable for the practice to offer Ms C bereavement counselling along with other treatment in relation to this. We considered that the care and treatment provided to Ms C was reasonable and we did not uphold the complaint.

Summary

Mr A fell at home and a 999 call was made to the Scottish Ambulance Service (SAS) to attend. The call was prioritised as an emergency response where an ambulance would be dispatched as soon as one became available. An ambulance arrived with Mr A approximately four hours after the initial call. Mr A was later diagnosed with a broken hip.

During Mr A's rehabilitation in hospital, there were concerns that he had sepsis. Staff at the hospital called for an ambulance and requested an emergency response to transfer Mr A to another hospital for treatment. The ambulance arrived over two hours after the initial request.

Mr A's daughter (Mrs C) complained that the time taken for an ambulance to attend on both occasions was unreasonable and that Mr A's condition, on both occasions, should have resulted in an emergency response.

We took independent advice from an appropriately qualified adviser. We found that on each occasion the delay in an ambulance attending was not attributable to failings on the part of SAS assessing and prioritising the requests for an ambulance, or not appropriately allocating its resources. The delays were a result of a lack of availability of resources at the times in question and ambulances attending to higher priority calls. Whilst there was a significant delay in the ambulance attending to Mr A on each occasion, this was not attributable to failings on the part of SAS handling the calls. We did not uphold the complaint.

Summary

Ms C complained about the decision of staff at the Royal Hospital for Sick Children to assess that two referral letters from her child's (Child A) GP should be graded as routine rather than urgent. Child A had ankyloglossia (tongue-tie); this occurs where the strip of skin connecting the baby's tongue to the bottom of their mouth is shorter than usual which affected their ability to feed. As the board had added Child A to the routine waiting list, Ms C paid for the procedure to be completed on a private basis, and Child A immediately improved their feeding ability. Ms C believed that the GP referral letters should have been graded as urgent which would have allowed the procedure to be carried out sooner.

We took independent advice from a consultant paediatrician (consultant specialising in the medical care of children). We found that as Child A was able to feed using a bottle and was gaining weight, there was no need to classify the referral letters as urgent; this was in line with board policy. We did not uphold the complaint.

Summary

Ms C complained about the medical care and treatment provided to her father (Mr A) when he was an in-patient at the Royal Infirmary of Edinburgh. Ms C had concerns about the medical reviews, the decision to withdraw treatment/fluids, the monitoring of Mr A's condition, whether Mr A had an infection, the decision to reinstate active treatment, and communication with Mr A's family.

We took independent advice from a consultant in geriatrics (a doctor who specialises in medicine of the elderly) and general medicine. We found that the care and treatment provided to Mr A was reasonable and decisions were made sensitively to balance the wishes of Mr A's family and to reduce distress for Mr A. We did not uphold this complaint.

Summary

Mrs C complained about the care and treatment her late brother (Mr A) received from the practice. Mr A attended two consultations at the practice as he had experienced shortness of breath on exertion for the previous few weeks. The GP arranged for a chest x-ray and blood tests to be carried out. These tests did not highlight any concerns but Mr A confirmed that his breathing difficulties were ongoing. The GP felt his breathing difficulties could have been caused by angina (chest pain caused by reduced blood flow to the heart muscles) and increased his medication for this with the intention to refer Mr A for more specialist assessment if his symptoms persisted. Mr A died suddenly one week after his second consultation. Following a post-mortem, it was confirmed that the primary cause of death was a pulmonary embolism (a blockage in one of the pulmonary arteries in the lungs, caused by a blood clot). Mrs C complained to the practice and queried why the GP did not look at Mr A's medical history, as this included details of a previous blood clot. In addition to this, Mrs C queried why no further investigation was carried out after the second consultation when Mr A's x-ray results were confirmed as clear. In their response to Mrs C's complaint, the practice concluded that the GP's clinical assessment and decision-making, based on the information at the time, was considered and reasonable. Mrs C was unhappy with this response and brought her complaint to us.

We took independent advice from a GP. We found that the care and treatment the practice provided to Mr A was reasonable. We were satisfied that appropriate consideration was given to Mr A's medical history in respect of blood clots when assessing his breathing difficulties. We also concluded that the practice's actions, after Mr A's x-ray results were known, were reasonable and appropriate. We were satisfied that the records indicated the practice had a firm treatment plan in place for Mr A and had clearly detailed the reasons for this approach. Therefore, we did not uphold Mrs C's complaints.

Summary

Ms C complained about the dental assessment she received from a consultant in restorative dentistry at the board and the consultant's report of their findings. Ms C said that the consultant failed to consider her health/dental health issues and the views of her own dentist appropriately. She complained that the consultant unreasonably concluded that she did not qualify for specialist treatment at the board. Ms C felt that the consultant should have agreed for her to have dental implants.

We took independent advice from a dentist. We found that Ms C's dentist felt that her natural dentition should be removed to make way for dentures and that they referred Ms C to the board for a second opinion. We found that dental implants were not available on the NHS, other than in exceptional circumstances, which Ms C did not meet those criteria. We noted that the two alternative treatment options identified for Ms C by the board consultant would most appropriately be carried out by her own dentist rather than a specialist at the board. We also found that Ms C's health and dental phobia issues would usually be managed by a patient's dentist and would not be the remit of a restorative consultant. However, we noted that if these proved to be too complex, then a patient should be referred to the Public Dental Service, where dentists are better versed in treating patients with medical, behavioural or phobia issues

We concluded that the board provided Ms C with appropriate care and treatment and, therefore, did not uphold the complaint.

Summary

Mr C complained about the way the practice removed his Duloxetine medication when he reported that it was not giving him adequate pain relief. When the medication was removed Mr C suffered from withdrawal symptoms and had to be admitted to hospital.

We took independent advice from a GP. We found that the practice had reduced Mr C's medication in line with accepted medical practice, while at the same time introducing an alternative painkilling medication. Unfortunately, Mr C then developed some signs of withdrawal, but this was not as a result of inappropriate medical treatment. We did not uphold the complaint.