Not upheld, no recommendations

Summary

Ms C complained about the care and treatment she received at Princess Royal Maternity Unit and Queen Elizabeth University Hospital following the birth of her baby. Ms C complained about the appropriateness of a speculum (a metal instrument that is used to dilate an orifice or canal in the body to allow inspection) examination and had concerns whether an ultrasound had been carried out and reported properly. Ms C also complained that it took around three weeks for it to be identified that she needed surgical treatment for ongoing bleeding and retained products of conception, and about the lack of breast pump available and support given regarding expressing milk.

We took independent advice from a consultant obstetrician and gynaecologist (a doctor who specialises in pregnancy, childbirth and the female reproductive system) qualified in ultrasound, a consultant obstetrician and gynaecologist, and a midwife. We found that it was appropriate to perform the speculum examination and that the ultrasound had likely been interpreted accurately. Therefore, we did not uphold this aspect of Ms C's complaint.

We also found that subsequent investigations did not identify significant products of conception that required earlier surgical intervention. We further considered that there was reasonable evidence to reflect that advice had been offered regarding breast care and that it was not unreasonable that a breast pump was not available at the time of discharge. However, we noted that the board reflected on Ms C's concerns and acknowledged the benefit of improving their supply of breast pumps. We did not uphold this aspect of Ms C's complaint.

Summary

Mr C complained about the care and treatment provided to his child (Child A) during an admission at Royal Aberdeen Children's Hospital. Child A had a life-limiting condition, including heart and lung problems which made them susceptible to infection. Mr C complained that the hospital did not monitor Child A's blood gases frequently enough which led to an unreasonable delay in them being intubated. Mr C also complained that the hospital failed to accept a referral to the respiratory department. The board confirmed that they performed monitoring of Child A's blood gases when it was clinically indicated. They also confirmed they could not find any evidence of a formal written referral to the respiratory department.

We took independent advice from a consultant paediatrician (consultant specialising in the medical care of children). We found that appropriate monitoring of Child A's blood gases was performed, particularly for in a high-dependency unit setting. We did not find any evidence that the board failed to act upon a referral to respiratory. We did not uphold Mr C's complaints.

Summary

Mr C complained about the lack of care which his wife (Mrs A) received from the Victoria Hospital Kirkcaldy. Mrs A had suffered from chronic knee pain for a number of years and had undergone episodes of arthroscopy (surgical technique to diagnose and treat problems in the knee joint) in the past. She requested further surgery but the surgeon decided that further surgery would not be of benefit and that she should continue with conservative treatment. Mrs A asked for a second opinion and another consultant discussed Mrs A's condition with the surgeon; it was again decided to continue with conservative treatment. Mr C thought that the decision of the surgeon was unreasonable and that they had influenced the decision from the consultant.

We took independent advice from a consultant orthopaedic surgeon (a specialist in the treatment of diseases and injuries of the musculoskeletal system). We found that the decision by the surgeon not to offer further surgery was reasonable in the circumstances. If a patient still suffers from pain following repeated arthroscopic surgery, it would not be appropriate to continue with the surgical interventions when there is no notable benefit for the patient. We also found that it was not unreasonable for the consultant and the surgeon to have discussed treatment options for Mrs A and that the decision to persevere with conservative treatment was appropriate. We did not uphold the complaint.

Summary

Mr C complained about the care his mother-in-law (Mrs A) received at Victoria Infirmary Hospital. Mrs A has emphysema (a lung condition that causes shortness of breath) and has particular difficulty with her breathing when moving around. Mr C raised concern that when he made enquiries about Mrs A receiving ambulatory oxygen therapy (the use of supplementary oxygen during exercise and activities of daily living) it was unreasonably refused.

We took independent advice from a consultant physician in general and respiratory medicine. We found that it was reasonable for board staff to have reached the view that ambulatory oxygen was not indicated in accordance with guidance issued by the British Thoracic Society. We, therefore, did not uphold the complaint. However, we also considered that board staff should have offered Mrs A a second opinion and so we provided feedback to the board for reflection in this respect.

Summary

Miss C complained about the treatment which she received from a dentist. She said that she had attended the dentist over a five month period complaining of a sore tooth and that the dentist told her she required eight fillings. Miss C said that following the treatment she still suffered sensitivity and discomfort from the treated teeth and that when she attended another dentist she was told that the fillings were not required.

We took independent advice on Miss C's complaint from a dentist. We found that there was evidence from Miss C's x-rays that decay was present in her teeth and that treatment was required. Although Miss C had not reported problems with some teeth, it did not mean that there was no decay present and that, if the decay was not too deep, it is not uncommon for dentists not to record the depth of the decay. There was no evidence to substantiate the complaint that the dentist failed to provide Miss C with a reasonable standard of treatment. We did not uphold the complaint.

Summary

Mr C complained about the aftercare and treatment provided to him following his knee surgery. Mr C underwent a full knee replacement and following the surgery he experienced difficulty with bending and positioning his knee, as well as extreme pain. Despite completing physiotherapy, hydrotherapy and intense exercises, the problem did not resolve.

The board acknowledged a rare complication had occurred following Mr C's surgery, however, they consider that there was no undue delay in addressing the stiffness in Mr C's knee and that it was dealt with in a reasonable timescale.

We took independent advice from a consultant orthopaedic surgeon (a medical expert who treats patients with problems in their muscles, bones, joints and other related structures). We found that the aftercare was provided promptly and that there was no unreasonable delay. The board were not provided the opportunity to carry out further investigations or treatment as Mr C chose to seek private treatment. The board acted reasonably by offering a second opinion, however the offer was declined. We did not uphold the complaint.

Summary

Mr C complained about a dentist's failed attempts to restore his broken tooth with a white composite filling. The filling fell out a week later and was replaced but unfortunately it failed again and fell out two days later. The option of fitting a crown was discussed but Mr C did not consider that he should have to contribute to the cost of this. He subsequently changed dentist and requested that the cost of subsequent treatment under the new dentist was reimbursed. We took independent advice from a dentist. We found that the treatment provided in attempting to restore Mr C's broken tooth was reasonable and in line with standard clinical practice. The dentist had no obligation to contribute to the cost of any treatment Mr C received from his new dentist. Therefore, we did not uphold the complaint.

Mr C also complained about concurrent root canal treatment he was undergoing on a different tooth. This was carried out over several visits and, at the second visit, the dentist temporarily restored the tooth and booked Mr C a further appointment. However, Mr C reported that the tooth broke around four hours later when he was eating soft food. We found that the treatment provided was reasonable and in line with normal clinical practice. There was no evidence to support Mr C's concerns that failings in his treatment contributed to the tooth breaking a few hours later, and did not consider that the quality of this treatment should be associated with the subsequent extraction of the tooth by the new dentist. We did not uphold the complaint.

Summary

Mr C complained that the college's handling of his concerns about the behaviour of a learning support worker was unreasonable.

We found that the college was aware of Mr C's support needs, how this affected him and had put in place reasonable support for him. We noted that two meetings that had been arranged to discuss Mr C's concerns were cancelled. However, we were satisfied from the evidence provided by the college that there were genuine reasons for these cancellations. Two meetings to discuss Mr C's concerns took place subsequently.

We did not find evidence to make a finding that the support worker and college staff behaved inappropriately towards Mr C. We considered that upon learning of the difficulties in Mr C's relationship with the support worker, the college staff took reasonable action to try to address Mr C's concerns. Therefore, we did not uphold the complaint.

Summary

Mrs C complained that after an inspection by the Care Inspectorate of the care service she runs was carried out, she was not given sufficient information regarding how to improve. She also complained that the Care Inspectorate failed to reasonably investigate her complaint.

We found that there was evidence that the Care Inspectorate had given Mrs C substantial feedback after the inspection and was offered further advice and support from both the inspector and team manager. We did not uphold this aspect of Mrs C's complaint.

In relation to complaint handling, we found that the Care Inspectorate handled Mrs C's complaint in line with their complaint handling procedures and therefore we did not uphold this aspect of Mrs C's complaint.

Summary

Mr C manages a direct payment on behalf of his son and he complained to the council about their procedures. Mr C complained that the council's financial monitoring procedures were not sufficiently robust to ensure that he can manage the direct payment appropriately. He said he was wrongly accused of spending the money inappropriately and that the council's monitoring procedures are not 'light touch' as the Scottish Government advises they should be; he also said that the council failed to make reasonable support and guidance available to him as a personal assistant employer. Mr C said it was not clear what he could and could not spend the direct payment budget on and that the council were not keen to fund a membership for a support service, which he required.

The council said that it is not always possible to list every item that might be permitted in a person's support plan, however, there is a system in place whereby if the finance department wanted to query an item of expenditure they would contact the allocated social worker. The council also provided details of the different ways they support personal assistant employers.

We took independent social work advice and found that the policies and procedures the council had in place were reasonable and there was clear information provided about the support that was available. The council's financial monitoring procedures were appropriate and reasonable, and there was evidence that the council provided the appropriate funding for support services to Mr C. We did not uphold the complaints.