Not upheld, no recommendations

Summary

Mr C, a lawyer, complained on behalf of his client (Ms A) regarding the university's handling of complaints she had made about an extra curricular programme provided by them. Mr C raised a number of concerns, the main points being that, Ms A had not been adequately consulted during the university's investigation, that the university had failed to disclose critical information, and that the university had failed to follow their complaints handling procedure.

We found that the university had reasonably followed their complaints handling procedure and had reasonably consulted Ms A during their investigation. Therefore, we did not uphold the complaints.

Summary

Mr C complained that an approved extension to a neighbouring property was in breach of the relevant planning guidance. Mr C considered that the height of the rooflights were too low and that the privacy and amenity of his garden would be compromised. Mr C also argued the development was inappropriate in size and scale and would be overbearing when compared with other properties. In addition, Mr C believed that the reduction in garden ground would be excessive as much of the front garden was taken up by parking and hardstanding.

We found that there had been no procedural errors on the part of the council when handling the application. Mr C's objections had been considered by the planning committee as part of the report. We considered that there were no grounds for this office to question the professional judgement the planning officers had exercised when compiling the report considered by the planning committee. Mr C subsequently contacted us raising further questions about the planning guidance which might apply. Whilst this was noted, we explained to Mr C that planning guidance is not binding and that a planning officer is entitled to take into account the circumstances of each individual application when deciding the extent to which the planning guidance needed to be applied. We found that the council's report to the planning committee set out in some detail how the application had been amended to bring it into line with planning guidance. Therefore, we did not uphold the complaint.

Summary

Mr C complained that the council did not reasonably respond to reports of bullying against his child (Child A).

We found that the school had appropriately followed both their own, and the council's anti-bullying policy in approaching the issues raised by Mr C. Therefore, we did not uphold the complaint.

Summary

Mr C complained about the care and treatment he was given for addiction issues while in prison. We took independent advice from a mental health nurse with experience in addictions. We found that the treatment and support offered to Mr C was reasonable. In particular, the decision not to offer Mr C alternative medications to methadone was reasonable given that he admitted to the ongoing use of heroin and other illicit medications in prison, and would therefore have been at risk of an overdose. We also noted that with alternative medications to methadone there is a risk of them being covertly diverted in the prison environment. We did not uphold Mr C's complaint.

Summary

Ms C complained on behalf of her late mother (Mrs A) who died during her admission at a community hospital. Ms C's complaints were that:

the partnership did not provide reasonable care and treatment to Mrs A;

there was a lack of reasonable communication with Ms C about Mrs A's care and treatment, and the behaviour of staff towards Ms C was unreasonable;

the partnership unreasonably obtained a second clinical opinion on Mrs A's eligibility for hospital based NHS continuing healthcare;

the decision to discharge Mrs A from hospital, on the grounds that her healthcare needs - did not meet the eligibility criteria for hospital based NHS continuing healthcare was unreasonable;

and that the partnership's handling of and their response to Ms C's complaints was unreasonable.

We took independent advice from a consultant in geriatric (elderly) and general medicine, and from a senior nurse. We found that, overall, the care and treatment provided to Mrs A was reasonable. We were unable to find evidence of a lack of reasonable communication with Ms C about Mrs A's care and treatment, and that the behaviour of staff towards Ms C was unreasonable.

We were satisfied that, in terms of the NHS continuing healthcare guidance which was in place at the time, the partnership were entitled to carry out regular formal reviews of Mrs A's health care needs and to reassess her eligibility for NHS continuing health care. We found that the partnership were entitled to carry out the two clinical assessments of Mrs A's current healthcare needs at the time; that they agreed with the decisions reached that Mrs A did not require the provision of NHS continuing healthcare in line with the relevant guidance and that the decision to discharge Mrs A from hospital was reasonable. We were also satisfied that the partnership appropriately informed Ms C of her right of appeal and of her right to complain to this office. Therefore, we did not uphold these aspects of the complaint.

We also considered that the partnership took reasonable steps to try and address Ms C's concerns and complaints, both informally in the ward setting and at meetings with her, and also more formally by the patient experience team. A review highlighted no overall system failings but did identify areas for improvement which concurred with all of the review findings made. Given this, we did not uphold this complaint.

Summary

Mrs C complained on behalf of her late relative (Mrs A) about the information given to Mrs A by doctors prior to her death in hospital. Mrs C was unhappy that Mrs A was told that she was dying, and that she was asked where she wanted to be when she died. We found that on one occasion Mrs A asked for information about her prognosis and she was provided with an honest response. We also found there was evidence of a further discussion with Mrs A regarding her future care when it was disclosed to her that she was dying. The General Medical Council (GMC) guidance states that a doctor must answer patients' questions honestly. It also states that information necessary for making decisions should not be withheld even if another relative asks the doctor to do this, unless the doctor considers that this would cause the patient serious harm. It was recorded that Mrs A had capacity and that she required to be involved in discussions about her future care. We found that the doctors were required to make Mrs A aware of her situation in order to obtain her consent. We did not uphold this aspect of the complaint.

Mrs C also complained about a failure to address her complaint about an item of hers that went missing in the hospital. We did not uphold this complaint on the basis that the board had initially logged the complaint. Although the board delayed in addressing the complaint they proceeded to apologise for the fact that it had not it had been addressed sooner.

Summary

Mr C complained about the antenatal care which his wife (Mrs A) received at the Royal Infirmary of Edinburgh. Mr C felt that Mrs A was not appropriately monitored by the community midwives, that they had been difficult to contact for advice when Mrs A started to suffer from swollen legs, and that she went on to develop pre-eclampsia (a pregnancy-related condition involving a combination of raised blood pressure and protein in the urine) which required an emergency hospital admission.

We took independent advice from a midwife and found that Mrs A's antenatal care was shared between the community midwives and her GP practice. Mrs A was appropriately monitored during the antenatal period although the nursing documentation could have been clearer. We also found that appropriate advice was given that Mrs A should take paracetamol for her swollen legs and to seek further advice if the symptoms did not improve. Appropriate contact details were contained in Mrs A's nursing records. There was also no indication from the nursing records that Mrs A had reported symptoms which were suggestive of pre-eclampsia. We did not uphold the complaint.

Summary

Mrs C complained about the care provided to her late sister (Mrs A) when she attended Raigmore Hospital with gastric symptoms. Investigations were carried out into Mrs A's symptoms over two admissions. During the latter admission, Mrs A was diagnosed with a perforated bowel, thought to be related to cancer. Her condition deteriorated very quickly and she died from her illness.

We took independent advice from a consultant gastroenterologist (a doctor who specialises in the digestive system) and from a registered nurse.

We did not identify any failings in the medical management of Mrs A's condition or in the nursing care provided. We did not uphold this aspect of the complaint. However, we noted that the documentation of her care could have been more detailed and fed this back to the board.

Mrs C was also unhappy that board staff did not contact her regarding Mrs A's discharge from the hospital following her first admission. In response to Mrs C's complaint, the board confirmed that another family member had been told about the discharge and so there was no requirement for duplication of information. We did not uphold this aspect of the complaint.

Summary

Mr and Mrs C complained on behalf of their child (Child A) about the care and treatment they received from the board's children and adolescent mental health services over several years. The concerns related to the stopping of treatment; the lack of support to aid Child A's understanding of a complex system and consenting to it; and lack of transparency regarding a number of matters. The board did not identify any failings in the care and treatment provided and explained this to the family.

We took independent advice from a consultant child and adolescent psychiatrist. We considered that there had been a reasonable amount of input at an appropriate level of seniority in place to make decisions in a complex case. We found that it was a reasonable course of action to stop a type of therapy and not carry out a risk assessment as there was evidence of engagement and future planning and no evidence of a high risk situation at this time. In addition, whilst the therapy was stopped, Child A continued to receive care from psychiatric and psychology services. In terms of consent, there was evidence in the clinical records to support that attempts were made by staff to tailor their approach towards Child A and we did not identify unreasonable practice. However, we did provide feedback to the board regarding ensuring that patients receive relevant information about their clinical condition. We also considered that further opinions were appropriately sought when the family questioned the clinical diagnosis in line with national guidelines. We did not identify any concerns regarding transparency in the clinical records or with the family. We did not uphold the complaint.

Summary

Miss C complained about the clinical and nursing care and treatment given to her late father (Mr A).

We took independent advice from a consultant geriatrician (a doctor who specialises in medicine of the elderly) and from a nursing adviser.

In relation to the clinical care and treatment, we found that the clinical records evidenced that an appropriate assessment of Mr A was carried out and that reasonable efforts were made by clinical staff to treat Mr A's condition. We found that, overall, the clinical care and treatment given to Mr A was reasonable and we did not uphold this aspect of the complaint.

In relation to the nursing care and treatment given to Mr A, we found that the nursing records were of a reasonable standard and that they demonstrated that there had been a risk-based assessment of Mr A. There was also evidence of care planning related to the level of risk and ongoing documentation around delivery of daily care for Mr A. However, we found that the documentation around the injury to Mr A's foot could have been better and we drew this to the board's attention. On balance, we found that the nursing care and treatment was reasonable and did not uphold this aspect of the complaint.

Lastly, Miss C complained about the communication from the hospital with her and her family. We found that the clinical records demonstrated an appropriate level of communication and we did not uphold the complaint.