Not upheld, no recommendations

Summary

Miss C complained about the time taken to refer her to a specialist in a different board area for her urology issues (urology is the area of medicine relating to the kidneys, bladder and urinary tract). She said she asked for this referral repeatedly, but that it took a number of months for the board to refer her. She also complained that the board did not send on some test results to her new consultant, so she was required to repeat these privately at her own cost.

In response to Miss C's complaint, the board said that referrals to another health board are not available on demand. They said that the consultant who reviewed Miss C's case and made the referral felt that it was appropriate to refer her on for more specialist advice at that time. The board acknowledged that they did not include a copy of the test results with the original referral, and they apologised for this. They said they had sent on the test results about two months later.

We took independent advice from a consultant urologist. We found that Miss C's condition was first investigated by gynaecology (the area of medicine that deals with the health of the female reproductive systems and the breasts) and, while Miss C did request a referral to the specialist during this time, she then agreed to continue with additional tests. Miss C then advised the gynaecology service that she was now seeing a private gynaecologist, and she was appropriately discharged from their care. About six months after this first urology appointment, Miss C was reviewed by urology, and there is no evidence in the medical records that she requested a referral to the specialist before this review. We considered that this time-frame was reasonable, and there was insufficient evidence to conclude that the board had failed to respond to her request for a referral. We did not uphold this aspect of Miss C's complaint.

In relation to the test results, we found there was evidence that the board did send these on two months after the referral (although it appeared they were never received by the specialist). We found the delay was unreasonable, but noted that the board had already apologised for this. We found that it was likely the specialist would have asked Miss C to repeat these tests in any case, so we did not recommend that the board refund this cost. We did not uphold this aspect of Miss C's complaint.

Summary

Mr C's late mother (Mrs A) was receiving palliative care (end of life care) for advanced pancreatic cancer at home in a sheltered housing complex. Mr C contacted the out-of-hours service a number of times over a weekend, as he was concerned about the amount of pain that Mrs A was in. On the Sunday evening, Mrs A was admitted to hospital and transferred to a hospice the following day, where she died several days after. Mr C complained that the board failed to provide a reasonable standard of medical care and treatment and that they failed to respond to his complaint in a reasonable way.

We took independent advice from a specialist in general practice medicine. We found that the medical care and treatment provided to Mrs A was of a reasonable standard and that she was admitted to hospital within a reasonable time. In relation to complaints handling, we found that the board had fully addressed the issues raised and took account of the evidence available at the time. We did not uphold Mr C's complaints.

Summary

Mr C complained about the treatment which his late brother (Mr A) received when he attended the accident and emergency department at Dumfries and Galloway Royal Infirmary. Mr C had received a phone call from Mr A early one morning saying that he had difficulty breathing. An ambulance was called and took Mr A to the hospital. Later that morning Mr C received a further call from Mr A saying that he was being discharged from the hospital and asking Mr C to pick him up. Mr C ensured that Mr A was settled in his house. However, Mr C later learned that Mr A had died. The cause of death was heart failure and Mr C felt that more care should have been taken at the hospital and that perhaps Mr A should have been admitted for further tests.

We took independent advice from a consultant in emergency medicine. We found that the staff at the accident and emergency department had carried out an appropriate examination of Mr A at the time, which included a history of heart problems. They had taken a chest x-ray, electrocardiogram (ECG - a test to check the heart's rhythm) and blood tests. Although there were subtle signs of heart failure from the results, we concluded that it was reasonable for the staff to diagnose that Mr A was suffering from a chest infection rather than heart failure. It was also reasonable that Mr A was prescribed antibiotics and discharged home. We did not uphold the complaint.

Summary

Miss C was due to have surgery on her leg at Dumfries and Galloway Royal Hospital but this was cancelled shortly before the scheduled time. Miss C complained that the board did not carry out her surgery and that the reasons for this were not properly explained to her. While the board apologised for the confusion surrounding the decision to cancel Miss C's surgery, they felt that the decision was appropriate as it was a major operation with significant risks and she had shown some recent improvement. Miss C was unhappy with this response and brought her complaint to us.

We took independent advice from a consultant vascular surgeon. We found that it was reasonable for the operation not to have been performed, but we considered that the decision-making process surrounding this could have been clearer. We found that the entries made at the time in Miss C's medical records indicated that the reasons for not going ahead with the surgery had been explained to her. We did not uphold Miss C's complaints but provided feedback to the board regarding their decision-making process for surgery in complex cases.

Summary

Mrs C complained about the care and treatment provided to her husband (Mr A) by the practice. Mr A attended the practice feeling unwell, having had a history of heart problems. In the following weeks Mr A was admitted to hospital where he was diagnosed with a condition in his heart. Mr A suffered an injury in the brain as a result of a bleed, and his short term memory has been impacted by this. Mrs C considered that if the heart condition had been diagnosed earlier, then Mr A's eventual outcome may have been different.

We took independent advice from a GP adviser. We found that the symptoms described and noted were not indicative of a particular illness. We also found that the classic symptoms of Mr A's condition were not seen until the day Mr A was admitted to hospital. We found that the GP took reasonable steps to establish the reason for Mr A being unwell and carried out appropriate tests. We also considered that the GP made an appropriate referral to a cardiologist (a  doctor who specialises in finding, treating and preventing diseases of the heart and blood vessels). The referral to the cardiologist was not sent as a matter of urgency. The GP surgery acknowledged this error and took steps to ensure that this did not happen again. We found that, even if the referral had been sent urgently, this would not have had an impact on the outcome. We did not uphold the complaint.

Summary

Ms C complained about the assessment of her father (Mr A)'s capacity by old age psychiatry staff who visited him at home and while he was an in-patient at University Hospital Crosshouse. She was also concerned that the assessment of the level of care Mr A required was unreasonable.

We took independent advice from a consultant in old age psychiatry. We found that Mr A's capacity had been assessed regularly and that the assessments themselves reached reasonable conclusions. Therefore, we did not uphold Ms  C's complaints. While we found that the assessment of Mr A's care requirements was appropriate, it was noted that Ms C and her family appeared to have received somewhat confusing information from social work staff regarding the level of care needed. We provided feedback to the board on this matter.

Summary

Mr C, who is an advocacy and support worker, complained on behalf of his client (Ms B) that the council unreasonably failed to provide her child (child A) with a Self Directed Support package (SDS, a package that allows individuals to choose how they receive their social care and support). Ms B was informed that it was likely child A would qualify for SDS but at the end of the eligibility assessment it was determined that they did not meet the criteria. Ms B was told by her social worker that the eligibility criteria had changed and child A did not meet these requirements. Ms B complained to the council about the change in criteria and that her expectations were unfairly raised. The council responded by explaining that the criteria had not changed and that this was incorrect information provided by the social worker. They also noted that the social worker did explain that any award given is always dependent on the outcome of the assessment. Ms B was unhappy with this response and Mr C brought her complaint to us.

We took independent advice from a social worker. We found that the criteria had not changed and that the social worker involved appeared to have misunderstood the content of an email from the team manager about eligibility criteria. We noted that the council had acknowledged this failing and apologised to Ms B for providing her with incorrect information. We found that child A had been assessed appropriately and against the SDS eligibility criteria set out in the council's guidance. Therefore, we did not uphold Mr C's complaint. However, we were concerned that Ms B's expectations of the SDS outcome had been unfairly raised and we asked the council to reflect upon this for future learning.

Summary

Mr C complained about the service he received from his housing association. He had experienced ongoing issues with his sleep and mental health as a result of noise generated by an extractor fan in the bathroom of the property below him. The property below was privately owned and rented out to tenants. Mr C complained that the housing association unreasonably declined to take appropriate action to address the noise and that the service provided by the association deteriorated after he disclosed his mental health issues to them.

We found that the association liaised with Mr C, the property's owner and the council's noise and environmental health teams to try and reach a solution. The setting of the extractor fan was adjusted but Mr C said that the noise was still impacting on him. The owner of the flat below decided not to allow any further access to the property as the council's environmental team found no issues with the fan. The association no longer had access to the flat below and stated that there was no further action that they could carry out. We considered that the association had taken reasonable steps to resolve the situation and that the owner of the flat below was within their rights to deny access. We also noted that the association's property maintenance manager had inspected the ventilation system and found no faults. Therefore, we considered that the housing association had acted reasonably and did not uphold this aspect of Mr C's complaint.

In relation to the service provided by the association, we found no evidence to suggest that the service had deteriorated after Mr C disclosed his mental health issues. We did not uphold this aspect of Mr C's complaint.

Summary

Mrs C complained on behalf of her late mother (Ms A) that the housing association failed to take reasonable action or provide an appropriate level of support in response to reports of anti-social behaviour. Ms A had made a number of complaints about anti-social noise caused by her upstairs neighbour. The association issued a warning to the neighbour after one report but did not take any further action following others. Mrs C felt that the association's lack of action in response to anti-social behaviour caused Ms A to complete suicide.

We found that the association had taken action against the neighbour on the one occasion that they had evidence of anti-social behaviour occurring. Given the type of anti-social behaviour, we considered that an initial warning was appropriate and in line with the housing association's internal policies. The association attempted to corroborate other reports of anti-social behaviour but were unable to do so. Therefore, we considered that it would not have been appropriate for them to take further action on these occasions. We also noted that the reports of anti-social behaviour increased within a relatively short timeframe and we found no evidence to suggest that the housing association would not have escalated the measures taken and offered further support had the incidents continued. We considered that the housing association had acted reasonably and in line with relevant procedures. Therefore, we did not uphold Mrs C's complaint.

Summary

Ms C's aunt (Ms A) was transferred to a care home and was provided full funding on an interim basis while Ms C applied for Financial and Welfare Guardianship. The partnership began a financial assessment to calculate Ms A's care costs. Once guardianship was approved, the partnership did not complete the financial assessment as they had concerns about Ms C's decision to keep Ms A's property. Ms C planned to use this property as a base for visits to Ms A, as most of her remaining family lived in another country. The partnership made an Adult Support and Protection (ASP) referral but before this procedure concluded, Ms C decided to sell the property as she felt pressured to do this in order for the assessment to progress. Ms C complained that the partnership unreasonably delayed in completing a financial assessment and that they failed to appropriately assess the finances in line with their obligations.

We took independent advice from a social worker. We found that the partnership acted reasonably in making an ASP referral as it was the correct procedure to follow given the concerns that they had. The adviser noted that communication between the partnership and Ms C could have been better, which may have aided a swifter resolution. However, the financial assessment was appropriate and Ms C made the decision to sell the property before the ASP procedures were concluded. Therefore, we did not uphold Ms C's complaints.