Not upheld, no recommendations

Summary

Mr C was concerned that the council had not reasonably assessed whether the structural stability and provision of natural light to his house met the tolerable standard in terms of the Housing (Scotland) Act, and that the council had not reasonably considered whether to exercise powers under the Roads (Scotland) Act in relation to a footpath outside his home.

We found that no request for an assessment of tolerable standard had been made by Mr C, and did not uphold this complaint. We also found that the council had correctly concluded that the Roads (Scotland) Act did not apply to the footpath outside Mr C's house, as it had not been adopted by them and they were not responsible for its maintenance. We did not uphold this complaint.

Summary

Mrs C complained about the council on behalf of her sister-in-law (Mrs A). Mrs C and Mrs A previously lived together in a private let along with their respective husbands and six children between them. Mrs C also provided care for Mrs A. After receiving a notice to quit from their landlord, Mrs A presented as homeless and asked for both family units to be rehoused together. The council advised that they were not able to provide temporary accommodation large enough and would struggle to provide permanent accommodation if they were rehoused together. After carrying out further assessment, including an occupational therapy assessment, the council insisted that Mrs C and Mrs A would have to submit two separate homeless applications. Mrs C complained that they were not able to submit a single homeless application. In addition to this, she complained about the staff attitude and the service they had received from the council.

After reviewing the council's records and the relevant legislation and guidance, we decided that it was reasonable for the council to insist on two separate homeless applications. We considered this to be reasonable as the families had only started living together relatively recently and that, in the council's opinion, there was no clear medical or social care evidence indicating that the families could not live apart. We also found that being rehoused together may result in both families having to stay in temporary accommodation for an indefinite period of time. Therefore, we did not uphold this aspect of the complaint.

In regards to the service received, we found that one record of phone contact used inappropriate wording when describing Mrs C's actions. We highlighted to the council the importance of using neutral, non-subjective language in their records. However, we concluded that there was not enough independent, verifiable evidence to suggest that the council's service was inappropriate or unreasonable. It was also noted that the council had attempted to find a suitable housing outcome for both families. Therefore, we did not uphold this aspect of Mrs C's complaint but did provide feedback to the council about how they record contact with service users.

Summary

Mr C, who works for an advocacy and support agency, complained on behalf of his client (Miss A). Miss A had complained to the council that they should have allowed her an extension to her tenancy to allow her to clear out her belongings when she was vacating her property. She had also complained that the council did not properly charge her for the rechargeable works they carried out to clear the property after she vacated. She also complained that the council coerced her to agree to leaving her belongings and did not disclose to her how much she would be charged for the removal of her belongings.

In their response to Miss A's complaints, the council confirmed that they had extended Miss A's tenancy to allow her time to remove her belongings and that she had not made them aware of any exceptional circumstances to grant a further extension. They did not consider they had coerced Miss A to agree to leave her belongings and they believed that the works carried out to clear her property were properly incurred given the condition of the property at the time. They did, following an inspection of the invoiced works, reduce the amount due by Miss A as they identified works that she should not be responsible for. Miss A was not happy with this response and Mr C subsequently brought her complaints to us.

We established that the council had provided Miss A with an extension of two weeks to her tenancy. We did not find any record of Miss A noting any exceptional circumstances to the council at the time, indeed Miss A had communicated to the council confirming the dates by which she would remove her belongings. On this basis, we concluded that the council had provided Miss A with an extension to her tenancy and had acted reasonably in the circumstances. With respect to the rechargeable repairs carried out by the council, we saw evidence that the property was inspected and that Miss A was aware of the works she was to carry out prior to leaving. We were satisfied that photos of the property provided evidencing the condition of the property when Miss A left, together with the details of the inspection, indicated a significant amount of work needed to be undertaken to clear the property. We found that the council acted correctly in reducing their invoice following the complaint made by Miss A, but we were satisfied that the works completed were reasonable and reflective of the condition of the property. As such, we did not uphold Mr C's complaints.

Summary

Due to raised levels of carbon dioxide in her home, Miss C was decanted to a new permanent home by the housing association. She complained to us that the association failed to manage her decant in line with their policy and that they failed to communicate with her in an appropriate manner throughout the process.

The association told us that, at an early stage of the carbon dioxide incident arising, they identified that they did not have a policy on decant and home loss allowances which covered an incident the scale of that experienced by Miss C. They took steps to put one in place and confirmed that they took guidance for the amounts to offer for home loss and furnishings from Shelter (a charity which offers advice and advocacy regarding poor housing) and other housing associations. The association also explained that they agreed with Miss C what work they would complete in her new home. In addition, Miss C received the appropriate home loss payment and she also received additional payments for replacing her floor coverings and curtains. The amounts Miss C received were in line with the allowances set out in the association's decant policy. As such, we did not uphold Miss C's complaint that the association failed to manage her decant in line with their policy.

We also did not identify any evidence to suggest the association failed to communicate with Miss C in an appropriate manner throughout the process. We saw evidence that staff had taken reasonable steps to keep in contact with Miss C throughout the process. In light of the evidence available, we did not uphold Miss C's complaint about the association's communication with her throughout the process.

Summary

Mr C complained that the council unreasonably prevented him from having contact with his mother who was living in a care home. The council informed Mr C that his mother did not want to see him and continued to prevent contact after his mother was assessed as not having capacity. Mr C believed his mother did have capacity and that she had expressed wishes that she wanted to see him.

We took independent advice from a social worker. We found that, when Mr C's mother first said she did not want to see her son, she had the capacity to make that decision. When Mr C's mother showed signs of confusion and disorientation, the council took the appropriate action and arranged for a consultant psychiatrist to assess her capacity. Mr C's mother was found to not have capacity to make decisions about her welfare. The adviser noted that the council acted appropriately following this result and arranged an Adult Support and Protection case conference to discuss whether Mr C should continue to be prevented from having contact with his mother. We found that the council thoroughly considered this matter and that their decision was reasonable. We did not uphold Mr C's complaint.

Summary

Mr C complained about a consultation he had at the fracture clinic at Perth Royal Infirmary and the following care and treatment he received. Mr C was referred to the clinic after he fell and injured his hip. Prior to attending the consultation, an x-ray of Mr C's hip had been arranged by his GP, whilst an MRI scan had been carried out privately. Mr C brought the written MRI report to the consultation, but did not bring the imaging CD. After examination, the surgeon decided that conservative treatment (medical treatment avoiding radical therapy or an operation) was appropriate and they arranged to review Mr C in three months' time. Mr C obtained a different opinion on the treatment of his injury from a surgeon at a different NHS board. Mr C then agreed to have surgery on his hip at this same NHS board and said that this improved his condition.

Mr C raised concern that the surgeon at Perth Royal Infirmary failed to carry out an appropriate assessment of his condition. Mr C felt that the surgeon should have reviewed the MRI images and spoken to the radiologist who carried out the MRI privately. We received independent advice from a consultant orthopaedic surgeon. They said that Mr C was responsible for providing the MRI images, if he wished for them to be considered. The adviser considered that the assessment carried out was reasonable, and we did not uphold the complaint.

Mr C also complained that the board had failed to provide him with the same care that he subsequently received from another health board. In response to our enquiries, the board said that, based on the information available to them, they could see no reason for surgery and were satisfied that conservative treatment was appropriate. The adviser was satisfied that the surgeon's diagnosis was reasonable and consistent with Mr C's symptoms and the radiological findings. The adviser said that it was appropriate for the surgeon to arrange to review Mr C again, but suggested that an earlier review might have been more reassuring for Mr C. The adviser did not consider the different treatment by another NHS board to reflect failure in care on the part of the board, and they were satisfied that the care and treatment provided by them was reasonable. We did not uphold this complaint.

Finally, Mr C raised concern about the quality of the board's complaint investigation. We found that the board's complaint response did provide an explanation about the surgeon's findings and a reason for the treatment they suggested. We noted that an independent clinician had reviewed the surgeon's findings and the medical records, which informed the board's response to the complaint. We were satisfied that the approach taken to investigating the complaint was reasonable, and we did not uphold this complaint.

Summary

Mr C complained on behalf of his wife (Mrs A). Mr C complained that, when his wife attended the accident and emergency department at Gilbert Bain Hospital following a fall, she was not given appropriate care and treatment. Mr C also complained that the GPs at Mrs A's GP practice did not provide her with appropriate care and treatment for problems that she had with her legs, and that staff attitudes towards Mrs A at the practice were unreasonable.

We took independent advice from a consultant in emergency medicine and from a GP adviser. We found that, when Mrs A attended the accident and emergency department following her fall, a full and thorough history and assessment were carried out. We considered that the care and treatment provided to her were reasonable. We also found that the care given to Mrs A for the problems with her legs by the GP practice was reasonable, and that there was no evidence that the attitude of practice staff towards Mrs A was unreasonable. We did not uphold Mr C's complaints.

Summary

Mrs C complained to us that the medical practice had failed to provide appropriate care and treatment to her father (Mr A) who had fallen whilst coming out of the shower. Mr A was seen by three GPs from the practice over a two week period, who treated him for a knee injury. Mr A then called an out-of-hours service and was seen by a different GP. It was found he had a fractured hip and he was taken to hospital where a rod and pins were inserted into his leg. Mrs C felt the GPs at the practice had failed to diagnose the hip fracture.

We took independent advice from an adviser in general practice medicine and concluded that at no time during the three GP consultations did Mr A complain of hip pain or hip injury and that there were no symptoms which indicated that his hip was fractured. There was also no report that he was unable to walk or bear weight which would have been an indication of a hip problem. We found that the GPs involved reasonably concluded from Mr A's reported symptoms that he had injured his knee and they provided appropriate treatment. We did not uphold the complaint.

Summary

Mrs C complained about the care and treatment provided to her late mother (Mrs A) by the practice. Mrs C complained that the practice failed to appropriately monitor and treat Mrs A's symptoms after she was diagnosed with a heart condition. Mrs A was referred to cardiology by the practice a number of years ago and was diagnosed with a heart condition known as mitral regurgitation (when blood back flows through a valve in the heart called the mitral valve). She was prescribed diuretic medication (also known as water tablets - tablets which can help reduce the fluid build up that can occur when the heart is not working normally). When Mrs A was reviewed by cardiology again two years later, the condition was noted to have resolved and the cardiology clinic advised that the diuretic medication could be reduced and stopped. In line with Mrs A's wishes, she continued to take the medication for a further three years before it was stopped when she was found to have low sodium levels. In the interim, Mrs A had also been given a steroid inhaler for suspected asthma. Mrs A suffered a heart attack and died less than two months after stopping the diuretic medication.

Mrs C complained that stopping the diuretic medication contibuted to her mother's death. She raised concerns that closer monitoring of Mrs A's known heart condition did not occur. She also raised concerns that the steriod inhaler prescribed for breathlessness may have masked the underlying problems with Mrs A's heart. In particular, Mrs C did not consider that Mrs A received the appropriate attention required to properly identify the cause of the symptoms she presented with in the final months of her life.

We took independent advice from a GP adviser. We found that the management of Mrs A's symptoms was reasonable. The adviser noted that the cause of the mitral regurgitation was never established and that, when it appeared to have resolved, no ongoing cardiology follow-up was arranged. Had heart valve disease, which is one of the possible causes of mitral regurgitation, been identified, the adviser confirmed that this would have been followed up by the cardiology clinic, and not by the practice. In light of the cardiology clinic's advice that the diuretic medication could be stopped, alongside the low sodium level later found in Mrs A, we were advised that it was reasonable for the practice to have stopped this medication. We were also assured by the advice we recieved that the prescription of inhalers was reasonable and that there was nothing to indicate that this masked an underlying heart condition. The adviser did not consider that Mrs A's death could reasonably have been forseen by the GPs at the practice, and they concluded that the care provided to her by the practice was reasonable. We accepted this advice and we did not uphold Mrs C's complaint.

Summary

Mrs C underwent dental work. After she submitted the invoice to her dental insurer, they refused to cover most of the costs as the work had been charged on a private treatment basis and the insurance policy only covered NHS costs. Mrs C complained that her dentist had never discussed this with her. She said that if she had known that the work was going to be charged at private costs she would not have agreed to it.

Mrs C's dental records included entries documenting discussion about the work being charged on a private basis, and an entry stating that she was given a written estimate. A copy of the written estimate was provided to us, showing itemised NHS and private treatment costs. We concluded that the fact that the work would be charged on a private treatment basis had been discussed with Mrs C. As such, we did not uphold her complaint.