Some upheld, recommendations

Summary

Mrs C had worsening hearing loss in both ears, with narrow ear canals that made use of in-ear hearing aids painful and intolerable. She complained that the board failed to refer her to the correct consultant at the right time, and that there was an unreasonable delay of a year in being sent to see the correct consultant. Mrs C also complained that she was not referred to a bone anchored hearing aid (BAHA) clinic when she first attended for investigations, and she questioned whether this clinic existed at all. BAHAs conduct sound to the inner ear directly through the bone, rather than through the air, which is how Mrs C's current in-ear hearing aids operate. In addition, Mrs C complained that the audiology clinic had no appropriate BAHA headband trial equipment available for nearly seven months.

We were critical of the board's lack of clarity in communicating with Mrs C about the availability of BAHA headbands, and we drew this to their attention. However, it is not for us to say how the board should use their resources, and it was clear that the lack of availability of BAHA trial headbands was a resource issue that the board had tried to remedy by ordering additional units. Therefore, we did not uphold this complaint.

When we looked into Mrs C's other complaints, we found that the BAHA clinic did exist. The board accepted there were difficulties and delays in progressing Mrs C's care and they apologised to her. Our adviser noted that a key referral should have been more clearly documented, and that Mrs C should have been considered for other hearing aid technologies more quickly, given that she was unable to use air conduction devices. We concluded that Mrs C did not see appropriate staff in reasonable time and, in particular, that she should have been considered sooner for referral to the BAHA clinic, and we upheld these complaints.

Recommendations

We recommended that the board:

• review pathways from Audiology to ENT (medicine of the ear, nose and throat), so that patients who do not benefit from air conduction hearing aids can be considered for other technologies in reasonable time.

Summary

Mrs C told us that her late mother (Mrs A) was admitted to hospital for oesophageal (gullet) enlargement to help reduce a thin membrane that had formed in her gullet. This was to be a day procedure. However, following the procedure, Mrs A suffered complications and remained in the hospital where further surgery took place. Her condition worsened and she was transferred to another hospital in the board's area where she died. Mrs C and her family complained to the board that Mrs A received inadequate care and treatment, communication and nursing care while a patient in the hospital. Mrs C said that there was a failure to take Mrs A's visual impairment into account, and was dissatisfied with the response she received to her complaint.

Two of our medical advisers reviewed Mrs C's complaint and Mrs A's medical records. After carefully considering their advice, we found that there was no evidence that Mrs A had not received appropriate care and treatment from the hospital and from nursing staff. We also found that, overall, the communication with Mrs C, Mrs A and her family was acceptable. We did not uphold any aspects of these complaints.

However, one of our advisers, a nursing adviser, was critical of the lack of documented information and care planning about Mrs A's visual impairment. We considered that the board failed to take Mrs A's visual impairment into account and upheld this complaint.

Recommendations

We recommended that the Board:

• ensure that, where a patient is visually impaired, this is recorded and taken into account of in their nursing assessment and care plan; and
• advise us of the outcome of any discussions with the Royal National Institute of Blind People concerning measures to improve the future care of patients with visual impairment.

Summary

Ms A requested that her first appointment with a new medical practice be longer than usual. Ms A was late for the appointment, and when the GP refused to see her she became upset. She wrote a letter about the situation while she was in the practice but this was not responded to. Within a few days she was informed that she had been removed from the practice list.

Ms A's representative (Ms C) complained to the practice on her behalf. They replied, saying that their views about the length of the scheduled appointment, how late Ms A had been and the behaviours she had displayed were different from those of Ms A. Ms A was dissatisfied with their response and raised her complaints with us.

We decided that the practice had reasonably fulfilled a request for a prescription and passed Ms A's records to her new practice. However, as they had not met the requirements of the relevant regulations for the immediate removal of a patient from a treatment list, we upheld Ms A's complaint that her removal had been inappropriate. We also upheld Ms A's complaint that the practice did not respond reasonably to complaints submitted about this matter.

Recommendations

We recommended that the practice:

• apologise to Ms A that her removal from their practice treatment list was not appropriate;
• review their procedure for the removal of patients from their treatment list to ensure that it complies with the relevant regulations, guidelines and guidance;
• apologise to Ms A that they did not respond reasonably to her letter; and
• review their complaints procedure to ensure that it is in line with the NHS Scotland complaints procedure.

Summary

Ms C completed work on a PhD (a postgraduate academic degree). The university examiners, however, decided that her thesis did not meet the requirements for a PhD, but did meet the requirements for a Masters degree. Ms C complained that the supervision and PhD support provided to her by the university was inadequate and did not give her a realistic expectation of the result of her thesis submission. She also complained about the academic appeal process and about the university's complaints handling.

We found, from the evidence, that Ms C's supervisors had concerns about her thesis. However, we could not say what the university staff said to her about this, prior to submission of the thesis. When the matter was discussed with the supervisors as part of the university's investigation into the complaint, they said they believed that their concerns were flagged to Ms C. There was insufficient evidence for us to say that they failed to communicate these concerns to Ms C and we did not uphold this complaint.

We upheld Ms C's complaint about the academic appeal process. When Ms C appealed the decision on her thesis, the university said the matter would be referred to an external person with the relevant expertise for a second opinion. However, the thesis was referred to an employee of the university for review. We considered that the university should have honoured the commitment they made in writing to Ms C, when they said they would refer the thesis to an external person for review.

Ms C also complained that the complaints process took too long and was inadequate in relying on verbal rather than written evidence. We found that the university had taken some time to investigate the complaints. However, it was clear that they carried out a detailed examination into the issues raised in her complaint. We did not consider that their investigation was unnecessarily prolonged, and were satisfied that the university did appropriately consider written evidence rather than relying on verbal evidence.

Recommendations

We recommended that the university:

• appoint someone external to the university with the appropriate expertise to review her thesis; and
• write to Ms C to apologise for their failure to get an external person to review her thesis, as stated in their letter.

Summary

Mr C complained about the way the council dealt with a planning application for a proposed development of social housing near his home. He felt the council had not consulted with the community appropriately, had failed to take into account objections properly, and had not given reasonable justification for the choice of site.

We found that the council dealt with the application appropriately and in accordance with planning policy. The planning report about the site had considered all objections and provided reasoned responses. We noted there had been an initial error with the documentation provided during neighbour notification, but that this had been rectified. In any event the council had given reasonable opportunity for representations to be made and heard during consultation events and during a planning committee meeting. We also found that, although the council were not required to justify choosing this specific site over others, they had nonetheless provided their reasoning for this choice of site to the community. We also did not uphold the complaint that construction started before planning condition pre-requisites were met, as we found evidence to the contrary. We did, however, uphold Mr C's complaint about the way the council handled his complaints, as we found the final response was unreasonably delayed and did not address any of the points on which Mr C had sought responses.

Recommendations

We recommended that the council:

• apologise to Mr C for the failings identified in the manner in which they dealt with his complaint; and
• review their complaints handling procedure to ensure full responses are sent to complainants.

Summary

Mr C lived in an old building, which was in a state of disrepair. He and other owners sought the assistance of a local councillor, who arranged for the owners to meet with council officers. The owners initially instructed a firm of surveyors whose report specified the extent of disrepair. With changes in the funding of private sector repairs taking effect from 1 April 2010, the owners agreed with the officers' proposal that the council serve a notice under section 108 of the Housing (Scotland) Act 1987. This would entitle owners to a minimum grant of 50 percent of eligible costs (less recording fee), with the possibility of a higher percentage based on an assessment of income over the previous 52 weeks. Applications would require to be submitted and approved by 31 March 2010. The notice was served in August 2009.

In January 2010, Mr C applied for a grant, and declared that his then partner was resident. The council asked for her income details and Mr C supplied them in mid-February. It turned out that Mr C's partner's income had been such that Mr C's application would attract only the minimum (50 percent) grant. While the application for the grant was still under consideration, Mr C's partner left the household. Mr C told a council grant officer about this when they visited him in late March. Mr C was awarded the minimum 50 percent grant (less recording fee).

Mr C was unhappy, as he felt that with his partner no longer resident, the application should only take his income into account, leading to a higher percentage of grant being awarded to him. Mr C's complaint to us had four aspects: that the council failed to provide him with clarity on his entitlement to repairs grants and how these are calculated; delayed, failed to communicate, and were inefficient in the re-assessment of his grant application; failed to deal with his complaint in accordance with their own complaints procedures; and failed to follow through with their requirement to ensure that plans were in place to adequately maintain the building in future.

We did not uphold the first two complaints. Our investigation found that the council provided adequate general information, and that the assessment takes into account the personal income of those declared to be resident over the year immediately before the date of application. Partners were included in the assessment, as the advice assumed that if two people live together as partners they have a shared interest in the condition of their property and should be assessed at the date of application. We, therefore, did not find that the council had done anything wrong in taking Mr C's former partner's income into account. We did find that the council failed to respond at one stage of their complaint procedure or to pursue with owners a proactive five year maintenance plan. We upheld these complaints and made recommendations.

Recommendations

We recommended that the council:

• review the information it gives to those seeking financial assistance in respect of private sector repairs; and
• follow up on a particular letter and take any requisite action in reminding owners of the building of action that they expect from them.

Summary

Mr and Mrs C left their dogs at a kennels for two and a half weeks. When they collected the dogs they found that one of them was in poor physical condition, and later had to be put to sleep. The kennels were privately owned, and were subject to an annual licence issued by the council. Mr and Mrs C complained that the council failed to adequately deal with their complaints about the kennels within a reasonable timescale that would allow a prosecution. They said that the council failed to regulate the kennels appropriately and to adequately carry out their duties in terms of relevant animal welfare legislation. In addition, Mr and Mrs C complained that the council did not deal adequately with their complaint about the council’s handling of the matter.

We upheld one of Mr and Mrs C’s complaints - that the council failed to adequately deal with their complaints about the kennels. We found from looking at the evidence that Mr and Mrs C’s concerns were taken seriously, their anecdotal evidence was recorded and considered, and was weighed against evidence that the council obtained from the vets who looked after their dog. However, we found that the council did not interview the licensee when investigating the complaint. Although the council told us that they did not have a duty to interview the licensee and would only do so if the conditions of the license appeared to have been breached, there seemed to be differing views about this in the council, and we made a recommendation to address this.

We did not see sufficient evidence that the council explained their responsibilities to Mr and Mrs C; specifically that the council had to ensure the kennels were complying with the conditions of their license, and that information gathered had been compared against the licence conditions. We also found that the council's further consideration of Mr and Mrs C’s complaint did not involve any new investigation of the matters they had raised. We took the view that Mr and Mrs C should have been told sooner that there was no appeal procedure, and directed to the corporate complaints procedure if they wished to complain about the council’s handling of the matter, as they later did.

In terms of the complaints that we did not uphold, we found that it was for the council to decide whether to refer a matter for possible prosecution. The council decided in reasonable time that there was insufficient evidence and so did not refer this case. We also found that animal health and welfare legislation did not require the council to inspect kennels; rather, it gave them the power to do so if appropriate. The conditions of the license issued to the kennels replicated the conditions stated in the legislation. We did not see evidence that the council failed to regulate the kennels appropriately or to adequately carry out their duties in terms of relevant animal welfare legislation. However, given what the council told us about differences between their role and that of an animal welfare charity in relation to complaints of alleged ill treatment and neglect of animals, we were of the view that the council should take steps to avoid any confusion about this in future.

Finally, we found that although the council did not reach a conclusion that satisfied Mr and Mrs C, the steps they took to investigate the complaint about the handling of the matter were adequate, and the response provided a detailed explanation.

Recommendations

We recommended that the council:

• that the council apologise for failing to adequately deal with complaints about the kennels;
• that the council ask the service to document the recognised procedure for dealing with complaints about licensed premises. This document should make clear that licensees should be interviewed at the earliest opportunity. It should also make clear why there is no appeal against decisions made, and that complainants should be signposted to the corporate complaints procedure if they are not satisfied with how their complaint about licensed premises has been handled; and
• that the council should explain to members of the public how their role is different from that of the SSPCA, and should appropriately signpost members of the public with concerns about animal welfare in boarding establishments to the SSPCA at the earliest opportunity.

Summary

Ms C lives in a block of four flats managed by the association. She and other tenants raised a number of complaints about the level of sound insulation between upper and lower properties. Although Ms C had raised concerns about the sound insulation since the properties were built in 2007, she told us that it took four years before any action was taken. The association agreed to lay an additional soundproofing layer between the properties, but Ms C complained that this was ineffective as it was laid incorrectly. After pursuing her complaint with the association's management committee, Ms C found that, although they accepted that noise levels were excessive, they would not spend the money required to resolve the situation.

We found that the association took too long to begin investigations into the cause of the poor sound insulation. Once these started, they were actively progressed, but we found that the association took too long to address the problem. We were, however, satisfied that the association listened to Ms C's complaints that the new sound-proof flooring was laid incorrectly. They were able to demonstrate that it had been laid in line with the manufacturer's guidelines. We found no evidence to suggest that their management committee found the noise levels at the flat to be excessive and were satisfied that they only decided not to carry out further remedial works after carefully considering a range of relevant information from a number of sources.

We upheld Ms C's complaint that, after an appeal panel hearing, the association's director failed to comply with the chairman's request to meet with tenants to discuss what other options might exist to help improve or solve the matter.

Recommendations

We recommended that the association:

• apologise to Ms C for the failures identified by our investigation.

Summary

Mrs C said she had applied to the association for permission to erect a suitable shelter or shed for her mobility scooter and later decided that a shed would be more suitable. She said that all the sites the association suggested were not suitable. The association, however, said that her preferred location was not possible as there was a communal access path leading to the rear of the terrace of houses at that point. Mrs C was also unhappy about the outcome of a tenants' meeting held by the association to discuss the matter of private rear gardens. She also said the association had ignored their own complaints process in dealing with her complaint and delayed in responding to her.

We found that the association had properly considered all the circumstances and Mrs C's views on the location of the shed and put forward two options that they considered would satisfy both Mrs C and all their current and future tenants. With reference to the tenants' meeting we found that the association had acted correctly in this matter. During our consideration of Mrs C's complaint the association acknowledged that they had not fully complied with their complaints policy. We, therefore, did not uphold Mrs C's complaints about the location of the shed or the outcome of the tenants' meeting but did uphold her complaint about the way the association had dealt with her complaint to them.

Recommendations

We recommended that the association:

• apologise for their failure to deal with the complaint in line with their complaints policy.

Summary

Ms C fell while away from home and fractured her wrist. At the time she was 70 years old with a history of osteoarthritis (a common form of arthritis causing chronic breakdown of cartilage in the joints). She had a cast applied to her wrist. On returning home, she was seen at a hospital. As the bones had not lined up properly, she had an operation to correct this using a fixator (a device to fix the position of fractured bones). Ms C was unhappy when the fixator was removed, as she was told that the bones were still out of alignment and she would not regain the full function of her wrist and fingers. She questioned whether the bones had been correctly aligned before the fixator was fitted. She further complained that the anaesthesia (pain relief) given to her failed to work and that she experienced a great deal of pain. She said that the operation had not been properly explained to her and that the board had taken too long to deal with her complaint.

We investigated the complaint taking into account all the relevant information, including the complaints correspondence, relevant clinical notes and x-rays. We also obtained advice from our medical adviser, who reviewed Ms C's notes and the care and treatment she received. He said that her treatment was entirely appropriate and satisfactory. He said that sometimes anaesthesia could be imperfect, but that this did not necessarily indicate any failure by the doctors. He said that her pain was managed in accordance with accepted practice. The adviser also took the view that the board's explanations to Ms C about her operation were appropriate and reasonable.

Taking all these factors into account, we did not uphold Ms C's complaints about her care and treatment. However, there was evidence to suggest that the board took too long to deal with her complaints on these matters.

Recommendations

We recommended that the board:

• apologise to Ms C for the delay in responding to her complaint; and
• remind their staff of the importance of adhering to their stated complaints handling timescales and process.