Some upheld, recommendations

Summary
Mrs C complained that she was removed from the practice list without warning or reasonable explanation. She also complained that the practice failed to give her advice about, or treat, a leg injury. In addition, Mrs C complained that the practice failed to refer her to appropriate specialists for treatment for ongoing health problems.

We did not uphold the complaint about referral to specialists. We found from looking at the practice's records and taking advice from one of our clinical advisers, that Mrs C was referred appropriately. We also found that, as Mrs C went to hospital for her leg injury, the practice were not responsible for treating it. The practice said they gave Mrs C appropriate advice about her leg injury. However, because they did not have a record of this, we upheld the complaint. We also upheld the complaint that Mrs C was removed from the list without warning, as we felt that the practice could have given one. However, we agreed that the practice had given Mrs C a reasonable explanation when they did remove her from the list.

Recommendations
We recommended that the practice:
• review their practice on making records of telephone conversations, with a view to making records where advice is given to a patient to attend a hospital department, or treatment advice is given; and
• review their policy on removal of patients from the list, to incorporate guidance on providing reasonable warning to patients who might be at risk of removal from the list.
 

Summary
Mr C complained that the Scottish Prison Service (SPS) had not told him why he was not allowed to progress to enhanced conditions when he believed he met the relevant criteria.

It is not for us to decide whether prisoners should progress to enhanced conditions. Such decisions are discretionary matters and are for the SPS and local management to take. It is for them to decide what information is important. What we have to determine is whether they have followed the proper processes and procedures and, where appropriate, explained the application of them to prisoners.

We found that Mr C was not in fact told that he was not being allowed to progress, or the reasons for this, until he made a complaint. Prisoners should not have to make a complaint to obtain this information. They should be informed promptly of the decision and the reasons for it. We, therefore, upheld this complaint.

Mr C also complained that his disability was not taken into account when the decision was made to transfer him to another prison. We did not uphold this complaint as we found that the SPS had carried out risk assessments before transferring him.

Recommendation
We recommended that the SPS:
• ensure that their new guidance on progression clearly states that prisoners should be informed promptly of the decision and reasons if their progression is not approved.
 

Summary
Mr C taught at a school which was the subject of an HMIE inspection. Mr C had a number of issues with the outcome of the inspection and this resulted in him raising his concerns in writing with HMIE. His complaint to the Ombudsman stemmed from the way in which HMIE dealt with his complaint.

Although we did not uphold one aspect of Mr C's complaint, we did find that there was an unreasonable delay in HMIE arranging a face-to-face meeting to discuss the complaint, contrary to HMIE complaints procedure. We made recommendations to redress this failing.

Recommendations
We recommended that Education Scotland:
• apologise to the complainant, in the circumstances of this complaint; and
• remind relevant staff of the terms of the complaints process and that when responding to complainants all the issues raised should be addressed.
 

Summary
Ms C suffers from Graves or Thyroid Eye Disease which is a complex and devastating condition. She complained that after 2007 her care and treatment was poor and likened it to a ‘production line’. She alleged that she had been examined and discharged without comment from either medical or nursing staff and that her condition has never been discussed with her. She maintained that there was no proper appreciation of her condition and its consequences and that little information has ever been made available to her. She also complained that she was incorrectly diagnosed with dry age related macular degeneration but this since turned out to be incorrect. She did not receive an apology. She also complained that when she submitted a complaint to the board, they failed to adhere to her request to keep some information confidential and delayed in responding.

While we did not uphold most of Ms C's complaints, we did find that she was misdiagnosed with age related macular degeneration and she was not adequately supported in relation to this. We made one recommendation to redress this failing.

Recommendation
We recommended that the board:
• apologise to the complainant for the confusion surrounding her diagnosis of dry age related macular degeneration.
 

Summary
Mrs C complained that the council had failed to provide a winter maintenance programme for the roads in her area for 2009/10 and, as a result, there were occasions when the council were not able to get access to collect household waste because of the condition of the roads at this time. Mrs C and her husband received a reminder about payment of their joint council tax account for 2009/10. Mrs C wrote to the council asking whether an amended council tax bill would be issued to her and her husband to reflect the council’s failure to provide road clearing services and waste collection during a recent spell of bad weather. Mrs C also complained about the handling of her representations and the council’s actions in pursuing her for payment of arrears of council tax, and she complaints that her complaints were not investigated fully.

Our investigation found that, despite the advice provided to Mrs C and to this office that an operational plan was in place, we found no operational plan for snow clearing operations for the roads in her area for 2009/10. In light of the difficulties experienced by Mrs C and subsequently this office in obtaining accurate responses from the council about this matter, and given the length of time it had taken to bring this matter to a satisfactory conclusion, we recommended that the council should consider Mrs C’s request for compensation favourably.

With regard to the council’s handling of Mrs C’s request for an amended council tax bill, we established that this was not dealt with properly. We found that the council failed to make clear in their correspondence with Mrs C that an amended council tax bill would not be issued to her and her husband. They also failed to make clear that payment of council tax could not be withheld whilst a dispute or correspondence with the council was ongoing, and they failed to make clear that on payment of the arrears, the summary warrant would be cancelled. We found that the council had followed the procedures set down in legislation to pursue Mrs C and her husband for payment of the arrears but were at fault in not making the position clear in their correspondence before the summary warrant was issued. We made a recommendation to ensure that a clear process would be put in place which would be communicated effectively to all stakeholders.

We also found that the council had failed to deal satisfactorily with Mrs C's representations to them about her complaints. In recognition that Mrs C was not provided with a satisfactory level of customer service, we asked the council to make a formal apology to Mrs C for the inconvenience she had been caused in pursuing her complaint.

Recommendations
We recommended that the council:
• provide a formal apology from the chief executive for not providing the complainant with a satisfactory level of customer service;
• ensure that the revenues department undertake a review of the current procedures to ensure a clear process is in place and is communicated effectively to all stakeholders when responding to enquiries or disputes about council tax; and
• consider Mrs C's request for compensation.
 

Summary
Ms C broke a bone in her foot and attended Accident and Emergency at hospital on 9 May 2010. A backslab plaster cast was fitted that day and she was asked to return on 10 May when a below the knee cast was applied. Replacement casts were fitted on 24 and 25 May but she had to return on 26 May because the cast had become loose and uncomfortable. The cast was removed by a nurse. Ms C alleged that she did this without proper consultation and that its removal was contrary to all the advice Ms C had been given previously. Ms C said that although she told the nurse this, she removed the cast regardless. Later, when Ms C complained about the circumstances, she says the nurse failed to provide a truthful account of what happened.

Our investigation showed that Ms C had an unusual fracture which needed to be held in a cast for up to eight weeks. After taking advice from one of our professional medical advisers, we found that the cast was removed too early and that there were deficiencies in the record-keeping. We also confirmed that Ms C's complaints about this were not properly investigated and that there was delay in responding to her. We did not uphold the complaint about the nurse’s account of events as, although there was some doubt about it, there was no evidence that it was untruthful.

Recommendations
We recommend that Highland NHS Board:
• apologise to Ms C for any pain and inconvenience she suffered as a consequence of her cast being removed on 26 May 2010;
• remind staff of the importance of listening to their patients and to be alert to the fact that their initial assumptions of a situation may not be correct;
• emphasise to staff the necessity and importance of maintaining a full and correct clinical record of patients' care and treatment; and
• apologise to Ms C for their failure to investigate her complaint properly.
 

Summary
Ms C was concerned at the level of care and treatment given to her late mother (Mrs A) while she was in hospital immediately prior to her death. When Mrs A was admitted to hospital she was suffering from shortness of breath, a respiratory infection and heart failure. She had ankle oedema. Regrettably, while she was in hospital she became increasingly unwell despite episodes of care in the Coronary Care Unit. She was also diagnosed as having clostridium difficile. Mrs A died just over a year later, and Ms C complained that the care and treatment her mother had received was totally inadequate in that she was not kept clean and comfortable, nor was she given proper nutrition. She alleged that some staff appeared unhelpful and uncaring.

Our investigation established that the board failed to ensure that Mrs A was clean and comfortable and they did not communicate appropriately with her, or with Ms C and her family (which meant that Ms C was unaware of a fee due to the Procurator Fiscal because of the board’s contact with that office). However, we were satisfied that Mrs A's nursing care was reasonable and that her food intake had been properly monitored and recorded.

Recommendation
We recommend that Greater Glasgow and Clyde NHS Board:
• reimburse Ms C the cost of any separate fee required by the Procurator Fiscal in connection with her complaint.
 

Summary
Mr C and Ms D were involved in extra-curricular activities at their son’s school. They were uncomfortable with the actions of another parent, who they felt was promoting unacceptable racist and sexist views among the school community. Ms D, in particular, felt the parent was using bullying behaviours to make it impossible for her to continue her involvement with the school and they decided not to have their younger son attend the school. Mr C and Ms D raised complaints with the school, but were dissatisfied with the conduct of the investigations, believing that assurances that had been made were not followed through. They were similarly dissatisfied with the council’s handling of the complaint and information provided by the council during that process.

Our investigation confirmed that the council dealt satisfactorily with these complaints. However, they did not carry out the investigations that Mr C and Ms D were led to believe would be carried out, and we upheld this element of their complaint. We did not uphold the complaint about the information given to Mr C and Ms D as we found it was generally appropriate.

Recommendation
We recommend that Glasgow City Council:
• apologise to Mr C and Ms D for the failure to investigate comments which were alleged to have been made.

Point of clarification - it was the nursery school from which the parents withdrew their younger son's application.
 

Summary
Mrs C's neighbour notified Mrs C that he was applying for planning consent for dormer extensions. He assured her that no window was planned for the elevation facing her property. Mrs C checked the council's online planning portal and found that that was the case, so she did not object. The council's case officer then suggested changes to the submitted scheme, including a window in that elevation. However, his delegated report was not amended and the changed plans were not assessed, and Mrs C only became aware of the change when construction started. She complained that the plans had changed without anyone telling her; that there had been a delay in placing the amended applications on the council website; and that the council had been inconsistent in the handling of this application compared with the treatment of another nearby application. We upheld her complaints about the changes and placement of the amended application online, as the amended plans were not readily available and this meant that Mrs C did not know about the new window before construction started. We did not uphold the third complaint as we did not find inconsistency of treatment.

Recommendations
We recommend that Perth and Kinross Council:
• apologise to Mrs C for the shortcomings in dealing with the application;
and
• offer to meet the costs of Mrs C’s neighbour installing obscure glazing on
both panes of the side dormer window.
 

Summary
Mr C complained that the council had failed to follow their anti-bullying policy in relation to recording and monitoring alleged incidents of bullying involving his son. The investigation found that the council had initially failed to complete the relevant forms as the school had allowed for a settling in period before using the forms. The council did, however, provide evidence that they had recorded all incidents of bullying and had used the appropriate forms as the school term had progressed.

Recommendation
We recommend that Inverclyde Council:
• ensure that their staff act in accordance with their anti-bullying policy in
relation to the use of the appropriate forms for recording and monitoring.