Some upheld, recommendations

Summary

Mr C, a support and advocacy worker, complained on behalf of his client (Ms A). Ms A had been receiving a direct payment to fund a personal assistant to help her care for her child. When Ms A met with the partnership, she said that she had purchased mountain bikes and placed a down payment on a caravan. The partnership said that this breached Ms A's agreement and stopped her direct payment. Mr C complained that the partnership's decision was unreasonable and that they failed to take account of their non-compliance with their statutory obligation to provide Ms A with support and guidance. Mr C also said that the statutory guidance gave the partnership flexibility to consider the use of funds by Ms A to see if they met the family’s broader needs.

We took advice from an appropriately qualified adviser. The partnership acknowledged that Ms A had not received regular support and guidance as required. However, there was no evidence that Ms A had submitted monitoring forms as required by her agreement with the partnership detailing her use of the direct payment. We considered that it was reasonable for the partnership to reach a decision based on the information they had available at the time and that staff appropriately followed the relevant procure. We did not uphold this aspect of Mr C's complaint.

Mr C also complained that the partnership failed to respond to his complaint reasonably. We found that the partnership had failed to respond fully to the issues raised by Mr C and upheld this aspect of his complaint.

Finally, Mr C complained that the partnership failed to take reasonable or appropriate follow-up action after their complaint decision. Mr C noted that the complaint decision said that they would reinstate the direct payment. It also committed to entering into further discussions with Ms A about how her child's support needs could be best met. However, four months after this letter had been sent, Ms A had not received any contact from the partnership.

We found that the partnership failed to meet commitments it had made to Ms A by not contacting her, or reinstating her direct payments. We upheld this aspect of Mr C's complaint. However, we noted that the partnership had taken reasonable steps to address these failings and made no further recommendations.

Recommendations

What we said should change to put things right in future:

• Remind staff at the partnership who handle complaints that complaints should be handled in line with the Model Complaints Handling Procedure (MCHP). Stage 2 complaint responses should respond to all relevant points made in the complaint. The MCHP and guidance can be found here: https://www.spso.org.uk/the-model-complaints-handling-procedures .

In relation to complaints handling, we recommended:

• Provide a response which addresses the specific issues raised by Mr C in his complaint letter.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Summary

C complained about the care and treatment they received from the board. C’s local NHS board referred them to a consultant bariatric (branch of medicine that deals with the causes, prevention, and treatment of obesity) surgeon at Tayside NHS Board. C complained that, although they had made lifestyle and health changes as requested by the multidisciplinary specialist weight management team, they were not put forward for surgery on a number of occasions. C complained that a consultant bariatric surgeon acted inappropriately during consultations with them and that information C provided upon request was ignored when considering their suitability for surgery. C considered the delays to their surgery to have been unreasonable and raised further complaints about the board’s handling of their concerns.

We found that the consultant bariatric surgeon inappropriately required C to bring their test results to a consultation and inappropriately referred to them having made a complaint during a consultation. We found that the decision to postpone the surgery until such time as C’s diabetes was being better managed was reasonable. However, in relation to the decision to postpone surgery, we found that the board’s poor administration of C’s case and poor communication with them led to C not being suitable for surgery. We found, therefore, that this had led to C’s request for later surgery being denied and that the board had contributed to this situation. We found that the board had taken reasonable action in response to C’s complaint but that they had unreasonably failed to advise C of the outcome of a multidisciplinary team meeting. We, therefore, upheld the complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C that the consultant inappropriately raised their formal complaint about them during a consultation. The apology should meet the standards set out inthe SPSO guidelines on apology available at www.spso.org.uk/information-leaflets
• That the board invite C to an multidisciplinary team review of their case with a view to forming a clear plan for them with specific targets and timescales for progression to surgery should that remain the best option for them.

What we said should change to put things right in future:

• That the board take steps to ensure specialist weight management team's from other health boards receive clear communication as to what criteria each patient needs to meet to progress to surgery.
• The board’s procedures should ensure bariatric patients are given a clear plan with scheduled review points as to their progression through Tiers 3 and 4, and onto surgery, and the criteria they must meet.
• All board staff should be aware of the importance of allowing the complaints procedure to operate independently of clinical discussions. Patients must be able to raise concerns about services or individuals without fear of confrontation or of their criticisms affecting decisions regarding their ongoing treatment.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Summary

Ms C, a support and advocacy worker, complained on behalf of her client (Ms A) who was treated for an abscess in her breast which failed to heal. Subsequently, a tissue sample was sent for tests and Ms A was diagnosed with breast cancer. Ms A considers that there was an unreasonable failure to consider cancer as a possible diagnosis at an earlier stage and that this contributed to the delay in providing diagnosis and treatment. Ms A also considers that concerns she raised about a possible cancer diagnosis were not taken seriously.

We took independent advice from an appropriately qualified doctor. We found that, although it was not reasonable to expect a cancer diagnosis to be considered sooner, excised tissue from two operations should have been sent for examination, which may have facilitated earlier diagnosis. On balance, we upheld this aspect of the complaint.

In relation to communication, we considered that the clinical records evidenced reasonable communication. Therefore, we did not uphold this aspect of the complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Ms A for failing to send tissue removed during surgical procedures for histological examination, and the likely delay in diagnosis this resulted in. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

What we said should change to put things right in future:

• All tissue removed during a surgical procedure should be sent for histological examination, unless it is considered not necessary by the operating surgeon and such justification is documented in the patient’s notes.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Summary

Ms C was admitted as an in-patient under the Mental Health (Care & Treatment) (Scotland) Act 2003. At this time, Ms C was prescribed an anti-psychotic medication. Following discharge, Ms C continued to take the medication until she stopped the following year. Ms C complained to the board about the dose of the medication and reported that she experienced multiple significant side effects. Ms C also had concerns about the way the board had handled her complaint about her previous Community Psychiatric Nurse (CPN).

We took independent advice from a consultant psychiatrist. We found that treatment had been provided to Ms C in accordance with the relevant clinical guidelines. We did not identify failings in relation to the management of Ms C’s medication. For this reason, we did not uphold this complaint.

We also considered the board’s handling of Ms C’s complaint about a previous CPN. By the time Ms C complained to the board, the CPN had retired, whilst the complaint was also complicated by the fact that it related to a third party. We found that there was a lack of clarity in the reasons the board provided for not investigating Ms C’s complaint. We noted that it appeared that the board could have investigated the complaint, even if only to a limited extent. We upheld the complaint and asked the board to provide a further response to Ms C.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Ms C for not appropriately handling her complaint about her previous CPN having a conflict of interest . The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

In relation to complaints handling, we recommended:

• In line with the NHS Scotland Complaints Handling Procedure, complaint handing staff should support people to decide whether a matter is a complaint or not and explain how complaints are handled. Clear and consistent reasons should be provided where it is considered that an investigation is not possible under the procedure.
• Investigate Ms C’s complaint about her previous CPN having a conflict of interest in line with the NHS Scotland Complaints Handling Procedure and provide Ms C with a response to the extent possible in accordance with data protection legislation.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Summary

Ms C brought a complaint to us on Ms A’s behalf about Edinburgh College. Ms A was a student at the college with a diagnosis of Asperger syndrome and is on the autism spectrum. Ms A was suspended from the college following concerns about her behaviour. Ms A was subsequently withdrawn from the course.

Ms C raised concerns that the college had failed to provide Ms A with reasonable adjustments during her studies. We sought independent advice from an equalities adviser. We found that the college did make reasonable adjustments to support Ms A in accordance with their obligations. We did not uphold this aspect of Ms C’s complaint.

Ms C complained that the college did not reasonably follow their own policies and procedures regarding complaints that had been made about Ms A. We found that the college had failed to follow their own policies and procedures. In particular, we found that:

the college did not give Ms A the full details of the reason for her suspension

Ms A was not given five working days’ notice of the investigatory meeting

Ms A was not made aware that she could bring representation to the investigatory meeting

there was no record or minutes of the investigatory meeting

Ms A was not made aware of the outcome of the investigatory meeting within five working days

there is no evidence that the college responded to Ms A’s appeal against the decision to withdraw her from the course.

We upheld this aspect of Ms C's complaint.

Ms C also complained about the way the college handled the complaint. We found that:

Ms C’s complaint was not acknowledged within three working days of the college receiving the complaint

there was a delay in responding to Ms C’s complaint and she was not kept updated on the progress of the complaint or provided with a revised timescale for the response.

We upheld this aspect of Ms C’s complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Ms A for failing to follow the college’s Positive Behaviour and Anti-bullying and Harassment Policy and the Positive Behaviour and Anti-bullying & Harassment Guidance and Procedures for Students. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

What we said should change to put things right in future:

• Records should be kept to explain the reasons for changes in approach.
• When the college decide to suspend a student and a call an investigatory meeting they should follow their Positive Behaviour and Anti-bullying and Harassment Policy and the Positive Behaviour and Anti-bullying and Harassment Guidance and Procedures for Students. If a decision is taken not to follow the relevant policies, this should be clearly documented and reasons provided.

In relation to complaints handling, we recommended:

• Complaints should be handled in line with the Model Complaints Handling Procedure (MCHP). The MCHP and guidance can be found here: https://www.spso.org.uk/the-model-complaints-handling-procedures

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Summary

Mr and Mrs C complained that the council failed to act appropriately, impartially or in line with their obligations when carrying out enforcement action against them.

We took independent advice from a planning adviser. We found that the council took appropriate action at specific points in the course of the enforcement process and had acted impartially. However, we found that the enforcement process took an unreasonable length of time to reach a conclusion and that the council could have carried out a more thorough assessment of the situation at an earlier stage. Therefore, we upheld this complaint.

Mr and Mrs C also complained that the council had handled information provided by a third party inappropriately and placed an unreasonable amount of weight on it. We concluded that the evidence did not support Mr and Mrs C's view that the council considered information provided by a third party in an inappropriate or unreasonable manner. Therefore, we did not uphold this complaint.

Finally, Mr and Mrs C complained that the council had failed to provide a reasonable level of communication with them during the enforcement process. This includes failing to meet with them despite their requests. We found evidence of good communication at certain points during the enforcement process. However, there was also clear evidence of several of Mr and Mrs C's requests to meet not being acknowledged or followed up by the council. This directly contradicted the council's position that there had been no requests to meet made by Mr and Mrs C or their agent. Therefore, we upheld this complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Mr and Mrs C for the failings that contributed to delays during the planning enforcement process and for not providing a reasonable level of communication at certain points, including failing to meet with Mr and Mrs C despite their requests. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.
• Mr and Mrs C have requested that the council reimburse them for the Planning Consultant fees incurred in respect of the period after they consider the enforcement notice to have been complied with. They have advised of the price and they can provide a copy of the invoice. The council should consider whether it is reasonable and appropriate to reimburse Mr and Mrs C for these costs. This is a decision for the council to make and they should advise Mr and Mrs C of the outcome.

What we said should change to put things right in future:

• Enforcement action should be carried out in an efficient and timely manner, allowing for individual circumstances on a case-by-case basis. Accurate assessments of the situation should be carried out at an early stage, allowing for individual circumstances on a case-by-case basis.
• Correspondence relating to planning enforcement matters should be responded to within a reasonable timescale. If a meeting is requested, this should either be arranged or an explanation provided for why on is not necessary or appropriate.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Summary

C was a tenant of the council and requested repairs after reporting issues with damp, leaks and the boiler. When C ended the tenancy they were charged for leaving items in the property. C complained that the council's responses to C's requests for repairs, for recharging them when they left the property and how they communicated were unreasonable.

C reported 90 repairs or faults over a tenancy of many years. With the exception of two occasions, the council responded within timescales as laid out in their repairs policy. Sometimes the fault required multiple attendances (due to access requirements or parts required) and led to the completion time taking longer but the initial response was within the target timeframe. We found that the council's response to C's requests for repairs were reasonable. We did not uphold this aspect of the complaint.

The council responded to C's complaints sometimes verbally, in writing or both. It was good practice to seek practical resolutions to complaints and the council made attempts to do this with bringing forward inspections and arranging tradespeople to attend C's property. We found that not all of the points C raised were responded to when they were first raised as a complaint, requiring C to raise the same point on multiple occasions and in some instances (such as the complaints about communication and previous faulty repairs) not being responded to at all. This was unreasonable.

After the council received C's complaints they responded at the frontline resolution stage five times. The council did not advise C on how they could escalate their complaint as part of these responses after it was clear that C remained dissatisfied. It was unreasonable that the council failed to advise them of how to escalate the complaint. Therefore, we upheld this aspect of the complaint.

Lastly, the council were clear in the information which they provided to C in the tenancy agreement and terminations, that there was a requirement that C remove all belongings from the property after their tenancy ended. Not doing so would result in C being charged by the council for the removal costs. The council followed their process and their actions were reasonable. We did not uphold this aspect of the complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C for failing to respond to all of the complaints they raised. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

What we said should change to put things right in future:

• The council should advise complainants how to escalate their complaint if they remain dissatisfied.
• The council should respond to all points of complaint raised by a complainant.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Summary

Mr and Mrs C complained about the actions taken by the council following their child's (Child A) disclosure that they had been inappropriately touched by another pupil. Mr and Mrs C complained that the council's education service had not reasonably followed their own procedures to safeguard their child.

We found that the education service had acted in accordance with their policy and guidance by discussing the matter with Child A and making a referral to social work. In the circumstances, we found that the steps taken by the school to safeguard Child A were a discretionary matter for the council's education service to determine and we were satisfied that the matter was appropriately considered and a number of measures were put in place. We did not consider that there was an obligation for the council to exclude the other child involved from school. In light of this, we did not uphold Mr and Mrs C's complaint about the council's education service.

Mr and Mrs C also complained that the council's social work service failed to provide them with reasonable support. We took independent advice from a social worker. We found that reasonable action had been taken by social work, including an assessment of the situation and contact with the school, the police and the families involved. We did not uphold Mr and Mrs C's complaint regarding the action taken by social work.

Lastly, Mr and Mrs C complained about how the council had handled their complaints. We found that there was a delay in responding to the complaint made on their behalf by an MSP and that they were not kept updated on the progress of their complaint or provided with a revised timescale for the response. We also found that the council's responses did not address all the concerns Mr and Mrs C raised. Therefore, we upheld this aspect of Mr and Mrs C's complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Mr and Mrs C for the delay in responding to the complaint made on their behalf by an MSP and that they were not kept updated on the progress of their complaint or provided with a revised timescale for the response. The council should also apologise for their responses not addressing all the concerns raised. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

In relation to complaints handling, we recommended:

• Complaints should be handled in line with the Model Complaints Handling Procedure (MCHP). The MCHP and guidance can be found here: https://www.spso.org.uk/how-to-handle-complaints.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Summary

Mr C, an advocacy worker, complained on behalf of his clients (Mr and Mrs A). Due to long-standing conditions, Mrs A was deemed to require personal care and had received self-directed support payments in order to employ a personal assistant (PA). Mr A also had personal care needs and the couple identified a PA who would be able to provide the required care for them both.

Mr and Mrs A, along with Mr C, met with a social worker to discuss how to get the necessary care in place. Mr C stated that the social worker told Mr A that he would be financially assessed and it was likely that he would have to make little or no contribution towards his care. In addition to this, Mr C stated that Mrs A was told that Mr A's assessment and support would not affect her.

After this meeting, Mr and Mrs A started using the services of the PA whilst the council's financial assessment process was ongoing. Later, the council sent Mr and Mrs A separate letters advising that they had to make a financial contribution of £49.98 per week each towards their respective care. In addition to this, the council advised Mr and Mrs A that they had incurred a debt of around £2000 for the care already provided.

Mr C complained about the council's financial assessment process and the information that was provided to Mr and Mrs A. In his view, the council did not provide Mr and Mrs A with appropriate information, and this contributed to them incurring a significant and unexpected debt.

We took independent advice from social worker. We concluded that the financial assessments had been carried out appropriately and in line with the relevant guidance at the time. Therefore, we did not uphold this aspect of the complaint.

In respect of the information provided to Mr and Mrs A, we concluded that the council did not provide appropriate information about how they would be jointly financially assessed. When reviewing the evidence, we placed particular weight on the social worker's statement which was contained in the council's investigation report. In their statement, the social worker confirmed that they were not aware Mr and Mrs A would be financially assessed as a couple. This meant that they did not have accurate information in order to make an informed decision about the care they received. In addition to this, we took the view that the council's standard documentation could have detailed how people would be financially assessed in a clearer fashion. In light of this, we upheld this aspect of the complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Mr and Mrs A for failing to provide accurate and appropriate information about how Mr and Mrs A would be financially assessed in respect of their personal care. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.
• In light of the failings identified, the council should revisit their decision not to waive (either in full or in part) Mr and Mrs A's debt. The council should provide an explanation and rationale for their decision to both the SPSO and to Mr and Mrs A.

What we said should change to put things right in future:

• Relevant social work staff should be fully aware of the council's Non-Residential Community Care Charging Policy and Procedure.
• Standard paperwork included in the Non-Residential Community Care financial assessment should clearly detail the process and potential charges involved.

In relation to complaints handling, we recommended:

• If a failing is identified as part of a complaint investigation, this should be acknowledged and addressed in the stage two response.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Summary

C complained that the council failed to take appropriate action in response to reports of bullying of their children (Child A and Child B) at primary school. C said that the reports of bullying were not investigated appropriately and the council denied that many of them occurred.

We considered both C's and the council's records of events, the school incident book, copies of emails between C and the council, and the school's anti-bullying policies. Whilst we recognised that the case was one that had been difficult for all involved, we found that the council had not always appropriately logged incidents in the incident book in line with their policy. We also found that on some occasions, though the school investigated incidents, they did not communicate with C regarding the investigations. Finally, we found that there appeared to have been several reports of incidents where there was no evidence they were investigated. On this basis, we were unable to conclude that the council had taken action in line with their anti-bullying policy and we upheld this aspect of the complaint.

C also complained about the council's communication during the complaint process. Having reviewed the correspondence, we found that the council corresponded appropriately with C, and handled the complaints in line with the complaints process. We did not uphold this aspect of C's complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C, and Child A and B, for the failure to appropriately investigate and record allegations and incidents of bullying. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

What we said should change to put things right in future:

• Allegations and incidents of bullying should be investigated and recorded in line with council policies.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.