Some upheld, recommendations

Summary

Land adjacent to C's property was used as the site compound during road construction carried out by contractors on behalf of the council. The compound was accessed by a temporary haul road which ran close to C's home. Construction vehicles used the road daily and vibration equipment was used to keep the road surface smooth.

After cracks developed on the façade of C's property and some of their neighbours' properties, C complained to the council about structural damage they believed was caused by the works. They also complained that the council's Environmental Health Officer (EHO) failed to return calls when C had left voicemail messages asking them to come and measure noise, dust and vibration levels.

C complained that a dilapidation survey should have been carried out by the council. We took independent advice from a planning specialist. We found that the road was constructed in accordance with the approved planning application. The council had taken appropriate action to address C's concerns over potential structural damage by conducting a survey of C's property (and neighbouring properties). We, therefore, did not uphold this complaint.

In relation to whether the council took reasonable steps to investigate C's complaints of vibration, noise and pollution, we took independent advice from an environmental health specialist. We found that the EHO initially took appropriate action. They attended C's property and then contacted the contractor, advising them of the relevant procedure. They closed the complaint when C made no request for monitoring, giving C their number to contact should C change their mind. Although it was C's position that they had left a number of messages for the EHO, there was no available evidence to indicate that further complaints were raised with the EHO. We did find, however, that the council team responsible for delivery of the road construction project were aware of C's concerns about noise, dust and vibration and ought to have passed these on to the EHO for action to be taken. On the basis that they failed to do so, we upheld this complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C for failing to take reasonable steps to investigate their complaints of vibration, noise and pollution, and for failing to oblige the contractor to provide evidence that levels were acceptable. 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:

• Council officers should ensure communication takes place between departments to relay complaints to the relevant service.

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 requested that their child (A) defer their entry to primary school. C also requested an additional year of early years funding for the nursery school A was attending. When C's application for funding was denied, they submitted an appeal which was also refused. C complained about the actions of the council in relation to the matter.

In relation to the consideration of the initial application for deferral and early years funding, we found that while there were elements of communication that could have been better, overall the actions of the council were reasonable. The deferral application process had an emphasis on the parent and nursery providing information and evidence to support the application. The council reasonably followed the appropriate process when considering the deferral application. We did not uphold the complaint.

On considering the complaint about the process regarding the appeal, we found that when the initial application for early years funding was denied there was no clear route of appeal. It would have been reasonable, and more in keeping with relevant guidance, to have a clear process set out for parents, at least from the point in time when they become aware their application was unsuccessful, including information about the evidence required to support their request.

In addition we found that the council's explanation of their decision lacked detail. To ensure the council were exercising their discretion appropriately, they should have clearly articulated what evidence they considered, their view on it and how they reached the conclusion they did. Therefore, we upheld this complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C for failing to follow an appropriate process when considering the appeal. 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:

• Ensure current active information is available to parents both online and via nurseries about the deferral process and appeals process.

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 way a member of the housing association's staff communicated with them and their partner about storing refuse bins at the rear of their property. Taking account of the evidence, overall, we did not consider that there was sufficient evidence to conclude that the association acted unreasonably in this regard. However, we considered that subsequent correspondence with C could have been more helpful and the situation handled better. We also noted some good practice by the association and that ultimately the situation regarding the storage of the bins was resolved. Therefore, we did not uphold this complaint.

C also complained that the association did not respond reasonably to their complaint. During our investigation, the association acknowledged that the complaint was not handled in line with their complaint handling procedure (the CHP). We agreed that this was the case because the timeframe for response was not met; C was not kept updated; the complaint was not handled according to the CHP; and the response lacked objectivity and impartiality. Overall, we considered that the association's handling of the complaint was unreasonable. Therefore, we upheld this complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C for the failings in their handling of the complaint. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.

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 partnership's response to the concerns C raised about the safety and wellbeing of their parent (A), the partnership's communication with C about A's care and support and the partnership's handling of C's complaints.

We took independent advice from a social work adviser.

We found that the partnership did not address C's concerns about A's safety and wellbeing when they were first raised but did when they were subsequently raised. We found that, on balance, the partnership failed to reasonably respond to C's concerns about A's safety and wellbeing and we upheld this complaint.

We found that the partnership did not initially provide correct information to C about A's care and support but that the circumstances were such that the staff member could not have reasonably been expected to have been able to give an accurate assessment of a complex scenario at the time. We determined that the staff member acted in good faith and tried to be helpful which was reasonable. Furthermore, advice was subsequently sought and A's family were made aware of the correct position. We considered that the partnership communicated reasonably with C about A's care and support and did not uphold this complaint.

We also found that the partnership failed to reasonably handle C's complaints in that they took significantly longer than expected to deal with the initial complaint, failed to appropriately categorise the initial complaint and failed to adequately respond to all points raised. Therefore, we upheld this complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C for failing to reasonably respond to their concerns and for failing to reasonably handle their complaints. 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:

• Staff should be aware of how to appropriately respond to concerns raised by family members about the safety and wellbeing of service users in line with relevant legislation and internal policy/procedure.

In relation to complaints handling, we recommended:

• Staff should handle complaints in line with the Model Complaints Handling Procedure, which includes correctly identifying the stage at which a complaint should be considered, responding to complaints within timescales and where this is not possible advising customers and providing revised timescales and specific issues should be clearly and sufficiently addressed.

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, an advocacy worker, complained on behalf of her client (Mr A) about the partnership's actions regarding his tenancy while he was resident in a care home. Mr A was moved into a care home following a hospital admission as it was considered not safe for him to return to his tenancy. Concerns were raised about Mr A's mental capacity and at times he had been assessed as not having capacity to make decisions about his welfare. Mr A had on different occasions expressed a wish to return to his tenancy. Ms C complained that the partnership failed to provide clear information to Mr A about his residency status while residing in the care home; that they failed to support Mr A to return to his tenancy as per his wishes; and that they failed to take reasonable action regarding his tenancy which led to Mr A accruing significant rent arrears. The partnership said that while Mr A was allowed to leave the care home if he wanted to, it would be against their professional recommendation and they would not support him to leave. However, if Mr A did return to his tenancy, they would put in place appropriate supports.

We took independent social work advice. We found that Mr A had been given clear information about his residency status and we did not uphold this complaint.

We found that the partnership unreasonably delayed in resolving Mr A's situation which resulted in him living in the care home without a legal mandate. We also found the partnership failed to take reasonable action in relation to Mr A's tenancy, particularly when he was deemed to not have capacity, and this resulted in Mr A accruing rent arrears. Therefore, we upheld these complaints.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Mr A for failing to resolve his situation which resulted in him residing in the care home without a legal mandate and accruing significant rent arrears. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.
• The partnership should make an appropriate contribution to Mr A's rent arrears and service charges which accrued from the day he moved to the care home up to the date he signed over his tenancy. This calculation should take into account all relevant factors, including the fact that he would not have qualified for housing benefit during this time.
• The partnership should take any necessary steps to fulfil Mr A's wishes to move to another care home without unnecessary delay.

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

• The partnership should use this case as an opportunity to reflect on social work practices and their application of the relevant legislation, policies and 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

C, a support and advocacy worker, brought a complaint on behalf of their client (A). A was concerned that the Child and Adolescent Mental Health Service (CAMHS) did not follow the correct process regarding a childhood autism assessment and about the communication from CAMHS about the process for getting an autism assessment.

We took independent advice from a registered mental health nurse. We found that it was reasonable for CAMHS to conclude that A would have to access an autism assessment through their GP because A was over 16 years of age at the time. We also found that the board had communicated reasonably with A and A's parent about the process of getting an autism assessment. We did not uphold these aspects of C's complaint.

C also complained about the way the board handled the complaint. We found that there was a delay in responding to C's complaint and that they were not kept updated on the progress of their complaint or provided with a revised timescale for the response. We upheld C's complaint that the board had failed to handle the complaint reasonably. The board have already apologised for this failing but we have made a further recommendation for learning and improvement.

Recommendations

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 on behalf of their daughter (Ms A) that the care and treatment Ms A received from practice was unreasonable. Mr and Mrs C said that the practice sought to reduce Ms A's prescriptions for morphine and diazepam when she joined as a new patient. Mr and Mrs C further complained that the doctor who saw Ms A did not give adequate reasons for why the medications were being reduced. We took independent advice from a GP. We found that it was reasonable for the practice to seek to reduce Ms A's medications. We also found that the doctor provided a clear explanation to Ms A, and Ms A's clinical records showed that she had received the same explanation on multiple occasions from other medical professionals involved in her care who had sought to reduce her medication doses. Therefore, we did not uphold this complaint.

Mr and Mrs C further complained that Ms A was unreasonably removed from the practice list. We found that it was reasonable for Ms A to be removed from the practice list as the doctor/patient relationship had broken down with all the partners in the practice, and while the relevant legislation states that a warning should be given within 12 months, that a warning does not need to be given if the GP does not feel that it is reasonable or practical to do so, which was the case here. Therefore, we did not uphold this complaint.

Mr and Mrs C also complained that the practice's handling of her complaint was unreasonable. We found that the practice's complaint responses did not adequately address the issues raised and the practice failed to signpost to this office. Therefore, we upheld this aspect of the complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Mr & Mrs C for the complaint handling failures identified. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/informationleaflets.

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 there was an unreasonable delay in being seen by neurological (relating to the anatomy, functions, and organic disorders of nerves and the nervous system) services after being referred with back and leg pain; and that when they were seen the care and treatment provided was unreasonable. C also complained that the communication from the board in relation to these matters was unreasonable.

We took independent advice from a neurologist. We found that the timescale for C's neurology appointment was unreasonable as it did not meet the NHS Scotland timescales. We upheld this aspect of C's complaint.

We considered that whilst the care provided to C at their appointment was of a good standard, and it was reasonable to conclude that no further neurological input was required, the timeframe between the appointment and the eventual decision was over ten weeks and we considered this to be unreasonable. We therefore upheld this aspect of C's complaint.

Finally, in relation to communication, whilst we fed back to the board that they may wish to reflect on how they communicate timescales for appointments, we noted that once the decision not to provide further treatment to C had been made this was communicated in a prompt manner. We therefore did not uphold this aspect of C's complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C for the unreasonable delay in providing C with an appointment following their referral to neurosurgical services, the unreasonable timeframe between the consultation and eventual decision, and that the Advanced Physiotherapy Practitioner did not have appropriate and timely access to a consultant opinion. 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:

• 95% of patients referred to neurosurgery should receive a first out-patient appointment within 12 weeks.
• Clinics being run by a non-consultant grade practitioner should have prompt access to a consultant or nominated deputy in order for decisions to treat or discharge to be made promptly.

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, a support and advocacy worker, complained on behalf of their client (A) regarding the care and treatment they received at the Queen Elizabeth University Hospital both before and after surgery to remove anal skin tags and banding of haemorrhoids. In particular, A was concerned that they were not properly consented for the surgical procedure; that the surgery and aftercare were not of a reasonable standard; and that information about a post-operative clinic consultation was shared with the operating surgeon.

The board investigated the complaint and apologised for the delay in A receiving pain relief after the operation; for the surgical wound area not being visually checked for signs of inflammation; and for the discharge letter having incorrectly advised A that they would be followed up post-surgery.

We took independent advice from a consultant in colorectal and general surgery. We found that informed consent had not been properly obtained from A prior to the surgical procedure being undertaken. We upheld this complaint.

We considered that there was no evidence to support that the surgery and aftercare were of an unreasonable standard. Therefore, we did not uphold this complaint.

We did not find evidence of failings regarding the sharing of information between surgical staff regarding a post-operative review appointment that took place relating to ongoing pain and bleeding that A was experiencing. Therefore, we did not uphold this complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to A for failing to adequately obtain their informed consent to surgery. 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:

• Surgeons should obtain a patient's consent for surgery in line with General Medical Council guidance.

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

Miss C complained about the medical and nursing care she received at Queen Elizabeth University Hospital in relation to idiopathic (of unknown cause) intracranial hypertension (a condition associated with raised fluid pressure around the brain). The main medical points of concern related to the lack of pain relief in relation to a lumbar puncture (a procedure in which fluid is removed from the spinal canal for diagnostic testing or treatment); discharge from hospital without proper monitoring of the medication she was prescribed; and the lack of pain relief following a surgical procedure to drain fluid. The main nursing points of concern included refusal to remove a cannula (a tube that can be inserted into the body, often for the delivery or removal of fluid); the refusal of pain relief following the surgical procedure and the need to await a doctor; that she was not allowed to leave the ward; and was not assisted with either her personal care, eating nor drinking. Miss C also complained that the board did not respond to all the points of concern that she had raised in her complaint correspondence.

We took independent advice from a consultant neurosurgeon and a registered nurse. In terms of the medical care, we found that the pain relief prescribed both at the time of the initial lumbar puncture and following the surgical procedure were reasonable and appropriate; and that it was reasonable to discharge Miss C with medication pending further specialist review. We, therefore, did not uphold this complaint.

In terms of the nursing care, we found that there was insufficient evidence to support Miss C's concerns about removal of a cannula or that she was advised not to leave the ward. We found that there was evidence to support that Miss C's pain monitoring was reasonable and appropriate given her pain score was regularly assessed, her pain escalated to medical staff where appropriate and her pain management reviewed by pain specialist staff. We also considered that there was a lack of evidence to show that there were failings in the nursing care in relation to Miss C's personal care, eating or drinking. Therefore, we did not uphold this complaint.

We did, however, uphold Miss C's complaint that the board failed to provide a full, objective and proportionate response to her complaint in terms of the NHS Scotland Complaints Handling Procedure. We made a learning and improvement recommendation to the board in September 2019 as a result of a similar complaint about failing to provide a full, objective and proportionate response and have followed up on this recommendation to ensure its implementation.

Recommendations

What we asked the organisation to do in this case:

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

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.