Some upheld, recommendations

Summary

Mr C complained to the council after being expelled from a council venue whilst distributing literature to other members of the public. During our investigation it became clear that the council staff involved were not aware of the relevant policy at the time of the incident, which led to poor communication with Mr C about why he was being asked to leave. The council had since apologised for this, and provided training to all relevant staff on this matter, which we found to be reasonable. On review of the policy in question, it also became clear that the council staff had discretion to make the decision to expel Mr C, so we did not uphold this aspect of his complaint.

He also complained that the council had failed to follow their complaints procedure. We found that they had failed to stick to their timescales for acknowledging Mr C's complaint, and also failed to contact Mr C to discuss the investigation, despite agreeing to do so. We upheld this complaint, but commented that we did not feel the failings identified would have affected the outcome of the council's investigation.

Recommendations

We recommended that the council:

• apologise for failing to contact Mr C as agreed during their investigation of his complaint, and for the delay in acknowledging his complaint.

Summary

Mr C complained that, after serving an emergency statutory notice on his property, the council unreasonably failed to inform him of the costs of associated works, and that they failed to tell him of the increasing cost of these works. In addition, he complained that the council failed to comply with their standing orders when procuring works for three statutory notices, and then failed to manage the works properly in line with the correct procedures.

We found that the council were not required to inform homeowners of the costs of the emergency notice in advance as, by their very nature, emergency works may be needed before the costs are known. The council provided us with some evidence which suggested that Mr C was notified at the time of the increasing costs of the works. Therefore, we concluded that there was not enough evidence to show that he was not informed of the escalating costs. We did not uphold these elements of his complaint.

We found that the council failed to have any reasonable record of the process they followed when tendering for the statutory notices. As a result, we were unable to say whether they followed their standing orders or the correct process. For this reason, we upheld this element of the complaint. We also found that the council had acknowledged carrying out non-emergency works under the emergency statutory notice. This removed the opportunity for neighbours to carry out the works themselves. We noted that the council took this step in order to keep the costs down for residents, as scaffolding was already erected. Nonetheless, the council itself had acknowledged that this was not the correct process, and we upheld this element of the complaint. We made a number of recommendations. These included that the council review their statutory notice procedures, that they refund the administration fee for two of the statutory notices, and that they clarify which aspects of the works were not of an emergency nature and refund the costs of the non-emergency work to Mr C.

Recommendations

We recommended that the council:

• review their statutory notice procedures to ensure that the correct procedures are followed when appointing contractors for works, and that they retain full and appropriate evidence of this process on file in order to demonstrate compliance with their procurement process and standing orders;
• review their procedures to ensure that only works of an emergency nature are carried out by the council;
• refund to Mr C the 15 percent administration fee charged for the works covered under the statutory notices referred to in the decision; and
• clarify which aspects of the works carried out under the emergency statutory notice were not of an emergency nature, and refund the costs of these non-emergency works to Mr C.

Summary

Mr C complained about the service he received from Business Gateway in relation to applications for grants for his new business. He said that he was encouraged to apply for grants but, when his applications were unsuccessful, staff did not respond reasonably to his requests for further information and assistance. When he complained about the service, he said that the council had handled his complaint poorly, and outside the appropriate response timescales.

We noted a lack of contemporary evidence on what was discussed at some of Mr C's meetings with Business Gateway. However, we did not find any evidence that Mr C had been given inaccurate information, though we did note that more detailed information could have been made available about the eligibility criteria for grants. We identified issues with the way that staff informed Mr C of the outcome of his applications, and how clear this information was. His applications had not been successful, but this was not clear from the emails Mr C initially received after a panel considered his applications.

When Mr C complained to the council, they did not initially handle his correspondence as a complaint. We agreed with Mr C that the council were inappropriately applying the timescales in their complaints handling procedure, by taking the day they received a complaint as 'day 0' rather than 'day 1'. Mr C also made a claim for compensation, which he complained had not be appropriately considered. While we found that there was no evidence that the council's legal department had appropriately considered this claim, we explained that it is not our role to assess claims for compensation.

Recommendations

We recommended that the council:

• consider reviewing the information on grant applications to provide more detail in relation to the definitions of ineligibility criteria;
• consider revising their customer service standards leaflet to explain what may happen if an applicant is initially unsuccessful with their grant application, in terms of being provided with the opportunity to provide additional supporting information;
• remind all relevant staff of the importance of handling complaints in line with the complaints handling procedure and the importance of providing a full response to the issues raised;
• provide a full response to Mr C in relation to his claim for compensation; and
• apologise to Mr C for the failings identified.

Summary

Ms C, a solicitor, complained to us on behalf of her clients, Mr and Mrs A. Mr and Mrs A were unhappy with the council's actions relating to a compulsory purchase order and repairs to a core path. A number of the issues complained of occurred outwith the last twelve months and we did not pursue those matters further. We upheld a complaint that the council failed to advise Mr and Mrs A promptly when the council revised their view on repairing the core path and began to consider a compulsory purchase order. We recommended that the council apologise to Mr and Mrs A for this delay, which they did. We did not uphold complaints about the council's overall communication with Mr and Mrs A.

Recommendations

We recommended that the council:

• apologise to Mr and Mrs A for not advising them in a timely manner of their revised position in relation to their right to enter Mr and Mrs A's land without their permission.

Summary

Mr C, who is an advice worker, complained to us on behalf of Mr A. He said that Mr A has diabetes and had experienced a number of hypoglycaemic (low blood sugar) episodes. His colleagues had contacted the Scottish Ambulance Service (the service) to request an ambulance when he had another hypoglycaemic episode just before starting work. When the ambulance crew arrived, they carried out a blood glucose test, which showed that Mr A had hyperglycaemia (high blood sugar levels). Mr C complained that the ambulance crew had failed to take the blood glucose reading appropriately. He said that Mr A had spilled a sugary drink on his fingers. He stated that the ambulance crew had failed to clean Mr A's skin before carrying out the blood test and, because of this, the blood tests incorrectly showed that his blood sugar levels were very high.

We took independent advice on the complaint from an adviser in emergency medicine. We found that the ambulance crew should have cleaned Mr A's hands, using either soapy water or an alcohol wipe, before taking the blood glucose reading. This was to prevent getting a high reading in error, and also to reduce the chance of infection, which is a particularly high risk for diabetics. The evidence showed that the ambulance crew failed to clean Mr A's hands so we upheld this aspect of Mr C's complaint.

Mr C also complained that the ambulance crew then unreasonably took Mr A to the local hospital. However, ambulance crews are required to transport patients with hyperglycaemia to hospital. Although it was likely that the high blood sugar reading was due to the sugary drink on Mr A's skin, we found that the ambulance crew were required to take Mr A to hospital when the blood test showed that he had hyperglycaemia. We did not uphold this aspect of the complaint.

Recommendations

We recommended that the service:

• issue a written apology to Mr A for the failure to clean his skin appropriately before taking the blood glucose reading; and
• take steps to ensure that relevant staff are aware of the requirement to clean skin before taking a blood glucose reading.

Summary

Mrs C complained about the care the board provided to her late husband (Mr C) when he attended the Western General Hospital for a scan. Mr C suffered from terminal cancer and had widespread pain which severely restricted his mobility. Mrs C said that Mr C's consultant had recommended he be transferred to hospital with specialist equipment which she said had not happened. She also complained that the mobile scanning unit was not suitable for Mr C due to his restricted mobility and that it did not have appropriate lifting equipment; and that a record was not made of Mr C having fallen in the mobile scanner unit.

We took independent advice from our nursing adviser and found that, although the consultant did not specify any specialist equipment, he had indicated an ambulance would be appropriate to transport Mr C to the mobile scanning unit, so we upheld Mrs C's complaint that this did not happen. We also found that the board had accepted that Mr C's mobility needs could not be met at the mobile scanning unit because it did not have the equipment he needed for being mobilised. However, we did not identify clear evidence to show that Mr C had fallen, so we did not uphold this aspect of the complaint.

Recommendations

We recommended that the board:

• apologise to Mrs C for the failings identified; and
• provide evidence that the learning from this case has been discussed at a multi-disciplinary meeting and fed back to staff.

Summary

Mr C complained to us that the medical practice had failed to provide appropriate care and treatment to his daughter (Miss A). He said that the practice had failed to act on Miss A's symptoms despite a history of abnormal smears and his view was that there was a delay in diagnosing cancer. Mr C also complained that during her treatment Miss A was asked to re-register with another practice as she had moved home and had therefore moved out of the practice catchment area. The practice had reasoned that Miss A may have needed access to district nurses which they would not have been able to provide if Miss A was outwith their area. Mr C felt this was insensitive.

The practice provided records that showed that they had issued an urgent referral and their view was that they had taken appropriate action. We took independent advice from an adviser in general practice medicine and concluded that the practice had provided a reasonable level of care. The complaint about treatment was not upheld. The adviser also said that although under the General Medical Services contract the practice had the right to ask Miss A to re-register with another GP as she had moved out of their catchment area, it was inappropriate to ask her to do so given that she was undergoing treatment and that she would be unlikely to need the services of district nurses. Therefore, we upheld the complaint about the timing of the practice’s request to re-register.

Recommendations

We recommended that the practice:

• provide Miss A with a written apology for the timing of their request that she re-register with another practice; and
• review their policy to ensure that any administrative request takes account of the clinical care and any treatment that the patient is undergoing.

Summary

Mrs C complained that her mother (Mrs A) did not receive adequate care during two admissions to hospital. Mrs A underwent surgery in Monklands Hospital to repair a fractured hip, before being transferred to Wester Moffat Hospital for rehabilitation. Mrs C complained that her mother had not been provided with reasonable nutrition at Wester Moffat Hospital, and that there had been a failure to take the appropriate steps in either hospital to prevent the development of pressure ulcers. Mrs C also felt an unacceptable standard of catheter care had been provided at Wester Moffat Hospital and that the board had taken an excessive and unreasonable length of time to respond to her complaint.

We took independent advice from our nursing adviser. The advice we received was that the evidence showed a reasonable standard of nutritional care was provided. Although there were gaps in the records, the board had recognised this failing and taken steps to address it. These gaps were not sufficient to show inadequate nutritional care. The advice said, however, that the standard of skin care was inadequate and nursing staff had failed to implement fully the recommendations of the specialist review of Mrs A's pressure ulcers. This represented an unacceptable standard of care.

Our investigation found that the standard of nutritional and catheter care was reasonable, but the standard of skin care was not. We also found the board's response was unreasonably delayed due to the reduced availability of a key member of staff, and a failure to progress the complaint in their absence.

Recommendations

We recommended that the board:

• apologise for the failings identified;
• provide evidence that the findings of the investigation have been shared with senior staff and the failure by the board to identify inadequacies in the nursing care discussed;
• provide evidence of the on-going SSKIN education and training (a care plan for pressure ulcer prevention) being provided to nursing staff; and
• remind all nursing staff of the importance of responding fully to complaints.

Summary

Ms C complained about the care and treatment her late father (Mr A) received at the Royal Northern Infirmary. She said the board failed to provide adequate nursing care for her father and unreasonably failed to diagnose his broken collarbone and stroke.

We obtained independent advice on the case from a nurse adviser and a GP adviser. Our nursing adviser said Mr A's fluid balance and food intake, repeat fall assessments and care planning fell short of what should have been in place. However, she said that even if these areas of Mr A's care had been up to standard, the outcome may not have changed. Our adviser said the board's response to Ms C's complaint was poor and she would have expected the board to have recognised their shortcomings, and to have apologised and ensured lessons had been learned.

Our GP adviser said there was documented evidence in Mr A's medical records of a review of his condition after each of his falls by a clinical member of staff. She noted that the documentation of the examination and assessment was thorough and of a reasonable standard. She said the doctor who attended to Mr A noted his on-going confusion, poor mobility and number of recent falls. The doctor identified that Mr A's condition had deteriorated and arranged transfer to Raigmore Hospital for further investigation. The doctor also identified that Mr A may have had a stroke and correctly referred him to Raigmore Hospital for a scan. Our adviser said this was reasonable management and was in accordance with relevant guidelines.

Recommendations

We recommended that the board:

• feed back our decision on this case to the nursing staff involved;
• remind their nursing staff about the importance of falls assessment and care planning; and
• provide Ms C with a written apology for the failings identified.

Summary

Ms C was charged by her dental practice for a missed appointment. Ms C felt this was unreasonable in the circumstances and complained to the practice about this. She was dissatisfied with the practice's response and made further complaints. Following a subsequent visit to the practice she and her daughter were removed from the practice's treatment list. Ms C complained about this and was dissatisfied with the response she received. She complained further and also received a reminder for a check-up despite her having been removed from the practice's treatment list. Ms C complained about these matters but did not receive a response from the practice. She raised her complaints with this office.

We attempted to resolve the matter but this was unsuccessful. Following consideration we decided that the practice's actions in charging Ms C for the missed appointment, failing to send a reminder for an appointment and sending two copies of the letter advising Ms C that she had been removed from their treatment list were not unreasonable. We also found that there was insufficient evidence to determine whether the practice had refused to treat Ms C's daughter due to Ms C's outstanding debt. However, we did decide that the practice's actions in refusing Ms C's request for a meeting to discuss her complaints, the process by which they removed Ms C from their treatment list, their response to Ms C's complaints and their having sent her a reminder for a check-up after they had removed her from the treatment list were unreasonable and upheld these aspects of the complaint.

Recommendations

We recommended that the practice:

• apologise to Ms C for the failures we identified; and
• undertake training with all practice staff in relation to the removal of patients from treatment lists and the practice's complaints procedure.