Upheld, recommendations

Summary

Mr C complained that his supervision level in prison was raised from low to medium supervision without good reason. We explained to Mr C that decisions to change someone's supervision level are a matter for the Scottish Prison Service (SPS), not for us, and our only role in considering such a complaint is to see whether they followed their procedures in reaching the decision. During our investigation the SPS could not provide us with a particular form, which meant they could not evidence that the process was followed in Mr C's case. For that reason, we upheld his complaint.

Mr C also made various complaints about the way SPS handled his complaint. We considered that a number of his points did show that it had not been handled appropriately. For example, he was not given part of a complaint form which related to escalating his complaint to the next level in SPS; they did not address a significant part of his complaint; and there was some delay.

Recommendations

We recommended that SPS:

• remind staff to retain completed PSS3 forms securely and in accordance with normal process;
• remind the officers who held the internal complaints committee of the need to address issues raised when considering complaints; and
• apologise to Mr C for the delay in the prison governor's reply.

Summary

Mr C, a prisoner, complained that staff at his prison carried out a personal search in a manner that was unreasonable in his particular circumstances. In looking at Mr C's complaint, our role was to examine whether the prison followed the correct procedure in carrying out the search.

When we looked at the search procedures we found that they said that, after a search, the final stage was to complete relevant paperwork. There was no paperwork, and we concluded that the prison had not completed this as they should have done. This meant we could not determine whether the prison followed the correct procedure when Mr C was searched and, consequently, whether it was reasonable. Because of this, we upheld Mr C's complaint.

Recommendations

We recommended that Scottish Prison Service:

• amend the body search procedures to make clear in which cases relevant paperwork should be completed.

Summary

Mr C was on a work placement from which he was expected to return directly to his open prison. However, he diverged from his designated route back there after finding out about particular family circumstances beyond his control. As this breached his temporary release licence conditions, a Risk Management Team (RMT) meeting was held to discuss this. As a result, Mr C was downgraded to closed prison conditions and his supervision level was increased.

Mr C complaint that the prison failed to adequately take into account his family situation when reaching their decision to downgrade him and the length of the downgrade. After reviewing his complaint, and all the relevant paperwork, including information from the prisons concerned, and the relevant RMT guidance, we concluded that the RMT paperwork failed to show which of four criteria listed in the guidance applied in Mr C's case, and so did not show why they took the view that he merited that punishment. We had further concerns that the paperwork did not indicate the reason(s) for the length of his downgrade and increase in supervision level, and it was unclear to us why the recommendations made at the final stage of the internal complaints procedure were not followed up. We upheld Mr C's complaint and made recommendations to address these failings.

Recommendations

We recommended that Scottish Prison Service:

• reconsider their decisions in light of the failings identified;
• apologise to Mr C for the failings identified;
• remind all open estate staff involved in RMT meetings and PSS3 form completion of the contents of section 8 of the RMT guidance, in relation to prisoners returned to closed conditions, and the importance of properly evidencing and recording decisions taken; and
• share this decision with complaints handling staff at the relevant prisons.

Summary

Mr C complained that the Scottish Children's Reporter Administration (SCRA) unreasonably restricted his contact with one of their offices, after some phone calls in which they felt Mr C was abusive and hostile towards staff. They wrote to him, explaining that he could only contact that office by email, although he could still phone their head office.

Our investigation found that although SCRA wrote to Mr C promptly to tell him about the restriction, there was no documentary evidence of his calls. There was only an internal email confirming the decision, and the recollection of a staff member. As there were no records, and as the staff member was not at work for a period afterwards, this had contributed to a delay in SCRA considering Mr C's complaint about the restriction.

SCRA are entitled to decide to restrict contact in appropriate circumstances, and we did not comment on their decision to do so in this case. In addition, we noted that phone contact was effectively restored some three months later when SCRA provided a named point of contact for Mr C. However, we were concerned that when they initially restricted Mr C's contact, they did not appear to make him aware that this decision could be reviewed or tell him the duration of the restriction, as their policy said they should. We upheld his complaint, as we considered that this, coupled with the lack of record-keeping and failure to document the reasoning behind the decision, meant that SCRA's administrative handling of the matter fell below a reasonable standard.

Recommendations

We recommended that the SCRA:

• ensure that people are advised of the review process and duration of any restriction of contact; and
• consider making notes of phone calls – particularly where restricting contact is a possibility – to ensure a clear, demonstrable audit trail.

Summary

Ms C owned a property in Edinburgh, on which work was done under a statutory notice issued by the council. She complained to the council that they had not told her how her complaint about the management of this work would be reviewed. She then complained about this to us, saying that the council's review of her complaint did not look into her concerns fully.

When we investigated the complaint, we found a gap in the council's record-keeping because they did not provide us with some relevant correspondence between Ms C and their property conservation section. We also found that they had not told her how the review process would be conducted, because they had not sent the letter containing the advice about this to her home address. The council acknowledged that Ms C had not been provided with assurances that, despite a backlog in the handling of complaints about statutory notice cases, her case was being reviewed through an approved process.

We also found that email correspondence from Ms C to the council about her concerns over the contract of works was not included in the documents that formed part of the review. However, we found evidence that the review did consider the management of the repairs and her concerns were, therefore, covered in it.

Recommendations

We recommended that the council:

• apologise to Ms C for the failure in their record-keeping and their failure to write to her at her home address with advice about how the review process would be conducted; and
• apologise to Ms C for their failure to include an email in their consideration of her complaint about the management of statutory notices.

Summary

Mr C's late aunt (Ms A) had been in hospital following a stroke, and was discharged to a nursing home. Mr C complained that council social workers did not give Ms A the chance to visit the nursing home before sending her there (even though the manager had offered to let her visit), and did not offer her a choice of homes. He also said that the council failed to obtain the views of or inform Ms A's advocate and her family.

We do not normally investigate complaints about the actions of social workers, as these are normally considered by a complaints review committee (CRC), who have greater powers than we do to question the decisions of social workers. In this case, however, the council had decided that the complaint could not be considered by a CRC, so we investigated the actions of the social workers. In doing so, we took independent advice from a social work adviser with significant experience in older people’s services.

Ms A was considered to lack the capacity to make her own decisions. However, the council's assessment of her said that she had a little insight and would be pleased to be helped to seek a good nursing home placement. Despite this, Ms A was then discharged to a nursing home that she had not seen. The council told us this was because hospital staff had said that a visit to another home had unsettled her. However, there was no evidence that, before Ms A was discharged, social workers had assessed her needs, taken into account her wishes, or gathered information from a range of sources, including her independent advocate. This amounted to a failure to obtain and consider material and important information. We took the view that, at the very least, social work staff should have recorded why they felt that the views and interests of hospital staff should take precedence over those of Ms A. We would have expected the records to show why the potential upset of a visit was felt to be more significant than that of having to move to a home that she had not seen or visited.

We also found that the council had failed to give Ms A a choice of nursing homes, as they should have done in line with both national policy and their own policy on patients being discharged from hospital to a home. In addition, Mr C was recorded as Ms A's next of kin, but the council had not contacted him about Ms A’s discharge in line with principle 4 of the Adults with Incapacity (Scotland) Act 2000. We found that these failings amounted to maladministration and upheld Mr C's complaint about Ms A’s discharge to the nursing home.

Mr C also complained about the way in which the council handled his complaint. They had suspended it, as they considered that he was not entitled to confidential information about Ms A, and in view of this decided that a CRC could not be held. Guidance from the Scottish Government on holding CRCs says that a complainant has no right of access to personal information held about a third party, unless the third party gives consent. As Ms A had died before Mr C made his complaint, consent could not be obtained. In view of this, we considered that it was reasonable for the council not to refer the complaint to a CRC, and noted that the decision to suspend it had in fact been approved by a CRC. However, we found that the council had delayed in dealing with Mr C's complaints. They had also incorrectly told him that no family members had been recorded as next of kin. In view of this, we also upheld this aspect of Mr C's complaint.

Recommendations

We recommended that the council:

• issue a written apology to Mr C for the failings we identified;
• take steps to ensure that all staff involved in the discharge of patients from hospital are aware of and are acting in line with the relevant national and council policies;
• consider issuing guidance to staff on how they should complete one of the relevant forms when patients are discharged to a care home; and
• confirm that lessons have been learned and steps have been taken to prevent similar delays occurring when they respond to complaints about social work issues.

Summary

Mr C and Ms C complained to us about how the council handled their complaints about their neighbours' antisocial behaviour (ASB). They said that their sleep was frequently disturbed and they were concerned for the safety of their family and property. They complained that the council had failed to investigate, had not responded to complaints within their published timescales and did not keep them informed about what action was being taken. Mr C and Ms C had also kept diary sheets with details of the disturbances that had been occurring, and they said that the council had failed to act on these.

We upheld Mr C and Ms C's complaint. Our investigation found that they had complained to the council over a nineteen-month period. The council had recorded or noted several incidents, and had taken action after the first few, but had then failed to follow up later complaints appropriately. We found that the council had only issued diary sheets once, and had not followed up when they did not receive completed copies. We also found that internal communication documents showed that the council were aware that the situation was deteriorating, but they took several months to achieve a satisfactory solution. The council also failed to appropriately record and respond to each complaint within their published timescales and, in particular, did not keep Mr C and Ms C informed of the outcome of their investigations or their decisions.

Recommendations

We recommended that the council:

• ensure that staff are fully aware of the requirements in relation to the maintenance of records of complaints, interviews and communications in relation to ASB;
• ensure that staff fulfil the requirements of the council's procedure and guidance in relation to diary sheets;
• highlight to staff the impact of not responding to complaints of ASB within their published timescales; and
• apologise to Ms C and Mr C for the failings we identified and for the time taken in bringing this complaint to us.

Summary

Mr C lives in a small estate. When the council granted planning consent for the development they approved landscaping plans, and put in place a planning condition to control the date of completion of the landscaping and the replacement of diseased or damaged plants. They did not, however, include any provision for a scheme of maintenance.

Mr C told us that some of the open space next to his home had not been landscaped, and he was concerned that other parts of the estate appeared to be getting a more frequent grass cut and related maintenance. He complained that the council failed to take reasonable action to ensure that landscaping in the housing development was in accordance with approved plans.

We took independent advice from one of our planning advisers, and we upheld the complaint. The adviser said that while one approved drawing had included a landscape maintenance schedule, this had not been included in any of the relevant consents and this had given rise to Mr C's complaint. Mr C wanted the council to take enforcement action, but this was not possible.

Recommendations

We recommended that the council:

• review their use of planning conditions with regard to securing control over the management arrangements for long term maintenance of landscaping and open space; and
• ensure that all application documents on which such matters depend are captured by references to approved documents in the terms of the decision.

Summary

Mr C was unhappy that the council breached a Tree Preservation Order (TPO). He told us that, because a council officer made wrong assumptions about which tree was to be felled, the council had granted permission for the felling of a healthy tree that was the subject of a TPO. Before Mr C brought his complaint to us, the council had acknowledged their error and apologised to him for it. However, Mr C said that the council had given him unsatisfactory and confusing responses to his complaint.

We took independent advice from one of our planning advisers. He said that the council had focused on inadequate explanations for the errors, instead of reviewing their procedures as they should have done. As the council appeared to have given more weight to defending their actions than to reviewing procedures, inconsistencies had then emerged in their responses to Mr C. The council had acknowledged that the wrong tree had been felled, and that the tree had not been properly identified before permission was given, which was a relatively serious mistake. The adviser had concerns that the complaint was not investigated thoroughly enough, especially as the deficiencies related to planning procedures. We upheld Mr C's complaint, as we found that the council's investigation and complaints handling was inadequate and inconsistent.

Recommendations

We recommended that the council:

• consider the comments on the content of procedural guidance on tree works consent applications (in addition to matters already identified by the council) and advise the Ombudsman of their intentions with regard to carrying out a review of procedures and making the relevant staff aware of them;
• ensure that appropriate action is taken to avoid such an incident recurring and advise the Ombudsman of the action taken; and
• issue Mr C with a full and sincere apology for the failings identified in this complaint.

Summary

Shortly after being placed on the waiting list for a day surgery procedure in hospital, Mr C had a phone call offering him an appointment for the following week. He did not receive the pre-operative information leaflet in the post until two days after the surgery. On the day of the operation he was told that he had been moved to last on the theatre list. When he asked why, he was told it was because he previously had methicillin-resistant staphylococcus aureus (MRSA - a bacteria that is resistant to some common antibiotics, can cause infection and can be difficult to treat). This caused Mr C some distress. He complained that his history of MRSA had impacted on how his surgery was managed, although he had told staff - both at his pre-operative appointment and on the morning of the operation - that he had been given the all-clear a few years before.

In responding to Mr C's complaint, the board acknowledged that it was unfortunate that he did not receive the information booklet in advance. They also said that there was no requirement to screen day surgery patients for MRSA, and that their infection control policy did not require MRSA-positive patients to be last on the theatre list, as measures were in place to mitigate against cross infection risks. However, they then went on to say that the consultant had placed Mr C last on the list as he had a history of MRSA and there was nothing in his records indicating that he was clear of the infection.

As part of our investigation, we obtained independent advice from one of our medical advisers. Having done so, we upheld the complaint. We noted that the board had failed to provide pre-operative information to Mr C at the right time. We also found that they had deviated from their normal policy without properly explaining the reason for this. Their response to Mr C's complaint had been contradictory, in failing to explain why the consultant had not adhered to their policy.

Recommendations

We recommended that the board:

• bring their infection control policy to the attention of staff and highlight the importance of adhering to this;
• review their process for ensuring patients receive any relevant pre-operative information in a timely manner;
• remind staff who handle complaints of the importance of providing clear and consistent responses; and
• apologise to Mr C for the failures highlighted in our decision.