Upheld, recommendations

Summary

Mrs C complained that a school had unreasonably excluded her child. She also complained that they offered a mediation session to allow her to discuss this but, when she went to it staff refused to listen to her side of the story or to allow her child to attend. She was also unhappy about the way the council dealt with her complaint about this.

The council said that they had offered the mediation session to ensure that appropriate support was in place to allow her child to return to school and that they had made clear to Mrs C that the meeting was not held to discuss the exclusion. They also said that they had dealt with her subsequent complaint in line with their complaints procedure.

We found that, although the council offered the mediation meeting in order to try and ensure that Mrs C's child returned to school as quickly as possible and were trying to help resolve this, they incorrectly told Mrs C that the mediation meeting and complaint were an alternative to the appeals process. This was not the case, and there is a separate statutory process that considers appeals against school exclusions. We concluded that the council provided Mrs C with misleading information. In terms of her complaint, we found no evidence to suggest that the school failed to take her concerns seriously or failed to investigate every allegation she made. We did, however, conclude that they failed to address all her complaints as they had said that they could not look at new issues she raised with them after concluding her original complaints. As a result of these failings, we upheld her complaints.

Recommendations

We recommended that the council:

• apologise to Mrs C for the misleading advice;
• ensure that they respond to all points of complaint and that any new and separate issues are duly investigated; and
• inform Mrs C of the steps she should take if she still wishes to formally appeal against her child's exclusion, making sure they fully explain what this process will involve.

Summary

Mrs C's child had suffered verbal abuse, physical assault and bullying on social media. Mrs C complained that the school did not follow anti-bullying policies, and that the council's policy did not provide adequate protection. She said that the school and the council had not taken enough steps to protect her child. The council responded that they were reviewing their policy, but that was a year after Mrs C had first raised her concerns.

We upheld Mrs C's complaint and made a number of recommendations, as our investigation found that policy and procedures were not followed, no action had been taken in relation to evidence of bullying on social media, and evidence of a serious incident had not been kept. We also found that the council had not taken reasonable steps to ensure the adequacy of their anti-bullying policy.

Recommendations

We recommended that the council:

• apologise for not ensuring that anti-bullying policy and procedures were followed;
• review anti-bullying staff training in light of the potential abuse of social media and actions that staff should take in such cases to ensure all staff are clear about their responsibilities when bullying is reported;
• consider how they could encourage schools to use specific incidents of bullying as learning opportunities for pupils within the curriculum;
• share the findings of our investigation with relevant staff; and
• consider the adequacy of their anti-bullying policy and their advice to schools.

Summary

Ms C complained that the housing association delayed in carrying out repairs to her property. She was unhappy about various issues, but her main concern was the noise that she could hear from another flat. The association had previously given general advice on noise reduction, and fitted insulation between the flats, but this did not resolve the problem to Ms C's satisfaction. They then arranged for a sound test to be carried out and reported to them. In line with the report's recommendations, they agreed that they would carry out more work. However, this was before they checked whether a building warrant would be necessary. When it turned out that a warrant was in fact needed, the cost of the proposed work drastically increased and the association told Ms C that they could no longer go ahead with it.

Although we could not question the decision not to proceed with the work, as the association had provided Ms C with a reasonable explanation of that decision, we upheld her complaints. The problems had been ongoing for some time and we took the view that the association should have been aware that a warrant might be necessary and should have checked this before telling Ms C that the work would proceed. They had also not kept Ms C updated as matters progressed, and there was confusion about whether her concerns were treated as complaints or enquiries.

Recommendations

We recommended that the association:

• apologise to Ms C for the delay and confusion in their handling of the matter;
• review their process so that staff are proactive in confirming the need for building warrants with the council; and
• confirm that the outstanding repairs have been addressed and explore alternative sound proofing options between the flats.

Summary

Mr C's mother (Mrs A) suffers from angina and vascular dementia (a common form of dementia, caused by problems in the supply of blood to the brain). Mr C holds welfare power of attorney for her. Mrs A was admitted to hospital after she collapsed. She was discharged home after two days but was readmitted several weeks later, following episodes of dizziness and falls. She was discharged again, but six days later was admitted (by her GP) for a third time due to chest pain, shortness of breath and poor balance. It was noted in her medical records that at the point of admission she was not 'coping in her social environment'.

Mr C said that he only found out on the day of the second discharge that Mrs A was being sent home to an empty house with no other family members present. This was despite Mr C specifically requesting that Mrs A's return home should be fully coordinated with the local care team to ensure her effective transition from hospital to home. He said that there was no effective liaison with the local care team. When he raised concerns, the hospital arranged for a health care assistant to accompany Mrs A home.

Mr C also said that the referring GP had asked the board to carry out a medical and social care assessment of Mrs A in relation to her third admission. Nearly two weeks after she was admitted, he found out it had not been completed and that staff were not aware of the request. He said that staff assumed Mrs A would return home on the same care package. The review was then carried out, but Mr C believes this was only because he insisted.

After taking independent advice on this case from one of our medical advisers, we upheld Mr C's complaints. Our adviser said that when people with dementia are being transferred home from hospital, there should be a proactive risk assessment. This should consider the person's physical and cognitive abilities, the home circumstances and whether anyone will be at home to receive them on arrival. The board failed in this respect. We also accepted the adviser's comments that there was no evidence that Mrs A was involved in her care in any meaningful way or that involvement of her relatives occurred in a planned or proactive manner. These failings were exacerbated by failures in record-keeping. Related to this, the board failed to formally assess Mrs A's capacity to consent to treatment, despite the evidence that her capacity was impaired, and they failed to acknowledge and effectively respond to Mr C's welfare power of attorney status.

In relation to the discharge, our adviser said that while there was no evidence the GP requested an assessment, in light of the evidence available to staff from Mrs A's second admission to hospital, a review of her care package should have been planned. Having said that, the adviser also said that the referral to the hospital discharge team took place within a reasonable time. However, it was not clear to us that without Mr C's intervention, this would have taken place, particularly in light of the failures in record-keeping.

Recommendations

We recommended that the board:

• ensure that communication with relatives and/or carers of people with dementia is a planned process - in particular with regard to discharge;
• ensure that the standard documentation is effectively utilised and completed;
• ensure that all staff are aware of the legislation with particular reference to consent, capacity and record-keeping, including completing section 47 certificates and recording that relatives and/or carers have welfare power of attorney;
• bring the failures identified to the attention of relevant clinical staff; and
• apologise to Mr C for the failures identified.

Summary

Mr C complained that his dentist did not provide a reasonable standard of treatment. At Mr C's initial appointment, the dentist carried out a detailed examination. She noted that there was extensive decay in one of his lower wisdom teeth and that it might require extraction. When Mr C returned to start the treatment, the tooth was drilled to remove the decay, but this led to exposure of the nerve. The dentist covered the exposed nerve by dressing it with a paste to treat inflammation/infection, and a filling material. She told Mr C that the tooth would need to be extracted at a later appointment.

Mr C attended the dentist again two days later as he had pain and swelling around the tooth. The dentist gave him an antibiotic and reduced the filling by cutting it back (this eases symptoms slightly by preventing the patient putting pressure on the tooth when biting). The next day, Mr C contacted NHS 24, as he was concerned about increasing swelling and pain around the tooth. He was referred to an emergency dentist who prescribed a different antibiotic. Mr C saw his dentist again several days later. She was unable to extract the tooth because of the swelling, although she thought that it had gone down slightly. Mr C was later admitted to hospital because the swelling had increased. It was found that he had an abscess and he had an operation to drain the abscess and to extract the tooth.

Mr C complained about the dentist's failure to extract the tooth. As part of our investigation we took independent advice from our dental adviser. We found that the decision to delay the extraction of the tooth until such time as it could be fully assessed was reasonable because of the risks associated with extraction of a lower wisdom tooth. However, the dentist had used a substance called glass ionomer to fill the tooth when the nerve was exposed. Our adviser said that this was not an appropriate choice for an exposed nerve and the dentist should have chosen a more appropriate sedative dressing material. This would have reduced the risk of complications and pain while Mr C was waiting for the tooth to be extracted. In addition, we found that the dentist had failed to ensure that the infection could drain away when the abscess began to develop. This allowed pus to continue to accumulate within the tooth, which then spread into the surrounding tissues and made the swelling worse. In view of this, we found that the dentist had not provided Mr C with a reasonable standard of dental treatment.

Recommendations

We recommended that the dentist:

• ensures that she has learned lessons from this case;
• issues a written apology to Mr C for the failure to use an appropriate sedative dressing material and for the failure to establish drainage in the tooth; and,
• ensures that responses to complaints provide information about how to refer the complaint to the SPSO.

Summary

Mr C, who is a prisoner, complained that the prison health centre unreasonably stopped his pain medication. He said he was prescribed the medication whilst he was in the community and it was the only type that helped his pain. The health centre had checked with Mr C's community doctor who confirmed he was being prescribed the medication. However, they then decided Mr C did not need the medication and prescribed him something else for his pain. Mr C told us he had tried many other types of medication but none of them helped.

We took independent advice on Mr C's complaint from one of our medical advisers. He felt that the prison health centre did not appear to have undertaken a detailed assessment of Mr C's circumstances. In his opinion, the information available suggested Mr C had tried various types of reasonable pain relief but they had been unsuitable. In addition, our adviser noted that the medication the health centre were refusing to prescribe was likely to be suitable for the type of pain Mr C was experiencing. In light of the information available to us, and having accepted this advice, we upheld Mr C's complaint.

Recommendations

We recommended that the board:

• undertake an appropriate review of Mr C's clinical need for the pain relief he requested.

Summary

Miss C, who is a prisoner, complained that there was an unreasonable delay in her receiving dental treatment. She also complained because the prison doctor refused to review her pain medication.

The board told us that Miss C saw the dentist for treatment but she was missed for a follow-up appointment. They told us that this probably happened because the way the waiting list system operated had changed. Miss C saw the dentist again a little over five months after her initial appointment. We agreed this delay was unreasonable and we upheld Miss C's complaint. In addition, Miss C said in her complaint to the board that her pain medication was not helping. The board told her that the doctor had said it was not appropriate to review her medication before she had been seen by physiotherapy, and had advised that if she responded poorly to physiotherapy then her medication would be reviewed. We took independent advice on this from one of our medical advisers, who said that it was not acceptable for the prison doctor to refuse to review Miss C's pain medication only after she had been to physiotherapy, as she had indicated she was in pain and her medication was not helping. In light of that, we upheld the complaint.

Recommendations

We recommended that the board:

• apologise for the delay in Miss C receiving further dental treatment; and
• take immediate steps to review Miss C's current pain medication and discuss the matter with her.

Summary

Mr C complained to us about the level of Business Stream's invoices. He thought his initial invoice – which had been based on a water meter - was too high and claimed that Business Stream had told him that he would be better off moving to unmetered billing. Four water meters were removed from Mr C's premises and an unmetered invoice was applied in place of the original invoice. Although the unmetered invoice was slightly cheaper, Mr C felt that it was still too high. When he complained, he was advised that he might wish to apply for reassessment. This is a process where Business Stream's customers can check whether or not they would be cheaper moving from unmetered to metered charges. Given that he had recently had four meters removed, Mr C remained unhappy and complained to us.

During our investigation, Business Stream confirmed that the initial invoice that Mr C had received was based on a 'bulk' meter. This meant that it served the entire building, while the other three meters removed were 'internal' meters. Although it was not clear whether another occupier's water consumption had been included in the original bulk-metered calculation, we considered that this at least cast doubt over the accuracy of the comparison with the cost of unmetered billing. Because of this, and in light of the fact that Mr C had recently had four meters removed, we took the view that it was unreasonable for them to advise Mr C to consider reassessment. We said that, in these particular circumstances, Business Stream should have taken a more proactive approach in confirming whether Mr C's water consumption could be metered accurately and we upheld Mr C's complaints.

Recommendations

We recommended that Business Stream:

• consider covering the installation cost if, following reassessment, an appropriate meter proves to be cheaper and can reasonably be installed; and
• consider backdating the charges to the point of opening the account, if such a meter is installed.

Summary

Ms C owns a property, which is sub-divided into eight units that she rents out individually to small businesses. Each unit has access to a shared kitchen and bathroom, the only sources of water in the building. To take advantage of a government small business bonus relief scheme, each unit has been assessed separately by the Scottish Assessor, giving each its own rateable value. Ms C has an account with Business Stream to pay for water used at the property. She complained that each business renting her units was being charged individually for water services at a disproportionately high rate, despite there only being a single water supply. She asked for a water meter to be installed so that she could be charged for the single supply and divide the costs between her tenants, but this was refused.

Due to the way that the property is divided, Scottish Water advised that a bulk meter would be required to measure the amount of water used. They said that they no longer install bulk meters. Instead, volumetric water charges were estimated for each unit based on their rateable values. As each unit had its own rateable value and no water meter, Business Stream's policy required that full fixed charges for waste water and drainage were applied to each unit. This meant that around £2,000 of fixed charges would be applied annually for the property, rather than around £275 had a meter been installed.

We upheld Ms C's complaint. Although we were satisfied that Business Stream had charged the units for water in line with their policy, we found that Scottish Water were, in fact, able to install bulk meters in certain circumstances and this had not been adequately explored. We also found Business Stream's customer service to have been poor when investigating Ms C's complaints.

Recommendations

We recommended that Business Stream:

• and Scottish Water jointly consider installing a bulk meter at the property;
• consider discounting the units' water accounts to show only one set of fixed charges for the water supply from the date of Scottish Water's refusal to install a bulk meter; and
• apologise to Ms C for the poor service that she received when attempting to change her billing arrangements.

Summary

Mr C complained that his business unexpectedly received water bills for more than £3000 in May 2012. He had thought that the water charges were his landlord's responsibility. He contacted Business Stream but found the advice he received unhelpful. Business Stream confirmed that his premises had been identified as a gap site (a property that is receiving water services without being charged) in January 2011. A month after receiving the bills, Mr C applied for reassessment of the water charges and as a result a credit was applied to his account.

Our investigation found that there was a delay between Business Stream being made aware of the gap site and their taking action to start charging for water services. Mr C also had a responsibility to advise a licensed provider that his business was in the premises and to start paying for water services. We did, however, uphold his complaint as, although Mr C and Business Stream had a shared responsibility to make arrangements to set up a water account, we were concerned that the delay in issuing the initial bill meant that Mr C was not given an opportunity to apply for reassessment until June 2012.

Recommendations

We recommended that Business Stream:

• should consider crediting Mr C's account with 50 percent of the difference between the unmeasured rateable value charges and the reassessed charges between January 2011 and June 2012; and
• apologise for the fact that written notice and an explanation were not given for the number of invoices sent.