South of Scotland

Overview

The complainant (Mrs C) raised a number of concerns about the care and treatment provided to her late husband (Mr C) by Ayrshire and Arran Health Board (the Board) in the months immediately prior to his death in June 2005 and in particular an alleged failure to properly diagnose and treat his cardiomyopathy in a timely manner which led to his dying before arrangements could be made for a heart transplant.

Specific complaints and conclusions

The complaints which have been investigated are that the Board:

• (a)      failed to provide Mr C with timely or adequate medical treatment (partially upheld); and
• (b)      failed to provide Mr C with timely or adequate nursing treatment (partially upheld).

Redress and recommendations

The Ombudsman recommends that the Board:

• (i)       give consideration to more urgent treatment being prescribed through the hospital pharmacy to prevent the administrative delays associated with prescribing through general practice and;
• (ii)      audit and review the existing procedures for monitoring possible cannula site infections and staff awareness of these procedures.

The Board have accepted these recommendations and will act on them accordingly.

Overview

The complainants (Mr and Mrs C) raised a number of concerns about East Lothian Council (the Council)'s actions in relation to works which they were carrying out to their house.  In particular it is alleged that amongst other things, the Council stopped works, failed to reply to correspondence, published their correspondence on a website and interfered in the sale of the property.

Specific complaints and conclusions

The complaints which have been investigated are that:

• (a)       the Council delayed in dealing with their application for a building warrant (not upheld);
• (b)       the Council stopped works on site (upheld);
• (c)       despite a reminder, the Council failed to respond to a letter of 27 April 2005 (upheld);
• (d)       the Council published their correspondence on the Council's planning website (not upheld);
• (e)       the Council interfered with the sale of their house (upheld); and
• (f)        the Council delayed in issuing a completion certificate (not upheld).

Redress and recommendations

The Ombudsman recommends that the Council:

• (i)        apologise for the stoppage of work in March 2005 and for the Planning Enforcement Officer calling the complainant's solicitor;
• (ii)       emphasise to staff the importance of timely responses to correspondence;
• (iii)      emphasise to planning officers when it is appropriate for them to discuss aspects of a planning application with third parties; and
• (iv)      apologise for the delay in issuing a completion certificate and give consideration to advising applicants of the likely timescales when a delay is likely.

The Council have accepted the recommendations and will act on them accordingly.

Overview 

The complainant (Mr C) was admitted to the Raigmore Hospital (the Hospital) following a car accident on 19 December 2004.  He suffered an injury to his shoulder.  Mr C was concerned that this was not correctly diagnosed or followed-up at the time.  He complained that subsequently he was seen by a number of different doctors at his General Practice (the Practice) and was not correctly diagnosed until May 2005. 

Specific complaints and conclusions

The complaints which have been investigated are that:

• (a) on 19 December 2004 there was a failure by the Hospital to diagnose the extent of his injuries or arrange appropriate follow-up care; (not upheld);
• (b) at subsequent appointments the the Practice failed to provide adequate care and treatment (not upheld); and
• (c) there was no continuity in the care provided by the Practice because MrChe was seen by so many different doctors. (not upheld).

Redress and recommendations

The Ombudsman recommends that :

during periods when the continuity of care may be problematic the Practice reinforce with all staff the desirability of clarifying, wherever possible, the patient's understanding of the full course of treatment at each contact.

The Practice have accepted the recommendations and will act on them accordingly.

Overview

The complainant (Mr C) raised a number of issues regarding the treatment and care provided to his late father (Mr A).

Specific complaints and conclusions

The complaints which have been investigated are that:

• (a) the treatment provided to Mr A was inadequate and this led to him sustaining a chyle leak (not upheld);
• (b) staff continued to replace Mr A's TPN lines despite them continually becoming infected (not upheld);
• (c) staff failed to ensure Mr A received adequate nutrition (not upheld);
• (d) staff failed to clean Mr A's room properly and this led to him becoming infected with MRSA (no finding); and
• (e) staff failed to adequately communicate with Mr A's family (upheld).

Redress and recommendations

The Ombudsman recommends that the Highland NHS Board (the Board):

• (i) remind staff of their responsibilities under the MRSA policy and ensure procedures are followed and audited for compliance; and
• (ii) remind staff to ensure a note is placed in the records where the patient has specifically refused the release of clinical information to relatives.

The Board have accepted the recommendations and have explained the action which has taken place since the complaint was raised.

Overview

The complainant (Mr C) raised a number of concerns that, following his father (Mr A)'s stroke in November 2004, his father became eligible for NHS funding of all his care in a Nursing Home rather than the limited funding he received from his local authority.  Ayrshire and Arran NHS Board (the Board) had not agreed to fund this care and Mr C raised a complaint that the matter had not been properly considered.

Specific complaints and conclusions

The complaints which have been investigated are that the Board failed to:

• (a) properly assess Mr A's eligibility for NHS funded Continuing Care (upheld); and
• (b) properly review Mr C's application for NHS funded Continuing Care (partially upheld).

Redress and recommendations

The Ombudsman recommends that the Board:

• (i) undertake a retrospective, evidenced assessment of Mr A's continuing care needs and;
• (ii)ensure that where there is an application either for NHS Continuing Care Funding or to review a decision to refuse funding, the process for dealing with that application is explained to the applicant at the outset.

The Board have accepted the recommendations and agreed to act on them accordingly.

Overview

The complainant (Miss C) was concerned she had been encouraged by the Crofters Commission (the Commission) to submit an application for apportionment as part of a planned scheme and that this was then considered as a single application and rejected.

Specific complaint and conclusion

The complaint which has been investigated is about the Commission's handling of Miss C's application (upheld).

Redress and recommendation(s)

The Ombudsman recommends that the Commission:

• (i) apologise to Miss C for their handling of her application;
• (ii) reimburse her for any expenses she can demonstrate were reasonably incurred in the course of making this application following the Commission's decision to proceed in April 2004 and include an additional payment of £150 for the inconvenience and distress caused to her; and
• (iii) review the advice and training given to staff as to the procedures to be followed when a planned scheme is envisaged and, in particular, ensure staff are aware of the need to clarify applicants' understanding of this process and respond appropriately to any changes in circumstances which occur during the application process which may affect this.

The Commission have accepted the recommendations and will act on them accordingly.

Overview

The complaint concerned a breach of planning permission which was acknowledged by the Highland Council (the Council) but where, the complainant (Mr C) alleged, little action had been taken.

Specific complaint and conclusion

The complaint which has been investigated is that despite complaints that a condition of planning consent had been breached, the Council delayed and took little action (upheld).

Redress and recommendations

The Ombudsman recommends that the Council:

(i)       proceed to implement enforcement action without delay and in the event that they fail to achieve compliance, seek to implement an appropriate penalty; and

(ii)      offer Mr C a fulsome and sincere apology, reinforced by a payment to recognise the time and trouble involved in pursuing the matter and making his complaint, and the impact on his home over the years.

The Council have accepted the recommendations and will act on them accordingly.

Overview

The complainant (Mr C) raised a number of concerns about his mother (Mrs A)'s treatment in Dumfries and Galloway Royal Infirmary prior to her death on 15 September 2005.

Specific complaints and conclusions

The complaints from Mr C which have been investigated are that:

• (a)  on 13 September 2005 his mother was inappropriately admitted to an assessment ward when her condition was already known (upheld);
• (b)  despite her agitated state and her family's request, she was not given any sedation or water (upheld); and
• (c)  there was delay in releasing his mother's body for cremation (upheld).

Redress and recommendations

The Ombudsman recommends that the Board:

• (i)       confirms the palliative care nurse's recommendations to her with a view to their early introduction;
• (ii)      reinforce to nursing and medical staff the need for good assessment and evaluation for patients with pain and agitation and, to emphasise the importance of communicating to families;
• (iii)      formally apologise to Mr C for their failure to provide  Mrs A with water and for the delay in re-evaluating her medication; and
• (iv)      confirm their improved procedures concerning cremation forms and the date when they are introduced.

The Board have accepted the recommendations and will act on them accordingly.

Overview

The complainant (Mr C) complained that East Lothian Council (the Council) did not respond appropriately to complaints concerning an Orange Parade and the subsequent representations made by the Orange Lodge (the Lodge).

Specific complaints and conclusions

The complaints which have been investigated are that:

• (a)      the Council improperly refused to grant a meeting to allow the Lodge to express its views on the complaints (not upheld);
• (b)      the Council refused to hold an internal review following a request by the Lodge (not upheld); and
• (c)      the Council refused to allow elected Council members to become involved in the complaints (not upheld).

Redress and recommendations

The Ombudsman has no recommendations to make.

Overview

The complainant (Mr C) raised a number of concerns on behalf of his adult daughter (Ms C) relating to the handling by North Ayrshire Council (the Council) of a building warrant application in respect of the conversion of a former hotel into two flats.  Following Ms C's purchase of one of the flats, substantial work had been required to eradicate rot and, although a certificate of completion had been issued, a number of matters remained outstanding.

Specific complaints and conclusions

The complaints from Mr C that have been investigated are that:

• (a)      the Council mishandled the application for building warrant for the conversion of the former hotel into two flats (not upheld);
• (b)      the Council issued a certificate of completion in respect of that warrant before works were completed (not upheld);
• (c)      the Council failed to deal in a timely manner with non compliance by the builder with the approved access dimensions in the planning consent (partially upheld); and
• (d)      in terms of the listed building consent, the Council allowed new windows to be installed that failed to comply with Historic Scotland's stipulation of like for like replacement (not upheld).

Redress and recommendation

The Ombudsman recommended that the Council apologise to Mr C for their failings in respect of (c).  The Council accepted the recommendation.