South of Scotland

Overview
The complainant (Mr C) complained that he had received misleading pre-planning application advice from The Highland Council (the Council). Mr C is aggrieved that he spent unnecessary time and substantial costs in preparing and submitting planning applications as a direct result of the advice from the Council.

Specific complaint and conclusion
The complaint which has been investigated is that the Council failed to deal adequately with the pre-planning application enquiry (upheld).

Redress and recommendation
The Ombudsman recommends that the Council:

• (i) inform him when the caveat has been introduced and publicised on their website.

The Council have accepted the recommendation and will act on it accordingly.

Overview
In 1995 the complainant (Mr C) obtained planning permission to build a new house on his land. Planning permission was granted subject to the condition that the existing property on the land (a croft house), would revert to use as a byre, with no use as a dwelling taking place after construction of the new house was completed. Mr C says that as a result of this condition he carried out work to convert the croft house to a byre. Thereafter, in October 2004 Mr C applied for planning permission to convert the byre back to a dwelling house. Permission was refused. He applied again in June 2005 when outline planning consent was granted, subject to conditions including significant access improvements. Mr C considered the planning conditions to be onerous, therefore, he decided to sell the building with outline planning consent to upgrade to a dwelling. He considered that the requirement to meet the planning conditions was reflected in the sale price.

When the new owners moved into and commenced work on the property, it became obvious to Mr C that they were not complying with the planning conditions as set in June 2005. Mr C contacted the Council regarding this, however, he was advised that the works he had previously carried out to convert the former croft house to a byre were not sufficient for the Council as planning authority to accept that the use of the building as a house had ceased. Mr C was also advised that under the Building Regulations the building was assessed as being a house, and had never been converted to byre status. Therefore, the new owners were not required to meet the planning conditions set in the outline planning permission of June 2005. In July 2008 Mr C formally complained to the Council that the house had been occupied without compliance with the 2005 conditions, however, at the conclusion of the Council's investigation he remained unhappy with the outcome. In April 2009, he asked the Ombudsman to investigate the matter.

Specific complaint and conclusion
The complaint which has been investigated is that the Council's handling of the planning situation, in relation to the building adjacent to Mr C's property, was inadequate (upheld).

Redress and recommendations
The Ombudsman recommends that the Council:

• (i) consider how best to meet the requirements of the planning conditions set in June 2005 where the need remains; and
• (ii) apologise to Mr C for the inadequate manner in which the planning considerations were handled.

Overview
A number of residents (54) from the South Ayrshire Council (the Council) area raised complaints about the Council's decision to close various facilities (Girvan Swimming Pool, Tarbolton and Dailly Activity Centres, Dalmilling Golf Course, The Gaiety Theatre, Pets' Corner, Public Toilets and Maybole and Troon Registration Offices) without consultation with the public.

Specific complaint and conclusion
The complaint which has been investigated is that the Council failed to consult the public, both before and after a decision was taken to close a public facility or centre, in accordance with the Council's practice and statutory procedures (not upheld).

Redress and recommendation
The Ombudsman recommends that, in the interests of good practice, the Council ensure that their strategy to communicate and engage with the community incorporates clear directives in relation to consistency in communication and engagement where it is proposed to close a Council facility or centre.

The Council have accepted the recommendation and will act on it accordingly.

Overview
The complainant (Mrs C) raised concerns regarding the orthopaedic treatment received by her husband (Mr A) at Crosshouse Hospital in the area of Ayrshire and Arran NHS Board (the Board). Mr A fractured his left ankle on 4 May 2007 and this was treated surgically on 8 May 2007. However, he had existing Peripheral Vascular Disease (a narrowing of the arteries) which contributed to his surgical wound failing to heal and he subsequently had to have his left leg amputated below the knee on 22 August 2008. Mrs C complained that Mr A's wound was managed inappropriately and that, as a result, his left leg was unnecessarily amputated. The specific complaints are listed below.

Specific complaints and conclusions
The complaints which have been investigated are that:

• (a) there was a failure to recognise Mr A's existing vascular condition and the decision to operate was inappropriate (upheld); and
• (b) Mr A's post-operative treatment was inappropriate (upheld).

Redress and recommendations
The Ombudsman recommends that the Board:

• (i) highlight this report to the relevant staff, particularly junior doctors, to ensure that they are aware of the deficiencies which have been identified; and
• (ii) apologise to Mr A for their failure to identify and take into account his vascular condition when deciding to operate on his ankle fracture, and for the delay in referring him for vascular review when his surgical wound failed to heal.

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

Overview
The complainant (Ms C) raised a number of concerns about the dental treatment she received from her dentist (the Dentist) in October and November 2008, which led to her attending her local hospital in great pain and with a swollen face.

Specific complaint and conclusion
The complaint which has been investigated is that, in October and November 2008, the Dentist provided Ms C with an inadequate level of treatment (upheld).

Redress and recommendations
The Ombudsman recommends that the Dentist:

• (i) apologises to Ms C for the failings identified in this report;
• (ii) reflects on the adviser's comments in regard to her technique in root canal treatment, in particular, in relation to working length calculation and the use of a rubber dam; and
• (iii) reflects on the adviser's comments with regard to record-keeping.

The Dentist has accepted the recommendations and will act on them accordingly.

Overview
The complainant (Mrs C) complained about parking restrictions proposed for introduction opposite her home. She also expressed her dissatisfaction at Scottish Borders Council (the Council)'s approach to reducing the impact of heavy goods vehicles entering and leaving commercial premises opposite her home.

Specific complaints and conclusions
The complaints which have been investigated are that the Council:

• (a) introduced excessive parking restrictions on X Street without justifiable reason (not upheld);and
• (b) acted unreasonably when deciding not to introduce protective bollards outside Mrs C's home (not upheld).

Redress and recommendations
The Ombudsman has no recommendations to make.

Overview
In early 2008, Ms A was diagnosed with osteomyelitis of the maxilla, following investigation at a private hospital. This is a condition where the main bone of the upper jaw (maxilla) has become inflamed and damaged by infection. Ms A had suffered from symptoms since at least 2004 and previously attended at both Borders NHS Board (Board 1) and Lothian NHS Board (Board 2) hospitals. She complained that, despite this, she had not been correctly diagnosed by the NHS and that, as a result, she had had to pay for private treatment. Ms A's complaint was brought to the Ombudsman's office by her MSP (Mr C).

Specific complaint and conclusion
The complaint which has been investigated is that Ms A was not investigated properly and that the diagnosis could have been made sooner by the NHS (upheld).

Redress and recommendations
The Ombudsman recommends that Board 1:

• (i) review their procedures for monitoring and auditing the referral process in light of the problems identified;
• (ii) remind clinicians involved of the need to consider carefully the information provided as part of the referral process;
• (iii) consider the best practice advice made by the Adviser to the Ombudsman; and
• (iv) provide him with reassurance that there has been an improvement in the time taken to review CT scans and discuss them with patients.  He also asks that Board 1notify him when the recommendations have been implemented.

The Ombudsman recommends that Board 2:

• (i) review their procedures for monitoring and auditing the referral process in light of the problems identified;
• (ii) remind clinicians involved of the need to consider carefully the information provided as part of the referral process;
• (iii) consider the best practice advice made by the Adviser to the Ombudsman;
• (iv) undertake a short, focussed audit of record-keeping in the Ear Nose and Throat clinic and the Dental Institute and put in place an action plan to deal with any problems identified; and
• (v) reimburse Ms A for the costs of the private treatment required to identify her condition.

Board 1 have accepted the recommendations and will act on them accordingly.

Overview
The complainant (Mr C) complained about the level of care he and his family received from Ayrshire and Arran NHS Board (the Board). Mr C explained that his seven-year-old son (Child C) has Autism Spectrum Disorder (ASD) and that he also has three other children aged five, three and two. Mr C said that the Board had failed to provide a programme of intervention to meet Child C's needs and that this had caused considerable distress for Child C and his family because of the effects of Child C's disability. Mr C considered that, in addition to the Board's own obligations towards Mr C and his family, it was incumbent on the Board to provide appropriate care to address Mr C and his family's deteriorating health, resulting from what he described as North Ayrshire Council (the Council)'s failure to fulfil their duties towards him and his family. Mr C subsequently complained to the Ombudsman's office about the level of service he and his family received from the Council. He said that the Council's social work services had failed to properly assess the needs of Mr C and his family and provide the appropriate support. Mr C advised that the Council had allocated a number of hours support for Child C and had agreed that, as Mr C had been unable to identify a suitable provider of this support, any unused hours could be 'banked', or carried over from one financial year to the next. Mr C said the Council then went back on this decision and that his son lost all his 'banked hours'. Mr C also raised a number of specific complaints about the Council's social work and education services.

Specific complaints and conclusions
The complaints against the Board which have been investigated are that during the period May 2006 to September 2007:

• (a) the Board failed to provide appropriate care to address Mr C and his family's deteriorating health, resulting from the Council's alleged failure to fulfil their duties towards Mr C and his family (not upheld);
• (b) the Board failed to put in place a programme of intervention to meet Child C's needs (not upheld); and
• (c) the Board failed to provide proper care to alleviate the distress caused to Mr C and his family from the effects of his son's disability (not upheld).

The complaints against the Council which have been investigated are that:

• (d) from March 2005 to May 2008, the Council failed to properly assess Mr C and his family's needs for support from social work services and subsequently provide this support, in accordance with procedure (not upheld);
• (e) the Council failed to inform Mr C that from 6 April 2008 Child C would lose his right to all his 'banked hours' (upheld); and
• (f) the Council failed to allocate Child C a new social worker, after the previous one left in December 2007 (not upheld).

Redress and recommendations
The Ombudsman recommends that the Council

• (i) re-instate Child C's unused hours of support for the period 25 October 2005 to 25 April 2008; and
• (ii) take note of both the Ombudsman's Mental Health Adviser (Adviser 1)'s and the Ombudsman's Psychiatric Adviser's comments on multi-agency working in this case, and seek to implement Adviser 1's suggestions at paragraph 128, in particular, the suggestion that stakeholders 'regroup' to re-establish and commit to effective future collaborative working arrangements, including a set of principles upon which future care should be based.

The Ombudsman recommends that the Board take note of both the Ombudsman's Mental Health Adviser (Adviser 1)'s and the Ombudsman's Psychiatric Adviser's comments on multi-agency working in this case, and seek to implement Adviser 1's suggestions at paragraph 128, in particular, the suggestion that stakeholders 'regroup' to re-establish and commit to effective future collaborative working arrangements, including a set of principles upon which future care should be based.

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

Overview
The complainant (Ms C) raised a complaint on behalf of her elderly father (Mr A) that the Highland Council (the Council) had failed over a considerable period of time to take appropriate action to require the owner (Mr B) of the property adjoining Mr A's house to rectify problems with his building. Ms C claimed the lack of action was having an injurious effect on Mr A's health and threatened the fabric of his house.

Specific complaint and conclusion
The complaint which has been investigated is that the Council had failed over a considerable period of time to take appropriate action to require Mr B, the owner of the property adjoining Mr A's house, to rectify problems with his building (no finding).

Redress and recommendation
The Ombudsman recommends that the Council continue to monitor closely the property currently owned by Mr B and its effect on Mr A's property, particularly should the current planning consent and building warrant expire.

Overview
The complainant (Ms C) complained about the care and treatment her client (Ms A) received while she was a patient at Crosshouse Hospital (Hospital 2).

Specific complains and conclusions
The complaints which have been investigated are that:

• (a) when Ms A was admitted as an emergency to Hospital 2 on 17 December 2007, there was a delay in performing surgery to remove a dermoid ovarian cyst (upheld);
• (b) there was a failure to inform Ms A of the removal of her right ovary and tube until 20 December 2007 - the day after her surgery (upheld);
• (c) there was a failure to take into account Ms A's description of the pain she was suffering while she was an out-patient (not upheld); and
• (d) when Ms A was a patient in Ward 6 of Hospital 2 she was sometimes forgotten about (not upheld).
   

Redress and recommendations
The Ombudsman recommends that Ayrshire and Arran NHS Board (the Board):

• (i) apologise to Ms A for the delay in undertaking her surgery and take steps to ensure that such delays do not recur;
• (ii) inform the Ombudsman of the measures being undertaken to address the issues raised; and
• (iii) take steps to ensure delays in communicating the results of surgery to patients do not recur.

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