Not upheld, no recommendations

Summary

C complained that the council's response to their reports of anti-social behaviour had been inadequate. C said that their neighbour was subject to an anti-social behaviour order which they had repeatedly breached.

The council provided C with a noise recording application which allowed them to record noise and disturbances and send these reports to the council. However, C complained that they were not provided with sufficient information on how to use the application and on what the council would accept as evidence of anti-social behaviour. The council rejected C’s submissions as evidence of significant noise problems and refused to let C submit additional recordings.

We found that the council had responded to C’s complaints of anti-social behaviour appropriately. Their response had been affected by delays in hearing court cases, but this was outwith the council’s control. It was also noted that actions taken by the council could not always be shared with C. We considered that C was provided with adequate guidance on using the noise recording application. Therefore, we did not uphold this part of C's complaint.

C also complained that they were prevented from making further complaints by the council. We found no evidence that C was being prevented from making further complaints about noise and anti-social behaviour. The council stated explicitly as part of their submission to the investigation that if there was evidence of a material change in circumstances, then C would be allowed to complain about this. Therefore, we did not uphold this part of C's complaint.

Summary

C complained about the care and treatment a close family member (A) received from the partnership. C complained that the partnership failed to ease restrictions to family visits in line with changes to national public health guidance and had unreasonably applied restrictions on indoor visiting at A’s group home. Consequently, A had effectively remained in their home for the best part of a year without in-person family contact or social interactions, causing A’s mental and physical wellbeing to decline significantly. C also complained that during restrictions the partnership failed to take reasonable steps to help A communicate effectively with family members, investigate concerns C had raised about A’s welfare, or keep them updated regarding A’s care and treatment, including decisions as to whether A should shield.

In response, the partnership explained that group home settings were not adequately provided for in the government’s guidance but had sought advice to follow care home guidance. They acknowledged that in light of the competing and often conflicting guidance it may have been helpful to have sought clarity on the most appropriate guidance to use at an earlier stage in the pandemic but disagreed with C’s assertions that their approach to indoor visiting had been overly restrictive or detrimental to A’s health.

We took independent advice from a social worker. We found that relevant national and local guidance at that time had been constantly subject to change, making the situation extremely challenging. While there was no specific guidance for group homes, it had been reasonable for the partnership to follow guidance applicable to care homes and it had been at their own discretion to assess whether indoor visits could be reintroduced safely at A’s group home. We did not find any evidence to support the view that visiting arrangements imposed by the partnership had been unreasonable or overly restrictive. Therefore, we did not uphold this part of C’s complaint.

We also found that the partnership had made reasonable attempts to provide support to A to maintain communication with their family during restrictions. We also found that C’s concerns regarding A’s welfare had been taken seriously by the partnership, and in accordance with relevant adult support and protection practices and procedures. We did not uphold these parts of C’s complaints.

We found there was evidence of ongoing communication between C and the partnership throughout the pandemic regarding A’s wellbeing. However we identified that C, in their capacity as welfare guardian, had not always been included in discussions about A’s forthcoming medical appointments. We found no evidence to suggest this failing was in any way harmful to A and it had been reasonable for the partnership to adhere to advice they had received from A’s GP that A should shield. On balance, we did not uphold this part of C’s complaint, however we did provide feedback to the partnership, specifically that it is considered good practice in residential care setting, that welfare guardians are informed on matters involving medical appointments.

Summary

C complained about the orthopaedic care (conditions involving the musculoskeletal system) and treatment that they received from the board. C had a wrist injury and underwent an initial operation and a second operation three years later. C complained that the reason for the second operation was because the first operation carried out had been ineffective and that mistakes had been made.

C also complained that they had been allocated two community health index (CHI) numbers which had unreasonably impacted on the care and treatment that they received from orthopaedics.

We took independent advice from a consultant orthopaedic surgeon and a consultant radiologist. We found that the orthopaedic care and treatment C received was reasonable and we did not uphold this complaint.

We also found no evidence that the issue of CHI numbers had impacted on C’s care and treatment regarding their two operations. We did not uphold this complaint.

Summary

C complained about the treatment they received from the board following a knee injury. C’s injury had occurred when level 3 of the Scottish Government’s COVID-19 lockdown measures were in place, which limited travel between local authorities to essential travel only. C’s accident had occurred outwith their own local authority area. C complained that the A&E staff repeatedly asked them about their local accommodation and travel arrangements. C reported that they were only admitted to hospital for one night, and they were obliged to make their own travel arrangements for their discharge the next day despite experiencing severe pain.

The board said that C had been timeously assessed and treated at the A&E, with orthopaedics (specialists in the musculoskeletal system) taking over their care due to the diagnosis of a displaced fracture with foot drop. C’s injury had been immobilised with a knee brace and they were assessed using crutches by physiotherapy prior to discharge the next day, with the plan being for C to travel back to their own health board area to arrange further care and treatment of their injury. C was given an immediate discharge letter to pass to the receiving clinical team and a prescription for pain killers.

We took independent advice from an orthopaedic consultant. We fond that the board’s treatment of C was reasonable, both in terms of the type of injury they had sustained, and in keeping with the guidance in place at the time for management of orthopaedic injuries during the pandemic. We considered it was appropriate for A&E staff to enquire about C’s travel and accommodation arrangements to help inform their plan of care. They also commented that without lockdown measures in place, C’s injury would have required transfer to a specialist centre for surgical reconstruction. However the guidance at the time had been appropriately followed by the board for non-operative management of the injury with later reconstruction. Therefore, we did not uphold C’s complaint.

Summary

C complained about the maternity care they received from the board when they gave birth to their twins. C was suspected to have COVID-19 and this was confirmed the day after delivery.

C complained that they were placed in a room that wasn’t equipped for labour and that they were pushed towards a vaginal delivery, rather than a planned caesarean section. The board explained that the labour room was set up with equipment stored outside the room for infection control purposes. C also complained that they weren’t provided with appropriate postnatal care.

We took independent advice from a midwife. We found that the records supported reasonable decision making surrounding the delivery method and that appropriate discussions had taken place with C in this regard. We also considered that the records evidenced a reasonable standard of postnatal care and that the decision to store equipment outside the room was reasonable. Therefore, we did not uphold this part of C's complaint.

C was unable to see their babies in the neonatal intensive care unit (NICU) until after their COVID-19 isolation period ended. C complained that it wasn’t explained to them why they weren’t allowed skin to skin contact before the babies were taken away to the NICU. C also complained that there was no clear process in place for them to see their babies and that staff were initially unable to tell them when this would happen. The board acknowledged that C did not receive an explanation as to why skin to skin contact was not allowed. We noted that the board had asked staff to reflect on C’s negative experience of communication and we were satisfied they had demonstrated learning from this.

We found that the restrictions in place for visiting the NICU were reasonable, that there were clear processes and guidelines in place to support this, and that the records showed this was appropriately communicated to C. Therefore, we did not uphold this part of C's complaint. We provided complaint handling feedback to the board as we noted some inaccuracies in their responses to C.

Summary

C, an advocacy worker, complained on behalf of their client (A) about the care and treatment provided by the board during a four day admission to hospital. A, a type 1 diabetic (a condition where blood glucose levels are too high because the body cannot make the hormone insulin), was admitted for lower abdominal pain. A received an ultrasound scan on the following day which proved inconclusive. The next day A received a CT scan which showed free fluid, in keeping with a burst ovarian cyst. A was discharged the following day.

C complained that A was discharged, having received no treatment, in pain, and without follow-up referrals. C complained that as a type 1 diabetic, A’s diabetes and food intake had not been correctly managed. The board said that treatment, discharge, and diabetes management were appropriate. The board apologised for not offering meals after breakfast on the day of discharge.

We took independent advice from a gastrointestinal and general surgeon (specialist in the digestive system). We found that A’s nutritional intake had been appropriately restricted due to investigations which were necessary to rule out surgery. A's diabetes had been appropriately managed via an insulin infusion called a sliding scale. We found that no treatment or follow-up care would be indicated for a burst ovarian cyst as this would usually resolve itself. We found that prior to discharge, A’s pain had reduced such that they were able to manage it with paracetamol alone and that discharge was therefore appropriate. Therefore, we did not uphold this part of C's complaint.

C also complained about the quality of complaints handling. We found that although there was a delay in providing a complaint response, this was because a meeting was being organised and that C was appropriately informed of the delays. Post decision correspondence was also delayed. However, this did not breach the Model Complaints Handling Procedure, which does not specify timescales for post decision correspondence. As the board had already increased administrative staff, improved procedures and apologised, we did not uphold this part of C's complaint.

Summary

C complained about the care and treatment provided to their late parent (A) by the practice in the months prior to A’s death in hospital. C complained that the practice failed to look at A’s leg and foot pain and that A was only prescribed water tablets. C also said that no home visits were arranged for A, that they were informed that A had a hiatus hernia (when part of the stomach moves up into your chest), and that A’s family did not receive a telephone call back when promised.

We took independent advice from a GP. We found that there was no failure on the part of the practice to look at A’s leg and foot pain or that A was prescribed water tablets. We also considered that there was no need for home visits in the time specified and that A had been diagnosed with a hiatus hernia in hospital. Finally, we considered that the practice had provided a reasonable explanation in relation to not phoning the family back given that A’s family had called an ambulance for A by the time in question, so a telephone consultation was no longer required. Therefore, we did not uphold C's complaint. We did provide feedback to the practice that they may wish to remind staff of the importance of keeping clear documentation for every home visit.

Summary

C complained about the partnership’s social work department in relation to their assessment for a Self-Directed Support budget for their child (A).

C complained to the partnership that their Children’s Resources Panel (CRP) had failed to adequately consider C’s funding request for after school care for A, and that they failed to adequately considers A's needs, A's carers needs or gather sufficient information to adequately consider the request. The partnership did not identify any failings.

We took independent advice from a social worker. We found that the CRP did adequately consider the needs of A and their carers, based on the information and circumstances presented to the panel. Therefore, we did not uphold the complaint.

Summary

C complained to the board about the treatment that they received from the board when they attended A&E on the advice of their GP. C had informed the GP that their back pain of three months had worsened over the week.

C reported concerns about the on-call doctor’s manner toward them. C also complained about the assessment and clinical decisions made, particularly that they were sent home despite experiencing a significant level of pain. C was later diagnosed with Cauda Equina Syndrome (CES, a collection of neurological symptoms caused by compression of the nerves at the end of the spinal cord) and required emergency surgery.

Summary

C complained about the care and treatment that their parent (A) received from the board.

A and their partner (B) both contracted Coronavirus (COVID-19). A had a history of diabetes and had previously had a stroke. After contracting COVID-19, A began to display signs of delirium. Concerned for A’s welfare, B contacted the GP who in turn arranged for the COVID-19 team to visit at home. The COVID-19 team attended and recommended that A be admitted to hospital for review that day. A was discharged the same day.

A’s condition worsened at home and the COVID-19 team was called back to visit. A was readmitted to hospital, where their condition continued to deteriorate. A was transferred to the Intensive Care Unit (ICU) where they later died. C considered whether it was appropriate for A to have been discharged home after the first hospital visit given the extent and nature of A's condition.

In response to the complaint, the board believed that the plan of care for A was appropriate, but recognised that communication with A’s family could be improved with respect to arrangements for A’s discharge.

Following the complaints response, C and family members met with representatives of the board to discuss concerns. The note of the meeting records shows that the board acknowledged and apologised that no phone call was made to obtain information about A’s circumstances at home. The board also recognised that the decision to discharge may have been queried had a consultant understood B was unwell at home. C disputes the account of the meeting and believed all present agreed with the position that A should not have been discharged.

We took independent advice from a geriatrician (doctor who specialises in treating older patients). We found that it was reasonable to determine that A was clinically fit for discharge. We noted that this was a complex situation and A had not stated concerns about the decision to discharge. We also noted that there was no indication in the records that, at the time of discharge, A’s family were unhappy with the decision made at the time. We therefore did not uphold the complaint. We did, however, provide some feedback to the board with respect to their complaints handling in this case.