9. Before we decide if we should investigate a complaint, we should consider attempting a resolution where it appears that, with minimal intervention, we could achieve a satisfactory result for the complainant.
10. The Ombudsman’s Principles for Remedy say we would expect organisations to acknowledge mistakes and apologise for the impact these mistakes had. We would also expect organisations to take action to learn and improve from mistakes.
11. The Trust has already in its responses acknowledged there were issues with the handling of the situation when Ms L raised concerns about the course. However, Ms L told us she was not reassured the Trust had learned lessons and or was going to make the service improvements it told her about.
12. On 9 October 2023 we contacted asking the Trust if it would agree to give her the information, she wants to address the already acknowledged failings and reassure her of the learning and improvement that has and is taking place. The Trust emailed us on 10 November advising it would provide Ms L with evidence and information about the service improvements it has taken to achieve outcome sought by Ms L to reach resolution. It emailed this information to us on 22 November. The Trust also provided some further information to us in April 2024. This information and the reasons why we are satisfied that this has resolved Ms L’s complaint are set out below under each complaint.
Course content 13. Ms L says the content of the course and attitude of those providing it was not appropriate and did not meet clinical standards. In relation to this Ms L wanted the Trust to: • acknowledge its shortcomings in these matters and to apologise • make service improvements that demonstrate it has learnt from these episodes and has taken action to improve • revise the Living Well with Autism Course.
14. On 22 November 2023, the Trust told us that it acknowledged the issues Ms L raised in her complaint and offered apologies for her experience. It said the Recovery College was sorry the Living well with Autism course did not meet Ms L’s needs and expectations.
15. The Trust explained it is important to bear in mind that the Recovery College is not a clinical service. It said the language used by the Recovery College is experiential and not a clinical intervention. It said it prioritises sharing of knowledge and experience in a safe environment and is not focused on the tutors being an expert in autism. It said the aim is to help people live a better life with autism.
16. The Trust also explained that it could not change the course in its entirety as feedback from other participants showed they found it beneficial. It said the Recovery College cannot rely solely on Ms L’s experience of Autism and it must consider all views when co-producing and reviewing courses. The Recovery College explained that it does not provide care and treatment, and its courses are for educational purposes. It said Ms L’s experience was not the experience of other students. It said they did not feedback that the content of the course and attitude of those providing was inappropriate.
17. Based on the evidence we have seen the Trust has now acknowledged Ms L’s experience of its course and how this made her feel. This is in line with our Principles of Good Complaint Handling which say, be open and honest when accounting for decisions and actions. It says to give clear, evidence-based explanations, and reasons for decisions and when things have gone wrong, explain fully, and say what they will do to put matters right.
18. It has fully explained the reasons why its course and the tutors are appropriate for the subject matter and its purpose. It has also fully explained why it has made the decision not to change the course. It has acknowledged the issues Ms L has with the course and what happened and has apologised for how this made her feel.
19. Our Principles for Remedy say organisations should acknowledge when something has gone wrong and apologise for the impact. It says organisations should learn and improve from what went wrong.
20. The Trust has acknowledged shortcomings in what happened and apologised for the distress caused. It has learned from what happened. This is an educational course not clinical treatment therefore it is not subject to meet NHS clinical standards. The Trust has explained why it cannot revise the course as Ms L wishes.
21. Based on the evidence we have seen; we are satisfied the Trust has addressed what happened and provided Ms L with a remedy in line with our Principles and what we would expect.
Discrimination 22. Ms L told us she feels she was subjected to discrimination as an autistic person on a course that was supposed to support its attendees, for example the course included a video describing Autism as ‘difficulty being normal.’ In relation to this Ms L wants the Trust to: • acknowledge its shortcomings in these matters and to apologise • make service improvements that demonstrate it has learnt from these episodes and has taken action to improve.
23. Firstly, we should explain that the Ombudsman does not make findings on matters of discrimination and there is a legal route should Ms L wants to pursue a complaint about discrimination.
24. The Trust has already in its complaint responses acknowledged there were errors in communication and how this matter was dealt with and apologised. On 22 November 2023, the Trust told us its action plan had already meant it had made changes to improve the course. The Trust confirmed that some changes were made in response to Ms L feedback and that this information is always being considered and any suggested amendments for courses are taken to the monthly quality assurance meeting for consideration and agreement. It said this regular meeting was set up earlier this year.
25. The Trust explained there is a routine review planned for 2024 and it hopes to reduce the five-week course to four weeks and introduce an online seminar to provide a broader overview of Autism. It said the course title is also likely to change in response to student feedback too.
26. It said the Recovery College now has a tutor development lead who has been in position for a year. It said the lead provides supervision sessions and monthly tutor development sessions which cover a wide range of subjects relevant to the role which includes facilitation. It added that all tutors in the college are expected to attend supervision and tutor development sessions, and these sessions are all recorded and shared to all tutors, and it continues reviewing practices to see if further changes needed to be made.
27. The Trust explained that the Recovery College is inclusive but does reserve the right to check that the course meets students’ expectations. It said students have the option to complete an ‘Individual Learning Plan’ either on their own or with a member of the team. This provides the opportunity for the student to consider their hopes and goals which will inform their course choices. As their courses are not individualised to specific needs but offer a space to share experiences and strategies.
28. In line with our Principles for Remedy, the Trust appears to have explained the nature of its course and its content which is educational rather than clinical. It has also acknowledged there were failings in communication and apologised for the impact for this and has taken action to address what went wrong with communication. It has also explained the review process it uses for the programme and that this is planned for 2024, in line with this process.
29. Based on the evidence we have seen; we are satisfied the Trust has addressed what happened and provided Ms L with a remedy in line with our Principles and what we would expect.
Asked to leave course 30. Ms L says after she complained, she feels the Trust mishandled the matter as the first response was to ask her to quit the course. In relation to this Ms L wants the Trust to: • acknowledge its shortcomings in these matters and to apologise • make service improvements that demonstrate it has learnt from these episodes and has taken action to improve • lift its ban on her attending further courses as needed.
31. During an independent review as part of the complaint process the Trust explained the request for Ms L to stop attending the course was not intended to penalise her. It explained she was asked to leave the course as the two peer tutors had reported that they could not lead the course with her on it. It said managers felt this left them with the responsibility of protecting their staff and the only option to make it possible to continue to provide the course for the other participants was to ask Ms L not to attend.
32. The Trust apologised for Ms L’s experience and explained the peer tutor’s suggestion of her leaving the course was after Ms L had told them how unhappy the course had made her during a phone call. The Trust explained it did not ‘ban’ Ms L but had suggested that if she was unhappy with course material and delivery and following feedback from the tutors that she, was questioning and challenging this during the sessions which was disruptive for others, then she should not return for further sessions at that time.
33. It explained that her behaviour was impacting negatively on the other attendees of the course. The Trust said its request for her to stop attending the course was not intended as a penalty, but the two peer tutors had reported that they could not lead the course with Ms L on it.
34. On 22 November 2023, the Trust apologised for Ms L’s experience and explained it did not intend to cause her distress or make her feel penalised. The Trust explained Ms L ‘s interpretation that the Trust mishandled the matter was addressed in the independent investigation. It said this was Ms L’d experience, but the evidence does not support that what happened was mishandled in general. The Trust said it was satisfied with the outcome of that investigation and where appropriate, it had apologised.
35. The Trust has explained to us that the decision was made for Ms L to consult with staff at the college should she wish to attend another course in the future. This was to ascertain whether the chosen course would meet her needs and expectations. It said the reason for this was to limit potential distress to herself, tutors, and other students.
36. In April 2024, the Trust further explained that at the beginning of every Recovery College course, the tutors go over a ‘group agreement’ with all students and a learner agreement form is sent to them before the course starts. We have received a copy of a blank learner agreement which includes information about what is expected of students and about behaviour and disrupting classes.
• The learner agreement says a student at the college should: treat everyone with compassion, dignity, and respect and to avoid the use of offensive, racist and sexist language always, and to not discriminate against others • to minimise distractions during the courses for example, having your mobile phone on silent and to refrain from using mobile devices where possible.
37. Although not all of the above is relating to what happened in this specific case, it appears that during the course Ms L challenging the content with tutors, could have been seen as disruptive behaviour and distracting for other students. It appears this was the perception of the tutors at the time, who are entitled to have this view.
38. Ms L has told us she did not see her behaviour as disruptive. The course tutor has said on reflection they regret not speaking to Ms L between the first and second sessions to discuss the impact her behaviour had on the group session and her peers. They asked for their apologies to be passed on that they did not do this.
39. Based on the evidence we have seen it appears the Trust has already in its complaint responses acknowledged there were errors and apologised for not effectively communicating with Ms L after the first session when Ms L said the suggestion of her leaving the course made her feel under undue pressure. It also apologised for her experience on the course and recognised the distress this caused her.
40. We are satisfied that the Trust has taken action in line with our Principles for Remedy to address this complaint. It has explained what happened and why and that she has not been banned from courses in the future. It has also apologised for any misinterpretation and how what happened made her feel.
Reasonable adjustments 41. Ms L she says the Trust failed to provide reasonable adjustments she requested without good or lawful reasons. In relation to this Ms L wants the Trust to: • give her evidence that all members of staff involved in services for autistic people have undergone as a minimum the legally required autism training for the job they hold and that all staff understand the requirements of the Equality Act regarding reasonable adjustments.
42. Firstly, we should explain that the Ombudsman does not make findings on matters of breaches of the Equality Act and there is a legal route should Ms L wants to pursue a complaint about this.
43. The Trust has acknowledged it could have managed communication with Ms L about reasonable adjustments at the time of events better and apologised for the distress caused. We therefore looked at what Ms L wanted regarding this part of her complaint.
44. On 22 November 2023, the Trust confirmed to us that all staff have received their mandatory Autism awareness training – Level 1 and training relevant to the Equality Act 2010. It said the college has also now appointed a ‘tutor development lead’ who provides supervision sessions and monthly tutor development sessions which cover a wide range of subjects relevant to the role which includes facilitation.
45. In April 2024, the Trust explained that at the beginning of every Recovery College course, the tutors go over a ‘group agreement’ with all students and a learner agreement form is sent to them before the course we have had sight of blank copies of both these forms. They include information about what is expected of students and about behaviour and disrupting classes.
‘As a student at the College, we ask you: • To provide us with any information that we need to support your enrolment and ongoing learning to make sure you get the most out of your learning experience if needed.’
46. It is clear the Trust makes students aware before the course starts about what is expected. It advises if any reasonable adjustments are needed students should inform the college, at the start during enrolment. The Trust says it is the student’s responsibility to request what reasonable adjustments they need. Reasonable adjustments need to be explained in detail. Ms L had not done this on her enrolment form.
47. Ms L specifically complained that when she requested reasonable adjustments for her review meetings the Trust refused and cancelled the meetings.
48. When the Recovery College received Ms L’s complaints, it postponed two planned review sessions, which it has scheduled for her to give feedback on the course. It sent her an email informing her of this said it would look to rearrange these once her complaint had been investigated and concluded.
49. Ms L say this breaches NHS regulation 16(1) which says complainants must not be discriminated against or victimised. In particular, people’s care and treatment must not be affected if they make a complaint. She pointed out that the care she was due to receive was the two meetings arranged for her to provide feedback on the Living Well with Autism course.
50. In the complaint responses the Trust explained the two planned review sessions were not to provide Ms L with care, they were to offer her a chance to feedback about the course to support the review of it. The Trust said Ms L requested these be face to face and not on Teams which the course tutor did not feel was a reasonable adjustment as Ms L had attended the first two sessions of the course online using Microsoft Teams. The course tutor felt none of the behaviour that was problematic during the two online sessions Ms L attended appeared to be linked to them being online. They also said it did not appear she was not coping using Teams online.
51. Ms L provided a copy of an email about her requests for these reasonable adjustments where the course tutor offered breaks as an example of the type of adjustment they could make during the meeting, and asked Ms L to tell them what adjustments she would find helpful. Ms L wanted the review meetings face to face, and the course tutor replied that these meetings could be completed on online and did not justify the travel time that would be necessary for staff to meet with Ms L face to face. The course tutor also pointed out some reasonable adjustment had already been made to facilitate Ms L’s involvement.
52. The Trust went on to explain that when it received Ms L’s second complaint and it started to investigate, it felt it was appropriate to wait and have the review and feedback meetings after its conclusion. Ms L was invited to provide her comments in writing and was given access to all the course material so she could do this. Ms L did not provide her feedback. The Trust apologised for the distress cancelling these sessions caused Ms L.
53. Based on the evidence we have seen the Trust has now acknowledged Ms L’s experience of its course and how this made her feel. This is in line with the Ombudsman’s Principles for Good Complaint Handling which say, be open and honest when accounting for decisions and actions. They say to give clear, evidence-based explanations, and reasons for decisions and when things have gone wrong, explain fully, and say what they will do to put matters right.
54. It has fully explained the process for requesting reasonable adjustments for students. It has also fully explained why it has made the decision that Ms L’s requests for face-to-face review meetings rather than online were not reasonable adjustments it could agree to and why. It has acknowledged the issues Ms L has with the course and what happened and has apologised for how this made her feel. It has also clarified that as she was not attending the course for care or treatment the NHS regulations do not apply.
55. Based on the evidence we have seen; the Trust appears to have addressed what happened and provided Ms L with a remedy in line with our Principles and what we would expect. It has also given the information she wanted about all staff training on reasonable adjustments.
Clinician’s attitude 56. Ms L says she was gaslighted and unfairly penalised in a phone call from the Trust’s clinician who ran the course, and a variety of false accusations were levelled against her which the Trust failed to substantiate and did not withdraw. In relation to this Ms L wants the Trust to: • acknowledge its shortcomings in these matters and to apologise • make service improvements that demonstrate it has learnt from these episodes and has taken action to improve.
57. Ms L complained to the Trust that she was gaslighted in a telephone call with the clinician who ran the Living Well with Autism course. She said this included them: • repeatedly closing down the discussion when she provided examples of wrong-doing or shortcomings by members of Recovery College staff • stating as fact something that she feels is demonstrably untrue • refusing to answer reasonable questions when she was trying to understand what they were saying • misquoting her.
58. Ms L says the Trust made the suggestion she attended the course for some ulterior motive rather than to learn how to ‘live well with autism.’ She said it blamed her for its poor time management of the sessions and defended a video which Ms L found offensive to autistic people. She said it attempted to shut down discussion about this or distract and divert from it.
59. Ms L said the clinician spoke largely in ungrammatical sentences or half-sentences, often trailing off into mumbles that she could not hear properly. She explained this was important as the most common reasonable adjustment for autism is to use clear, concise, and accurate language as the condition involves communication difficulties. Ms L says the Trusts course leader persisted with ungrammatical speech and mumbling even after she asked several times for them to be clearer.
60. Trust apologised that the telephone call was so difficult and was not more satisfactory for Ms L. The Trust said the call was made because the staff wanted to speak to her in person about the reasons she had been asked to not continue to attend the course. It explained it did want her to get this message only in an email, as it felt it was not appropriate and would be more distressing for her.
61. The Trust told us in November 2023 that it did not intend to blame Ms L but to explain to her what had become difficult for the course leaders to manage while continuing to provide the course for other participants. It has explained its staff had reflected on her experience and the telephone call to learn from this.
62. Based on the evidence we have seen it appears the Trust has already in its complaint responses acknowledged there were errors in communication and apologised for not effectively communicating with Ms L. It also apologised for her experience on the course, recognised the distress this caused her.
63. We have not seen enough evidence to enable us to say that the Trust gaslighted and unfairly penalised Ms L in the telephone call from the Trust’s clinician who ran the course. Or that it made a variety of false accusations against her which it failed to substantiate and did not withdraw. We were not present for either the course sessions which the Trust was speaking about or the telephone call. It appears there are two significantly differing views about what happened, and unfortunately further investigation will not bring a conclusion to this matter.
64. We are therefore satisfied that the action the Trust has taken to acknowledge how Ms L felt about this matter and apologise and reflect on this, is in line with our Principles for Remedy.
Conclusion 65. We are now satisfied that the additional information the Trust has given to us resolves this complaint in line with our Principles for Remedy which say we expect organisations to acknowledge mistakes and apologise for the impact these mistakes had. We would also expect organisations to take action to learn and improve from mistakes.
66. Will therefore take no further action on this complaint, and we hope that our explanations above give Ms L some reassurances that the Trust has taken what happened seriously and learned from what happened.