SPSO Individual Decisions

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

C complained on behalf of their client (A) about Fife Health and Care Partnership's (HSCP) assessment of A’s needs and the level of support being provided by the HSCP. A is registered blind and has a number of other health conditions, including diabetic neuropathy (nerve damage) requiring A to use a wheelchair. C complained to the HSCP that support previously available for C to access the community or go shopping had been withdrawn. C also believed that the HSCP operated a blanket policy not to fund services to support service users to access the community or go shopping. In response to the complaint, the HSCP said that the arrangement to go shopping was via an unregistered cleaner and that the Care Inspectorate identified issues with this, and the worker was removed. They explained that a worker taking A shopping was not deemed as critical care criteria, that they could not offer funding for it and that alternative options were not taken up by A. We took independent advice from an adult social work adviser. We found that, whilst there was evidence that the HSCP undertook an assessment of A’s needs, the assessment was unclear about what needs were assessed as being critical and substantial, and therefore eligible for funding. We also found that the Assessment and Support Plan failed to offer sufficient detail about the discussions with and options available to A with respect to the support available. We upheld the complaint that the assessment of A’s care plan was unreasonable. With respect to complaints made about the operation of a blanket policy, it was noted that a number of statements and comments in A’s case notes and assessments gave the impression that this may be the case. However, whilst we found failings with respect to the assessments in this case, there was no evidence available which demonstrated that the HSCP operated a blanket policy not to fund access to social supports or the community. We did not therefore uphold this aspect of the complai

C provides care to their child (A) who is an adult living in their own tenancy. A has a learning disability, is registered blind, has some hearing loss and has epilepsy. A receives care in their property under Self Directed Support (SDS). C provides care for A when other carers are not present. This is done around C's full-time work. C receives six weeks of respite provision. C has requested an increase in A's support as they are struggling to provide the extra care A needs in their tenancy. The partnership proposed that A share their two bedroom home with another service user so they could 'pool' their care packages. Alternatively, A could move to a different tenancy with support already in place. C, who holds welfare power of attorney for A, has declined these options, saying A is more settled and confident living alone in their own tenancy. We took independent advice from a social work adviser. The partnership are obliged to follow the Self Directed Support Act 2013. We found that the parternship had followed that legislation and considered both A's needs and C's needs as a carer. That the available options (sharing accommodation or entering residential care) are not ones C wishes to pursue, does not mean they are unreasonable options in and of themselves. We did not uphold this complaint. Related reading View Decision Report 201906085 as a PDF (24.45 KB) Updated: May 19, 2021

C was previously resident in England and received a package of care from the local authority to assist them with activities they are unable to do due to poor mobility and mental health needs. C chose to move to Scotland and asked their social worker to contact Fife Health and Social Care Partnership (the partnership) so their care could continue. After moving to Scotland, C was aware that two adult protection referrals (referrals made to social work services about an adult at risk from harm) about C were made to the partnership. The partnership assessed C and determined that they did not meet the criteria to receive a package of care. C complained that the partnership failed to support them with their move and failed in their duty to ensure continuity of care. C also complained that the partnership did not investigate or act on the adult protection referrals appropriately. C was unhappy with the way in which their complaint was handled and with the communication they received from the partnership. As a result of their complaint investigation, the partnership found that they had failed to follow their usual process and that the correspondence from C's social worker was not responded to as it should have been. They apologised for this and upheld C's complaint. They also highlighted that it may have been helpful to connect C with non-statutory support. The partnership told us they offered to connect C with non-statutory support as a part of their complaint investigation, but that this was refused by C. They apologised that C felt the way they communicated with them about their complaint was not appropriate. The partnership said they gave C appropriate advice before C moved, and they assessed C (including the adult protection referrals) appropriately when they were resident in Scotland. We found the partnership's failure to follow their usual process was unreasonable and that the partnership failed to reasonably support C prior to their move to Scotland. On thi

C complained on behalf of their child (A) who is an adult with incapacity. C complained that the partnership failed to reasonably safeguard A before and after a reported incident involving a support worker. We found that the partnership's commissioning of services for provision of care followed standard practice and that reviews carried out did not indicate A was at any risk from support workers. We also found that, after the reported incident, the support worker was removed from the care package. We considered that the partnership reasonably safeguarded A before and after the reported incident. We did not uphold these aspects of C's complaint. C also complained that the partnership failed to involve them and their partner in the decision-making process regarding A's welfare and that there was a failure to discuss with them the importance of seeking medical screening after the reported incident. We found that there was a lack of communication with C and their partner (which the partnership had apologised for), but we did not consider it was usual practice for the partnership to involve them in professional meetings where decisions were made under Adult Support and Protection procedures. We also did not consider that it was the role of the partnership to advise C and their partner to arrange any medical screening. Therefore, we did not uphold these aspects of C's complaint. Related reading View Decision Report 201805773 as a PDF (24.32 KB) Updated: July 22, 2020

Mr C complained that his mother (Mrs A) was having problems with her monitored alarm system, which kept activating a carbon monoxide alarm. Mr C said the partnership had taken inadequate steps to investigate this, leaving Mrs A stuck in cycle of alarm activation, gas disconnection and reconnection, which was costing her money. It also meant that the source of the alarm was never identified. Mr C noted that the partnership's final action had been the removal of the alarm, which meant Mrs A potentially still had an unexplained source of carbon monoxide within her property. The partnership had told Mr C that they were at a loss as to how they should investigate further. They had provided him with a third party claim form, to seek to recover the costs of the gas reconnection for Mrs A, but Mr C had opted not to do this. We found that Mr C had provided the partnership with a reasonable suggestion for possible causes of activation for the alarm system. We considered that it was inaccurate for the partnership to say they had carried out a thorough investigation into the possible causes of the false activations of the carbon monoxide alarm. We upheld this aspect of Mr C's complaint. Mr C also complained that the partnership failed to communicate with him reasonably or appropriately. Mr C said that he had insisted that his correspondence was not a formal complaint, although the partnership had treated it as one. We found that the partnership have the discretion to decide when correspondence would be better handled under their complaints procedure. However, the partnership did not explain to Mr C why they felt it was appropriate to take the matter forward as a complaint. They also failed to respond to the specific points Mr C raised in his subsequent correspondence. Therefore, we upheld this aspect of Mr C's complaint.

Mr C, a lawyer, complained on behalf of his clients (Mr and Mrs A), parents of an adult with additional needs. Their child lives independently in their own home, which is partly funded by the partnership and supplemented by Mr and Mrs A in order to provide 24/7 hour support. Mr and Mrs A requested an increase in funding from the partnership, as they are no longer able to provide the same level of support due to their own health needs. While the partnership had assessed the client as requiring 24/7 support, they advised that they cannot provide the level of support that would allow the client to live in his own home within their finite resources. As an alternative, they offered to place the client in foster care or shared accommodation. Mr C complained that the partnership unreasonably failed to provide the appropriate support to meet the client's needs. We took independent social work advice. We found that while the partnership are working within their statutory framework by considering their overall resources, we did not consider that the partnership had fully taken account of the reasonable evidence, based on previous experience, that the client would not cope in a shared accommodation setting. The Ombudsman is clear that she cannot instruct the partnership on how to spend their resources, however, we recommended that they should assess the fragility of the care package. We upheld Mr C's complaint.

Mr and Mrs C complained to the partnership about their response to adult support and protection concerns they raised in respect of their daughter (Ms A) who has additional needs and lives independently with support from a care provider. Mr and Mrs C said that they raised a number of concerns that Ms A was being financially abused and negatively influenced. The partnership said they considered that all reports and concerns raised were responded to and that they followed their Adult Support and Protection procedures correctly. We took independent advice from a social worker. We found that there was adequate evidence that demonstrated that the partnership took the appropriate action in response to the concerns raised about Ms A. We identified that appropriate support was provided to Ms A and that the appropriate agencies were contacted to ensure that Ms A was properly supported. As we found no evidence that the partnership failed to respond appropriately to the adult support and protection concerns raised in respect of Ms A, we did not uphold the complaint. Related reading View Decision Report 201809739 as a PDF (24.17 KB) Updated: March 18, 2020

Ms C complained about the treatment which her mother (Mrs A) received from district nursing staff while she was in a care home. Mrs A had entered the care home for respite for one week but ended up in the care system for more than five months. Mrs A had developed pressure ulcers in her heels and although care was provided by the district nursing team, Ms C felt the care was inadequate and that it resulted in Mrs A's ulcers becoming infected, which affected her mobility. We took independent advice from an adviser in district nursing. We found that the district nurses had provided appropriate care to Mrs A in that her pressure ulcers were treated and dressed, and that appropriate pressure relieving aids such as a special mattress and boots were in use. There was also an appropriate referral to podiatry to provide the ongoing management of Mrs A's foot care. We did not uphold the complaint but did provide feedback to the staff about a lack of record-keeping which would have highlighted which risk assessments had been carried out in order to substantiate the need for the treatment options which were put in place. Related reading View Decision Report 201807981 as a PDF (23.9 KB) Updated: June 19, 2019