Aston Court inquest hears of carer failings

Three care assistants told a coroner they lifted frail Iris Teale in or out of bed without using a hoist, as they were supposed to, at the Bupa-run Aston Court home in Little Aston.

Mrs Teale suffered a fractured thigh bone in an incident at the care home which was first noticed on October 8 2011.

She was taken to Good Hope Hospital in Birmingham but died 16 days later.

An inquest at Cannock Coroner's Court heard from Aston Court staff who had contact with Mrs Teale.

Nurse Santhosh Rajan from Walsall, who is due to give evidence to the coroner later, was found not guilty of Mrs Teale's manslaughter after a trial earlier this year.

Coroner Andrew Haigh heard former care assistants Kerry Pemberton, of Walsall, and Rachel Foulger, of Little Aston, and current employee Rizwana Kosar, of Walsall, admit handling Mrs Teale incorrectly.

However, they all said Mrs Teale was fine when they last had contact with her, with Mrs Pemberton describing her as 'normal'.

She was asked by the coroner: "The day before Iris was admitted to hospital, on October 7, did you on that occasion use a hoist to move her?"

Mrs Pemberton replied: "No."

Mr Haigh added: "Was that something you recall happened quite often?"

"Yes," the former carer replied.

He asked the same question of Mrs Foulger, who said she moved Mrs Teale without the hoist and had done so previously.

Under the care home's policy, Mrs Teale should have been moved in and out of bed with the use of a hoist and slip-sheets.

Mrs Teale's family, including son Clive Teale, were in court to hear the evidence.

Their barrister, John Coughlan, said to Mrs Foulger: "There was a culture of manual handling otherwise than in accordance with the care plan, wasn't there?"

She replied: "It did happen quite frequently, yes."

Mr Coughlan asked Mrs Pemberton if she was aware of other carers mishandling residents.

She said she had been aware before Mrs Teale's death, and he asked: "Did you inform any member of management about what you had heard?"

Mrs Pemberton said she had not, adding she was "not sure" why.

Mr Coughlan asked Mrs Kosar: "Do you accept that you along with others moved Iris other than in accordance with her care plan?"

She replied: "Yes."

The coroner also heard from registered general nurse Carol Akers, who worked the 12-hour day shift, and whose job was to supervise the care of the 23 residents on her floor.

Asked about Mrs Teale, she said: "She was frail, needing practically all care, and was confused at times. She used to talk more, but she did say a few words."

Mr Haigh asked if she had seen care assistants failing to use hoists.

Mrs Akers replied: "No, as a nurse you don't get a lot of hands-on. There's an element of trust that the care assistants are doing things correctly."

Mrs Teale suffered heart disease, chronic renal failure and Lewy bodies dementia, which was "compounded by a femur fracture" according to a Home Office pathologist.

A forensic examination by Alexander Kolar found the widow had a 16cm spiral fracture of her left thigh with significant bruising over a 60cm area of her leg.

With her underlying poor health and frailty, Dr Kolar said the break was "a significant event, resulting in multiple consequences, essentially acting as a tipping point to her pre-existing conditions".

Mrs Teale, who had osteoporosis, also had a small bleed on the brain, but Dr Kolar said it was not possible to be certain when it happened.

However, the leg fracture dated to about 14-21 days before her death, putting it around the time when it was first noticed on October 8.

Mr Haigh asked: "Are you able to comment whether Iris sustained this injury herself?"

Dr Kolar replied: "I don't believe that's a realistic prospect."

Mr Haigh, senior coroner for South Staffordshire, then asked: "Can you envisage an old lady in bed who gets her foot tangled in the bedding, is that a conceivable cause of this injury?"

Dr Kolar responded: "That's an unlikely mechanism given the size of the fracture."

The post-mortem also found tearing of the muscle in her arm and shoulder.

Dr Kolar concluded: "I cannot say for certain it was resultant of an act of neglect or excessive force, in an individual of this age."

Asked if the leg fracture "accelerated" Mrs Teale's death, Dr Kolar replied: "Yes, on a number of different physiological levels."