Wallingford care home is facing review after death of resident

Herald Series: Oxford Coroner’s Court Oxford Coroner’s Court

A CORONER has ordered a review of a care home’s procedures after the death of an elderly resident taken to hospital more than eight hours after a fall.

Retired consultant psychiatrist Peter Nott suffered from Parkinson’s disease and degenerative condition shy-drager syndrome, which affected his balance.

The 75-year-old fell in his room at Rush Court Nursing Home in Shillingford Road, Wallingford, at about 10.30am on September 2 but died on September 8 at Oxford’s John Radcliffe Hospital.

Oxfordshire Coroner’s Court heard that care home staff found him after the fall responsive with no obvious head injury so they made him comfortable.

Jane Ritchie, former clinical care manager at the home, said this was the agreed care plan. She said that Dr Nott sometimes needed help getting up and could be aggressive if offered help when he wasn’t ready.

Dr Nott was still on the floor about two hours later so staff hoisted him on to his bed and continued to do regular checks.

Staff called his GP Dr Simon Morris at about 5.45pm when Dr Nott’s condition deteriorated and left a message with the surgery receptionist.

Paramedics were called at 6.43pm.

Nurse Avril Alexander said: “The paramedic said: ‘He fell at 10.30am this morning and you are calling us now?’”

Geratologist Dr Sudhir Singh said earlier admission would not have changed the outcome.

Cause of death was subdural haemorrhage as a result of a fall.

Assistant coroner Nicholas Graham ordered a prevention of future deaths report and said he will ask the care home to review its procedures. A verdict of accidental death was recorded.

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