Trafford News
Care given to war veteran from Flixton at two nursing homes deemed 'unacceptable'
6:07pm Friday 3rd February 2012
A CORONER has criticised the standard of care in two nursing homes following the death of a Flixton war veteran.
Harold Massey was admitted to Urmston Cottage Care Home, on Greenfield Avenue, in May 2008 with dementia.
Stockport Coroner's Court heard today, how, in September 2009, Urmston Cottage staff learned that Mr Massey had developed a small ulcer on his right ankle.
By October, the wound had become infected and 83-year-old Mr Massey received a visit from GP Samina Ashraf, from Davyhulme Medical Centre, who prescribed him antibiotics.
After that the great-grandfather of seven, who served in Burma and Singapore during the Second World war, was put under the care of visiting district nurses.
Over the following month, they failed to inform Dr Ashraf that the sore, now measuring 12cm, was getting worse due to failure to use the correct dressings.
Mr Massey, of Marlborough Road, was admitted to Trafford General Hospital where his leg was so badly infected it had to be amputated.
His surgeon Sureen Sanjay said: "I felt that Mr Massey had been neglected. The situation went way beyond the level of acceptable care."
A leg ulcer nurse told an earlier hearing how nursing home nurses at Urmston Cottage should have observed the wound, rather than district nurses, and that he should have been immediately referred to tissue specialists.
The inquest was told by a staff nurse that the home was in financial difficulties, which led to a shortage of basic medical equipment.
Coroner John Pollard said: "Communication between health staff fell below an acceptable standard."
Following his operation, Mr Massey was fitted with a urinary catheter and he was discharged from hospital on December 22.
He was then placed into Barton Brook Nursing Home, in Eccles, and was said to have been making a good recovery from his operation.
On December 28, a care assistant checked Mr Massey at 8.45am and saw that his face was ashen, his abdomen swollen and his catheter bag empty.
She told the inquest it was clear that staff from the night shift had been arguing and that no proper handover was carried out.
Concerned, the assistant asked senior nurse Carmelita Castro to examine the patient.
Ms Castro pressed on Mr Massey's stomach and removed his catheter and asked the assistant to observe him.
He was then fed his breakfast by one of the cleaners at the home.
Ms Castro called a GP out of hours service rather than an ambulance, saying she did not think he seemed very poorly.
She then failed to take his vital signs, including his temperature, heart rate and blood pressure and Mr Massey died in the early afternoon, before a doctor arrived.
Ms Castro told the inquest she had taken his temperature that day with a thermometer then later said she had in fact used her hand.
Mr Pollard added: "The care given was minimal, ineffective and unprofessional. It fell short of what people are entitled to in a nursing home.
"This was a medical emergency and should have been dealt with effectively.
"During the last months of his life, Mr Massey endured severed emotional and physical pain."
Pathologist Charles Wilson deemed that Mr Massey had died as a result of a severe urinary tract infection, bronchopneumonia and his dementia.
He said: "If you are not passing urine then you are not passing blood through the kidneys and this is a severe medical emergency.
"I can see a potential for Mr Massey's life having been saved if action had been taken earlier."
A verdict of natural causes was recorded.
Mr Pollard will now write to the Royal College of General Practitioners, asking for clarity in the responsibilities nurses have.
Speaking after the inquest, Mr Massey's family said: "We feel he was let down by the nurses at Urmston Cottage because they had a duty of care and to the nurses at Barton Brook.
"He was a lovely guy who didn't deserve this treatment, it would be horrible if this happened to someone else."