Stowmarket care home resident was left on commode chair overnight
- Credit: Gregg Brown
An elderly Stowmarket man was left on a commode chair for hours, an inquest has heard.
Roland Stannard, 81, died in October 2020 at the West Suffolk Hospital in Bury St Edmunds.
Prior to his death Mr Stannard - who had dementia - had been a resident at the Bupa-run Chilton Meadows Care Home in Stowmarket.
The inquest at the Suffolk Coroner's Court in Ipswich on Wednesday heard that Mr Stannard had only been in the home for a few months prior to his death.
On August 22, Mr Stannard was seen by staff on a commode chair in his room at the home.
Later on in the day staff attempted to get him to change into his night wear and have his personal care attended to but he refused.
Although safety checks were carried out through the night Mr Stannard did not have his incontinence pads changed for hours overnight and was found the next morning having not had personal care and being still dressed in the same clothes from the night before.
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It's believed that Mr Stannard had been sat on the padded commode chair all night.
When his incontinence care pads were changed the next day staff noticed that Mr Stannard had a read mark on his sacrum, which one care assistant described as "intense".
Staff at the home called the district nurse; staff and medical professionals were unsure if the marks had come from pressure sores or from end of life skin deterioration.
Mr Stannard continued to have problems with his sacrum following the incident.
He died a few weeks later, having been admitted to hospital because of an infection.
Linda Burrows, regional director for Bupa, told the inquest that staff had been given additional training on skin integrity since the incident while a full investigation into what went on that night had also been carried out.
Two members of staff received disciplinary action.
During the inquest, Mr Stannard's family also raised questions about changes to his medication which could have had a huge impact on his health and that were not communicated to them, despite their wishes.
"I think we failed in that aspect," said Ms Burrows.
Chilton Meadows was put into special measures by the CQC following an inspection earlier this year.
Ms Burrows added: “We are very sad at loss of Mr Stannard and our thoughts are with his family."
The inquest continues.