Care was difficult for businessman

A FATAL combination of independence and vulnerability, left a former Suffolk company director's care fraught with difficulties, his family agreed after an inquest.

By Tracey Sparling

Health and Social Services Editor

A FATAL combination of independence and vulnerability, left a former Suffolk company director's care fraught with difficulties, his family agreed after an inquest.

Lawrence Startup, 78, died after a series of falls at the 120-bed Anglesea Heights nursing home in Ipswich on March 2.

In his earlier days he had been director of PJ Trailer Services in Felixstowe.

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"It was a difficult situation. We will always have questions," said Mr Startup's eldest son James, from Westbourne Road, Ipswich, at the town's crown court inquest yesterday.

"Until he fell, his care at the home was very good. There were probably some issues on not calling the doctor soon enough."

But his sister Ann Crisp of Barham, added there had also been problems after he was hospitalised, and said his long waits for drinks on the ward was symptomatic of the country's care of the elderly.

Dementia-sufferer Mr Startup, who had a history of falls, moved to Anglesea Heights in January, after his previous nursing home in Felixstowe closed down.

In a statement read to the inquest, Mrs Crisp said that she had never been asked whether he needed cot sides attached to his bed, and said he was given a zimmer frame but not shown how to use it.

On February 15, he fell out of bed and was hospitalised until February 22 with broken ribs.

On his return to the home, Mrs Crisp agreed to bed rails being used, but his condition deteriorated and he died on March 2, the day after a GP found signs of bronchial pneumonia.

A postmortem revealed the condition caused his death, and had been due to his fractured ribs, and changes to blood vessels in the brain.

Bupa care home manager Tina Askew said he fell over regularly, at least once a week, but was very independently mobile with a walking stick.

But she added that he waved it causing a danger to others, so she once gave him a zimmer frame to use instead, but he became aggressive.

She said: "He was a very happy man, provided he was able to walk around freely and go where he wanted, when he wanted."

Mrs Askew said after he fell in the home lounge on February 13 – after two previous falls including one when he fell into a wall - senior sister Linda Chambers and Mrs Crisp discussed care options.

But it was felt a recliner chair which was difficult to get out of, and bed rails and a zimmer frame, would aggravate him or possibly pose a greater risk.

On February 15 he was taken to hospital by emergency ambulance after being found in distress, hyperventilating and with a swollen torso. A doctor was called on his return to the home.

James Startup asked why a doctor had not been called earlier, and Mrs Askew said uncomplaining Mr Startup had appeared uninjured when he fell into the plasterboard wall.

Mrs Crisp said she had never been asked 'face-to-face' about methods to restrain her father, although she had chatted to a carer about a zimmer frame.

Mrs Askew said notes written by Mrs Chambers showed there had been a discussion.

Coroner Peter Dean said: "Clearly this was a gentleman who was very independent, very mobile, and the difficulty came because he was vulnerable to falling. There was a very real difficulty to preventing his falls, short of restraining him.

"There was a discussion about his care, and I note the family's views about the note not being a signed document, but there was some discussion. There is no suggestion that any care was withheld during convalesence, from home staff or GPs."

He recorded a verdict of accidental death.