BANNISTER: RECORDS WERE IN DISARRAY AS PATIENT DIED

A care home manager accused of failing to call for help with a dying resident had ‘no evidence’ to show how critically ill she was, a hearing was told.

Rosalie Bannister, 62, did not ensure basic medical records were kept at the Silverlands home in Oldbury, West Midlands, it is alleged.

The patient known as ‘Resident A’, a diabetic, was ‘essentially unconscious’ and suffering from severe dehydration by the time a district nurse was called in, the Nursing and Midwifery Council heard.

She died on October 22, 2004, the day before a GP was due to visit.

Bannister is facing a series of charges relating to her time in charge of the home, in Silverlands Avenue, which she ran with her husband Tony between April 2003 and November 2004.

She is accused of failing to maintain adequate staffing levels, failing to keep medical records, nutritional assessments and accident books up to date and failing to ensure patients were given prescribed medication in correct doses.

Giving evidence, Amanda Hennessy, of the Commission for Social Care Inspection, said she had visited the home the day after Resident A’s death and found the record keeping was in disarray.

She said: ‘In this instance the care staff had tried to give fluids but the charts were not completed and there’s no evidence that would allow the GP to appreciate how little fluid had been taken.

‘There was no evidence of how much or how little she had to drink.

‘The daily records spoke about taking small amounts or sips of fluid but it was very difficult to see how often she was given these fluids or whether she was taking them and how great the risk was to her health.

‘It was also difficult to see whether a GP needed to be contacted more urgently, or maybe she needed to be sent as an emergency admission to hospital.

‘It was difficult to identify the level of risk, other than to know she was very poorly.’

She added that, given Resident A’s decline, she should have been assessed by a district nurse on October 11 – nine days before such a check actually took place.

Ms Hennessy made several visits to the home during the following weeks and said conditions appeared to be worsening.

‘Things were actually becoming a greater concern,’ she said.

‘The original visit was to look at specific concerns but as we started looking at wider issues, more concerns came to light.

‘We started to feel more uncomfortable about the people on the unit and the documentation remained poor.’

Some residents were suffering from unexplained bruising and Bannister had ignored an immediate requirement notice telling her to increase staffing levels, she added.

There were often just two care assistants on duty in the dementia ward, who were also responsible for cooking and cleaning, and only one of the 23 staff files examined contained a criminal record check, the panel was told.

Bannister also made ‘disparaging remarks’ about district nurses after they raised concerns about the home, Ms Hennessy said.

‘She couldn’t understand the strength of feeling with the district nurses about the fact Resident A hadn’t got the level of care she needed.

‘She didn’t understand they were trying to protect people and she didn’t really understand the principle of safeguarding.

‘It was all about the criticism of her, without understanding about keeping people safe.’

She added: ‘I wanted to give her advice. I tried to be helpful and she disregarded all the advice I had given to her.

‘I don’t know what her personal circumstances were, but she did not give any explanation for poor practices.’

Bannister admits failing to keep adequate records on patients and staff, failing to register one resident with a GP and failing to ensure  prescription drugs were administered as required to several patients.

But she denies failing to ensure adequate staffing levels, failing to call a nurse for Resident A when required, failing to work collaboratively with district nurses and failing to keep the home’s accident book up-to-date.

If found guilty of misconduct she could be struck off the nursing register.

The hearing continues.

ends