Woman found unconcious in bed covered in vomit and blood on same day coroner raised concerns over her care

Debbie Fossey and Michael Taylor with a picture of their aunt Rose Hollingworth. Photograph: Julia Gregory

A coroner raised concerns about the care a much-loved aunt received from a care agency on the day she was found unconscious in bed covered with vomit and blood.

Inner London assistant coroner Jonathan Stevens said 83-year-old Rose Hollingworth should have been given a check when staff from an Islington care agency visited her home at 9am for the first of three daily visits.

Her niece Debbie Fossey  said her “beloved and fiercely independent” aunt was “well known within her local community, always “paying forward ” as she called it.

“From acts of random kindness to individuals she’d only met to donations to her favourite charities Cancer Research and the British Heart Foundation.”

She said her aunt  from Swords in County Dublin “remained sharp, lucid and respondent and holding onto her independence.”

She had a care package after admission to hospital the November before she died.

The coroner  described how Miss Hollingworth “was normally up and waiting for carers to arrive” at her home

When a carer from Islington care agency, HomeDot Care, visited her Finsbury Park home on 3 January 2022, she found Miss Hollingworth was still in bed.

According to evidence from paramedic Ashley Earl, the carer said she contacted her company and was told to leave Miss Hollingworth until the afternoon visit.

It was only on the second visit that a carer raised the alarm  at 2.14pm and called the ambulance, the inquest was told.

However the day she was found, paramedics were so concerned when they discovered she had not been checked fully during a carer’s earlier visit that they raised a safeguarding concern.

The paramedic was told the carer had not turned on the light or removed the duvet.

In a statement paramedic, Ms Earl described how she found Miss Hollingworth face down in bed  wtih coffee looking vomit and blood clots “dried on the sheet”.

Ms Earl said her airway was blocked by the vomit.

Emergency care consultant Dorothy Ip said the inhalation of vomit was most likely caused following the brain haemorrhage and can happen when people are unconscious.

She said delays in sounding the alarm could not have prevented Miss Hollingworth’s death from a catastrophic stroke.

Mr Stevens told the inquest: “It is clear to me that there are a number of reasons to have concerns about the care that was provided to Rose and indeed my finding that there are significant failings in the care given to Rose by HomeDot Care on the 3rd January 2022. The carer should have done a welfare check, should have turned on the light, should have checked that Rose was waiting for her as usual.”

He said he was also concerned that the carer was told by the home care agency “that it was ok for Rose to have left her and go back at lunch time.”

He added: “There are matters of real concern in relation to the actions of the care agency and it is right that I will consider making a Prevention of Future Deaths report.”

Such a report sets out recommendations to avoid a repetition of issues raised at an inquest.

He said the carer should also have checked the catheter which  Whittington Hospital emergency consultant Dr Dorothy Ip noted contained two litres of urine, when people usually produce 800ml to 1 litre of urine a day.

Speaking after the inquest the care agency said it was not their responsibility to empty the catheter.

Mr Stevens added: “It’s clear to me that  on the visit in the morning there was no effort to make sure that medication was taken.”

The Islington based care agency said “we would support Rose with her medication.”

Dr Ip saw Miss Hollingworth three hours after she arrived in hospital  told the inquest that a CT scan showed that Miss Hollingworth suffered a catastrophic brain haemorrhage and would not have recovered  from the major stroke even if there had been earlier intervention.

He said any delays “did not contribute in any way to Rose’s death.”

He ruled that she died at the Whittington Hospital on 4 January 2022 of natural causes.

No witnesses from HomeDot Care, which provided thrice daily visits to Miss Hollingworth, were heard at the inquest.

In a statement afterwards, the company which was commissioned by Islington council offered condolences to Miss Hollingworth’s family.

The company said: “HDC were commissioned by the Local Authority to provide care three times a day to Rose from 26 November 2021 through to her death. The care was to support with activities of daily living. Rose had capacity, and was relatively self-sufficient but did need assistance with dressing, washing and meal preparation. ”

It added: “Rose was bright, sharp and had a good relationship with her carers.”

Staff said she had praised carers in the December before her death.

The company said : “We are confident that Rose was attended to for her planned visits and that her medication was being given. On the morning of 3 January 2022 the carer attended and found Rose to be asleep and snoring. “Rose had complained of not sleeping well at nights and had made her carers aware she liked a lie-in. We considered that it was reasonable not to disturb her that morning noting we’d be back at lunch time. When our carer returned she found her position to be unchanged and of concern and called the ambulance. ”

“We have been actively making improvements to our systems following Rose’s death and will continue to cooperate with any further investigations.”