Coroner criticises nurse for ‘not caring’

Philip McCaffrey rejected the assertion and said he “cared sincerely and genuinely” for all the residents at the Brithdir home in south Wales.

An inquest in Newport, Gwent, is hearing evidence into the deaths of seven residents of the care home between 2003 and 2005, some of whom suffered from dehydration, malnourishment and pressure sores.

Mr McCaffrey worked as a nurse at Brithdir from June 2005 to January 2006, after a long career in health service management.

Assistant coroner Geraint Williams took Mr McCaffrey through a series of documents detailing concerns of care staff about resident Edith Evans, 85, and the deteriorating condition of the feeding tube to her stomach.

A dementia sufferer, she was admitted to hospital on September 16 2005 with MRSA and an infection to her peg feeding system.

Mrs Evans, a widow, died two weeks later and a pathologist found her death was caused by sepsis that developed from the peg site – an infection which had been present “seven weeks before admission to hospital”.

Mr McCaffrey told the inquest he had no recollection of being told about the concerns over Mrs Evans.

“Any time any of the care staff mentioned an issue to me I always go and investigate the issue and I have no recollection of carers involving me with Mrs Evans’s peg site,” he said.

Mr Williams asked: “During this period you were often the only qualified nurse on duty, and when you make notes all you record is ‘peg feeding regime maintained’.

“You don’t mention looking at the site, you don’t mention a description of what might be there. Your entries are bland to the point of being useless.

“How can it be that the carers are making notes which they tell you, as the only person on duty, that there is a problem, and you don’t make any record of it at all?”

He replied: “I can say what my practice was. If carers had a problem about a resident and they came to me I would go and see the resident and see what the problem was.

“One did not have the time to read the carers’ notes every day to follow on from one day to the next.

“You relied on carers to come to you with problems associated with the resident they were caring for.”

Mr Williams asked Mr McCaffrey: “Isn’t the reality that you were told and you did nothing because you didn’t care?”

Mr McCaffrey replied: “I cared sincerely and genuinely for all of the residents in Brithdir, otherwise I would not have been working there if I didn’t have a commitment, which I demonstrated for 50 years working between the health service and the social services sector.

“I think it would be wrong to think I didn’t care, of course I cared very much about the residents in Brithdir.”

Mr McCaffrey, who is now retired, told the inquest he had no knowledge of the worsening condition of Mrs Evans’s peg site, but documents show he took swab of it on September 5, 2005.

“Do you accept that what this demonstrates is that whatever your recollection now, you must have understood the site was deteriorating, as otherwise you would not have asked for a swab?” the coroner asked.

He replied: “Correct. That’s why I took the swab. I must have been aware of an infection at the peg site.”

The following day another nurse made an entry in Mrs Evans’s notes about the peg site being “mucky”.

A day later, Mr McCaffrey wrote in her notes: “Peg regime maintained.”

The coroner suggested that by this time, Mr McCaffrey should have been calling for a doctor to visit Mrs Evans.

Mr McCaffrey replied: “I can’t recall the specific situation. Generally, when I found it necessary I would call the GP.”

The inquest, set to last until March, is also looking at the deaths of former Brithdir residents Stanley James, 89, June Hamer, 71, Stanley Bradford, 76, Evelyn Jones, 87, and William Hickman, 71.

A hearing into the death of a seventh resident, Matthew Higgins, 86, will be held following the conclusion of the other six.