FURTHER concerns have been raised about the standards of care at a home for vulnerable elderly patients following the death of a 90-year-old man. Ringshill Nursing Home in Sallowbush Road, Huntingdon, had already been issued with a threat of enforcement proceedings if standards did not improve, and is being regularly monitored by the Care Quality Commission. And last week it was revealed that Charles Day, a resident at the home, had died after trying to remove a catheter that had been inserted by a Ringshill nurse without his consent and without a medical reason. Mr Day, who served in the Royal Engineers during the Second World War, died of sepsis blood poisoning caused by the injuries he received trying to remove the device, an inquest was told last week. The catheter had been inserted by Melanie Bardell, a registered nurse who had previously been dismissed from her job at Hinchingbrooke Hospital for gross misconduct. She was arrested by police investigating Mr Days death but no criminal proceedings were brought against her. Sitting at Huntingdon Law Courts on Thursday (December 1), coroner David Morris was told by Mr Days GP, Diana Hunter, that Mrs Bardell had asked her to bring up the subject of inserting a catheter with Mr Day. She said the nurse commented that his room smelt strongly of urine and, because he used a mobile urinal, he often had wet clothes and a wet bed. However, Dr Hunter said it was clear Mr Day did not want to use a catheter. He was quite clear that he didnt wish to have a catheter. He said no and at that time I felt he had sufficient capacity to consent, she said. I didnt feel that I could overrule his decision at that time. His refusal was clear and unequivocal. Four Ringshill staff members were called to give evidence at the inquest, including care assistant Marina Broder, who said Mrs Bardell told her not to bother washing Mr Day on October 30 because she was going to insert the catheter. Ms Broder said: I asked how she was going to fit one and didnt she need consent? She said I will tell him the doctor said he needed to have one. She described hearing Mr Day shouting and swearing while Mrs Bardell and senior care assistant Claire Lawrence were in his room. Melanie came out of the room and I saw her raise her fist and pump it in the air. I have seen her make this gesture before when she has achieved something something Mrs Bardell denied. Mr Day was discovered two days later bleeding heavily. His catheter was lying on the bedside table. He was taken to Hinchingbrooke Hospital where he died. Claire Lawrence, who was also interviewed by police under caution, said she didnt help fit the catheter but helped Mrs Bardell wash and dress Mr Day. She said Mrs Bardell didnt make any jubilant gesture and she didnt speak to anyone about the procedure. Despite Dr Hunters evidence that she had not authorised a catheter insertion, Mrs Bardell claimed she had the doctors consent but couldnt recall the exact conversation. Paul Spencer, representing Ringshill owner Four Seasons Health Care, said Dr Hunter would have needed to have written a prescription for a catheter in order for the procedure to be carried out. Mrs Bardell admitted she had not thought about the prescription and added that is my failing. The coroner said he was satisfied that it was the removal of the catheter by Mr Day that caused the damage to his urethra and ultimately resulted in the sepsis that killed him. But he added that he found it difficult to accept the evidence given by Mrs Bardell. He recorded a narrative verdict and said: Mr Day died as a consequence of an injury sustained when he removed a catheter which had been inserted two days previously without his consent and when it was not medically needed. Four Seasons Health Care said: The manager and staff at Ringshill Care Home were shocked and distressed by the circumstances of Mr. Days death and our thoughts are with his family. When concerns were raised with the manager about Mr Days care, she rightly notified his family, the local authority safeguarding team and the police in line with our procedures and the home co-operated fully with the subsequent investigation. The wellbeing and comfort of our residents is our prime concern and it is our policy that a catheter may only be fitted for medical reasons with patient consent or in an emergency. We require that a catheter fitting is authorised and prescribed by a GP. Clearly there was a breach of our policy and our procedures were not followed, which resulted in very regrettable consequences. Nurse Bardell is no longer employed by Four Seasons Health Care. A care assistant remains suspended and is subject to an internal investigation.