A DEMENTIA patient, whose condition affected his ability to swallow, choked to death on yoghurt fed to him by a care home worker, an inquest heard.

William Knowles died, aged 84, on February 1 at Four Seasons care home in Breightmet — two days after being discharged from the Royal Bolton Hospital, where doctors had given 'nil-by-mouth' instructions and the pensioner was fed intravenously.

Mr Knowles was released from hospital on January 30 after medics were unable to treat a case of pneumonia he had developed following a hip operation.

He was prescribed end-of-life care and instructions were sent to the home telling carers that small amounts of thickened fluid or pureed food could be given to him if he became more alert or if his condition improved.

But care assistant Anne Marie Crane, who fed Mr Knowles the yoghurt, said no one at the home had told her that he had been fed nil-by-mouth in hospital.

She said: "I remember being told that he was on end-of-life care and that we asked to sponge his lips to moisten them."

Coroner Simon Jones asked: "What were you told, if anything, about him being provided with food?"

Ms Crane replied that she was told nothing about it, and did not see diet instructions sent from the hospital on Mr Knowles' discharge.

She said she saw an unfinished thickened drink on a cabinet near Mr Knowles' bed which she presumed the day staff had given him.

Ms Crane said Mr Knowles tried to chew the sponge when she moistened his lips, and said he looked as if he wanted to eat something.

She then gave him two teaspoons of yoghurt, and he started to cough.

Ms Crane added: "I sat him up and he was coughing. He took a deep breath and then he passed away."

Mr Jones ruled that there were "shortcomings" with Four Seasons but said the home was not responsible for his death.

The court heard how Four Seasons had admissions frozen following a string of inspections from the Care Quality Commission, with the most recent published report classing it as 'inadequate' following a visit in January this year.

Concerns were raised by the CQC over the level of training given to staff. Judith Stanley, an inspector, told the court that the training given to staff was inadequate.

The hearing heard that staff had not had training in dealing with dementia patients and were "just left to it".

Tracey Johnson, an operations director at HC-One, the firm who runs Four Seasons, told the court the organisation had been restructured and improvements had been made to the home.

Four Seasons now has a permanent manager and has made improvements in that time, Mrs Johnson added.

The most recent CQC inspection in May reported improvements at the home.

Recording a verdict of accidental death, Mr Jones said: “In this case I recognise that although there were shortcomings at Four Seasons they were not involved in the sequence of events that led to William Knowles’ death.

“I also consider the steps that are being taken by the home to deal with all the issues surrounding the CQC reports."

Mr Jones said he would not be writing a report so future deaths could be prevented as he was confident appropriate steps were being taken to address issues outlined in the CQC reports.

He added that Ms Crane's actions in feeding Mr Knowles the yoghurt would not have been affected, even if she had been told of the hospital's advice.

An only child, Mr Knowles lost his wife Winifred in 1995 and had four children, including sons Geoffrey and David who attended yesterday's inquest hearing at Bolton Coroner's Court.

Mr Knowles worked as deputy clerk to the justices at Bury Magistrates' Court.

He was diagnosed with Parkinson's disease in 2012, before moving into Four Seasons in November, 2013 after displaying symptoms of dementia.

Dr Angelia Ong, a pathologist at the Royal Bolton Hospital, said Mr Knowles died of asphyxiation caused by aspiration.

A spokesman for the home said: “Nothing is more important to us than the health, safety and wellbeing of each person we support. We were deeply saddened by Mr Knowles’ death and our thoughts are with his loved ones at this difficult time.

“We are working tirelessly to address the points raised in the CQC report of January.

“We have made significant improvements to the environment, provided enhanced training for staff and strengthened our internal safeguarding policies."