A dementia sufferer who had not eaten for days at a nursing home where she was receiving "tender loving care" died of natural causes, an inquest has found.

Joan Peasley, 86, died at Epsom Hospital, on May 29, 2012, four days after being admitted there from Firtree House Nursing Home, in Fir Tree Road, Banstead.

Coroner Simon Wickens, sitting at Woking Coroner's Court yesterday, concluded that she died from "ischemic heart disease leading to left ventricular failure" and there was no evidence of neglect contributing to this - despite Mrs Peasley not eating or drinking much at the nursing home in the weeks leading up to her death.

A widow, who was born in Sutton, Mrs Peasley worked for Surrey County Council as a home help retiring aged 60.

She was described by her son Maurice Peasley as "very independent and stubborn" and moved to Firtree House from Hailsham 18 months before she died.

Mr Wickens told the court that Mrs Peasley's condition deteriorated in the weeks leading up to her death, during which time her interaction with others waned, she did not eat much food or drink, and slipped in and out of consciousness.

Mrs Peasley was suffering from severe dehydration, a urinary tract infection and an infected wound with "deep lesions" on her right arm when she was admitted to Epsom Hospital.

In a statement read to the court, Tracey Carpenter, a paramedic called to Mrs Peasley at the nursing home that day, said: "A male member of staff said they hadn't tried to give her water or food since the previous morning."

Epsom Hospital consultant Dr Vidhu Nayyar told the coroner: "I suspect it would have been longer than two days that she hadn't been eating or drinking."

When asked by the coroner whether there was a correlation between the conditions Mrs Peasley came into hospital with and what she died of, Dr Nayyar said: "Given the fact that she had a really nasty infection and kidney injury and dehydration, all of this with a background of heart disease, is a fair amount of strain on the heart."

Giving evidence before the coroner, Maria Varnava, who was the manager at Firtree House Nursing Home from 2000 until her resignation last year, said: "Joan was deteriorating. Her appetite was very poor.

"Myself and the staff nurses discussed this with the GP who recommended TLC [Tender Loving Care].

"Her mental state was getting more confused and disorientated."

Mrs Varnava said she had called Mrs Peasley's GP, Dr Dean, of the Nork Clinic, on May 16 after she lost consciousness.

She said she then had a conversation with Maurice Peasley about his mother who said he would prefer for her to be cared for at the home and not in hospital.

She said: "TLC is Tender Loving Care.  I told Maurice your mum will be staying in bed and she will be given extra fluids and food."

The coroner told the court that on May 17, Mrs Varnava had written "presenting with good intakes" in Mrs Peasley's notes and on May 18, "appetite good".

When asked what the latter meant, Mrs Varnava said "it meant fluid taken or good intake", but that she had not taken the food or drink to Mrs Peasley personally.

The coroner said: "'Appetite good' is based on you being told by others that she has eaten something but we don't know what or how much?" To which Mrs Varnava replied "yes".

He also pressed her on the use of the word "given" in Mrs Peasley's notices in entries such as "given fluids".

Mr Wickens said: "If I give you a pen it doesn’t mean you have written with it.

"The fact that someone has written 'given', does that indicate someone was always sat with Joan and it was drunk or was the reality that the drink was placed on a table beside her?"

Mrs Varnava said: "Someone would have sat with her and made sure she drank it."

When Mrs Peasley's condition deteriorated on May 25, Dr Dean said he was visited by Maurice Peasley and his sister.

The GP said he told them their mother could not be "treated aggressively" by the nursing home and that she should be taken to hospital.

When asked why Mrs Peasley was not taken to hospital before this since Mrs Varnava had concerns about her lack of consciousness and dehydration, she said her son's decision had been that she was not to be taken to hospital.

The ex-manager also said she did not know about the wound on Mrs Peasley's arm.

Concluding the inquest, Mr Wickens said: "I have seen the notes of Firtree House Nursing Home leading up to Joan's admission to Epsom Hospital.

"There were clear concerns over Joan's condition and intake of food and drink.

"Maurice her son was spoken to about this and the home made it his preference as to what should happen.

"It appears Maurice indicated Joan should be treated in a palliative way at Firtree. I heard this referred to as TLC.

"On May 25, it appears, in discussion with Dr Dean, that Maurice informed Firtree it couldn't assist Joan for she required aggressive care and despite Maurice's initial wishes, he agreed with Dr Dean that Joan should be taken to hospital."

He added: "I have no evidence before me that aspects of neglect hastened a natural cause of death.

"[She] died as a result of a naturally occurring heart condition."

Speaking after the inquest, Maurice Peasley said he was "not happy" with the outcome but that he "couldn't argue with the coroner".

He said: "I think it was neglect.

"The nursing home are there to try and feed them. They don't just give up as well when people don't want to eat or drink."

Mr Peasley also disputed that his preference was for his mother to be treated at the nursing home: "I wanted her in hospital if anything happened but wanted them to care for her in the meantime.

"I certainly don't remember anything about TLC."