A woman who was supposed to be under close observation at a Bristol mental health hospital died after falling in the garden, an inquest heard.

Aileen Andrews, 81, of Gordon Road, Whitehall, got out through an unlocked dining room door during a staff change over.

Josephine Kelly, a ward sister at the Callington Road Hospital in Brislington, admitted not following policy and leaving Mrs Andrews in the lounge watching TV on November 25, 2007, after her observation shift ended.

The next nurse on the rota should have taken over at 9pm but was still in the main office at 9.15pm, the inquest was told.

Mrs Andrews, who was at the hospital to receive electro-convulsive therapy for severe psychotic depression, slipped into the garden unnoticed.

Another member of staff found her lying face down in a pool of blood at the bottom of the garden sometime later.

She had suffered bleeding in the brain and died at the Bristol Royal Infirmary on November 27, 2007.

The inquest into Mrs Andrews' death is being heard by a jury at Avon Coroner's Court at Flax Bourton.

Mrs Andrews' daughter Jennifer West, of Longwell Green, said her mother had been well until the summer of 2007 and had celebrated her diamond wedding anniversary in June that year.

But she began suffering from abdominal pain which led to an operation to remove a stone from her bile duct. She continued to suffer pain and went back into the Bristol Royal Infirmary for four weeks in October.

It was while she was in hospital that her mental health deteriorated to a point where she thought staff were trying to poison her and refused to eat or drink.

Despite her family's concern about her mental health she was sent home on November 7, only to be admitted to a mental health unit at Southmead Hospital the following evening after delusional and aggressive behaviour at home.

She was diagnosed with severe psychotic depression and was transferred to Callington Road Hospital on November 19.

Less than a week later she was dead.

Mrs West told the inquest that her mother was under one to one observation and someone should have been with her even when she went to bed.

On November 25 at 9.45pm staff telephoned Mr Andrews to tell him that his wife had fallen.

Mrs West said: "I was told that they had lost her and all hell broke loose trying to find her.

"I thought the hospital was a safe place for my mother and feel let down that the duty of care was breached.

"I can't reconcile the fact that she was found in the garden when she was supposed to be under constant supervision."

Consultant psychiatrist Jonathan Hewitt, who was in charge of Mrs Andrew's care at Callington Road Hospital said: "I can remember feeling very distressed and shocked by what had happened.

"She should have been under one to one observation. The main reason was the risk of suicide."

A police investigation ruled out foul play and the inquest heard that it was likely that Mrs Andrews had either tripped, fallen during a dizzy spell or while trying to climb the fence around the garden.

Mental health nurse Michael Knowles, of Allerton Crescent, Whitchurch, said Mrs Andrews had been under the highest level of observation so that staff could intervene if she tried to harm herself.

He said that staff changeovers should be "like a baton in a relay race" so that patients were never left out of sight.

He recalled seeing Marcia Baker, the person due to take over observation from Mrs Kelly, in the office at 9.15pm. She was writing up patients' notes.

Mrs Baker was due to give evidence at the inquest on Tuesday.