"Mum with dementia had a fall"

My mum is in her 70s and has severe dementia, she had an unwitnessed fall in her supported living accommodation. She was able to call for assistance via her call button. As she was complaining of pain in her head and neck the staff called for an ambulance. I am unsure if she complained of foot pain at this stage.

NIAS attended, checked her out and were happy she could remain at home with hourly checks from staff. Staff tried to assist mum with personal care and she could not weight bear on her left foot and was complaining of foot pain. Staff called NIAS and my sister and I went to mum's to meet the ambulance.

A paramedic arrived. They were very kind and compassionate towards mum who was very distressed. They checked her out and said they were satisfied there is no break in her left foot/ankle. They advised that mum was probably feeling stiff from her fall and the best thing would be to get her on her feet. With the help of staff mum got up and walked with extreme difficulty and pain to the living room. The paramedic witnessed this and said the important thing was to keep her mobilising. They said mum did not need to attend hospital.

The next day mum still could but weight bear without extreme pain and her foot appeared swollen. As we could not get her into a car ourselves we phoned phone first to see if transport could he arranged to get mum to Minor Injuries to get her left foot/ankle checked. The staff advised they would organise an urgent ambulance but due to mum's age and diagnosis she would have to attend A&E rather than Minor Injuries.

A few hours later an ambulance arrived (proparademics) they assessed mum and said they were in agreement with previous paramedic that there was no break but that mum could get an x-ray for peace of mind of family and supported living staff. They said they did not think A&E was the best option as mum would have a long wait and it would be distressing for her.

They advised they would contact Minor Injuries to see if they would accept mum. If not they suggested we get in touch with mum's GP to organise an appointment for an x-ray over the next few days. The x-ray they said was not urgent as it was only for peace of mind and they were satisfied there is no break.

Minor injuries agreed to see mum.  The ambulance crew were kind and compassionate to mum while they transported her and I accompanied her. Once we got to Minor Injuries mum had her x-ray which revealed a fracture to her lower left leg. Mum's leg was put in plaster and she was admitted to hospital. 

The ambulance staff we encountered were all very kind and treated mum with dignity and compassion  But they missed a fracture. Not only did they miss it but they were adamant there was no fracture and encouraged mum to walk on a broken leg which could have worsened her injury. Without an x-ray I am unsure how the paramedics could be satisfied there was no break.

Due to her dementia mum was unable to say how she had fallen and was unable to give them accurate information about the location of her pain other than saying her foot was sore. On the advice of the paramedics if Minor Injuries had not been agreeable to see mum we would have kept her at home and tried to contact GP to arrange a routine x-ray. She could have spent several more days with an undiagnosed broken leg. 

Surely it is not acceptable for paramedics to say they are satisfied there is no break without an x-ray.