The ambulance crew transporting a Norfolk grandmother home thought she was snoring in the hours leading up to her death in an M11 layby, her inquest was told.

The third day of the inquest into the death of Peggy Copeman heard from the service manager and staff at Premier Rescue Ambulance Service, the service responsible for transporting the 81-year-old back to Norfolk.

She died in the ambulance on December 16, 2019.

The inquest heard that crew members Rory McKenna, Trudy Nanyunja and Kim Kunaka - with Miss Kunaka a shadowing member of staff.

Miss Kunaka was shadowing Miss Nanyunja and said she was "not supposed to do anything" apart from observe Mrs Copeman during transit, and the court heard this was not communicated to Cygnet Hospital.

Mr McKenna, the driver of the Ford Transit, said he was shocked to be transporting someone of Mrs Copeman's age.

He said: "I was shocked at how old she was. I have not collected anyone of that age before. The patients we deal with are young and more sprightly."

He told the inquest he thought at the time the journey should "not have gone ahead".

He said he had not had any training in his role at PRAS, nor was he aware what was in the first aid kit in the Ford Transit.

Mr McKenna said: "I'm so sorry this whole thing ever happened."

Miss Nanyunja said she checked the kit before the journey and knew there was a mouth-to-mouth mask but did not use it.

The three staff members told the inquest Mrs Copeman was asleep when they picked her up from the Taunton hospital and were told by Cygnet staff that she was "acting up" and may become verbally and physically aggressive on the journey.

Jacqueline Lake, senior coroner for Norfolk, questioned the crew on how Mrs Copeman got into the vehicle as well as asking if she had laughed when she was inside.

All three members of the crew said she had not because she was sleeping and remained so during the journey.

Miss Nanyunja and Miss Kunaka sat on either side of Mrs Copeman and said they carried out regular visual observations to check she was breathing.

Miss Kunaka said: "We were observing. She was snoring and we could tell she was breathing."

A couple of hours into the journey, the crew stopped at a service station, Mr McKenna said he offered to get Mrs Copeman a drink but did not receive a response.

After leaving the station, Mrs Copeman's snoring was described as "louder" by Miss Kunaka.

In the second half of the journey, Mr McKenna said he asked his colleagues about a noise "so loud I thought there was something caught under the car."

The driver said this did not raise alarm until his colleague said mucus was coming out of Mrs Copeman's nose which became "alot". Mr McKenna was asked to find a safe place to stop - pulling on to the hard shoulder so they could clean her up.

The court heard in Miss Kunaka's initial statement she said as her colleague cleaned Mrs Copeman's nose "she took in a strained breath before no further breath came".

In court, both Miss Nanyunja and Miss Kunaka said Mrs Copeman was breathing when the vehicle came to a stop.

Mr McKenna in his evidence said he came to the back and checked for breath and called 999 before being told to move Mrs Copeman to the floor and begin CPR with Miss Nanyunja until paramedics arrive.

On Tuesday, Cygnet health care assistant Emily Sanderson said she took a call from staff at Premier Ambulance shortly before 2.30pm and said she "talked through" CPR with staff after she was told "Peggy is not breathing".

Miss Nanyunja said she had rung to ask Cygnet about Mrs Copeman's medication.

Prior to this, the court heard she had called PRAS service manager Kuda Sigobodhla who instructed her to call Cygnet and call 999.

Mr Sigobodhla told the court he gave "generic advice" based on the information from the team and said to contact the hospital to find out about any medication that could make her sedated, monitor her and call 999 in an emergency.

He told the court: "We are a non emergency transport service, in the event there has anything that requires an intervention of the emergency services we contact them."

The court heard no mouth-to-mouth resuscitation was attempted and no defibrillator was aboard the van.

A pandemics report to the court said due to the positioning in the back of the van the CPR was ineffective.

Miss Nanyunja said: "I was doing it [CPR] in the right way. We were doing it the right way and that her position on floor was the right position at that moment."

"I believe we did everything possible."

The inquest is expected to conclude on Friday.