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Why was his body always turned to the side when he was lying in the bed?

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James suffered a traumatic injury after falling off of a balcony during a fight with "some guy" who'd posted intimate pictures of Bella online without her permission.

Bella: I sent these pictures to some guy. And then when I woke up the next morning, they were all over the internet. They were everywhere, everyone had seen them. Everyone at school and my Mom and my brother...

Maxine: So, what happened?

Bella: James wanted to find the guy who did it, and he lived in a three-storey apartment building. There was a really big fight and .... he [James] went over the balcony.

The ending suggests that he wasn't just comatose, he was in a persistently vegetative state.

VO: But two years prior to the murders, James was in a coma, a vegetative state.

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He had a fight with the guy who cyber-bullied his sister Belle in a 3rd story apartment and fell of the balcony. Belle herself explains this to her friend Marissa.

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