CALGARY — The family of a 35-year-old Calgary man who died from complications after being scalded in a bath in 2011 says they are disappointed the inquiry into his death had no specific recommendations about staff training and qualifications.
David Holmes was a resident at a home for people with developmental disabilities and had severe cognitive impairment with little or no verbal communication, requiring help from full-time caregivers for all activities of daily living.
The report says the care attendant was working a 12-hour shift alone and had left Holmes alone in the tub to open the door to let in a new worker.
When the attendants were dressing him, they noticed blistering and called supervisors about what to do, but the supervisors didn't get back to them right way, with about 2 1/2 hours passing from when Holmes was scalded to when he was taken to hospital in the personal car of one of the attendants.
Judge Judith Shriar recommended that care attendants be able to make decisions without waiting for the OK from supervisors.
She also recommended that shift lengths and how many consecutive days an attendant worked be looked at to manage the role that stress, burnout or fatigue play in incidents of error.
The Holmes family said in a statement that it would like to see the province and contracted care agencies require more stringent pre-employment qualifications such as formal certification for clients with medically complex conditions.
"Today, an Albertan who receives their care in the health care system will have their personal care needs met by an individual with 16 weeks of formal training," the family said Tuesday in a statement.
"Disabled Albertans cared for in the PDD (persons with developmental disabilities) system, many of whom have complex care and medical needs, can be cared for by someone without standard pre-employment qualifications, who only receives on the job orientation, and little support."
Human Services Irfan Sabir said the province must learn from Holmes' death, calling it a "preventable tragedy."
"We will be examining this sector as part of the second phase of our PDD safety standards consultation to address qualifications, recruitment, and retention in this valued workforce," Sabir said in a statement.
“Every Albertan deserves to live safely, with dignity, and to be cared for in a manner that ensures their well-being. Our ongoing consultation on home safety with persons with developmental disabilities, their families and guardians, service providers, health and safety professionals, landlords, and other stakeholders is part of this work.”
