This report details the findings and recommendation of an independent inquiry into the events surrounding the forced relocation of residents at the Earle Haven Retirement Village on the Gold Coast.
On 11 July 2019, 69 elderly residents of Hibiscus House and Orchid House, aged care facilities at the Earle Raven Retirement Village, were evacuated from their homes. The evacuation of the high-care wings of this facility occurred with no forewarning and were considered 'life-threatening' to the vulnerable residents of Earle Haven.
In response to the event, on 19 July 2019, Senator the Hon Richard Colbeck, Minister for Aged Care and Senior Australians, announced an independent inquiry (the Inquiry) into the sudden closure, to be led by Ms Kate Carnell AO.
Focus of the Inquiry
The terms of reference for the Inquiry can be viewed at Appendix A of the Inquiry Report, however the main focus of the Inquiry was the impact these events had on the residents of Earle Haven. The Inquiry heard evidence from the care staff responsible for those evacuated, as well as the friends and family of residents at Hibiscus House and Orchid House.
The Inquiry examined the circumstances leading to the collapse in aged care services at Hibiscus House and Orchid House the consequences of the collapse. The Inquiry heard about the relationship between the approved provider of aged care services, People Care Pty Ltd (People Care) and Help Street Villages (Qld) Pty Ltd (Help Street), who had been sub-contracted to manage delivery of the aged care services. This relationship became a central focus for the Inquiry, who came to conclude that that senior management of both companies 'allowed personal animosity and financial considerations to override their responsibility for the people in their care.'
The Inquiry also heard that, contrary to media reports, care staff actually remained on site during the evacuation in order to support the residents and despite being told they would not be paid or covered by insurance. The Inquiry applauded these staff for their commitment and compassion.
Due to the fact that the Inquiry was being held concurrently with examinations of the events by the Royal Commission into Aged Care Quality and Safety (the Royal Commission) and the Queensland Parliament Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee (the Queensland Parliamentary Committee), the Inquiry also drew information from the sources available to the Royal Commission and the Queensland Parliamentary Committee.
The Inquiry was assisted by Mr Paul Croft, Director of BRI Ferrier and forensic accountant, who examined the organisational structures and financial arrangements in place at Earle Haven. People Care provided a large amount, but not all, of the financial information requested by the Inquiry. However, Help Street senior management provided little information to the Inquiry and ultimately Help Street and their liquidator refused the Inquiry access to any financial information. Further, the Inquiry was advised by Help Street that the company had nothing to add to the witness statements they had provided to the Royal Commission and Queensland Parliamentary Committee. The Inquiry considered that this attitude suggested 'a deplorable lack of accountability by Help Street for the consequences of their actions.'
Finally, the Inquiry examined the history of the approved provider, People Care, and assessed the risk that were presented by its sub-contracting arrangement with Help Street.
The Inquiry found that Help Street did not have the requisite experience in Aged care and took advantaged of sub-contracting arrangements allowed under the Aged Care Act 1997 (the Act) to enter the aged care sector, without having been first assessed by aged care regulators. The Inquiry considered that 'the lack of control in place to provide oversight of the contract terms and key personnel posed risk to the people living Hibiscus House and Orchid House.' The Inquiry found that People Care, the approved service provider, had a history of regulatory non-compliance with its obligations under the Act and that aged care regulators should have picked up on a number of warning signs, including:
- the organisational culture of People Care and Help Street, including the attitude of senior management and the deteriorating relationship between the two companies;
- the nature of contractual arrangement between People Care and Help Street;
- people Care's financial arrangements and the way the risks inherent in them were compounded in the arrangement with Help Street;
- an increase in complaints about the quality of services; and
- high levels of chemical and physical restraints.
Ultimately, the Inquiry found that poor communication and 'capability gaps' left regulators unable to appreciate the 'mounting risk' posed by the arrangements at Earle Haven. Unfortunately, the sanctions imposed and the reluctance of People Care to resume service delivery meant that Hibiscus House and Orchid House were forced to close and the elderly residents were unable to return to their homes.
The Inquiry concluded that the type of emergency response employed at Earle Haven on 11 July 2019, should only be used in life threatening situations such as floods or fires and that 'the act of sudden relocation is life threatening in itself'.
The findings of the Inquiry led to recommendations within six broad categories. In order to prevent the sudden collapsed of aged care service delivery as occurred at Earle Haven on 11 July 2019, the Inquiry recommended:
- greater regulatory capacity and coordination;
- greater oversight of financial commercial arrangements
- greater oversight of the purchasing and sub-contracting of approved provider status;
- better managing the risks associated with key personnel and organisational culture.
In order to better safeguard residents in the care of approved providers that are not meeting their obligations under the Act, the Inquiry recommended:
5. sanction options which better balance the need for decisive action with the desire of people to remain in their homes
Finally, in order to better manage events such as those of 11 July 2019, the Inquiry recommended:
6. better planned and coordinated responses to emerging situations in aged care facilities.