The inquiry into the sudden collapse of aged care services at Earle Haven on the Gold Coast has recommended greater regulatory capability and better oversight of approved providers and financial, commercial and sub-contracting arrangements.
These are among 23 recommendations the inquiry led by Small Business Ombudsman Kate Carnell has made to prevent another sudden collapse in aged care service delivery, better safeguard residents of providers not meeting their obligations and better manage similar events.
All recommendations are supported by the government, Minister for Aged Care and Senior Australians Richard Colbeck announced on Monday when he released the report he commissioned in July publicly (read our backgrounder here).
The report confirms the forced evacuation of 69 residents on 11 July occurred because of a breakdown in the relationship between approved provider People Care and service delivery subcontractor Help Street Village.
“Based on the information available to it, the Inquiry’s view is that senior management of both companies allowed personal animosity and financial considerations to override their responsibility for the people in their care,” according to the inquiry report.
After People Care issued Help Street with a one-month notice of termination on 8 July, Help Street demanded more than $4 million on 10 July including half the next day or it would close the facility.
However, the inquiry found that contrary to media reports of a staff exodus, care staff remained on site to support residents despite being told they would not be paid or covered by insurance.
“This compassionate act demonstrated their commitment to the wellbeing of the people in their care. This is a trait consistent with most of the dedicated and caring people who work in the aged care industry and is something we should all applaud,” the inquiry found.
‘A deplorable lack of accountability’
The report highlights a lack of information provided to the inquiry.
People Care provided a large amount of information to the inquiry, although not all requested, but Help Street gave no more than the witness statements provided to the royal commission and the Queensland parliamentary committee, the report said.
“The Inquiry is of the view that this attitude suggests a deplorable lack of accountability by Help Street for the consequences of their actions. Both the management of Help Street and the appointed liquidator refused access to any financial information.”
The inquiry found that Help Street lacked experience in aged care and used its arrangement with People Care to enter the sector without being assessed by aged care regulators and that People Care had a history of regulatory non-compliance.
It also found that regulators missed several warning signs including:
- the organisational cultures, attitude of senior management and the deteriorating relationship between the two companies
- the nature of the companies’ contractual arrangements
- People Care’s financial arrangements
- an increase in complaints about the quality of services
- high levels of chemical and physical restraints.
People Care has since been subject to significant sanctions, including having all residential aged care places and home care packages revoked.
The inquiry found that aged care regulators need a greater array of tools to more effectively respond to a failure in aged care services and manage events similar to those on 11 July.
“Following consultation with families of the residents who were evacuated, the Inquiry is of the view this type of emergency response should only be reserved for life threatening situations such as floods and fires, as the act of sudden relocation is life threatening in itself,” the report said.
Government commits to recommendations
The 23 recommendations fall into the following six categories:
- greater regulatory capacity and coordination
- greater oversight of financial and 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
- sanction options which better balance the need for decisive action with the desire of people to remain in their homes
- better planned and coordinated responses to emerging situations in aged care facilities.
The inquiry’s first recommendation is to prioritise the amalgamation of aged care regulatory functions in the Aged Care Quality and Safety Commission including functions relating to approved providers’ compliance with prudential responsibilities.
Reforms to give further regulatory power to the ACQSC are due to come into force on 1 January 2020 subject to the passing of legislation amendments.
Mr Colbeck said he would push for swift passage of the Bill now before Parliament “to beef up the powers of the independent aged care regulator” in a statement that confirmed the Morrison Government’s support of all 23 recommendations.
“I will work methodically to implement all the recommendations from the report, particularly in the context of the findings of the Royal Commission final report, as well as incorporating the interim report,” he said.
Mr Colbeck said he has written to Aged Care Quality and Safety Advisory Council chair Andrea Coote to request she provide advice before Christmas on what further powers the ACQSC needed.
“I will refer this report to the Advisory Council for inclusion in that advice,” he said.
Qld, Opposition call for action
Queensland’s Palaszczuk Government has welcomed the Federal Government’s commitment to implement the 23 recommendations and called on it to act immediately.
Minister for Health and Ambulance Services Steven Miles said the report showed a shocking lack of Federal Government oversight and missed warning signs.
“The report makes clear that there was a complete lack of care from the providers, who clearly weren’t up to the job of looking after elderly and vulnerable Queenslanders,” Mr Miles said.
“Some of the stories of how that night unfolded are devastating.
“The Palaszczuk Government has been calling on the Morrison Government for months now to step up, take ownership and increase regulation of aged care facilities.”
He said he hoped the Federal Government could implement the recommendations and make the changes needed quickly.
Shadow Minister for Ageing and Seniors Julie Collins in a joint statement with Labor Senator for Queensland Murray Watt called the report another damning indictment of the Morrison Government’s oversight of Australia’s broken aged care system.
She said the report on Earle Haven was hidden from the public for more than 10 days. Its release confirms an inadequately resourced quality and safety commission, she said.
“The new Aged Care Quality and Safety Commission must have stronger powers and be better resourced so events like the evacuation of residents at Earle Haven nursing home never happens again,” she said.
“Sadly the report into what went wrong mentions recommendations not fully implemented by previous reports handed to the Government.”
She said this report could not be allowed to collect dust like others on aged care system.
The Aged Care Royal Commission is also examining the events at Earle Haven and may make further findings.
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