Earle Haven inquiry recommendations to prevent future aged care service collapses

The independent inquiry into Earle Haven, led by Ms Kate Carnell AO, showcased a range of issues within current regulations and laws around aged care, and will potentially become a benchmark case study for any similar events in the future.

A dramatic event in July, the Earle Haven closure resulted in nearly 70 residents being evacuated to alternative accommodation in nearby aged care respite beds and hospitals. 

Only a few staff stayed at the facility after their employer, Help Street, told them to vacate. the remaining staff were aware they would not be paid for staying behind.

The report found fault with the aged care regulators for not identifying the warning signs leading up to the closure, but also blamed the relationship breakdown between aged care service sub-contractor, Help Street, and the facility owner, People Care. 

This breakdown led to a huge emergency response which would normally be implemented during flood or fire disasters.

In the conclusion of the report, it says, “The events of 11 July were deplorable and should never have occurred. The senior management of People Care and Help Street should have worked through their dispute in a more constructive fashion and placed the interests of care recipients ahead of their own personal interests.

“Without diminishing the culpability of these individuals, aged care regulators should have been more alert to the risks presented by the senior management personnel at both People Care and Help Street and by the agreement between the two companies itself. 

“Regulators should also have had a greater array of tools to deal with the situation on 11 July so that an evacuation could be avoided and to more effectively respond to the failure in care demonstrated by People Care and Help Street.

“This inquiry cannot undo the events of 11 July or take away the pain that those events have caused. It is, however, incumbent on all of us to learn the lessons of the events and to take action to ensure they are not repeated. The Inquiry offers its findings and recommendations as a contribution to that effort.”

There were 23 recommendations made in the report fitting within six categories, including:

• 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 management of 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

• Aged care facilities having better-coordinated emergency situation responses

Inquiry not pleased by senior management leadership

While People Care provided a large amount of information to the inquiry, they did not provide all financial information requested.

The report highlighted People Care’s long history of non-compliance, which it believes is an indicator that there is systemic problems around culture and responsibility for provided services. 

Consultants, Government officials and advocacy organisations all reported to the inquiry that People Care has been a difficult organisation to work with.

The inquiry was also very unimpressed by sub-contractor, Help Street, and their ability to provide services.

The report states that Help Street had exploited a loophole in the Aged Care Act 1997 to provide their services without the need of an assessment from aged care regulators. 

There was additional comment that Help Street lacked experience in aged care and there were lacking controls in place for oversight of the contract terms and key personnel, which posed risks to residents in the Hibiscus House and Orchid House at Earle Haven.

Help Street senior management was criticised in the report for not providing further evidence besides their witness statements to the Aged Care Royal Commission and the Queensland Parliamentary Committee, which the report described as “cursory” statements.

The report says that the attitude from Help Street suggests a “deplorable lack of accountability” for the consequences of their actions and that Help Street and the appointed liquidator refused access to any of their financial information.

Accountability and necessary regulation changes

Concerns were raised in the report around Help Street, which, under the current Aged Care Act, are not held accountable to their actions.

The report believes, if the recommendation is accepted, the Help Street/People Care case will be an example case of why future sub-contractor companies need to be subject to the same responsibilities and sanctions as approved providers.

Another recommendation, if implemented, will make key personnel, who acted in the same fashion to senior management of Help Street, will be disqualified from holding similar roles in the future.

The inquiry was critical of aged care regulators who missed warning signs for early intervention which could have prevented the July incident.

The report says, “The aged care regulators failed to appreciate the mounting risk primarily due to communication and capability gaps. There were also occasions when regulators failed to engage critically with information received or follow through with necessary action.”

Industry and Government accept recommendations

Minister for Aged Care and Senior Australians, Senator Richard Colbeck, says all 23 recommendations in the inquiry report are supported by Federal Government.

“We owe it to the residents and families caught up in this tragedy to do all that we can to prevent situations like Earle Haven occurring again,” says Minister Colbeck.

“As I said at the time, this inquiry is about ensuring we understand why the situation occurred, that we do what we can to prevent this type of event in the future, and that those responsible are held to account.

“I will be pushing for swift passage of the Bill before Parliament to beef up the powers of the independent aged care regulator. I will work methodically to implement all the recommendations from the report.

“In addition, I have already written to Chair of the Aged Care Quality and Safety Advisory Council, Andrea Coote, for advice on what further powers the Commission needs and to report back before Christmas.”

Industry peak body, Leading Age Services Australia (LASA), has demanded action from the Federal Government to respond to the inquiry.

Chief Executive Officer of LASA, Sean Rooney, says, “Reforms and investment in the Aged Care Quality and Safety Commission must be fast-tracked to avoid, in the words of the report, ‘commercial considerations and personal animosity’ once again overriding the care of older Australians.

“It was a shameful situation, poorly overseen by the home’s management and the regulators, that resulted in distress and in some cases, harm, for residents and families.

“A shining light revealed in the report was the dedication of staff, that saw Earle Haven’s outstanding care workforce continuing to look after residents despite being told they would not be paid.”

LASA supports extra training and investment for the aged care regulator, more information sharing on service regulation and risks, and amendments to the Aged Care Act to limit the risks showcased at Earle Haven.