Earle Haven inquiry report released
The Australian Government is supporting the 23 recommendations made by the report of Inquiry into Events at Earle Haven, which was produced by Ms Kate Carnell AO and released 11 November 2019.
Minister for Aged Care and Senior Australians Richard Colbeck commissioned the inquiry to examine the circumstances leading up to the collapse in provision of aged care services at the facility, and the impact of the events on the safety and wellbeing of the affected residents.
The report found that effectively what led to the forced evacuation of the residents was a breakdown in the relationship between the approved provider of aged care services at Earle Haven, People Care Pty Ltd, and the company engaged to deliver these services, Help Street Villages (Qld) Pty Ltd.
The report’s recommendations have a significant focus on greater regulatory oversight of approved providers and their commercial arrangements.
The report supports the Government’s structural reform to give further regulatory power to the Aged Care Quality and Safety Commission. The powers are set to come into force on 1 January 2020, subject to the passage of the Aged Care Legislation Amendment (New Commissioner Functions) Bill 2019 currently before Parliament.
The Government has also already delivered on the recommendation regarding the obligation to report changes in key personnel.
Mr Colbeck said the events at Earle Haven were devastating, unprecedented and completely unacceptable.
Mr Colbeck said, “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.
“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."
The report makes 23 recommendations that fall into six broad 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.
Since the events at Earle Haven, People Care has been subject to significant sanctions, including the revocation of all residential aged care places and home care packages.
The Queensland Government is calling on the Federal Government to act immediately on the damning report.
Minister for Health and Ambulance Services Steven Miles said the report showed a shocking lack of oversight by the Federal Government.
“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.
“The report also makes clear warning signs were missed by the Morrison Government due to a lack of oversight and regulation.
“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."
Member for Gaven Meaghan Scanlon said the collapse happened under the watch of the Federal Government.
“I saw the devastating events that unfolded that night and the impact it had on residents, many of whom had dementia, and their families,” Ms Scanlon said.
“I want to thank all of the emergency services, health staff and those aged-care staff who stayed behind to ensure that everyone had a safe place to stay.”
Mr Miles said the report recognised the hard work of Queensland’s first responders.
“Our Ambos and Healthcare workers did a fantastic job, working through the night to care for affected residents,” Mr Miles said.
“In total around 32 paramedics were involved in the mass operation and over 250 health staff from Gold Coast Hospital and Health Service helped coordinate and respond to the incident.
Mr Miles said the Queensland Government had already acted to make the sector more accountable where the Federal Government refused.
“The Palaszczuk Government has introduced a bill to parliament to ask the private providers, who deliver the vast majority of aged care places in Queensland, to publish their staffing levels so families know who is taking care of their parents and grandparents,” he said.
Report recommendations summary
R1. Progress as a priority the amalgamation of aged care regulatory functions in the Aged Care Quality and Safety Commission. This should include functions relating to approved providers’ compliance with prudential responsibilities.
R2. Ensure the planned delivery of an information portal which provides a single, real-time view of all information about approved providers which is available to both the Department of Health and the Quality and Safety Commission. This should include financial and prudential information as well as complaints and quality monitoring data.
R3. Further invest in staff training and other resources to support a shared culture within the newly expanded Quality and Safety Commission which emphasises information sharing and cooperative action between the Commission’s various functions.
R4. The Quality and Safety Commission should appoint a Senior Responsible Officer or Case Manager for each high risk provider. This officer will have responsibility for ensuring effective information sharing and timely action.
R5. The Quality and Safety Commission should enhance its cooperation and intelligence sharing with other regulatory authorities and stakeholders.
R6. The Australian Government should finalise as a matter of priority reforms to aged care prudential arrangements, including to:
- · revise metrics used for assessment of Annual Prudential Compliance Statements to incorporate measures which may indicate risk to quality of care
- · introduce specific liquidity and capital requirements
- · provide greater visibility of corporate structure and related-party transactions
- · require updates to material changes in ownership or management arrangements
- · allow regulators to request updated financial information at any time.
R7. Approved providers that do not meet the specified liquidity and capital requirements be automatically placed on a watch list and required to submit a detailed plan to rectify the situation.
R8. Approved providers should be required to report to regulators the financial information of:
- · any related parties providing guarantees for the approved provider
- · any organisation sub-contracted to manage the delivery of aged care services.
R9. Update the Governance Standard in the Fees and Payments Principles 2014 (No. 2) to require approved providers to assess on a quarterly basis their liquidity and ability to continue as a going concern. This should extend to any sub-contractor responsible for the management of care services.
R10. Clarify that the requirement in section 9-1 of the Aged Care Act 1997 to advise aged care regulators of material changes would apply to any identified issues about an approved provider’s ability to continue as a going concern.
R11. Ensure aged care regulators have the capacity to understand risks to quality of care that might arise from an approved provider’s financial or contractual arrangements, including by:
- · increasing the capacity of aged care regulators to effectively scrutinise financial information.
- · providing the Quality and Safety Commission with the capacity to include people with expertise in contracts and accounting in the team undertaking assessment contacts where there is an indication that there are risks associated with the approved provider’s financial or contractual arrangements.
R12. The Australian Government make available business or financial advisory services to providers who voluntarily disclose significant financial and/ or contractual risks which may impact on the stability of service delivery.
R13. The Australian Government amend the Aged Care Act so that management of care services can only be sub-contracted to an approved provider.
R14. The Aged Care Act be amended to require notification of sub-contracting of management of care and/or sale of a business with approved provider status before they take effect.
R15. The amended Act require the Secretary of the Department of Health to consider whether the proposed arrangement is in the best interest of care recipients and provide the power to veto the arrangements.
R16. The Australian Government revisit the requirement for approved providers to report changes in key personnel.
R17. The Australian Government introduce provisions to allow the disqualification of specific individuals from acting as key personnel of an approved provider.
R18. The risk profiling tool being developed for use by the Quality and Safety Commission should consider:
- · the responsiveness of approved providers to feedback from consumers and the manner of their response to identified cases of non-compliance
- · the nature of any sub-contracting arrangement in relation to management of care services
- · the relationship between parties responsible for care, especially when management of care services has been sub-contracted
- · intelligence from other regulators.
R19. The Australian Government amend the Aged Care Act so that an additional alternative to revocation of approved provider status is an undertaking to sell the approved provider company and/ or specific services under its control.
R20. Residents of aged care facilities should only be evacuated in life-threatening situations (such as fire or flood).
R21. The Department of Health should develop a response plan for emerging situations where there is risk of an imminent collapse in the provision of aged care services (the plan).
- · The plan should include provision for rapid access to resources to assist in stabilising service provision.
- · The plan should be communicated to all aged care providers to encourage early notification to the Commonwealth and to state/ territory governments.
R22. Aged care regulators should have the power to appoint an independent manager to stabilise an aged care service at imminent risk of collapse.
R23. There should be agreed protocols between the Commonwealth and each state and territory for situations involving the imminent collapse of service provision at residential aged care facilities.
- · The protocols should clearly allocate decision-making authority depending on the nature of the situation.
- · The basic premise of these protocols should be that evacuation from a residential aged care facility should only take place in a life threatening situation because the process of evacuation can itself be life threatening.
12 November 2019.