A distraught 92-year old woman and a disoriented elderly man were among residents caught up in the middle of chaotic scenes during a recent emergency evacuation of a Gold Coast nursing home, the Brisbane Hearing of the Aged Care Royal Commission heard this week.

The sudden closure of the Earle Haven Retirement Village in Nerang resulted in 68 residents being forced to evacuate with the help of state emergency response services following a 000 call onsite on 11 July.

Frail residents, many with dementia, were transferred to other nursing homes and hospitals until the early hours of the following morning, causing distress to residents and their families, the Royal Commission was told.

The Commission heard the aged care provider had a history of poor compliance and had raised “serious red flags”.

People Care, an approved provider for 89 residential care beds, contracted the services of Help Street to manage the residential facilities and employ staff.

Relations between People Care and Help Street deteriorated by March 2019, the Royal Commission heard.

The dispute escalated on 10 July when Help Street CEO Kristofer Bunker requested $3 million from the provider by midday 11 July for breach of contract.

Earle Haven owner Arthur Miller had given the contractor a month’s notice, ending 9 August.

Witness testimony varied on when the decision was made to leave the premises but by 11 July or possibly earlier, Help Street was removing computer equipment from the facilities at Earle Haven, which contained electronic care plans and records for residents.

Earle Haven clinical manager Telecia Tuccori, who placed the 000 call to evacuate residents, was questioned on whether she realised the magnitude of the prospect of there being no staff at Help Street to look after the 70-odd residents.

“It was quite panicky. I was sort of hoping it was just a possibility and it wasn’t going to come to that, but yes,” she said.

Paramedic and senior operations manager for Queensland Ambulance Service, Cary Strong, arrived at 2.13pm to “quite a number of people having a verbal confrontation”.

He said he initially couldn’t identify who was in charge.

“There was a number of vehicles in the driveway, one of those being a removalist truck and a small ute. Due to the tightness of that area, I actually parked in behind.

“The place was in administration, the staff had left. I ascertained that there was a possibility of 69 residents, 40 in Hibiscus, 29 in Orchard and the possibility of anywhere from 20 to 25 in the independent living area that may need to be transported or relocated.

“Going on a ratio of patient care, nine staff to a possibility of 69 patients, I didn’t believe that to be safe and that’s when I actually asked for further ambulance resources to be responded.”

A QAS incident management team, as well as two RNs from QLD Health and a critical-incident team responded.

Earle Haven nurse administrator Karen Heard, an external consultant employed by People Care, said it “was very chaotic.”

“When I drove through the gates of Earle Haven, there were up to – eight to 10 ambulances. There was quite a lot of people out the front of Hibiscus House. It was very disorganised.”

A 92-year old lady was very distressed, very disorientated and crying, Mr Strong added.

“Her daughter was there; she was crying as well, trying to get the elderly lady to settle down and comfort her, and she just kept crying and screaming that – she thought her daughter was her mother and kept referring to her as her mother to – ‘Please stop this’….She was deemed not safe to be transported to another nursing facility so therefore was transported to a public hospital.”

“And there was an elderly tall gentleman who became very disoriented, became what you’d call – if you didn’t know dementia, would be seen to be aggressive, raising his voice, raising his hands, very emotional about what’s happening around him.”

The Commission heard People Care experienced a history of poor compliance and “serious red flags” since its approval as an aged care provider back in 2006.

A risk report in 2007 indicated serious doubts about its ability to deliver aged care given failings around personnel and recruitment of unqualified staff.

Evidence presented at the Royal Commission showed People Care had a history of reasonably persistent and quite serious non-compliance as at February 2016.

The aged care provider was monitored closely by the department and the agency in 2016, including attempts to make it compliant with quality standards.

Sanctions required People Care to appoint a nurse adviser in 2016 who intended to cease services.

“From its approval in 2006 as a provider of community, flexible and residential care, People Care appears to have had a poor compliance record, raising potential red flags about governance and management capacity,” said Senior Counsel Assisting, Peter Gray QC.

The Royal Commission’s focus was risks presented by the outsourcing arrangement, Commissioner Richard Tracey said.

“The focus of our inquiry today is on the regulatory system, whether all was done by regulators that should have been done and whether the system itself is appropriately designed to address risks of the kind that eventuated at Earle Haven.”