This inquiry was initially established in June 2017 in response to incidents of poor quality care and abuse of residents at the Makk and McLeay wards of the Oakden Older Persons Mental Health Facility (Oakden) in South Australia (SA). These two wards were classified as aged care facilities, and were therefore regulated by the Commonwealth aged care regulation frameworks. The inquiry was intended to review the critical care failures at Oakden in relation to the level of accountability that may lie with the Commonwealth aged care regulatory frameworks, which have a responsibility to ensure vulnerable aged Australians receive quality care and are protected from abuse.

The tragic incidents at Oakden have been used as a spotlight on aged care, and were recently described by the newly appointed Aged Care Quality and Safety Commissioner as 'a shock wave' which sent a 'wake-up call' to providers and to consumers but also to the regulators, and that sent people to look at regulation best practice...in a more searching fashion.

However the view that the regulator and provider responses to Oakden were swift and searching is not supported by other events. In the nearly two years since the incidents at Oakden became public, much more evidence has come to light of poor care, service provider non-compliance and regulatory failures, and the Australian Government is now undertaking a Royal Commission into aged care due to 'non-compliance and abuses and failures of care'.

During the course of the inquiry, the Senate Community Affairs References Committee (committee) was presented with compelling evidence which pointed to systemic issues that negatively impact the quality of aged care services, not only at Oakden but throughout Australia. This evidence pointed to failures of care within residential aged care facilities (RACFs) across a range of different areas, from personal and clinical care standards, nutrition and social inclusion, to rehabilitation and palliative care.

This inquiry has taken close to two years to come to completion. During that time there has been a significant shake-up in how RACFs operate and are overseen, and aged care has since been placed forefront in the national agenda through the establishment of a Royal Commission.

As noted in the interim report, the number of recent reviews and inquiries into various aspects of aged care service delivery is a compelling argument that the regulatory system is failing to provide adequate oversight of the aged care sector. However, it is important to assess the likely impacts of the significant reforms undertaken and still underway to establish whether these changes are likely to be successful in resolving ongoing clinical care issues in the RACF sector.

Following this introductory chapter, this report consists of four subsequent chapters:

• Chapter two discusses the delivery of clinical care within the residential aged care context, providing an overview of what is clinical care, who delivers clinical care, and who has responsibility for the standards of clinical care;
• Chapter three discusses the regulation of clinical care within RACFs in its current form, noting the recent reforms to the regulator and the aged care standards and outlining the continuing concerns of stakeholders;
• Chapter four discusses the intersection of aged care with external allied health, primary health and acute care sectors; and  chapter five contains the committee's concluding comments and recommendations.