In this report, titled Care, Dignity and Respect, the two Royal Commissioners, Tony Pagone QC and Lynelle Briggs AO, call for fundamental reform of the aged care system in Australia.

For too long, they say, the legislation that governs aged care in Australia has focused on the funding requirements of aged care providers rather than the care needs of older people. They propose a clearly articulated purpose for the new aged care system.

• Volume 1 provides the background to the Royal Commission’s inquiry, explains how it was conducted, presents a summary of the final report and lists all recommendations made.
• Volume 2 explores the current aged care system, problems of access, the nature and extent of substandard care and other systemic problems.
• Volume 3 outlines a new system for aged care, addressing access, governance, financing, workforce, Aboriginal and Torres Strait Islanders, regional, rural and remote Australia, disability, younger people in aged care, and more.
• Volume 4 provides a summary of Royal Commission hearings, held in centres across Australia, where themes, such as the use of restraints, end-of-life care and workforce matters in aged care were explored.
• Volume 5 comprises appendices including lists of witnesses, overviews of community forums, commissioned reports, a summary of the Commissioners’ international research, service provider visits, and more.

Key recommendations:

• A new Aged Care Act that puts older people first, enshrining their rights and providing a universal entitlement for high quality and safe care based on assessed need.
• An Inspector-General of Aged Care to identify and investigate systemic issues and to publish reports of its findings.
• A plan to deliver, measure and report on high quality aged care, including independent standard-setting, a general duty on aged care providers to ensure quality and safe care, and a comprehensive approach to quality measurement, reporting and star ratings.
• A new aged care program that is responsive to individual circumstances and provides an intuitive care structure, including social supports, respite care, assistive technology and home modification, care at home and residential care. In particular, the new program will provide greater access to care at home, including clearing the home care waiting list.
• Equity of access to services for older people with disability and measures to ensure younger people do not enter or remain in residential aged care.
• A minimum quality and safety standard for staff time in residential aged care, including an appropriate skills mix and daily minimum staff time for registered nurses, enrolled nurses and personal care workers for each resident, and at least one registered nurse on site at all times.
• A simpler and fairer approach to personal contributions and means testing, including removal of co-contributions toward care, reducing the high effective marginal tax rates that apply to many people receiving residential aged care, and phasing out Refundable Accommodation Deposits.
• Financing arrangements drawing on a new aged care levy to deliver appropriate funding on a sustainable basis.