Interim report on aged care predicts reforms needed

Gilbert + Tobin

On 31 October 2019 the Royal Commission into Aged Care Quality and Safety  released its interim report after 10 months of public inquiries on the aged care industry.

The interim report provides a narrative of the aged care landscape in Australia, structured into three volumes. Volume 1 – which contains the bulk of the report – is set out in three parts:

  • Part 1 provides a historical overview of the aged care system and previous inquiries and reforms, and considers demographic, social and economic pressures on the system.
  • Part 2 sets out persons’ experiences of the aged care system through direct evidence records and submissions.
  • Part 3 highlights several issues in the aged care system, such as the availability of information on aged care services, access to aged care, use of restraints in residential aged care, and recruitment of trained staff.

Volume 2 contains an overview of public hearings conducted by the Commission to-date, and Volume 3 contains appendices and summaries of community forums held by the Commission.

The Commission has not included specific recommendations pending its final report.

Overarching theme

The theme recurring through the Commission’s interim report is that of a system not meeting the needs of the aged population and in need of reform.

The report describes the problems that older persons and their families face in accessing aged care. It also details service shortfalls, the use of restrictive practices in aged care, the experience of the workforce, and highlights the issue of young people living in residential aged care.

What recommendations are likely to be proposed in the final report?

While it is still early days and the Commission’s recommendations will only be published in its final report, the Commission has set out its observations and early conclusions on a number of issues. These are:

  1. Improving people’s experience in navigating the aged care system and helping them to access the right service. Specifically, the Commission has indicated it will look into improving access to information to enable comparisons of available aged care services, and into improving the availability of information as to the length and progress on home care waiting lists.
  2. Considering options to address the current waiting times for Home Care Packages, which may include more localised approaches to service planning and allocation; greater transparency of the waiting list; increased flexibility in Home Care Packages; ‘uncapping supply’ of home care; combining home care with home support; and allocation of unspent funds. The Commission has also stated additional funding should be provided for Home Care Packages immediately and into the future, to ensure that supply meets community expectation.
  3. Improving the provision of aged care for Aboriginal and Torres Strait Islander people so it is delivered in ways that are flexible, adaptable and culturally safe. The Commission will also explore ways to support aged care services to be staffed and managed by Aboriginal and Torres Strait Islander people.
  4. Making recommendations on changes in the medical and operational practices utilised in residential aged care, to address the prevalence of restrictive practices (particularly the use of chemical restraints).
  5. Addressing workforce issues, including attracting and retaining staff; education and training; choosing the right staff; remuneration and careers; continuity of care; and staffing levels and staff mix.
  6. Considering solutions for younger people currently accessing aged care. The Commission has proposed that, subject to very limited exceptions, by 2022 no younger people should be entering residential aged care, and by 2025 no younger people should be living in residential aged care except for those who choose to be there.

Areas for more immediate attention

The Commission also identified three areas for more immediate attention:

  • providing more Home Care Packages to reduce the waiting list for higher level care at home;
  • responding to the over-reliance on chemical restraints in aged care; and
  • stopping the flow of younger people with disability going into aged care and speeding up the process of getting out younger people already in aged care.

Government’s response

The Government has on 25 November 2019 responded to the Commission’s report by pledging a $537 million funding package across the three priority areas identified, which will be used to:

  • increase the number of Home Care Packages;
  • improve medication management programs to reduce the use of medication as a chemical restraint on aged care residents;
  • provide training and support for aged care workers and providers; and
  • invest to help meet new targets to remove younger people from aged care.

The Government’s response can be found here:

What is next?

The Commission’s comments make clear that reforms to all aspects of the aged care industry, and not just the practices of aged care providers, will be proposed in its final report. Indeed, the Commission has flagged that it will ‘recommend comprehensive reform and major transformation of the aged care system in Australia’.

This will be welcome news to applicants facing issues accessing aged care or funding, although details as to how the changes impact them will only be clear when final specific recommendations are published. For aged care service providers, the likelihood of increased regulation and tougher accreditation and service standards following from the inquiry, may result in providers facing increased capital and operating cost requirements. We could potentially see consolidation in the sector and investment opportunities could present themselves for potential investors, as the impact of the Commission becomes clearer over time.

However, the Commission is still midway through its inquiry and implications arising from its inquiry will only be clear when its final report is issued (the final report is due in November 2020). In the meantime, the interim report sends a clear signal that the aged care sector will likely see comprehensive and significant changes over the next few years.

More information about the Aged Care Royal Commission can be found here: