Report on the quality of care in residential aged care facilities

The House of Representatives, Health, Aged Care and Sport Committee today presented its Report on the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia.


The inquiry examined the delivery and regulation of the current aged care system and the prevalence of mistreatment.


The Committee Chair, Mr Trent Zimmerman MP, stated that ‘while many Australians experience high quality aged care, the community is justifiably concerned about the many examples of abuse and mistreatment that have been exposed through recent inquiries and reporting.’


‘Our Committee received submissions from many residents and family members which outlined harrowing examples of mistreatment. This is not good enough for a nation like Australia.’


‘Australia’s population is ageing, which will inevitably lead to more demand for residential aged care places. It is vital that there is an aged care system in place which has the confidence of consumers, is able to respond to changing expectations of care, and which responds effectively to any instance of mistreatment.’


‘As the inquiry was nearing its end, the Australian Government announced a Royal Commission into Aged Care Quality and Safety. The Committee has welcomed this announcement and other recent government measures to improve the provision of aged care services. At the same time, the Committee considers that the Royal Commission should not delay the implementation of improvements recommended in this Report and other recent reviews,’ Mr Zimmerman said.


The report made 14 recommendations:


Recommendation 1

2.173  The Committee recommends that the Department of Health develop national guidelines for the Community Visitors Scheme, including policies for volunteer visitors to follow in the event of observed or suspected abuse or neglect.


Recommendation 2

2.174  The Committee recommends the Australian Government review:

  •  the Aged Care Funding Instrument (ACFI) to ensure that it is providing for adequate levels of care for the individual needs of aged care recipients;
  •  the adequacy of funding levels to ensure ACFI funding is indexed annually; and
  •  the range of penalties relating to breaches of ACFI funding standards by aged care providers.

Recommendation 3

2.175  The Committee recommends that the Australian Government review the Medicare Benefits Schedule relating to medical practitioner visits to residential aged care facilities.


Recommendation 4

2.176  The Committee recommends that the Australian Government:

  •  legislate to ensure that residential aged care facilities provide for a minimum of one Registered Nurse to be on site at all times; and
  •  specifically monitor and report on the correlation between standards of care (including complaints and findings of elder abuse) and staffing mixes to guide further decisions in relation to staffing requirements.


Recommendation 5

2.177  The Committee recommends that the Department of Health ensure consumer information, including the Charter of Rights, for aged care residents and their families is available in a wider range of languages to ensure better access for those from culturally and linguistically diverse backgrounds.


Recommendation 6

2.178  The Committee recommends that an independent review and a parliamentary inquiry (by the appropriate Committee) be undertaken into the Aged Care Quality and Safety Commission after two years to determine its effectiveness in ensuring high standards of care, best clinical practice and reducing mistreatment.


Recommendation 7

2.179  The Committee reiterates and supports the recommendation from the Carnell-Paterson Review for the current to move to unannounced audits in residential aged care facilities and that any unannounced visits to residential aged care facilities should not be confined to business hours.


Recommendation 8

3.178  The Committee recommends that the reportable assault ‘resident-on-resident’ exemption, in which assaults committed by a resident with a cognitive impairment are not required to be reported to the Department of Health, be removed.


Recommendation 9

3.179  The Committee recommends that the National Aged Care Quality Indicator Program (the Program):

  •  be made mandatory for providers of Australian Government-funded residential aged care services; and
  •  be expanded to include a broader range of key indicators, to be determined with the involvement of the aged care sector and consumer groups.


Recommendation 10

3.180  The Committee recommends that the Australian Government amend the Aged Care Act 1997 to legislate that:

  •  the use of restrictive practices in residential aged care facilities be limited to the ‘least restrictive’ and be a measure of last resort only;
  •  any use of restrictive practices within the legislated meaning be recorded by providers and collected by the Department of Health;
  •  restrictive practices are only to be used after a medical practitioner has prescribed/recommended such use; and
  •  the legal guardian and/or family member must be advised immediately.


Recommendation 11

4.115  The Committee recommends that the Department of Health work with the aged care sector to implement a rating system (for example, a star or point rating system) for residential aged care facilities, and develop an action plan for how such a system could be implemented.


Recommendation 12

4.116  The Committee recommends that that the public be provided with information through the My Aged Care website regarding the number of complaints and reportable incidents that have been lodged, responded to and resolved, and the number of complainants, at individual aged care facilities.


Recommendation 13

4.117   The Committee recommends that the Australian Government examine ways to ensure all consumers have access to the Older Persons Advocacy Network (OPAN) advisory services, and include in consumer experience reports the providers that refuse OPAN access to their facilities.


Recommendation 14

4.118   The Committee recommends that the Australian Government agencies responsible for the delivery of aged care services commit to a more consumer-oriented focus, with greater, and more transparent, consumer involvement in the delivery of aged care services.


The Report, "Report on the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia" is available at:


22 October 2018.