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Royal Commission Final Report

The final report of the Royal Commission into Aged Care Quality and Safety was tabled on 1 March 2021. The Final Report: Care, Dignity and Respect comprises five volumes covering: Summary and recommendations; The current system; The new system; Hearing overviews and case studies; and Appendices. 

In total, the Royal Commissioners made 148 wide-ranging recommendations for the fundamental reform of the aged care system. They included:

  • A rights-based Aged Care Act and a system responsive to the needs of the individual
  • An integrated system for the long-term support and care of older people and their ongoing community engagement
  • Comprehensive changes to governance and accountability of the system
  • 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
  • Changes to information access and provision
  • A more restorative and preventative approach to care, with increased access to allied health care in both home and residential aged care
  • An Aboriginal and Torres Strait Islander aged care pathway
  • Improved access to health care for older people, including a new primary care model and access to multidisciplinary outreach services
  • 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
  • Comprehensive workforce proposals including aged care workforce professionalization, registration of personal care workers, minimum quality and safety standard for staff time
  • Funding to meet the actual cost of high-quality care and an independent Pricing Authority to determine the costs of delivering it.

Importantly, the report also recognises that ageing inevitably associates with dying. This is not to say that preventative, restorative, and rehabilitative approaches are not essential, but the report acknowledges the reality of end of life and the need to address the care needs of older Australians for whom end of life is a reality.

Compulsory palliative care training for workers and comprehensive sector funding that specifically includes palliative and end-of-life care are among 124 recommendations. The tone and intent of the report sees that palliative and end-of-life care, like dementia care, needs to be considered as core business for aged care providers. Many of these recommendations has been presaged in the interim report but have been detailed and addressed in detail in the final report.

The Federal Government made a preliminary response after the initial tabling of the report providing extra funding while anticipating a formal response built around five pillars:

  1. Supporting older Australians who choose to access Home Care
  2. Quality and safety in residential aged care delivers dignity alongside care
  3. Investing to drive improvements in residential aged care Services and Sustainability
  4. Workforce: growing a passionate and skilled aged care workforce
  5. Governance: oversight, standards and accountability – a new era.

The formal response of the Australian Government to the final report of the Royal Commission into Aged Care Quality and Safety was delivered in May 2021. The Government agreed with the Commissioners that strong action is needed for fundamental and ambitious reforms. The 2021–22 Federal Budget included significant elements that addressed the response to the Royal Commission’s final report. The proposed $17.7 billion aged care reform package is designed to deliver sustainable quality and safety in home and residential aged care services.

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Page updated 13 May 2021