Staff ratios emerge as key issue as Royal Commission into Aged Care begins

More than half of the 300 public submissions already received by the Royal Commission into Aged Care have raised concerns about substandard or unsafe care and staffing issues, including staff ratios, evidence at the opening hearing of the inquiry into Australia’s aged care system has revealed.

About 81% of the public submissions detailed concerns over the provision of care in residential aged care facilities.

The findings were unveiled last week in Adelaide as part of the preliminary hearing of the Royal Commission into Aged Care Quality and Safety established last October.

In her statement at the hearing, Commissioner Lynelle Briggs said the inquiry would examine existing policy, regulations and practices in order to deliver better outcomes to those receiving aged care amid “a rising torrent of concern that the aged care system is faltering in certain areas of safety and quality” and that it may not be “fit for purpose”.

She said likely major themes to be examined by the Royal Commission include quality and safety, young people with a disability, future challenges and opportunities and workforce implications.

The largest 100 aged care providers were asked to make submissions to the Royal Commission by 7 January and the remainder by 8 February detailing information about incidents since 2013 where their facility provided substandard care, including cases of mistreatment and all forms of abuse.

To date, responses have been received by 83 providers relating to about 2000 facilities.

Initial analysis shows most complaints and incidents related to residential care.

The most common incidents reported surrounded elder abuse, medication mismanagement, issues of food safety and not responding in a timely manner to residents requiring assistance.

Commissioner Richard Tracey labelled the Royal Commission a “once-in-a-lifetime opportunity” for the nation to come together to create a better system of care for elderly Australians.

“The hallmark of a civilised society is how it treats its most vulnerable people, and our elderly are often amongst our most physically, emotionally and financially vulnerable,” Commissioner Tracey said.

The preliminary hearing heard the Royal Commission, which is required to submit an interim report by October this year and a final report by April 2020, will conduct public hearings across all capital cities as well as some regional centres throughout 2019 and into next year.

The public hearings will be bolstered by visits to facilities, roundtables and community consultations, with the investigative body focusing on reforming Australia’s aged care system to ensure quality care for people receiving care now and in the future.

Commissioner Tracey said public hearings would form an important part of the investigation over the course of this year and that submissions had the potential to lead to real improvements in the lives of older Australians.

The Commission is still seeking submissions, which can be made anonymously or confidentially.

About 5000 submissions were made to the Department of Health prior to the Terms of Reference of the Royal Commission being announced and the insights will be treated as submissions when fully examined in the near future.

The first substantive public hearing will be held on 11 February in Adelaide and continue into the week of 18 February.

Commissioners will have a number of compulsory powers at their disposal as part of the information gathering process, including being able to issue notices requiring individuals to give information or a statement in writing, a first for Royal Commissions.

Commissioner Tracey said the commission wanted to hear from a wide range of people directly receiving aged care services, families, carers and members of the aged care workforce.

He warned that it would be illegal for an employer to take punitive action against an employee or former employee who assists the commission.

“We would be gravely concerned if any operators in the aged care sector or government bodies were to instruct their staff not to talk to the Royal Commission or to withhold information from us,” he said.

Counsel assisting the Royal Commission also addressed last week’s preliminary hearing.

Peter Gray QC told commissioners the Letters Patent “expressly acknowledge the dedication of many thousands of those engaged in the aged care workforce and the critical role of those people in delivering high quality aged care”.

Australia’s elderly deserve high quality and safe care that protects their wellbeing and respects their dignity, and while there are many dedicated people working in the aged care sector, systemic failings must be examined and understood in order to move forward, he added.

Dr Timothy McEvoy QC said the first-hand perspective of people receiving care would be central to the inquiry as public hearings get underway.

Staff ratios was identified as a leading issue to be examined.

Other issues include young people living with a disability in aged care, access to aged care for Indigenous Australians and LGBTI Australians, person-centred care, future challenges and sustainable investment in workforce and infrastructure.

The Australian Nursing and Midwifery Federation (ANMF) is currently preparing its submission to the Royal Commission and will inform members in the coming weeks on how they can get involved.

For more information on how to make a submission or to follow the Royal Commission into Aged Care, visit

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