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What it’s like for people inside the aged care system

Only around one-quarter of the people living in a residential aged care facility or receiving a home care package feel that their care needs are always met, according to new surveys by the National Ageing Research Institute (NARI). The share of people with care needs at least 'mostly' met is 39.0% in residential care and 32.5% in home care. Care needs are met only 'sometimes', 'rarely' or 'never' for 33.4% of people in residential care and 44.1% in home care. The share of people with care needs met 'sometimes', rarely' or 'never' are even higher among people who use aged care respite services.

The surveys were undertaken by the NARI for the Royal Commission into Aged Care Quality and Safety. The findings are presented in Research Paper 13 – Inside the system: aged care residents' perspectives and Research Paper 14 – Inside the system: home and respite care clients' perspectives.

In the surveys people identified concerns across many areas of their aged care. Aged care facility residents are most commonly concerned about staffing, which includes lack of staff, call bells not being answered, high rates of staff turnover, inadequate training, and agency staff not knowing the resident or their needs. The most common area of concern for people receiving a home care package is finance and administration, which includes lack of value-for-money, fee transparency, service coordination and rostering.

NARI's reports say many of the concerns that people have about their aged care are not raised as an official complaint or even informally because they do not think anything will change, the concerns are seen as too minor, they do not want to be a nuisance, or they are not sure who to report to. Of the concerns that are raised officially, less than 1% are raised with the Aged Care Quality and Safety Commission, and less than half are resolved to the satisfaction of the care recipient.

The authors note that the survey results provide a benchmark that can be used to monitor the progress of aged care reforms over time and ensure public awareness is maintained.

The research paper was prepared for the information of the Royal Commission and the public. Any views expressed in it are not necessarily the views of the Commissioners.

To read the Royal Commission's research papers, please visit the publications page.

Table 1: How often clients felt their care needs were met in different areas of aged care

Care type

% of clients answering in all areas#

'always' in all areas

at least 'mostly' in all areas*

'sometimes' or less in any area

Residential care clients




HCP clients




CHSP respite clients




Residential respite clients




# The areas included are: (1) respect and dignity; (2) being supported to make decisions about the care and services received; (3) receiving care from staff with appropriate skills and training; (4) receiving the services and support important for health and wellbeing; and (5) support to maintain social relationships and community connections. Complaints are not included in this table as they are a response to an unmet need. All percentages exclude 'don't know' answers.

* Excludes clients in the column 'always' in all areas so columns are all mutually exclusive and equate to 100% across the row.

Figure 1: The most common areas in which respondents identified concerns

Figure 1 continued

Figure 2: Reporting and resolution of main concerns by care type