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5 years on: the state of home care since the Royal Commission into Aged Care Quality and Safety 

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The Royal Commission into Aged Care Quality and Safety established a blueprint and vision for the future of aged care in Australia.  

The Royal Commission was established in 2018 to respond to growing concerns about the state of aged care in Australia. It investigated issues, such as neglect and systemic failures, that may be impacting the wellbeing and dignity of elderly Australians.  

The final report by the commission outlines 148 recommendations to be implemented over a 10-year period, promising a revolution in aged and community care. 

Five years after the Royal Commission began, we’re roughly halfway along the government roadmap of reforms. With the release of the Intergenerational Report 2023 (IGR 23) and the 2024 Aged Care Task Force Report, prompted by the findings of the Royal Commission, we’re getting a clearer idea of the rise in demands in the home care sector that the industry needs to address. 

We’ve delved into these reports to summarise their implications for the home care sector. But before we share those, we need to take a step back to look at some of the recommendations the royal commission outlined. 

Royal Commission into Aged Care Quality and Safety recommendations 

Australia launched the Royal Commission into Aged Care Quality and Safety to investigate the current state of care in Australia, find solutions for tomorrow, and provide recommendations to improve the quality and safety of care provided. 

The recommendations cover a wide range of areas, from quality and safety standards to stipulations on how to improve person-centred care. 

Some of the most impactful recommendations currently in development for the home care sector include: 

  • Recommendation 1: A call for a New Aged Care Act which is currently in draft form. This outlines the protections and entitlements for the aged population. 
  • Recommendations 2 & 3: An outline of the rights of older people and the key principles under which care is delivered.  
  • Recommendations 18 & 19: Recommendations for the revision and improvement of the Aged Care Quality and Safety Standards also currently in draft form, and the inclusion of Quality Indicators and Star Ratings for quality improvements. 
  • Recommendation 25: A new Home Care Packages Program which currently has a proposed two-stage implementation plan, the first of which will commence 1 July 2025. 
  • Recommendation 28: A single assessment process replacing the Aged Care Assessment Program and the Regional Assessment Services with one assessment process. 

Progress toward Royal Commission recommendations 

As a result of the recommendations, there have been many reforms and trends within the aged care space in Australia. 

The following points outline the current developments and changes being made in aged care in Australia. These changes have been either directly or indirectly influenced by the Royal Commission into Aged Care Quality and Safety. 

These reforms are constantly being implemented and updated, with many becoming effective from July 2025. As a provider, being ready for these revolutionary changes is imperative to remaining competitive, compliant, and sustainable.  

Changing and upcoming legislation and regulations 

  • The New Aged Care Act makes access to the aged care system easier and fairer. It provides a new approach to regulating providers and strengthens the powers of the regulator for safe and quality services. This has been delayed from its initial commencement date of 1 July 2024, with some predicting it may now commence from July 2025.
  • A new regulatory framework is to be rolled out subject to the New Aged Care Act coming into force. This supports reforms, including the expansion of the Quality Indicator program, where providers will need to report on specific metrics for in-home services. 
  • A new Single Assessment system is planned to be implemented from 1 July 2024. This has been created following the Royal Commission recommendation for a singular system that can be accessed and used by multiple programs across home and residential care. This aims to prevent consumers from repeating their personal or medical history to multiple care providers. 
  • A new Support at Home Program is being implemented in two stages. The first stage is proposed to be implemented on the 1 July 2025 and will merge two current programs, the Home Care Packages (HCP) Program and the Short-Term Restorative Care (STRC) Program. The second stage will occur after 1 July 2027 and will include incorporation of the Commonwealth Home Support Program (CHSP). 

Stronger governance and accountability 

  • Stronger provider governance is already being implemented in the home care space (except for those under grant agreements such as the Commonwealth Home Support Program) to address Royal Commission recommendations. These relate to current quality standards on feedback and complaints, quality staffing, and providing a high standard of service delivery. This governance creates greater transparency and accountability relating to provider complaints, feedback, staffing and services and provider governance.  
  • The Independent Health and Aged Care Pricing Authority (IHACPA), formally known as the hospital pricing regulator, now includes aged care. This means that the Independent Health and Aged Care Pricing Authority can now provide annual advice to the government on future home care pricing under the new Support at Home Program when it’s implemented. This aims to improve the quality of pricing, as well as the sector’s financial viability, to meet service delivery costs. 
     
  • A recent KPMG report of the aged care sector predicts increasing consolidation of aged care businesses through mergers and acquisitions. Despite this, there is also increased competition as the sector continually grows. 
  • The National Worker Registration Scheme is being implemented over a five-year period. This is a framework for regulation and screening which includes alignment with the National Disability and Insurance Scheme (NDIS) to create a nationally consistent approach to assessing and monitoring workers. This worker screening is planned to be effective from 1 July 2024. 

Deeper insights into the current state of Australian aged care  

There has been a large amount of progress in the industry following the Royal Commission into Aged Care Quality and Safety. 

Two reports have provided a deeper understanding of the current state of the aged care industry in 2024. These are the Intergenerational Report (IGR 23), published in 2023, and the Aged Care Task Force report, published in 2024. 

What is the Intergenerational Report 2023? 

The IGR 23 is the sixth such government report since 2002. The report looks at the outlooks for the Australian economy and Australian government budgets over the next forty years, based on demographic, technological and structural trends that will affect the government, its sustainability, and its policies.  

Some of the key focus areas of the IGR 2023 report are Australia’s ageing population, the expanded use of digital and data technology, and the rising demand for care and support services. The report also examines the need to sustainably provide these essential services. 

What is the Aged Care Task Force report? 

The Aged Care Task Force was comprised of sixteen members from diverse but relevant backgrounds including banking, finance, aged care providers and participants in the aged care sector. It was chaired by the Minister for Aged Care and Sport, the Hon Anika Wells MP.  

The Government established the task force to build on the work of the Royal Commission into Aged Care Quality and Safety to ensure the sector can meet forthcoming increasing financial demands. It advises on funding arrangements to meet sector challenges and to ensure that funding is predictable, sustainable, and will support innovations in care. 

The Final Report by the task force was released in March 2024. The report outlines recommendations and options for person-centred funding with means-based equitable access and co-contributions. It also outlines sustainable, predictable, and consistent funding options for providers. 

Both reports highlight the impact of an ageing population on the elderly care system.  

Although each report was born from different government bodies and intended for different purposes, both emphasise the need for the reforms recommended by the Royal Commission in Aged Care Quality and Safety. 

What do the reports and the Royal Commission tell us about the future of home care in Australia? 

Australians have a firm desire to stay at home as long as possible as we age according to the IGR 23 and the Aged Care Task Force report. 

The IGR 23 highlighted that the population over 65 years old is predicted to double over the next forty years, and the number of people over 85 years old will triple. As life expectancy continues to increase and people stay in their homes longer, both reports emphasise that there is a greater need to be able to support our ageing population. 

With five more years to go in the Royal Commission’s 10-year roadmap, what does the current progress and insights mean for the future of home care? 

Home care demands will continue to rise 

The Aged Care Task Force predicts that over the next twenty years, older people using home care will double from one to two million.  

The Aged Care Task Force Report, the IGR 23, and the Royal Commission itself predict that government spending on aged care as a proportion of gross domestic product (GDP) will also grow, at the same time as Australia’s old-age dependency ratio (the number of people over 65 years old vs working-aged people under 65) will increase (1). 

The Aged Care Task Force report highlights the need for increased services to meet this demand, stating, “as the home care sector grows in scale, there is a need to ensure it is on a stable footing with capacity to scale services and support quality of life for older people.”  

The IGR 23 agrees that the sector will grow as the population expands to over forty million by 2063. However, it suggests growth will be at a slower rate than previously. It does emphasise the need to provide sustainable essential services to meet the rising demand for care and support requirements.  

With these insights, it is clear the homecare sector must continue to rapidly expand to meet the mounting needs of this ageing population. 

The shift to a service-based economy 

Over the past forty years, the economy has shifted from 26% of roles being in manufacturing, mining, and agriculture, to now only 10%. At the same time, we have seen service-related jobs rising to 90%.  

Added to this, the number of workers in the care sector specifically is predicted to double over the next forty years. 

This comes at a time when the active working population is declining, and the support services needed to sustain both older Australians and the disabled is increasing. This puts a large amount of pressure on the sector to not only grow, but to be increasingly productive and efficient as well.  

This is good news for job seekers, as roles in the sector are predicted to expand by 22% over the next decade (2). But new roles alone will not be able to meet the increasing demands in the sector.  

Technology is proposed to improve productivity and ease the increasing demands on the industry by the IGR 23 and the Aged Care Task Force report. This is already happening, with modern technologies making it possible to automate repetitive tasks, improve efficiency and prioritise sustainability.  

What does this mean for your home care company? 

These reports emphasise that high demands on the sector will continue. Government reforms, a tight labour market with increasing competition between providers for staff, and a new funding model all make it essential for providers to focus on productivity and resilience.  

While the foundations of excellent quality care will of course remain at the centre of providers’ focus, those who embrace change and innovation will tackle the shifting landscape much more easily.  

This is a time for providers to build capacity with a partner who can support you to navigate the fluctuations of these reforms. 

How AlayaCare helps you navigate the reforms 

Technology is the key component to delivering quality client care while remaining resilient in the face of enormous change.  

AlayaCare can partner with you to meet these challenges with a robust end-to-end platform for the disability and community services sector that offers improved efficiencies, reduction of repetitive tasks and increased analytical insights.  

We are a modern, configurable, and interoperable platform spanning clinical documentation, mobile care worker functionality and scheduling. We help your organisation: 

  • Streamline and optimise operations 
  • Gain real-time access to data 
  • Gain access to specialised tools through a seamless ecosystem 
  • Revolutionise your care delivery 

We prioritise investment in research and development to meet the industry’s transformational needs.  

Learn more about how our dedicated Australian team can help your organisation improve outcomes and navigate emerging changes in the sector.  


Footnotes

(1) 26.6% to 38.2%: The projected increase in Australia’s old-age dependency ratio from 2022-23 to 2062-63, indicating a significant growth in the proportion of people aged 65 and over relative to those of traditional working age (Aged Care Taskforce Report, 12th March 2024). 

(2) 22%: The estimated employment increase for the sector over the next decade. (Detailed Occupation Projections-Personal carers and Assistants in Employment Projections | Jobs and Skills Australia) 

Sources

Australian aged care sector analysis 2023 | KPMG 

2023 Intergenerational Report 

Aged Care Quality and Safety Final Report 

Final report of the Aged Care Taskforce | Australian Government Department of Health and Aged Care 

Measuring success in the sector 

The strengthened Aged Care Quality Standards – Final draft (November 2023) 

Working Future: The Australian Government’s White Paper on Jobs and Opportunities 

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