Royal Commission NARI responds to the Final Report of the Royal Commission into Aged Care Quality and Safety 12 March 2021 NARI welcomes the Final Report of the Royal Commission into Aged Care Quality and Safety. Overall, it provides a strong roadmap for much needed reform of aged care in Australia. NARI is particularly pleased to note the emphasis on a rights based, entitlement approach to care, centred on the older person. We believe it is essential for older people to be part of the reform process and support Commissioner Brigg’s recommendation for a Council of Elders to advise the Minister and Department on any aspect of aged care (Recommendation 9). We note that a monumental amount of work has gone into the final report and the 148 recommendations, including the over 10,500 submissions and 640 witnesses. Many of these were people with lived experience of aged care who told harrowing stories of neglect and abuse. NARI’s research, commissioned by the Royal Commission, found one in three people in residential care reported their care needs were only sometimes met and at least three in every five respondents had one or more main concerns either directly or indirectly indicative of substandard care. It is critically important therefore for government to carefully consider the many recommendations about quality of care (including a duty to provide high quality and safe care enshrined in the new Act), navigation of the system and designing for the full diversity of older people. There is clearly a need for stronger governance and regulation and improved funding mechanisms and transparency across the aged care sector. To improve quality of care, it will also be essential to increase access to appropriately skilled staff, especially for people living in residential care, so it is good to see recommendations about increased staffing, particularly nursing allocations. Fundamental workforce reforms in dementia care are also needed to ensure a properly skilled, adequately remunerated workforce. Recognition of dementia care being core business for aged care is an important step towards greater equity of access to quality care for people with dementia. There are welcome recommendations about increased integration between health and aged care systems, including better access to allied health and primary care. These reforms, taken together should improve the experience of care for both residential and community care service recipients and restore some degree of trust in the system. This is especially important for people living with dementia and their family carers. We support the recommendation for an Aged Care Research Council to be established as there is an important role for research to drive best practice in the sector. As both Commissioners recommend, this research should be co-designed with older people, industry partners, and government to ensure that it is practical and meets their needs and priorities. This research should extend rather than replace or duplicate, existing efforts, including NARI’s current program of work in healthy ageing, clinical care and health and aged care systems. Research should also respond to the current and future needs of Australia’s older populations, including planning for a third demographic transition and continuously focusing on equitable access to safe and high quality care. NARI is concerned that the Commissioners could not reach agreement on the fundamental governance structure for aged care in Australia and hope that this will not prevent progress of the reforms. Given the clear need for reform and the extent of investment (both financial and emotional) that has gone in to producing this report, we call on the government to act swiftly and comprehensively to capitalise on this “once in a generation” opportunity to design and provide a fit-for-purpose aged care system of which all Australians can be proud.