11.1       Older people in receipt of aged care—whether in the home or in residential aged care—may experience abuse or neglect. Abuse may be committed by paid staff, other residents in residential care settings, or family members or friends.

11.2       There are a range of existing processes in aged care through which the quality and safety of aged care is monitored. This chapter identifies these, as well as making a number of proposals for reforms to aged care laws and legal frameworks to enhance safeguards against abuse for older people in receipt of aged care. The proposals are in keeping with the broader direction of reform in aged care, which seeks to provide a more flexible aged care system for consumers of aged care, while focusing regulation on ‘ensuring safety and quality [and] protecting the vulnerable’.[1]

11.3       In this chapter, the ALRC proposes:

  • expanding the scope of the type of incidents required to be reported under the Aged Care Act 1997 (Cth) (Aged Care Act), and establishing a reportable incident scheme;

  • reforms relating to the suitability of people working in aged care—enhanced employment screening processes, and ensuring that unregistered staff are subject to the proposed National Code of Conduct for Health Care Workers;

  • regulating the use of restrictive practices in aged care; and

  • national guidelines for the community visitors scheme, and the introduction of an official visitors scheme to provide independent rights monitoring for people in residential aged care.

11.4       This chapter also addresses decision making in aged care. It highlights the recommendation made in the 2014 ALRC Report, Equality, Capacity and Disability in Commonwealth Laws (Equality, Capacity and Disability Report) that aged care laws should be reformed consistently with the Commonwealth decision-making model, and proposes that aged care agreements cannot require that a person has formally appointed a decision maker.