The interim report of the aged care royal commission has put the government on notice and provided an imprimatur for change, aged care minister Richard Colbeck says.

Lack of home care, the use of chemical restraints in nursing homes and younger people with disability in residential facilities have been identified as areas requiring immediate action by the Royal Commission into Aged Care Quality Safety, which described the aged care system as “a shocking tale of neglect”.

The report condemns an aged care system which it says is designed around transactions rather than care and relies on a regulatory model that does not provide transparency or an incentive to improve.

In their report, tabled in parliament on Wednesday, Commissioners Richard Tracey and Lynelle Briggs said they had heard and read a great deal of evidence about the heavy toll on older Australians of the long waiting times for home care.

1600 die while waiting for home care services

The three-volume report, titled simply Neglect, says home care is of central importance for the future of aged care in Australia but the current system is unable to deal with the level of demand.

Waiting times of up to 12 months or more for high care home care funding packages were unacceptable, the commissioners said, citing evidence that more than 16,000 people died last year waiting for a package they never received.

“We are in no doubt that the current aged care system is not able to deal with the level of unmet need for home care services and the demographic pressures behind it. It is clearly unacceptable for there to be more people waiting for home care packages than are receiving them. It is unsafe. It is neglect,” the commissioners said.

“This situation has contributed to unnecessary and premature deaths; has driven some people into residential aged care and has placed terrible pressure on informal carers. It cannot be allowed to continue.”

It also noted concerns about quality and capacity associated with the rapidly growing home care market and the workforce implications of increasing package numbers, as well as poor regulation of home care.

“We have been alarmed to find that many people die while waiting for a home care package. Others prematurely move into residential care. By any measure, this is a cruel and discriminatory system, which places great strain on older Australians and their relatives.

Confusion and lack of understanding

The royal commission also heard frequently that the aged care assessment process is confusing and there is little understanding of the criteria used to place people in the home care queue.

The Commonwealth Ombudsman received 164 complaints about the Australian Department of Health, with 44 per cent relating to the My Aged Care portal, which is meant to provide a gateway to the aged care system.

The complaints focused on delays in the allocation of home care packages and packages being allocated and then withdrawn. People also suffered serious delays in receiving letters from the Department, which were all too often unnecessarily complex and poorly written.

There was also a lack of follow up from the department after home care packages were approved.

Calls for change

Aged care minister Richard Colbeck said the report had put the government and the industry on notice.

“I said to industry last week that it would put us all on notice,” he told the ABC on Thursday. “It has done that in spades. It’s put the government on notice, it’s put the industry on notice, but as importantly as it’s put the entire community on notice.”

The consumer advocacy group Council on the Ageing Australia (COTA) said the report gave the government a mandate for transformation and recognised the failure of successive administrations to implement recommendations from over 18 government inquiries.

CEO Ian Yates welcomed the Royal Commission’s finding that aged care needs fundamental reform and redesign, as well as more funds.

“If the government is taking the Royal Commission seriously and is also serious about respecting the many people and experts who have given their time to the process so far, then they cannot ignore this report and must commit more funds in the forthcoming MYFEO,” Mr Yates said.