By GOLTC Australian Long-Term Care Interest Group Steering Group Members

Janine Margarita Dizon – ARIIA, Flinders University, Moira Dunsmore – University of Sydney, Nicole Sutton – University of Technology Sydney, Karen Watson– University of Sydney

Australia is reshaping its aged care system through one of the most significant reform agendas in its history. The changes reflect a commitment to addressing systemic weaknesses while embedding the principles of dignity, choice, safety, and quality through a rights-based model of care.

Why Australia’s aged care system needs the reform

The Australian Government’s push for structural transformation stemmed directly from the stark realities highlighted in the 2021 Royal Commission into Aged Care Quality and Safety, which uncovered deep, systemic failures across quality, safety and provision of basic dignity. The previous framework was a provider-centric model under the Aged Care Act 1997, which focused on funding and compliance rather than guaranteeing an individual’s fundamental right to care.

Decades of underinvestment and structural design flaws also created unsustainable bottlenecks. Older Australians faced historically long waiting times, up to 28 months for high-level Home Care Packages, with individuals deteriorating or reaching crisis before receiving assistance. At the same time, significant workforce issues were evident: chronic understaffing, high turnover, and an annual loss of roughly 65,000 workers driven by low pay and minimal career progression. This, in addition to an ageing demographic with complex health and social needs, meant that piecemeal policy adjustments were no longer viable. Genuine structural redesign became essential to move away from administrative rationing, and establish an equitable, needs-based foundation.

Moving from traditional model of care to a rights-based future

In traditional models of aged care, service delivery was primarily dictated by what providers were funded or prepared to deliver, reducing older people to recipients rather than active partners of care. A rights-based model re-focuses this dynamic by mandating that the individual holds an enforceable, universal entitlement to safe, high-quality, and timely support. This premise shifts the central question of care and support from “what does the service offer?” to “what are the individual’s goals, rights, and choices?”

In everyday practice, this shift demands a move away from institutional risk aversion toward principles of autonomy and “dignity of risk”, giving individuals the freedom to make meaningful decisions about their own daily routines, health pathways, and social lives. Structurally, this principle underpins critical changes across both residential and community care:

• Enforceable workforce standards: Mandating minimums like 24/7 Registered Nurse coverage and 215 care minutes per day to ensure basic safety is a guaranteed right rather than an operational variable.
• Needs-based entitlements: Transitioning residential funding from activity checklists to objective, independent assessments (Australian National Aged Care Classification (AN-ACC)).
• Flexible, person-centred living: Introducing a more granular classification of funding entitlements under Support at Home, with separate funding pools for end-of-life care, restorative care, and assistive technology and home modifications.

Ultimately, rights-based care moves beyond compliance checklists to ensure every older Australian experiences genuine respect, agency, and person-centred dignity as a lived reality.

The New Aged Care Act and regulatory transformation

Australia’s new Aged Care Act (2024) signals a regulatory transformation in how quality is perceived and ensured in aged care settings. Policies in line with this Act place emphasis on lived experience, and the rights and quality of life of older people. A key question is how contemporary care can support rights, safety, dignity, choice, independence, relationships, and meaningful quality of life within these new policy parameters. The shift towards person-centred care encourages providers to listen and respond to changing needs and individual goals, and to demonstrate how their services have adopted a rights-based person-centred approach to care. It does recognise that compliance in systems does not necessarily mean respectful, safe, or responsive care.

Many key outcomes, (such as belonging, autonomy, and dignity) are however difficult to measure consistently. Current policy changes may increase documentation, diverting time from direct care if evidence requirements remain poorly designed. Similarly, workforce capability is important, and inconsistent interpretation and assessment (such as through the Integrated Assessment Tool (IAT)) by regulators, assessors, and providers may create risk avoidance or attention to measurable results over individual priorities.

Smaller and rural providers face specific pressures with more limited workforce, data systems, and financial capacity. This means that effective and sustainable implementation of reform needs clear guidance, oversight, feedback (from consumers and providers), workforce support, and flexibility aligned with local circumstances, in order for accountability measures to improve care quality rather than simply access.

Turning the reform into reality

A rights-based aged care system is not simply a regulatory change. It is a cultural transformation that seeks to place older Australians’ dignity and wellbeing at the centre of care while ensuring the sector remains capable and sustainable. It will depend on how providers, workers, older people, families and governments translate key principles into everyday practice. Organisations will need to embed a rights-based approach into their policies, service delivery, workforce training, and decision-making processes so that older people are genuinely supported to exercise choice, independence, cultural identity and self-determination in their care.

Practical actions include supporting staff to build meaningful relationships, tailoring services to individual goals and cultural backgrounds, actively seeking and responding to consumer feedback, and using quality improvement processes to address gaps identified by older people and their families. Strong leadership, workforce capability, and ongoing co-design with consumers are essential to ensuring that reforms move beyond compliance and translate into tangible and meaningful change in quality of life, wellbeing, inclusion, and independence for older Australians.

Balancing rights, quality, capability and sustainability

This transformation is taking place at a time of growing demand for aged care services, fiscal pressures and rising expectations from older people, families and the broader community. These challenges highlight the need for a balanced approach to reform, one that delivers on the rights and expectations of older people while ensuring the quality, workforce capability, and sustainability required to support the system into the future.

Balancing rights, quality, capability, and sustainability requires recognising that these are not competing priorities but interconnected elements of a high-performing aged care system. Putting older people’s rights at the centre of aged care can help shape services around what matters most to older people while encouraging providers to continuously improve care delivery and resident outcomes. New approaches to service delivery, workforce models and organisational practice may help providers respond to changing expectations while maintaining financial and operational sustainability.

What’s next?

As this transformation unfolds, important questions remain about how best to support quality, capability, innovation and sustainability in a sector facing significant change. Join us in exploring the answers to these questions in our upcoming webinar on the 4th of November 2026, 1.00-2.00 pm (AEDT) entitled:

“Diverse lenses, shared priorities, new opportunities: What matters most for aged care practice?”

Click here to register.

Suggested citation

Dizon, J.M., Dunsmore, M. Sutton, N. and Watson, K. (2026) Australia’s Aged Care Transformation: Building a Rights-Based Future for Long-Term Care. GOLTC Blog, Global Observatory of Long-Term Care, Care Policy and Evaluation Centre, London School of Economics and Political Science. 10.5281/zenodo.23800645. https://goltc.org/publications/australias-aged-care-transformation-building-a-rights-based-future-for-long-term-care/