ON the 24th of December 2018, the Royal Commission into the Quality and Safety of Aged Care in Australia officially called for members of the public to make submissions using an online form. The form is designed to capture information that is relevant and consistent with the areas of inquiry set out in the Royal Commission's Terms of Reference.
Not all questions will be relevant to every person or entity making a submission, but completing as much of the form as possible will assist to identify issues and trends. Please also consider suggestions as to how you think aged care can be improved.
Making a submission
It's a good idea to save responses to your questions before filling out the online form, then simply copy and paste your responses as you will not be able to save your responses and come back to it.
Your submission to the Royal Commission can be completed using the online submission form. To view and prepare for the four page online form questions, you can download the submission form as a PDF document and complete it offline, either digitally or by printing and then scanning the document.
The word limit on the online form for free text is 20,000 characters (approx. 5 A4 pages), however, you can also provide supporting material by attaching a maximum of five files.
(Please note that not all file types can be uploaded to the Royal Commission. Accepted file attachment types are JPG, GIF, PNG and PDF with a file size limit of 10 MB per file).
Frequently Asked Questions
The following questions are provided as a guide only:
Q: Where can I find the Royal Commission's Terms of Reference?
Q: How do I make a submission?
Q: Can I start the online submission process and then come back later to complete it?
No. You need to think about how to prepare your final draft of your submission in its totality prior to making your submission using the online Submission form, although the online form will allow you to navigate between the 4 pages of the submission saving your responses.
Q: Can I view all of the questions before I make my submission?
You can view the questions to prepare your submission by downloading the submission form as a PDF document.
Q: Is there an interpreting service I can use to assist me with my submission?
Yes. Try contacting the Centre for Cultural Diversity in Ageing where they have a comprehensive list of resources for multilingual health and aged care information for consumers.
Q: Can I make a submission without using the online Submission form?
Yes. If you are not comfortable using the online Submission form, the Royal Commission would still like to hear from you. You can:
- Write to the Royal Commission: Royal Commission into Aged Care, GPO Box 1151 Adelaide SA 5001.
- Telephone: 1800 960 711 (between 8:00am-8:00pm AEDT Mon-Fri except on public holidays).
Q: Can I make more than one submission?
Yes. When filling out the online Submission form, you will be asked "Have you already made another submission to the Royal Commission?" and if you have done so, you will be asked to enter a Reference number provided by the Royal Commission.
Q: Can I make a submission about more than one aged care service provider?
Yes. If you are concerned about the conduct of more than one aged care services provider then the Royal Commission has advised that you should complete a separate submission for each provider.
Q: Is there provision to enter text describing my experience in the online submission form?
Yes. On Page 3 of 4 of the online Submission form, there is provision to enter formatted free text with a word limit of 20,000 characters. This is approximately six A4 pages of text, however, you can also provide supporting material by attaching a maximum of 5 files (limit of 10MB per file).
Q: Does the Royal Commission support file attachments to submissions?
As part of your submission, you can also provide supporting material by attaching a maximum of 5 files. Accepted file types are JPG, GIF, PNG and PDF with a file size limit of 10 MB per file and maximum of 5 files can be uploaded. Please note that not all file types can be uploaded (using the online Submission form) to the Royal Commission.
Q: When do submissions close?
The Royal Commission will continue to accept submissions until at least the end of June 2019. A date for the closing of submissions will be announced in the second half of 2019. It might be timely to send your submission as soon as possible so that it may be able to better inform public hearings due to be scheduled around Australia.
Q: Do you have any concerns about the aged care service having enough skilled staff to look after you or someone close to you - and how did this impact on the delivery of care?
- Write down how many staff were present in your experience - were there Registered Nurses?
- How many nurses to the number of residents?
- Were they present during the day/night/weekends?
- What about Personal Carers or other care staff?
- How many were non-care staff?
- Were the skills appropriate to the tasks of looking after your loved one? Were they qualified?
- Could staff understand the issues (medical and non-medical) you raised?
- Did you see any bullying, assaults or threatening behaviour by staff members?
Q: Are or were your concerns or complaints taken seriously by the aged care service?
- Did you feel comfortable and supported escalating any issues or complaints?
- Were there owners or managers present when an issue could not be resolved?
- Were there managerial staff present who could answer your queries and concerns?
Q: Do you have any concerns regarding sub-standard or unsafe aged care services delivered, including any of the following areas:
- Clinical care;
- Medication management;
- Quality of food, Nutrition (including malnourishment) (was the food cooked onsite, brought in frozen, microwaved?)
- Oral or Dental health;
- Restrictive practices - eg physical or chemical restraints;
- Palliative care;
- Skin care (wound treatments; pressure sores, etc);
- Mistreatment, neglect or abuse;
- Physical or sexual abuse, assault, unexplained bruising, etc.
Provide as much information and evidence especially if you contacted a third party such as police and law enforcement to address mistreatment, neglect or abuse. These instances may not only be physical but can also be mental/psychological, emotional and financial. Provide as much detail on your knowledge and awareness of elder abuse or neglect in this section.
Q: Did you have any difficulties getting information about care of your loved one?
If possible, provide records such as dates of calls, copies of emails, photos and other materials.
Q: Did you find the aged care service receptive to complaints?
If possible, provide records such as dates of calls, copies of emails, photos and other materials.
Q: Did you feel there were any barriers for you or your loved one to exercise 'choice' and 'control' with regards to the aged care services received?
Barriers can include physical (prevention of seeing your loved one), non-physical (lack of communication, emotional manipulation etc), legal (use of lawyers and other professionals to threaten/harass/intimidate you or your loved one) and others.
Q: Did you feel you were receiving value for money with regards to service delivery?
Write the amount you or your loved one were required to pay upfront (the fixed amount) at the commencement of services, and the ongoing (the variable amounts) fees you or your loved one were required to pay for the use of their services such as food, laundry, continence pads etc and assess whether the amount you paid was value for money - was it adequate/inadequate in the delivery and provision of these products and services?
Provide copies of contracts, invoices, bank statements, pension statements, shopping receipts (to compare eg how much the daily food given to you and your loved one vs the market rate of bought store food if there was no in-house chef) etc to show this.
Q: Did you seek help from any of the following government or funded agencies and were they able to assist?:
1: Aged Care Complaints;
2: Government funded aged care advocacy or peak organisations;
3: Minister for Ageing/Aged Care
4: Department of Health (or previously: Department of Health & Ageing or Department of Social Services)
5: Did you or a family member or friend participate in any interviews from the Aged Care Quality Agency and were they helpful? (or it's predecessor, the Aged Care Standards and Accreditation Agency)
If possible, provide records such as dates of calls, copies of emails, photos and other materials.
Q: What changes would you like the Royal Commission to recommend?
Provide a list of recommendations on what you believe needs to happen for the Royal Commission to meet its future-proof objectives. Recommend on addressing the failures and weaknesses you see in the current system and provide reasons why these changes are necessary.
Q: How will my information be used?
The information you give to the Royal Commission is provided to help the Royal Commission with its work and will be used only for the purposes of the Royal Commission.
The Royal Commission may contact some individuals or entities that make submissions. The Commission will not contact everyone who makes a submission, but will ensure that all submissions are recorded, reviewed and used to inform the Commission's work.
The information you provide may be published by the Royal Commission during its proceedings or in its reports without revealing the identity of the person or entity who supplied the information. At the conclusion of the Royal Commission all of its records, including submissions will become subject to requests under the Freedom of Information Act 1982 (the FOI Act). Royal Commissions are not subject to the FOI Act while they are in operation.
If you need any independent help with making a submission or organising attachments, please contact us and our volunteers will try and provide assistance where possible.
Updates: You should check the official Royal Commission into Aged Care Quality and Safety website for any official news or information regarding the progress of the Royal Commission. You can also subscribe to our free eNews to be kept updated.
To date, more than 300 public submissions have been received. Approximately 81% of these submissions have been about care provision. The most common concerns are about substandard or unsafe care and staffing issues, including staff ratios, with about 54 per cent and 59 per cent of the submissions raising these issues respectively.
A common theme arising to date from submissions, are incidents related to residential aged care and include elder abuse, medication mismanagement, overuse of psychotropic medications, issues of food safety, not responding in a timely manner to residents requiring assistance, and inadequate wound management leading to death. It also appears that record keeping and record management is an issue for some providers.
The collapsible section below, summarises the Submission form process and questions you may choose to familiarise yourself with prior to preparing a submission.
You need to think about how to prepare your final draft of your contribution in its totality prior to making your submission, as although the online form will allow you to navigate between the 4 page online form saving the responses, there is no provision to save your response and come back to it at a later time.
Submission form questions (click to expand/collapse section)
The online Submission form includes questions about:
Submission form: Page 1 of 4
- Who is making the submission, (eg your details, what is it about, is it about your own experiences or on behalf of someone else)
Submission form: Page 2 of 4
You will be asked three questions about your submission to the Royal Commission including:
Question 1: Which of the Royal Commission’s terms of reference is your submission about? (Select all that apply)
- Substandard or unsafe aged care services delivered (including mistreatment, all forms of abuse and systemic failures)
- Challenges and how to best deliver aged care services to people with disabilities and persons living with dementia
- Challenges and opportunities to deliver accessible, affordable and high quality aged care services to those who wish to remain living at home and/or those living in remote, rural and regional Australia
- Challenges and how to ensure aged care services are person-centred (including by allowing people to exercise choice, control and independence of care and improving engagement with family and carers)
- Challenges about understanding what care is available, the assessment process, how to get care, and at the level of care needed
- Challenges about the availability of post-hospital care and rehabilitation services or other supports that might assist living at home
- Challenges and how to best deliver aged care services in a sustainable way (including through innovative models of care, use of technology and investment in the aged care workforce and infrastructure)
- Challenges and how to ensure high quality and safe end of life care
- Challenges associated with providing high quality, safe and affordable aged care services generally
- Interface between aged care services and primary health services, acute care and disability services and regulatory systems (including how people transition from other care environments or between aged care settings)
- Challenges about what to do with your home and your relationships when you enter residential care
- Staff challenges in operating in the system, and what might be changed in order to deliver better quality and safe
- Examples of good practice and innovative models in delivering aged care services
Question 2: What, if any, specific concern/s does your submission relate to? (Select all that apply)
- Physical abuse or assault
- Sexual abuse or assault
- Emotional abuse
- Financial abuse
- Discrimination of any kind
- Staffing issues including ratios
- Independence, choice and control over care
- Clinical care
- Medication management
- Mental health
- Dental health
- Loneliness, disengagement, disconnection and/or boredom
- Personal care
- Nutrition (including malnourishment)
- Restrictive practices
- Governance arrangements and management support systems
- End of life care
- No concerns
Question 3: Which of the following best describes the aged care services that your submission is about?
- Care in an aged care home (nursing home)
- Entry level help or care in people’s own home (such as help getting dressed, transport, or help with meals and cooking)
- More complex help or support in their own home (Level 1, 2, 3 or 4 home care package)
- Short term care after a hospital stay
- Short term care to help older people get their independence back after a setback
- Short term care to give older people or their carer a break (respite care)
- Services of any kind to a veteran (including care or help in their own home under the Veterans’ Home Care Program)
- Services of any kind to a person living with dementia
- Care to a person with a disability living in an aged care home (nursing home) under the age of 65
Submission form: Page 3 of 4
You will be asked if there is anything else you would like to tell the Royal Commission. Although the free text field is limited to 20,000 characters (this is approximately up to six A4 pages of text), you can also provide supporting material by attaching a maximum of 5 files.
If you wish to provide supporting material (such as a photo) or accompanying document such as a PDF file, please upload the file by clicking the "Attach Files" button below.
Submission form: Page 4 of 4
The last page of the Submission form asks you to confirm the Publication of your submission:
- I agree to my submission being made public under my name
- I agree to my submission being made public anonymously
- I do not want my submission to be made public
Important: please ensure you complete the form in one sitting and press 'submit' or it will not be saved. Before you begin filling in the form, it may be useful, and save time, to prepare your submission in a Word document beforehand and then copy and paste it into the form.
You may make your submission anonymously and you may choose not to provide contact details. Your submission will still be reviewed by the Royal Commission. However, the Royal Commission will be unable to contact you if it needs to verify details in your submission.
Your submission may be made public unless you request that it not be made public or the Royal Commission considers it should not be made public. That will usually only occur for reasons associated with fairness. Submissions that are made public may include redactions made as the Royal Commission considers appropriate. You may request that, if your submission is made public, it is made public anonymously.
The terms of reference for the Royal Commission are included in the Letters Patent, which the Administrator of the Government of the Commonwealth of Australia signed on 6 December 2018.
Terms of reference (click to expand)
The Commissioners were appointed to be a Commission of inquiry, and required and authorised to inquire into the following matters:
- the quality of aged care services provided to Australians, the extent to which those services meet the needs of the people accessing them, the extent of substandard care being provided, including mistreatment and all forms of abuse, the causes of any systemic failures, and any actions that should be taken in response;
- how best to deliver aged care services to:
- people with disabilities residing in aged care facilities, including younger people; and
- the increasing number of Australians living with dementia, having regard to the importance of dementia care for the future of aged care services;
- the future challenges and opportunities for delivering accessible, affordable and high quality aged care services in Australia, including:
- in the context of changing demographics and preferences, in particular people's desire to remain living at home as they age; and
- in remote, rural and regional Australia;
- what the Australian Government, aged care industry, Australian families and the wider community can do to strengthen the system of aged care services to ensure that the services provided are of high quality and safe;
- how to ensure that aged care services are person‑centred, including through allowing people to exercise greater choice, control and independence in relation to their care, and improving engagement with families and carers on care‑related matters;
- how best to deliver aged care services in a sustainable way, including through innovative models of care, increased use of technology, and investment in the aged care workforce and capital infrastructure;
- any matter reasonably incidental to a matter referred to in paragraphs (a) to (f) or that [the Commissioners] believe is reasonably relevant to the inquiry.
The Royal Commission has been asked to investigate the following issues:
- The quality of aged care services provided to Australians, including the level of substandard care provided, prevalence of abuse and systemic failures, and actions that must be taken;
- How to best deliver aged care services to people with disabilities living in aged care facilities, as well the increasing number of Australians living with dementia;
- Future challenges and opportunities for delivering accessible, affordable and high quality aged care services in Australia;
- What the Australian government, aged care industry, Australian families and wider community can do to strengthen the sector and ensure high quality and safe services;
- How to guarantee aged care services are person-centred, with a focus on allowing people to exercise greater choice, control and independence in relation to their care, as well as improving engagement with families and carers regarding care delivery; and
- Innovative models of care, increased use of technology and investment in the aged care workforce and capital infrastructure.
The Royal Commission will consider:
- All Commonwealth-funded aged care services;
- All aspects of the quality and safety of aged care services, including dignity, choice and control, clinical care, medication management, mental health, personal care, nutrition, positive behaviour supports to reduce or eliminate the use of restrictive practices, end of life care, and governance and management support systems;
- The critical role the aged care workforce plays in delivering high quality, safe, person-centred care and the need to engage families, carers and others;
- The diversity among older Australians and barriers they face in accessing and receiving high quality aged care services, taking into account increasing chronic and complex conditions; and
- Findings and recommendations of past relevant reports and inquiries.
Powers of a Royal Commission
The Royal Commission has the power to:
- Summon witnesses to give evidence and produce documents;
- Request a person give information, or a statement, in writing; and
- Apply for search warrants.
Suggestions for writing a submission
Submitting to a Royal Commission is a very personal matter. This is your own aged care story. Do not rush into writing it until you feel you are ready to do so. It takes time and energy (both emotional and physical) to write your account.
If you are making a submission via your computer, make sure you save a copy of the document (If you don’t have a computer or can't type, write it out on a piece of paper or a journal; see if you can find someone to type it out later by using stenographer services).
- Pick the issue/s you think your submission will best fit the Commission’s investigation. View the Submission form questions (above) to help with this.
- Write your submission honestly and in a free-flowing manner. Don’t worry about spelling or grammar at this stage! This will be your first draft.
- Stick to the facts and write about the impact the issues you have raised has had on you and others such as your family and friends personally, financially and emotionally.
- If you have evidence (such as emails, receipts, mementoes, personal effects, diary entries, calendar entries, notes, notebooks, photos, audiotapes, video footage, transcripts, internet chats etc.) to back up the issues you have raised, find them now. They are useful reminders to help you write about the events and they will help corroborate the account you have written.
- A suggestion is to write your submission using a timeline from the first point of concern you had and from then onwards. Dates are useful and having a timeline will clarify your submission.
- For your first draft, write as much as you can. Now, find a trusted person to read your draft. Ask what their thoughts are, and what ways you can improve your arguments without asking you to change the facts and evidence in your story.
- Try one of the support helplines below if you can’t find someone to listen to you. Reading it aloud to someone face to face or over the phone will help strengthen and improve your writing.
After you have done your first draft, it is time for your second draft. This is the time where you make sure you check your spelling and grammar are correct. Don't forget the Commission team are seasoned lawyers. Being able to write in an eloquent and convincing manner will help them understand your story.
A word-processing document for example, usually uses 11 or 12 point size font, 1.5 spacing, page numbers and headings when necessary. Having a clear submission will help the Commission’s work and will allow them to read your submission more easily.
If you use a word-processor you can easily perform a "Word count" (eg, in MSWord: Tools; Word count) prior to filling out the online Submission form. You will be able to determine your 20,000 character limit for the "free text" field on page 3 of the submission form. (Don't forget you can also provide additional or supporting material by attaching a maximum of 5 files).
Now, think about the things in your submission that you can expand on and write on what you feel the Commission should also investigate. Note, Issue 5 asks the Commission to investigate other matters it considers necessary. By the way, congratulations! You have written up your submission. We hope it has been a cathartic experience.
About Royal Commission hearings
A Royal Commission can take evidence in a number of ways for different purposes, including conducting formal hearings. Hearings may either be open or closed, or restricted to a certain class of persons. Evidence given in a closed hearing will not be made publically available and will be used in a way that protects an individual’s identity.
Royal Commissions can refer information about suspected or alleged crimes to relevant law enforcement authorities or share relevant information with other ongoing inquiries.
Information about hearings and how individuals can participate in the Royal Commission will be made available on its website Royal Commission into Aged Care Quality and Safety.
Royal Commission powers
The Royal Commission has broad powers to gather information and assist with its investigations and inquiries. These are sometimes called coercive powers because they can compel an individual to participate in the inquiry. The Royal Commission has the power to:
- summons witnesses to appear before it and require them to answer questions under oath or affirmation, and
- summons witnesses to produce a document or other material piece of evidence.
If summoned, there are very few grounds on which a person can refuse to give evidence to a Royal Commission. Failure to comply with a summons issued by a Royal Commission may result in an individual receiving a fine or in some circumstances imprisonment.
In some circumstances a search warrant and/or arrest warrant might be issued if a person fails to comply with a summons. It is an offence to intentionally provide false or misleading evidence to a Royal Commission or by intentionally insulting or disturbing it.
If you need support
Writing about your experience may trigger post-traumatic stress (PTS) or unpleasant memories. Please have a conversation with someone if you think the thought of writing, or the act of writing about this will make you upset. You will be helping the Royal Commission’s work when you make a submission but please look after yourself first, especially your mental health. We need your story to help the Commission’s investigation.
The following numbers may be useful before, during and/or after your submission:
- Beyond Blue: 1300 22 4636
- Cancer Information and Support: 13 11 20
- Carers Australia: 1800 242 636
- Elder Abuse Helpline: 1800 628 221
- Epilepsy Foundation: 1300 761 487
- Griefline: 1300 845 745
- Lifeline: 13 11 14
- Mensline Australia: 1300 789 978
- Mental Health Help Line: 1800 011 511
- Motor Neurone Disease Association: 1800 777 175
- National Dementia Help Line: 1800 100 500
- National Disability Abuse and Neglect Hotline: 1800 880 052
- Open Arms – Veterans and Families Counselling: 1800 011 046
- QLife: 1800 184 527
- Parkinson’s Australia: 1800 644 189
- Suicide Call Back Service: 1300 659 467
If you have found a useful support group number that can be added to the above list, please let us know.
Thank you for reading this guide. If you have any suggestions on how we can improve it, please let us know. We are all volunteers at Aged Care Crisis and will do our best to try and help where we can. Please email us if you have any feedback, questions or need some help.