One in three aged care residents in Australia has suffered substandard care, according to a damning royal commission report which has urged sweeping reforms.
The final report and its 148 recommendations was made public on Monday after a two-year inquiry which heard countless tales of abuse and neglect.
Up to 18 per cent of residents had been either physically or sexually assaulted, the commission determined.
It also concluded more than 30 per cent of residents had experienced substandard care, a reflection on the poor quality of some providers and "fundamental systemic flaws" in system design and governance.
"People receiving aged care deserve better. The Australian community is entitled to expect better," the commissioners wrote.
The report described current regulatory arrangements as "weak and inefficient", a scenario that arose because of the government's desire to restrain spending in the sector.
Commissioner Lynelle Briggs said successive governments have "misunderstood and not fulfilled their responsibilities" in regards to governance of the sector.
"At times in this inquiry, it has felt like the government's main consideration was what was the minimum commitment it could get away with, rather than what should be done to sustain the aged care system," she wrote.
In response, Scott Morrison pledged an initial $452 million to bolster the sector, with more funding flagged in the May federal budget.
The Commonwealth has agreed to tear up the 1997 Aged Care Act in light of the commission's call for new laws that put older people first and provide a universal entitlement for high quality care.
Among recommendations, the report calls for home care packages to be approved within a month of assessment and for staff to receive a minimum amount of training, like in childcare.
It also wants anti-psychotic drugs to be prescribed by a psychiatrist or a geriatrician, so their use can be restricted in residential settings.
An interim inquiry report found there was an overuse of drugs to restrain residents.
There is also a recommendation to strengthen the sector regulator.
However, commissioners Tony Pagone QC and Briggs differ in their recommended governance models and funding models, which are based on levying peoples' incomes.
"It is concerning the royal commissioners did not provide a unanimous and clear position of how aged care should be funded in future," said Pat Sparrow from the Australian Aged Care Collaboration, which represents more than 1000 providers.
"Funding is what supports the employment of more care staff, better trained care staff, better paid care staff and better facilities for residents."
Ms Sparrow said more time was needed to go through the recommendations in detail.
In 2018/19, $27 billion was spent on aged care, including $19.9 billion by the Australian government.
The inquiry received more than 10,000 submissions and heard from 641 witnesses at hearings across the country.
Australian Associated Press
Sign up for our newsletter to stay up to date.