Webinar 4: Principle 2 – Cultivate a home

Rethinking Aged Care Homes

Australia's residential aged care system, home to around 250,000 people, has long been criticised for institutional layouts that prioritise efficiency over dignity. Large shared spaces and clinical corridors often heighten stress and isolation, particularly for residents with dementia or frailty.

The National Aged Care Design Principles and Guidelines mark a deliberate pivot. Released in final form after consultations, they centre on four principles, with Principle 2 – Cultivate a Home – urging familiar, domestic environments that grant privacy, control, and belonging. Key recommendations include small households of 15 residents or fewer, private bedrooms with ensuites, domestic kitchens for everyday activities, and personalised spaces.

This push aligns with broader reforms under the incoming Aged Care Act, originally slated for 2024 but postponed to mid-2025 to allow preparation. Recent budgets have injected billions to strengthen in-home support and workforce, yet residential design remains a flashpoint: poor environments contribute to higher depression rates and restricted movement, while evidence shows household models cut anxiety and boost socialisation.

Tensions persist. Retrofitting existing facilities for smaller clusters demands significant capital, straining providers already grappling with staffing shortages and thin regional margins. Critics highlight potential conflicts with mandated care minutes under funding models like AN-ACC, where household tasks could blur clinical roles. Yet inaction risks entrenching substandard conditions as demographics swell demand.

The stakes involve not just resident quality of life but system sustainability: better-designed homes could ease pressure on acute health services by delaying hospitalisations, while failure to adapt may amplify scandals that have dogged the sector.