Webinar 7: Designing culturally safe aged care

Redesigning for Cultural Safety

Australia's aged care sector is undergoing its most substantial overhaul in decades following the Royal Commission into Aged Care Quality and Safety, whose 2021 report exposed systemic neglect, including culturally unsafe conditions for Aboriginal and Torres Strait Islander older people. The Royal Commission highlighted that mainstream services frequently disregard cultural identity, spirituality, connection to Country, and family, contributing to poorer outcomes and disengagement.

In response, the Aged Care Act 2024 came into effect on 1 November 2025, shifting the system to a rights-based framework. It mandates that all funded services deliver culturally safe care, defined as care that respects, values, and supports cultural identity without imposing assimilation. Strengthened Aged Care Quality Standards, also effective from that date, incorporate measurable expectations for providers to embed cultural safety in policies, environments, and daily practices.

For residential aged care, this translates to concrete requirements around physical design: spaces that facilitate connection to culture, community, and healing-informed environments. A complementary resource, co-designed with older Aboriginal and Torres Strait Islander people, families, carers, and sector experts, provides guidance on these elements and was released in early 2026 to support implementation.

The stakes are high. Non-compliance can lead to regulatory action from the Aged Care Quality and Safety Commission, including sanctions, restricted funding, or loss of accreditation. Older Aboriginal and Torres Strait Islander people—already facing higher chronic disease burdens, lower life expectancy, and barriers to mainstream care—stand to benefit most from change, but inaction perpetuates disparities. Providers, particularly smaller or regional ones, face costs for redesigns, staff training, and community consultation, balanced against the risk of alienating residents or families if designs ignore local needs.

Non-obvious tensions include the balance between national uniformity and local autonomy: while standards apply broadly, Aboriginal Community Controlled Health Organisations argue for dedicated funding and priority status to lead culturally safe delivery, as mainstream providers often lack the trust or expertise. Progress on Royal Commission recommendations specific to First Nations pathways remains partial, fueling calls for stronger enforcement and resources before further gaps widen.