Where Legislation Ends and Service Design Begins

Australia's aged care system has just undergone its most significant transformation in nearly three decades. The Aged Care Act 2024 came into force on 1 November 2025, replacing legislation that had governed the sector since 1997. It is, by any measure, a meaningful step forward. Rights are now enshrined in law. Fee transparency is mandated. Providers are legally obligated to put older people first.

And yet, if you sit down with someone navigating aged care for the first time, or with a family trying to support a parent through the transition, the picture looks rather different.

The fears are real. The uncertainty persists. And the gap between what the legislation promises and what people actually experience is, in many cases, still wide.

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What the Act Gets Right

The Aged Care Act 2024 was built on a simple but powerful idea: aged care should be organised around the people receiving it, not the organisations delivering it. The Royal Commission into Aged Care Quality and Safety, which ran from 2018 to 2021, made this case with devastating clarity. Across more than 10,500 submissions and 600 witnesses, commissioners Tony Pagone and Lynelle Briggs documented what they described as a story of "neglect," making 148 recommendations for fundamental reform.

One of the commissioners' most pointed observations was that "for too long, legislation has focused on the funding requirements of aged care providers rather than the genuine care needs of older people." The Aged Care Act 2024 is the direct legislative response to that finding. It shifts the organising principle of the entire system: from provider funding models to the rights, needs, and choices of older Australians.

The reforms, backed by a $5.6 billion government investment, introduce a Statement of Rights covering independence and autonomy, privacy, safety and quality of care, and the right to raise concerns without fear of reprisal. Hidden entry and exit fees for home care are now banned. A new Support at Home program consolidates what was previously a fragmented patchwork of in-home care arrangements. According to the Australian Institute of Health and Welfare, the system currently supports more than 1.5 million people, and the number of Australians aged 70 and over now exceeds 4.2 million, a figure set to grow substantially over coming decades.

These are genuine, substantive changes. They matter. And for people who enter the system now, they represent a meaningfully better foundation than what existed before.

But legislation sets a floor. It does not, on its own, build the ceiling.

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The Reform Gap

Spend time listening to older Australians and their families, and a consistent set of fears emerges. Some are practical: will I be able to afford this long-term? Are there costs I cannot see yet? What happens if my needs change? Some are social and emotional: will I fit in? Will I lose my independence? What if my family disagrees with my choices?

These are not concerns that fee transparency reforms or statutory rights frameworks will resolve on their own. They are fundamentally human concerns, rooted in the vulnerability of a major life transition, the complexity of a system that still takes real effort to navigate, and the fear of losing control at precisely the moment when control matters most.

The Inspector-General of Aged Care's 2025 Progress Report, published in September 2025, was candid about exactly this risk. Inspector-General Natalie Siegel-Brown warned that Australia is not on track to deliver the transformation the Royal Commission envisioned, observing that "reforms have largely addressed isolated issues rather than driving the systemic change required." She also noted that "questions still remain about how the human rights and high-quality care described by the Act will truly be enforced."

In other words, we have the framework. The hard work is only beginning.

Consider what the Act does not address:

The emotional weight of leaving home. For many older Australians, moving into aged care means leaving a house they have lived in for decades, a neighbourhood they know, a community that knows them. A constant theme throughout the Royal Commission's inquiry was that people want to remain at home. The Act creates rights around dignity and respect. But the process of transition, from the first assessment through to settling into a new environment, is still largely left to providers to design and to families to manage. There is no standard for what good emotional support looks like during this transition. There is no requirement to address grief as part of onboarding.

The affordability anxiety that persists beyond fee transparency. Banning hidden fees is necessary and welcome. But the fear driving people's hesitation is not just about undisclosed costs today; it is about long-term financial security across an unknown care horizon. People do not know how their needs will change, how long they will need care, or what that will ultimately cost. Transparency about current fees does not resolve uncertainty about future circumstances. This requires a fundamentally different kind of conversation, one that most providers are not yet equipped or resourced to have.

The social fit problem. According to the AIHW's data on social isolation and loneliness, around 16% of older Australians aged over 65 experience loneliness, and 11% are socially isolated. Research consistently shows that loneliness and social isolation are associated with poor physical and mental health, with some studies linking them to increased mortality risk comparable to that of obesity and physical inactivity. Community and social connection are among the things people most hope to find in aged care, yet "access to social activities" as a line in a provider brochure and actually finding your people in a new community are entirely different experiences. The Act does not, and arguably cannot, legislate for belonging. That is a service design and culture challenge.

Family dynamics. The Act introduces formal registered supporter roles, enabling trusted individuals to help older people navigate decisions about their care. This is thoughtful and practical. But it does not address the harder reality: that families often disagree. That adult children carry their own anxiety, guilt, and conflicting views. That the person at the centre of the decision is sometimes the quietest voice in the room. Supporting families through this process is not a compliance function; it is a human-centred design challenge.

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What This Means for Providers

The most important thing to understand about the Aged Care Act 2024 is that compliance is not the same as excellence.

Meeting obligations under the Statement of Rights is the minimum. It is the foundation. The organisations that will genuinely transform aged care in Australia are the ones that ask a harder question: not "are we compliant?" but "are we actually good?"

Being good in this context means understanding the people you serve at a level of depth that goes well beyond assessment forms and care plans. It means knowing what someone is afraid of, not just what they need. It means designing the transition experience with as much rigour as the clinical care pathway. It means training staff not just in rights and obligations, but in how to hold a difficult conversation with a family under stress.

It also means being honest about what you do not do well yet, and having a genuine plan to improve.

The sector now has a rights-based framework. What it needs next is a service design culture to match.

Where to Start

For aged care providers, commissioners, and policymakers looking to close the gap between legislative intent and lived experience, three areas are worth prioritising.

1. Map the transition experience. The period from first inquiry to settling into care is the moment of highest anxiety and greatest risk of disengagement. Most providers have clinical intake processes; few have genuinely mapped the emotional journey of the person and their family. Customer journey mapping, informed by direct conversations with older people and their supporters, is a practical and high-impact place to start.

2. Invest in financial conversations, not just financial disclosures. Transparency is necessary but not sufficient. Providers who build genuine capability to have honest, unhurried conversations about long-term affordability, what care might look like across different scenarios, and how to access hardship assistance, will build trust that no brochure can create.

3. Design for belonging, not just activity. Social connection programs that are genuinely built around how people form friendships, find common ground, and feel at home in a new community are categorically different from activity schedules. This is a design challenge, and it is one of the highest-value investments a provider can make in resident wellbeing.

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A Moment of Real Opportunity

Australia's aged care sector is at a genuine inflection point. The legislative architecture is in place. The direction of travel is clear. But as Inspector-General Natalie Siegel-Brown stated on the release of the 2025 Progress Report, the community is "still waiting on the actions needed to make this more than just a vision."

The people navigating this system, older Australians and the families who love them, deserve more than a system that is technically rights-compliant. They deserve one that is actually designed around them.

That is the work ahead.

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How The Strategy Group Can Help

At The Strategy Group, we exist to transform human experiences. In aged care, that means helping providers move beyond compliance to build services that genuinely reflect the dignity, choice, and wellbeing of the people they serve.

We have partnered with some of Australia's leading aged care providers to do exactly this. Working with Bolton Clarke, one of the country's largest not-for-profit providers of residential aged care, retirement living, and at-home support, we co-designed end-to-end customer journey maps across all three of their service lines. Through customer interviews, focus groups, staff workshops, and on-site observations across NSW, Victoria, and Queensland, we surfaced the real pain points and unmet needs of residents and their families. The result was a set of customer experience priorities that gave Bolton Clarke a clear, evidence-based roadmap for improvement, grounded in the lived experience of the people they care for.

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That work reflects how we approach every aged care engagement: listen first, design from evidence, and build solutions that are practical enough to implement and meaningful enough to matter.

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If you are working on aged care reform, care model redesign, or want to understand what person-centred service design looks like in practice, we would welcome the conversation.

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Get in touch with our team or explore our aged care work.