Developing the approach to the review
In developing the approach to this review, we worked with the Australian Centre for Evaluation (ACE) within the Department of the Treasury. The ACE provided analytical foundations and practical outputs to inform the Inspector-General’s approach to this review.
Approach to the review
This review will carefully assess whether the measures and actions taken by the Australian Government in implementing the Aged Care Royal Commission recommendations have met, or are likely to achieve, the intended outcomes of the royal commission.
To assist in answering this question, the review will take a 3-tiered approach, assessing:
- the system as a whole
- key strategic outcome areas of the Aged Care Royal Commission
- the implementation of each royal commission recommendation.
1. System-wide questions
The review will consider how the aged care system has changed since the Aged Care Royal Commission, including exploring:
- improvements in the aged care system
- what has not improved or has deteriorated
- whether further action is required to achieve the intended outcomes of the Aged Care Royal Commission.
2. Key strategic outcome areas
We have identified 9 key strategic outcome areas that capture the intended outcomes of the Aged Care Royal Commission’s recommendations:
- People-centred aged care: a rights-based system: Older people’s rights are upheld in aged care and care is integrated with other support systems.
- Leadership and government accountability: The aged care system has clear strategic direction, supports long-term goals, monitors performance, addresses emerging issues and ensures accountability.
- Access and navigation: Older people can find, understand and access timely aged care and support.
- High quality and safe care and support: Older people, their families and friends receive the right care and support to meet their needs when they need it.
- Aboriginal and Torres Strait Islander pathway: Aboriginal and Torres Strait Islander people receive culturally safe and trauma-informed care.
- Equitable aged care: Older people receive equitable and inclusive care.
- Regulation and provider accountability: Providers are supported and capable of delivering high-quality care and are held accountable for doing so.
- Workforce: Aged care workers are skilled and empowered to provide high-quality care.
- Sustainable aged care: The aged care system is equipped, financed and funded to provide high-quality aged care and support over time.
The review will consider the Australian Government’s progress against these strategic outcome areas.
For more information, read the background paper on the review, which includes how we mapped each recommendation to a strategic outcome.
The review will closely examine the measures and actions the Australian Government has taken on these key strategic outcome areas. The review will consider:
- Appropriateness: How appropriate are the measures and actions taken or proposed?
- Effectiveness: How effective are the measures and actions taken or proposed?
- Accountability: Does the government’s response allow for public accountability for achieving the intended outcomes of the royal commission?
- Opportunities for improvement: Whether further action is required to deliver the royal commission’s intended outcomes?
The Inspector-General will consider the actions taken in response to each of the 148 recommendations of the Aged Care Royal Commission. However, they will prioritise key areas of reform that are most likely to support or hinder the royal commission’s intended outcomes across these 9 outcome areas.
3. Assessment of the implementation of the recommendations
The Inspector-General will assess the government’s response to the royal commission’s recommendations using the assessment framework outlined in this section. This is based on the framework used in the 2025 Progress Report, which assessed the ‘government position’ and ‘delivery status’ of each recommendation. The government will be asked to provide a response using this framework.
The Inspector-General’s framework for appraising implementation
Government position
In the 2025 Progress Report, the Inspector-General classified the government’s position on a recommendation using the following 5 criteria:
- ‘Accepted in full’: The government has agreed to implement the recommendation, including all relevant sub-components, in full.
- ‘Accepted in part’: The government has agreed to implement some parts of the recommendation but with some sub-components rejected (either in full or in favour of an alternative approach) or under further consideration.
- ‘Under further consideration’: The government is still considering its position on the recommendation and its sub-components.
- ‘Rejected in favour of an alternative approach’: The government has decided not to proceed with implementing the recommendation and its sub-components as per the final report, and has instead decided on an alternative course of action which is fundamentally different from the recommendation.
- ‘Rejected in full’: The government has decided not to take any action to implement the recommendation or any of its sub-components.
A recommendation was classified as ‘rejected’ where:
- the government chose an approach which did not align with that proposed by the royal commission
- no action had been taken because a decision was made not to implement a recommendation
- the government needed to choose between alternative recommendations presented by commissioners.
The review will not revisit the 2025 assessment of the government’s position unless:
- the recommendation was assessed as ‘Under further consideration’ in 2025.
- an agency/government seeks a reassessment and provides new evidence to support a change in category (see ‘Approach to evidence’ below). The Inspector-General will only undertake a reassessment in exceptional circumstances and not to relitigate issues raised during the 2025 Progress Report process.
Delivery status
The review will seek an update from government entities against each recommendation assessed as ‘accepted in full’, ‘accepted in part’, ‘under further consideration’ or ‘rejected in favour of an alternative approach’.
In providing this update, entities will be asked to identify the following, and provide evidence supporting their response:
- Plan – what was intended and why? Summarise scope, timelines, dependencies, governance and resourcing, how lived-experience and provider and other stakeholder input was incorporated, and how the work aligns to the recommendation’s intent or, if it does not, what the intent of the work is.
- Do – what has been delivered? Describe actions taken and outputs relevant to the recommendation, with dates and coverage outlined
- Check – what verifies that the change is operating as intended? Provide proportionate verification through routine monitoring or evaluation
- Act – what will happen next? Show course-corrections, mitigations, or refinements made as issues emerged, including how lived experience and provider feedback informed adjustments.
Entities may elect to address multiple recommendations collectively in their delivery status update.
The entities’ responses will be used to inform the Inspector-General’s assessment of appropriateness, effectiveness, accountability and opportunities for improvement.
The responses may be published through the review process or in the final report.
Approach to evidence
In addition to asking entities to provide evidence to support their response to the ‘delivery status’ or their request for a change to the ‘Government position’, the Inspector-General may also request evidence in other contexts.
The Office will assess evidence for:
- sufficiency – is there enough of the right kind of evidence?
- relevance – is the evidence relevant?
- credibility – can the material be relied on?
The amount and detail of the evidence provided should be proportionate to the recommendation and intended outcomes. Broader reforms will generally require more detailed evidence than more targeted reforms.
Principles guiding the review
The review will be guided by the following principles:
- Evidence-based assessment
- Independence and objectivity
- Transparency
- Person-centred focus, prioritising the experiences of older people, their carers and advocates
- Commitment to provider perspective
- Proportionality and fairness
- Cultural safety for Aboriginal and Torres Strait Islander peoples
- Trauma-informed
- Inclusivity for diverse groups, including veterans, LGBTIQA+ communities, CALD communities, and people with disability.