Care of the elderly in New Zealand is nearing crisis point, according to an Opposition inquiry.

Undertaken by Labour and the Greens, with Grey Power, the nationwide inquiry found under-staffing and lack of training led to the poor quality of many aged-care facilities.

The report, made public today, says the sector is "in desperate need of a revolution... a new, less institutionalised approach to how we deliver care to older New Zealanders".

Based on more than 450 written and oral submissions, 20 meetings attended by more than 1200 people and discussions with aged-care experts, "the overwhelming feedback has been of an unregulated, desperately short-staffed sector driven, in many areas, more by cost-cutting and the pursuit of profit than best-care practices".

The report makes 14 recommendations, including the creation of a public star-rating system based on clinical indicators such as each provider's medication mistakes, use of anti-psychotic drugs and the rate of pressure ulcers in residents.

Another key recommendation is that aged-care auditors be chosen by the Health Ministry or the proposed Aged Care Commissioner, not providers, and audits be unannounced.

"We heard many shocking stories of neglect and abuse," said Greens aged-care spokeswoman Sue Kedgley.

"Residents suffering chronic dehydration or malnutrition, being left in bed for entire weekends, or not being walked or toileted regularly, resulting in incontinence and loss of mobility."

The report says a 2002 certification system abolished regulated minimum staffing levels. But the ministry later issued guidelines recommending, in effect, a minimum of 2.1 hours of registered nurse care per resident each week and 11.9 hours by caregivers.

A recent survey found rest homes gave from one to four hours of nursing care per resident each week, and eight to 13 hours by caregivers.

Aged Care Association chief executive Martin Taylor said staffing standards had been established under the Labour-Greens Government. "Therefore any criticism has to fit fairly and squarely with [that] government."

The industry and DHBs were already developing a system similar to the recommended star-rating scheme. He said it seemed the report misrepresented the reality of aged care. Poor quality care was, in fact, rare.

Health and Disability Commissioner Anthony Hill said the issues found by the inquiry reflected complaints to his office.

Recommendations:

* Government establish an Aged Care Commissioner.

* Mandatory minimum staffing ratios.

* All caregivers to receive state-funded training.

* Pay parity with public hospital staff.

* Star rating system of facilities, based on clinical indicators such as rates of infection, falls, and use of restraints on residents.

The sector:

* 42,000 people live in 700 aged residential care facilities.

* 75,000 people receive home support.

* Government spends about $1.3 billion a year, including rehabilitation.

* Residential care residents are increasingly frail.

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