About three-quarters of people living in Australian aged care facilities say their needs aren't always met, a survey for the Royal Commission into Aged Care Quality and Safety has found.
Low staffing levels, unanswered calls for help, high staff turnover and poor training for workers worried many facility residents, according to a report by the National Ageing Research Institute.
"Everyone living in residential aged care has the right to quality of care," Associate Professor Frances Batchelor said.
"Although this study found the majority of residents are satisfied with the some aspects of the quality of their care, it is clear that a substantial proportion are not."
Prof Batchelor said the findings highlight the need to improve the quality of care in a system that is "clearly failing".
"Residents' social and emotional needs should also be better addressed," she said.
She said the survey of about 400 people also showed many residents feel lonely, bored and misunderstood by their care provider.
Similar results were reported by people receiving a home care package, who also say their care needs are not always met
Poor value-for-money, fee transparency, service coordination and staff rostering were among the concerns troubling them.
Researchers found 44.1 per cent of people in home care and 33.4 per cent of people in residential care say their care needs are met "only sometimes, rarely or never".
While 32.5 per cent of people receiving home care and 39 per cent of people in residential care say their care needs are "at least mostly met".
The share of people unsatisfied with their care is even higher among those using aged care respite services, with 50.7 per cent of Commonwealth Home Support Program respite clients and 45.7 per cent of people in residential respite saying their care needs are met only "sometimes, rarely or never".
Prof Batchelor said many people receiving care didn't bother raising their concerns as official complaints or even informally.
This is because they don't think anything will change or they feel their problems will be viewed as too small to worry about.
"They don't want to be a nuisance, or they are not sure who to report to," she said.
Of the concerns that were raised officially, less than one per cent were raised with the Aged Care Quality and Safety Commission, and less than half are resolved to the satisfaction of the care recipient.
"The survey results suggest that institutional factors play an important role in residents' experiences," Prof Batchelor said.
"It's clear staffing issues - including understaffing, high staff turnover, and family-staff communication - are in need of addressing, as are many other aspects of residential aged care quality and services," she said.
Residents in government residential aged care facilities reported the best results on average. Those in non-profit facilities usually reported better outcomes than residents in for-profit care.
The research was conducted from January to mid-March, with residents selected from 67 residential aged care facilities.
Australian Associated Press