A federal government report released last month revealed that 378 reports of "alleged or suspected unlawful sexual contact" were made in residential aged care in the last financial year - up from 344 in 2011-12.

Combined Pensioners & Superannuants Association of NSW senior policy adviser Charmaine Crowe said the 2012-13 Report on the Operation of the Aged Care Act 1997 showed that sexual and physical assaults of elderly residents had more than doubled in the past five years.

Silence enables 'sexual assault of older women'

"Reports of alleged sexual and physical assault of nursing home residents have increased by 144 per cent since 2007, with a record 2256 reports in 2012-13," she said.

"It's likely that assaults are greatly under reported because many would be committed by fellow residents with a cognitive impairment, and do not fall under mandatory reporting requirements.

"Many homes would not report these assaults because they're worried about their reputation."

Ms Crowe said this week's conviction of a Horsley man who sexually abused two elderly, disabled patients at Unanderra's Marco Polo nursing home was a case in point.

On Monday, Daniel Thomas Mooney, 41, was jailed for 11½ years in Wollongong District Court with presiding judge Deborah Payne describing the abuse case as one of the worst she'd dealt with.

Mooney had earlier confessed to assaulting two female patients at the home in 2010 and 2012 while employed as a carer.

According to the police facts, the first incident in October 2010 was reported to the head nurse on duty and to the home's senior management but was not reported to police.

Almost two years later, in September 2012, Mooney abused a second patient, a woman in her 80s suffering from physical and mental disabilities. He was interrupted but the matter went unreported and the following month he abused the same woman twice in one night. Senior managers were alerted and suspended Mooney's employment before reporting the matter to police.

Ms Crowe said that under 63-1AA of the Aged Care Act 1997, all nursing homes must report to the Department (of Social Services) and police any suspected or alleged physical or sexual assault of a resident within 24 hours.

"Marco Polo breached its obligation under the Aged Care Act to report any suspected physical or sexual assault of its residents when it failed to notify police and the [department] of the first assault in 2010," she said.

"All suspected sexual and physical assaults of residents by staff must be reported to the police. Marco Polo was grossly negligent for not reporting the first incident in 2010 and as a consequence, it failed its basic responsibility of keeping its residents safe from harm."

The Unanderra nursing home was issued with a notice of non-compliance by the then Department of Health and Ageing on January 22, 2013, for failing to report an allegation or suspicion of a reportable assault. The department also claimed the nursing home had not taken reasonable steps to require staff to report suspicions of reportable assaults, however, the non-compliance notice has since been lifted.

Two former Marco Polo staff members contacted the Mercury this week, claiming the 2010 incident was reported to senior management, who took it no further.

"It's horrendous ... we had to come to work on night shift and work with him [Mooney] after that and we were shaking in our shoes," said one of the workers, who wished to remain anonymous.

However, Marco Polo manager Robert O'Shea told the Mercury that senior management had only become aware of the October 2010 and September 2012 assaults when they read about them in the paper this week. He said no staff reports had been made to management prior to October 31, 2012.

"We at Marco Polo are absolutely heartbroken at the thought of an incident of this nature occurring at our home," Mr O'Shea said.

"Every person who continues to work with us is absolutely devoted to the care and safety of the vulnerable people who rely on us. Any evidence of danger to our residents is, and always has been, taken with the utmost seriousness.

"The allegations against Mr Mooney were first reported to management on October 31, 2012. Mr Mooney was suspended from duty that day pending an investigation. The NSW Police service and the Department of Health and Ageing were also notified that day.

"Members of the NSW Police service met with management on November 1, 2012 and, at their request, all available information was turned over to them."

Mr O'Shea said counselling and support had immediately been made available to staff, residents and their families, and continued to be available.

He said education on reporting allegations of assault, including sexual assault, was one of the mandatory topics regularly provided to all staff.

"We have double-checked all our policies and together with the Department of Health and Ageing, and the Aged Care Services Association, reviewed the ways we work to ensure that we are continuing to do everything we possibly can to protect the people in our care," he said. "Despite the stresses of the last 14 months we are pleased and humbled that none of our residents and their families, or the core team who care for our residents, have chosen to leave Marco Polo as a result of this incident and the ongoing publicity surrounding it."

A Victorian research study, Norma's Project (see separate story), is investigating the sexual assault of older women, referred to as a "hidden crime" by lead researcher Dr Catherine Barrett.

Ms Crowe, of the pensioners' association, said more needed to be done to prevent elder sexual abuse.

"There must be staff-to-resident ratios in all nursing homes to reduce the risk of assault occurring. Under-staffing of nursing homes, especially at night, is a systemic problem," she said. "The use of cameras in residents' rooms also needs to be considered, providing privacy issues were adequately addressed. Nursing homes are institutions and, sadly, abuse and institutions are intrinsically linked."

Ms Crowe said relatives also needed to watch out for any change in behaviour or unexplained bruising and report any suspicions of abuse to the home's management or the Aged Care Complaints Scheme.

Minister for the Illawarra John Ajaka said elder abuse was an "unacceptable issue" that needed greater attention.

He said concerned older people, friends, family and support workers could call the NSW Elder Abuse Helpline on 1800 628 221.