sadly it is not simply self governing. the aged care system is complex and bureaucratic with different approaches for in home and out of home care
while in theory the individual is allocated funds for in home care in practice in practice it is not that easy and residential care is hopelessly entangled. there are supposedly standards but these change according to government policy. for example under the last government changes were made to staffing levels as a result of changes to ACFI guidelines. these are government standards and they determine funding and how funding is used. - they are government guidelines designed to provide a measure of regulation. but behind the way they work is government policy and funding. if we followed the royal commission into aged care - which some appear not to have done - it is very obvious that there are deeply entrenched systemic failures and these appear to be worse where there is a profit motive in the provision of care - or the not for profits have inadequate governance practices.
i'm not sure that you are right that there are lots of workers who do nothing though. The system is hopelessly under resourced and that is in part because aged care workers are paid badly and typically as casual or part timers. you might like to try and work in a residential facility and see what the gruelling expectations are - particularly in those run FOR PROFIT.
