Barbara Spriggs says she prefers to give compliments rather than criticism.

Yet from the moment her 66-year-old husband Bob was admitted to the Oakden Older Persons Mental Health facility in South Australia, her gut feeling told her things were terribly wrong and she would have to speak up.

Prime Minister Scott Morrison cited the Oakden nursing home as one of the reasons for announcing the royal commission last September.

On the first day of the Royal Commission into Aged Care Quality and Safety, Mrs Spriggs revealed how Bob's accommodation was "like something from the 19th century".

A bare, locked room with just a sheet to lay on.

No seat on the toilet bowl, paper towels to dry himself.

Her husband was drugged up, she believed, to make it easier for staff.

She saw other residents sedated.

"It was like a prison," she said.

When Bob Spriggs — who had Parkinson's and dementia — was rushed to hospital with severe bruising, thought to be caused by restraints, no one in authority was concerned.

The injuries did not raise alarm bells, the police were not called and no one informed any of the Government agencies responsible for nursing homes.

"To this day, I don't know what happened to Bob at Oakden," Mrs Spriggs said.

Clive and Barb Spriggs arriving at the royal commission in Adelaide today. ( ABC News: Candice Prosser )

"I can't believe that nobody else could pick up how bad that place was."

It is the central question likely to be asked time and again at this long-awaited royal commission.

Tough questions for those responsible

This question of regulation is where the parallels between the recent royal commission into the financial services industry and this one into the aged care sector will be extremely evident.

The Australian Prudential Regulation Authority (APRA) and Australian Securities and Investments Commission (ASIC) came under fire for leaving misconduct unpunished or imposing penalties that "did not meet the seriousness of what had been done".

How will the equivalent bodies responsible for the safety of the elderly in nursing homes fare?

You would expect those bodies — the Aged Care Quality Agency and the Aged Care Complaints Commissioner — would be subject to some tough questions from the royal commission.

However, both bodies were disbanded by the Federal Government on December 31, last year.

They were replaced with yet another configuration, the new Aged Care Quality and Safety Commission.

The Oakden Aged Mental Health Care service passed accreditation year after year. ( ABC News: Matt Coleman )

It is not clear whether a representative from those former bodies will be compelled to speak.

National attention desperately deserved

In terms of hearing from other members of the public, it will be some time.

Although 800 members of the public have already made submissions about their experience in residential aged care, this first round of hearings is a fact-finding mission, devoted to hearing from industry, unions and professional bodies about how the system operates.

That might seem excessive to some, especially in an industry which has been subject to a staggering 72 reviews, inquiries and reports in the past 11 years.

Prime Minister Scott Morrison cited the Oakden tragedy as one of the reasons for announcing the royal commission last September, despite the fact Oakden had already been the subject of an ICAC investigation and a national review.

Those inquiries heard shocking instances of abuse, neglect and the murder of a man in care, but did not receive the national attention it so desperately deserved.

Bob Spriggs was drugged up at the Oakden facility in Adelaide. ( Supplied: Barb Spriggs )

Despite Barbara Spriggs having the ear of various influential Government agencies, she still does not know the truth about what happened to her husband.

And because there is no register for personal care workers, who make up 75 per cent of the industry, little is known about those who worked at Oakden or any suspicions about them.

"I think about those who hurt Bob and I wonder whether they're employed somewhere else," she said.

"I wonder if their employers know about their previous employment."

It is just one of the many issues and personal stories this royal commission will need to examine to restore public faith in a system which many of us or our loved ones will need as we age.