Commission defends compliance scores

No action if non-compliant providers ‘self-correct’.

Non-compliance will not necessarily affect an aged care home’s star rating, the regulatory body’s chief has told Australian Ageing Agenda.

Responding to a AAA request for an explanation as to how facilities listed on the Aged Care Quality & Safety Commission’s non-compliance register are able to score a 4- or 5-star compliance rating – which, in turn, influences a home’s overall appraisal – commissioner Janet Anderson said: “The existence of non-compliance at a residential service does not reflect in that service’s star rating unless the commission uses its regulatory powers by issuing a sanction or other notice to direct a service to take suitable corrective action … Our approach means that there will be times when a service on My Aged Care has non-compliance recorded against it that has not influenced their overall star rating.”

Janet Anderson

While acknowledging that there may be “uncertainty or confusion” surrounding the distinction between the commission finding non-compliance at a facility and any regulatory action it may take, Ms Anderson told AAA: “How and when we deploy our powers, and what powers we use, depends on the level of risk that the non-compliance is posing to people receiving care.”

When assessing risk, the commission factors in “a level of trust” in a provider, said Ms Anderson. “Specifically, we consider their willingness and ability to remediate the identified non-compliance in a timely manner.”

Also responding to a AAA request for comment, a spokesperson for the Department of Health and Aged Care said: “The compliance rating is calculated using regulatory actions or absence of actions for a certain time period that correspond to a compliance rating.”

The commission pointed AAA to page 13 of the Star Ratings Provider Manual (pictured below) for further clarification. However, the advice states that in order for a facility to receive a 5-star compliance rating, the site must record no non-compliance for a full three-year period. For a home to receive a 4-star compliance rating, it has to have had no non-compliance for a one-to-three year period.

Source: Star Ratings Provider Manual, Department of Health and Aged Care
Rodney Jilek

“At the end of the day, the guidelines and public expectations are clear – a non-compliant service should not be receiving ratings of adequate or better, because they simply are not,” Professor Rodney Jilek – author of a report that questions the validity of the government’s star rating system – told AAA.

Accusing the commission of attempting to “muddy the water”, Professor Jilek added: “What is the sense of having minimum basic standards if the regulator can, through its internal opaque decision-making processes – their subjective ‘trust’ in the provider – deem them to be not important enough to alert the community through a system designed to enhance transparency?”  

Patricia Sparrow

Speaking on behalf of consumers, Patricia Sparrow – chief executive of advocacy organisation Council on the Ageing Australia – told AAA: “It’s clear that the star rating system needs ongoing work to provide reliable information and restore community confidence. It’s concerning that a system meant to reliably inform older people and the community is sometimes delivering conflicting or confusing information with compliance data and this must be addressed through ongoing improvement and monitoring.”  

The star rating system – which came into play in December 2022 – was established to help older people and their families make informed choices when selecting an aged care facility.

Under the government’s star rating system:

  • 1 star indicates significant improvement needed
  • 2 stars show improvement needed
  • 3 stars equal an acceptable quality of care
  • 4 stars suggest a good quality of care
  • 5 stars highlight an excellent quality of care.

Aged care services are awarded a star rating based on four sub-categories: residents’ experience (which accounts for 33 per cent of the overall rating), staffing (22 per cent), quality measures (15 per cent), and compliance (30 per cent).

The compliance component of the star rating is measured against a provider’s performance in relation to government regulations and standards as outlined in the Aged Care Act 1997

Ms Anderson defended the commission’s approach when handling matters of non-compliance. She told AAA: “We want to create an environment where providers are incentivised to actively engage with us and demonstrate they are willing to take necessary action to self-correct as soon as possible when things go wrong.”

Bringing attention to the fact that a non-compliant provider’s actions are monitored, Ms Anderson added: “If at any point this situation changes and we identify risk to residents at a service, we will not hesitate to take further action – which could well include compliance enforcement action.”

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Tags: Aged Care Quality & Safety Commission, compliance, Janet Anderson, non-compliance, Rodney Jilek, star ratings,

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