Care minute error hits most homes

Published care minute targets for this quarter have changed by more than a minute for two in five residential aged care services.

Published care minute targets for this quarter have changed for most residential aged care services – including by more than a minute for 41 per cent of services, the Department of Health and Aged Care has told Australian Ageing Agenda.  

That comes to over 1,000 of the country’s 2,600-plus residential services. A third of services – about 880 homes – have had their targets reduced by more than a minute including 18 per cent by 1-2 minutes and 15 per cent by two or more minutes.

While “no service has seen a decrease in their overall star rating” more than 50 homes have seen a change in a sub-rating, a spokesperson for the department said in a response to AAA.

Aged & Community Care Providers Association chief executive officer Tom Symondson said the peak was heartened that providers would not be penalised through their overall star rating for the department’s mistake, but said they’ve told the department it can’t happen again “because we do need to have confidence in the system,” Mr Symondson told AAA.  

AAA understands no service has been reviewed by the Aged Care Quality and Safety Commission in relation to this matter.

The issue became public the Friday before last when the department informed providers an issue with the transmission of residential care exit and entry records between Services Australia and departmental systems meant care minutes targets published for some services were out by a small margin.

“While undertaking routine analysis of AN-ACC classification data, the department became aware of anomalies and worked closely with Services Australia to identify the cause and extent of the issue and to find a resolution,” a spokesperson for the department told AAA.

Aged care consultantcy Mirus Australia told AAA it had also raised concerns with the department after identifying anomalies between its calculations and the published care minute targets.

In a written response to questions from AAA, the department did not answer AAA’s question about the number of services impacted but did reveal that published care minute targets have changed for most services for the current October-December 2023 quarter – Q2 of 2023-24.  

While the change for most services was less than a minute, it was more than a minute for 41 cent of services, according to those statistics, which included the following breakdown:

  • “18 per cent of services have seen their care minute targets decrease by more than 1 minute but less than 2 minutes
  • “15 per cent of services have seen their care minute targets decrease by 2 minutes or more
  • “4 per cent of services have seen their care minute targets increase by more than 1 minute but less than 2 minutes
  • “4 per cent of services have seen their care minute targets increase by 2 minutes or more.”

The error featured in the Auditor-General’s report released on Monday in a list of “minor non-conformances” related to the implementation of staffin reforms. The report states the department advised ANAO in November that “care minute and RN minute targets for all services were inaccurately calculated between October 2022 and December 2023” and provided the provisional analysis for the October to December 2023:

Source: Department of Health and Aged Care via Design and Early Implementation of Residential Aged Care Reforms

Care minute targets impact the resourcing of nursing and care staff. In our previous coverage of the issue, Rob Covino – co-founder of Mirus Australia – said even a small change could be significant. “Even a change of less than one minute for a facility of let’s say 140 beds, we’re talking over hours a day of staff personnel,” Mr Covino told AAA.

Meanwhile, the department has made it clear that providers should be calculating their own targets.

“Providers should verify the target and contact the department if there appears to be an inconsistency.” As previously reported, the department has published a spreadsheet with formulas to assist.

Tom Symondson

Mr Symondson agreed that providers should be calculating their targets to have a clear view of what they’re aiming for and achieving. He said providers should act immediately if their calculations don’t match the department’s.

“If a provider thinks that there’s something not quite right about the numbers they’re submitting, then raise it with us, raise it with the department as soon as possible, because we need to go back to government and say, ‘you’re getting it wrong. You’ve got to fix it. We’ve got to have trust in this system.’”

Impact on star ratings

An example of a residential aged care service’s overall and sub-star ratings as at 8 December 2023

While care minutes became mandatory in October 2023, the sector does not report care time for this quarter until February 2024 as part of the Quarterly Financial Report. This data feeds into the star ratings system – which means the star ratings are informed by data from six-nine months previously.

While no service has seen a decrease in its current overall star rating, the data error has resulted in a change to 53 homes’ staffing or quality measures sub-rating.

“For Quarter 4 (April-June 2023), due to be published this month, 40 services will see an increase of their Staffing or Quality measures sub-ratings, by 1 star; 13 will see a decrease in their Staffing or Quality Measures sub-ratings, by 1 star,” the department spokesperson told AAA.

Out of date review ‘worthless’

The issue has also raised concerns about the accuracy of star ratings because of the delay from data collection to star rating publication.

Mark Sheldon-Stemm – CEO of West Australian rural service ValleyView Residence – said the out-of date data made the start ratings system worthless.

Mark Sheldon-Stemm

“The star ratings that are about to be published do not reflect the up-to-date quarter (July to September 2023) and the latest resident survey. Publishing out-of-date information is misleading and defeats the purpose of any rating system,” Mr Sheldon-Stemm told AAA.

He said the latest data should be used in any ratings system because customers wanted to know what was it like today.

“If the department is unable to publish up-to-date information then the system should be scrapped as it does not serve the purpose for which it was intended,” Mr Sheldon-Stemm said. “Good or bad reviews that are out of date are worthless.”

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Tags: ACCPA, care minute targets, Department of Health & Aged Care, featured, star ratings, Tom Symondson,

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