Nine in 10 services receive a positive score in new rating system

Ninety per cent of residential aged care homes have received three stars or above in a new rating system established to provide greater transparency about the quality of care in Australia’s aged care homes.

The star ratings – which went live this month and are due to be published on the My Aged Care website – follow recommendations by the royal commission and others before it of the need for residents and their families to be informed about the quality and safety of services.

Under the system, aged care homes receive ratings between one and five stars with three stars indicating an acceptable level of quality. According to the Star Ratings Provider Manual:

• 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.

That 90 per cent of services scored three stars or more “shows that services are providing everything they are funded by the government to provide for older Australians, at a good level of quality,” said Tom Symondson – CEO of industry peak the Aged & Community Providers Association – in a statement. He added: “They have achieved this despite extraordinary funding and workforce challenges.”

However, the star ratings also show that 10 per cent of homes have fallen short, receiving just one or two stars.

A full breakdown of the ratings reveals that:

• 1 per cent of all aged care facilities in Australia received one star
• 9 per cent received two stars
• 59 per cent received three stars
• 30 per cent received four stars
• 1 per cent received five stars.

Under the new system, aged care homes receive an overall star rating measured against four sub-categories that each have their own star rating:

• service compliance
• residents’ experience
• staffing minutes
• quality measures.

The compliance component reflects a home’s current compliance status based on regulatory decisions by the Aged Care Quality and Safety Commission including compliance with the Aged Care Quality Standards. Compliance makes up 30 per cent of the overall star rating and is updated daily.

The measure of residents’ overall experience of their aged care home – the largest weighting at 33 per cent – is based on face-to-face interviews with consumers. At least 10 per cent of each aged care homes’ residents are interviewed by an independent third-party annually.

Staffing minutes – which makes up 22 per cent of the overall star rating – shows the amount of care received from a registered nurse, enrolled nurse or personal care worker to each resident in an aged care home compared to the average government-set care targets. Minutes are case-mix adjusted through the recently introduced Australian National Aged Care Classification and reported quarterly.

Since its introduction in October, AN-ACC funds homes to meet 200 minutes of care per resident per day – the target that will be mandated from October 2023.

The quality measures are based on data reported quarterly on five existing quality indicators ­– pressure injuries, physical restraint, unplanned weight loss, falls and major injury, and medication management ­– and make up 15 per cent of the overall star rating. Additional quality indicators will be introduced from 1 April 2023.

“The star rating system means that consumers will be able to make an informed choice when deciding on an aged care service for their loved ones,” said Mr Symondson. “However, every effort must be made to ensure the information used to decide the ratings is both fair and accurate and that every effort is made to help consumers understand what the ratings tell us about providers.”

“Three stars is an acceptable standard.”

In an interview in the upcoming issue of Australian Ageing Agenda magazine, Mr Symondson said he wouldn’t want people comparing the aged care star rating system to the sorts of star ratings used to review hotels, restaurants or movies.

“Everybody expects you’ve got to be five stars or there’s a problem. Well, actually, the star rating will show that three stars is an acceptable standard and four or five is good or excellent,” said Mr Symondson.

“A facility may always do great on resident satisfaction with 85 per cent of residents saying, ‘it’s the best place for me’ and ‘I love the people’ and ‘I get great care’ but if they haven’t met 200 staffing minutes, they might end up with three stars,” Mr Symondson told AAA magazine.

“People will say why is that? So it’s going to be a challenge, and we’ve got to work with government to make sure that it’s described appropriately so that people can use it as a decision-making tool.”

In a statement, Minister for Aged Care Anika Wells said: “The delivery of star ratings is a significant milestone on the path to a transparent and accountable residential aged care sector.”

Speaking to sector executives, Ms Wells added: “To achieve our shared goal of reforming aged care, providers need to embrace transparency and accountability, and not make excuses.”

Providers have been issued with a preview of their ratings ahead of publication to allow them time to communicate with staff, residents and their families, and – if need be – to develop an improvement plan, said Ms Wells.

“My department and the Aged Care Quality and Safety Commission will continue to work with providers that have services with low ratings,” she added.

Department advice

Providers should have received a preview of their star ratings by Monday 12 December. If a provider hasn’t received a preview by that date, they should contact the My Aged Care helpline on 1800 836 799 and select option four, star ratings. The helpline is open Monday to Friday between 8am-8pm and Saturday between 10am-2pm.

If providers are uncertain about the overall star rating or sub-category ratings their service has received, they must act by 17 December to:

• check and correct self-reported data with any corrections directed to health@formsadministration.com.au
• understand calculations using the Star Ratings Provider Manual
• report any IT or technical errors to the My Aged Care helpline.

For more information about aged care star ratings providers should visit the Department of Health and Aged Care website.

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