Star ratings online, but validity questioned

The star ratings for aged care homes have been published this week for providers and the public to view.

The star ratings for residential aged care homes were released on Monday and published on the My Aged Care website for providers and the public to view.

As per the preview sent to providers last week, the star ratings show 90 per cent of facilities received three stars – an acceptable quality of care – or more.

The final star ratings percentages for Australia’s aged care homes are:

  • 1 per cent of all aged care facilities in Australia received one star
  • 8 per cent received two stars
  • 54 per cent three stars
  • 36 per cent four stars
  • 1 per cent five stars.

Included among the five-star facilities is Sundale’s Bowder Care Centre in Nambour, Queensland – visited by Minister for Aged Care Anika Wells on Monday.

In a statement, Ms Wells said: “Star ratings is a significant milestone in the delivery of aged care reforms, achieved through collaboration with older Australians, aged care providers and sector experts.”

She added: “Star ratings will enhance accountability, transparency and capability with the residential aged care sector.”  

Residential aged care homes receive an overall star rating from one to five that is measured against four sub-categories:

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

Under the star ratings system – which has been established to increase sector transparency and to help older people and their families make informed choices:

  • 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.

“All older people are entitled to five-star care.”

Consumer peaks welcome launch

The peak advocacy body for older Australians – the Older Persons Advocacy Network – welcomed the release of the star ratings.

Craig Gear

“This nationally consistent benchmark – a key recommendation of the Royal Commission into Aged care Quality and Safety – will provide greater transparency across the sector,” said OPAN CEO Craig Gear.

“Even more importantly,” added Mr Gear, “star ratings will enable older people and their families to compare quality across residential aged care homes and to make informed choices about where they want to live.”

However, Mr Gear expressed concern for those older Australians living in low-rated facilities.

“One in 10 residential aged care homes need to improve or significantly improve their care and services across issues that include breaches of the code of conduct, misuse of restrictive practices or mishandling serious incidents,” Mr Gear said.

Mr Gear has called for an improvement plan to be “urgently in place for each of these residential aged care homes with oversight by the Aged Care Quality and Safety Commission.”

And while Mr Gear was pleased to see the majority of facilities scoring a three-star rating, he said he expected providers to be actively working towards the gold standard. “All older people are entitled to five-star care.”

Patricia Sparrow

The Council on the Ageing Australia also welcomed the introduction of the star ratings system. “Increased transparency and accountability will help older Australians navigate a complex system and drive improvements over time,” said new COTA Australia CEO Patricia Sparrow.

“This is a big step forward for high-quality aged care in Australia,” added Ms Sparrow. “Combined with further system reforms and the improved regulations recommended by the royal commission, the star ratings system will hold providers to account, give older Australians confidence and highlight areas for improvement.”

While noting that no simplified star ratings system can be perfect, Ms Sparrow said “the online tool is a great resource to get an objective assessment and clear, consistent information.”

Unions, opposition, provider peak raise concerns about accuracy

However, some unions and the federal opposition have questioned the validity of the star ratings system.

Carolyn Smith

Speaking to The Guardian, United Workers Union aged care director Carolyn Smith pointed to the nine per cent of facilities falling into the bottom two classifications. “That certainly hasn’t been the numbers we’ve previously seen. That surprises me,” said Ms Smith. “I don’t think any aged care worker would say 91 per cent of providers are three stars and above.”

And speaking to the ABC, Shadow Aged Care Minister Anne Ruston said several care providers had expressed concern to her about out-of-date information on the My Aged Care website. “It is very concerning that the government has published these ratings without making sure they’re accurate,” Ms Ruston said.

Also speaking to the ABC, Ms Wells later refuted claims of false information. “Well, the data is absolutely not inaccurate. And this is the opposition saying this, and they would not know transparency if they looked through a window.”

However, Ms Wells added: “In those very small instances where there is genuinely something in question, that star rating is pulled with an explanatory note on the website until that can be resolved and then the star rating goes back up.”

Aged & Community Providers Association CEO Tom Symondson also raised concerns about the accuracy of information – in relation to staffing minutes – following the announcement revealing the percentage of homes in each star band.

Tom Symondson

“Ninety per cent of providers have received a rating of three stars or above which shows that services are providing everything they are funded by the government to provide for older Australians, at a good level of quality. They have achieved this despite extraordinary funding and workforce challenges,” Mr Symondson said in a statement on 9 December.

“The scores for minutes of care are also reduced because they are taken from earlier in the year, at a time when the sector was neither funded for, nor required to meet, the 200 minutes of care requirement. We expect to see ratings increase in the new year as we approach October 2023 when that requirement begins and providers will be working as hard as they can in the meantime to recruit the necessary workers. This will be challenging, especially in rural areas where shortages are at their worst.”

Ratings fall short on food reporting

Meanwhile, Dietitians Australia has highlighted the fact that the star ratings “only scraped the surface” when reporting on the food served to residents. Under the resident experience rating, residents are asked “Do you like the food here?” The question, said Dietitians Australia CEO Robert Hunt, doesn’t adequately address nutrition.

Robert Hunt

“It is important that food is enjoyed – and introducing a resident food satisfaction rating is warmly welcomed,” said Mr Hunt. “But we want to make sure the food being served to our older Australians in care is not only delicious but nutritious.”

He added: “It is critical that Australian families understand that a food satisfaction rating is not a measurement of the nutritional quality of the overall menu, individual meals and snacks being served to residents.”

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Tags: ACCPA, anika wells, carolyn smith, cota australia, craig gear, dieticians australia, opan, patricia sparrow, Robert Hunt, Senator Anne Ruston, star ratings, Tom Symondson, United Workers Union,

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