Dec 20, 2022

Drama surrounds the public launch of aged care star ratings

Drama surrounds the public launch of aged care star ratings

The new aged care star ratings have made a controversial debut, with some providers hitting out at the “inaccurate” ratings, while there are concerns over the fact that just 1% of aged care homes received a five star rating.

Mixed reactions have also been shared by the unions, the Australian Nursing and Midwifery Federation Federal Secretary, Annie Butler, told The Guardian she was “very surprised” that only 9% of homes were ranked as needing improvement. 

United Workers Union Aged Care Director, Carolyn Smith, also said she expected higher numbers to perform poorly.

“That certainly hasn’t been the numbers we’ve previously seen, that surprises me,” said Ms Smith.

“I don’t think any aged worker would say 91% of providers are three stars and above.”

But the Minister for Aged Care, Anika Wells, has remained optimistic as she wants to see the three star benchmark become the “floor” for providers as the minimum standard and that they should all be aiming for five star excellence.

Speaking at a press conference on Monday, she said the launch of the star ratings is vital to fixing the aged care crisis.

“Star ratings were a key election commitment from the [Anthony] Albanese Government because sunshine is the best disinfectant,” said Minister Wells.

“I’m thinking of residents and their families, and if they log on today and see that they’re in a one star facility, we want them to be able to call that facility and for that facility to be able to explain why that is, and what they’re doing to fix it.”

Introduced to clearly display an organisation’s performance to help inform aged care decisions by consumers, the star ratings were a key recommendation of the Royal Commission.

Available through the Government My Aged Care website, homes have received a rating between one – five, reflective of four key performance areas: compliance, quality measures, resident experience and staffing.

Each performance area can be broken down further to highlight important outcomes, such as the number of care minutes delivered, if staff treat residents with respect, or the number of falls and major injuries that have occurred.

The released ratings are similar to the statistics revealed in early December when providers received a sneak peek of their results. Percentage-wise, the publicly released aged care star ratings are as follows: 

  • Five stars (excellent) – 1% of providers
  • Four stars (good) – 36%
  • Three stars (acceptable) – 54%
  • Two stars (improvement needed) – 8%
  • One star (significant improvement needed) – 1%

Concerns over inaccurate ratings

Some providers have reportedly told the Shadow Aged Care Minister, Anne Ruston, that their ratings online are inaccurate or unexpected due to out-of-date information. 

This comes after some providers claimed the interview process to source data was rushed and distressing.

Currently, not all aged care facilities have a star rating as of yet – the My Aged Care website says that there are instances where a ‘no rating’ label is displayed, for example, they may be a new provider or have a temporary exemption due to certain circumstances.

Additionally, the star ratings will be displayed after 12 months as long as data from all four subcategories has been collected, meaning any delays in the data collection may have impacted the first release of ratings. 

“It is really quite distressing that the Department would provide this out-of-date information that misleads older Australians and their families, particularly leading into Christmas,” said Senator Ruston.

“I would say to the Department it should remove or pull down these ratings until it can be absolutely sure and guarantee Australians that the information contained in those ratings is accurate and up-to-date.”

Ms Ruston defended the aged care providers who may have had inaccurate information published as it could negatively affect their operation.

“For the Department to knowingly be providing information in the public domain that they know may not be up-to-date or accurate is very, very distressing,” said Senator Ruston.

Industry peak body, the Aged & Community Care Providers Association (ACCPA), has also been told by some members they believe their ratings are incorrect, with Chief Executive Officer (CEO) Tom Symondson telling The Guardian there are some teething problems with the release of the new star ratings, however, they remain optimistic about the new system.

“Care in the vast majority of facilities is actually good, that’s what these scores tell us,” said Mr Symondson.

“Does it mean everyone has a great experience? No, but on the whole, it’s a good or excellent level of care.”

Despite some concerns regarding up-to-date information, Council of the Ageing (COTA) CEO, Patricia Sparrow, understands the tool is the first step towards major improvement across the board. 

She said the transparency provided by the star ratings will benefit both older Australians and aged care providers.

“This is a big step forward for high quality aged care in Australia,” explained Ms Sparrow, “Providers with lower ratings still have a lot of work to do to improve on quality measures and transparency is a big part of the solution.

“Combined with further system reforms and the improved regulations recommended by the Royal Commission, the star rating system will hold providers to account, give older Australians confidence and highlight areas for improvement.

“While no simplified star rating system can ever be perfect, the online tool is a great resource to get an objective assessment and clear, consistent information.”

Acknowledging that the star ratings were just launched this week, Ms Sparrow believed there will be a long path of reform towards better standards and that it will take some time to get it right.

Poor performers should be penalised

While just 9% of homes received one or two star ratings, some advocates believe there must be additional ways to ensure those providers can meet appropriate standards of care.

That’s the view of Older Persons Advocacy Network (OPAN) CEO, Craig Gear, who said there should be no reason for the providers to settle for a pass mark at three stars either.

“One in ten 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,” said Mr Gear.

“An improvement plan must be urgently put in place for each of these residential aged care homes with oversight by the Aged Care Quality and Safety Commission.” 

Currently, homes do receive notices of non-compliance based on major issues with Aged Care Quality and Safety Standards and they are able to address these matters internally, although there is no formal plan in place.

Despite the early concerns, Mr Gear praised the providers who had achieved four or five stars and said the rest must aim for those high standards.

“But while three stars might well be considered a pass, we expect providers to be actively working towards a four or five star rating through their continuous improvement plans,” said Mr Gear.

“About 30 per cent of providers have achieved this gold standard, which shows it can be done. All older people are entitled to five star care.”

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  1. The “star rating” currently appears as a quick fix. The recommendations for such a rating I believe needed much more transparency and input from geriatricians, nusrsing, GPS and care recipients and advocates.
    The categories supposedly at care of rating rating system are just weasel word terms.

    E.g hours of care for each care for each recipient is a complete nonsense without first having the numbers of each level of care recipients from those requiring high levels of care level 4 to those level 1

    I would like to see who and how the measures were determined in order to create the Star rating. I am sure that that commissioners intention of a star rating system had not been addressed by tick boxes by providers and their lobbyist peak bodies. The same influences and bodies under different identity have highjacked the intended transparent star rating as intended by commissioners in my opinion

  2. My Mother is in aged care and has been for 18 months whilst the facility is generally good I have consistently picked up on issues like a lack of regular toileting, cleanliness in her room, reviews on medication, reminded them the care for my mum should be the same as what they would provide to theirs etc…. just always seems to be something.
    Recently their was an incident where a male resident came into my mum’s room and there tried to be a cover up of information until I commenced questions then all of a sudden it became “a critical incident”.
    I asked would it have been that if I hadn’t said anything!!
    I would suggest when ratings are being done independent family members of the residents are survey because as we know MUCH more goes on behind the front door of these facilities.

  3. I recieve a Home Care Package level 3, and in the past I have spent respite care in two nursing homes. Both were excellent with their services and care. However the food in both places was boarding house style stews every day. No wonder many patients have sandwiches.
    The HCP sector is the next big mess the Govt has to fix. Home care Providers are just about making a $$$$ for ehemselves and hopeless in caring for clients. I await the ratings for them. Mine will get a zero+.

  4. No inaccuracies here, it’s about time that these privately owned homes are held accountable for what’s going on in our Aged Care. For example, every resident was allocated and extra $10 per day for their meals in Ugust 2021 (I stand to be corrected, but I’m sure I’m right). Their meals have got smaller and nothing has changed as far as giving them DECENT meals. The Royal Commission has changed nothing, all its fine is cost taxpayers a bloody fortune..

  5. There are a number of issues with this. The implementation was rushed and used incorrect and/or incomplete data.

    For example, one of the domains used to calculate the ratings was the Clinical indicators.
    This information is required to be submitted quarterly and is published. In a large number of cases (including ours) this data was missing, showing 0 %. When it was queried the Department admitted there was an issue and would suspend the publication until the data had been corrected. That did not happen and the rating have been published anyway.

    For noting, the interviews with residents were not conducted as per the guidelines. In addition, one of the questions was “Does this feel like home?” Really? This is a ridiculous question. A more appropriate one may be “Do you feel comfortable here?” Asking older Australians who have lived in their cherished homes all their lives and who have given up possessions, furniture, gardens for a one bedroom room is absurd. Those of us who work in this industry pride ourselves on the care we provide, and while we work hard to provide a ‘homelike environment ‘ we don’t fool ourselves into thinking that living in what is essentially a hotel/shared accommodation can be compared to our home. That should never be a measure of care.


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