A campaign to raise awareness of aged care star ratings is wasting public money

Oct 17, 2024
Teen hands holding elderly couple with walking sticks in heart shape, older people.

Last week the government launched a media campaign to “build awareness, trust, and use” of the system of aged care star ratings.

The launch came a week after the Commonwealth Ombudsman told the Senate inquiry into the Aged Care Bill that “I am concerned that the current star ratings system is not sufficiently meaningful to help people make decisions about aged care – and may in fact mislead or misinform people”.

What is going on?

The Aged Care Royal Commission recommended that the government should introduce star ratings to “allow older people and their families to make meaningful comparisons of the quality and safety performance of services and providers”.

The first ratings were released in December 2022, at which time 91 per cent of nursing homes received three stars (indicating an acceptable level of care) or better.

Six months later in May 2023 the percentage of homes receiving three or more stars had increased to 95 per cent. The latest data from the July 2024 quarter shows 2,581 out of 2,617 homes or over 98 per cent of homes receiving three or more stars.

However, this high level of performance is inconsistent with other information relating to aged care performance published by the government.

Since October last year homes have been required to deliver at least 200 minutes of care per resident per day, including 40 minutes of care from a registered nurse (RN). (These targets increased on 1 October this year to 215 minutes and 44 minutes respectively.)

The Department of Health and Aged Care recently published data showing that as at 30 June this year only 58 per cent of homes were meeting the total care minutes target, and 58 per cent were meeting the RN care minutes target. However, only 41 per cent were meeting both targets.

Put another way, almost 60 per cent of services are not meeting the care minute targets – yet according to the star ratings, less than 2 per cent are not providing an acceptable level of care.

How can a home provide an acceptable level of care if it is not providing the required minutes of care?

The Aged Care Quality and Safety Commission publishes regular information on the results of its assessments of homes against the aged care quality standards.

Its most recent data shows that for assessments finalised in the June quarter this year, only 81 per cent of homes complied with all elements of the standards. In the Commission’s words “this means that… around one in five residential care services were below the minimum standard in at least one area of the care they provide”.

Again, how can a home be providing an acceptable level of care if it is not complying with the quality standards?

When questioned in the past about homes continuing to receive three stars or more while failing to comply with the standards, the Minister has explained that star ratings are only affected by non-compliance with the standards if the Commission takes regulatory action against the home concerned.

It may be appropriate, as part of a graduated enforcement regime, for the Commission to refrain from regulatory action in every case of non-compliance if it considers that a home is making efforts to rectify the problem.

But if the quality standards reflect the minimum standard of care that a home should provide, it is a nonsense to claim that a home that fails to meet the standards is providing an acceptable level of care.

An older person assessing nursing homes, or a family member acting for an older relative or friend, should be able to assume that a three-star rating or better means that a home is adequately staffed and is meeting the quality standards.

The current star ratings system can provide no such assurance. As the Ombudsman wrote, it may in fact mislead or misinform.

Until the system is reformed so it does work properly, expenditure on a campaign to raise awareness of the system is a waste of public money.

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