Star Ratings in Residential Aged Care

Star Ratings in Residential Aged Care

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By the end of 2022, the Department of Health expects to have installed a new star ratings system for all residential aged care facilities across Australia. As intended, this will have huge effects upon the residential aged care industry, mainly by holding aged care facilities publicly accountable for the services they provide to vulnerable members of the Australian community.

Additionally, the Department of Health hopes this system empowers potential residents – as well as families and workers – to make informed decisions about their care and facilities.

NOTE: This new ratings system is a redesign of the Service Compliance (AKA 4-Points) System. Whereas the 4-points system displayed delayed ratings, the new Star Ratings System will be a real-time ratings system out of 5 stars.

What will the new star ratings encompass?

Each residential aged care facility will receive an overall star rating, which is intended to be used as a superficial guide for older adults and their families – as well as care workers and professionals – to understand the functionality and personality of the facility itself. The ratings will be controlled and delivered by the Department of Health.

Each facility will also be awarded four sub-ratings:

  1. Five quality indicators
    1. Pressure injuries
    2. Physical restraint
    3. Unplanned weight loss
    4. Falls and major injury
    5. Medication management
  2. Service compliance records
  3. Consumer experience
  4. Staff care minutes (i.e. how much time one worker is able to spend per resident in their care)

These ratings will continue to change as more data is made available to the Department of Health and as residents, families and staff provide further insight into the everyday functioning of facilities.

In terms of outcomes, the new Star Ratings System is expected to deliver a range of benefits. The most pressing goal is to incentivise providers to engage in continuous quality improvement: through this, there should be an increase in the delivery of high quality care to older Australians.

Additionally, now that the Department of Health will be working so closely with aged care facilities, the government will be able to make more informed decisions regarding funding allocations and the prioritisation of support.

How will consumers interact with these ratings?

The Department of Health wants to encourage older Australians to compare services and make informed choices by providing simple ‘at-a-glance’ information: this way, people with various levels of English literacy and comprehension can still make informed decisions about their own care.

In terms of accessing this information, consumers will need to access My Aged Care using the ‘find a provider’ tool on the Department of Health website.

Has this star ratings system been used before?

The United States has utilised a star ratings system for their aged care sector; three stars is the industry average, with four and five stars being above average scores. The US ratings are based upon the amount of time each staff member is able to spend per resident, with adjustments made regarding the specific needs of the resident (these adjustments ensure the accurate comparison of facilities).

In 2019, the Australian Health Services Research Institute applied the US five-star ratings system to the Australian residential aged care industry. This research proved that over 57% of residents in Australian aged care facilities are living in homes that would rate only one or two stars out of five. Only 1.3% of Australian aged care residents live in what the US system would rate as 'five star' homes.

Has this star ratings system worked for the US residential aged care industry? Initially, yes: originally, the star ratings system in the US empowered consumers to choose a residential facility that suits their needs. However, in August 2021, The New York Times has reported that a number of US facilities manipulated the ratings system to receive five stars despite residents reporting issues such as maggot infestations and sexual assault. The US system relies upon a mixture of “self-reported data and on-site examinations performed by state health inspectors”.

This failure in the US should act as a warning to Australia’s upcoming mirrored system: these star ratings will likely become an influential source of information for potential residents and their families. Australia should use independent or government-employed inspectors to physically inspect facilities, while also interrogating any self-reported data before it is approved.

What can residential aged care facilities do to improve their star ratings?

As these Australian ratings are not static, facilities have the power to influence their star rating by improving their offering in a targeted way. Facilities can even use these ratings to help prioritise and strategise systematic improvements to their offerings and their staff cultures, and can use these ratings to advertise the authenticity of their commitment to high-quality aged care.

For more information about this new ratings system, contact the Star Ratings Section via QPSec@health.gov.au, or read more from the Department of Health here:

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