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Aged care ratings system judged a failure

The new federal government star ratings were supposed to make the system transparent and help us get the care we want. But a new study suggests it’s worse than ever.

  • Health
  • Read Time: 6 mins

How the system is meant to work

The star rating system draws on data from the National Aged Care Mandatory Quality Indicator Program, consumer experience reports and provider compliance with and performance against the Aged Care Quality Standards as assessed by the Aged Care Quality and Safety Commission.

The star ratings are based on:

  • Quality has the lowest weighting in the overall stars making up 15% of the rating. The quality measure uses data on five care quality indicators that operators provide to the government on a quarterly basis under the National Aged Care Quality Indicator Program.

  • Staffing has a weighting of 22% towards the total star rating. It uses data reported by the provider on the average number of care minutes each resident receives per day and how many of those minutes are with a registered nurse.

  • Compliance makes up 30% of the overall rating and is based on audits and non-compliance decisions made by the Aged Care Quality and Safety Commission.

  • Resident experience has the greatest weighting, contributing 33% to the overall rating. To measure this, the government contracts a third party to interview at least 10% of residents face-to-face about their experience at home.

The star rating system introduced in December 2022 by the then federal government aimed to provide simple, reliable information about the quality of care in the nation’s aged-care homes.

We were assured the system would help us easily assess and compare aged-care services based on measurable information. Previously, trying to compare homes and services was difficult to say the least.

A recent report by Dr Rodney Jilek, The Failure of the Aged Care Star Ratings, suggests that instead of providing the transparency to compare and choose an aged-care home, the ratings may influence people into choosing a home delivering poor care.

Dr Jilek’s analysis found there was little correlation between the overall star rating and the actual performance of the residential aged care facility.

There was also little correlation between the Quality Measures rating awarded to the facility by the Department of Health and Aged Care and its ability to meet the minimum aged-care standards.

A significant proportion of non-compliant homes were self-rated at three, four, or five stars for quality while on any measure, non-compliance with minimum basic standards would be considered unacceptable, the study says.

According to the study, this means that a facility can fail all eight standards of accreditation and have no formal action taken or have its star rating amended.

Dr Jilek questions why the department continues to give “this level of trust” to providers who he says have not met the minimum standards for more than three years or have a history of non-compliance spanning decades.

“What we now have is a system even murkier than the previous one, where the new official star rating doesn’t even take into consideration whether a provider can meet the minimum basic standards or not but is based upon provider-submitted, unverified data and a ‘gut feel’ of the delegate.

“Would you fly on a plane that failed some or all of the minimum safety standards? Would you eat at a restaurant that failed the food safety standards? Would you go to a hospital that failed to meet their basic standards of accreditation?” Dr Jilke said.

He concluded that this was “an enormous issue that raises serious questions of whether the general public and parliament, are being misled”, and asked, “Why is this seen as acceptable for older Australians?”

Do some research

One of the best ways to research an aged-care home is to arrange for a respite stay.

You can stay in a home for up to a total of 63 days (nine weeks) a year, whether in one home or a number of homes.

A stay of a few weeks is sufficient to assess whether you like the activities, the other residents, the food, and the care.

Respite can be affordable as there are no accommodation payments and no means-tested fees. You simply pay the basic daily fee, set at 85% of the Age Pension, currently $61 per day plus any extra or additional service fees for things such as hairdressing, wine, and entertainment.

Respite is government funded so to get access you will need to have your care needs assessed by the Aged Care Assessment Team (ACAT). Call My Aged Care on 1800 422 737 for guidance or the Carer Gateway on 1800 422 737 for emergency respite.

Related reading: Inside Ageing PDF, Inside Ageing report, First Links


John Austin

John Austin

Policy and Communications Officer, National Seniors Australia

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