Star ratings system for aged care a failure, says expert

Ratings are a big part of life these days. Appliances are ranked for efficiency and energy. We get a chance to rate restaurants, hotels, resorts and businesses. Even doctors and lecturers receive online star ratings. But how accurate are these ratings and do they always paint a clear picture? In the aged care sector, research suggests the answer is ‘no’.

In December 2022, the federal government introduced a star rating system for aged care facilities. The aim was to provide reliable information about the quality of care being delivered at each.

Now, little more than a year later, there are serious doubts about the system’s efficacy. A study conducted by University of Canberra Adjunct Professor Rodney Jilek found many homes were receiving positive ratings that were very much at odds with their compliance rankings.

Prof. Jilek’s findings formed the basis of an article published in the Melbourne Age titled ‘Why some five-star aged care homes are the worst in the country’.

Such a headline does not suggest a well-functioning ratings system.

Rating the star ratings system

So where does the ratings system fall down? In his report, Prof. Jilek, also the managing director of Community Home Australia, identified four major areas.

First, resident experience. This is the experience of residents as gauged through an annual survey. The survey consults 10 per cent of residents. This fails to reflect that residents’ experiences can change on an almost daily basis, says Prof. Jilek.

Second, compliance. The compliance rating makes up 30 per cent of the total rating and is “supposedly based upon” the accreditation and compliance information provided by the Aged Care Quality and Safety Commission.

Third, staffing.This aspect is self-reported, with unvetted staffing levels provided by the provider, says Prof. Jilek. “The department of health recently advised that figures they have been reporting for some time are completely incorrect,” he said.

Finally, quality measures. These are also self-reported, again with unvetted data submitted by providers, says Prof. Jilek’s report. “Many of the providers appearing on the Non-Compliance Register rated themselves either 4 or 5 stars for quality measures.”

It appears that the disparity between compliance and star ratings is largely attributable to the latter being reliant on self-reporting. The weighting of the resident experience being 33 per cent is also a potentially confounding factor, Prof. Jilek says.

His report delivered a scathing summary of the star ratings system. “The review team found no evidence to suggest the Star Rating system achieved its stated objectives,” it concluded. Those objectives included, “being clear, transparent or effectively driving improvement.”

So what’s the solution?

Rachel Lane, author of the book Aged Care, Who Cares?, suggests the clichéd method of ‘do your own research’. At least until the star ratings system is improved to a point where it inspires confidence, she says. “If you are investigating an aged care home for yourself, the best research you can do is to try a respite stay.”

As for star ratings of aged care homes, for now it might be best to take them as you might take those of restaurants – with a grain of salt.

Have you relied on the aged care star rating system to help choose a residence? Did you find it to be accurate? Let us know via the comments section below.

Also read: ‘Staggering’ number of conflicts of interest declared in aged care audits

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