SAHMRI league table could reveal aged care’s best and worst

A league table system for the embattled aged care sector has been created by SA researchers – but they fear the public might never get to use it.

The first league table of Australia’s best and worst performing aged-care providers has been created in South Australia, but researchers fear it will not be made publicly available.

SAHMRI has devised the breakthrough system combining 12 key measures that show how well every nursing home – and, within months, every home-care provider to older people – is performing.

Consumers have limited information from the Federal Government’s website on how homes compare or perform, unless they have been hit with sanctions.

The new system was created through SAHMRI’s Registry of Senior Australians, which was asked by the Royal Commission into Aged Care Quality and Safety, due to report on Friday, for an international review of quality and safety indicators.

However, SAHMRI feared the commission would not choose its system, but opt for one the institute believed would be more costly and limited. SAHMRI executive director Professor Steve Wesselingh said its model drew together national data already collected within the health system, and could be ready quickly without great cost to aged-care providers.

“We think consumers should have more information about the sorts of services that are provided and the quality of those services,” Dr Wesselingh said.

SAHMRI Executive Director Steve Wesselingh.

“I’m not saying we jump straight into league tables, as there would be concerns, particularly by the providers, about that. But, ultimately, the consumers should have all that information and there are places around the world where that does happen.”

He said the information would also spur providers to improve.

“If I’m head of Helping Hand, like if I’m heading up the Crows, I want to know where I sit on the league table as a team and where my players rank in their 100m sprints,” he said.

“You can’t manage anything without data. One of our biggest arguments and greatest hopes is that the royal commission will recommend this – but we don’t know that they will.”

About 240,000 Australians are in nursing homes, costing the government $13bn a year.

Another 170,000 receive home-care packages, with 100,000 more waiting.

The royal commission has been scathing of the “shocking” system.

The commission’s lawyers have identified major problems, ranging from the challenge to find appropriate care to inadequate staffing, poor food, the use of drugs as restraints, assaults and lack of transparency for consumers.

“Public reporting is really important to improve transparency in the system and it’s something that is completely lacking,” said Dr Gillian Caughey, one of the researchers on the SAHMRI project.

She said the table used 12 indicators drawn from medical records of all Australians who had received an aged- care assessment. It included weight loss, pressure sores, falls, fractures, use of sedatives, opioid and antipsychotic drugs, pain management and premature mortality.

One key indicator that could not be measured from records was how people felt about their quality of life – but that should be collected at the facilities and added in, along with data on the use of physical restraints, she said. The system was recommended following research in 11 countries. SAHMRI also had a system almost ready to provide the same insight into providers who delivered home-care packages.

Dr Gillian Caughey.

The system would help aged-care providers by showing how others did better, and also consumers by showing how facilities compared.

But Dr Caughey felt the royal commission was heading to a model requiring information to be collected by aged-care providers at their cost “when we can already do it”. Still, SAHMRI hoped to have data for SA aged-care providers later this year, but not currently the public.

Dr Caughey said it was important for information that did not identify individuals to be made available.