Aged care quality monitoring worse in Australia than comparable countries

Australia’s nursing home care quality is not monitored as closely as other countries, and in-home care isn’t monitored at all, new report finds.

Australia’s nursing home care quality is not monitored as closely as other countries, and in-home care isn’t monitored at all, new report finds. Picture: istock

Australia’s monitoring and reporting of aged care quality lags far behind comparable countries and is non-existent for the 800,000 Australians who receive care at home, a new report warns.

Existing data including hospital readmissions, falls and fractures, pain and premature mortality could all be provided to authorities by aged care providers with no additional regulatory burden, the study prepared for the aged care royal commission said.

At present Australia only requires care quality outcome reporting on three indicators for residential aged care – pressure injuries, use of physical restraints and weight loss – and none for home care.

Commissioners Tony Pagone and Lynelle Briggs said it was an “unacceptable” state of affairs, blaming successive federal governments.

“Unbiased measurement and reporting of performance is vital to create accountability and continuous improvement in the aged care sector. Without it, problems are hidden from sight and not addressed,” the commissioners said.

“It is unacceptable that in 2020 the aged care system is still without this. Had the Australian Government acted upon previous reviews of aged care, the persistent problems in aged care would have been known much earlier and the suffering of many people could have been avoided.”

In 2011, the Productivity Commission recommended aged care quality indicators be established and published at the service provider level. In 2017, the Carnell/Paterson review of aged care quality regulation agreed.

In 2019 the Aged Care Quality and Safety Commission commenced requiring providers to report quarterly on the three aged care indicators.

The report, prepared by the Registry of Senior Australians (ROSA) at the South Australian Health and Medical Research Institute, found Australia’s comparative performance wanting on monitoring and reporting on weight loss and utilisation of care plans and medical reviews.

It said Australia could immediately establish independent and transparent monitoring and reporting of many aged care quality measures, as is done in Denmark, Germany, the Netherlands and the US.

The report recommended a renewed focus on in-home care services, where the vast majority of Australians receive their aged care.

“With the increasing utilisation and demand for home care packages to support older people to remain at home in the community, routine monitoring of home care quality and safety is also essential.

“Key domains commonly used by international monitoring systems in home care settings include changes in cognition, mood, functional abilities and pain (i.e. to measure improvements or decline), in addition to incidence of hospitalisations, falls and incontinence and medication use. Such indicators should be included in Australia’s aged care monitoring.”

It also recommended Australia introduce a broader measure of wellbeing among people using aged care services.

“It is suggested that a strategy for obtaining quality of life or other measures of wellbeing and consumer experience data be developed to support routine evaluation and reporting using standard assessments performed within Australia’s aged care sector.

“While a number of measures currently exist, the use of an instrument that has been developed specifically for assessing quality of life in aged care would be preferred,” it said.