Hundreds of aged-care homes to be shamed in new rating system

Hundreds of nursing homes will receive just one or two stars in a new five-star aged-care rating system after falling short on measures such as staffing, food and the use of ­physical restraints.

Aged-Care Minister Anika Wells called on providers who own facilities with low ratings to improve them and not make excuses. Picture: Patrick Woods.

Hundreds of nursing homes across Australia will receive just one or two stars in a new five-star aged-care rating system after falling short of acceptable standards on measures such as staffing levels, food quality and the use of ­physical restraints.

And in a sector looking after some of the nation’s most vulnerable citizens, just 1 per cent of the 2671 residential aged-care homes across the country will receive a five-star rating.

The ratings, to be issued to aged-care providers on Friday, ­reveal almost two in three facilities, 59 per cent, were given three stars and 30 per cent four stars. But 1 per cent of homes face being told they have a one-star ­rating and 9 per cent two stars, both considered below standard. Those facilities have not been named but will be in coming weeks when the ­ratings are published on the My Aged Care website.

Against the backdrop of ­Anthony Albanese promising to “fix the crisis in aged care” as a key election pledge, federal Aged-Care Minister Anika Wells called on providers who own facilities with low ratings to improve them and not make excuses.

“The delivery of star ratings is a significant milestone on the path to a transparent and accountable residential aged-care sector,” Ms Wells said. “Star ratings provide a nationally consistent benchmark to monitor, compare and improve residential aged-care services. (They) provide Australians ­greater and more accessible ­choices regarding residential aged care.

“Providers need to embrace transparency and accountability, and not make excuses.”

Introducing a star rating system by the end of this year was a key recommendation of the aged-care royal commission, which ­reported in March last year.

That recommendation was ­accepted by the previous Coalition government and the Albanese government. It was legislated in the first bill to passed through parliament under the current government in August.

The Prime Minister campaigned heavily on aged care ­during the election campaign, criticising his opponents for neglecting vulnerable Australians and vowing to fix the broken sector as a priority if he came to power. In July he introduced to parliament the first tranche of aged-care legislation, which included a requirement to have a qualified registered nurse on site in residential homes 24 hours a day.

That legislation also included the introduction of the star rating system.

Star ratings are awarded to all nursing homes by the Department of Health and Aged Care using a range of criteria, from staffing ­levels, residents’ experience, complaints, reports of serious incidents and non-compliance with current standards.

The standard of food, a hot-button issue in aged care, is ­included in the questions to residents about their experience in the facility.

Other measures include quality indicators such as pressure injuries, physical restraint, unplanned weight loss, falls and major injuries, and medication management.

The government is giving providers a couple of weeks to prepare stakeholders for the change before the information is uploaded to the My Aged Care website.

“We have issued providers a preview of their star rating which allows them time to prepare for their public release by talking to staff and residents, communicating with families, or developing an improvement plan,” Ms Wells said. “(The ratings will) allow residential aged-care providers the opportunity for continuous, measurable improvement.

“My department and the Aged Care Quality and Safety Commission will continue to work with providers that have services with low ratings.”

Frank Weits, chief executive of ACH Group, a South Australian aged-care provider with eight homes, said the introduction of a ratings system was an important step forward.

“I think it’s a good thing. I have a strong view that open disclosure and being transparent can only help lift the standard in this sector, like any other sector,” Mr Weits said.

“We don’t yet know our rating, but we’ve talked to our staff about what’s to come and the opportunity it creates for continuous improvement. What gets measured gets done.

“Our own staff are already ­offering ideas for how we can get better at providing services for our residents, which can only lead to improvements.”

The star rating system was seen by the royal commission as a way to lift standards that had ­fallen well short of community expectations.

In her final report, commissioner Lynelle Briggs pointed to evidence presented to the inquiry that 22 to 50 per cent of people in residential aged care were malnourished, 75 to 80 per cent were incontinent and 60 per cent were regularly taking psychotropic drugs such as antidepressants and antipsychotics.

Ms Briggs said the commission heard evidence that between 13 and 18 of every 100 residents in aged care had been subject to physical or sexual assaults, 8 per cent had experienced significant unplanned weight loss in the last quarter of 2019-20 and 7 per cent had a pressure injury in the same time period.

“Substandard care has affected over 30 per cent of older people accessing aged care,” she said. “It is shocking to think that at least one in every three older people using aged care has experienced substandard care.”