Preparing for the Star Rating System for Aged Care

First and foremost this month, it was Aged Care Employee Day on 7 August and I would like to take a moment to express my gratitude for the amazing work of everyone in this industry. Aged care workers are truly special people who, even at the best of times, do challenging work that not everyone would be able to handle. The past few years have been especially difficult, and I think we will be feeling the effects for years to come, so from the bottom of my heart, I would like to say thank you.?

On to this month's topic...

Star Rating System for Aged Care

The Royal Commission into Aged Care Quality and Safety highlighted a need for those seeking and receiving aged care to be able to compare the quality and safety service of various providers. In support of this, one of the recommendations of the Royal Commission was the implementation of a star rating system for providers.

The previous government announced back in March that they intended to have the system in place by the end of this year, and the current government have confirmed that they mean to see the plan through. They hosted a webinar for providers earlier this week, in which they expressed the view that they expected to refine the system over the next five years.

The system has been developed in partnership with The University of Queensland Centre for Health Services Research, the Aged Care Industry Information Technology Council of Australia and PricewaterhouseCoopers, and will rate providers out of five stars on an overall basis, as well as against four sub-categories, namely:?

1. Five quality indicators
2. Pressure injuries
3. Physical restraint
4. Unplanned weight loss
5. Falls and major injury
6. Medication management
7. Service compliance ratings
8. Consumer experience
9. Staff care minutes.

Does a star rating system work?

A star rating system has been used for aged care in the United States and, in fact, Australian Health Services Research Institute used their system in 2019 to evaluate Australian providers. Our providers didn't rate particularly well using that system, which primarily considers the amount of time that each staff member was able to spend with each resident. That shouldn't be especially surprising though, considering that the amount of time staff were able to spend with residents was also identified as an issue during the Royal Commission.

Importantly, although the system worked well initially, it was later found that providers were easily able to manipulate their ratings as the system used a combination of self-reported data and on-site visits by health inspectors. If Australia is to avoid the same mistakes, they will need to carefully consider how data will be gathered.

Will the system be fair?

Who doesn't want to improve the quality of aged care in Australia? It's a goal we all share, and the new system has the potential not just to allow providers to be easily compared, but also to give a set of measurable standards that providers can aim to improve on. But let me just circle back to something I mentioned earlier: the difficulties that everyone in aged care have experienced over the last few years.

ACCPA recently published the results of a survey that CompliSpace conducted, which was completed by over 1000 aged care workers. Some of the key findings of that survey were:

• 45% of workers have lost half or more of their management team in the last 12 months. This includes 11% of workers who have lost their entire management team within the last year.
• 57% say new staffing targets are impossible to achieve and 39% say that they are difficult to achieve. Only 4% say they are easy to achieve.
• 50% intend to quit in the next three years.
• 78% include stress in their top three reasons for leaving.
• 89% ranked relationships with residents and families in their top three reasons for staying.

For me, that last finding is a big one. We have a workforce that is under a great deal of pressure. A workforce where workers are leaving the industry in larger numbers than we can currently hope to replace them. And the ones that are staying are doing so because they care. Aged care workers are personally invested in providing five star service to every resident, but there are factors beyond their control that mean that won't necessarily translate to a five star rating for the provider.?

Ultimately, I think the system will be good for both providers and the community, but is it fair to implement it within the next four months? When there is a nationwide shortage of aged care workers and there has been only limited time for other recommendations of the Royal Commission to be addressed? We all want a high standard of care from all providers. But is it perhaps a little unfair to introduce a rating system before we have really addressed the aged care crisis in a meaningful way?

Further reading

You can find information on the new system from the Australian Government Department of Health and Aged Care health department here.

You can read more information about how the system will work from Australian Ageing Agenda here.

If you'd like to know more about the survey conducted by CompliSpace you can view it here.

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