Aged care star ratings questioned as 91% of Australia’s homes deemed acceptable

Aged care unions and experts have questioned the federal government's new star ratings system for residential facilities, expressing surprise that so few were rated as substandard after damning findings of poor conditions and compliance problems in the sector.

Some providers have also complained that their ratings - widely available on a public website - are incorrect or lower than they had been told to expect by the health department.

Annie Butler, the federal secretary of the Australian Nursing and Midwifery Federation, welcomed the launch of the new system, saying it is "exactly what needs to happen".

"We need to know who's doing a good job and who's not, and what can we do to fix those things."

But unions queried the fact 91% of facilities nationwide were ranked as three stars or higher, with just 9% falling in the bottom two brackets.

"I'm very surprised at 9%," Butler said, adding that she didn't believe the majority were meeting adequate staffing levels.

Butler expressed concern about self-reporting of some measures by facilities, and whether unscrupulous providers would pressure residents to give higher scores on surveys.

Carolyn Smith, aged care director at the United Workers Union, said she "expected higher" than 9% to be ranked poorly.

"That certainly hasn't been the numbers we've previously seen. That surprises me," she said. "I don't think any aged worker would say 91% of providers are three stars and above."

The government's star rating tool, a key recommendation of a royal commission to help compare providers, was launched on Monday.

Available on the my aged care website, it rates facilities out of five, with three stars deemed "acceptable", four stars "good" and five stars "excellent". Conversely, two stars is classed as "improvement needed" and one star as "significant improvement needed".

The aged care minister, Anika Wells, said the one- and five-star brackets included just 1% of facilities each, while 36% were rated four stars, 54% rated three stars and 8% rated two stars.

The system also shows individual star on the values of compliance, quality measures, residents' experience and staffing. The measures are given different weightings for a final score, with residents' experience counting for twice as much as compliance.

Dr Sarah Russell, a health researcher and director of Aged Care Matters, said the royal commission in 2021 found one in three residents experience neglect, abuse or poor care.

"The bar must be set very low for 90% of aged care homes to be assessed as providing an acceptable standard of care," she said.

"We know there is a workforce crisis. So how is it possible for 90% aged care homes to provide an acceptable standard of care?"

Smith said she was concerned there would be an "exodus" of staff from facilities given poor rankings, but she and Butler welcomed the star ratings as a tool to promote transparency and incentivise higher standards in aged care.

"Workers in those centres know what's going on," Smith said. "It's confronting to get that sort of rating but they would know.

Butler said: "It could be the impetus for some providers to lift their game, if workers know they can easily find a position in a better place."

Tom Symondson, the chief excecutive of the Aged and Community Care Providers Association industry group, praised the sector for achieving such high scores. He said providers had experienced "incredible challenges" around workforce and the pandemic, and believed 91% of providers scoring three stars or above was an accurate picture of the sector.

"Care in the vast majority of facilities is actually good, that's what these scores tell us," Symondson said.

"Does it mean everyone has a great experience? No, but on the whole, it's a good or excellent level of care."

Symondson said the sector was in favour of further transparency. But he said some facilities believed they'd been given incorrect ratings.

He alleged some facilities had been listed as having compliance problems they were not aware of, or given lower rankings than the department had advised.

"A number of members believe some of the information is inaccurate, and there's teething problems," he said.

In a statement, a health department spokesperson confirmed facilities were given a preview of their rating last week, but that a number of ratings had been "amended" after further data validation.

The department had received complaints from providers about their ratings, and that scores may be amended if appropriate.

"This includes queries where they believe there are data issues, including whether self-reported data was accurate or submitted on time," the spokesperson said.

"Data feeding into the Star Rating system is dynamic and may be updated daily."