Star Ratings for residential aged care – design changes

Closes 13 Dec 2024

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Design changes for Star Ratings – Survey

Background

Star Ratings for residential aged care was introduced by the Australian Government in 2022, in response to recommendations from the Royal Commission into Aged Care Quality and Safety.

Star Ratings help older people and their representatives understand the quality of care being provided at residential aged care homes. This information helps people compare homes and make informed choices about their care.

Star Ratings also enables aged care providers to monitor, compare and improve the quality of their service across nationally standardised measures.

The Australian Government Department of Health and Aged Care is undertaking a public consultation to investigate and inform Star Ratings design changes. This survey forms part of the consultation process.

Each aged care home has an Overall Star Rating, and a rating in each of 4 sub‑categories:

  • Residents’ Experience – how people feel about the care they get. An independent survey team surveys around 20% of all residents every year about their overall experience at their home.
  • Compliance – based on regulatory decisions made by the Aged Care Quality and Safety Commission.
  • Staffing – the average amount of care time residents get from nurses and care workers. This is compared with the minimum average care targets the Australian Government sets.
  • Quality Measures – about 5 important areas of care. This includes pressure injury, unplanned weight loss, falls and major injury, medication management and the use of restrictive practices.

Purpose

The purpose of this survey is to seek your views and perspectives on certain aspects of Star Ratings that will contribute to design changes. Prior to completing this survey, we encourage you to read the Design Changes for Star Ratings consultation paper which can be found on the Read the Consultation paper page to ensure you have the necessary context and information required to complete the survey.

Privacy and use of information

The information collected is for the purpose set out above. The survey includes collection of some sensitive, non-identifiable information. By participating in this survey, you consent to the collection of personal information.

The survey is estimated to take around 15 minutes to complete, and it is necessary for you to respond to every question to make a valid submission. We thank you for taking the time to provide feedback.

 

What group of people would you categorise yourself in? (select all that apply)
What age group are you?
Where do you live?
What location are you based?
Are you of Aboriginal or Torres Strait Islander origin?
Are you from a culturally and linguistically diverse background?
Compliance ratings are based on whether the aged care home has formal regulatory notices. These are regulatory notices the Aged Care Quality and Safety Commission (the Commission) gives if the aged care home isn’t providing safe and high-quality care.
When the new Aged Care Act comes into effect, the design of the Compliance rating must change to align to the new regulatory model. This change will include each individual provider becoming registered by the Commission to deliver residential aged care services, as opposed to accreditation of individual aged care homes.
A regulatory notice is issued to a provider if they are not meeting their obligations to deliver safe and quality care. Depending on the type of regulatory notice, the provider may be required to take certain actions, refrain from certain actions or have a penalty issued to them.
A provider is the organisation that owns and operates an aged care home. They may operate one or more homes nationally.
An aged care provider receives a formal regulatory notice for non-compliance across their operations. Do you agree or disagree that the Compliance rating of all the provider’s aged care homes should be impacted?
How confident are you that changes to the Compliance rating, due to provider level non-compliance decisions, will help older people and their representatives to compare aged care homes?
When the new Aged Care Act comes into force each aged care home will be assessed against the new strengthened Aged Care Quality Standards (strengthened Standards). The performance of aged care homes will be measured using graded assessments. These grades will include a new measure of exceeding conformance for those aged care homes delivering excellence in care, above the required obligations.
Do you agree or disagree that a previously awarded exceeding grade still be displayed on the My Aged Care website if the home is later issued with a formal regulatory notice for non-compliance with their obligations?
Would display of the exceeding grade and a formal regulatory notice at the same time make it hard for older people and their representatives to compare aged care homes?
Do you agree that an aged care home should be able to restore its former Compliance rating immediately after resolving non-compliance issues?
How much do you agree with the following: An aged care home should be limited to 3 Stars (acceptable) for one year after non-compliance has been resolved.
How much do you agree with the following: An aged care home should be limited to 4 stars (good) where non-compliance has been resolved in the last 1–3 years.
Regulatory notices are currently only issued by the Aged Care Quality and Safety Commission. When the new Aged Care Act comes into force the Department will also be able to issue regulatory notices.
Should Department issued regulatory notices impact the Compliance rating the same way regulatory notices issued by the Commission do?
If a provider receives a regulatory notice for non-compliance with financial prudential requirements, do you believe it should impact the Compliance rating?
The Staffing rating shows whether an aged care home has met or exceeded their two care minute targets. These are: the total amount of nurse and personal care time, from a registered nurse, enrolled nurse, personal care worker and assistant in nursing, and the care time from a registered nurse, this can include up to 10% of care time contributed by an enrolled nurse.
From 1 October 2025, the Staffing rating will change so that aged care homes will need to meet both of their mandatory care minute targets to receive a Staffing rating of 3 or more stars.
If an aged care home fails to meet either of its care minute targets, do you agree or disagree that their Staffing rating should be limited to a maximum of 2 stars (improvement needed)?
Should the requirement to have a registered nurse available 24/7 be included in the Staffing rating calculation?
If an aged care home does not meet its requirement to have a registered nurse available 24/7, should the Staffing rating be limited to a maximum of 2 stars (improvement needed)?
The Department recently undertook an independent evaluation of Star Ratings. The evaluation investigated the impact Star Ratings has had on improving care quality and transparency for older people. Preliminary findings from the evaluation have provided some recommended changes to the display of Star Ratings.
Currently Star Ratings are measured on a scale of 1 to 5 stars, using whole stars. Should Star Ratings include half stars?
The proportion of residents who are subject to restrictive practices impacts the Quality Measures rating. This information is also published alongside the Quality Measures rating.
Restrictive practices include physical restraint, mechanical restraint, environmental restraint and seclusion. This aligns with the definition of restrictive practices provided in the Quality of Care Principles 2014 (Quality of Care Principles), with the exception of chemical restraint which is not included in the restrictive practices quality indicator.
Environmental restraint, is a practice or intervention that restricts, a resident’s free access to all parts of their environment (including items and activities) for the primary purpose of influencing their behaviour. Environmental restraint can include the use of a secure area, such as a locked behavioural support unit or dementia care unit.
Should new information about environmental restraint be displayed alongside Star Ratings, in addition to information about restrictive practices?
Would having details around environmental restraint as well as all restrictive practices appropriately indicate the quality of care being provided at the aged care home?
Thank you for taking the time to complete the survey, we value your feedback. If you wish to engage further with the consultation process, please visit the Department's Consultation Hub for information on face to face and virtual sessions, as well information on how to submit a written response.