Mismatch between aged care 5-star ratings and community expectations

In this guest post, Kevin McCreton, Managing Director of Catalyst Research shares the latest results from their consumer insights Catalyst Report – surveying the views of 4,610 Australians – into understanding their expectations when it comes to aged care quality and standards.

The Department of Health (DoH) aged care ratings were published last Friday. The results combine consumer feedback, quality indicators, service compliance ratings and care minutes. Three in ten sites (30%) achieved 4-stars. Six in ten sites (59%) gained 3-stars. One in ten (10%) was assessed as below the acceptable level.

The 5-star system is controversial. There is positive intent in providing consumers with a common assessment method. Shining a light on sub-standard operators is also a worthy aim. However, establishing a system where the ‘pass mark’ is 3 stars is out of step with community expectations. As Australians search for cafes, hotels, retailers etc., we look for a 4-star provider at the least. This behaviour mirrors The Catalyst Report which reveals 84% of Australians believe an acceptable aged care facility should be 4 or 5-star.  That’s based on 4,610 survey respondents.

The aged care industry is punch drunk. The Royal Commission (rightly) uncovered the worst cases of substandard care. Covid-19 put immense pressure on providers and employees. Staffing shortages became chronic. 60% of RAC homes run at a loss.1 Whilst these pressures mounted, a new rating scheme has been imposed. In many cases DoH assessments occur before funding for services is received. Is the 5-star system a good fit for an industry in survival mode?

The mismatch between the DoH results and consumer expectations could be read in three ways:

  1. Consumers are out of step: Some Australians take the view that a lifetime of tax contributions means they are entitled to a 4 or 5-star aged care experience
  2. Aged care providers are not yet up to scratch
  3. The government’s measurement processes are problematic

On the latter point, DoH reached the conclusion that 3 stars were acceptable based on research with fewer than 120 people.

My concern is that the 5-star system will reinforce consumer confusion and anxiety. A five-point measurement system is a very blunt instrument. The majority of sites being at a 3-star level is not an appealing prospect as I consider options for my parents. Ratings will not be updated for another 12 months. Providers have no recourse to dispute their assessment.

Satisfaction ratings from The Catalyst Report show that aged care standards are getting better. The industry needs to do a better job of telling positive stories.

This will improve prospects for staff retention, staff recruitment and the willingness of Australians to entrust their family members to the industry. The Aged & Community Care Providers Association (ACCPA) has a role to play here.

Catalyst has already commenced discussions with providers on adding a single question to their customer experience surveys, to develop a care and support index. This offers the potential for providers to put their best foot forward and give consumers more confidence in aged care.

  1. Stewart Brown Aged Care Financial Performance Survey Dec 2021



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