Are star ratings for aged care missing the mark?

28 January 2025

Are star ratings for aged care missing the mark?

Transparency and accountability in aged care are critical, especially as Australia continues to respond to the findings of the Royal Commission into Aged Care Quality and Safety. The introduction of the Star Ratings system in 2022 was intended to provide older Australians and their families with a clear, accessible way to evaluate residential aged care services. But, as revealed in the recently released summary report evaluating Star Ratings, the system may not be delivering on its promise.

The evaluation, commissioned by the Department of Health and Aged Care and conducted by Allen + Clarke Consulting, highlights key challenges that undermine the Star Ratings system’s effectiveness. While there have been improvements in residential care standards—62% of aged care homes now receive four or five stars compared to just 41% a year ago—questions remain about how well these ratings reflect the true quality of care.

One major issue raised in the report is that many Australians remain unaware of the Star Ratings system. Among those who are familiar with it, scepticism about its accuracy and credibility persists. This distrust stems from perceptions that the data used to calculate ratings lacks thorough verification. For instance, some stakeholders have pointed out instances where homes with regulatory non-compliance still manage to achieve acceptable or high ratings.

The evaluation also found that only 7% of surveyed aged care residents were aware of the ratings system when entering care. This highlights a disconnect between the system’s intended goal of empowering informed decisions and its actual reach among the people it’s meant to serve.

Star Ratings assess aged care services across four key sub-categories: residents’ experiences, compliance with regulations, staffing levels, and quality measures (e.g., pressure injuries, medication management). However, critics argue that these metrics may not fully capture what matters most to residents and their families—like the quality of food, meaningful social interactions, and culturally specific care.

Additionally, the weighting and calculation methods for the ratings have been criticised as overly complex and opaque. This lack of clarity fuels doubts about whether the ratings genuinely reflect care quality or simply compliance with minimum standards.

The report highlights the need for refinements to the Star Ratings system to make it more accessible, accurate, and relevant. Recommendations include:

  • Increasing public awareness: Ensuring that consumers understand and trust the Star Ratings system through targeted communication campaigns.
  • Improving data rigour: Strengthening verification processes to build confidence in the reliability of the ratings.
  • Addressing diverse needs: Incorporating more detailed metrics that reflect the experiences of culturally and linguistically diverse residents, those with dementia, and other vulnerable groups.

The Star Ratings system is a step in the right direction, but it’s clear from the evaluation that it has a long way to go before it achieves its full potential. As Australia’s aged care system evolves, the challenge remains: How can we transparently measure quality in a way that truly reflects the lived experiences of residents?

As the government considers updates to the system, now is the time to prioritise meaningful metrics and consumer trust. After all, aged care isn’t just about meeting benchmarks—it’s about providing dignity, comfort, and respect to some of the most vulnerable members of our community.

Renae Beardmore

Managing Director, Evohealth