The aged care sector’s star rating system is “deceptive” and being used as a “political tool”, a former federal government compliance officer has told 7.30.
The star rating system was introduced by the Albanese government two years ago in response to shocking findings of elder abuse and neglect by the Royal Commission into Aged Care Quality and Safety . It rates nursing homes between 1 and 5 stars.
Aged Care Minister Anika Wells previously said the scheme is designed to open up a transparent conversation and give people better options about choosing a facility they will be happy with.
She recently told 7.30 there’s been a 27 per cent increase in the number of 4-5 star rated nursing homes across Australia since December 2022.
However former compliance officer Rodney Jilek, who has 30 years’ experience in the sector, has cast doubt over those numbers.
Rodney Jilek has worked in aged care for three decades. (ABC News: Michael Nudl)
“The system is designed to over-inflate the star ratings so that the minister can say that the quality of aged care services is improving,” he told 7.30.
“The reality is that all of the other data sources are pointing out that aged care is actually getting worse.”
Mr Jilek published a paper about star ratings and found 300 homes were rated between 3 and 5 stars despite being found by the Aged Care Safety and Quality Commission to be non-compliant with government standards.
Newcastle-based Wallsend aged care home, which is owned by the NSW government, has been rated 5 stars at the same time a government audit found the home to be non-compliant with all eight standards.
NSW Health told 7.30 that Wallsend is due to close as the facility is in an aging hospital style setting.
The government’s own guidelines stress that non-compliant nursing homes would not receive more than 2 stars. However, the Aged Care Commission recently clarified that star rating is only affected if homes also had regulatory action taken against them.
Mr Jilek says the government relies on this loophole to skew the numbers.
The star rating system allows families to compare the quality and safety of different providers. (ABC News: Luke Bowden)
“[The star rating system] is giving a deceptive picture of what is happening in aged care,” he said.
“You would have to go back and have a look at the intent of the system, whether it was truly intended to be a transparent avenue for people to choose homes, or whether it was intended to be a political tool to over-exaggerate the quality of care.”
Mr Jilek has warned against using star rating system as an accurate measure of quality.
“I would not rely on it at all if I was choosing a service for my loved one,” he said.
Sepsis, dehydration and renal failure missed
Geelong resident Rodney Reed says he still feels guilty for choosing Charles Brownlow nursing home for his wife Kath.
The facility in Highton Victoria has been consistently rated between 4 and 5 stars, and it had a glowing audit with “no specific areas identified” for improvement.
Before selecting the nursing home, Mr Reed says he sent out questionnaires, interviewed staff, went on tours and observed residents’ interactions.
Rodney Reed took six months to select what he thought was the right nursing home for his wife Kath. (ABC News: Andrew Altree-Williams)
“The budget was not an issue,” Mr Reed told 7.30. “We wanted Kath to be safe, secure and comfortable.”
“When you look at the building, you think, this is a 6-star hotel. Their brochures and information books were glowing. But I guess it was the physical things that I got lured into.”
The first alarm bell for Mr Reed came when he realised the gym and pool from the brochure were off-limits for nursing home residents and were only to be used by the retirement village nearby.
But that was the least of his worries. In August 2023, his wife’s health worsened.
Kath would later suffer poor health when she was in a nursing home. (ABC News)
Their daughter Steph Foley recalls how her mum suddenly appeared lost and confused.
“I remember I tried to take her for a walk, and she put a magazine on her head,” Ms Foley told 7.30.
“I said ‘could she have had a stroke’?”
Within the following month, Mrs Reed lost 7 kilograms. When Ms Foley and her father asked for information and answers from the nursing home, their pleas fell on deaf ears.
Mr Reed decided to hire an independent geriatrician to examine his wife. In her report, the geriatrician wrote that Kath was in a near-terminal state after nine days of having no food and minimal fluids.
The signs on Kath’s door days before she passed away. (Supplied)
Immediate hospitalisation was recommended to increase her chances of survival.
Hospital records obtained through FOI show that Kath had sepsis, dehydration and renal failure.
Once she was stabilised she was returned to the nursing home, where her family say things got worse.
“There was a time when I thought she was in a lot of pain, and I went out to ask the coordinator to help, and her reply was, ‘how long will it take?’ I was crying,” Ms Foley said.
A few days later, when Mr Reed and Ms Foley visited they noticed two new signs on Kath’s door: One had a picture of a butterfly, and one had a picture of a nature scene with a staircase going up to a light.
Ms Foley said she thought it meant that her mum was dead.
Kath was still alive that day, but the signs were the first time Ms Foley and Mr Reed knew that their loved one was so close to dying.
Two days before Kath died, her husband said he was told by a nurse that she “wasn’t going anywhere”, and that “this can go on for months”.
“Two days later she died, so we felt a real sense of betrayal that we were so ignorant in terms of her real condition,” he said.
‘Deficits in care’ but increased ratings
Mr Reed and his daughter complained to the Aged Care Quality and Safety Commission.
A subsequent investigation found Kath Reed was ‘malnourished’, her pain was undermined and under-treated and she was given the wrong medication.
Steph Foley and her father say they were never told Kath was so close to dying. (ABC News: Andrew Altree-Williams)
7.30 obtained records of a phone call between Charles Brownlow’s clinical quality manager and the Aged Care Commission complaints officer.
In one phone call, the manager says she was “horrified” by the nursing home’s “deficits in care”. She also said she wants the Commission to refer Charles Brownlow to “compliance”.
However, three months after the investigation concluded, Charles Brownlow had its star rating for compliance increased from 4 to 5 stars.
“I just don’t understand how it’s possible,” Mr Reed said.
Charles Brownlow said in a statement that some aspects of Kath Reed’s care did not meet their standards. It said the nursing home adopted all the recommendations the commission made to address this.
Two senior managers involved in this case no longer work at the facility.
Aged Care Commissioner Janet Anderson said, if a nursing home can quickly demonstrate its ‘taken appropriate action to address any risk of non-compliance’ then it does not use its ‘formal regulatory powers’.
She also said that ‘overall star rating is accurate and reliable’.
Ms Wells told 7.30 that star ratings are enhancing accountability, transparency and capability within the sector.
The ownership loophole
Mr Jilek’s research identified another loophole that has the effect of eliminating a nursing home’s negative history.
He found that when facilities transfer ownership, any sanctions are removed, a new time frame for an audit kicks in, and the facility has no star rating at all for 12 months.
“The consequence of that is that the general public has no idea of what the current performance of the service is, and they also don’t know what the past performance of the service is,” he said.
“It’s a clean slate.”
In February, Australia’s biggest aged care provider, Opal Healthcare, bought a Queensland-based nursing home and renamed it Bethania Parklands.
Its former name was Jeta Gardens, a nursing home with a shocking history of non-compliance in relation to workforce training and monitoring, COVID protocols and financial governance.
Jeta Gardens made headlines after a COVID outbreak at the aged care facility. (ABC News: Chris Gillette)
In 2022, a COVID outbreak struck the facility, where 15 people died after 100 residents and 82 staff were infected.
During that time, Shaz Campbell’s mother Diana Bourn was a resident of Jeta Gardens.
Ms Campbell, who was unable to visit due to a lockdown, had been wondering how her mum was faring.
“She had no COVID. They don’t tell you about all the rest,” Ms Campbell told 7.30.
A history of failure
When Jeta Gardens’ doors re-opened, Ms Campbell found letters her mum had been writing to members of the family.
Shaz Campbell visited her mum daily until a COVID outbreak struck the nursing home in 2022. (ABC News: Shaun Kingma)
One of them reads: “It’s like a madhouse in here. Please help me. Lots of love, mum.”
A few weeks later, Ms Campbell was told by a nurse at Jeta Gardens that her mum was in an ambulance on the way to hospital.
Ms Campbell rushed to hospital where she found her mum unconscious and close to dying. She says her mum appeared so dirty and dishevelled that the hospital staff told her they believed she was homeless.
“When I went up to give her a hug, she just smelled. The smell was … awful.”
Diana Bourn died 12 days after getting a UTI while at the nursing home. (Supplied)
When Ms Campbell inquired about her mum’s state, a nurse at Jeta Gardens emailed her saying that her mother had a UTI and was given antibiotics.
Accidentally, the nurse also forwarded on internal correspondence, where staff admitted they feared they’d be sanctioned for neglect because Ms Bourn had never been given the antibiotics she needed.
The attachments in the email revealed that while in a ‘lethargic’ state, Mrs Bourn herself requested to be transferred to hospital.
Ms Bourn was diagnosed with sepsis, and she died in hospital 12 days after getting the original UTI.
While cleaning out her mum’s room at Jeta Gardens, Ms Campbell found the unopened box of antibiotics which could have helped to save her mum’s life.
She says that two weeks later she got a letter from Jeta Gardens requesting payment for the unused antibiotics.
An investigation by the Aged Care Quality and Safety Commission found that Diana Bourn did not receive the care that she deserved.
In response, Jeta Gardens committed to changing care protocols and re-educating staff.
Now under new ownership and known as Bethania Parklands, the facility currently shows no star rating.
Ms Campbell says she thinks her mum’s tragic experience, and the findings of the Aged Care Quality and Safety Commission, should be made public.
“No other family should go through this heartache,” she told 7.30.
“These are human beings, family members.
“You’re elderly, you’ve worked all your life, you get sick, you get dementia, you need to be cared for.”
Opal Healthcare declined to be interviewed about this case saying that Ms Bourn’s experience happened when the facility was owned and operated by an entirely different organisation.
It said in a statement that after the takeover, Opal Healthcare introduced a new management team and made wholesale improvements.
However, in a statement from February, Opal Healthcare said that the majority of Jeta Gardens’ aged care team have switched over to Opal HealthCare “so they can continue to provide dedicated and compassionate care for our residents”.
The star rating system is currently being reviewed by an external consultancy.
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