Numbers without narrative: The aged care reporting conundrum

The Aged Care Quality and Safety Commission’s Sector Performance Report for Q3 (January – March 2025) has ignited debate within the aged care sector, with industry leaders like Nick Loudon, CEO of Envigor Home Care, highlighting the lack of nuance in how data is presented.

In a recent conversation, Loudon questioned the value of reporting raw notification numbers, such as 936 neglect cases in home services, without exploring investigation outcomes or context.

His critique, echoed by industry peers, underscores a critical issue: the current reporting framework risks misrepresenting the sector, eroding public trust, and diverting focus from meaningful improvements.

The mirage of metrics

The Commission’s report details 1,566 reportable incidents in home services, with neglect comprising 60% (936 cases), and 14,799 incidents in residential care, including 4,075 neglect notifications.

These figures, particularly the prominence of neglect, are primed for headlines. However, as Loudon points out, “It’s just simply a notification.” Without clarity on how many incidents were investigated, validated, or attributed to providers, families, or third parties, the numbers lack depth.

“It’s completely open to interpretation,” Loudon says, noting the absence of detail on what constitutes neglect or whether notifications reflect actual occurrences.

Industry feedback reinforces this concern. Jane Floyd, a board director with expertise in aged care governance, notes that providers are often encouraged to report incidents “just in case,” even when issues stem from family members rather than provider actions, inflating figures.

Adrian Morgan, General Manager at Flexi Care, calls the reporting “actively misleading,” arguing that skilled data analysis could yield valuable insights if shared transparently.

The headline trap

The lack of nuance in the Commission’s reporting fuels sensationalism. Loudon predicts, “The media will report just three figures: 1,566 incident notifications, neglect accounts for 60% of incidents in home services, 936 incidents of neglect.”

Without context on investigations or outcomes, these stats can paint an unfairly grim picture. “It’s saying to the public, be afraid of the entire sector,” Loudon warns, labelling this approach “completely irresponsible.”

This focus on raw data also obscures critical issues. “There’s so much noise in those numbers that no one’s actually getting to the bottom of what is problematic and what we need to be fixing,” Loudon explains.

The report notes a 5% rise in neglect notifications in residential care from Q2 to Q3, but without root cause analysis or provider response details, it’s unclear whether this signals a genuine issue or simply more diligent reporting.

Glenn Bunney, a non-executive director, distinguishes between “data” and “information,” arguing that the Commission’s reports lack the latter. Brendan Moore, an executive in human services, adds that the report fails to define acceptable risk levels for a sector serving nearly 250,000 residents and 300,000 home care package recipients annually.

“What sort of rates of falls, medication errors, etc., are within acceptable boundaries?” Moore asks, noting that zero incidents is unrealistic given the sector’s scale.

Craving clarity in the chaos

Loudon calls for a more analytical approach, particularly for issues like medication errors, which account for 46% of neglect notifications in residential care. “If someone misses a dose of one medication, what relevance does that actually have?” he asks, comparing it to everyday lapses like missing an antibiotic dose.

He recounts how, in his experience running retirement villages, dispensing errors by pharmacies were often reported as provider errors, further muddying the data. “That error is not actually our error,” he says, yet it’s recorded as such.

He also questions the logic of reporting minor incidents, like falls, as serious events. Citing his father-in-law with Parkinson’s disease, who fell while sneaking a chocolate, Loudon notes that such incidents are reportable if a staff member is present but not if they occur independently.

“The idea that we can get to zero risk and zero incidence of people having a fall in any environment is ludicrous,” he argues, urging the Commission to differentiate between preventable systemic issues and inevitable events.

Balancing risk and respect

A core tension in aged care is reconciling safety with the dignity of risk, which upholds individuals’ rights to make choices, even risky ones. Loudon notes that the sector has shifted away from this principle in recent years, driven by political fallout from the Royal Commission into Aged Care Quality and Safety.

“The Royal Commission came along and said, effectively, everything’s a disaster,” he says, criticising its failure to contextualise findings against the volume of care interactions.

The Commission could help by setting realistic risk benchmarks in collaboration with providers.

“No one goes to work to do the wrong thing,” Loudon says. “So often, the errors being made are system errors.” He advocates focusing on systemic fixes rather than emotive outliers, noting that while individual incidents matter to families, policy should target broader trends.

“If it’s your family member, then it does matter,” he acknowledges, but adds, “At a policy level, that’s actually, to be crude, irrelevant.”

Charting a smarter course

To enhance reporting, the Commission could include investigation outcomes, such as the proportion of validated notifications, the nature of perpetrators, and incident severity.

For example, distinguishing minor medication errors from serious clinical failures would guide providers and policymakers more effectively.

Benchmarking incident rates against care volume – such as hours delivered or occupied bed days – would also provide a clearer picture.

Loudon stresses the need for actionable data. “What are we collecting it for if we’re not doing anything with it?” he asks. By educating the media and public about the nuances of incident data, the Commission could counter sensationalism and foster informed discussions about care quality.

A call for contextThe Aged Care Quality and Safety Commission’s current reporting, while well-meaning, misses the mark by prioritising raw data over insight.

As Loudon and industry peers argue, unnuanced statistics distort the sector’s image, undermine trust, and hinder progress. By embracing detailed analysis and collaboration with providers, the Commission could transform its reports into tools for real improvement, ensuring the focus stays on enhancing care while respecting the complexities of aged care.

As Loudon puts it, “Punching out whole big chunks of data is useless to anyone in any environment without investigation and analysis.”