Quality Indicator trends showcase mixed outcomes
Last updated on 1 April 2025
Long-term Quality Indicator trends have revealed positive growth for the consumer experience and overall quality of life in residential aged care despite limited movement for indicators such as falls, unplanned weight loss and the use of antipsychotic medications.
Key points
- The two newest Quality Indicators, consumer experience and quality of life, have consistently trended upward since being introduced in quarter 4 (Q4) 2022-23. As of Q2 2024-25, 84% of surveyed residents reported a ‘good’ or ‘excellent’ consumer experience, while 75% said the same for quality of life.
- There has been little movement in the percentage of care recipients recording a fall since Q1 2021-22 with the figure hovering around 31% – 33%. Recent data reveals that 1.7% of care recipients had a fall that resulted in major injury, which is the equal-lowest percentage since data began being collected.
- Quality Indicators linked to weight loss and polypharmacy have trended downward in the long-term, although there has been significant short-term increases that suggest ongoing challenges in the area.
Quality of life improves
When the Quality Indicator Program 2023/24 annual report was released in November, the sector was alerted to the fact that several critical indicators have either stalled or increased in the past year.
The latest data release builds on the findings with a mixed bag of outcomes over the last 12 months in particular.
As highlighted already, the greatest gains have occurred with the percentage of care recipients reporting ‘good’ or ‘excellent’ in quality of life and consumer experience indicators: 84% of surveyed residents reported a ‘good’ or ‘excellent’ consumer experience, while 75% said the same for quality of life.
There is some variation to the latest responses based on location (Modified Monash Model/MMM) with care recipients living regional, rural and remote settings slightly happier with their consumer experience. Interestingly, quality of life is higher for metropolitan residents.
However, the greatest determining factor is how a response was sourced. Care recipients who responded via proxy completion record the lowest amount of ‘good’ or ‘excellent’ responses in all scenarios with the sharpest drop off occurring in quality of life.
While the overall average was 75%, just 62% who responded via proxy shared ‘good’ or ‘excellent’ responses, and that dipped to 59.2% in rural and remote areas.
Workforce turnover stays down
Workforce turnover remains significantly low at 5.3%, compared to 7% when the Quality Indicator was first introduced in 2023.
There are some intriguing location-based outliers, though, such as Tasmania recording a 14.1% turnover in nurse practitioners/registered nurses in Q2 2024-25. The Northern Territory also saw one-fifth of its service managers depart, while there were notable losses in the Australian Capital Territory where providers lost one in ten service managers and enrolled nurses.
New South Wales, Victoria, Western Australia and South Australia reported steady turnover rates across all categories, ranging from 3% – 8%.
Meanwhile, there were no statistically significant trends when comparing metropolitan and regional, rural or remote locations. Metropolitan providers recorded 5% turnover rates for all eligible staff, followed by 5.7% for rural and remote locations, and 5.8% for regional centres.
Trends rise and fall
Looking at the nine original Quality Indicators, Australian Institute of Health and Welfare (AIHW) data indicates eight have recorded a statistically significant downward trend and just one — falls — has not significantly changed.
Despite this, the short-term rise for weight loss (significant and consecutive, physical restraint (including through the use of a secure area) and medication management (polypharmacy) are concerning.
Whereas Quality Indicators such as falls, falls that resulted in a major injury and pressure injuries suggest the sector is at a baseline of expected occurrences, the other areas can evidently be lower.
For example, significant unplanned weight loss and consecutive weight loss both hit an all time low of 7.1% in Q4 23-24 before rising to 9.1% and 8.4%, respectively.
Rates of physical restraint and physical restraint exclusively through the use of a secure area had also decreased before progress stalled and then disappeared. Now, 19.3% of homes recorded the use of physical restraint, with 15.1% through the use of a secure area.
Critically, it’s important to note that the data provides just a surface level analysis. As per the usual technical notes, “The results for some QIs may therefore not represent the occurrence of those events across other, non-assessed periods in the quarter.”
Despite this, it will no doubt be interesting to see what progress occurs once a new rights-based Aged Care Act is introduced. Will trends continue upward, or will there be a return to downward movement?