The aged care sector has spent the better part of four years debating the merits and failings of the Star Rating system and we’ve covered them. The recurrent questions remain: Is it current enough? Does it measure the right things? Can complex care really be reduced to a handful of public-facing metrics?
They’re all valid and the debate should continue.
Regardless of whether providers agree with the system itself, Star Ratings are now embedded into their operating environment. Consumers use them, the government publishes them and boards monitor them. The conversation now needs to shift from whether the data is good enough to how leaders can use it.
Enter independent consultant Michael Carman who, off his own bat, has dived into the data to bring greater clarity to aged care leaders.
“The data will always be imperfect,” he says. “But the fact of the matter is we know more about how the system is functioning now than we did three years ago… data that’s a little bit out of date is better than no data at all, and partial transparency is better than complete opacity.”
His analysis doesn’t attempt to defend the Star Rating system, or critique it. Instead, it accepts the data for what it is and asks: what can we do with this information?
From dashboards to decision making
Carman says we don’t need another dashboard. This analysis is key in helping leaders understand which levers actually influence the numbers they’re already reporting.
“It’s one thing to uncover patterns,” he explains. “But I want to go one step beyond that… What are the levers and buttons senior management can push to improve those outcomes?”
“Everyone loves dashboards… but the dashboard just gives you the results. I want to give them the steering wheel and the accelerator.”
Aged care leaders rarely suffer from a lack of information. More often, they’re overwhelmed by it. The solution isn’t collecting more data, but distinguishing the signal from the noise.
Two levers in plain sight
Analysing publicly available Star Rating data, Carman identified two operational levers that providers can directly influence.
The first is care minutes.
The second is what he calls the “clinical millstones”: falls with major injury, unplanned weight loss and pressure injuries.
Together, they form what he describes as a “dual engine”. Additional care minutes pull Star Ratings in one direction, while preventable clinical incidents pull them in the other.
His modelling also suggests that not all staffing investments carry the same weight. When analysing the relationship between care minutes and Star Ratings, Carman found that increasing total care minutes delivered by personal care workers was almost three times more cost effective than increasing registered nurse care minutes alone. For leaders balancing workforce shortages with financial sustainability, that’s a practical insight worth looking into within their own organisation.
Carman isn’t suggesting leaders chase five stars for their own sake. He’s suggesting that improving the systems which influence those measures is likely to improve resident outcomes as well.
“If I was a senior executive,” he says, “I’d be thinking, ‘Care minutes are important. What’s the most cost-effective way to optimise our roster?’ Then I’d ask, ‘Which clinical indicators are having the biggest impact, and what does that tell us about our clinical governance?'”
Clarity is a leadership tool
Carman’s work is valuable not simply because of what it finds, but because it demonstrates what can be learned from the sector’s growing compliance dataset. If nothing else, it’s evidence that the reporting burden can produce operational insights, not just regulatory compliance.
“I’m just helping clear away some of the fog from the morass of reporting, staffing and regulation that senior management has to deal with,” he says.
The debate around Star Ratings will continue. In the meantime, leaders still have organisations to run. Carman’s contribution isn’t another dashboard. It’s a clearer view of which levers are worth pulling first.
