Australia’s aged care compares poorly to global benchmark

New research delivers alarming findings on Australian aged care standards.

Australian aged care disgrace

New research from the University of Wollongong has found more than half of all Australian aged care residents are in homes with staffing levels that would be rated one or two stars in the United States’ five-star rating system.

The research was produced for the aged care Royal Commission to analyse staffing of Australian residential aged care homes compared to standards in other jurisdictions.

Staffing levels and the skill mix of staff in residential aged care are proving to be significant issues at the Royal Commission.

The report examines staffing benchmarks used in the United States, British Columbia in Canada, Germany, Victoria and Queensland. The report concludes the United States has the best system currently available to evaluate staffing levels.


In the US system, each aged care home is rated on a five-star scale. Three stars is the sector average, one to two stars is below average, and four to five stars is above average.

The US star ratings are based on the amount of nurse and personal carer time per resident, adjusted for differences in residents’ care needs so that homes can be compared against each other.

When the US system was applied to Australian data, the report found that 57.6 per cent of all Australian aged care residents are in homes with staffing that would only rate one or two stars in the US’s five-star rating system.

The authors of the report consider that one or two stars represent unacceptable levels of staffing, while three stars is acceptable, four stars is good, and five stars is best practice.

Only 27 per cent of Australian aged care residents are in three-star homes, while 14.1 per cent receive four stars and just 1.3 per cent are in homes with five stars.

Raising the standard so that all Australian aged care homes are rated at least three stars would require an average increase of 37.3 per cent in total care staffing in the homes currently rated one or two stars. This would require an increase of 20 per cent in total residential aged care staffing across Australia.

Allied health staff (including physiotherapists) is not counted in the US system but are part of standards set in British Columbia.

The report found only two per cent of Australian aged care residents are in homes that would meet British Columbian allied health staffing standards.

Do you have a frail family member in an aged care facility? What do you think of the staffing levels at the facility? Do you think we should be aiming for world’s best practice in Australian aged care facilities?

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    The Sheriff
    16th Oct 2019
    It seems obvious that Australians prefer not to work in Aged Care and thus it will always be difficult to find suitable staff, which probably accounts for some of the ill treatment directed at Aged Care clients by unsuitable staff who don't want to work there. The solution may be to grant visas to Asian nurses who are encountering adverse employment opportunities in their own countries. Asian culture is more compassionate and understanding to older people than ours and inviting such qualified nurses to work in Australia under specific conditions would be a win/win for all concerned.
    16th Oct 2019
    Oddly - at age 70 I was considering taking on a job in the local village.... I'm sure I could relate to the older people there...

    Hmm ... and here I was mistaken about the number of foreign-trained medical staff... nurses are on the list of jobs the government puts out where people are needed, though there remains the reality that local graduates often find it hard to get a job.

    Looking at some of the Asians - bashers and even nursing home burners - we might want to re-consider that option.
    Life experience
    16th Oct 2019
    I beg to differ about Asian nurses being more compassionate. What I found working in aged care is they respected their elderly In their own culture but not elderly Australians. I don’t say that lightly but it’s what I learned working for 20 years in aged care.
    Why would we bring in people from overseas when there are Australians who can do the job. And need the employment.
    I agree the staffing levels are too low and needs to increase to give the residents quality care. The staff want to do a great job but don’t have the time which is frustrating for them. If they weren’t so short staffed more people would want to do the job. Also they are poorly paid compared to the public hospitals. They need a pay increase to attract suitable staff. They work so hard in aged care they deserve every cent.
    16th Oct 2019
    Why would we bring in people from overseas ? Because they accept meager wages just to have work and many are underpaid, overworked and abused, so some take it out on residents in nursing homes and hence they provide low standard of care.
    16th Oct 2019
    Older lady - 100% correct. To me, as a simple old grunt, the issue seems to be adequate oversight, initial selection and on the job training...

    Arvo - as you say, when people are underpaid, overworked and abused - they will adopt the classical position of dumping on those 'lower' down the chain - in this case - the Inmates (word chosen carefully).

    I trust that most of you realise that people constrained in any institutional situation are easily confused with inmates.

    We see this with those held in detention for visa etc issues - often they are treated as inmates in a prison, when they are not.

    Similarly, people in 'aged facilities' - when under the Fuhrerprinzip of total control by the paid staff - can be treated as inmates instead of honoured residents with issues that need to be carefully handled.

    I spent enough time in DVA situations to see more than clearly that often the 'staff' think they are dealing with idiots and nutters - when they are supposed to have been assisting with genuine issues of military service and often with people far their betters and superiors in many ways. If such 'staff' were ever under my command - they would be RTU'd instantly.... returned to their factory... and would have NO gig.

    So I can see clearly that many in institutions not properly handled and with many people from outside the culture of care, would be treated badly, if at all.... as long as it suited the wants of the 'staff'.

    Staff - if you can't serve - don't ever consider yourself suited to be a tyrant....

    16th Oct 2019
    I see no reason why organisations would not want to be rated according to some system - star or otherwise. Of course, that should not mean that because we accept one article in the system of belief of US aged/health care, we should accept the lot.

    Sign over the door of Grampa Simpson's nursing home:- "Please do not upset clients by discussing the outside world."
    16th Oct 2019
    its not just lack of staff , but working conditions , how can you care for the elderly without enough sheets for the beds , no soap /shampoo or bandaids etc unless you bring them from home , cockroaches in the kitchen and no one cares ( this is what we had to face as nurses in 1980 ) who do you report it to?? those who are supposed to be responsible dont want to know
    16th Oct 2019
    ...and don't go 'rocking the boat'..... it's more than your job's worth...

    "It has come to the attention of management that your work performance in terms of inter-action with other staff is deficient...."

    Some of these people need a thorough shake-up.....
    16th Oct 2019
    it is not generally the work or the clients that keep people from working in aged care. Even Registered Nurses are paid far less than those Registered Nurses in other health sectors. Aged Care Workers (who by the way make up the vast majority of all those working in aged care) are some of the lowest paid workers in the country like child care. Even doctors are not well paid for nursing home visits. This needs to be rectified. As does the type and quality of training. Currently there is no mandatory requirement for age care workers to be trained or qualified at any level. Compare that with child care workers who must have a minimum Certificate III and even a Diploma in Early Childhood Education. But it is not just a qualification that is needed, we have to look at the content and then the competency of the individual to execute it. Much of this will come out in the Royal Commisssion report
    16th Oct 2019
    As I've said about medical schools many times - the quality and natural ability and skills trumps the endless horde of nerds we now see... and I've seen some beauties...

    They may excel at academics - but they will never be Doctors (capital D)... there are actually different requirements for the job.... such as a natural affinity with healing(??)and an absolute affinity with your patients..

    Same applies here....
    17th Oct 2019
    I agree KSS, good comments.
    16th Oct 2019
    A very poor study in that not one mention is made of the wage differential between US and Australian workers, and the impact on staffing. Well, Americans in this industry are paid much less than Australians; no wonder their facilities can be more highly staffed.

    It's a bit of a minefield trying to find the relevant figures but American "aides" are paid about USD 10/hour (AUD 15) while Australian "assistants" are paid about AUD 23.
    16th Oct 2019
    Hmmm... yessss... but the issue being contrasted was the rating system - not staff wages...

    ... and we do not want a US style system of anything - even our roads, power, and gas and so forth...

    Australia was good as it was, thank you very much.... when honest, hard-working people gave a damn about their homes, families and communities... then we imported criminals and made them politicians....
    16th Oct 2019
    Pretty bad when Australia is worse than our American neighbours. Of course another sign indicating that business can pretty well do as it likes. The problem with bad governments which accept donations to look the other way. We have one.
    16th Oct 2019
    As usual - the 'business model' has failed to produce the much-vaunted benefits - the benefits in reality are negative...

    If you ever see me in one of those hell-houses - shoot me out of mercy. I'll be the old bastard with the bruises from telling the 'staff' where to get off ... and who is such a difficult case and needs constant restraint and DISCIPLINE!!!..

    Jesus - tie me to the wheel of the yacht and let the seagulls have me...
    16th Oct 2019
    p.s.once dated the gorgeous daughter of a woman who ran a nursing home... it was later savaged for maltreatment and abuse and neglect .... jeez...... and she (the daughter) had such a fine, well-rounded, balanced ... (oh, well)....

    Guess the mum wasn't up to the same standard....
    16th Oct 2019
    Would bringing in a star rating have the same results as the hotel industry - the higher the star rating the more costly it is to stay. I think the ideal aged care nurse would be a mature aged person who still wants to work. They would have more empathy than young people who need to work with companions their own age.
    16th Oct 2019
    Ya got me, honey - thinking of taking a position at the local nursing home - I'm only 70, but still got all my marbles (I think) and galloping like a gazelle and full of spirit...

    Already known around town as very empathic with the really old people... if I ever grow up and slow down to suit my age, break it to me gently,....
    16th Oct 2019
    Surprise, surprise but I'm not surprised. People in charge of age care are there to make a millions at all cost. I use to visit my sister in-law who had stroke and paralysed down the right side and could not fed herself, the food was just brought in and left, even having difficulty when nature called but the biggest issue I had was that a good portion of the staff were foreigners which no doubt had no experience but were cheap to employ and nothing is going to improve but get worse. This once beautiful country is totally ruined.
    16th Oct 2019
    Greed Is Good! Trickle-down will ensure that the inmates get proper care and treatment and even good food....
    Karl Marx
    17th Oct 2019
    Maybe the solution is for the residence to revolt with so much force, terror, physical abuse with weapons on staff & more directly the management to the point that they are charged & convicted of serious assault causing injury & even attempted murder.
    The outcome will be jail, 3 better meals a day, better accommodation, better health dental optical care, exercise yard, 24 hr CCTV in case of falls etc & all at no cost. nice
    17th Oct 2019
    Understaffing is a huge problem and maybe choice of staff as well. Teachers need to be suited to teaching children and young people, nurses need to be suited to caring for patients, etc.
    You have to love what you are doing and be continually inserviced. Obviously, a lot more money needs to be allocated to age care.
    This government does not prioritise care across the board. It is not a shortage of money but ho you prioritise for funding. Close the tax loopholes to allow sufficient funds to go where it is needed. Problem solved.
    17th Oct 2019
    I was a nurse in Julia Farr Centre for the incurables and we had good staffing but this was due to State Gov. help. However, in most private nursing homes staffing levels were inadequate, with staff overworked and poorly paid and this was the 1980's. Nothing has changed. I believe, that like and industry or utility should be in government hands but operated by a separate body as non-profit and controlled by that body under scrutiny by the public. Good staff training with emphasis on advancement and wages would help.
    17th Oct 2019
    I was a nurse in Julia Farr Centre for the incurables and we had good staffing but this was due to State Gov. help. However, in most private nursing homes staffing levels were inadequate, with staff overworked and poorly paid and this was the 1980's. Nothing has changed. I believe, that like and industry or utility should be in government hands but operated by a separate body as non-profit and controlled by that body under scrutiny by the public. Good staff training with emphasis on advancement and wages would help.

    17th Oct 2019
    I guess the only question is why does Univ of Wollongong have to point out these results when we have a whole bunch of Govt public servants paid to oversee this badly performing sector!
    Why hasn't the Govt moved much, much faster (as soon as they privatised it and unleashed private sector greed) to implement the best rating systems for this critical sector (being human care) such as in British Columbia?
    Are they waiting for recommendations from the Royal Commission to be forced to act? While existing Aged Care recipients suffer, and some die? Doesn't look like a Govt for the people!
    17th Oct 2019
    Considering that aged care staff are one of the lowest paid, yet they have a big responsibility, I think raising the wages, better and longer training, and screening of potential staff to see if they are deemed fit mentally and physically to handle aged care jobs should be first priority. And maybe have Government owned aged care so that profits are not the main thing they care about. Big changes need to happen fast with a growing older population I cannot see how it is going to happen soon enough. More support at home also needs to happen. I hope I don't have to see my mum in aged care.