Consumers themselves have identified their experience with residential aged care as critical to support informed choice (COTA Australia 2018). Since 2017, the former Australian Aged Care Quality Agency (AACQA) and its successor, the Aged Care Quality and Safety Commission (the Commission), have conducted consumer experience surveys of residents in residential aged care services (RACSs), in conjunction with regulatory audits. Survey results for each service are published on the Commission’s website (ACQSC 2019d).
This report summarises the combined 2017–18 and 2018–19 survey results and, through analysis, seeks to identify factors associated with positive responses.
The surveys asked aged care residents to describe their experiences across 10 domains that are of relevance to the experience of residential aged care. The domains were identified through research commissioned by the AACQA (Jeon & Forsyth 2016; Wells et al. 2017):
- Firstly, residents were asked whether, from their perspective:
Q1. Do staff treat you with respect?
Q2. Do you feel safe here?
Q3. Do staff meet your healthcare needs?
Q4. Do staff follow up when you raise things with them?
Q5. Do staff explain things to you?
Q6. Do you like the food here?
- Secondly, residents were asked whether they agreed with these statements:
Q7. If I’m feeling a bit sad or worried, there are staff here who I can talk to
Q8. The staff know what they are doing
Q9. This place is well run
Q10. I am encouraged to do as much as possible for myself.
Residents were also asked to nominate the ‘best thing’ about their home and to make a suggestion for improvement. This information is not included in this report.
A range of response categories gave some dimension to the residents’ experiences. Residents selected answers offered both in words and in images depicting ‘grumpy’ through to ‘smiley’ faces. For Q1 to Q6, no ‘neutral’ response was offered, reducing the number of possible responses to 4.
In this report, the analysis was simplified to focus on whether or not the experience is positive—responding either ‘Most of the time’ or ‘Always’ to the first group of 6 questions listed above, or ‘Agree’ or ‘Strongly agree’ to the 4 statements in the second group. These combined response categories are described throughout this report as ‘positive responses’ (the combination of green and blue smiley face responses).
The results indicate that survey respondents have a generally positive view of their experience in residential aged care. Overall, positive responses were given by the majority of respondents for each of the questions asked—for instance, for question 2 (‘Do you feel safe here?’), 98% felt safe either ‘All the time’ or ‘Most of the time’. Similar proportions of positive responses were given for questions that asked if staff treated respondents with respect (Q1), and met their healthcare needs (Q3). Even for those questions drawing the lowest levels of positive responses—having staff to explain things (Q5) and liking the food (Q6)—the proportions of respondents reporting those experiences were 80% and 85%, respectively.
Two of the response distributions are illustrated here—the rest can be seen on the Quality in Aged care topic on the GEN website.
The following graph depicts the percentage of positive responses to all questions, making it easier to compare them. The closer the dark line is to the outer boundary of the ‘web’, the higher the percentage of positive responses for each question.
Proportion of positive responses to questions 1–10 for all respondents
Chapter 3 and the Quality in Aged care topic on the GEN website display more charts which compare responses across respondent characteristics (for example, sex and mobility status), characteristics of the RACS resident group (for example, proportion born in English-speaking countries) and RACS characteristics (for example, size and organisation type).
The sex of respondents made little difference to the proportion of positive responses; however, restricted respondent mobility, a lower proportion of RACS residents born in English-speaking countries, larger service size, and private organisation type, were all associated with lower proportions of positive responses to survey questions, as was respondent type, when answers were provided by a proxy.
Chapter 4 presents results from logistic regression modelling that explores associations between the levels of positive response and personal, RACS resident and RACS-level characteristics and allows for the control of the possible confounding effects of these variables. This analysis generally supports results from the descriptive analyses in Chapter 3. For example, after controlling for the effects of other variables, the proportion of residents born in English-speaking countries was the factor most associated with positive reporting of consumer experience across questions: more positive responses were given by respondents in RACSs that had higher proportions of such residents. Service size and organisation type were also associated with positive responses in the models: For these factors respondents in smaller services or those operated by not-for-profit organisations were those more likely to report more positively than those in larger or privately-operated RACSs. The mobility status of respondents, which in the descriptive analysis was associated with the proportion of positive responses, was not included in the regression analysis as reliable data for this were not available for 2018–19.
The methods and sampling arrangements are described in Chapter 2. Note that although a random sample (10%) of respondents was drawn at each RACS during regulatory audits, the selection of services was not random: inclusion depended on the program of regulatory audits being conducted by the Commission and its predecessor. While this could indicate potential for biased results, some confidence can be drawn from the fact that 2,070 RACSs were audited during the period covered by this report—over 75% of all RACSs—and the profile of the selected RACSs contributing to the data for the consumer experience report aligned well with that of the residential aged care sector more broadly.