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Residential Aged Care Quality Indicators — April to June 2021

This page includes data available for 1 April to 30 June 2021. You can download data directly from the visualisations by clicking in the graph area and using the 'download' menu. 
Quality indicators measure aspects of service provision that contribute to the quality of care given by residential aged care services. Between 1 July 2019 and 30 June 2021, the National Aged Care Mandatory Quality Indicator Program has required residential aged care services to collect and report on 3 quality indicators:
  • Pressure injuries
  • Use of physical restraint
  • Unplanned weight loss.
Information on these indicators was submitted by 2,611 residential aged care services in the quarter 1 April to 30 June 2021. This represented 96% of all residential aged care services that received Australian Government subsidies for delivering care, services and accommodation (compared with 95% in the previous quarter). 

More information about the National Aged Care Mandatory Quality Indicator Program (QI Program) is available on the Department of Health’s website, where there is also a description of 2 additional QIs and of revisions to current QIs that were implemented from 1 July 2021. Consequently, future quarterly reporting on the QI Program will feature new QI data and an updated report format beginning in the next quarter (July to September 2021).

Quality Indicator 1: Pressure Injuries

In accordance with the National Aged Care Mandatory Quality Indicator Program Manual 1.0, a pressure injury is a localised injury to the skin or underlying tissue due to pressure or friction. Six categories are assessed in relation to pressure injuries:

  • Stage 1 pressure injuries: non-blanchable erythema of intact skin
  • Stage 2 pressure injuries: partial-thickness skin loss with exposed dermis
  • Stage 3 pressure injuries: full-thickness skin loss
  • Stage 4 pressure injuries: full-thickness loss of skin and tissue
  • Unstageable pressure injuries: obscured full-thickness skin and tissue loss
  • Suspected deep tissue injuries: persistent non-blanchable deep red, maroon or purple discolouration.

Quality Indicator 2: Use of physical restraint

In accordance with the National Aged Care Mandatory Quality Indicator Program Manual 1.0, physical restraint refers to any practice, device or action that restricts a care recipient’s ability to move freely or make decisions. Physical restraint does not include chemical restraints or prescribed medication. This indicator includes 2 categories:

  • Intent to restrain: observed assessments of intentional physical restraint of a person, at which a count of the number of restraints in use is made
  • Physical restraint devices: observed physical restraint devices of certain kinds in use—bedrails, chairs with locked tables, seatbelts other than those used during active transport, safety vests, shackles and manacles.

Quality Indicator 3: Unplanned weight loss

In accordance with the National Aged Care Mandatory Quality Indicator Program Manual 1.0, weight loss is considered to be unplanned where there is no written strategy and ongoing record relating to planned weight loss for the care recipient. This indicator includes 2 categories:
  • Significant unplanned weight loss: loss of 3 or more kilograms over a 3-month period (the last measurement of the current quarter compared with the last measurement of the previous quarter).
  • Consecutive unplanned weight loss: loss of any amount every month over 3 consecutive months of the quarter.

Geographic variation

Disaggregation of quality indicators by state/territory and by remoteness categories for 1 April to 30 June 2021 were calculated from raw data with no risk adjustment. This means that it has not been possible to take into account variation in the complexity of people’s care needs at the facility level (casemix) nor how this interacts with other features known to vary across geographical areas, such as service size, facility ownership or interaction with healthcare services (such as hospitals and palliative care services).
Data collection
All Australian Government-subsidised residential aged care services are required to inform each care recipient about the assessment and ask their permission to include their data in the QI Program. In the QI Program from 1 July 2021, consent will be required from care recipients for the purposes of two quality indicators only: unplanned weight loss and pressure injuries.

Pressure Injuries
Aged care residents are assessed for 6 categories of pressure injury with a full-body assessment. Assessments are made on or around the same time and day in each quarter of the year. This can be done as part of the resident’s usual personal care.

Use of physical restraint
The use of physical restraint is assessed in the morning, afternoon and night on 3 different days each quarter, i.e. counts are aggregated across 9 observational assessments during the quarter. Assessments are not announced in advance to staff or care recipients. For specified physical restraint devices, the number in use is counted, whether the devices are being used to intentionally restrain a care recipient or not. Although amendments to the Restraints Principles that occurred on 1 July 2021 are not relevant to this quarter’s report, differences may exist in the definitions of physical restraint in the QI Program before and after 1 July 2021 given legislative changes. Specifications for the new quality indicator reports are set out in the National Aged Care Mandatory Quality Indicator Program Manual 2.0 (July 2021).

Unpanned weight loss
Care recipients are weighed each month, in clothing of similar weight each time. Residential aged care services report the number of care recipients with significant unplanned weight loss since the last measurement, and the number of residents with significant weight loss of any amount recorded over the 3 consecutive months of the quarter. Data are not collected from care recipients who are absent (for example, in hospital), residents who are receiving end-of-life palliative care, or respite care recipients.

More information
Detailed specifications for the quality indicators reported here are set out in the National Aged Care Mandatory Quality Indicator Program Manual 1.0 (June 2019). Since 1 July 2021, this version of the Manual has been superseded, but it remains the relevant manual for the purposes of this report.

Information on the compilation of Quality Indicators for April to June 2021, including data quality, is available in the Technical notes below.