Choosing a nursing home for yourself or a loved one is one of the most significant decisions a family can make. You want to feel confident that the facility provides safe, respectful, and high-quality care. But how do you actually know whether a nursing home meets the mark?

Australia has a structured quality framework that every aged care facility must follow. This includes eight Quality Standards, a star ratings system, regular assessments by an independent commission, and publicly available data that families can access before making a decision.

This guide explains the entire quality system in plain language, so you know exactly what to look for and how to compare facilities with confidence.

Need help finding a quality aged care facility? Carevo connects families with top-rated providers across Australia. Call 1800 953 253 to find the right provider for your family.

The Aged Care Quality and Safety Commission (ACQSC)

The Aged Care Quality and Safety Commission is the independent body responsible for regulating and monitoring aged care services across Australia. It was established in 2019, bringing together functions that were previously spread across multiple agencies.

The ACQSC is responsible for:

  • Setting and enforcing the Aged Care Quality Standards
  • Conducting assessments and audits of aged care providers
  • Publishing star ratings and compliance information
  • Handling complaints from residents, families, and staff
  • Taking enforcement action against providers that fail to meet standards
  • Registering and approving aged care providers
  • Educating providers about quality expectations

The Commission operates independently from the Department of Health and Aged Care. This separation is important because it means the body that sets the rules is different from the body that funds the system, reducing conflicts of interest.

Since the Royal Commission into Aged Care Quality and Safety delivered its final report in 2021, the ACQSC has been given stronger powers and additional resources to hold providers accountable.

The 8 Aged Care Quality Standards explained

Every aged care provider in Australia, whether residential, home care, or flexible care, must meet the eight Aged Care Quality Standards. These standards came into effect on 1 July 2019, replacing the previous accreditation standards.

Each standard has a core requirement (what the organisation must do) and specific consumer outcomes (what residents should experience). Here is what each standard covers in detail.

Standard 1: Consumer dignity and choice

This standard is the foundation of quality aged care. It requires that residents are treated with dignity and respect, and that their identity, culture, and diversity are valued.

What this means in practice:

  • Residents have the right to make informed choices about their care and daily life
  • Staff address residents by their preferred name
  • Cultural, spiritual, and personal preferences are respected
  • Residents can maintain relationships with family and friends
  • Privacy is protected, including during personal care
  • Residents are supported to exercise their rights, including the right to refuse care

What to look for during a visit: Do staff knock before entering rooms? Are residents dressed in their own clothes? Do residents appear to have autonomy over their daily routines, such as when they eat or sleep?

Standard 2: Ongoing assessment and planning with consumers

This standard ensures that each resident receives care tailored to their individual needs, and that this care is regularly reviewed and updated.

What this means in practice:

  • A comprehensive assessment is completed when each resident enters care
  • Care plans are developed collaboratively with the resident and their family
  • Care plans are reviewed regularly, especially after any change in health or circumstances
  • Residents and families can access their care plans at any time
  • There is clear communication when care needs change

What to look for: Ask the facility how often they review care plans. Ask whether families are invited to care plan meetings. A good facility will welcome your involvement and provide regular updates.

Standard 3: Personal care and clinical care

This is the standard most families focus on, and rightly so. It covers the quality and safety of all care provided, from help with daily tasks to complex medical treatment.

What this means in practice:

  • Personal care (bathing, dressing, grooming, toileting) is delivered safely and with dignity
  • Clinical care (medications, wound care, pain management, chronic disease management) meets best practice guidelines
  • Residents receive timely access to allied health professionals (physiotherapy, speech therapy, dietetics, podiatry)
  • Medications are managed safely, with regular reviews by a pharmacist or doctor
  • Deteriorating health is identified early, and appropriate action is taken
  • End-of-life care is available and delivered with compassion
  • Minimising the use of physical and chemical restraint

What to look for: Ask about staff-to-resident ratios. Ask how the facility manages after-hours medical needs. Find out whether there is a registered nurse on site 24 hours a day. Since 1 July 2023, residential aged care facilities are required to have a registered nurse on site 24/7.

Standard 4: Services and supports for daily living

This standard covers everything beyond direct care that contributes to a resident’s quality of life. It includes meals, laundry, social activities, and the overall living environment.

What this means in practice:

  • Meals are nutritious, appetising, and meet individual dietary needs and preferences
  • Residents have access to meaningful activities and social connections
  • The physical environment is clean, comfortable, and well-maintained
  • Residents can access the outdoors and communal spaces
  • Assistance with daily living tasks is provided as needed
  • Laundry and cleaning services meet acceptable standards

What to look for: Visit at mealtimes if possible. Look at the menu. Check whether there is a variety of activities available, including options for residents with different abilities. Are common areas inviting and well-kept?

Planning facility visits? Our guide on what to look for on nursing home tours covers the key questions to ask during your visit.

Standard 5: Organisation’s service environment

This standard focuses on the physical environment and its design, including safety features, infection control, and how the layout supports residents’ wellbeing.

What this means in practice:

  • The facility is designed to support residents’ needs, including those with dementia
  • Infection prevention and control measures are in place and followed
  • Equipment is well-maintained and fit for purpose
  • The environment is safe, reducing risks of falls and injuries
  • Emergency procedures are documented and practised
  • The facility meets all relevant building and safety codes

What to look for: Check whether corridors are wide enough for mobility aids. Look for handrails, non-slip flooring, and clear signage. Are there secure outdoor areas? How does the facility manage infection control, particularly in shared spaces?

Standard 6: Feedback and complaints

A quality facility welcomes feedback and has clear processes for handling complaints. This standard ensures residents and families can raise concerns without fear of negative consequences.

What this means in practice:

  • There is a clear and accessible complaints process
  • Residents and families are encouraged to provide feedback
  • Complaints are handled promptly, fairly, and confidentially
  • The facility uses feedback to improve its services
  • Residents are not disadvantaged for raising concerns
  • Information about external complaint options (such as the ACQSC) is readily available

What to look for: Ask about the complaints process during your visit. Is there a feedback box or system? Are residents and families aware of how to raise issues? A facility that is defensive about complaints may have deeper problems.

Standard 7: Human resources

The quality of care is directly linked to the quality and quantity of staff. This standard addresses workforce planning, training, and the overall staffing model.

What this means in practice:

  • There are enough qualified staff to meet residents’ needs at all times
  • Staff have the right qualifications, skills, and training
  • Staff are supervised and supported
  • Workforce planning considers the number and complexity of residents’ needs
  • Staff receive ongoing education and professional development
  • The facility has strategies to recruit and retain quality staff

What to look for: Ask about staff turnover rates. High turnover can indicate poor working conditions, which affects care quality. Ask whether staff receive regular training and whether there is consistency in who cares for each resident.

Since 1 October 2023, residential aged care facilities must meet mandatory care minute targets. The national average target is 200 care minutes per resident per day, with at least 40 of those minutes delivered by a registered nurse.

Standard 8: Organisational governance

This standard ensures that the organisation running the facility is well-managed, financially sound, and accountable for the care it provides.

What this means in practice:

  • The organisation has effective governance and leadership
  • Clinical governance systems are in place to oversee care quality
  • Risk management strategies are implemented
  • The organisation is financially sustainable
  • Information management systems protect residents’ data
  • There is a culture of continuous improvement
  • Regulatory requirements are consistently met

What to look for: Check whether the provider publishes annual reports or financial statements. Look at whether the facility has a track record of compliance. A well-governed organisation will be transparent about its performance.

The star ratings system

In December 2022, the Australian Government introduced star ratings for residential aged care facilities. This system gives families a quick way to compare facilities, similar to hotel star ratings but based on care quality.

How star ratings are calculated

Each facility receives an overall star rating from 1 to 5 stars, based on four sub-categories:

Sub-categoryWhat it measuresWeighting
CompliancePerformance against the 8 Quality Standards, based on assessments and any regulatory actionHighest weighting
Residents’ experienceResults from resident experience interviews conducted by the ACQSCSignificant weighting
StaffingCare minutes per resident per day and registered nurse availabilityModerate weighting
Quality measuresClinical quality indicators reported by the facilityModerate weighting

What each star level means

Star ratingMeaning
5 starsExcellent. Facility significantly exceeds expectations across multiple categories
4 starsGood. Facility meets and often exceeds expectations
3 starsAcceptable. Facility meets the basic requirements across categories
2 starsBelow average. Facility has areas that need improvement
1 starSignificant improvement needed. Facility has serious shortcomings

A 3-star rating does not mean a facility is poor. It means the facility is meeting its obligations. Many quality facilities sit at 3 or 4 stars. A 5-star rating indicates consistently high performance across all four sub-categories.

Important notes about star ratings

Star ratings are updated regularly as new data becomes available. A rating can change after a new assessment, a complaint investigation, or when new quality indicator data is published.

Some things to keep in mind:

  • A high star rating does not guarantee a perfect experience. Ratings are based on available data and may not capture every aspect of life in the facility
  • A low star rating does not always mean the facility is unsafe. It may indicate areas for improvement that the facility is already addressing
  • Sub-category ratings matter as much as the overall rating. A facility with 4 stars overall but 2 stars for compliance may warrant further investigation
  • Newer facilities may have limited data. Their ratings may change as more information is collected

Making a decision about residential care? Our guide on how to choose a nursing home in Australia walks you through the full decision-making process.

How to check a nursing home’s quality rating

Checking a facility’s quality rating is straightforward and free. Here is how to do it step by step.

Option 1: My Aged Care website

  1. Visit the My Aged Care website (myagedcare.gov.au)
  2. Use the “Find a provider” search tool
  3. Enter the facility name or your location
  4. Select “Residential aged care” as the service type
  5. Browse results to see star ratings displayed alongside each facility
  6. Click on a facility to see detailed information, including sub-category ratings

Option 2: Aged Care Quality and Safety Commission website

  1. Visit the ACQSC website (agedcarequality.gov.au)
  2. Use the “Find a provider” tool
  3. Search by facility name, provider name, or location
  4. View the facility’s compliance history, assessment reports, and any regulatory action

What to look for when reviewing ratings

When you review a facility’s profile, pay attention to:

  • Overall star rating as a starting point
  • Sub-category ratings for a more detailed picture
  • Compliance history to see if there have been past issues and whether they were resolved
  • Assessment contact dates to see when the facility was last reviewed
  • Any current regulatory action such as sanctions or notices to agree
  • Quality indicator data for clinical performance metrics

Do not rely on star ratings alone. Use them as one part of your research, alongside facility visits, conversations with staff, and feedback from current residents and families.

Quality indicators in aged care

Quality indicators are specific, measurable data points that facilities must report regularly. These indicators provide objective information about clinical care quality and help identify trends across the sector.

Current quality indicators

Residential aged care facilities report on the following National Aged Care Mandatory Quality Indicator Program (QI Program) measures:

Quality indicatorWhat it measures
Pressure injuriesPercentage of residents who have developed a new pressure injury (stages 1-4)
Physical restraintPercentage of residents who are physically restrained
Unplanned weight lossPercentage of residents who have experienced significant unplanned weight loss
Falls and major injuryPercentage of residents who have had a fall resulting in major injury
Medication managementUse of antipsychotic medications, polypharmacy rates
Activities of daily livingChanges in residents’ functional ability over time
Incontinence careAppropriate use of continence aids and management strategies
HospitalisationsUnplanned transfers to hospital
Workforce indicatorsStaffing hours per resident per day, staff turnover
Consumer experienceResident and family satisfaction survey results

How quality indicators are used

Quality indicators serve multiple purposes:

  • Benchmarking. Facilities can compare their performance against national averages
  • Identifying trends. A sudden increase in falls or pressure injuries may signal a systemic issue
  • Informing star ratings. Quality indicator data feeds directly into the star ratings system
  • Driving improvement. Facilities use their own data to identify areas for improvement
  • Public transparency. Aggregated data is published so families can compare facilities

When reviewing quality indicator data, look for trends rather than single data points. One quarter of higher-than-average falls does not necessarily indicate poor care, but a consistent trend over multiple quarters warrants attention.

How facilities are assessed

The ACQSC uses several methods to assess whether aged care facilities meet the Quality Standards. Understanding these methods helps you interpret compliance reports and assessment outcomes.

Assessment contacts

Assessment contacts are the primary method of evaluating compliance. These are on-site visits conducted by trained assessors who observe care delivery, review documentation, and speak with residents, families, and staff.

There are two types:

  • Announced assessments. The facility receives advance notice. These are used for comprehensive reviews
  • Unannounced assessments. The facility receives no advance notice. These provide a more authentic picture of daily operations

Since the Royal Commission’s recommendations, the ACQSC has significantly increased the proportion of unannounced visits. This shift was a direct response to concerns that facilities were “putting on a show” for announced assessments.

What assessors look for

During an assessment, the team evaluates:

  • Direct observation of care being delivered
  • Interviews with residents, families, and staff
  • Review of documentation including care plans, medication charts, incident reports, and staffing records
  • Physical environment including cleanliness, safety, and suitability
  • Governance systems including how the facility manages risk and handles complaints
  • Clinical outcomes compared to quality indicator data

Assessment outcomes

After an assessment, the ACQSC determines whether the facility meets, or does not meet, each of the applicable Quality Standards. Possible outcomes include:

  • Met. The facility meets the standard. No action required
  • Not met. The facility does not meet one or more standards. The ACQSC will require the facility to take corrective action
  • Significant risk. There is an immediate or serious risk to residents’ safety. The ACQSC will take urgent regulatory action

Assessment reports are published on the ACQSC website, so you can read the full findings for any facility you are considering.

Enforcement and regulatory action

When a facility fails to meet the Quality Standards, the ACQSC has a range of enforcement tools at its disposal. The type of action depends on the severity of the failure and whether the facility has demonstrated a willingness to improve.

Types of regulatory action

ActionWhen it is used
Notice to agreeFor moderate non-compliance. The facility must agree to specific improvements within a set timeframe
SanctionsFor serious or repeated non-compliance. Restrictions are placed on the facility’s operations, such as preventing new admissions
Compliance noticeA formal direction to rectify specific issues
Revocation of approvalFor the most serious failures. The facility loses its approval to operate and must close or transfer residents
Appointment of administratorIn extreme cases, the government may appoint an external administrator to manage the facility

Resident protections during enforcement

If a facility is facing serious regulatory action, residents are protected. The government ensures that:

  • Residents are informed about what is happening
  • Alternative care arrangements are made if a facility must close
  • Residents’ preferences are considered when arranging transfers
  • Financial obligations are managed fairly
  • Family members and representatives are kept informed throughout the process

No resident should ever be left without care because of a provider’s failures. If you are concerned about a facility’s compliance status, contact the ACQSC directly on 1800 951 822.

The complaints process

If you have concerns about the quality of care at a nursing home, you have several options for raising them.

Step 1: Raise it with the facility

Start by raising your concern directly with the facility. Most issues can be resolved at this level. You can speak with:

  • The facility manager or director of nursing
  • The resident’s designated care coordinator
  • The facility’s complaints or feedback officer

Document your concern in writing if possible, including dates, times, and specific details about what happened.

Step 2: Contact the ACQSC

If the facility does not resolve your concern, or if you feel uncomfortable raising it with them directly, you can contact the ACQSC.

  • Phone: 1800 951 822 (free call)
  • Online: Lodge a complaint through the ACQSC website
  • In writing: Send a letter to the ACQSC

The ACQSC will assess your complaint and may:

  • Investigate the matter
  • Require the facility to take corrective action
  • Conduct an unannounced visit
  • Take regulatory action if warranted

Step 3: Other avenues

You can also contact:

  • The Aged Care Advocacy Service for independent support and advice
  • Your state or territory health complaints commissioner for health-related concerns
  • The police if you believe a criminal offence has occurred
  • Your local member of parliament if systemic issues are not being addressed

You have the right to raise concerns without fear of retaliation. It is illegal for a facility to disadvantage a resident because a complaint has been made.

Post-Royal Commission improvements

The Royal Commission into Aged Care Quality and Safety, which delivered its final report in March 2021, identified widespread failures in the aged care system. The report contained 148 recommendations for reform. Many of these recommendations have already been implemented, with others in progress.

Key reforms already in place

Mandatory care minutes (from 1 October 2023)

Residential aged care facilities must now deliver a minimum of 200 care minutes per resident per day on average, with at least 40 minutes from a registered nurse. This was one of the most significant changes, directly addressing chronic understaffing in the sector.

24/7 registered nurse requirement (from 1 July 2023)

Every residential aged care facility must have at least one registered nurse on site and on duty at all times. Previously, some facilities relied on enrolled nurses or personal care workers during overnight and weekend shifts.

Star ratings system (from December 2022)

The introduction of public star ratings gave families a standardised way to compare facilities for the first time. This was a direct response to the Royal Commission’s call for greater transparency.

Strengthened regulatory powers

The ACQSC received additional funding and stronger enforcement powers. This includes the ability to issue civil penalties, conduct more unannounced visits, and take faster action against underperforming providers.

Increased unannounced visits

The proportion of unannounced assessment contacts has increased significantly. The goal is to see facilities as they operate day to day, not as they perform when they know assessors are coming.

Serious Incident Response Scheme (SIRS)

Since April 2021, all aged care providers must report serious incidents to the ACQSC within specific timeframes. This includes unreasonable use of force, neglect, unlawful sexual contact, psychological or emotional abuse, unexpected death, stealing or financial coercion, and inappropriate use of restraint.

Code of Conduct for aged care

A Code of Conduct now applies to all aged care workers, setting clear behavioural expectations. Breaches can result in banning orders that prevent individuals from working in aged care.

Reforms still in progress

Several major reforms are continuing to be rolled out:

  • A new Aged Care Act is being developed to replace the existing legislation with a rights-based framework that puts older Australians at the centre
  • Support at Home program is set to replace Home Care Packages and the Commonwealth Home Support Programme, creating a simplified system for home-based care. Read more about this transition in our guide to Support at Home classification levels
  • Improved food and nutrition standards with stronger requirements for meal quality and nutritional adequacy
  • Worker screening through a national registration scheme for aged care workers
  • Better palliative care integration across all aged care settings

These reforms represent the most significant overhaul of Australia’s aged care system in decades. While progress has been meaningful, full implementation of all Royal Commission recommendations will take several more years.

How to use quality data when choosing a facility

Quality data is most useful when you combine it with your own observations and conversations. Here is a practical approach to using the available information.

Before visiting

  1. Check star ratings on the My Aged Care website for facilities in your preferred area
  2. Review compliance history on the ACQSC website for each facility on your shortlist
  3. Compare quality indicator data across facilities, looking for patterns rather than single data points
  4. Note any current regulatory actions and consider what they mean for residents

During your visit

  1. Observe how staff interact with residents. Are interactions respectful, warm, and unhurried?
  2. Look at the physical environment. Is it clean, well-maintained, and safe?
  3. Talk to residents and families if possible. Ask about their experience
  4. Ask about staffing. How many care minutes do residents receive? What is the staff turnover rate?
  5. Ask about the complaints process. How does the facility handle concerns?
  6. Check meal quality. If you can visit at mealtimes, observe what is being served

After visiting

  1. Compare your observations with the published data. Do they align?
  2. Follow up on any concerns. If something did not feel right, investigate further
  3. Speak with other families. Online forums and community groups can provide additional perspectives
  4. Trust your instincts. Data is important, but your impression of how residents are treated matters too

Preparing for facility visits? Read our guide on what to look for on nursing home tours for a comprehensive checklist.

Understanding quality in the context of your loved one’s needs

Not every high-rated facility will be the right fit for every person. Quality is partly objective (meeting standards, having adequate staff, maintaining safety) and partly subjective (whether the facility’s culture, activities, and environment suit your loved one).

Consider these factors alongside quality ratings:

  • Specialised care needs. If your loved one has dementia, look for facilities with dedicated memory care units and staff trained in dementia care
  • Location. Being close to family and friends can significantly impact quality of life
  • Cultural and language needs. Some facilities cater to specific cultural communities or have multilingual staff
  • Religious or spiritual preferences. Faith-based providers may offer chaplaincy services and religious observances
  • Activity preferences. A facility with a strong activities program may be better suited to someone who enjoys social engagement
  • Size and atmosphere. Some people prefer smaller, home-like settings while others enjoy the amenities of larger facilities

The aged care section of our website provides resources to help you navigate these decisions.

Frequently asked questions

Can I see a facility’s full assessment report?

Yes. Assessment reports are published on the ACQSC website. You can search for any facility and view their full assessment history, including any areas of non-compliance and the facility’s response.

How often are star ratings updated?

Star ratings are updated quarterly as new data becomes available. Sub-category ratings may change independently of each other.

Do all aged care services have star ratings?

Currently, star ratings only apply to residential aged care (nursing homes). Home care services do not have star ratings, though quality information is still available through the ACQSC.

What should I do if I suspect abuse or neglect?

Contact the ACQSC immediately on 1800 951 822. If someone is in immediate danger, call 000. You can also report concerns to the police. The ACQSC has a dedicated team that handles serious incident reports.

Are private nursing homes held to the same standards as government-run ones?

Yes. All residential aged care facilities in Australia, whether government-run, not-for-profit, or private, must meet the same 8 Quality Standards. The ACQSC assesses all providers using the same framework.

Can a facility improve its star rating?

Yes. Facilities can improve their ratings by addressing areas of non-compliance, improving staffing levels, achieving better quality indicator results, and delivering positive resident experiences. Rating improvements are reflected in the next quarterly update.

Getting support with your aged care decisions

Navigating the aged care quality system can feel overwhelming, especially when you are making decisions during a stressful time. You do not have to do this alone.

Carevo is a connection platform that helps Australian families find quality aged care providers. We can help you:

  • Understand quality ratings and what they mean for your situation
  • Compare facilities in your preferred area
  • Connect with providers that match your loved one’s specific needs
  • Navigate the aged care system from assessment through to placement

Whether you are looking at residential aged care, home care packages, or other aged care services, our team is here to support you through every step of the process.

Call us on 1800 953 253 or visit carevo.com.au to get started.

Your loved one deserves quality care, and you deserve the peace of mind that comes with knowing they are in good hands.