Beneficiary evaluation in residential aged care: navigating accountability between rights and care ethics

Purpose This research explores how beneficiary-focussed evaluation operates as a mechanism of downward accountability in residential aged care (RAC). We examine the interplay between rights-based frameworks and care ethics, questioning whether Government reforms intended to promote residents’ agency translate into meaningful accountability in practice. Design/methodology/approach A qualitative case study was conducted in an Australian RAC facility, drawing on interviews with residents, family members, staff and management, as well as observations and document analysis. Residents’ experiences of evaluation are interpreted through the theoretical lenses of rights and care ethics. Findings Beyond revealing tensions between rights- and care-based logics, findings highlight the limits of rights-based accountability and the challenges of enabling voice in contexts of dependency. Rights-based mechanisms are insufficient where beneficiaries lack the capacity or willingness to claim rights. While relational forms of accountability can support responsiveness, they remain ineffective in the absence of corresponding authority. Accountability mechanisms risk becoming symbolic when expressions of voice are recognised but not translated into response, highlighting responsiveness as fundamental to accountability. Originality/value This research advances theory and practice in beneficiary evaluation and downward accountability by proposing a model of accountability that reconceptualises the rights/care relationship in contexts of constrained agency, moving beyond dominant framings of rights and care as distinct forms of accountability. Findings show how residents’ affective responses restrict rights enactment in care-based settings, helping to explain why rights-based frameworks weaken when not underpinned by relational, moral and emotional dimensions. The research proposes the potential for an independent intermediary to support the enactment of downward accountability.