Deficiency Reports Key trend in health and social services in many developed countries is the increasing recognition of the relevance and importance of the consumer’s voice in determining how well services are meeting needs. In the residential aged care sphere in the US, one of the most notable developments in this regard could be the introduction of outcome standards. These standards can used as a basis for external monitoring and assessment of residential aged care facilities by the federal government. While this monitoring and assessment process will always take residents’ views into account, it may not do so in any systematic way, relying largely on ad hoc, often impromptu “interviews” with a small number of residents during visits by standards-monitoring teams to different aged care homes. Revised residential aged care standards, which reflect a number of recent changes within aged care provision, linked to accreditation, should be introduced in the future. A key feature of these revised standards is the requirement that service providers demonstrate that they have in place appropriate management systems, which permit continuous quality improvement (CQI) across all their operations. This requires that aged care facilities adopt a cycle of monitoring, assessment, action and follow-up. A particular example of CQI given in the standards guidelines is that consumers are more informed and satisfied. In addition, it is indicated that CQI activities should be responsive to management, staff and residents; in fact, CQI activities should actively seek their feedback on all aspects of the services provided. Evidence that appropriate mechanisms have been implemented to meet these requirements is now a key aspect of the new accreditation process. At the formal level, this requirement that residents’ views should be systematically incorporated into quality improvement systems is an important development related to the increased empowerment of residents, in that they are being given the opportunity to participate more directly in the planning and provision of their care.