Understanding the Intent and Expectations

Standard 5 sets clear expectations for how aged care providers implement safe, effective, person-centred clinical care. It acknowledges that older people often have complex and evolving health needs, and that addressing them requires an interprofessional, evidence-based approach led by a competent, well-supported workforce.

This standard also reinforces that clinical governance is not optional. It must be integrated into the way the organisation is run, from how workers are trained and supervised to how care is planned, provided, and reviewed. The standard draws on and depends heavily on the systems introduced in other standards, especially Standards 1, 2, and 3.

What Training Is Required and Why?

Training under Standard 5 is essential because clinical care is high-risk. Getting it wrong has serious consequences, yet it can transform outcomes and preserve quality of life.

Staff must be trained not just to perform clinical tasks but to do so in a person-centred, coordinated, evidence-based manner that is aligned with the older person’s preferences and goals. That means that training for Standard 5 needs to cover everything from infection control and safe use of medicines to clinical risk, pain management, palliative care, and dementia support.

Using Training to Meet Standard 5 Outcomes

Standard 5 includes seven outcomes. The table below links each outcome to key clinical training focus areas:

Outcome	Training Focus
5.1 Clinical Governance	Clinical governance principles, scope of practice, clinical delegation, performance reviews, and digital clinical systems.
5.2 Infection Prevention and Control	IPC protocols, antimicrobial stewardship, PPE use, aseptic technique, and managing invasive devices.
5.3 Safe and Quality Use of Medicines	Medication safety, polypharmacy risks, adverse events, medication reviews, scope and administration responsibilities.
5.4 Comprehensive Care	Comprehensive assessment, care planning, multidisciplinary care, recognising and responding to change, and clinical documentation.
5.5 Clinical Safety	Managing clinical risks (falls, pain, pressure injury, continence, oral health, nutrition), referrals, escalation, and incident response.
5.6 Cognitive Impairment	Understanding dementia and delirium, behaviour support, communication strategies, and restrictive practice alternatives.
5.7 Palliative and End-of-Life Care	Recognising deterioration, advance care planning, eating and drinking with acknowledged risk (EDAR), anticipatory medicines, grief and bereavement support.

Who Needs Training?

With such a large number of training requirements attached to this standard, applying a structured, needs-based approach is essential. This ensures training is targeted by role, service type, and site, and avoids becoming a broad, one-size-fits-all program that only results in training fatigue and low engagement and compliance rates.

The following strategies can apply best-practice principles to clinical training across your organisation.

1. Build training around clinical risk.
   Use data from internal sources and quality indicators(e.g. falls, pressure injuries, feedback complaints) to set training priorities.
   
2. Align to roles and responsibilities.
   Avoid generalised sessions. Do not spray and pray! Target learning by role, risk, and scope of practice.
   
3. Validate competence, not just attendance.
   Require observation, simulation or post-training evaluation to confirm capability. Make training time count.
   
4. Embed into governance
   Make clinical education a standing agenda item in governance and quality meetings.
   

Training Focus by Staff Role

Staff Role	Training Focus
Registered and Enrolled Nurses	Clinical governance, assessment and care planning, safe medication use, escalation, end-of-life care.
Personal Care Workers	Recognising deterioration, infection prevention, assisting with ADLs, dementia care, and documentation.
Allied Health Professionals	Supporting reablement, referrals, sensory support, continence and mobility.
Managers and Clinical Leaders	Clinical supervision, oversight of risk systems, data monitoring, audit preparedness, and leading quality improvement.
Agency and Contractors	Scope of practice awareness, induction on local clinical systems, IPC and medication safety.

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Key Training Topics

Focus on Clinical Care

Standard 5 is the most extensive and most rigorous of all seven standards. With seven outcomes and 35 specific actions, it sets a powerful and transparent benchmark for clinical governance, safety, medication management, and comprehensive care.

Significant training requirements are being asked of providers to deliver on this standard, more than any other standard.

The message is clear: clinical care in aged care has changed, and expectations have risen.

Topics Required

• Clinical governance and scope of practice
• Infection prevention and outbreak management
• Antimicrobial stewardship
• Medication safety and polypharmacy
• Comprehensive clinical assessment
• Pain, nutrition, oral and wound care
• Pressure injury and falls prevention
• Managing cognitive impairment and responsive behaviours
• Advance care planning and end-of-life care
• Communication, documentation and escalation

List of Ausmed Modules on Standard 5

The following modules from the Ausmed Library help you meet the education and training requirements of Standard 5.

Explore the full library here.

Ausmed Module	Duration (minutes)
Standard 5: Clinical Care	22
Clinical Governance in Healthcare
Working With Clinical Information Systems (CIS)	56
Scope of Practice: Care Workers	18
Infection Prevention and Control	28
All About Aseptic Technique	13
Managing Urinary Catheters in Acute Settings	57
Central Venous Access Devices (CVADs)	54
CVAD Complications: Prevention and Management	67
Enteral Feeding and Nutrition	63
Clinical Management of a Tracheostomy	77
Medication Safety Principles	32
Medication Prompting, Assistance and Administration for Care Workers	25
Adverse Drug Reactions: An Overview	10
Medicines and Crushing - A Guide	38
Dysphagia and the IDDSI Framework	27
Choking Management in Aged Care	20
Documentation in Aged Care	25

Audit Expectations and Evidence

Standard 5 is one of the most highly audited areas, with large volumes of possible evidence items across multiple themes and evidence types.

While this list may seem overwhelming, rest assured that many of the evidence items collected for Standard 5 will also help demonstrate conformance with related outcomes in these other standards.

Audit Evidence Summary – Standard 5: Clinical Safety

This table summarises evidence items relating to the theme of clinical safety.

Evidence Type	Examples of Required Evidence
Documents and Records	Policies and procedures for managing clinical risk Clinical assessment tools Care plans and referrals Risk documentation and reporting systems Policies and procedures for choking, pain, continence, mobility, nutrition, wounds, and pressure injuries Training materials for staff Clinical audits and assessments Meeting minutes related to clinical care Data analysis and continuous improvement plans Documentation of multidisciplinary involvement
Governing Body Feedback	A governing body (Board) may be asked: Oversight of clinical risk systems Monitoring processes for clinical incidents and near misses Alignment with evidence-based practice Recent improvement actions
Management Feedback	Managers may be asked about: How clinical risks (e.g. falls, nutrition, pressure injuries, oral health, continence) are identified, assessed, and managed How referrals are made to appropriate health professionals Training provided to staff on clinical risk management Analysis of incidents and near misses, and application of learnings Access to internal and external health professionals Implementation of clinical policies and improvement actions
Worker Feedback	Workers (staff) may be asked about: Role in identifying and managing specific clinical risks Making and following referrals Understanding and confidence in managing conditions like swallowing difficulty, pain, and pressure injuries Concerns about clinical safety systems
Third Party Feedback	Role in managing specific clinical risks or supporting referrals for individuals Perceptions of collaboration and coordination of care
Experience of Individuals	Individuals and their families, via direct questions from auditors or indirect (i.e., surveys), may be asked about: Satisfaction with clinical care Ability to access timely support (e.g. toileting, medication) Clarity about health condition management Experience of falls, wounds, or hospitalisation Perceptions of being checked on and monitored
Observations	Auditors may directly observe the following: Staff monitoring eating, hydration, and medication Timely toileting support Proper use of mobility aids and pain management Room setup to reduce sensory risks Clinical procedures aligned with care plans
Care Outcomes	Auditors may review the following care outcome indicators to assess the quality and safety of clinical care: Incidence of pressure injuries (across all six stages) Rates of significant unplanned weight loss (≥5%) Consecutive unplanned weight loss events Cases of incontinence-associated dermatitis Frequency of hospitalisations and emergency department presentations

Integrating Standard 5 Clinical Care Using Education

Alignment with NSQHS Standards

Many aspects of the strengthened Aged Care Standards, especially Standard 5, will feel familiar to those familiar with acute care. This isn’t by accident. Following recommendations from the Royal Commission, the Australian Commission on Safety and Quality in Health Care (ACSQHC) was tasked with developing Standard 5. While a broader transfer of responsibility was not accepted, the intent was clear: to raise the clinical standard of aged care and protect older people from harm.

The Role of Education

These Standards are not just a checklist. Standard 5 demands workforce capability, clinical leadership, and real change at the point of care. At Ausmed, we believe that education is the most effective tool for translating this regulatory shift into everyday practice. Our education, tools, and guidance are designed to help providers not just meet these standards but meaningfully improve the health and lives of older Australians.