Soft skills are actually hard

In our first article we discussed the focus on person-centred, rights-based care in the new Aged Care Quality Standards. Today we explore what is required in practice to provide quality person-centred care. 

Relational skills are not optional in the caring professions.  Rather, they are a clinical skill that can directly influence health outcomes.  For leaders of health, aged care and disability services, the strategic question is how to ensure that relational skills are built into the fundamental training foundation for care workers, alongside other clinical and technical skills.

Why relational skills drive outcomes

As our previous article outlined, person-centred care is a pillar of Australia’s Strengthened Aged Care Quality Standards.  Relational skills such as empathy, communication, trust-building, and emotional regulation are the mechanisms through which person‑centred care is delivered.  Person‑centred care is consistently associated with better outcomes for people receiving care.  Relational interactions between health professionals and clients can lead to:

• increased adherence to treatment

• reduced unplanned health service use

• improved self-reported health status and wellbeing.

Quality interactions are characterised by good listening and responding skills, consistency and trustworthiness, and an ability to understand and respond to a client’s concerns. 

The new Aged Care Quality Standards recognise the link between relational skills and health outcomes.  The Standards require providers to demonstrate that safety, health, wellbeing and quality of life are delivered through person‑centred, relationship‑based care, not just technical competence.  Good communication through respectful relationships is framed as core to safe, effective care, not an optional extra. 

To meet the Standards, however, a service needs to have staff who are trained and understand the importance of interpersonal relationships.  This means that the so-called ‘soft skills’ need to be embedded into training and professional development programs as well as recruitment processes. 

What relational care looks like in practice

For frontline workers, relational care skills include:

• empathy and compassion: recognising and responding to emotional as well as physical needs 

• active listening and responding: adapting language, checking understanding, and using body language that conveys respect 

• patience and emotional regulation: slowing down, tolerating repetition, and managing one’s own frustration in the face of distress or cognitive impairment 

• cultural awareness and respect for diversity: honouring different backgrounds, identities and preferences 

• observation and feedback: noticing subtle changes in mood, behaviour or function and escalating concerns appropriately.

The Standards highlight the importance of all of these skills, for example in requiring providers to demonstrate that they:

• develop “funded aged care services with, and tailored to, individuals, taking into account their needs, goals and preferences” (Outcome 1.1) or

• support “individuals to exercise choice and make decisions about their funded aged care services and provide them with support to exercise choice and make decisions when they want or need it” (Outcome 1.3).

To demonstrate these outcomes, care workers need to use excellent communication and interpersonal skills consistently in client interactions, not just in initial planning for care but in daily delivery of that care.  There is growing evidence that providing training to carers in communication and engagement skills can reduce distress in people with dementia and improve the quality of care.  

Person‑centred, relationship‑based approaches can reduce dementia-related behaviours of distress, the use of psychotropic medications, and resident aggression towards staff, all of which influence physical and mental health.  Empathic communication and relationships are also recognised as a component of clinical governance for safe care in aged care services. 

Upskilling workers: beyond one‑off training

For leaders, the core challenge is that relational skills cannot be fully developed through initial qualifications alone.  Certificate III and IV programs cover communication, person‑centred care and cultural awareness, but real capability depends on reinforcement in practice.  This ‘reflection in action’ approach requires embedding a learning culture into daily work practices to ensure that any person providing care to older people is fully present and applying their knowledge and experience to every interaction. 

A deliberate upskilling strategy needs to operate on several levels, as outlined below. 

1. Targeted relational skills programs

Specialist short courses and micro‑credentials can help deepen particular care skills.  For instance, dementia communication and empathy training (e.g. Dementia Australia programs, the national Dementia Training Program) can reduce behaviours of distress and improve engagement.  Modules on trauma‑informed care, cross‑cultural awareness and mental health can help staff respond safely to complex histories and diverse identities. 

Person‑centred communication training that explicitly links listening, shared decision‑making and health outcomes for older people can reinforce the important reality that how we behave in our work can influence how others behave towards us.  Government‑funded initiatives such as Equip Aged Care Learning and TAFE Certificate III create opportunities to embed these relational competencies without adding prohibitive cost. 

2. Supervision, coaching and reflective practice

Relational skills are best strengthened “on the floor” through reflection-in-action and other learning approaches such as:

• regular reflective practice sessions where staff debrief complex interactions and explore alternative relational responses 

• coaching by experienced mentors who model calm communication, de‑escalation and dignity‑preserving care at the bedside 

• incorporating relational scenarios into clinical supervision, not just task‑based audits.

The evidence suggests that “contextually relevant professional education and development improves staff retention”.  Learning on the job not only ensures that insights are incorporated into daily practice but provides opportunities to practice new skills immediately and in the appropriate context.    

3. Embedding relational skills into systems and metrics

If relational skills are invisible within performance systems, they will remain secondary in practice.  Leaders can promote relational skills in a number of ways, such as:

• integrating relational competencies (e.g. empathy, communication, cultural safety) into role descriptions, recruitment criteria and performance reviews 

• using feedback from residents, clients, families and peers specifically about communication, respect and responsiveness as part of quality dashboards 

• aligning internal indicators with the language of the Quality Standards, which connect person‑centred care, communication and health and wellbeing outcomes.

There are many examples of health and aged care providers that have already invested in human‑centred education models combining technical skills with empathy, communication and teamwork, with reporting improvements in both care quality and workplace culture.  

4. Culture, workload and leadership

Upskilling individuals alone is not enough; learning will not be sustained unless the organisational context supports relational work.  Leaders can influence this by:

• designing workflows that allow time for conversation, not just task completion, recognising that investing time in relationships is also part of clinical work 

• visibly valuing stories of excellent relational care in team meetings, recognition programs and governance forums 

• providing training for line managers in coaching, feedback and emotionally intelligent leadership so they can reinforce care skills day‑to‑day.

National workforce initiatives recognise that retaining aged care workers depends not only on pay and conditions, but on meaningful relationships, recognition, and supportive cultures.  Providing these important elements for staff provides a model for how staff can and should be treating clients. 

Strategic opportunity for leaders

The challenges, of course, are how to create the time for reflective learning into busy care schedules, and how to fund more person-centred approaches to care, recognising that relational care takes time and cannot be reduced to care minutes spent. 

However, investing in relational care is not an optional extra.  For aged care and disability leaders, developing the relational care skills of the care workforce is both a quality strategy and a retention strategy.  It aligns with regulatory direction, responds to what older people and people with disability say they value, and is associated with improved health, wellbeing and service efficiency. 

The strategic shift is to treat relational capability as a core clinical asset you build over time, not as an individual personality trait, and certainly not an optional extra once mandatory training is done.  Building relational capability may require changes to cultural, operational and professional development processes, but will provide a return on investment through improved client satisfaction, increased staff retention, and reduced critical incidents.  All in all, those soft skills do lead to hard, measurable outcomes. 

This is the second in a series of blogs exploring how greater focus on relational care skills can make rights-based reforms a reality, the everyday human skills that promote dignity, choice and independence in individuals’ lived experience. 

Subsequent blogs will dive deeper into current carer training paradigms, what effective training for relational care looks like, the implementation challenges and the outcomes.

References

Aged Care Quality and Safety Commission (2019) Clinical Governance in Aged Care: Fact Sheet 3 – Core Elements of Clinical Governance. Available at: https://www.agedcarequality.gov.au/sites/default/files/media/Fact_sheet_3_Core_elements_of_clinical_governance.pdf.

Australian Commission on Safety and Quality in Health Care (2018) Review of the Key Attributes of High-performing Person-centred Healthcare Organisations. Sydney: ACSQHC. Available at: https://www.safetyandquality.gov.au/sites/default/files/resources/attachments/FINAL-REPORT-Attributes-of-person-centred-healthcare-organisations-2018.pdf.

Australian Government Department of Health, Disability and Ageing (2025) Strengthened Aged Care Quality Standards. Canberra: Commonwealth of Australia. Available at: https://www.health.gov.au/sites/default/files/2025-08/strengthened-aged-care-quality-standards-august-2025.pdf.

Giusti, A., Nkhoma, K., Petrus, R. et al. (2020) ‘The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review’, BMJ Global Health, 5. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7733074/.

Morris, M.E., Brusco, N.K., McAleer, R. et al. (2023) ‘Professional care workforce: a rapid review of evidence supporting methods of recruitment, retention, safety, and education’, Human Resources for Health, 21, 95. Available at: doi: 10.1186/s12960-023-00879-5.

Schön, D.A. (1991) The Reflective Practitioner: How Professionals Think in Action. New York: Basic Books.

Tjia, J., Hunnicutt, J.N., Herndon, L., Blanks, C.R., Lapane, K.L. and Wehry, S. (2017) ‘Association of a communication training program with use of antipsychotics in nursing homes’, JAMA Internal Medicine, 177(6), pp. 846–853. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5818825/. 

Photo by Age Cymru on Unsplash

Authors

This blog has been co-authored and also appears on the Stillpoint Strategy Website. 

Dr Linda Kurti is managing director of Stillpoint Strategy collaborating partner at MYMAVINS.  Her expertise lies in applying evidence to address complex challenges and develop strategy within the health and social service sectors, with extensive experience in aged care.

Contact Linda on 0412 040 217 or linda@stillpointstrategy.com.au.

Tai Rotem is a consulting partner at MYMAVINS and a collaborating partner at Stillpoint Strategy. He has several decades experience in public health, consumer, financial services and social research.