Aim To identify aged care specific work health and safety management issues by applying James Reason's safety culture theory to one residential aged care provider in Australia. Methods Qualitative, semi-structured interviews with frontline care staff at three residential care facilities - all operated by the same provider - garnered employee perceptions of the safety culture and aged care specific challenges in their work environment. Thematic analysis of participant responses against the premises of James Reason's safety culture theory was undertaken. Results An aged care safety dilemma exists for frontline staff between looking after their own safety, a fundamental premise in work health and safety management, and caring for residents. Conclusions A 'culture of care' and professional identity inhibit safe behaviour. Organisational learning from incidents could assist employees in putting their safety first in care scenarios. Evaluating perceived barriers to carer-first safety practices, such as understaffing or time pressures, may facilitate safer outcomes.