Inadequate community housing and support for adults under 65 years with complex health needs often leads to residential aged care placement. In 2006, Australian government authorities funded a range of supported housing alternatives for younger adults requiring access to 24-hour support including the Integrated Living Model (ILM). The ILM provided purpose-built accommodation for 10–20 people and represented a change in practice from traditional 24/7 nursing care toward a more holistic, individualised approach. Aim: Examine workforce challenges in implementing disability service standards (DSS) within an ILM. Method: Thematic Analysis of workforce practices was conducted by coding staff interviews (n = 20) against the prevailing DSS. Results: Emerging challenges identified against each standard were: expectation management; coordination; client expertise; blurred boundaries; role confusion; valued status beyond client; unclear practice boundaries; multilayered communication; reflective practices; and mixed service model responses. Conclusion: This ILM setting requires workforce development in rights-based practice, personalisation and effective communication. Key paradigm shifts are also recommended.