In response to recent community care policies in Britain, co-ordinated, needs-led models of care have been introduced into day care services for older people. Whilst their introduction has prompted detailed consideration of the changes required in the organisation and management of these services, less attention has been paid to their implications for the design of day care premises. Yet design factors impinge on all aspects of service delivery and any shortcomings in design may undermine the effective delivery of new models of care. This article uses findings from recent research to explore how design factors may facilitate or constrain service delivery, focusing on two aspects of the new models of care – that services should meet the needs of individual users and be locally-based.