Background: Banksia Village in Broulee, NSW is an 80-bed aged care home that introduced a small household model of care in October 2025. Two 11-resident households were created within an existing high-care lodge to foster a homelike, person-centred environment, aligned with national and international shifts toward autonomy, wellbeing and social connection. Methods: A pre–post mixed-methods evaluation compared residents in the new households (n=22) with those in the traditional lodge model (n=58) over five months. Clinical measures included falls, wounds, infections, weight loss, polypharmacy and emergency call system response times. Economic outcomes included care minutes, staffing costs and cost per resident per day. Interviews with residents, staff and families, and individual-level wellbeing assessments (n=20) captured acceptability. Results: The small household model was associated with clinical improvements over baseline: new wound incidence fell by 50% (p=0.001), emergency call system response time decreased from 2.31 to 1.44 minutes (p<0.001), and unplanned weight loss >5% decline from 4.40% to 0.50% (p<0.001). Falls were reduced from 17.70 to 11.82 per 100 person-months, but this was not statistically significant (p=0.21). The new model operated at higher cost due to increased direct care minutes. Acceptability was high among residents, staff and families, with residents reporting greater comfort, autonomy and quality of life, staff describing more meaningful engagement, and families observing improved wellbeing. Conclusion: Implementation of the small household model at Banksia Village was safe, acceptable and compliant with the Strengthened Aged Care Quality Standards, with improvements in key clinical areas supporting broader adoption of this model.