Australia’s aged care reforms aim to improve quality, safety, accountability, and consumer choice. However, less is understood about how these reforms are experienced by frontline staff delivering care within increasingly complex and regulated service environments. This study examines how recent reforms are reshaping frontline work, service delivery, and workforce wellbeing in residential aged care. Drawing on 31 semi-structured interviews and field observations across residential aged care homes, the findings reveal a persistent imbalance between expectations of person-centred care and compliance requirements. Staff described increasing documentation, time pressure, and scrutiny, often at the expense of meaningful interactions with residents. Rather than achieving a stable balance, frontline staff engaged in ongoing trade-offs between relational care and administrative demands. These tensions shaped everyday service delivery and were managed through a range of coping strategies such as task prioritisation, resilience, adaptability, and workarounds. These findings highlight important unintended consequences of reform for both service delivery and the aged care workforce. While policy efforts aim to strengthen accountability and care quality, they may also reshape care work in ways that risk undermining the relational aspects central to resident wellbeing and staff satisfaction. This research provides insight into how reform-driven pressures affect service delivery and workforce sustainability. It highlights the need for closer alignment between policy design, organisational systems, and frontline realities. Advancing the “Ageing Revolution” requires reforms that support staff to deliver meaningful, person-centred care within the constraints of everyday practice.