Background: Physiotherapists for adults with intellectual disabilities often work in day centres, relying on care staff to support programmes. This study investigates factors affecting physiotherapy delivery in 4 day centres in one London borough. Materials and Method: Semi-structured interviews were carried out with day centre care staff, managers and physiotherapists. Results: Service users' needs were reported not to be met at three of the four centres. Barriers included low staffing levels, high absences and use of agency staff. Relevant variables included level of physiotherapist attendance, management priorities for care staff time, care staff confidence and whether a consistent team support delivery. Discrepancies emerged between staff and physiotherapists' views on training needs. Conclusions: Physiotherapy delivered in day centres is an important part of a complex care package. It requires effective multiagency working to meet the known--and potentially unidentified--needs of individuals and to ensure that care staff are adequately supported.