Background The aim of this study was to understand current clinical practice, adherence to evidence-based guidelines, and the perceptions, knowledge and attitudes of the multidisciplinary team caring for inpatients with an eating disorder at a small metro hospital. Methods This mixed methods study involved a retrospective audit of eating disorder patient care and a semi-qualitative staff survey. The audit was undertaken at a small metro hospital from 2018 to 2019. Documented practices were compared to state-wide best-practice guidelines. A staff survey was designed to understand health care professional’s knowledge and use of evidence-based practice guidelines, as well their perception of caring for this patient population and areas for improvement. Results Twenty-three discrete admissions (18 individuals) were included in the audit. Findings highlighted several evidence-practice gaps including delayed nutrition initiation and inconsistent medical refeeding and management of refeeding risk. Survey themes (from 60 hospital staff) included: lack of confidence with providing eating disorder care; uncertainty about professional roles/responsibilities; and lack of clear processes/guidelines to inform clinical care. Conclusions Gaps exist between evidence-based practice and eating disorder patient care. Staff lack confidence providing care to this patient group. These findings will allow for targeted implementation strategies to improve patient care and the uptake of research into practice.