A 63-bed care home is to be built on the former police station and magistrates court site in Leighton Buzzard.
The premises will replace Westlands Residential Home, in Duncombe Drive, which is due to close.
The development includes day care facilities and community space, with a lounge and a hair and beauty salon.
Outline plans were granted for a 68-place facility on the Hockliffe Road site in 2017.
But Central Bedfordshire Council’s project has been revised since it was first submitted.
Westlands will close as part of a local authority programme to deliver improved accommodation for older people.
The buildings which occupied the 1.1-acre site near the town centre have been demolished.
Architect for the agent Steven Ryles said: “The plans will see the closure of a smaller care home Westlands, which has reached the end of its operational life after 50 years.”
Resident Toby Phillips supported the principal of the project, saying a number of concerns have been addressed.
“There’s a fundamental issue over the size of the development,” he explained.
“The building’s height and how imposing it appears on neighbouring properties will cause harm to the appearance of the area.
“The new drawing makes the building at least a storey taller than the building approved in the outline plan.”
Leighton Buzzard Town Council backed the scheme, but it suggested “careful consideration to parking is required”, according to a report to CBC’s development management committee.
There were three comments and 11 objections from neighbours over loss of privacy, loss of light to gardens, inadequate parking and the height of the building.
Liberal Democrat Linslade Councillor Peter Snelling asked about the relocation of the Duncombe Drive day centre.
“We were told the new facility would cope well with what goes on at the day centre.
“I find it difficult to see that there’s enough space within the new building, so everything that happens at the day centre can occur there.”
He suggested “parking looks limited at the front of the building”.
CBC highways engineer Dave Ager told the committee: “Our parking standards are the maximum, so any change would be a deviation.
“There’s space for two minibuses outside,” he said.
Independent Linslade Councillor Victoria Harvey described Leighton Buzzard as “in urgent need of care provision” and highlighted the importance of the travel plan.
“We’re in an area where we’re having huge housing growth, but there can be a problem of intensifying the town centre,” she warned.
“That area is low houses and gardens and it’s a terrifically difficult balance on how we’re planning on growth.”
A vote to refuse the application because of over-development and a loss of amenity for nearby residents was defeated by nine votes to two, with one abstention.
Conservative Dunstable Watling Councillor Nigel Young suggested the executive “could move on swiftly to the regeneration of the south side of Leighton Buzzard High Street” after this.
Conservative Leighton Buzzard South Councillor Ray Berry said a lot of the information about “getting the process of the development to this point are in the officer’s report.”
Councillors approved the full plans with nine votes in favour, two against and one abstention.
Work is scheduled to start in April and be completed in July 2022.
