The implementation of policies associated with deinstitutionalisation has dominated the development of services for people with intellectual disabilities in most, although not all, of the world's richer countries (Braddock, Emerson, Felce & Stancliffe, 2001; Hatton, Emerson & Kiernan, 1995). In England, traditional large-scale institutional care was provided in hospitals operated under the auspices of the National Health Service (NHS). In 1976, there were just over 51,000 recorded NHS long-stay hospital "beds" for people with intellectual disabilities in England. By April 2002 this number had decreased by 93% to 3,638. This change has been accompanied by an increase in the number of people supported in community-based residential services and by wide ranging legislative changes and central policy guidance (e.g., Department of Health, 1971, 1992a,b, 1993, 2001; Office of the Deputy Prime Minister and Department of Health, 2003). It has also generated a significant amount of research in the UK (Emerson & Hatton, 1996; Felce, 2000), the results of which are consistent with those of research undertaken in the USA and Australia (Kim, Larson & Lakin, 2001; Young, Sigafoos, Suttie, Ashman & Grevell, 1998). In short, deinstitutionalisation has been shown to be associated with a range of benefits for people with intellectual disabilities, including increases in satisfaction, social inclusion, engagement and support (although it appears to have little impact on levels of challenging behaviour (Emerson & Hatton, in press).