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This article presents the findings of a review of evidence related to quality of life in models of supported accommodation for adults with intellectual disabilities identified in English‐speaking nation deinstitutionalization and postdeinstitutionalization studies. An international literature‐based investigation of research published between 1995 and 2005 in English‐language peer‐reviewed academic journals was conducted to: (1) review the outcome of deinstitutionalization and postinstitutionalization studies; (2) examine instruments used to measure outcomes for individuals; and (3) compare costs and benefits associated with different models of supported accommodation. In the deinstitutionalization studies, there was consistent evidence of greater choice and self‐determination, participation in social networks or relationships and community‐based activities, and personal satisfaction in community‐based settings. Postdeinstitutionalization studies provided consistent evidence for greater choice, self‐determination, and participation in community‐based activities in smaller settings, but no evidence for greater physical health or material well‐being, and little evidence for a relationship between type of setting and employment. Future research is needed to meet methodological challenges identified here, to investigate the apparent failure of smaller residences to improve residents’ well‐being and to study systematically factors not directly addressed in the studies under review: poverty and income, organizational culture, and geographical variation.

The COVID-19 epidemic caused disruption and dislocation in the lives of people with disabilities, their families, and providers. What we have learned during this period regarding the strengths and weaknesses of the service system for people with disabilities should provide a roadmap for building a more robust and agile system going forward. Based on a canvas of leaders in our field, I propose a way of outlining a reimagined system.