Institutions, and their problems, have traditionally dominated learning disability histories. We know far more about what happened in areas where councils established and/or enthusiastically used local institutions than other places. Local authorities less committed to institutional care must have relied more on family and other carers. This may have signalled a more positive, even inclusive, approach to caring for people with learning disabilities. The Halifax case study provides some evidence to support this conclusion, but limited provision and reliance on distant facilities also permitted the neglect, and even abuse, of individuals in ways that resonate with recent scandals in the care sector. Note: for accuracy, this study uses the historically correct terminology with sincere apologies for any distress this may inadvertently cause.