Background: The provision of residential services for adults with intellectual disability in developing countries has not been widely researched. This study presents a survey of such facilities in a South African context. Method: Managers of 37 nongovernmental facilities in the Western Cape Province of South Africa responded to a survey about their facilities and their residents. Results: Facilities struggled with accessing adequate funding, and tended to focus more on their protective role than on the promotion of human rights. Residents were generally isolated from the community, and did not receive vocational and life skills development. Conclusion: Residents in facilities are far from realising their human rights as delineated in the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). Although the need remains for such facilities and the protective function that they offer, services in low- to middle-income countries should still be evaluated and developed in line with human rights principles.