Far too many people with a disability are denied choices about their accommodation, often leading to neglect and abuse, a royal commission says.
The commission on Wednesday released a report into group home care after hearings held in December.
It said a shift from large housing complexes to smaller group homes had not eliminated institutional forms of violence, abuse, neglect and exploitation.
In some cases, a lack of oversight by providers and inadequate reporting mechanisms allowed perpetrators to continue abusing.
The needs of individuals in group homes were "not often" prioritised and routines were organised for the convenience of staff and management, the report said.
This has led to a diminished quality of life for some residents and too often neglect and abuse.
One witness said she lived with 16 others in a hostel where she was sexually abused.
She said she wasn't given a choice about moving into a community residential unit or about who she lived with and staff made those decisions without consultation.
"People with disability have the right to autonomy ... the right to control their own lives, to make their own decisions and to exercise choice," the report said.
"The evidence at this hearing indicates that although the experiences of people with disability in group homes is not uniform, far too many people are denied autonomy.
"People lack choice about the accommodation allocated to them. They often cannot choose their co-residents or those who care for them."
The report also said the sector's largely casualised workforce made it difficult for support staff to be well-trained and for providers to implement a strong culture.
"Many witnesses stressed the need for better training and monitoring of support staff in group homes to minimise the risk of violence, abuse, neglect or exploitation," it said.
Practices at group homes were sometimes no different from those used by large institutions in decades gone by, the report said.
Ahead of its final report, the commission will examine reforms needed to give people more autonomy, as well as mechanisms for increasing the amount of accommodation.
Evidence from people living in group homes, advocacy groups, government agencies, one large service provider and other experts was heard by the inquiry.
Australian Associated Press