In this article, we build upon a historical and critical analysis of de-institutionalisation strategies, representing a fundamental shift in disability policy and practice starting in the 1960’s. We state that de-institutionalisation has commonly been interpreted and translated as a vital ‘transition’ – referring to the dismantling of residential care and institutions – in rights discourse, policy, and (self-) advocacy. Whereas de-institutionalisation currently often interferes with neo-liberal welfare state reforms, we argue that the focus on ‘transition’ tends to ignore controlling and oppressive institutional care cultures that circulate in a variety of settings, whether ‘community based’ or not. In this article, we elaborate on Francois Tosquelles’ Institutional Pedagogy as a theoretical framework to radically ‘transform’ (residential) care in a wide variety of settings. Our analysis is based on qualitative interviews with residential care providers and (self-) advocacy groups, and offers a more in-depth insight in the complexities of de-institutionalisation as ‘transformation’.