Background The purpose of this study was to uncover and understand factors influencing quality of care received by adults with developmental disabilities and/or mental health disorders living in group homes. Methods The present authors conducted a secondary analysis of data from nine focus group discussions with adults with developmental disabilities and/or mental health disorders, and their family and paid caregivers (N = 52). To focus the analysis, the present authors drew on the research literature to craft a model of quality of group home care using concepts of social inclusion and self‐determination, and corresponding staff approaches that include active support and person‐centred care. Results Social inclusion and self‐determination for adults in group homes are facilitated by staff approaches and manifest in residents being understood and experiencing security and freedom. Conclusions The present authors offer recommendations for group home resources, training, communication and outcome measures that promote residents’ being understood and experiencing security and freedom.