Severely disabled care home residents in Northern Ireland who could not speak have suffered physical and psychological abuse, a review found.
Some at the Londonderry premises drew pictures to communicate and needed wheelchairs to move around plus constant assistance to cope with their learning problems.
An investigation was initiated following anonymous allegations about staff at Ralphs Close.
Stormont health minister Edwin Poots said: "This highlights the challenges we face in protecting the most vulnerable people in our society, people who cannot always speak for themselves and who rely on others for their care.
"There is no room in the health and social care family for those who exploit their position of trust by inflicting suffering and harm, or indeed, standing by and ignoring others who do."
Mr Poots said no concerns remain over standards of care and there had been a transformation in the treatment provided to residents over the past 18 months.
The accommodation is intended for those who formerly would have been confined to hospital wards for life, living in separate buildings with four residents each.
It is part of a wider move away from hospital care and placing people back into the community.
Around 30 caring staff are employed at Ralphs Close, plus caterers and porters.
The initial allegations of abuse were made in July 2012 and subject to investigations by the police and Western Health and Social Services Trust which organises care.
The Police Service of Northern Ireland (PSNI) concluded that without witness evidence it was unlikely the burden of proof required for prosecutions would be met.
But a safeguarding investigation by the health trust concluded that, on the balance of probabilities, abuse was perpetrated between September 2010-July 2012.
Mr Poots said: "The nature and type of abuse includes physical and psychological abuse and neglect by omission.
"Over 50% of allegations made have been substantiated and, on the basis of these findings, disciplinary proceedings are now progressing as well as investigations by the relevant regulatory bodies."
He added the findings were disturbing.
The 19 recommendations included:
:: A review should be carried out of supervision arrangements to ensure care standards are met.
:: Whistle-blowing advice should be made available to staff.
:: Learning disabilities services should review the role of care management.
A Trust spokesman said: "Trust staff continue to meet the families concerned and have apologised to them for any distress caused to their family members resident in the home."