Individuals with intellectual disability living in a care facility are at high risk of sexual abuse. Formal policies on sexual abuse within these care facilities and their effective implementation are a prerequisite to reducing the risk of sexual abuse in this group. The present study aimed to determine the state of affairs in this regard in the Netherlands and identify areas of improvement regarding both policy formulation and implementation. An online survey was sent to the management boards of 129 Dutch care facilities for individuals with intellectual disability. Sixty-nine managers completed the survey on behalf of their care facility. Descriptive statistics were used to characterize the state of affairs regarding policies on sexual abuse. Areas of improvement reported by the managers were examined qualitatively by thematic analysis. Most care facilities complied with the national legal requirements on sexual abuse, which include the availability of a protocol on sexual abuse and mandatory reporting. It varied across the care facilities to what extent the protocols on sexual abuse are brought to the staff's attention and used in practice. About half of them provided no staff training on the protocol on sexual abuse, while nearly one-third of the care facilities provided no organizational protective factors on sexual abuse, such as a special-task official on sexual abuse, sexuality or sexual abuse department, or cooperation with the vice squad. Most areas of improvement reported by the managers pertained to the need for staff training and the improvement of practical use of policies and protocols on sexual abuse. In conclusion, the availability of policies and protocols on sexual abuse in care facilities for individuals with intellectual disability does not guarantee a caring culture in which these policies and protocols are implemented effectively, and in which sexual abuse is prevented and detected in a timely way.