In England the pioneer of moral treatment was the York Retreat, a private Quaker house specialising in the care of the mentally ill. Following ideas adopted on the continent, the Retreat - run by successive generations of the Tuke family - was opened in 1792 and its moral regime was based upon the structure of the family. Patients were treated as children and the Retreat operated as a 'surrogate home'. Staff dined with the patients; patients helped with the chores, and they organised social events together. (See A. Digby Madness, Morality and Medicine) Due to its small patient intake, and the fact that the Retreat only cared for wealthy Quakers, its methods were not widely adopted in county asylums. This did not occur until the 1840s and 1850s after Dr John Conolly of the Hanwell Asylum had successfully proved that the abandonment of mehcanical restraint could work in a large institution.
Along with the use of non-restraint, the new institutions built after the 1845 County Asylums Act were opened with the moral management of patients in mind. Central to the new moral regimes of care were: a nourishing diet - often a departure in the lives of most pauper lunatics living in destitution; exercise - absent from those living in cramped conditions; useful employment in tasks which benefit the running of the asylum in order to divert the minds of the insane from unwanted thoughts; religion, and recreational pursuits.