Adult Safeguarding - Raising a Concern and the Decision Making Tool (DMT)

 MK Together has developed a Decision Making Tool to make it clearer and easier for people to understand what a safeguarding concern is and what to do with a concern.


A person living in a way that puts their health, safety, or well-being at risk.


  • Self-care causing some concern - no signs of harm or distress
  • Property neglected but all main services work
  • Some evidence of hoarding - no major impact on health/safety
  • First signs of not engaging with professionals
  • Property shows some signs of neglect
  • Evidence of low-level hoarding
  • No access to support


  • Refusing/non-engagement with medical treatment/care/equipment required to maintain independence and health
  • High level of clutter/hoarding
  • Insanitary conditions in property
  • Not engaging with professionals
  • Problematic or chaotic substance misuse
  • Potential fire risk/gas leaks
  • Lack of essential amenities
  • Property/environment shows signs of neglect that are potentially damaging to health


  • Life in danger without intervention
  • Chaotic substance misuse
  • Environment injurious to health
  • Imminent fire risk/gas leaks
  • Access obstructed within property
  • Multiple reports from other agencies
  • Behaviour poses risk to self/others
  • Self-neglect is life threatening
  • Tenancy at risk because of hoarding/property condition, i.e. notice served
  • Lack of self-care results in significant deterioration in health/wellbeing/safety

Please note: All standard interventions must be used first to manage risk, e.g. Care Management/ Care Plan Approach/ Multi-Disciplinary Team. Refer to self-neglect guidance at:

Last Updated: 7 December 2021