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.

Organisational Abuse

This is neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation, resulting in ongoing neglect or poor care.


  • Adult not enabled to have a say in how the service is run
  • Denial of individuality and opportunities to make informed choices and take responsible risks
  • Care-planning documentation not person-centred/does not involve the adult or capture their views
  • Single incident of insufficient staffing to meet all people’s needs in a timely fashion but causing no harm
  • Odours at low level
  • Unclean environment causing no harm


  • Rigid/inflexible routines that are not always in the adult’s best interests
  • Adult’s dignity is occasionally undermined e.g. lack of privacy during support with intimate care needs, pooled under-clothing
  • Recurrent bad practice which lacks management oversight and is not being reported to relevant organisations/ departments
  • Unsafe and unhygienic living environments that could cause harm to the adult or have caused minor injury requiring no external medical intervention/consultation
  • Lack of stimulation/opportunities to engage in social and leisure activities
  • Inability of providers to manage own safeguarding enquiries


  • Staff misusing position of power over adults using the service
  • Over-medication and/or inappropriate restraint managing behaviour
  • Recurrent or consistent ill-treatment by care provider to more than one adult over a period of time
  • Recurrent or consistent incidents of insufficient staffing resulting in harm requiring external medical intervention or hospitalisation
  • Recurrent incidents of insufficient staffing resulting in some harm

Last Updated: 7 December 2021