Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
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Immediate social danger
Violence, coercion, neglect, medication withholding, unsafe wandering, fire risk, absent essential care, carer collapse or discharge to an inaccessible home can cause imminent harm even when physiology is stable.
Action: Make the person safe, treat medical consequences, speak privately where possible, preserve evidence, assess capacity and immediate risk, and refer through local adult-safeguarding and emergency social-care pathways without promising secrecy.
Synopsis
Map the person's relationships, care work, housing, access and safeguarding context accurately enough to build a lawful, feasible plan that supports autonomy without assuming family availability or overlooking risk.
Ask who lives with the person, who matters to them and who actually performs meals, medicines, personal care, finances, transport and night support.
Home assessment covers tenure, stairs, toilet and bathing access, heating, food, phone, alarms, pets, fire, clutter, neighbourhood and emergency entry.
Collateral is valuable but seek consent when capacity is present and offer private conversation to both the person and carer.
Key red flags
Injuries with inconsistent explanations, fearfulness, controlling accompaniment or restricted access to money or medicines raises abuse concern.
Carer strain
Exhaustion, poor health, resentment, financial impact or inability to leave the person signals a support need.
Investigation priorities
01
Private social interviewFirst step
Establish the person's account and chosen relationships.
Management branches
First-line social mapTranslate household reality into care needs
Illness or function changes the support required.
Interview the person with consented collateral and list every daily and night task, helper and gap.
Assess home access, carer willingness, capacity, finances, loneliness and safeguarding concerns.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.