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Advice for professionals

People in many job roles encounter hoarding behaviours — housing officers, social workers, fire safety teams, NHS staff, police and environmental health officers. This page provides resources to support effective, trauma-informed practice.

Understanding hoarding disorder

Hoarding Disorder has three key symptoms: the accumulation of large quantities of possessions; significant difficulty discarding them; and severe clutter that prevents normal use of living spaces.

Important: a severely cluttered property does not automatically mean the occupant has a hoarding disorder — they may have reduced mobility or other conditions. Alternative explanations should always be considered.

Assessments and tools

Professional assessment tools including the Clutter Image Rating Scale and Hoarding Rating Scale for use in casework.

View assessment tools →

Recommended reading

For professionals

Frost, R.O., & Steketee, G. (2014). The Oxford Handbook of Hoarding and Acquiring. Oxford University Press.
Tolin, D.F., Frost, R.O., & Steketee, G. (2014). Buried in Treasures. 2nd ed. Oxford University Press.
Fay, L. (2024). A pragmatic approach to chronic disorganization and hoarding: using the DESIRE method. Jessica Kingsley Publishers.
Edwards, L.J., & Drummond, L. (2025). Everything you need to know about hoarding. Cambridge University Press.

For people who hoard and their families

Cooke, J. (2021). Understanding Hoarding. Sheldon Press.
Paxton, M. (2022). Keep the memories, lose the stuff. Portfolio.

Frameworks, protocols and practical tools

Policy and guidance documents for practitioners. Listed here for reference; use alongside your own organisation’s procedures and local safeguarding pathways.

National Tools

Hoarding Fire Safety Checklist

Two-page checklist covering fire safety, access, amenities and hazard mitigation, with details on pre-entry planning, engagement and hazard reduction.

VIEW HERE →

Self-neglect policy and practice

Research briefing on effective practice with adults who self-neglect, including hoarding, drawing on serious case reviews and practitioner findings.

VIEW HERE →

Local Frameworks

Westminster Hoarding Practice Handbook

City of Westminster, 2026

Practitioner handbook covering fire risk, environmental health powers, mental capacity, Care Act eligibility, hospital discharge and legal escalation.

VIEW HERE →

Multi-Agency Hoarding Framework

Nottingham City & Nottinghamshire

Practitioner guidance including a three-level action framework tied to Clutter Image Ratings, referral forms and panel templates.

VIEW HERE →

Hoarding Protocol

Cambridgeshire and Peterborough, 2016

Multi-agency hoarding protocol with agency roles, referral routes and assessment tools.

VIEW HERE →
Across the UK

Current UK initiatives

A directory of current initiatives taking place around the country to help people who hoard. Last updated: February 2026.

INITIATIVE

DESCRIPTION

LEAD

ORGANISATION

B.I.T

Support group based on the Buried in Treasures workbook

Ian McPherson

Royal Borough of Greenwich

Provider Framework

Cleaning/clearing services using trauma-informed approach

-

Norfolk County Council

Safe Habitable Homes

Multi-agency task force

Rachel Omori

Norwich City Council

Sheffield Mind Magpies

Intervention and support

Jon Friend

Sheffield Mind

Safe Spaces

Person-centred support

Rosemary Leach

Lightbulb (Leicestershire)

Southend Hoarding Alliance

Multi-agency initiative

Maxine Nutkins

Southend-on-Sea City Council

Grant a Smile

Support for hoarding

Melody Waterworth

Grant a Smile