Drawing on data from a Scottish research study, this paper explores the relationship of professionals’ perceptions about specific perpetrators and victims to their constructions of ‘adult protection’ issues in practice. It finds that professionals’ perceptions of victim distress did not consistently coincide with the construction of adult protection issues, whilst the connection to any assessment of victims’ heightened vulnerability in specific cases was not clear. With respect to perpetrators, implicit practice rules were evidenced which differed from explicit policy criteria. In particular, there were different rules for relatives, staff and service user perpetrators, whilst harms attributed to institutions were de-emphasized. Explanations of the findings are advanced based on the complex power relations underpinning practice but unacknowledged in policies. More research is recommended to deepen this analysis in a changing policy context, to foreground service user perspectives, and to contextualize harms potentially resolvable through adult support and protection/safeguarding routes with respect to harms better addressed in other ways.