Aim: This study examined the responses of care managers and direct care staff to vignettes of inappropriate sexual behaviour (ISB) by a man with an intellectual disability. The aim was to identify psychological factors that influenced their assessment of risk and the perceived need for risk management strategies. Method: The vignettes varied in response topography and the age of the victim. Regression analysis was used to examine the effect of three sets of psychological factors (causal explanations, causal attributions and emotional responses) on perceptions of risk, seriousness and appropriate service level responses to the ISB, and the inter-relationships between these outcome variables. Results: Behaviours involving intimate sexual contact or a child victim were rated as more serious, and more in need of supervision and management, than vignettes describing non-contact behaviours or in which the victim was another adult with an intellectual disability. Levels of concern were generally lower for care managers than for direct care staff. The study cast little light on how care staff make decisions concerning the risk of recurrence of ISB. For care managers, high levels of concern were associated with the perception that the ISB was sexually motivated or was triggered by a negative emotional state, and with high levels of anger. Care managers appeared to make decisions about the appropriate intensity of service response based on an evaluation of the seriousness of the ISB, which was informed by the topography of the ISB and the identity of the victim. For direct care staff, high levels of concern were associated primarily with the perception that the cause of the behaviour was poor management; other factors associated with high levels of concern were the perception that the ISB was sexually motivated, and attributions that the ISB was controllable and stable. The central constructs in the decision making of direct care staff appeared to be the perceptions that, for it to have occurred, the behaviour must have been badly managed, and that offences against children require a response. Implications: These differing approaches to decision making by care managers and care staff may lead to conflict in the implementation of care plans for men with intellectual disabilities who display ISB.