Tenancy check form

• Address of Property
  Address

• Any comments made from Tenancy manager about household:

• Are they a 2 person visit?

  Yes

  No

  N/A

• Date of Interview planned

  Date

• Officers Name

  Select Daniel Jones Tracey Reed Jessica Coats Paula Quirke Loraine Pruden Other officer

  • Daniel Jones
  • Tracey Reed
  • Jessica Coats
  • Paula Quirke
  • Loraine Pruden
  • Other officer

• Photo ID

  Media

• 5. Proof of Identity produced

• Officer Satisfied

  Yes

  No

• Reasoning

Tenant 1

• Name

• Gender

  Male

  Female

  Other (please specify)

  Prefer not to say

• Ethnicity

  Select White English/Welsh/Scottish/N.Ireland/British Any other white background Mixed or multiple ethnic groups Asian or Asian British Black, Black British, African or Carribean Any other ethnic group Prefer not to say

  • White English/Welsh/Scottish/N.Ireland/British
  • Any other white background
  • Mixed or multiple ethnic groups
  • Asian or Asian British
  • Black, Black British, African or Carribean
  • Any other ethnic group
  • Prefer not to say

• Date of birth (if not on ID)

  Date

Tenant 2

• Name

• Gender

  Male

  Female

  Other (please specify)

  Prefer not to say

• Ethnicity

  Select White English/Welsh/Scottish/N.Ireland/British Any other white background Mixed or multiple ethnic groups Asian or Asian British Black, Black British, African or Carribean Any other ethnic group Prefer not to say

  • White English/Welsh/Scottish/N.Ireland/British
  • Any other white background
  • Mixed or multiple ethnic groups
  • Asian or Asian British
  • Black, Black British, African or Carribean
  • Any other ethnic group
  • Prefer not to say

• Date of birth (if not on ID)

Other household members

• Name(s)

• Members to be added (with D.o.B+relationship)

• Members to be taken off

Communications

• Telephone number

• Email address

• Communication preference

  Mobile

  Email

  Letter

• Do they have any special communication requirements? e.g Bad vision/hearing impairments

  Yes

  No

• Please specify

• Are they usually available during the working week?

  Yes

  No

• When are they not available?

Housing needs

• Do they have any health/medical needs that may impact their housing situation that we are not aware of?

  Yes

  No

• Please specify

• Do they have a disability under the equality act 2010? (Any long term physical/mental impairments which has substantial adverse affects on day to day activities)

  Yes

  No

• Please specify

• Does anyone in the household have a special housing need because of any of the following:

  Select Permanent physical disability Learning disability Visual impairment Hearing impairment Experiencing domestic abuse Mental health problems Young person leaving care Ex-offender Isolated-no support English is not my first language Issue with alcohol misuse Issue with drug misuse issue with literacy May need help bidding and has no one to help Experiencing anti-social behaviour or harassment Age-related mental infirmity i.e mental health difficulties like Alzheimers/Dementia Age-related physical infirmity i.e arthritis/unsteady Long term mental health condition Long term physical health condition

  • Permanent physical disability
  • Learning disability
  • Visual impairment
  • Hearing impairment
  • Experiencing domestic abuse
  • Mental health problems
  • Young person leaving care
  • Ex-offender
  • Isolated-no support
  • English is not my first language
  • Issue with alcohol misuse
  • Issue with drug misuse
  • issue with literacy
  • May need help bidding and has no one to help
  • Experiencing anti-social behaviour or harassment
  • Age-related mental infirmity i.e mental health difficulties like Alzheimers/Dementia
  • Age-related physical infirmity i.e arthritis/unsteady
  • Long term mental health condition
  • Long term physical health condition

• Please specify who and their need.

  Select Permanent physical disability Learning disability Visual impairment Hearing impairment Experiencing domestic abuse Mental health problems Young person leaving care Ex-offender Isolated-no support English is not my first language Issue with alcohol misuse Issue with drug misuse issue with literacy May need help bidding and has no one to help Experiencing anti-social behaviour or harassment Age-related mental infirmity i.e mental health difficulties like Alzheimers/Dementia Age-related physical infirmity i.e arthritis/unsteady Long term mental health condition Long term physical health condition

  • Permanent physical disability
  • Learning disability
  • Visual impairment
  • Hearing impairment
  • Experiencing domestic abuse
  • Mental health problems
  • Young person leaving care
  • Ex-offender
  • Isolated-no support
  • English is not my first language
  • Issue with alcohol misuse
  • Issue with drug misuse
  • issue with literacy
  • May need help bidding and has no one to help
  • Experiencing anti-social behaviour or harassment
  • Age-related mental infirmity i.e mental health difficulties like Alzheimers/Dementia
  • Age-related physical infirmity i.e arthritis/unsteady
  • Long term mental health condition
  • Long term physical health condition

• Does anyone have mental health issues and diagnosis?

  Yes

  No

• Please specify

• Are they working with any support workers/support services

  Yes

  No

• Please specify

  Yes

  No

  N/A

Property

• Do they have any pets living there?

  Yes

  No

• Please specify

• Communal landing area clear of household item? (in flats)

  Yes

  No

  N/A

• Are fittings/fixtures we provide in good condition?

  Yes

  No

  N/A

• Please specify

• Is there any damp or mould in the household? (Provide evidence if possible)

  Yes

  No

• Is the home in a clean and tidy manner and decorated as necessary?

  Good

  Fair

  Poor

  N/A

• Is the garden maintained?

  Good

  Fair

  Poor

  N/A

• Tree Survey – Any Trees larger than House/Flats close to the building?

  Yes

  No

• Any alterations carried out including occupational adaptations?

  Yes

  No

• Please specify. Has permission been sought?

  Yes

  No

  N/A

• Are there any outstanding repairs which we haven't followed up with?

  Yes

  No

• Please specify

• Would they benefit from being contacted in respect of income maximisation- UC, HB, PC, Fuel Debt?

  Yes

  No

  N/A

• Advise tenants if they are on Universal credit about 'Social Tariffs' that could help them with paying water bills/phones/broadbands

  Yes

  No

  N/A

• Do they feel they need a referral regarding fuel poverty? e.g struggling with the cost of heating homes/energy usage

  Yes

  No

  N/A

• TDC has a number of opportunities for tenants to be involved in the delivery of its housing services – would you be interested in finding out more?

  Yes

  No

  N/A

• What do you think the Council does well as a landlord / what do you think it could improve on?

• Is there anything else the tenant would like to discuss?

• Ensure they have the new contacts list.

• Ensure they know their tenant manager for the area?

• Officers Signature

  Sign

• Tenants Signature

  Sign

• Date of visit completed

  Date

• What action has been taken from this visit?