Housing Jigsaw PRAH Quick Guide 16b – Using Map Codes
Quick Guide 16b – Using Map Codes
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Housing Jigsaw PRAH Quick Guide 16b – Using Map Codes
What are Map CodesMap codes work in the same way as merge fields, the only difference is, the map code will display any answers to any questions that have been asked in PRAH rather than any displaying any basic information.For example, if you wanted to add the “Date Customer is likely to Become Homeless” into your letter template, you can do so by adding the map code.
The list of available map codes can be found at the bottom of this guide.
How to Add a Map CodeTo add a map code to your template, put the cursor in the correct place, select “Insert” in the word menu, then select “Quick Parts” followed by “Field”.
Choose “Merge Field” from the “Field Name” list then enter the name of the map code into the “Field Name” text box.For example, if you want to add the answer to the question “Reason for Approach” to your template, the correct format is:QU_REASONS_FOR_APPROACH
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Click “OK” and the merge field will be added to your template in the following format.«QU_REASONS_FOR_APPROACH»When you have saved your letter template into PRAH and generated it, the map code will look for the information in PRAH and, if the information is there, it will populate your letter template.Please note, if there is no information, nothing will be pulled into the template.
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Housing Jigsaw PRAH Quick Guide 16b – Using Map Codes
Available Map CodesPage Question Internal CodeReasons for Approach
Detail the reason for approaching for assistance today
QU_REASONS_FOR_APPROACH
Reasons for Approach
Detail any steps which have already been taken to resolve current housing issues
QU_STEPS_TAKEN_TO_RESOLVE
Reasons for Approach
Detail any assistance which would be helpful
QU_HOPES_FROM_MEETING
Reasons for Approach
Have you been homeless before?
QU_PRESENTED_BEFORE
Reasons for Approach
If so, how many times have you been homeless?
QU_PRESENTED_BEFORE_COUNT
Reasons for Approach
When did you most recently approach an LA for assistance with your housing/homeles
QU_PRESENTED_MOST_RECENTLY
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sness?Additional Factors
Drug/alcohol use?
QU_DRUG_OR_ALCOHOL_ISSUES
Additional Factors
Care history? QU_CARE_HISTORY
Additional Factors
Served in the Armed Forces?
QU_ARMED_FORCES
Additional Factors
Prison history? QU_PRISON_HISTORY
Additional Factors
Health Issues? QU_HEALTH_ISSUES
Additional Factors
Has any member of the household experienced domestic abuse or harrassment?
QU_DOMESTI_FROM_HARASSMENT
Additional Factors
Residential Status QU_RESIDENTIAL_STATUS
Additional Factors
Detail current medication and dosage for all household members
QU_CURRENT_FROM_DOSAGE
Additional Factors
Detail any members of the household who are receiving support including the support provider, nature and frequency of the support
QU_SUPPORT_FROM_AGENCIES
Outcomes Initial triage outcome?
QU_TRIAGE_OUTCOME
Outcomes Referral to Housing Advice Officer
QU_REFERRAL_TO_HOUSING_ADVICE
Outcomes Detail the initial advice provided today
QU_INITIAL_ADVICE_PROVIDED
Outcomes Detail any agencies the customer has been signposted to
QU_INITIAL_AGENCY_SIGNPOSTING
Outcomes Reason to believe homeless or
QU_TRIAGE_OUTCOME_REASON
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threatened with homelessness within 56 days
Data sharing consents
GPs QU_DATA_SHARING_GP
Data sharing consents
Revenues & Benefits
QU_DATA_SHARING_R_AND_B
Data sharing consents
Landlords QU_DATA_SHARING_LANDLORDS
Data sharing consents
Solicitors QU_DATA_SHARING_SOLICITORS
Data sharing consents
Social Services QU_DATA_SHARING_SOCIAL_SERVICES
Data sharing consents
Banks or other financial organisations
QU_DATA_SHARING_BANKS
Data sharing consents
Police & Probation services
QU_DATA_SHARING_POLICE_PROBATION
Data sharing consents
HMCS (Her Majesty's Court Services)
QU_DATA_SHARING_HMCS
Data sharing consents
Other local authorities
QU_DATA_SHARING_OTHER_LAS
Data sharing consents
Support agencies QU_DATA_SHARING_SUPPORT
Data sharing consents
The Department for Communities and Local Government
QU_DATA_SHARING_DCLG
Data sharing consents
Other agencies you consent to us sharing your data with
QU_DATA_SHARING_OTHER_CONSENT
Data sharing consents
Other agencies you do not consent to us sharing your data with
QU_DATA_SHARING_OTHER_DO_NOT_CONSENT
Office use + Main reason for QU_TRIAGE_MAIN_REASON_LOSS_LAST_SETTLED
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Approach checklist
loss of last settled accommodation
Office use + Approach checklist
Main reason for loss of last settled accommodation (P1E values)
QU_TRIAGE_MAIN_REASON_LOSS_LAST_SETTLED_P1E
Office use + Approach checklist
Secondary reason for loss of last settled accommodation
QU_TRIAGE_SECONDARY_REASON_LOSS_LAST_SETTLED
Office use + Approach checklist
If last settled accommodation was an AST, provide reason for loss
QU_TRIAGE_AST_REASON_FOR_LOSS
Office use + Approach checklist
Main reason for end of private rented tenancy
QU_TRIAGE_REASON_END_PRIVATE_TENANCY
Office use + Approach checklist
Main reason for loss of social rented tenancy
QU_TRIAGE_REASON_END_SOCIAL_TENANCY
Office use + Approach checklist
Main reason for loss of supported housing
QU_TRIAGE_REASON_END_SUPPORTED_TENANCY
Office use + Approach checklist
Private tenant checklist
QU_TRIAGE_PRIVATE_TENANT_CHECKLIST
Office use + Approach checklist
Told to leave by friends or family checklist
QU_TRIAGE_TOLD_FAMILY_CHECKLIST
Office use + Approach checklist
Owner-occupier checklist
QU_TRIAGE_OWNER_OCCUPIER_CHECKLIST
Office use + Approach checklist
Health or substance misuse checklist
QU_TRIAGE_HEALTH_MISUSE_CHECKLIST
Office use + Approach checklist
Victim of violence, abuse or harassment checklist
QU_TRIAGE_VICTIM_HARASSMENT_CHECKLIST
Office use + Approach checklist
General advice checklist
QU_TRIAGE_GENERAL_ADVICE_CHECKLIST
Equal Opportunities Monitoring
Age QU_E_AND_D_AGE
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Equal Opportunities Monitoring
Disability QU_E_AND_D_DISABILITY
Equal Opportunities Monitoring
Nationality QU_E_AND_D_NATIONALITY
Equal Opportunities Monitoring
Ethnicity QU_E_AND_D_ETHNICITY
Equal Opportunities Monitoring
Sex QU_E_AND_D_SEX
Equal Opportunities Monitoring
Religion QU_E_AND_D_RELIGION
Equal Opportunities Monitoring
Sexual orientation
QU_E_AND_D_SEXUAL_ORIENTATION
Equal Opportunities Monitoring
Are you pregnant?
QU_E_AND_D_PREGNANCY
Equal Opportunities Monitoring
Have you had a baby in the last 12 months?
QU_E_AND_D_RECENT_MOTHER
Equal Opportunities Monitoring
Marriage and Civil Partnership
QU_E_AND_D_MARRIAGE
Equal Opportunities Monitoring
Are you a refugee or an asylum seeker?
QU_E_AND_D_REFUGEE
Equal Opportunities Monitoring
What country or region are you a refugee/asylum seeker from?
QU_E_AND_D_REFUGEE_FROM
Equal Opportunities
Please select the option that best describes your
QU_E_AND_D_LANGUAGE
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Monitoring languageCircumstances - About homelessness
Is the customer homeless or threatened with homelessness within 56 days?
QU_HOUSEHOLD_HOMELESS_IN_56_DAYS
Circumstances - About homelessness
Detail the reason for approaching for assistance today:
QU_HOUSEHOLD_HOMELESS_IN_56_DAYS_DETAILS
Circumstances - About homelessness
When is the customer likely to become homeless?
QU_HOUSEHOLD_WHEN_THINK_HOMELESS
Circumstances - About homelessness
Has the customer ever approached this or any other local authority as homeless before?
QU_APPLICANT_APPROACHED_THIS_LA_BEFORE
Circumstances - About homelessness
If yes and this authority please provide date
QU_APPLICANT_APPROACHED_THIS_LA_BEFORE_DATE
Circumstances - About homelessness
If yes and another authority please provide name of authority
QU_APPLICANT_APPROACHED_OTHER_LA_BEFORE
Circumstances - About homelessness
If yes and another authority please provide date
QU_APPLICANT_APPROACHED_OTHER_LA_BEFORE_DATE
Circumstances - About homelessness
What happened (why is the customer homeless or threatened with homelessness)?
QU_WHY_IS_APP_HOMELESS_OR_THREATENED
Circumstances - About previous homelessness
Has the customer been homeless previously?
QU_APP_HOMELESS_BEFORE
Circumstances - About previous homelessne
If yes, when did the customer first become homeless?
QU_WHEN_MAIN_APPLICANT_FIRST_HOMELESS
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ssCircumstances - About previous homelessness
If yes, how old was the customer when they first become homeless?
QU_AGE_THE_MAIN_APPLICANT_WHEN_FIRST_HOMELESS
Circumstances - About previous homelessness
Has customer ever slept rough?
QU_APP_EVER_SLEPT_ROUGH
Circumstances - About previous homelessness
If yes - How many nights did the customer sleep rough last year?
QU_DAYS_THE_MAIN_APPLICANT_SLEEP_ROUGH_LAST_YEAR
Circumstances - About previous homelessness
If yes - What age was the customer when they first slept rough?
QU_AGE_MAIN_APPLICANT_WHEN_THEY_FIRST_SLEPT_ROUGH
Circumstances - About previous homelessness
Has the customer been placed in temporary accommodation before by this local authority?
QU_MAIN_PLACED_TEMP_BY_LA_PREVIOUSLY
Circumstances - About previous homelessness
If Yes - add any further details about the placement here:
QU_MAIN_PLACED_TEMP_BY_LA_PREVIOUSLY_DETAILS
Circumstances - Current situation and aspirations
Are there any additional reasons for requesting assistance from housing options?
QU_ADDITIONAL_REASONS_FOR_ASSISTANCE
Circumstances - Current situation and aspirations
Please specify any other reasons for requesting assistance
QU_ADDITIONAL_REASONS_FOR_ASSISTANCE_OTHER
Circumstances - Current
We have talked through your homelessness
QU_CURRENT_SITUATION_ASPIRATIONS
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situation and aspirations
and your additional reasons for requesting assistance, can you now tell me what you are hoping to get from this meeting?
Circumstances - Current situation and aspirations
What are your main interests/hobbies/skills?
QU_CURRENT_SITUATION_HOBBIES
Circumstances - Current situation and aspirations
What would you like to see yourself doing in five years time?
QU_CURRENT_SITUATION_5_YEAR_PLAN
Circumstances - Current situation and aspirations
What support do you think you will need to help you achieve this?
QU_CURRENT_SITUATION_5_YEAR_PLAN_SUPPORT
Circumstances - Current situation and aspirations
What do you think might prevent you from achieving this?
QU_CURRENT_SITUATION_5_YEAR_PLAN_HURDLES
Circumstances - Current situation and aspirations
List which other local agencies may be able to support the customer to achieve the above
QU_CURRENT_SITUATION_5_YEAR_PLAN_AGENCIES
Circumstances - Current housing details
What type of property are you living in?
QU_CURRENT_PROPERTY_TYPE
Circumstances -
How many bedrooms does
QU_CURRENT_PROPERTY_BEDS_TOTAL
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Current housing details
your accommodation have?
Circumstances - Current housing details
How many bedrooms are for the sole use of your household?
QU_CURRENT_PROPERTY_BEDS_OWN_USE
Circumstances - Current housing details
How many living rooms does your accommodation have?
QU_CURRENT_PROPERTY_LIVING_ROOMS_TOTAL
Circumstances - Current housing details
How many living rooms are for the sole use of your household?
QU_CURRENT_PROPERTY_LIVING_ROOMS_OWN_USE
Circumstances - Current housing details
How many bathrooms does your accommodation have?
QU_CURRENT_PROPERTY_BATHROOMS_TOTAL
Circumstances - Current housing details
How many bathrooms are for the sole use of your household?
QU_CURRENT_PROPERTY_BATHROOMS_OWN_USE
Circumstances - Current housing details
Is there a kitchen in your accommodation?
QU_CURRENT_PROPERTY_KITCHEN
Circumstances - Current housing details
Is the kitchen for the sole use of your household?
QU_CURRENT_PROPERTY_KITCHEN_OWN_USE
Circumstances - Current housing details
Is there a garden with your accommodation?
QU_CURRENT_PROPERTY_GARDEN
Circumstances - Current housing
Is the garden for sole use of your household?
QU_CURRENT_PROPERTY_GARDEN_OWN_USE
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detailsCircumstances - Current housing details
If a flat - what floor is the accommodation on?
QU_CURRENT_PROPERTY_FLAT_FLOOR
Circumstances - Current housing details
If a flat - is there a lift?
QU_CURRENT_PROPERTY_LIFT
Housing & Accommodation Needs - Property details
Is the accommodation in the district?
QU_PRS_ACCOMMODATION_OUT_OF_DISTRICT
Housing & Accommodation Needs - Property details
If the accommodation is out of district, how far out of the district boundary?
QU_PRS_ACCOMMODATION_OUT_OF_DISTRICT_DIST
Housing & Accommodation Needs - Property details
Landlord name QU_PRS_LANDLORD_NAME
Housing & Accommodation Needs - Property details
Landlord address QU_PRS_LANDLORD_ADDRESS
Housing & Accommodation Needs - Property details
Agent name QU_PRS_AGENT_NAME
Housing & Accommodation Needs - Property details
Agent address QU_PRS_AGENT_ADDRESS
Housing & Accommodation Needs - Property details
Is the property in disrepair?
QU_PRS_IS_DISREPAIR
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Housing & Accommodation Needs - Property details
Are you sufferring harassment at the property?
QU_PRS_HARASSMENT
Housing & Accommodation Needs - Property details
If yes, please provide details:
QU_PRS_HARASSMENT_DETAILS
Housing & Accommodation Needs - Property details
Are you overcrowded at the property?
QU_PRS_OVERCROWDED
Housing & Accommodation Needs - Property details
Has notice been served at the property?
QU_PRS_NOTICE
Housing & Accommodation Needs - Property details
Are there reasons why you think the property is not fit for purpose?
QU_PRS_NOT_FIT
Housing & Accommodation Needs - Property details
If yes, explain why it is not suitable?
QU_PRS_NOT_SUITABLE_OTHER
Housing & Accommodation Needs - Property details
Is there another reason why the current property is not suitable - support network, school, work, etc.?
QU_PRS_NETWORK_QUESTION
Housing & Accommodation Needs - Property details
If yes, please provide details:
QU_PRS_NETWORK
Housing & Accommodation Needs - Property details
Was a deposit paid?
QU_PRS_DEPOSIT_PAID
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Housing & Accommodation Needs - Property details
If yes, please provide details:
QU_PRS_DEPOSIT_PAID_AMOUNT
Housing & Accommodation Needs - Property details
Who paid the deposit?
QU_PRS_DEPOSIT_PAID_WHO
Housing & Accommodation Needs - Property details
Do you have a copy of the deposit protection certificate?
QU_PRS_DEPOSIT_PAID_CERTIFICATE
Housing & Accommodation Needs - Property details
Was the deposit paid by cash or bond?
QU_PRS_DEPOSIT_PAID_METHOD
Housing & Accommodation Needs - Property details
If cash, is it in a protected scheme?
QU_PRS_DEPOSIT_PAID_PROTECTED
Housing & Accommodation Needs - Property details
Is there a valid energy performance certificate?
QU_PRS_VALID_EPC_AND_GAS_SAFETY
Housing & Accommodation Needs - Property details
Is there a valid gas safety certificate?
QU_PRS_VALID_GAS_SAFETY
Housing & Accommodation Needs - Health and wellbeing
Do you or any of your household members have any self-reported vulnerabilities - including physical or mental health needs?
QU_HEALTH_VULNERABILITIES_NEW
Housing & Accommodation Needs - Health
If yes, please provide details:
QU_HEALTH_VULNERABILITIES_DETAILS
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and wellbeingHousing & Accommodation Needs - Health and wellbeing
Do you or any member of your household have any confirmed medical conditions?
QU_HEALTH_MEDICAL
Housing & Accommodation Needs - Health and wellbeing
If yes, please provide details:
QU_HEALTH_MEDICAL_DETAILS
Housing & Accommodation Needs - Health and wellbeing
Are you or your family members on any medication?
QU_HEALTH_MEDICATION
Housing & Accommodation Needs - Health and wellbeing
If yes, please provide details:
QU_HEALTH_MEDICATION_DETAILS
Housing & Accommodation Needs - Health and wellbeing
Does your current housing situation impact on your medical condition?
QU_HEALTH_MEDICAL_IMPACT
Housing & Accommodation Needs - Health and wellbeing
If yes, please provide details:
QU_HEALTH_MEDICAL_IMPACT_DETAILS
Housing & Accommodation Needs - Health and wellbeing
Do you or your family members have any other health care professionals working with you?
QU_HEALTH_AGENCIES
Housing & Accommod
If yes, please provide details
QU_HEALTH_AGENCIES_DETAILS
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ation Needs - Health and wellbeing
including consultants, health visitors, community psychiatric nurse, occupational therapist etc.
Housing & Accommodation Needs - Health and wellbeing
Do you use alcohol and/or drugs?
QU_HEALTH_DRINK_DRUGS
Housing & Accommodation Needs - Health and wellbeing
If yes, please provide details including how this affects your life
QU_HEALTH_DRINK_DRUGS_DETAILS
Housing & Accommodation Needs - Health and wellbeing
Does any member of your household require any assistance with addiction (gambling, drugs or alcohol)?
QU_HEALTH_ADDICTION_NEW
Housing & Accommodation Needs - Health and wellbeing
If so, who and what addiction
QU_HEALTH_ADDICTION_DETAILS
Housing & Accommodation Needs - Health and wellbeing
Do you or any member of your household need support to be able to live independently or to develop independent living skills?
QU_HEALTH_SUPPORT_TO_LIVE_INDEPENDENTLY_NEW
Housing & Accommodation Needs - Health and wellbeing
If yes, please provide details:
QU_HEALTH_SUPPORT_TO_LIVE_INDEPENDENTLY_DETAILS
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Housing & Accommodation Needs - Health and wellbeing
Have you or any member of your household ever been in local authority care?
QU_HEALTH_EVER_BEEN_IN_CARE
Housing & Accommodation Needs - Health and wellbeing
If yes, please provide details:
QU_HEALTH_EVER_BEEN_IN_CARE_DETAILS
Housing & Accommodation Needs - Health and wellbeing
What is the name of your family GP?
QU_HEALTH_GP_NAME
Housing & Accommodation Needs - Health and wellbeing
Does this member of the household have any of the following mobility or support issues?
QU_MOBILITY_AND_SUPPORT_ISSUES
Housing & Accommodation Needs - Education and employment
Is this member of the household in full time education or employment?
QU_EDUCATION_EMPLOYMENT_STATUS
Housing & Accommodation Needs - Education and employment
Does this member of the household have any qualifications?
QU_QUALIFICATIONS
Housing & Accommodation Needs - Education and employment
If yes, please provide details:
QU_QUALIFICATIONS_DETAILS
Housing & Accommod
If employed, details of
QU_EMPLOYMENT_DETAILS
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ation Needs - Education and employment
company, hours worked and position held.
Housing & Accommodation Needs - Education and employment
If in education, details of course undertaken, the hours and days studying.
QU_EDUCATION_DETAILS
Housing & Accommodation Needs - Education and employment
Which secondary school/college did they attend?
QU_PHP_WHAT_SCHOOL_OR_COLLEGE
Housing & Accommodation Needs - Financial assessment
Income (£) QU_SALARY
Housing & Accommodation Needs - Financial assessment
Frequency QU_SALARY_PAID
Housing & Accommodation Needs - Financial assessment
Other income (£) QU_BENEFITS
Housing & Accommodation Needs - Financial assessment
Frequency QU_BENEFITS_PAID
Housing & Accommodation Needs - Financial assessment
Housing benefit (£)
QU_HOUSING_BENEFIT
Housing & Accommodation Needs
Frequency QU_HOUSING_BENEFIT_PAID
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- Financial assessmentHousing & Accommodation Needs - Financial assessment
Savings (£) QU_SAVINGS
Housing & Accommodation Needs - Financial assessment
Debt / Loans (£) QU_DEBT_LOANS
Housing & Accommodation Needs - Financial assessment
Arrears (£) QU_ARREARS
Housing & Accommodation Needs - Financial assessment
Is the customer claiming benefit towards their housing costs?
QU_BENEFITS_TOWARDS_HOUSING
Housing & Accommodation Needs - Financial assessment
Is the customer claiming benefit towards their other living costs? If the customer receives more than one benefit, identify the one which contributes most to their income.
QU_BENEFITS_TOWARDS_LIVING
Housing & Accommodation Needs - Financial assessment
Is the household managing financially?
QU_HOUSEHOLD_MANAGING_FINANCIALLY
Housing & Accommodation Needs - Financial assessment
Do either the customer or joint customer have an interest in a mortgage?
QU_HOUSEHOLD_HAS_MORTGAGE_INTEREST
Housing & Accommodation Needs
If yes, please provide details:
QU_HOUSEHOLD_HAS_MORTGAGE_DETAILS
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- Financial assessmentHousing & Accommodation Needs - Pets
Does the household have any pets?
QU_HOUSEHOLD_HAS_PETS
Housing & Accommodation Needs - Pets
Please provide details of the type and age of the pets
QU_HOUSEHOLD_PET_DETAILS
Housing & Accommodation Needs - Pets
Are any of the pets expected to be rehoused with the household?
QU_HOUSEHOLD_PETS_TO_BE_REHOUSED
Housing & Accommodation Needs - Pets
Is an assistance dog to be rehoused with the household?
QU_HOUSEHOLD_ASSISTANCE_DOG_TO_BE_REHOUSED
Housing & Accommodation Needs - Other comments from customer
Any other comments:
QU_OTHER_COMMENTS
Housing & Accommodation Needs - PHP Supplementary information
Detail any appointments made, including agency, date of appointment and time
QU_PHP_APPOINTMENTS
Housing & Accommodation Needs - PHP Supplementary information
Detail any leaflets or websites provided to the customer
QU_PHP_LEAFLETS
Housing & Accommodation Needs - PHP Supplementary information
Any other information / advice provided
QU_PHP_ANY_OTHER_INFO_PROVIDED
Support - What support QU_SUPPORT_HOUSEHOLD_NEEDS
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Support needs and support network
needs have been identified within the household?
Support - Support needs and support network
What kind of support do you receive from family members?
QU_SUPPORT_FROM_FAMILY
Support - Support needs and support network
What kind of support do you receive from friends?
QU_SUPPORT_FROM_FRIENDS
Support - Support needs and support network
Do you receive any other additional support and if so from which agencies?
QU_SUPPORT_FROM_AGENCIES_CURRENT
Support - Support needs and support network
Is there any other support you feel you would like?
QU_SUPPORT_FROM_AGENCIES_REQUIRED
Support - Support needs and support network
Do you provide any support to anyone in your household?
QU_SUPPORT_A_HOUSEHOLD_MEMBER
Support - Support needs and support network
If yes, who do you support and what with?
QU_SUPPORT_HOUSEHOLD_MEMBER_DETAILS
Support - Criminal behaviour
Has any member of the household any criminal convictions including unspent or pending, cautions or final warnings?
QU_ANY_CRIMINAL_CONVICTIONS
Support - Criminal behaviour
If Yes - add any further details here:
QU_ANY_CRIMINAL_CONVICTIONS_DETAILS
Support - Has any member QU_ANY_IN_PRISON
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Criminal behaviour
of the household been in prison?
Support - Criminal behaviour
Please provide details
QU_ANY_IN_PRISON_DETAILS
Support - Criminal behaviour
Has the customer been in prison in the last year?
QU_MAIN_APP_IN_PRISON_LAST_YEAR
Support - Criminal behaviour
If yes - what date did customer leave prison?
QU_MAIN_APP_OUT_OF_PRISON_DATE
Support - Criminal behaviour
If yes, was the customer homeless before they went to prison?
QU_MAIN_APP_HOMELESS_PRIOR_TO_PRISON
Support - Criminal behaviour
Please provide details
QU_ANY_OTHER_CRIMINAL_INFORMATION
Support - Risk Assessment
Incidents of violence?
QU_RISK_VIOLENCE
Support - Risk Assessment
If yes, to whom? QU_RISK_VIOLENCE_TOWARDS_WHOM
Support - Risk Assessment
Most serious damage caused
QU_RISK_MOST_SERIOUS_CAUSED
Support - Risk Assessment
Emotional / Mental health problems
QU_RISK_EMOTIONAL_PROBLEMS
Support - Risk Assessment
Self-care / Risk from others
QU_RISK_SELF_CARE_OTHERS
Support - Risk Assessment
Other risk factors QU_RISK_FACTORS
Support - Risk Assessment
Tenancy risks QU_RISK_TENANCY_RISKS
Support - Risk Assessment
PNC Check Information and other additional information:
QU_RISK_PNC_INFORMATION
Support - Risk Assessment
If you have indicated yes to any question
QU_RISK_DESCRIPTION
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above please describe behaviour/incidents in detail. Please also list any risk assessment work previously undertaken with this individual
Support - Risk Assessment
Who is at risk? QU_RISK_WHO
Support - Risk Assessment
What are the risks?
QU_RISK_WHAT
Support - Risk Assessment
Where is the risk greatest?
QU_RISK_WHERE_IS_GREATEST
Support - Risk Assessment
What factors might increase risk?
QU_RISK_WHAT_FACTORS_RISK
Support - Risk Assessment
What risk strategy / actions should be put in place as a direct result of this form?
QU_RISK_WHAT_STRATEGY
Checklist 1: Referral
Did the customer self-refer?
QU_CL1_SELF_REFER
Checklist 1: Referral
If no, who was the customer referred by?
QU_CL1_REFERRER
Checklist 1: Referral
Was this an agency referral under s213B (specified public body)?
QU_CL1_AGENCY_REFERRAL
Checklist 1: Referral
Is the referral a re-application following discharge of duty via a PRSO offer?
QU_CL1_REAPPLICATION
Checklist 1a: Reapplication duty
Has the customer accepted a PRSO made to a Council to end
QU_CL1A_REAPPLICATION
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the main housing duty under s193(7AA) within the past 2 years?
Checklist 1a: Reapplication duty
If yes, Has the customer approached the initial authority with the re-application duty?
QU_CL1A_REAPPLICATION_TO_INITIAL_LA
Checklist 2: General advice (triage outcomes)
Has general advice been provided to the customer?
QU_CL2_ADVICE_PROVIDED_YN
Checklist 2: General advice (triage outcomes)
Was the general advice provided by the LA or other?
QU_CL2_GENERAL_PROVIDED_BY_LA
Checklist 2: General advice (triage outcomes)
If the advice was not provided by the LA, who provided it?
QU_CL2_ADVICE_NOT_BY_LA_YN
Checklist 2: General advice (triage outcomes)
Please tick if the customer falls within any of the following specified groups:
QU_CL2_APPLICANT_GROUPS
Checklist 2: General advice (triage outcomes)
Any other group identified by the local authority as being at particular risk of homelessness, including:
QU_CL2_APPLICANT_OTHER_GROUPS
Checklist 2: General advice (triage outcomes)
Ensure general advice covers the key elements below;
QU_CL2_ADVICE_GENERAL_ELEMENTS
Checklist 2: General advice (triage outcomes)
Please specify the general advice given below:
QU_CL2_ADVICE_GENERAL
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Checklist 2: General advice (triage outcomes)
Please specify any advice given that was tailored to the needs of the customer because you have identified that they are either in a specified group or they are in a group identified as being at particular risk of homelessness below:
QU_CL2_ADVICE_TAILORED
Checklist 2: General advice (triage outcomes)
The customer has been signposted to the following agencies;
QU_CL2_APPLICANT_SIGNPOSTED
Checklist 3: * Reason to believe homeless or threatened with homelessness
Reason to believe homeless or threatened with homelessness within 56 days?
QU_CL3_REASON_TO_BELIEVE
Checklist 3: * Reason to believe homeless or threatened with homelessness
If yes - state why there is reason to believe homeless or threatened with homelessness
QU_CL3_REASON_TO_BELIEVE_DETAIL
Checklist 3: * Reason to believe homeless or threatened with homelessness
Has it been recommended to the customer that they attend a full housing advice/assessment interview?
QU_CL3_FULL_ASSESS_RECOMMENDED
Checklist 3: Has the meeting QU_CL3_FULL_ASSESS_TODAY
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* Reason to believe homeless or threatened with homelessness
been booked for today?
Checklist 4: Enquiries into whether the customer is eligible and homeless or threatened with homelessness s.184
List the initial enquiries that have been made into whether the customer is eligible and homeless or threatened with homelessness.
QU_CL4_ENQUIRIES_INTO_HOMELESSNESS
Checklist 5: * Interim accommodation
Is there reason to believe the customer may be homeless, eligible and in priority need?
QU_CL5_HOME_ELIGIBLE_PRIORITY
Checklist 5: * Interim accommodation
If yes, please provide further information regarding the reason to believe the customer is in priority need.
QU_CL5_HOME_ELIGIBLE_REASON
Checklist 5: * Interim accommodation
Has the customer been placed into interim accommodation under the s188 duty?
QU_CL5_TA_PLACEMENT
Checklist 5: * Interim accommodation
If yes, confirm date of placement:
QU_CL5_TA_PLACEMENT_DATE
Checklist 5: * Interim accommodation
If yes, confirm address of placement:
QU_CL5_TA_PLACEMENT_ADDRESS
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Checklist 5: * Interim accommodation
Has the customer been placed in temporary accommodation in another local authority district?
QU_CL5_TA_PLACEMENT_OTHER_LA
Checklist 5: * Interim accommodation
If yes, please confirm s188 duty letter has been sent to the customer and a copy held on file?
QU_CL5_TA_PLACEMENT_S188_ON_FILE
Checklist 5: * Interim accommodation
If customer has been placed, please confirm the customer's Housing Register application has been updated (or that the customer has been registered at the interim accommodation address):
QU_CL5_TA_PLACEMENT_HR_UPDATED
Checklist 5: * Interim accommodation
If the customer was placed into interim accommodation as they have given you reason to believe they were homeless, however, enquiries demonstrate that they are instead “threatened with homeless within 56 days”, interim accommodation can be ended. Please make any relevant notes here if this is the case:
QU_CL5_TA_PLACEMENT_WHY_ENDED
Checklist 5: * Interim
Date placement ended (if
QU_CL5_TA_PLACEMENT_DATE_ENDED
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accommodation
appropriate):
Checklist 5: * Interim accommodation
If the customer has not been placed into interim accommodation, please set out the reason(s) why when the “reason to believe” threshold has been met? This decision is open to legal challenge via judicial review.
QU_CL5_TA_PLACEMENT_WHY_NOT_MADE
Checklist 6: * Discretionary power to accommodate (i.e. rough sleepers)
Has the customer been placed into interim accommodation under a discretionary power (i.e. s.1 Localism Act 2011)?
QU_CL6_DISCRETIONARY_INTERIM
Checklist 6: * Discretionary power to accommodate (i.e. rough sleepers)
If no, please confirm the reasons why:
QU_CL6_DISCRETIONARY_INTERIM_NO
Checklist 6: * Discretionary power to accommodate (i.e. rough sleepers)
If yes, confirm date of placement:
QU_CL6_DISCRETIONARY_INTERIM_YES_DATE
Checklist 6: * Discretionary power to accommodate (i.e.
Please confirm the customer's Housing Register application has been updated and or that the
QU_CL6_DISCRETIONARY_HR_UPDATED
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rough sleepers)
customer has been registered at the discretionary accommodation placement address:
Checklist 6: * Discretionary power to accommodate (i.e. rough sleepers)
Please list the agency referrals you have made with regard to accessing support and emergency accommodation for the customer here:
QU_CL6_AGENCY_REFERRALS
Checklist 7: * Eligibility
Please outline any enquiries that have been made into the customer's eligibility here:
QU_CL7_ELIGIBILITY_ENQUIRIES
Checklist 7: * Eligibility
Eligibility category
QU_CL7_ELIGIBILITY_CATEGORY
Checklist 7: * Eligibility
Is the person eligible for assistance?
QU_CL7_ELIGIBILITY
Checklist 7: * Eligibility
Ineligible customer/household - details of referrals made for further support:
QU_CL7_ELIGIBILITY_REFERRALS
Checklist 7: * Eligibility
Please provide details of the reason(s) for ineligibility here:
QU_CL7_INELIGIBLE_WHY
Checklist 7: * Eligibility
Has interim accommodation been provided?
QU_CL7_INTERIM_ACCOMM_PROVIDED
Checklist 7: * Eligibility
If yes, confirm date of placement:
QU_CL7_INTERIM_ACCOMM_DATE
Checklist 7: * Eligibility
If yes, confirm address of placement:
QU_CL7_INTERIM_ACCOMM_ADDRESS
Checklist 8: If customer is QU_CL8_16_17
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Homeless 16 or 17 year olds
either homeless or threatened with homelessness, are they 16/17 years old?
Checklist 8: Homeless 16 or 17 year olds
If yes, please confirm that a referral has been made to Children's Services:
QU_CL8_REFERRAL_MADE
Checklist 8: Homeless 16 or 17 year olds
Date of referral to Children's Services:
QU_CL8_REFERRAL_DATE
Checklist 8: Homeless 16 or 17 year olds
Has a joint assessment with Children's Services been undertaken?
QU_CL8_JOINT_ASSESSMENT_MADE
Checklist 8: Homeless 16 or 17 year olds
Outcome of joint assessment / referral to children's services
QU_CL8_JOINT_ASSESSMENT_DATE
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Does the customer have accommodation in the United Kingdom which is available to occupy together with any person who normally lives with them as a member of their household or who could reasonably be expected to reside with them?
QU_CL9_ACCOMM_AVAILABLE_UK
Checklist 9: * Enquiries to satisfy whether homeless
Does the customer have accommodation anywhere else in the world which
QU_CL9_ACCOMM_AVAILABLE_WORLD
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or threatened with homelessness
is available to occupy together with any person who normally lives with them as a member of their household or who could reasonably be expected to reside with them anywhere else in the world?
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Has the customer's legal right to occupy their accommodation been terminated?
QU_CL9_ACCOM_TERMINATED
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Will the customer's legal right to occupy their accommodation be terminated in the near future (including a valid s21 notice to quit that will expire within 56 days)?
QU_CL9_ACCOM_TERMINATED_SOON
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Is it reasonable for the customer to continue to occupy or return to his accommodation, considering issues of affordability, physical conditions, violence from persons not associated with
QU_CL9_ACCOM_REASONABLE_RETURN
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the customer, domestic abuse or other reason?
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Is the customer unable to gain entry to accommodation which they have a legal entitlement to occupy?
QU_CL9_ACCOM_CANT_ENTER
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Is the customer's accommodation a moveable structure (e.g. caravan, boat, or other)? If yes, do they have somewhere to legally place it and reside in it?
QU_CL9_ACCOM_MOVABLE
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Is the customer threatened with homelessness within 56 days (including valid s21 notice to quit that is due to expire within 56 days)?
QU_CL9_APP_THREATENED_HOMELESS_56
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Copy of Notice to Quit
QU_CL9_NTQ_RECEIVED
Checklist 9: * Enquiries to satisfy whether homeless
Date received QU_CL9_NTQ_DATE_RECEIVED
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or threatened with homelessnessChecklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Tenancy agreement
QU_CL9_TA_RECEIVED
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Date received QU_CL9_TA_DATE_RECEIVED
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Deposit protection certificate
QU_CL9_DPC_RECEIVED
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Date received QU_CL9_DPC_DATE_RECEIVED
Checklist 9: * Enquiries to satisfy
Copy of Notice Seeking Possession
QU_CL9_NSP_RECEIVED
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whether homeless or threatened with homelessnessChecklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Date received QU_CL9_NSP_DATE_RECEIVED
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Copy of Possession Order
QU_CL9_PO_RECEIVED
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Date received QU_CL9_PO_DATE_RECEIVED
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Copy of Bailiff's Warrant
QU_CL9_BW_RECEIVED
Checklist 9: Date received QU_CL9_BW_DATE_RECEIVED
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* Enquiries to satisfy whether homeless or threatened with homelessnessChecklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Other QU_CL9_OTHER_RECEIVED
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Date received QU_CL9_OTHER_DATE_RECEIVED
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Please set out the enquiries that have been made into whether the customer is homeless or threatened with homelessness:
QU_CL9_ENQUIRIES
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessne
As a result of the enquiries you have made, are you satisfied the customer is homeless or threatened with homelessness?
QU_CL9_APP_THREATENED_HOMELESS
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ssChecklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
Was positive action successful in preventing homelessness?
QU_POSITIVE_ACTION_SUCCESSFUL_PREVENTING_HOMELESSNESS
Checklist 9: * Enquiries to satisfy whether homeless or threatened with homelessness
What was the most significant action taken in preventing homelessness?
QU_POSITIVE_ACTION_SUCCESSFUL_PREVENTING_HOMELESSNESS_TYPE
Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
Have the details of the circumstances causing the customer's homelessness or threat of homelessness been captured on the initial assessment forms?
QU_CL10_HOMELESS_DETAILS_COLLECTED
Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
If yes, add any evidence or attachments to documents list and include here any further enquiries
QU_CL10_HOMELESS_DETAILS_FURTHER
Checklist 10: * Prevention
If no, provide notes:
QU_CL10_HOMELESS_DETAILS_NO_NOTES
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/ Relief duty (assessment under s189A and notification to the customer in writing)Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
Have the details of the specific housing needs of the customer (and any members of their household) been captured?
QU_CL10_HOUSING_NEEDS_DETAILS_COLLECTED
Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
If yes, add any evidence or attachments to documents list and include here any further enquiries
QU_CL10_HOUSING_NEEDS_DETAILS_FURTHER
Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
If no, provide notes:
QU_CL10_HOUSING_NEEDS_DETAILS_NO_NOTES
Checklist 10: * Prevention
Have the details of what accommodation
QU_CL10_SUITABLE_ACCOM_COLLECTED
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/ Relief duty (assessment under s189A and notification to the customer in writing)
would be suitable for the customer and any persons with whom the customer resides or might reasonably be expected to reside with been captured?
Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
If yes, add any evidence or attachments to documents list and include here any further enquiries
QU_CL10_SUITABLE_ACCOM_FURTHER
Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
Have the details of what support would be necessary for the customer and any other relevant persons to be able to have and retain suitable accommodation been captured?
QU_CL10_SUPPORT_COLLECTED
Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
If yes, add any evidence or attachments to documents list and include here any further enquiries
QU_CL10_SUPPORT_COLLECTED_FURTHER
Checklist 10: *
Please set out your assessment
QU_CL10_SUPPORT_ASSESSMENT
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Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
of what accommodation is required by the household, based on your assessment of their individual circumstances (demonstrate that you have actively considered what accommodation would be suitable for the customer and any person(s) included in the customer's household):
Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
Please set out your assessment of what support would be necessary for the customer and any members of their household to be able to have and retain suitable accommodation in the space provided below:
QU_CL10_SUPPORT_ASSESSMENT_SUSTAIN
Checklist 10: * Prevention / Relief duty (assessment under s189A and notification to the customer in writing)
Has the customer been notified about the s189A assessment of their needs, housing and support requirements?
QU_CL10_189A_YES_NO
Checklist 11: Is the customer owed a
Please select which category applies
QU_CL11_PREVENTION_OR_RELIEF
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prevention or relief duty?Checklist 12: * Relief duty (enquiries into local connection and referrals)
Resident in the area for 6 months out of the last 12?
QU_CL12_LC_6_OF_12
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Details: QU_CL12_LC_6_OF_12_DETAILS
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Resident in the area for 3 years out of the last 5 years?
QU_CL12_LC_3_OF_5
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Details: QU_CL12_LC_3_OF_5_DETAILS
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Proof of local employment?
QU_CL12_LC_EMPLOYMENT
Checklist 12: * Relief duty (enquiries into local
Details: QU_CL12_LC_EMPLOYMENT_DETAILS
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connection and referrals)Checklist 12: * Relief duty (enquiries into local connection and referrals)
Proof of close relatives with at least 5 years residence in the locality?
QU_CL12_LC_RELATIVES
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Details: QU_CL12_LC_RELATIVES_DETAILS
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Care leaver owed leaving care duties by the local authority?
QU_CL12_LC_CARE_LEAVER
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Details: QU_CL12_LC_CARE_LEAVER_DETAILS
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Care leaver under 21 who is owed leaving care duties and has lived in the local area for at least 2 years including some time before they were 16 years old?
QU_CL12_LC_CARE_LEAVER_2_YEARS
Checklist 12: * Relief duty
Details: QU_CL12_LC_CARE_LEAVER_2_YEARS_DETAILS
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(enquiries into local connection and referrals)Checklist 12: * Relief duty (enquiries into local connection and referrals)
Safe local connection elsewhere?
QU_CL12_LC_ELSEWHERE
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Details - including local authority (or authorities) where there is a safe local connection including which of the above reasons apply
QU_CL12_LC_ELSEWHERE_DETAILS
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Safe local connection anywhere?
QU_CL12_LC_ANYWHERE
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Details: QU_CL12_LC_ANYWHERE_DETAILS
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Has the customer made an application to any other housing authority?
QU_CL12_LC_APPLIED_ELSEWHERE
Checklist 12: * Relief
Details: QU_CL12_LC_APPLIED_ELSEWHERE_DETAILS
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duty (enquiries into local connection and referrals)Checklist 12: * Relief duty (enquiries into local connection and referrals)
Please confirm - has the customer got a local connection with this district?
QU_CL12_LC_CONFIRMED
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Details: QU_CL12_LC_CONFIRMED_DETAILS
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Detail enquiries here:
QU_CL12_LC_ENQUIRIES
Checklist 12: * Relief duty (enquiries into local connection and referrals)
List enquiries made to determine why a referral cannot be made due to an customer or household member would be at threat of violence, which is likely to be carried out in the receiving local authority area
QU_CL12_REFERRAL_ENQUIRIES
Checklist 12: * Relief duty (enquiries
Is the customer being referred to another local authority?
QU_CL12_REFERRAL
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into local connection and referrals)Checklist 12: * Relief duty (enquiries into local connection and referrals)
Receiving local authority
QU_CL12_REFERRAL_RECEIVING
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Receiving local authority contact details
QU_CL12_REFERRAL_RECEIVING_CONTACT_DETAILS
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Date notification letter sent to customer (and advising of right to request a review):
QU_CL12_REFERRAL_LETTER_SENT_DATE
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Date notification sent to receiving authority:
QU_CL12_REFERRAL_NOTIFICATION_SENT
Checklist 12: * Relief duty (enquiries into local connection and referrals)
Date referral accepted:
QU_CL12_REFERRAL_NOTIFICATION_ACCEPTED_DATE
Checklist 13: Has the customer been
Is the customer owed a prevention duty?
QU_CL13_OWED_PREVENTION_DUTY
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notified that a prevention / relief duty is owed?Checklist 13: Has the customer been notified that a prevention / relief duty is owed?
Is the customer owed a relief duty?
QU_CL13_OWED_RELIEF_DUTY
Checklist 14: Determining steps that need to be taken to prevent homelessness with the customer / relieve homelessness with the customer
Have any steps already been taken with the customer to prevent homelessness?
QU_CL14_PRIOR_STEPS
Checklist 14: Determining steps that need to be taken to prevent homelessness with the customer / relieve homelessness with the customer
If yes, please provide details:
QU_CL14_PRIOR_STEPS_DETAILS
Checklist 14: Determining steps that need to be taken to
Has a Personalised Housing Plan been completed with the customer?
QU_CL14_PHP_AGREED
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prevent homelessness with the customer / relieve homelessness with the customerChecklist 14: Determining steps that need to be taken to prevent homelessness with the customer / relieve homelessness with the customer
Have the steps been agreed with the customer (as they relate to preventing them from becoming homeless – steps to address wider support needs including assisting the customer to achieve aspirations that are not directly related to their imminent homelessness)?
QU_CL14_PHP_STEPS
Checklist 14: Determining steps that need to be taken to prevent homelessness with the customer / relieve homelessness with the customer
If no, why doesn’t the customer agree with the steps?
QU_CL14_PHP_STEPS_NOT_AGREED_REASON
Checklist 14: Determining steps that need to be taken to prevent homelessne
Comments about the PHP
QU_CL14_PHP_STEPS_AGREED
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ss with the customer / relieve homelessness with the customerChecklist 14: Determining steps that need to be taken to prevent homelessness with the customer / relieve homelessness with the customer
Why does the Council believe it would be reasonable and appropriate for the customer to take the required steps?
QU_CL14_PHP_STEPS_NOT_AGREED_APPROPRIATE
Checklist 14: Determining steps that need to be taken to prevent homelessness with the customer / relieve homelessness with the customer
Date steps discussed with customer
QU_CL14_PHP_STEPS_DISCUSSED_DATE
Checklist 14: Determining steps that need to be taken to prevent homelessness with the customer / relieve homelessness with the customer
Has the customer been notified in writing of the steps that are considered to be reasonable and appropriate for the customer to take, and including the steps the Council will take in order to prevent the customer
QU_CL14_PHP_STEPS_LETTER_DATE
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becoming homeless?
Checklist 15: 56 days duty to prevent homelessness / 56 days duty to relieve homelessness
Record of work undertaken to prevent homelessness including levels of cooperation received from the customer, and identifying any particularly successful approaches to preventing homelessness arising from following the agreed steps in this case:
QU_CL15_PREVENTION_WORK
Checklist 15: 56 days duty to prevent homelessness / 56 days duty to relieve homelessness
Record of work undertaken to relieve homelessness including levels of cooperation received from the customer, and identifying any particularly successful approaches to preventing homelessness arising from following the agreed steps in this case:
QU_CL15_RELIEF_WORK
Checklist 16: * Ending the prevention duty
Please indicate below the reason for the Prevention duty ending and complete details as may be required
QU_CL16_PREVENTION_DUTY_ENDING_REASON
Checklist 16: *
Please provide a brief outline
QU_CL_16_WHY_PROPERTY_SUITABLE
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Ending the prevention duty (continued)
setting out why the property is suitable:
Checklist 16: * Ending the prevention duty (continued)
Please select which of these apply to the accommodation
QU_CL_16_ACCOMMODATION_TYPE_AND_LENGTH
Checklist 16: * Ending the prevention duty (continued)
Is the customer in priority need?
QU_CL_16_IS_APP_PRIORITY_NEED
Checklist 16: * Ending the prevention duty (continued)
If the accommodation is a tenancy with a private landlord - Have you considered the requirements of Suitability Order 2012 (Officers are encouraged to consider these in all cases, however, must consider it where the customer is in priority need)?
QU_CL_16_SO2012_CONSIDERED
Checklist 16: * Ending the prevention duty (continued)
Have the Suitability Order 2012 requirements been met by the property?
QU_CL_16_SO2012_MET
Checklist 16: * Ending the prevention duty (continued)
Date duty ended: QU_CL_16_1_DUTY_ENDED
Checklist 16: * Ending the prevention
Is the prevention duty being extended to continue to
QU_CL_16_EXTENDED
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duty (continued)
explore prevention options?
Checklist 16: * Ending the prevention duty (continued)
Please provide a new date when the duty will be reviewed:
QU_CL_16_EXTENDED_NEW_DATE
Checklist 16: * Ending the prevention duty (continued)
Has the local authority taken the reasonable steps within the PHP?
QU_CL_16_LA_PHP_STEPS_DONE
Checklist 16: * Ending the prevention duty (continued)
If no, please record any steps that have not been taken and why? - including where they relate to deliberate or unreasonable refusal to cooperate
QU_CL_16_PHP_STEPS_NOT_DONE
Checklist 16: * Ending the prevention duty (continued)
Date duty ended: QU_CL_16_2_DUTY_ENDED
Checklist 16: * Ending the prevention duty (continued)
Date duty ended: QU_CL_16_3_DUTY_ENDED
Checklist 16: * Ending the prevention duty (continued)
Please provide a brief outline setting out why the property is suitable:
QU_CL_16_4_PROPERTY_SUITABLE
Checklist 16: * Ending the prevention duty
Address: QU_CL_16_4_ADDRESS
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(continued)Checklist 16: * Ending the prevention duty (continued)
Property Type: QU_CL_16_4_PROPERTY_TYPE
Checklist 16: * Ending the prevention duty (continued)
Floor level (g/f if house):
QU_CL_16_4_FLOOR_LEVEL
Checklist 16: * Ending the prevention duty (continued)
Tenure Type: QU_CL_16_4_TENURE_TYPE
Checklist 16: * Ending the prevention duty (continued)
Length of Tenancy:
QU_CL_16_4_TENANCY_LENGTH
Checklist 16: * Ending the prevention duty (continued)
Number of Bedrooms:
QU_CL_16_4_NUMBER_OF_BEDS
Checklist 16: * Ending the prevention duty (continued)
Landlord: QU_CL_16_4_LANDLORD
Checklist 16: * Ending the prevention duty (continued)
Notes: QU_CL_16_4_NOTES
Checklist 16: * Ending the prevention
Is the customer in priority need?
QU_CL_16_APP_PRIORITY
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duty (continued)Checklist 16: * Ending the prevention duty (continued)
If the accommodation is a tenancy with a private landlord - Have you considered the requirements of Suitability Order 2012 (Officers are encouraged to consider these in all cases, however, must consider it where the customer is in priority need)?
QU_CL_16_4_SO2012_CONSIDERED
Checklist 16: * Ending the prevention duty (continued)
Have the Suitability Order 2012 requirements been met by the property?
QU_CL_16_4_SO2012_MET
Checklist 16: * Ending the prevention duty (continued)
Date duty ended: QU_CL_16_4_DUTY_ENDED
Checklist 16: * Ending the prevention duty (continued)
Date duty ended: QU_CL_16_5_DUTY_ENDED
Checklist 16: * Ending the prevention duty (continued)
Date duty ended: QU_CL_16_6_DUTY_ENDED
Checklist 16: * Ending the prevention duty (continued)
Date duty ended: QU_CL_16_7_DUTY_ENDED
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Checklist 16: * Ending the prevention duty (continued)
Has the customer been notified in writing that the Council is ending the s195 Prevent duty under one of the above sections (and specifying which one)? (The letter must ensure the customer is advised that they have the right to request a review).
QU_CL_16_APP_NOTIFIED
Checklist 16: * Ending the prevention duty (continued)
Date of decision: QU_CL_16_DECISION_DATE
Checklist 16: * Ending the prevention duty (continued)
The main prevention activity that was undertaken by the local authority as part of the Prevention Duty.
QU_MAIN_PREVENTION_ACTIVITY
Checklist 16: * Ending the prevention duty (continued)
Homelessness prevented - household assisted to obtain alternative accommodation, in the form of (P1E values)
QU_P1E_PREVENTION_ACCOMMODATION_SECURED
Checklist 16: * Ending the prevention duty (continued)
The customer's accommodation when Prevention Duty ended.
QU_ACCOM_AFTER_PREVENTION
Checklist 16: * Ending the prevention
In what local authority district is the accommodation
QU_ACCOM_AFTER_PREVENTION_DISTRICT
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duty (continued)
outcome?
Checklist 16: * Ending the prevention duty (continued)
Was the household engaged with help for their support needs before the Prevention duty ended?
QU_ENGAGED_WITH_SUPPORT_PREVENTION
Checklist 16: * Ending the prevention duty (continued)
What assistance with support needs that the household was referred to did they engage with during the prevention period?
QU_ENGAGED_WITH_SUPPORT_PREVENTION_TYPE
Checklist 17: Prevention - deliberate and unreasonable refusal to cooperate
Has the customer deliberately and unreasonably refused to cooperate with the reasonable steps to prevent homelessness set out in the personalised housing plan?
QU_CL_17_DEL_AND_UNR_REF
Checklist 17: Prevention - deliberate and unreasonable refusal to cooperate
If yes, outline the lack of cooperation and why it is considered to be deliberate and unreasonable to the extent it warrants ending the Prevent duty:
QU_CL_17_DEL_AND_UNR_REF_DETAILS
Checklist 17: Prevention - deliberate and unreasonable refusal to cooperate
Has a warning been sent to the customer explaining what they need to do and within what timescale, and outlining the
QU_CL_17_DEL_AND_UNR_WARNING_SENT
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consequences of failing to do so?
Checklist 17: Prevention - deliberate and unreasonable refusal to cooperate
Please note the date of the warning letter:
QU_CL_17_DEL_AND_UNR_WARNING_DATE
Checklist 17: Prevention - deliberate and unreasonable refusal to cooperate
Has the customer complied with the warning letter and timescale set out?
QU_CL_17_DEL_AND_UNR_COMPLIED
Checklist 17: Prevention - deliberate and unreasonable refusal to cooperate
If no, has a written notice been issued to bring the prevention duty to an end?
QU_CL_17_DEL_AND_UNR_NOTICE_SENT
Checklist 17: Prevention - deliberate and unreasonable refusal to cooperate
Date of Decision (written notice):
QU_CL_17_DEL_AND_UNR_NOTICE_DATE
Checklist 18: * Ending the relief duty
Please indicate below the reason for the Relief duty ending and complete details as may be required
QU_CL_18_1_RELIEF_DUTY_ENDING
Checklist 18: * Ending the relief duty (continued)
Please provide a brief outline setting out why the property is suitable:
QU_CL_18_1_WHY_PROPERTY_SUITABLE
Checklist 18: *
Please select which of these
QU_CL_18_ACCOMMODATION_TYPE_AND_LENGTH
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Ending the relief duty (continued)
apply to the accommodation
Checklist 18: * Ending the relief duty (continued)
Is the customer in priority need?
QU_CL_18_1_IS_APP_PRIORITY
Checklist 18: * Ending the relief duty (continued)
If the accommodation is a tenancy with a private landlord - Have you considered the requirements of Suitability Order 2012 (Officers are encouraged to consider these in all cases, however, must consider it where the customer is in priority need)?
QU_CL_18_1_SO2012_CONSIDERED
Checklist 18: * Ending the relief duty (continued)
Have the Suitability Order 2012 requirements been met by the property?
QU_CL_18_1_SO2012_MET
Checklist 18: * Ending the relief duty (continued)
Date duty ended: QU_CL_18_1_DUTY_ENDED
Checklist 18: * Ending the relief duty (continued)
Are you proposing to extend the relief duty to continue to explore options?
QU_CL_18_2_EXTENDED
Checklist 18: * Ending the relief duty (continued)
Please provide a new date when you will review the duty again:
QU_CL_18_2_EXTENDED_NEW_DATE
Checklist 18: *
Have you reconsidered the
QU_CL_18_2_INTERIM_CONSIDERED
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Ending the relief duty (continued)
provision of interim temporary accommodation for the customer if they remain on the streets and do not have priority need?
Checklist 18: * Ending the relief duty (continued)
Have you taken the reasonable steps you said you would?
QU_CL_18_2_PHP_STEPS_DONE
Checklist 18: * Ending the relief duty (continued)
If no, please record any steps that have not been taken and why? - including where they relate to deliberate or unreasonable refusal to cooperate
QU_CL_18_2_PHP_WHAT_NOT_DONE
Checklist 18: * Ending the relief duty (continued)
Date duty ended: QU_CL_18_2_DUTY_ENDED
Checklist 18: * Ending the relief duty (continued)
Please provide a brief outline setting out why the property is suitable:
QU_CL_18_3_PROPERTY_SUITABLE
Checklist 18: * Ending the relief duty (continued)
Address: QU_CL_18_3_ADDRESS
Checklist 18: * Ending the relief duty (continued)
Property Type: QU_CL_18_3_PROPERTY_TYPE
Checklist 18: * Ending the relief duty
Floor level (g/f if house):
QU_CL_18_3_FLOOR_LEVEL
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(continued)Checklist 18: * Ending the relief duty (continued)
Tenure Type: QU_CL_18_3_TENURE_TYPE
Checklist 18: * Ending the relief duty (continued)
Length of Tenancy:
QU_CL_18_3_TENANCY_LENGTH
Checklist 18: * Ending the relief duty (continued)
Number of Bedrooms:
QU_CL_18_3_NUMBER_OF_BEDS
Checklist 18: * Ending the relief duty (continued)
Landlord: QU_CL_18_3_LANDLORD
Checklist 18: * Ending the relief duty (continued)
Notes: QU_CL_18_3_NOTES
Checklist 18: * Ending the relief duty (continued)
Is the customer in priority need?
QU_CL_18_3_APP_PRIORITY
Checklist 18: * Ending the relief duty (continued)
If the accommodation is a tenancy with a private landlord - Have you considered the requirements of Suitability Order 2012 (Officers are encouraged to consider these in all cases, however, must consider it where the customer is in priority need)?
QU_CL_18_3_SO2012_CONSIDERED
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Checklist 18: * Ending the relief duty (continued)
Have the Suitability Order 2012 requirements been met by the property?
QU_CL_18_3_SO2012_MET
Checklist 18: * Ending the relief duty (continued)
Date duty ended: QU_CL_18_3_DUTY_ENDED
Checklist 18: * Ending the relief duty (continued)
Date duty ended: QU_CL_18_4_DUTY_ENDED
Checklist 18: * Ending the relief duty (continued)
Date duty ended: QU_CL_18_5_DUTY_ENDED
Checklist 18: * Ending the relief duty (continued)
Date duty ended: QU_CL_18_6_DUTY_ENDED
Checklist 18: * Ending the relief duty (continued)
If refused - has a referral been made to social services where the customer is pregnant, has dependent children or is vulnerable?
QU_CL_18_7_SS_REFERRAL
Checklist 18: * Ending the relief duty (continued)
If refused - has the customer been provided with advice explaining that a review can still be requested even if the property is accepted - thus ensuring the customer has accommodation available to them
QU_CL_18_7_ADVICE
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irrespective of the outcome of the review?
Checklist 18: * Ending the relief duty (continued)
Please provide a brief outline setting out why the property is suitable:
QU_CL_18_7_PROPERTY_SUITABLE
Checklist 18: * Ending the relief duty (continued)
Address: QU_CL_18_7_ADDRESS
Checklist 18: * Ending the relief duty (continued)
Property Type: QU_CL_18_7_PROPERTY_TYPE
Checklist 18: * Ending the relief duty (continued)
Floor level (g/f if house):
QU_CL_18_7_FLOOR_LEVEL
Checklist 18: * Ending the relief duty (continued)
Tenure Type: QU_CL_18_7_TENURE_TYPE
Checklist 18: * Ending the relief duty (continued)
Length of Tenancy:
QU_CL_18_7_TENANCY_LENGTH
Checklist 18: * Ending the relief duty (continued)
Number of Bedrooms:
QU_CL_18_7_NUMBER_OF_BEDS
Checklist 18: * Ending the relief duty (continued)
Landlord: QU_CL_18_7_LANDLORD
Checklist 18: * Ending the relief duty
Notes: QU_CL_18_7_NOTES
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(continued)Checklist 18: * Ending the relief duty (continued)
Is the customer in priority need?
QU_CL_18_7_APP_PRIORITY
Checklist 18: * Ending the relief duty (continued)
Have the requirements of the Suitability Order been met by the property? (this must be compliant where the customer is in priority need)?
QU_CL_18_7_SSO2012_MET
Checklist 18: * Ending the relief duty (continued)
If yes, please provide a brief outline setting out how the property meets the suitability order:
QU_CL_18_7_SSO2012_MET_HOW
Checklist 18: * Ending the relief duty (continued)
Is the customer under contractual or other obligations in respect of the customers existing accommodation?, and; if yes, is the customer able to bring these obligations to an end before being required to take up the offer?
QU_CL_18_7_CONTRACTUAL_OBL
Checklist 18: * Ending the relief duty (continued)
Date duty ended: QU_CL_18_7_DUTY_ENDED
Checklist 18: * Ending the relief duty (continued)
If refused - has a referral been made to social services where the customer is pregnant, has
QU_CL_18_8_SS_REFERRAL
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dependent children or is vulnerable?
Checklist 18: * Ending the relief duty (continued)
If refused - has the customer been provided with advice explaining that a review can still be requested even if the property is accepted - thus ensuring the customer has accommodation available to them irrespective of the outcome of the review?
QU_CL_18_8_ADVICE
Checklist 18: * Ending the relief duty (continued)
Please provide a brief outline setting out why the property is suitable:
QU_CL_18_8_PROPERTY_SUITABLE
Checklist 18: * Ending the relief duty (continued)
Address: QU_CL_18_8_ADDRESS
Checklist 18: * Ending the relief duty (continued)
Property Type: QU_CL_18_8_PROPERTY_TYPE
Checklist 18: * Ending the relief duty (continued)
Floor level (g/f if house):
QU_CL_18_8_FLOOR_LEVEL
Checklist 18: * Ending the relief duty (continued)
Tenure Type: QU_CL_18_8_TENURE_TYPE
Checklist 18: * Ending the relief duty
Length of Tenancy:
QU_CL_18_8_TENANCY_LENGTH
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(continued)Checklist 18: * Ending the relief duty (continued)
Number of Bedrooms:
QU_CL_18_8_NUMBER_OF_BEDS
Checklist 18: * Ending the relief duty (continued)
Landlord: QU_CL_18_8_LANDLORD
Checklist 18: * Ending the relief duty (continued)
Notes: QU_CL_18_8_NOTES
Checklist 18: * Ending the relief duty (continued)
Date duty ended: QU_CL_18_8_DUTY_ENDED
Checklist 18: * Ending the relief duty (continued)
The relief activity that was successful in relieving homelessness. In cases where the Relief Duty was not successful the main activity should be recorded.
QU_MAIN_RELIEF_ACTIVITY
Checklist 18: * Ending the relief duty (continued)
Homelessness relieved - household assisted to obtain alternative accommodation, in the form of (P1E values)
QU_P1E_RELIEF_ACCOMMODATION_SECURED
Checklist 18: * Ending the relief duty (continued)
The customer's accommodation when Relief Duty ended.
QU_ACCOM_AFTER_RELIEF
Checklist 18: *
In what local authority district
QU_ACCOM_AFTER_RELIEF_DISTRICT
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Ending the relief duty (continued)
is the accommodation outcome?
Checklist 18: * Ending the relief duty (continued)
Was the household engaged with help for their support needs before the Relief duty ended?
QU_ENGAGED_WITH_SUPPORT_RELIEF
Checklist 18: * Ending the relief duty (continued)
What assistance with support needs that the household was referred to did they engage with during the relief period?
QU_ENGAGED_WITH_SUPPORT_RELIEF_TYPE
Checklist 19: Relief - deliberate and unreasonable refusal to cooperate
Has the customer deliberately and unreasonably refused to cooperate with the reasonable steps to relieve homelessness set out in the personalised housing plan?
QU_CL19_DEL_AND_UN_REF
Checklist 19: Relief - deliberate and unreasonable refusal to cooperate
If yes, outline the lack of cooperation and why it is considered to be deliberate and unreasonable to the extent it warrants ending the Relief duty
QU_CL19_DEL_AND_UN_REF_DETAIL
Checklist 19: Relief - deliberate and unreasonable refusal to cooperate
Has a warning been sent to the customer explaining what they need to do and within what timescale, and outlining the consequences of
QU_CL19_DEL_AND_UN_WARNING
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failing to do so?Checklist 19: Relief - deliberate and unreasonable refusal to cooperate
Please note the date of the warning letter:
QU_CL19_DEL_AND_UN_WARNING_DATE
Checklist 19: Relief - deliberate and unreasonable refusal to cooperate
Has the customer complied with the warning letter and timescale set out?
QU_CL19_DEL_AND_UN_COMPLIED
Checklist 19: Relief - deliberate and unreasonable refusal to cooperate
If no, has a written notice been issued to bring the relief duty to an end?
QU_CL19_DEL_AND_UN_NOTICE
Checklist 19: Relief - deliberate and unreasonable refusal to cooperate
Date of Decision (written notice):
QU_CL19_DEL_AND_UN_DECISION_DATE
Checklist 20: Relief - deliberate and unreasonable refusal to cooperate duty ends - would the main duty have been owed?
Would the main duty (s.193(2) have been owed if the relief duty had not been ended due to the customer deliberately and unreasonably refused to co-operate?
QU_CL20_WOULD_MD_BE_OWED
Checklist 21: Ending the s.193C(4) deliberate and unreasonab
Please indicate below the reason for the deliberate and unreasonable duty ending and complete details
QU_CL21_DEL_AND_UNR_END
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le refusal to cooperate duty
as may be required
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Date duty ended: QU_CL21_1_DUTY_ENDED
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Date duty ended: QU_CL21_2_DUTY_ENDED
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Address: QU_CL_21_3_ADDRESS
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Property Type: QU_CL_21_3_PROPERTY_TYPE
Checklist Floor level (g/f if QU_CL_21_3_FLOOR_LEVEL
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21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
house):
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Tenure Type: QU_CL_21_3_TENURE_TYPE
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Length of Tenancy:
QU_CL_21_3_TENANCY_LENGTH
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Number of Bedrooms:
QU_CL_21_3_NUMBER_OF_BEDS
Checklist 21: Ending the s.193C(4) deliberate
Landlord: QU_CL_21_3_LANDLORD
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and unreasonable refusal to cooperate duty (continued)Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Notes: QU_CL_21_3_NOTES
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Have the Suitability Order 2012 requirements been met by the property?
QU_CL21_3_SUITABLE
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Date duty ended: QU_CL21_3_DUTY_ENDED
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate
Date duty ended: QU_CL21_4_DUTY_ENDED
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duty (continued)Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
If the offer is refused - has the customer been provided with advice explaining that a review of suitability can still be requested even if the property is accepted - thus ensuring the customer has accommodation available to them irrespective of the outcome of the review?
QU_CL21_5_ADVICE
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Address: QU_CL_21_5_ADDRESS
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Property Type: QU_CL_21_5_PROPERTY_TYPE
Checklist 21: Ending the s.193C(4) deliberate and
Floor level (g/f if house):
QU_CL_21_5_FLOOR_LEVEL
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unreasonable refusal to cooperate duty (continued)Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Tenure Type: QU_CL_21_5_TENURE_TYPE
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Length of Tenancy:
QU_CL_21_5_TENANCY_LENGTH
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Number of Bedrooms:
QU_CL_21_5_NUMBER_OF_BEDS
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty
Landlord: QU_CL_21_5_LANDLORD
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(continued)Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Notes: QU_CL_21_5_NOTES
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Have the Suitability Order 2012 requirements been met by the property?
QU_CL21_5_SO2012
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
If yes, please provide a brief outline setting out how the property meets the suitability order:
QU_CL21_5_SUITABILITY
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Is the customer under contractual or other obligations in respect of the customers existing accommodation?, and; if yes, is the customer able to bring these obligations to an end before being required to
QU_CL21_5_CONTRACTUAL
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take up the offer?Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Date duty ended: QU_CL21_5_DUTY_ENDED
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
If the offer is refused - has a referral been made to social services?
QU_CL21_5_SS_REFERRAL
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
If the offer is refused - has the customer been provided with advice explaining that a review of suitability can still be requested even if the property is accepted - thus ensuring the customer has accommodation available to them irrespective of the outcome of the review?
QU_CL21_5_ADVICE_REFUSED
Checklist 21: Ending the s.193C(4) deliberate and unreasonab
Address: QU_CL_21_6_ADDRESS
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le refusal to cooperate duty (continued)Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Property Type: QU_CL_21_6_PROPERTY_TYPE
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Floor level (g/f if house):
QU_CL_21_6_FLOOR_LEVEL
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Tenure Type: QU_CL_21_6_TENURE_TYPE
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Length of Tenancy:
QU_CL_21_6_TENANCY_LENGTH
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Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Number of Bedrooms:
QU_CL_21_6_NUMBER_OF_BEDS
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Landlord: QU_CL_21_6_LANDLORD
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Notes: QU_CL_21_6_NOTES
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Please provide a brief outline setting out why the property is considered to be suitable:
QU_CL_21_6_SUITABLE
Checklist 21: Ending the s.193C(4)
Is the customer under contractual or other obligations in
QU_CL_21_CONTRACTUAL
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deliberate and unreasonable refusal to cooperate duty (continued)
respect of the customers existing accommodation?, and; if yes, is the customer able to bring these obligations to an end before being required to take up the offer?
Checklist 21: Ending the s.193C(4) deliberate and unreasonable refusal to cooperate duty (continued)
Date duty ended: QU_CL_21_DUTY_ENDED
Checklist 22: * Final main duty assessment - priority need
Customer is pregnant or living with a pregnant woman?
QU_CL22_PREGNANCY
Checklist 22: * Final main duty assessment - priority need
Details (including relevant confirmation/proof):
QU_CL22_PREGNANCY_DETAILS
Checklist 22: * Final main duty assessment - priority need
Customer is responsible for dependent children who live with him/her, or might reasonably be expected to do so?
QU_CL22_RESPONSIBLE_FOR_DEPENDENT_CHILDREN
Checklist 22: * Final main duty assessment - priority need
Details (including relevant confirmation/proof):
QU_CL22_RESPONSIBLE_FOR_DEPENDENT_CHILDREN_DETAILS
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Checklist 22: * Final main duty assessment - priority need
Customer is homeless as a result of fire, flood or other disaster?
QU_CL22_HOMELESS_FIRE_FLOOD_DISASTER
Checklist 22: * Final main duty assessment - priority need
Details (including relevant confirmation/proof):
QU_CL22_HOMELESS_FIRE_FLOOD_DISASTER_DETAILS
Checklist 22: * Final main duty assessment - priority need
Customer is 16 or 17 years old and not classed as a relevant child?
QU_CL22_CUSTOMER_16_OR_17
Checklist 22: * Final main duty assessment - priority need
Details (including relevant confirmation/proof):
QU_CL22_CUSTOMER_16_OR_17_DETAILS
Checklist 22: * Final main duty assessment - priority need
Customer is under 21 and was looked after, accommodated or fostered when 16, 17 or 18?
QU_CL22_CUSTOMER_UNDER_21_IN_CARE_16_17_18
Checklist 22: * Final main duty assessment - priority need
Details (including relevant confirmation/proof):
QU_CL22_CUSTOMER_UNDER_21_IN_CARE_16_17_18_DETAILS
Checklist 22: * Final main duty assessment - priority need
Does the customer or any member of their household have a medical condition or disability?
QU_CL22_MEDICAL_CONDITION
Checklist 22: * Final main duty assessment - priority need
If yes, what is the nature of the medical condition or disability:
QU_CL22_MEDICAL_CONDITION_DETAILS
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Checklist 22: * Final main duty assessment - priority need
Does the customer have a disability or other relevant protected characteristic that is relevant to assessing whether they are in priority need?
QU_CL22_DISABILITY
Checklist 22: * Final main duty assessment - priority need
If yes, what is the relevant protected characteristic and how does it impact on the customer (in particular, what are the effects of any disability on the customer)?
QU_CL22_DISABILITY_DETAILS
Checklist 22: * Final main duty assessment - priority need
Does the customer (or relevant household member) receive any support?
QU_CL22_RECEIVES_SUPPORT
Checklist 22: * Final main duty assessment - priority need
If yes, what support is available (list all support available, for example, from members of the household, family, statutory services, charitable organisations et cetera):
QU_CL22_RECEIVES_SUPPORT_DETAILS
Checklist 22: * Final main duty assessment - priority need
Is any of this support provided under a statutory duty?
QU_CL22_RECEIVES_SUPPORT_STATUTORY_DUTY
Checklist 22: * Final main duty
If yes, provide details:
QU_CL22_RECEIVES_SUPPORT_STATUTORY_DUTY_DETAILS
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assessment - priority needChecklist 22: * Final main duty assessment - priority need
Is any non-statutory support consistently and predictably available for the customer?
QU_CL22_RECEIVES_SUPPORT_NON_STATUTORY
Checklist 22: * Final main duty assessment - priority need
If yes, what is the non-statutory support?
QU_CL22_RECEIVES_SUPPORT_NON_STATUTORY_DETAILS
Checklist 22: * Final main duty assessment - priority need
Is it reasonable to expect the third party to provide the support for this particular person?
QU_CL22_RECEIVES_SUPPORT_REASONABLE
Checklist 22: * Final main duty assessment - priority need
Provide details including evidence of any inquiries to confirm that non-statutory support is consistently and predictably available for the customer and why is it reasonable to expect this support to be provided for this particular person should they be, or become, homeless:
QU_CL22_RECEIVES_SUPPORT_REASONABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
How does the customer cope on a typical day?
QU_CL22_HOW_CUSTOMER_COPES
Checklist 22: * Final
How would they cope if they were
QU_CL22_HOW_WOULD_CUSTOMER_COPE_HOMELESS
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main duty assessment - priority need
homeless?
Checklist 22: * Final main duty assessment - priority need
Mobility QU_CL22_MOBILITY
Checklist 22: * Final main duty assessment - priority need
Impact on ability to cope:
QU_CL22_MOBILITY_IMPACT
Checklist 22: * Final main duty assessment - priority need
Ability to manage independently
QU_CL22_INDEPENDENCE
Checklist 22: * Final main duty assessment - priority need
Impact on ability to cope:
QU_CL22_INDEPENDENCE_IMPACT
Checklist 22: * Final main duty assessment - priority need
Psychiatric history
QU_CL22_PSYCHIATRIC
Checklist 22: * Final main duty assessment - priority need
Impact on ability to cope:
QU_CL22_PSYCHIATRIC_IMPACT
Checklist 22: * Final main duty assessment - priority need
Old age QU_CL22_OLD_AGE
Checklist Impact on ability QU_CL22_OLD_AGE_IMPACT
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22: * Final main duty assessment - priority need
to cope:
Checklist 22: * Final main duty assessment - priority need
Enquiries to ascertain a general view of the customers physical and mental health
QU_CL22_PHYSICAL_AND_MENTAL_HEALTH_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Details of any current medication and other treatment including levels of dosage taken, etc.
QU_CL22_MEDICATION_AND_TREATMENT
Checklist 22: * Final main duty assessment - priority need
Details of anyone GP, consultant, support worker who are relevant to the customer.
QU_CL22_GP_CONSULTANT_SUPPORT_DETAILS
Checklist 22: * Final main duty assessment - priority need
Any recent psychiatric hospital admission or evidence of current psychosis treated by anti-psychotic drugs
QU_CL22_PSYCHOSIS_OR_PSYCHIATRIC_ADMISSION
Checklist 22: * Final main duty assessment - priority need
Impact on ability to cope:
QU_CL22_PSYCHOSIS_OR_PSYCHIATRIC_ADMISSION_IMPACT
Checklist 22: * Final main duty assessment - priority need
Drug / alcohol dependence
QU_CL22_DRUG_ALCOHOL_DEPENDENCE
Checklist 22: * Final main duty assessment
Impact on ability to cope:
QU_CL22_DRUG_ALCOHOL_DEPENDENCE_IMPACT
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- priority needChecklist 22: * Final main duty assessment - priority need
Any institutional background and impact
QU_CL22_INSTITUTIONAL_BACKGROUND
Checklist 22: * Final main duty assessment - priority need
Impact on ability to cope:
QU_CL22_INSTITUTIONAL_BACKGROUND_IMPACT
Checklist 22: * Final main duty assessment - priority need
How do any of the above interfere with their normal life
QU_CL22_HOW_DO_ABOVE_INTERFERE
Checklist 22: * Final main duty assessment - priority need
If the customer receives services to help with any of the above (as listed above) record here how it helps the customer to cope with their issues:
QU_CL22_SERVICES_RECEIVED
Checklist 22: * Final main duty assessment - priority need
Hospital, Consultant, Social Services, CPN, Support worker, Charity, Refuge, Education Authority, Police, Youth Services, Probation, etc.
QU_CL22_OTHER_SERVICES
Checklist 22: * Final main duty assessment - priority need
Customer is over 21 years old and claims to be vulnerable as a result of being looked after, accommodated or fostered by a local authority?
QU_CL22_OVER_21_VULNERABLE_PREVIOUSLY_CARE
Checklist Enquiries Made: QU_CL22_OVER_21_VULNERABLE_PREVIOUSLY_CARE
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22: * Final main duty assessment - priority need
_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Customer claims to be vulnerable as a result of fleeing violence or threats of violence.
QU_CL22_FLEEING_VIOLENCE_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_FLEEING_VIOLENCE_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Customer claims to be vulnerable as a result of spending time in the armed forces.
QU_CL22_ARMED_FORCES_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_ARMED_FORCES_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Customer claims to be vulnerable as a result of having served a custodial sentence or having been remanded in custody.
QU_CL22_CUSTODY_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_CUSTODY_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment
Customer is vulnerable as a result of being elderly
QU_CL22_ELDERLY_VULNERABLE
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- priority needChecklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_ELDERLY_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Customer is vulnerable as a result of Physical Disability
QU_CL22_PHYSICAL_DISABILITY_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_PHYSICAL_DISABILITY_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Customer is vulnerable as a result of Mental Illness or disability
QU_CL22_MENTAL_ILLNESS_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_MENTAL_ILLNESS_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Customer is vulnerable as a result of drug dependency
QU_CL22_DRUG_DEPENDENCY_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_DRUG_DEPENDENCY_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty
Customer is vulnerable as a result of alcohol
QU_CL22_ALCOHOL_DEPENDENCY_VULNERABLE
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assessment - priority need
dependency
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_ALCOHOL_DEPENDENCY_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Customer is vulnerable as a result of being a former asylum seeker
QU_CL22_ASYLUM_SEEKER_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_ASYLUM_SEEKER_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Customer is vulnerable as a result of domestic violence
QU_CL22_DOMESTIC_VIOLENCE_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_DOMESTIC_VIOLENCE_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Customer is vulnerable as a result of learning difficulty
QU_CL22_LEARNING_DIFFICULTY_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_LEARNING_DIFFICULTY_VULNERABLE_ENQUIRIES
Checklist 22: * Final
Customer is vulnerable due to
QU_CL22_OTHER_REASON_VULNERABLE
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main duty assessment - priority need
other specific reason
Checklist 22: * Final main duty assessment - priority need
Enquiries Made: QU_CL22_OTHER_REASON_VULNERABLE_ENQUIRIES
Checklist 22: * Final main duty assessment - priority need
Note any other factors that may be relevant to the customer’s vulnerability here:
QU_CL22_OTHER_FACTORS_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Note any further enquiries you have made that are relevant to the customer’s vulnerability here:
QU_CL22_OTHER_ENQUIRIES_VULNERABLE
Checklist 22: * Final main duty assessment - priority need
Has a referral been made to any internal or external Health Advisor (if applicable) – this could include an OT?
QU_CL22_REFERRAL_MADE_HEALTH_ADVISOR
Checklist 22: * Final main duty assessment - priority need
If yes, please record the outcome and advice received below:
QU_CL22_REFERRAL_MADE_HEALTH_ADVISOR_DETAILS
Checklist 22: * Final main duty assessment - priority need
Having considered all of the above, in the light of the customer’s particular characteristics and situation in the round when homeless, is the customer
QU_CL22_IS_CUSTOMER_VULNERABLE
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significantly more vulnerable than an ordinary person facing homelessness would be?
Checklist 22: * Final main duty assessment - priority need
Set out the reason for the decision below:
QU_CL22_IS_CUSTOMER_VULNERABLE_DETAILS
Checklist 22: * Final main duty assessment - priority need
Do enquiries conclude that the customer is in priority need?
QU_CL22_IS_CUSTOMER_PRIORITY_NEED
Checklist 22: * Final main duty assessment - priority need
Most relevant priority need reason?
QU_CL22_PRIORITY_NEED_REASON
Checklist 22: * Final main duty assessment - priority need
The applicant's accommodation following the decision on whether a duty is owed
QU_ACCOM_AFTER_DECISION_OUTCOME
Checklist 22: * Final main duty assessment - priority need
In what local authority district is the accommodation
QU_ACCOM_AFTER_DECISION_DISTRICT
Checklist 23: * Final main duty assessment - intentional homelessness
Which of the customers previous addresses is considered to be the last settled address and why?
QU_CL23_LAST_SETTLED_ADDRESS
Checklist 23: * Final
Is there reason to believe the
QU_CL23_RTB_CUSTOMER_INTENTIONALLY_HOMELESS
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main duty assessment - intentional homelessness
customer may be intentionally homeless?
Checklist 23: * Final main duty assessment - intentional homelessness
Did the customer deliberately do something (or fail to do something) which resulted in him/her ceasing to occupy his/her last settled accommodation, or is likely to lead to him/her ceasing to occupy his/her current accommodation?
QU_CL23_DID_CUSTOMER_DELIBERATELY_DO_SOMETHING
Checklist 23: * Final main duty assessment - intentional homelessness
Did the customer acquiesce (comply) in the action of another person who did something (or failed to do something) which resulted in him ceasing to occupy his/her last settled accommodation, or is likely to lead to the loss of the current accommodation?
QU_CL23_DID_CUSTOMER_DELIBERATELY_ACQUIESCE
Checklist 23: * Final main duty assessment - intentional homelessness
Was it reasonable for the customer, and any other person who might have reasonably been expected to reside with him/her, to continue to occupy the
QU_CL23_WAS_IT_REASONABLE_FOR_CUSTOMER_TO_OCCUPY
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accommodation?Checklist 23: * Final main duty assessment - intentional homelessness
Was the customer aware of all the relevant facts before taking any action (or failing to take any action) relating to the above? (The action or inaction is not deliberate if done in ignorance of material facts and in good faith).
QU_CL23_WAS_CUSTOMER_AWARE_OF_FACTS
Checklist 23: * Final main duty assessment - intentional homelessness
Did the customer enter into an arrangement under which he/she must cease to occupy accommodation?
QU_CL23_DID_CUSTOMER_ENTER_ARRANGEMENT
Checklist 23: * Final main duty assessment - intentional homelessness
If yes, was this accommodation that would have been reasonable to continue to occupy?
QU_CL23_DID_CUSTOMER_ENTER_ARRANGEMENT_DETAILS
Checklist 23: * Final main duty assessment - intentional homelessness
Was this arrangement entered into in order to make the customer eligible for assistance under the Act?
QU_CL23_WAS_ARRANGMENT_TO_MAKE_ELIGIBLE
Checklist 23: * Final main duty assessment - intentional homelessne
Details of enquiries made to establish intentionality: (Note – any negative findings must be put to
QU_CL23_WAS_ARRANGMENT_TO_MAKE_ELIGIBLE_ENQUIRIES
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ss the customer and their comments taken into account when reaching a decision).
Checklist 23: * Final main duty assessment - intentional homelessness
If the authority is considering an intentional homelessness decision, send the customer a minded to decision letter. Date of letter:
QU_CL23_INTENTIONALITY_INTENT_AND_DATE
Checklist 23: * Final main duty assessment - intentional homelessness
Customer's comments:
QU_CL23_INTENTIONALITY_INTENT_AND_DATE_CUSTOMER_COMMENTS
Checklist 23: * Final main duty assessment - intentional homelessness
Do enquiries conclude that the customer is intentionally homeless? (Note – where there are dependent children and the customer is intentionally homeless, it is recommended practice for the Council to notify Children’s Services of the situation, in the interests of engaging other relevant services to support the family and in the interests of safeguarding children).
QU_CL23_IS_CUSTOMER_INTENTIONALLY_HOMELESS
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Checklist 23: * Final main duty assessment - intentional homelessness
Does the customer have dependent children and consent to Children's Services being notified of the situation?
QU_CL23_DEPENDENT_CHILDREN_CONSENT_CHILDRENS_SERVICES
Checklist 23: * Final main duty assessment - intentional homelessness
If yes, give details of contact with Children's Services:
QU_CL23_CHILDRENS_SERVICES_DETAILS_OF_CONTACT
Checklist 23: * Final main duty assessment - intentional homelessness
Please provide details of household makeup and circumstances- with confirmation of how long the local authority will continue to accommodate.
QU_CL23_HOUSEHOLD_DETAILS_AND_MAKEUP
Checklist 23: * Final main duty assessment - intentional homelessness
Has the local authority continued to provide temporary accommodation for a reasonable period of time?
QU_CL23_IS_TA_PROVIDED_FOR_REASONABLE_PERIOD
Checklist 24: * Final main duty - full duty acceptance
Has the local authority determined a main duty is owed to the customer?
QU_CL24_IS_MAIN_DUTY_OWED
Checklist 25: Full duty: enquiries into local connection & referrals
Has the section relating to local connection been completed and do the findings remain relevant to the customer's
QU_CL25_HAS_LOCAL_CONNECTION_SECTION_BEEN_COMPLETED
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current circumstances?
Checklist 25: Full duty: enquiries into local connection & referrals
Was it concluded that the customer did not have a local connection?
QU_CL25_DOES_CUSTOMER_NOT_HAVE_LOCAL_CONNECTION
Checklist 25: Full duty: enquiries into local connection & referrals
Resident in the area for 6 months out of the last 12?
QU_CL25_RESIDENT_6_MONTHS_OF_12
Checklist 25: Full duty: enquiries into local connection & referrals
Details: QU_CL25_RESIDENT_6_MONTHS_OF_12_DETAILS
Checklist 25: Full duty: enquiries into local connection & referrals
Resident in the area for 3 years out of the last 5 years?
QU_CL25_RESIDENT_3_YEARS_OF_5
Checklist 25: Full duty: enquiries into local connection & referrals
Details: QU_CL25_RESIDENT_3_YEARS_OF_5_DETAILS
Checklist 25: Full duty: enquiries into local connection & referrals
Proof of local employment?
QU_CL25_PROOF_OF_LOCAL_EMPLOYMENT
Checklist 25: Full duty: enquiries
Details: QU_CL25_PROOF_OF_LOCAL_EMPLOYMENT_DETAILS
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into local connection & referralsChecklist 25: Full duty: enquiries into local connection & referrals
Proof of close relatives with at least 5 years residence in the locality?
QU_CL25_PROOF_OF_CLOSE_RELATIVES
Checklist 25: Full duty: enquiries into local connection & referrals
Details: QU_CL25_PROOF_OF_CLOSE_RELATIVES_DETAILS
Checklist 25: Full duty: enquiries into local connection & referrals
Care leaver owed leaving care duties by the local authority?
QU_CL25_CARE_LEAVER_DUTY_OWED
Checklist 25: Full duty: enquiries into local connection & referrals
Details: QU_CL25_CARE_LEAVER_DUTY_OWED_DETAILS
Checklist 25: Full duty: enquiries into local connection & referrals
Care leaver under 21 who is owed leaving care duties and has lived in the local area for at least 2 years including some time before they were 16 years old?
QU_CL25_CARE_LEAVER_UNDER_21_IN_CARE_UNDER_16
Checklist 25: Full duty: enquiries into local connection & referrals
Details: QU_CL25_CARE_LEAVER_UNDER_21_IN_CARE_UNDER_16_DETAILS
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Checklist 25: Full duty: enquiries into local connection & referrals
Local connection due to special circumstances?
QU_CL25_LOCAL_CONNECTION_SPECIAL
Checklist 25: Full duty: enquiries into local connection & referrals
Details: QU_CL25_LOCAL_CONNECTION_SPECIAL_DETAILS
Checklist 25: Full duty: enquiries into local connection & referrals
No Local connection anywhere?
QU_CL25_NO_LOCAL_CONNECTION_ANYWHERE
Checklist 25: Full duty: enquiries into local connection & referrals
Details: QU_CL25_NO_LOCAL_CONNECTION_ANYWHERE_DETAILS
Checklist 25: Full duty: enquiries into local connection & referrals
Has the customer made an application to any other housing authority?
QU_CL25_APPLIED_TO_OTHER_HOUSING_AUTHORITY
Checklist 25: Full duty: enquiries into local connection & referrals
Details: QU_CL25_APPLIED_TO_OTHER_HOUSING_AUTHORITY_DETAILS
Checklist 25: Full duty: enquiries into local connection
Please confirm – has the customer got a local connection with this district?
QU_CL25_LOCAL_CONNECTION_WITH_DISTRICT
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& referralsChecklist 25: Full duty: enquiries into local connection & referrals
Details: QU_CL25_LOCAL_CONNECTION_WITH_DISTRICT_DETAILS
Checklist 25: Full duty: enquiries into local connection & referrals
Is the customer being referred to another local authority?
QU_CL25_CUSTOMER_BEING_REFERRED_TO_OTHER_LA
Checklist 25: Full duty: enquiries into local connection & referrals
Receiving local authority
QU_CL25_CUSTOMER_BEING_REFERRED_TO_OTHER_LA_DETAILS
Checklist 25: Full duty: enquiries into local connection & referrals
Date notification letter sent to customer (and advising of right to request a review):
QU_CL25_REFERAL_LETTER_DATE_SENT_TO_CUSTOMER
Checklist 25: Full duty: enquiries into local connection & referrals
Date notification sent to receiving authority:
QU_CL25_REFERAL_LETTER_DATE_SENT_TO_OTHER_LA
Checklist 25: Full duty: enquiries into local connection & referrals
Date referral accepted:
QU_CL25_REFERRAL_DATE_ACCEPTED
Checklist 25: Full duty: enquiries into local
Date of Decision: QU_CL25_REFERRAL_DATE_OF_DECISION
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connection & referralsChecklist 26: Temporary accommodation
Has a written offer of suitable temporary accommodation been made to the customer, notifying the customer of the consequences of refusing an offer including their right to request a review?
QU_CL26_WRITTEN_OFFER_OF_TA_MADE
Checklist 26: Temporary accommodation
Has the customer been placed into temporary accommodation under the s193 duty?
QU_CL26_TA_PROVIDED_UNDER_S193
Checklist 26: Temporary accommodation
If yes, confirm date of placement:
QU_CL26_TA_DATE_OF_PLACEMENT
Checklist 26: Temporary accommodation
If yes, confirm address of placement:
QU_CL26_TA_ADDRESS_OF_PLACEMENT
Checklist 26: Temporary accommodation
If customer has been placed, please confirm the customer’s Housing Register application has been updated (or that the customer has been registered at the temporary accommodation address):
QU_CL26_HR_APPLICATION_UPDATED
Checklist 26: Temporary accommod
Please list the agency referrals you have made with regard to
QU_CL26_AGENCY_REFERRALS_MADE
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ation accessing support here:
Checklist 26: Temporary accommodation
Has the customer been placed in temporary accommodation in another local authority district?
QU_CL26_PLACED_IN_TA_IN_OTHER_LA_DISTRICT
Checklist 26: Temporary accommodation
Date placement ended (if appropriate):
QU_CL26_TA_PLACEMENT_ENDED_DATE
Checklist 27: * Ending the main duty
Please indicate below the reason for the main duty ending and complete details as may be required
QU_CL27_MAIN_DUTY_ENDING_REASON
Checklist 27: * Ending the main duty (continued)
Address: QU_CL27_1_ADDRESS
Checklist 27: * Ending the main duty (continued)
Property Type: QU_CL27_1_PROPERTY_TYPE
Checklist 27: * Ending the main duty (continued)
Floor level (g/f if house):
QU_CL27_1_FLOOR_LEVEL
Checklist 27: * Ending the main duty (continued)
Tenure Type: QU_CL27_1_TENURE_TYPE
Checklist 27: * Ending
Length of Tenancy:
QU_CL27_1_LENGTH_OF_TENANCY
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the main duty (continued)Checklist 27: * Ending the main duty (continued)
Number of Bedrooms:
QU_CL27_1_NUMBER_OF_BEDROOMS
Checklist 27: * Ending the main duty (continued)
Landlord: QU_CL27_1_LANDLORD
Checklist 27: * Ending the main duty (continued)
Notes: QU_CL27_1_NOTES
Checklist 27: * Ending the main duty (continued)
Please provide a brief outline setting out why the property is considered to be suitable:
QU_CL27_1_PROPERTY_SUITABILITY
Checklist 27: * Ending the main duty (continued)
Date duty ended: QU_CL27_1_DATE_DUTY_ENDED
Checklist 27: * Ending the main duty (continued)
Date duty ended: QU_CL27_1A_DATE_DUTY_ENDED
Checklist 27: * Ending the main duty (continued)
Did the customer deliberately do something (or fail to do something) which resulted in him/her ceasing to occupy his/her temporary accommodation?
QU_CL27_2_DELIBERATE_ACTION
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Checklist 27: * Ending the main duty (continued)
Did the customer acquiesce (comply) in the action of another person who did something (or failed to do something) which resulted in him ceasing to occupy his/her temporary accommodation?
QU_CL27_2_ACQUIESCE_DELIBERATE_ACTION
Checklist 27: * Ending the main duty (continued)
Was it reasonable for the customer, and any other person who might have reasonably been expected to reside with him/her, to continue to occupy the temporary accommodation?
QU_CL27_2_REASONABLE_TO_OCCUPY
Checklist 27: * Ending the main duty (continued)
Was the customer aware of all the relevant facts before taking any action (or failing to take any action) relating to the above? (The action or inaction is not deliberate if done in ignorance of material facts and in good faith).
QU_CL27_2_CUSTOMER_AWARE_OF_FACTS
Checklist 27: * Ending the main duty (continued)
Did the customer enter into an arrangement under which he/she must cease to occupy
QU_CL27_2_CUSTOMER_ENTERED_ARRANGEMENT
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the temporary accommodation?
Checklist 27: * Ending the main duty (continued)
Details of enquiries made to establish intentionality: (Note – any negative findings must be put to the customer and their comments taken into account when reaching a decision).
QU_CL27_2_INTENTIONALITY_ENQUIRIES
Checklist 27: * Ending the main duty (continued)
Customer's comments:
QU_CL27_2_INTENTIONALITY_CUSTOMER_COMMENTS
Checklist 27: * Ending the main duty (continued)
Does the customer have dependent children and have Children's Services being notified of the situation?
QU_CL27_2_CUSTOMER_HAS_DEPENDENT_CHILDREN
Checklist 27: * Ending the main duty (continued)
If yes, give details of contact with Children's Services:
QU_CL27_2_CHILDRENS_SERVICES_DETAILS_OF_CONTACT
Checklist 27: * Ending the main duty (continued)
Date duty ended: QU_CL27_2_DATE_DUTY_ENDED
Checklist 27: * Ending the main duty (continued)
Address: QU_CL27_3_ADDRESS
Checklist Property Type: QU_CL27_3_PROPERTY_TYPE
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27: * Ending the main duty (continued)Checklist 27: * Ending the main duty (continued)
Floor level (g/f if house):
QU_CL27_3_FLOOR_LEVEL
Checklist 27: * Ending the main duty (continued)
Tenure Type: QU_CL27_3_TENURE_TYPE
Checklist 27: * Ending the main duty (continued)
Length of Tenancy:
QU_CL27_3_LENGTH_OF_TENANCY
Checklist 27: * Ending the main duty (continued)
Number of Bedrooms:
QU_CL27_3_NUMBER_OF_BEDROOMS
Checklist 27: * Ending the main duty (continued)
Landlord: QU_CL27_3_LANDLORD
Checklist 27: * Ending the main duty (continued)
Notes: QU_CL27_3_NOTES
Checklist 27: * Ending the main duty (continued)
Please provide a brief outline setting out why the property is considered to be suitable:
QU_CL27_3_PROPERTY_SUITABILITY
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Checklist 27: * Ending the main duty (continued)
Date duty ended: QU_CL27_3_DATE_DUTY_ENDED
Checklist 27: * Ending the main duty (continued)
Address: QU_CL27_4_ADDRESS
Checklist 27: * Ending the main duty (continued)
Property Type: QU_CL27_4_PROPERTY_TYPE
Checklist 27: * Ending the main duty (continued)
Floor level (g/f if house):
QU_CL27_4_FLOOR_LEVEL
Checklist 27: * Ending the main duty (continued)
Tenure Type: QU_CL27_4_TENURE_TYPE
Checklist 27: * Ending the main duty (continued)
Length of Tenancy:
QU_CL27_4_LENGTH_OF_TENANCY
Checklist 27: * Ending the main duty (continued)
Number of Bedrooms:
QU_CL27_4_NUMBER_OF_BEDROOMS
Checklist 27: * Ending the main duty (continued)
Landlord: QU_CL27_4_LANDLORD
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Checklist 27: * Ending the main duty (continued)
Notes: QU_CL27_4_NOTES
Checklist 27: * Ending the main duty (continued)
Please provide a brief outline setting out why the property is considered to be suitable:
QU_CL27_4_PROPERTY_SUITABILITY
Checklist 27: * Ending the main duty (continued)
Date duty ended: QU_CL27_4_DATE_DUTY_ENDED
Checklist 27: * Ending the main duty (continued)
Details: QU_CL27_5_DETAILS
Checklist 27: * Ending the main duty (continued)
Date duty ended: QU_CL27_5_DATE_DUTY_ENDED
Checklist 27: * Ending the main duty (continued)
Address: QU_CL27_6_ADDRESS
Checklist 27: * Ending the main duty (continued)
Property Type: QU_CL27_6_PROPERTY_TYPE
Checklist 27: * Ending the main duty (continued)
Floor level (g/f if house):
QU_CL27_6_FLOOR_LEVEL
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Checklist 27: * Ending the main duty (continued)
Tenure Type: QU_CL27_6_TENURE_TYPE
Checklist 27: * Ending the main duty (continued)
Length of Tenancy:
QU_CL27_6_LENGTH_OF_TENANCY
Checklist 27: * Ending the main duty (continued)
Number of Bedrooms:
QU_CL27_6_NUMBER_OF_BEDROOMS
Checklist 27: * Ending the main duty (continued)
Landlord: QU_CL27_6_LANDLORD
Checklist 27: * Ending the main duty (continued)
Notes: QU_CL27_6_NOTES
Checklist 27: * Ending the main duty (continued)
Date duty ended: QU_CL27_6_DATE_DUTY_ENDED
Checklist 27: * Ending the main duty (continued)
Address: QU_CL27_7_ADDRESS
Checklist 27: * Ending the main duty (continued)
Property Type: QU_CL27_7_PROPERTY_TYPE
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Checklist 27: * Ending the main duty (continued)
Floor level (g/f if house):
QU_CL27_7_FLOOR_LEVEL
Checklist 27: * Ending the main duty (continued)
Tenure Type: QU_CL27_7_TENURE_TYPE
Checklist 27: * Ending the main duty (continued)
Length of Tenancy (this must be an AST with a fixed term of at least 12 months):
QU_CL27_7_LENGTH_OF_TENANCY
Checklist 27: * Ending the main duty (continued)
Number of Bedrooms:
QU_CL27_7_NUMBER_OF_BEDROOMS
Checklist 27: * Ending the main duty (continued)
Landlord: QU_CL27_7_LANDLORD
Checklist 27: * Ending the main duty (continued)
Notes: QU_CL27_7_NOTES
Checklist 27: * Ending the main duty (continued)
Has the authority considered the requirements of Suitability Order 2012?
QU_CL27_7_SUITABILITY_ORDER_2012_CONSIDERED
Checklist 27: * Ending the main duty (continued)
Do you consider those requirements have been met by the property?
QU_CL27_7_SUITABILITY_ORDER_2012_MET
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Checklist 27: * Ending the main duty (continued)
If yes, please provide a brief outline setting out why you consider the property to be suitable:
QU_CL27_7_SUITABILITY_ORDER_2012_CONSIDERED_DETAILS
Checklist 27: * Ending the main duty (continued)
Date duty ended: QU_CL27_7_DATE_DUTY_ENDED
Checklist 27: * Ending the main duty (continued)
Has the customer been notified in writing that the Council is ending the main s193 housing duty under one of the above sections (and specifying which one)? (The letter must ensure the customer is advised that they have the right to request a review)
QU_CL27_CUSTOMER_NOTIFIED_IN_WRITING
Checklist 27: * Ending the main duty (continued)
Date of decision QU_CL27_DATE_OF_DECISION
Checklist 27: * Ending the main duty (continued)
The customer's accommodation when the Main Duty ended.
QU_ACCOM_AFTER_MAIN
Checklist 27: * Ending the main duty (continued)
In what local authority district is the accommodation outcome?
QU_ACCOM_AFTER_MAIN_DISTRICT
Checklist That it has taken QU_CL28_ACCOUNT_OF_DISRUPTION
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28: Suitability of accommodation checklist
account of the significance of any disruption which would be caused by the location of the accommodation to the employment, caring responsibilities or education of the customer or members of his / her household
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_ACCOUNT_OF_DISRUPTION_DETAILS
Checklist 28: Suitability of accommodation checklist
That it has considered the proximity and accessibility of the accommodation in relation to medical facilities and other support, which are currently used by or provided to the customer or members of their household and / or are essential to the wellbeing of the customer or to members of the household
QU_CL28_ACCOUNT_OF_PROXIMITY_MEDICAL
Checklist 28: Suitability of accommod
Details: QU_CL28_ACCOUNT_OF_PROXIMITY_MEDICAL_DETAILS
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ation checklistChecklist 28: Suitability of accommodation checklist
That it has considered the proximity and accessibility of the accommodation to local services, amenities and transport
QU_CL28_ACCOUNT_OF_PROXIMITY_AMENITIES
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_ACCOUNT_OF_PROXIMITY_AMENITIES_DETAILS
Checklist 28: Suitability of accommodation checklist
That the accommodation is in reasonable physical condition
QU_CL28_ACCOUNT_OF_PHYSICAL_CONDITION
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_ACCOUNT_OF_PHYSICAL_CONDITION_DETAILS
Checklist 28: Suitability of accommodation checklist
That any electrical equipment complies with the Electrical Equipment (safety) Regulations 1994
QU_CL28_ELECTRICAL_SAFETY
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_ELECTIRCAL_SAFETY_DETAILS
Checklist That the landlord QU_CL28_FIRE_SAFETY
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28: Suitability of accommodation checklist
has taken reasonable fire safety precautions
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_FIRE_SAFETY_DETAILS
Checklist 28: Suitability of accommodation checklist
That the landlord has taken reasonable precautions to prevent the possibility of carbon monoxide poisoning
QU_CL28_CARBON_MONOXIDE_SAFETY
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_CARBON_MONOXIDE_SAFETY_DETAILS
Checklist 28: Suitability of accommodation checklist
That the accommodation has a valid Energy Performance Certificate
QU_CL28_VALID_EPC
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_VALID_EPC_DETAILS
Checklist 28: Suitability of accommodation
Where the accommodation is a house in multiple occupation (HMO), the
QU_CL28_HMO_COMPLIES_WITH_LICENSING
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checklist landlord has complied with any licensing requirements they may be subject to under sections 55 and 56 of the Housing Act 2004, and that the landlord has also complied with any selective licensing regime operated by the authority in that area
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_HMO_COMPLIES_WITH_LICENSING_DETAILS
Checklist 28: Suitability of accommodation checklist
That the landlord is a fit and proper person?
QU_CL28_LANDLORD_FIT_AND_PROPER
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_LANDLORD_FIT_AND_PROPER_DETAILS
Checklist 28: Suitability of accommodation checklist
The authority has made all necessary enquiries into the landlord’s previous conduct.
QU_CL28_LANDLORD_CONDUCT_ASSESSED
Checklist 28: Suitability of
Details: QU_CL28_LANDLORD_CONDUCT_ASSESSED_DETAILS
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accommodation checklistChecklist 28: Suitability of accommodation checklist
Is the accommodation offered within the local authority district?
QU_CL28_WITHIN_DISTRICT
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_WITHIN_DISTRICT_DETAILS
Checklist 28: Suitability of accommodation checklist
Has the customer viewed the property?
QU_CL28_CUSTOMER_VIEWED_PROPERTY
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_CUSTOMER_VIEWED_PROPERTY_DETAILS
Checklist 28: Suitability of accommodation checklist
Was the customer accompanied by a local authority representative?
QU_CL28_CUSTOMER_ACCOMPANIED_BY_LA_REP
Checklist 28: Suitability of accommodation checklist
Details: QU_CL28_CUSTOMER_ACCOMPANIED_BY_LA_REP_DETAILS
Checklist 28: Suitability
Name of the local authority representative
QU_CL28_LA_REP_NAME
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of accommodation checklistChecklist 28: Suitability of accommodation checklist
Position of the local authority representative
QU_CL28_LA_REP_POSITION
Checklist 28: Suitability of accommodation checklist
Date of the visit with the local authority representative
QU_CL28_LA_REP_VISIT_DATE
Checklist 28: Suitability of accommodation checklist
Has the customer accepted the offer of accommodation?
QU_CL28_CUSTOMER_ACCEPTED_OFFER
Checklist 28: Suitability of accommodation checklist
address: QU_CL28_CUSTOMER_REJECTED_OFFER_REASON
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