Independent Living 1 2 3 4
Define Issue
Diagnostic
Action
Health Factors
  • Mobility problems: coping with stairs etc
  • Unmet need for aids/adaptations to property
  • Difficulty coping with household tasks, as a result of age/infirmary
  • Difficulty coping with household tasks as a result of mental health
  • Difficulty coping with household tasks as a result of addiction
Health Factors
Physical Property Factors
  • Poor property condition
  • Poor state of repair
  • Lack of essential household items
  • Sound proofing issues
Establish other reason
Multiple factors are making
it difficult to manage
my tenancy and to
remain at home
Establish & note if any of the above issues have created any problems within any of the following:
  • Feeling unsafe/intimidated/at risk
  • Complaints from neighbours
  • Warnings/action by landlord
  • Complaints made about neighbours
  • Warnings/action from other agencies:
    • Police;
    • Social work;
    • Citizen warden scheme;
    • Environmental Health; etc
Has this lead to any kind of legal action against your household?
The customer may have complex needs which involve several of the factors listed
Yes
Yes
Yes
Yes
No
No