Questionnaire for Agency Professionals Seeking Funded Specialist Decluttering

When agency professionals require a professional specialist decluttering service for their service user, certain information is essential for us to offer the best approach for each individual/family.

Specialist decluttering requires full participation and capacity, as it requires collaboration. It is about habit change and working towards sustainable outcomes.

Kindly complete the following questionnaire and acknowledge the next steps proposed. We estimate this will take no more than 5 minutes to complete.

Information will be sent to Change Your Space so that we can discuss the situation in more detail and arrange a formal assessment visit (2-hour visit at the home, plus a write up with options and a plan).

Thank you,
Jasmine Sleigh

Change Your Space www.changeyourspace.co.uk
Addressing Overwhelm
Specialist Decluttering and Organising

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Name (required)

Role (required)

Telephone (required)

Email (required)

Has a Home Fire Safety Visit taken place at the property? (required)

• Yes
• No

Did the Home Fire Safety Visit trigger a safeguarding referral due to high levels of stockpiling, causing risk? (Level 7 of The Clutter Rating Scale). (required)

• Yes
• No

Is the home at Level 9 and so likely to require clearance? (required)

• Yes
• No

Is the home squalid or infested? Does a deep clean or part clearance need to attend first? (required)

• Yes
• No

Has the householder agreed they are ready to make changes and engage with a decluttering support service? (required)

• Yes
• No

Are there children at the property? (required)

• Yes
• No

Is there a TAC in place? (required)

• Yes
• No

Are there any concerns or signs of substance abuse in the household? (required)

• Yes
• No

Is there any information to be shared with regards to any professional working alone in the property with the householder or any persons of concerns within their close family/network (for example, Restraining Orders). (required)

• Yes
• No

Has a visit taken place by a housing officer, whereby the volume of belongings of chaotic layout is now impacting on the sustainability of their tenancy? For example, gas and electric checks cannot take place, or vital modernisation is currently not possible? (required)

• Yes
• No

Has a Housing Officer or Social Worker considered the volume of belongings or chaotic layout as now having a serious impact on the persons wellbeing. That their home environment is increasing their risk of hospitalisation? This could be increased major trip hazards, not being able to sleep in their own bed, or having clear and easy access to cooking facilities. (required)

• Yes
• No

Has an agency professional assessed the mental health of the householder and considered that to manage their home environment effectively and to stay living in their own home, that they require a specialist decluttering service? (required)

• Yes
• No

Does the householder have full capacity? (required)

• Yes
• No

If no, does the householder have a Power of Attorney in place? (required)

• Yes
• No

Has the householder had issues with hoarding behaviours previously? Is this a recurring issue? (required)

• Yes
• No

Does the householder own their own home? (Note any funded specialist decluttering work in their care plan my trigger a financial assessment form to be sent out and can cause anxiety in potential clients) (required)

• Yes
• No

Could a multi-agency funded project between the housing provider and social services be an option? (required)

• Yes
• No

Submit