Significant hazard reporting tool

Please remember to report all emergencies to us straight away by calling 0300 3300 900.

If you need to report multiple significant hazards, you will need to complete a new form for each issue you want to tell us about.

Please provide us with as much information as possible so we can understand the issues you’re experiencing before we start working with you to resolve them.

Thank you for working with us to resolve your issue.

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Step 1 of 4

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Please select the answer that applies(Required)

I’m the resident (or I am completing on behalf of the resident)

I’m a member of the Havebury team completing the form on a resident’s behalf

I’m a Havebury contractor completing the form on a resident’s behalf

Is this the first time you are reporting the issue to us?(Required)

Yes

Please provide us with your information and the issue you are reporting

You can only report one issue per form. If you need to report multiple issues, please complete another form after this one.

Name(Required)

First Last

Name of organisation(Required)

Name of person completing the form on a resident's behalf(Required)

First Last

Name of resident(Required)

First Last

Resident's address(Required)

Street Address Address Line 2 Town County Post Code

Resident's email

If you want a PDF sent to you to confirm what you have put in this form, please provide your email address below.

Resident's phone number(Required)

What are you reporting today?(Required)

Excess Cold

We know homes can naturally feel colder during periods of very cold weather. These questions will help us understand whether there may be something about your home that is causing it to become unusually cold or making it difficult to keep your home warm.

Is your home colder than you would normally expect for the weather? Please tell us if your home remains very cold even when your heating is on, takes a long time to warm up, or quickly becomes cold again. If you can, tell us whether this happens all the time or only during particularly cold weather. Please tell us if your home remains very cold even when your heating is on, takes a long time to warm up, or quickly becomes cold again. If you can, tell us whether this happens all the time or only during particularly cold weather.(Required)

Is your heating working at the moment? Please tell us if your heating is not working at all, is only working in some rooms, or is on but does not seem to be warming your home. If only certain rooms are affected, please tell us which ones.(Required)

If no, how long has it not been working for?

Are you able to keep your home at a comfortable temperature? Please tell us if you are having to use your heating much more than you would normally expect, or if there are rooms you cannot keep warm even when the heating is on.

If you have any photos please upload them here

Drop files here or

Max. file size: 50 MB.

Excess heat

We know homes can naturally become warmer during hot weather. These questions will help us understand whether there may be something about your home that is causing it to become unusually hot or making it difficult for the temperature to come down.

Which rooms are getting too hot? Please also tell us if one room is noticeably hotter than the others.(Required)

When is it worst? For example, is your home too hot during the day, in the evening or at night? Is it worse at a particular time of day or when the weather is warm? Please tell us how often this happens and how long it usually lasts.(Required)

Is your boiler constantly running, or does your heating come on when you turn on your hot water? For example, do your radiators get hot when you’re only using the hot water?(Required)

Are you able to cool the home or open the windows safely? For example, are you able to open your windows and use any ventilation provided in your home? Please tell us if there is a reason you cannot safely open a window, or if opening the windows does not make a difference.(Required)

Does the room stay very hot overnight?(Required)

Have you noticed anything about your home that you think is making it hotter? For example, is there a problem with windows, ventilation, blinds or other fittings we have provided? Please tell us what you have noticed. You don’t need to know what is causing the problem – we just need to understand what is happening.(Required)

If you have any photos please upload them here

Max. file size: 50 MB.

Falls

Is the trip or fall hazard on the same level or stairs/between levels?(Required)

Same level

Stairs/between levels

Where is the trip or fall risk?(Required)

What is causing the trip or fall risk? For example, is there damaged or uneven flooring, a loose floorboard, a raised or broken surface, a change in floor level, or another part of the home that is damaged? Please describe what you can see.(Required)

Is the problem getting worse? For example, has the flooring become more uneven, loose or damaged, or has the affected area become larger? Please tell us what has changed and, if you can, how quickly.(Required)

Has anyone already tripped or fallen because of it? Please tell us what happened and whether anyone was injured. If someone nearly fell but managed to stop themselves or hold onto something, please tell us about this too.(Required)

Is the problem somewhere you need to regularly walk through? For example, is it on the main route to your front door, bathroom, kitchen or bedroom? Please tell us if it is difficult or unsafe to avoid the affected area.(Required)

Are you able to safely use the affected area at the moment? Please tell us if you or anyone else in your home has stopped using the area, needs help to get through it, or has had to change how you move around your home because of the problem.(Required)

Has this issue been previously been reported to us? If yes details on what we did and when .(Required)

If you have any photos please upload them here

Drop files here or

Max. file size: 50 MB.

These questions are about problems with stairs, steps, handrails, bannisters or other parts of your home or communal areas that we are responsible for maintaining.

What is the problem with the stairs or steps?(Required)

Is the handrail or bannister secure?(Required)

Are any steps loose, damaged or uneven?(Required)

Has anyone fallen or nearly fallen? Please tell us what happened, including whether anyone was injured. If someone nearly fell but was able to stop themselves or hold onto something, please tell us about this too.(Required)

Are you able to use the stairs safely at the moment?(Required)

Is the problem affecting a route you need to use to get into, out of or around your home? For example, is it on your main staircase, at your front or back door, or on steps that you need to use to enter or leave your home?(Required)

Are the stairs outside your home? For example, in a communal area.(Required)

Please upload any photos you have here.

Drop files here or

Max. file size: 50 MB.

Structural collapse

These questions are about possible problems with the structure or parts of the building that we are responsible for maintaining. This could include walls, ceilings, floors, roofs, stairs or external parts of your home.

What have you noticed? For example, have you noticed new or growing cracks, walls or ceilings bulging, movement, sagging, or parts of a wall, ceiling, floor or other part of the building becoming loose?(Required)

When did you first notice it? Please tell us roughly when you first noticed the problem. If you’re not sure of the exact date, an estimate is fine.(Required)

Has it changed or become worse? For example, has a crack become wider or longer, has there been more movement, or does anything look more loose, uneven or unstable than when you first noticed it? Please tell us how quickly you think it has changed.(Required)

Has anything fallen? For example, have any pieces of the ceiling, wall, brickwork, tiles or other parts of the building fallen or become detached? Please tell us what has fallen, where it happened and roughly how much.(Required)

Is the affected area somewhere you regularly use? Please also tell us if the problem is affecting an entrance, exit or route through your home.(Required)

Do you feel safe remaining in that part of your home? Please tell us if you are worried that something could fall, collapse or cause an injury. If you have stopped using the room or area because you don't feel it is safe, please tell us.(Required)

Has anyone been injured or had a near miss because of the problem? For example, has anything fallen close to someone, or has anyone been hit or injured by something that has fallen or come loose?(Required)

Please upload any photos you have here.

Drop files here or

Max. file size: 50 MB.

Fire and explosion concern

If there is a fire, you smell gas, or you believe there is an immediate risk of fire or explosion, leave the building if it is safe to do so and call 999. Do not wait for us to respond to this form. If you smell gas but there is no immediate danger, call the National Gas Emergency Service on 0800 111 999.

What are you concerned about?(Required)

A possible fire

A possible explosion

A smell of gas

A fault with an appliance or electrical equipment

A problem with fire safety equipment, such as a smoke alarm

Something else

Where is the problem?(Required)

Can you tell us what you’ve noticed? For example, have you seen smoke, flames, sparks or damage, or noticed a burning or gas smell?(Required)

When did you first notice the issue?(Required)

Today

Within the last week

More than a week ago

I’m not sure

Is it happening now?(Required)

Yes

It happens occassionally

Does the issue appear to be getting worse?(Required)

Yes

I’m not sure

Has the issue been reported to us before?(Required)

Yes

I’m not sure

If yes, please tell us when it was reported and, if you know, what action we took.(Required)

Please upload any photos you have here

Drop files here or

Max. file size: 50 MB.

Electrical Hazard

These questions are about problems with the electrical installation and fittings in your home that we are responsible for, such as fixed wiring, sockets, switches and fittings we have provided

What have you noticed? For example, sparking, burning smells, exposed wires, damaged sockets or the electrics tripping?(Required)

When did you first notice it? Please tell us roughly when it started. If you’re not sure of the exact date, an estimate is fine. Please also tell us if it has happened more than once or is becoming more frequent.(Required)

Is it still happening now? Please tell us whether the problem is happening at the moment, happens all the time or comes and goes. If it only happens when you use a particular socket, switch or appliance, please tell us.(Required)

Is anything hot to touch? For example, have you noticed a socket, switch, plug, cable or other electrical fitting becoming unusually warm or hot? Please don't touch anything you think may be unsafe just to check.(Required)

Has the power gone off anywhere in your home? Please tell us whether you have lost power to your whole home or only certain rooms, sockets or lights. If you know whether anything happened immediately before the power went off, please tell us.(Required)

Is water or damp close to the affected electrics? For example, is there water leaking or dripping near a socket, switch, light fitting, wiring or other electrical fitting? Is there damp or condensation around the affected area? Please don't touch any electrical fittings if they are wet or close to water.(Required)

Domestic hygiene concern

Please tell us what the concern is about(Required)

Personal hygiene (for example; problems with the facilities or services provided as part of your home, such as toilets, sinks, baths, showers, hot water and drainage)

Food safety (for example; roblems with your home that may affect your ability to safely store, prepare or cook food).

Pests (for example; vermin, flying insects, woodworm etc).

Personal hygiene

These questions are about problems with the facilities or services provided as part of your home, such as toilets, sinks, baths, showers, hot water and drainage. If you’re not sure whether we’re responsible for the problem, please still tell us about it, and we’ll check.

What isn’t working or what are you unable to use? For example, is there a problem with a toilet, bath, shower, sink, hot water supply or drainage?(Required)

Do you currently have working washing and toilet facilities?(Required)

How long has this been happening? Please tell us roughly when the problem started. If you’re not sure of the exact date, an estimate is fine.(Required)

Is there another toilet/bath/shower you can safely use? For example, if your shower isn’t working, do you have a bath or another shower you can use? Please also tell us if there is another facility available, but you or someone in your home cannot safely use it because of a health condition, disability or mobility need.(Required)

Is the problem getting worse, or has anything changed since you first noticed it? For example, has a facility stopped working completely, has a leak become worse, or have you lost access to something you could previously use?(Required)

Please upload any photos you have here

Drop files here or

Max. file size: 50 MB.

Food safety

These questions are about problems with your home that may affect your ability to safely store, prepare or cook food. This could include problems with the electricity, water supply, drainage, kitchen facilities or appliances we have provided.

Are you able to safely store, prepare and cook food? For example, do you have access to running water, electricity and suitable kitchen facilities?(Required)

What isn’t working or what are you unable to use? For example, is there a problem with the water or electricity supply, drainage, kitchen sink, work surfaces, cupboards or an appliance we have provided? Please tell us what is affected and what is happening(Required)

How long has the problem been happening? Please tell us roughly when the problem started. If you’re not sure of the exact date, an estimate is fine.(Required)

Do you have another way to safely prepare or store food? For example, if you cannot use your usual cooking facilities, do you have another safe way to prepare a hot meal? If your food storage is affected, are you still able to safely keep food chilled or frozen?(Required)

Is the problem affecting what you or anyone else in your home can eat or drink? For example, are you unable to prepare meals, safely store food or make food for a baby, young child or someone with specific dietary or health needs?(Required)

Please upload any photos you have here

Drop files here or

Max. file size: 50 MB.

Pests

These questions are about pests or signs of pests in your home, garden, communal areas or outbuildings. This could include rats, mice, squirrels, bedbugs, fleas, wasps or other pests. If you’re not sure what type of pest it is, please tell us what you have seen or noticed.

What type of pest have you seen?(Required)

Rats

Mice

Squirrels

Bed bugs

Wasps/bees

Insects

If you haven't seen a pest, have you noticed signs of any? For example, droppings, nests, scratching noises, damage to food packaging or other signs of pests?(Required)

Where is the problem located? Please tell us whether the problem is inside your home, in a communal area, an outbuilding, loft space, bin store, garden or elsewhere. Please provide as much detail as possible.(Required)

Which rooms or areas are affected? For example, kitchen, bedroom, bathroom, loft, hallway, cupboard, garden, communal hallway or bin store.(Required)

When did you first notice the problem? Please tell us roughly when it started. If you're not sure of the exact date, an estimate is fine.(Required)

How often are you seeing signs of pests? For example, every day, occasionally, only at night or only in certain areas.(Required)

Is the problem getting worse? For example, are you seeing more pests, signs of pests or affected areas than when you first noticed the problem?(Required)

Have you noticed any holes, gaps or damage that could be allowing pests to enter? For example, holes in walls, damaged brickwork, broken air vents, damaged pipework, gaps around pipes, damaged roofs, missing tiles or holes in skirting boards or flooring.(Required)

Have you already taken any action to deal with the problem? For example, using traps, pest treatments, sealing gaps or seeking advice from a pest control company.(Required)

Has anyone attended to treat the problem previously? If yes, please tell us when and whether the treatment resolved the issue.(Required)

Has this issue been reported to us before? If yes, please tell us when and what action was taken.(Required)

Is the problem affecting your use of your home? For example, are there rooms you are unable to use, are you concerned about contamination of food, or is the problem affecting your sleep or wellbeing?(Required)

Has anyone been bitten, stung or become unwell because of the problem? Please tell us what has happened.(Required)

Do you believe the problem may also be affecting neighbouring homes or communal areas? For example, communal hallways, bin stores, car parks, shared gardens or loft spaces.(Required)

Please upload photos, only if it's safe to do so. This could include photographs of the pest, droppings, nests, damage or possible entry points.

Drop files here or

Max. file size: 50 MB.

Bed bugs

In which rooms have you noticed bedbugs or signs of bedbugs?(Required)

Have any mattresses, beds, furniture or soft furnishings been affected?(Required)

Has anyone in the household experienced bites?(Required)

Wasps/bees

Have you identified a nest? If yes, where is the nest located? Please tell us whether it is inside your home, in a communal area or elsewhere.(Required)

Can the affected area be used safely at the moment?(Required)

Additional questions

Do you have any dependents under the age of 14 living in your home?(Required)

Yes

Please confirm their ages(Required)

Is anyone who lives in your home over the age of 60 years old?(Required)

Yes

Could anyone living in your home be pregnant?(Required)

Yes

Does anyone in your home have a health condition, disability or other need that could get worse or put them more at risk because of the hazard you’re reporting? For example, this could include breathing or heart conditions, mobility or balance problems, a weakened immune system, dementia, a learning disability, or a condition that affects how someone responds to heat or cold. Please also tell us if anyone relies on medical equipment that needs electricity.

If you’re not sure whether something is relevant, please tell us a bit more if you feel comfortable doing so.