House to Home Referral
The ‘House to Home’ programme supports vulnerable people who have been homeless
or at risk of
homelessnes
s
to sustain tenancies in rental accommodation by helping them to make a house a
hom
e.
This is through both practical work such as painting or light refurb or through the provision of essential household items.
Agency Details
Referral Agency
Please select...
Ballymena Action for Children/SureStart
Belfast Central Mission
Connect Family Resource Centre
Depaul
Drogheda Homeless Aid
Drogheda Refuge
Extern
Lisburn YMCA
MACS
Mindwise
NIACRO
Quaker Service
Queens Quarter Housing
The Red Door Project, Drogheda
Threshold
Triangle
Welcome Organisation
Women's Aid Dundalk
Womens Aid ABCLN
Young Homeless Team (N HSCNI)
Other
Other
A Partner Agreement must be in place with all Referral Agencies. If your organisation is not on this list, we will be in touch to discuss
Support Worker
Contact Number of support worker
Email Address of Support Worker
Client Details
Client Name
Gender
Please select...
Male
Female
Other
Date of Birth
Address
This refers to the address of the property where the practical work is to completed or household items delivered
Town
Postcode
Accommodation Type
Please select...
NI Housing Executive
ROI Council Housing
Housing Association
Private Rental
Other
Name of Housing Association
Please detail
Number of Adults living in the property?
Number of Children living in the property?
Other Key Information
What primary reason initiated the clients need for support
Please select...
Loss of Employment/Income
Refugee Resettlement
Domestic Violence
Re-entry to community
Substance Abuse
Mental Health Challenges
Other
Other - Please Detail
Client Background/Other Useful Information that will help Habitat staff assessing this form
Client risk to Habitat Staff/Volunteers
(
Please note that if a client does pose a risk, this would not deter them from being supported through the programme. It may mean that
additional
support is required)
High
Medium
Low
Clients ability to engage in the programme (
Where possible, clients will be encouraged to be involved in the programme. This could include assisting with the painting and practical work or selecting the essential household items)
Good
Average
Low
House to Home Support Required
Which location area is your House to Home Referral for?
Please select...
Ballymena
Belfast
Drogheda
Lisburn
Newry
Newtownards
Manager
Please select
Please select...
Practical Work Only (eg painting)
Essential Household Items Only
Both Practical Work and Essential Household Items
Works Required
Brief outline of the works required (eg painting, number of rooms etc)
Works required risk to tenancy sustainment
High
Medium
Low
Please note that we currently have a high level of demand for House to Home practical in the Belfast/Lisburn area so there may be a delay in getting back to you to schedule the assessment and work.
Essential Household Items
Habitat Ireland can support individuals with emergency furniture support to allow them to feel more at home. Individuals can come to one of the Habitat ReStores to select these items. The support value will be for a maximum of 5 items up to a value of £250.
Clients can buy
additional
items from ReStore which offer a wide range of new and used home improvement materials at 50-75% lower than retail price
Please list any essential household Items & Priority Level (High, Medium, Low)
To allow us to serve more individuals, please detail if the client has a budget or grant support to put towards the essential household items.
Volunteering & Accredited Training
ReStore delivers volunteering opportunites for people of all ages, backgrounds and abilities. Volunteering not only benefits the community but helps individuals develop new skills and has a positive impact on mental health. Volunteering opportunities are available at
Habitat ReStores
. Tasks include helping with collections, sorting donations and assisting customers.
Habitat offers a range of OCN-Accredited Training courses at ReStores. These include Retail Business, Employability, Wellbeing and DIY Skills.
Tick here if volunteering or accredited training would be of interest to your client
Thank You
Thank you for completing the House to Home Client Referral form.
We will review your requirements and will be in touch to discuss further.
Contact Information