NOTES FOR COMPLETING THE QUESTIONNAIRE

Most questions are answered by selecting the appropriate box.

For some questions you need to write a number in a larger box.

Please follow the questions in the numbered order unless the box you tick has a ‘Go to question XX’ next to it, where you will need to go to the question stated.

Most of the questions are about your household. A household is made up of either:
• One person living alone, or
• A group of people (not necessarily related) living at the same address who share cooking facilities and share a living room or sitting room or dining area.
 
SEE MAP BELOW FOR USE WITH QUESTIONS D3, F4 and G6

Question Title

Image

Question Title

* Please enter your current postcode and/or the parish in which you live.

SECTION A - YOUR CURRENT HOME

The first section of the form asks for some information about your current housing, including
the type and size of the accommodation.

Question Title

* (Question A1) What type of property do you and your household live in?

Question Title

* (Question A2) Is your property a bungalow?

Question Title

* (Question A3) Do you live in any of the following types of supported/specialist housing?

Question Title

* (Question A4) Do you own or rent the home?

Question Title

* (Question A5) If you own your own home – did you have assistance from a buying scheme (such as Help-to-Buy) to help make the purchase more affordable?

Question Title

* (Question A6) How many bedrooms does your home have?

Question Title

* (Question A7) Do you currently rent out any spare bedrooms within your home?

Question Title

* (Question A8) Are you interested in renting out any spare bedrooms within your home in the future? (Tick all that apply)

Question Title

* (Question A9) When was the home you live in built?

Question Title

* (Question A10) Please indicate whether the following are no problem, a problem, or a serious problem. Please tick one box per item.

  Not a problem/not applicable A problem A serious problem
a) The health of someone in your household is suffering because of condition of your home
b) Your home is in major disrepair
c) You have difficulty maintaining your home and/or garden
d) You have difficulty heating your home and/or it is too costly to heat your home
e) You have to share a bathroom, toilet or kitchen with another household
f) You are lacking basic facilities (such as bathroom/toilet/kitchen)
g) Someone in your household has difficulty using stairs and/or lifts to or within your home
h) Your rent or mortgage is too expensive
i) You are under notice of eviction/re-possession, threat of notice, or lease is coming to an end
j) Someone in your household is suffering harassment
SECTION B - ENERGY EFFICIENCY

Question Title

* (Question B1) Does your property have any of the following energy efficiency measures?

  Yes No
Central Heating
Double Glazing
Loft insulation
Cavity wall insulation

Question Title

* (Question B2) What fuel type do you use to heat your home and hot water? Please tick one response for a) Heating, and one response for b) Hot Water.

  Heating Hot water
Mains Gas
Oil
Electricity
LPG/Bottled Gas
Solid Fuel (e.g. coal/wood)
Solar Power

Question Title

* (Question B3) On average how much do you spend a month on these utilities? Please enter one figure for a) Electricity, and one figure for b) Other Fuel.

Question Title

* (Question B4) Do you have a charging facility installed to charge an electric vehicle at home?

SECTION C - YOUR HOUSEHOLD

In this section we want to find out about the people living in your home, including ages, relationship and working status. Please note for confidentiality we do not want the names of current occupants.

Question Title

* (Question C1) How many people (including you) currently live in your household?

Question Title

* (Question C2) How many couples are there?

Question Title

* (Question C4) Is anyone in the household currently in the armed forces? (this includes reserve and special forces)

Question Title

* (Question C5) Has anyone in the household been discharged from the military due to medical/health grounds?

SECTION D - PREVIOUS MOVES AND ACCOMMODATION

In this section we want to find out about your recent housing history, including where you have moved from and the reasons for moving home. If you have not moved home in the last five years please tick the relevant box below and move on to Section E.

Question Title

* (Question D1) When did you move to your current home?

Question Title

* (Question D2) What was your last home?

Question Title

* (Question D3) Where was your last home? Please tick a box and enter the area code (if in Maldon District).

Question Title

* (Question D4) Why did you decide to move? Please tick as many as apply.

SECTION E - SUPPORT NEEDS

In this section we want to find out about any members of your household who have a disability or long-term health problem. If this does not apply to anyone in your household then please tick the ‘No’ box below and move on to Section F.

Question Title

* (Question E1) Does any member of your household (including you) have any health problem or disability that limits their (your) day-to-day activities and which has lasted, or is expected to last, at least 12 months – please also indicate if they are a wheelchair user?

Question Title

* (Question E2) What age groups are they? Please tick one box per person.

  0-9 10-15 16-24 25-44 45-59 60-74 75+
First person
Second person

Question Title

* (Question E3) What is the nature of the disability or long-term illness? Please tick as many as apply.

  First Person Second Person
Physical/mobility impairment
Walking difficulty (not in wheelchair)
Learning disability or autism
Mental health condition
Visual/hearing impairment
Asthmatic/respiratory condition
Other physical disability
Limiting long-term illness

Question Title

* (Question E4) How could the accommodation or services for your/their support needs best be improved? Please also say if you already have these improvements. Please tick one box per row.

  Need No Need Already Have
a) Wheelchair accessible e.g. wider doorways, room to manoeuvre
b) Lift/stair lift
c) Handrails/extra handrails
d) Other alterations to improve accessibility (e.g. ramps to front door).
e) Improvements to internal accessibility (e.g. widening internal door openings)
f) Downstairs toilet
g) Level shower unit
h) Other alterations to the bathroom/toilet
i) Alterations to the kitchen (e.g. low level units)
j) Emergency alarm (e.g. Careline)
k) Car parking space near to front door of home
l) Accessible external route to property (e.g. level surface, dropped kerb)
m) More support services to your present home (e.g. a home carer, meals on wheels)
n) Need support managing finances, completing forms etc
o) Need help maintaining home e.g. handyperson service
p) Need to move to alternative housing with specialist adaptations
q) Need to move to alternative housing with care/support
SECTION F - FUTURE HOUSING INTENTIONS

In this section we want to find out about your future housing intentions and if you need or are likely to move home in the next five years. We also want to find out if you wish to move home but are prevented from doing so for some reason.

Question Title

* (Question F1) Does your household need, or is it likely to move to a different home...?

Question Title

* (Question F2) How many bedrooms would you a) LIKE and b) EXPECT in your new home?

Question Title

* (Question F3) What are the main reasons for wanting/needing to move to a different home? Please tick as many as apply.

Question Title

* (Question F4) Please state the area where you would a) most LIKE to move to and b) where you EXPECT to move to.
Please tick one box for each of a) Like and b) Expect. If you would like or expect to live within the Maldon District, please indicate up to two areas in the box(es) below, using the map on page 1 of the printed survey as reference.

  a) Like b) Expect
Maldon District Council area
Colchester Borough Council area
Braintree District Council area
Chelmsford City Council area
Rochford District Council area
Elsewhere in Essex
Elsewhere in the East of England
Elsewhere in the United Kingdom
Abroad

Question Title

* Like: area code (if in Maldon District - see map on page 1) - choose up to two

Question Title

* Expect: area code (if in Maldon District - see map on page 1) - choose up to two

Question Title

* (Question F5) What type of housing: a) would you LIKE to move to and b) would you EXPECT to move to? Please tick one response for a) Like, and one response for b) Expect.

  a) Like b) Expect
Buy own home
Rent from a Council/Housing Association
Rent from a private landlord or letting agency
Rent from a relative or friend
Tied/linked to a job
Shared Ownership
House/flat share or student accommodation
Other

Question Title

* (Question F6) What type of property: a) would you LIKE to move to and b) would you EXPECT to move to? Please tick one response for a) Like, and one response for b) Expect.

  a) Like b) Expect
Detatched house
Semi-detatched house
Terraced house (including end terrace)
Bungalow
A flat, maisonette, or apartment
A caravan, park home or houseboat
Bedsit/Studio/Room Only

Question Title

* (Question F7) What type of accommodation: a) would you LIKE to move to and b) would you EXPECT to move to?
Please tick one response for a) Like, and one response for b) Expect. See definitions below.

  a) Like b) Expect
Sheltered housing scheme with a warden
Sheltered housing scheme without a warden
Extra care (Independent living) scheme
Residential care and/or nursing home
None of these types of accommodation
Definitions:

Sheltered housing: accommodation with access to services like a 24-hour emergency contact alarm system, and/or a warden.

Extra care (Independent living) schemes: accommodation for people aged 55 or over with care needs but who want to stay independent. These properties provide 24-hour care and support onsite

Question Title

* (Question F8) Are you intending to build your own home?

Question Title

* (Question F9) Are you currently on the Council’s self-build and custom housebuilding register?

SECTION G - REQUIREMENTS OF FUTURE HOUSEHOLDS

In this section we want to find out whether there are any members of your household who need or are likely to leave home and move to their own separate accommodation within the next five years. If there are no household members likely to move then please tick the appropriate box below and move on to Section H.

Question Title

* (Question G1) Will any of the other people in your household need, or are they likely to move to their own separate accommodation within the next five years? For example, a son or daughter.

Question Title

* (Question G2) For each person that needs and/or is likely to move in the next five years, please give an indication of
when they will need separate accommodation.

  1st person 2nd person 3rd person
Within the next year
In 1 to 2 years
In 2 to 5 years

Question Title

* (Question G3) How many bedrooms would they a) LIKE and b) EXPECT in their new home?

Question Title

* (Question G4) What are the main reasons for them wanting/needing to move to a different home? Please tick as many as apply.

Question Title

* (Question G5) Are they likely to be setting up home with anyone not currently living in your household?

Question Title

* (Question G6) Please state the area where they would a) most LIKE to move to and b) where they EXPECT to move to.
Please tick one box for each of a) Like and b) Expect. If they would like or expect to live within the Maldon District, please indicate up to two areas in the box(es) below, using the map on page 1 of the printed survey as reference.

  a) Like b) Expect
Maldon District Council area
Colchester Borough Council area
Braintree District Council area
Chelmsford City Council area
Rochford District Council area
Elsewhere in Essex
Elsewhere in the East of England
Elsewhere in the United Kingdom
Abroad

Question Title

* Like: area code (if in Maldon District - see map on page 1) - choose up to two

Question Title

* Expect: area code (if in Maldon District - see map on page 1) - choose up to two

Question Title

* (Question G7) What type of housing: a) would they LIKE to move to and b) would they EXPECT to move to? Please tick one response for a) Like, and one response for b) Expect.

  a) Like b) Expect
Buy own home
Rent from a Council/Housing Association
Rent from a private landlord or letting agency
Rent from a relative or friend
Tied/linked to a job
Shared Ownership
House/flat share or student accommodation
Other

Question Title

* (Question G8) What type of property: would they a) LIKE to move to and would they b) EXPECT to move to? Please tick one response for a) Like, and one response for b) Expect.

  a) Like b) Expect
Detatched house
Semi-detatched house
Terraced house (including end terrace)
Bungalow
A flat, maisonette, or apartment
A caravan or other temporary structure

Question Title

* (Question G9) What type of accommodation: a) would they LIKE to move to and b) would they EXPECT to move to?
Please tick one response for a) Like, and one response for b) Expect. See definitions below.

  a) Like b) Expect
Sheltered housing scheme with a warden
Sheltered housing scheme without a warden
Extra care (Independent living) scheme
Residential care and/or nursing home
None of these types of accommodation

Question Title

* (Question G10) In your opinion, would they be able to afford suitable private sector housing (either rented or bought) in the Maldon District Council area without claiming benefits?

Question Title

* (Question G11) Are they currently registered separately to your household on a Council or Housing Association waiting list?

Question Title

* (Question G12) Please indicate the total monthly or annual gross (before tax) income of this household member.

Question Title

* (Question G13) Please indicate any financial resources they have access to for a deposit/rent bond (e.g. savings/help from parents).

SECTION H - FURTHER HOUSEHOLD INFORMATION

In the final section we want to find out a bit more about your household (including household finances).

This information will be treated in the strictest confidence and cannot be linked to any individual household.

The information is only used in statistical analysis to help establish the ability of households in the council area to afford housing and to assist in providing new housing that meets the needs of a range of different households.

Question Title

* (Question H1) Please indicate how much your household pays in rent or mortgage costs for accommodation per week or month. Please include any service charges for maintaining the building and grounds.

Question Title

* (Question H2) Do you receive any financial support to run your home? (please tick as many as apply)

Question Title

* (Question H3) Is the amount of Housing Benefit/Local Housing Allowance enough to cover your rent?

Question Title

* (Question H4) Is your household on a Council or Housing Association waiting list?

Question Title

* (Question H5) Please indicate the total monthly or annual gross (before tax) income of your household inclusive of investments and household state benefits.  Please combine the incomes of all members of the household.

Question Title

* (Question H6) Please indicate your total net household savings/debt (excluding mortgage debt).

Question Title

* (Question H7) If you own your own home, please a) estimate the value of your home and b) indicate how much money (equity) you estimate you would get if you sold your home now, after paying off any remaining mortgages and other associated debts. Please tick one response for a) Value, and one response for b) Equity.

  a) Value b) Equity
More than £15,000 negative equity
Up to £15,000 negative equity
None
Up to £10,000
£10,001 - £25,000
£25,001 - £50,000
£50,001 - £75,000
£75,001 - £100,000
£100,001 - £150,000
£150,001 - £200,000
£200,001 - £300,000
£300,001 - £500,000
£500,001 - £750,000
Over £750,000

Question Title

* (Question H8) Please indicate any financial resources (other than income/savings already stated above) you have access to for a mortgage deposit/rent bond, for example help from parents.

T