Safer Homes Check

Is your home safe from fire?

This questionnaire will assess fire safety in your home. Once completed, you will get a personalised fire safety plan, which will offer advice on how to prevent fires in your home. The form will take no more than five minutes to complete.

If you complete your contact details at the end of this form we may be able to provide you with FREE smoke alarms.

Already have smoke alarms but having an issue with them? Contact your local station for help: www.clevelandfire.gov.uk/contact-us/

Step 1 of 14

Smoke Alarms
Do you have working smoke alarms in your home?*
- Yes
- No
Is the accommodation rented?*
- Yes
- No
Do you have at least one working smoke alarm on each floor level in your home?*
- Yes
- No
How often do you test them?*
Would you like further information on purchasing and/or fitting smoke alarms?*
- Yes
- No

Fire risk - smoking
Does anyone smoke inside your home?*
- Yes
- No
Do they smoke in bed?*
- Yes
- No
Are ashtrays left on armchairs or other places where they could fall or be knocked over?*
- Yes
- No
Does anyone use e-cigarettes inside your home?*
- Yes
- No

Fire risk - cooking
Does anyone cook after drinking alcohol?*
- Yes
- No
Does anyone in your home use a traditional chip pan?*
- Yes
- No
Has your oven, grill, microwave or extractor fan got a build-up of grease or cooking fat residue?*
- Yes
- No
Is your toaster or kettle positioned underneath a kitchen cupboard?*
- Yes
- No
Hidden
Cooking*

Fire risk - heating your home
Do you have portable heaters such as fan heaters, ceramic heaters, gas heaters or paraffin heaters in your home?*
- Yes
- No
Are clothes ever dried in front of fires or heaters (not including radiators)?*
- Yes
- No
Is a wood-burning stove or open coal fire used?*
- Yes
- No
Do you get the chimney swept every year?*
- Yes
- No
Hidden
Heating*

Fire risk - candles, oil burners and air fresheners
Does anyone use lit candles, incense sticks or oil burners in your home?*
- Yes
- No
Does anyone use plug in air fresheners?*
- Yes
- No

Fire risk - wheat bags
Does anyone use wheat bags in your home?*
- Yes
- No
Note – wheat bags are cotton bags filled with grain or buckwheat. They can be heated inside a microwave. They are often used as a natural alternative for treating and managing aches and pains.

Fire risk - wheelie bins
Do you store wheelie bins away after collection?*
- Yes
- No

Bedtime routine
Do you close inside doors at night before you go to bed?*
- Yes
- No
Do you unplug or switch off electrical appliances (unless they are designed to be left on, such as fridges and freezers)?*
- Yes
- No
Do you leave candles, oil burners or incense sticks burning while you are asleep?*
- Yes
- No
Do you keep door and window keys where everyone can access them?*
- Yes
- No
Hidden
Bedtime*

Escape planning - part 1
Do you have an escape plan, so that everyone in the house knows what to do if the smoke alarm goes off during the night?*
- Yes
- No
Are hallways, stairs and landings kept clear enough to allow safe and easy escape?*
- Yes
- No
Would people in your home be able to escape through all exit doors and without having to search for a key?*
- Yes
- No

Your details part 1
Cleveland Fire Brigade want to make you safer and to do this would like to send you your personalised safety plan by email, and possibly some more specific advice in the future. To opt in to this please fill in your name, postcode and email.
Email opt in
- I agree you may contact me by email.
If you opt in we will also store and analyse your safety plan which will help us to identify further safety requirements for our communities across Cleveland.
First Name*
Surname*
Email*
Postcode*
Address*
District*
Phone No.
If at any time you decide you no longer want to receive specific safety advice you can opt out by sending an email with the words STOP EMAILS to communitysafety@clevelandfire.gov.uk
Safer Home Visit
Your results indicate that you have a person living in your home who is 65+ years of age. If you live in Cleveland, we can arrange a FREE safer homes visit.
Would you like us to contact you to arrange a safer homes visit?*
- Yes
- No
First Name*
Surname*
Email*
Phone No.

Have you had a Safer Homes Assessment?

We are always looking to improve the services we deliver to our communities. If you’ve had smoke alarms installed and received a Safer Home Assessment, we’d love to know what you think.

Take our Survey

Is your home safe from fire?

Step 1 of 14

Smoke Alarms

Fire risk - smoking

Fire risk - cooking

Fire risk - electrical

Fire risk - heating your home

Fire risk - candles, oil burners and air fresheners

Fire risk - wheat bags

Fire risk - wheelie bins

Bedtime routine

Escape planning - part 1

Escape planning - part 2

People living in your home

Your details part 1

Safer Home Visit

Have you had a Safer Homes Assessment?