Welcome to your annual survey. Please fill in this Survey to tell us your views about your home and the service.

We will use the results to make improvements to the services we provide. It is confidential and you will not be identified in any report we produce about the quality of our service.

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* 2. Who is completing this form?

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* 3. What do you think of your home?

 
Poor

Okay

Good
The things in your home ie sofa.
The cleaning
How does it look - Decoration
Your bedroom
Choice of activities in the home

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* 4. Staff

 
Poor

Average

Good
Care for you
Staff helping you
Communication with you

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* 5. Support

 
Poor

Average

Good
Support from key worker
Privacy and dignity
Access to the community - Going out
Meeting friends & family 

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* 6. Food

 
Poor

Average

Good
How nice is the food
Choice of food
Choice of Drinks

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* 7. Your Manager

 
Poor
Average
Good
Kind & Caring
Helping you
Spends time with you

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* 8. Reaching Your Goals and outcomes 

 
Poor

Average

Good
Your care plan
How well do we look after you
Developing your skills
Health care support
Keeping you safe from viruses, such as COVID

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* 9. Visitors

 
Poor

Average

Good
Privacy for your visitors
Visiting times

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* 10. General Questions

 
Yes

No

Sometimes
Do you know who to talk to if you have a problem - Complaint
Do you feel safe
Are you happy that your information is held safely
Are you treated well
Are you invited to house meetings
Are your belongings kept safe
Can you move freely around your home and grounds
Do you know about the service user association 
Are you aware of the activities arranged by us: makaton choir, competitions, disco

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* 11. Tell us three things we do well?

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* 12. List three things could we do better?

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* 13. Overall how happy are you with what we do?

 
Poor

Average

Good
Overall rating?

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* 14. Is there anything else you would like to tell us about your home?

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