Outreach - Service Users Survey

Welcome to the regular quality assurance survey. Please fill in this Survey to tell us your views about our service.

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

	Poor	Average	Good	Excellent
Caring	Caring Poor	Caring Average	Caring Good	Caring Excellent
Organised	Organised Poor	Organised Average	Organised Good	Organised Excellent
Response to concerns	Response to concerns Poor	Response to concerns Average	Response to concerns Good	Response to concerns Excellent
Knowledge and experience	Knowledge and experience Poor	Knowledge and experience Average	Knowledge and experience Good	Knowledge and experience Excellent
Communication skills	Communication skills Poor	Communication skills Average	Communication skills Good	Communication skills Excellent

Poor

Average

Good

Excellent

Caring

Poor

Caring

Average

Caring

Good

Caring

Excellent

Organised

Poor

Organised

Average

Organised

Good

Organised

Excellent

Response to concerns

Poor

Response to concerns

Average

Response to concerns

Good

Response to concerns

Excellent

Knowledge and experience

Poor

Knowledge and experience

Average

Knowledge and experience

Good

Knowledge and experience

Excellent

Communication skills

Poor

Communication skills

Average

Communication skills

Good

Communication skills

Excellent

	Poor	Average	Good	Excellent
Core Team	Core Team Poor	Core Team Average	Core Team Good	Core Team Excellent
Privacy and dignity	Privacy and dignity Poor	Privacy and dignity Average	Privacy and dignity Good	Privacy and dignity Excellent
Opportunities to socialise	Opportunities to socialise Poor	Opportunities to socialise Average	Opportunities to socialise Good	Opportunities to socialise Excellent
Choice of activities	Choice of activities Poor	Choice of activities Average	Choice of activities Good	Choice of activities Excellent

Poor

Average

Good

Excellent

Core Team

Poor

Core Team

Average

Core Team

Good

Core Team

Excellent

Privacy and dignity

Poor

Privacy and dignity

Average

Privacy and dignity

Good

Privacy and dignity

Excellent

Opportunities to socialise

Poor

Opportunities to socialise

Average

Opportunities to socialise

Good

Opportunities to socialise

Excellent

Choice of activities

Poor

Choice of activities

Average

Choice of activities

Good

Choice of activities

Excellent

	Poor	Average	Good	Excellent
Caring	Caring Poor	Caring Average	Caring Good	Caring Excellent
Organised	Organised Poor	Organised Average	Organised Good	Organised Excellent
Response to concerns	Response to concerns Poor	Response to concerns Average	Response to concerns Good	Response to concerns Excellent
Knowledge and experience	Knowledge and experience Poor	Knowledge and experience Average	Knowledge and experience Good	Knowledge and experience Excellent
Communication skills	Communication skills Poor	Communication skills Average	Communication skills Good	Communication skills Excellent

Poor

Average

Good

Excellent

Caring

Poor

Caring

Average

Caring

Good

Caring

Excellent

Organised

Poor

Organised

Average

Organised

Good

Organised

Excellent

Response to concerns

Poor

Response to concerns

Average

Response to concerns

Good

Response to concerns

Excellent

Knowledge and experience

Poor

Knowledge and experience

Average

Knowledge and experience

Good

Knowledge and experience

Excellent

Communication skills

Poor

Communication skills

Average

Communication skills

Good

Communication skills

Excellent

	Poor	Average	Good	Excellent
Quality of support plans	Quality of support plans Poor	Quality of support plans Average	Quality of support plans Good	Quality of support plans Excellent
Opportunity to develop life skills	Opportunity to develop life skills Poor	Opportunity to develop life skills Average	Opportunity to develop life skills Good	Opportunity to develop life skills Excellent
Opportunity to develop your education	Opportunity to develop your education Poor	Opportunity to develop your education Average	Opportunity to develop your education Good	Opportunity to develop your education Excellent
Access to external services e.g.. hairdressers medical appointments	Access to external services e.g.. hairdressers medical appointments Poor	Access to external services e.g.. hairdressers medical appointments Average	Access to external services e.g.. hairdressers medical appointments Good	Access to external services e.g.. hairdressers medical appointments Excellent

Poor

Average

Good

Excellent

Quality of support plans

Poor

Quality of support plans

Average

Quality of support plans

Good

Quality of support plans

Excellent

Opportunity to develop life skills

Poor

Opportunity to develop life skills

Average

Opportunity to develop life skills

Good

Opportunity to develop life skills

Excellent

Opportunity to develop your education

Poor

Opportunity to develop your education

Average

Opportunity to develop your education

Good

Opportunity to develop your education

Excellent

Access to external services e.g.. hairdressers medical appointments

Poor

Access to external services e.g.. hairdressers medical appointments

Average

Access to external services e.g.. hairdressers medical appointments

Good

Access to external services e.g.. hairdressers medical appointments

Excellent

	Poor	Average	Good	Excellent
Suitability of the car	Suitability of the car Poor	Suitability of the car Average	Suitability of the car Good	Suitability of the car Excellent
Cleanliness	Cleanliness Poor	Cleanliness Average	Cleanliness Good	Cleanliness Excellent
General upkeep and condition	General upkeep and condition Poor	General upkeep and condition Average	General upkeep and condition Good	General upkeep and condition Excellent

Poor

Average

Good

Excellent

Suitability of the car

Poor

Suitability of the car

Average

Suitability of the car

Good

Suitability of the car

Excellent

Cleanliness

Poor

Cleanliness

Average

Cleanliness

Good

Cleanliness

Excellent

General upkeep and condition

Poor

General upkeep and condition

Average

General upkeep and condition

Good

General upkeep and condition

Excellent

	Yes	No	Sometimes
Are you aware of our complaints procedure?	Are you aware of our complaints procedure? Yes	Are you aware of our complaints procedure? No	Are you aware of our complaints procedure? Sometimes
Do you feel confident in making a complaint?	Do you feel confident in making a complaint? Yes	Do you feel confident in making a complaint? No	Do you feel confident in making a complaint? Sometimes
Do you feel your needs are being met?	Do you feel your needs are being met? Yes	Do you feel your needs are being met? No	Do you feel your needs are being met? Sometimes
Are you satisfied that your information is held securely?	Are you satisfied that your information is held securely? Yes	Are you satisfied that your information is held securely? No	Are you satisfied that your information is held securely? Sometimes
Do you feel respected and valued?	Do you feel respected and valued? Yes	Do you feel respected and valued? No	Do you feel respected and valued? Sometimes
Are you involved with your care and support?	Are you involved with your care and support? Yes	Are you involved with your care and support? No	Are you involved with your care and support? Sometimes

Yes

Sometimes

Are you aware of our complaints procedure?

Yes

Are you aware of our complaints procedure?

Sometimes

Do you feel confident in making a complaint?

Yes

Do you feel confident in making a complaint?

Sometimes

Do you feel your needs are being met?

Yes

Do you feel your needs are being met?

Sometimes

Are you satisfied that your information is held securely?

Yes

Are you satisfied that your information is held securely?

Sometimes

Do you feel respected and valued?

Yes

Do you feel respected and valued?

Sometimes

Are you involved with your care and support?

Yes

Are you involved with your care and support?

Sometimes

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* 1. Who is completing this form?

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* 2. Staff

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* 3. Comment Box

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* 4. Support

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* 5. Comment Box

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* 6. Outreach Manager and Co-ordinators

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* 7. Comment Box

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* 8. Reaching Your Goals and Outcomes

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* 9. Comment Box

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* 10. Support Worker Cars

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* 11. Comment Box

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* 12. General Questions

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* 13. Comment Box

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* 14. List three things we do well?

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* 15. List three things could we do better?

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* 16. Overall how do you rate the services we deliver?

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* 17. General comments and suggestions for improvements (please be honest)?

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* 18. Contact information (optional)