West Sussex Short Breaks Survey

Barnardo’s Children’s Charity are conducting a survey on Short Break provision within West Sussex.

We are keen to know what you would like from your Short Break.

The survey will be anonymous unless you wish to leave your name and contact details.

The survey is short and will only take 5 minutes to complete.

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* 1. What part of West Sussex do you live in?

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* 2. Are you filling this in as a:

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* 3. Tick all that apply.
If you are a parent/carer how old is the child/young person who accesses short breaks? If you are a child/young person, how old are you?

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* 4. Please tick all that apply.
Do you prefer your short break:

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* 5. Please tick all which apply.
I would like my short break to be:

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* 6. Please tick all that apply.
I would prefer my short break to be:

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* 7. This is about where you would like your short break. Tick all that apply.
I would like my short break:

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* 8. How far would you travel for your short break?

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* 9. Please tick all that apply.
I am able to travel by:

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* 10. Please tick all that apply:

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* 11. On a scale of 1-5, where one 1 is strongly agree and 5 is strongly disagree please answer the following:

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I think the short breaks in West Sussex are priced about right
I think short breaks should be free
I think short breaks should be subsidized for families that need support
I think short breaks are reasonably priced
I think short breaks are too cheap
I think there should be cheaper breaks when I book in advance
I am happy to pay the whole fee up front
I would like to pay week by week
I would like to do half in advance and the rest half way through

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* 12. On a scale of 1-5, where 1 is strongly agree and 5 is strongly disagree please answer the following:

  1 2 3 4 5
Short breaks should be about having fun and having a good time
Short breaks should be about developing skills to be more independent
Short breaks should be about developing self confidence
The content of short breaks should be directed by Young People
Short breaks should be a place for Young People to share feelings and preferences
Short breaks should enable us to form and develop supportive relationships
Short breaks should be a place for Young People to overcome challenges
Short breaks should help support health needs
Short breaks should enable Young People to prepare for and achieve successful moves to the next stage of their development
Short breaks should provide a break for other family members

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* 13. Please tick all that apply.
Popular activities in short breaks are included in the list below. Please can you tick any you would like to be included on a short break and add any others:

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* 14. Please tick all that apply.
What is the best way to find out about a short break in West Sussex?

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* 15. As a parent/carer would you like a short break provision for siblings of a disabled child?
Please comment on the provision you would like.

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* 16. If you are happy to be contacted and have a further conversation on short breaks please leave your contact details below.
Many thanks Barnardo’s Moving Forward Team

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