Service Users Survey

	Poor	Okay	Good	Excellent
Quality of Furnishings	Quality of Furnishings Poor	Quality of Furnishings Okay	Quality of Furnishings Good	Quality of Furnishings Excellent
Cleanliness	Cleanliness Poor	Cleanliness Okay	Cleanliness Good	Cleanliness Excellent
Decoration	Decoration Poor	Decoration Okay	Decoration Good	Decoration Excellent
Overall facilities provided	Overall facilities provided Poor	Overall facilities provided Okay	Overall facilities provided Good	Overall facilities provided Excellent
Freedom to personalise your bedroom	Freedom to personalise your bedroom Poor	Freedom to personalise your bedroom Okay	Freedom to personalise your bedroom Good	Freedom to personalise your bedroom Excellent
Choice of activities in the home	Choice of activities in the home Poor	Choice of activities in the home Okay	Choice of activities in the home Good	Choice of activities in the home Excellent

Poor

Okay

Good

Excellent

Quality of Furnishings

Poor

Quality of Furnishings

Okay

Quality of Furnishings

Good

Quality of Furnishings

Excellent

Cleanliness

Poor

Cleanliness

Okay

Cleanliness

Good

Cleanliness

Excellent

Decoration

Poor

Decoration

Okay

Decoration

Good

Decoration

Excellent

Overall facilities provided

Poor

Overall facilities provided

Okay

Overall facilities provided

Good

Overall facilities provided

Excellent

Freedom to personalise your bedroom

Poor

Freedom to personalise your bedroom

Okay

Freedom to personalise your bedroom

Good

Freedom to personalise your bedroom

Excellent

Choice of activities in the home

Poor

Choice of activities in the home

Okay

Choice of activities in the home

Good

Choice of activities in the home

Excellent

	Poor	Average	Good	Excellent
Caring	Caring Poor	Caring Average	Caring Good	Caring Excellent
Get things done	Get things done Poor	Get things done Average	Get things done Good	Get things done 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

Get things done

Poor

Get things done

Average

Get things done

Good

Get things done

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
General support from key worker	General support from key worker Poor	General support from key worker Average	General support from key worker Good	General support from key worker Excellent
Privacy and dignity	Privacy and dignity Poor	Privacy and dignity Average	Privacy and dignity Good	Privacy and dignity Excellent
Access to the community	Access to the community Poor	Access to the community Average	Access to the community Good	Access to the community Excellent
Opportunities to socialise	Opportunities to socialise Poor	Opportunities to socialise Average	Opportunities to socialise Good	Opportunities to socialise Excellent

Poor

Average

Good

Excellent

General support from key worker

Poor

General support from key worker

Average

General support from key worker

Good

General support from key worker

Excellent

Privacy and dignity

Poor

Privacy and dignity

Average

Privacy and dignity

Good

Privacy and dignity

Excellent

Access to the community

Poor

Access to the community

Average

Access to the community

Good

Access to the community

Excellent

Opportunities to socialise

Poor

Opportunities to socialise

Average

Opportunities to socialise

Good

Opportunities to socialise

Excellent

	Poor	Average	Good	Excellent
Quality of food	Quality of food Poor	Quality of food Average	Quality of food Good	Quality of food Excellent
Choice of food	Choice of food Poor	Choice of food Average	Choice of food Good	Choice of food Excellent
Availability of Drinks	Availability of Drinks Poor	Availability of Drinks Average	Availability of Drinks Good	Availability of Drinks Excellent
Timing of meals	Timing of meals Poor	Timing of meals Average	Timing of meals Good	Timing of meals Excellent

Poor

Average

Good

Excellent

Quality of food

Poor

Quality of food

Average

Quality of food

Good

Quality of food

Excellent

Choice of food

Poor

Choice of food

Average

Choice of food

Good

Choice of food

Excellent

Availability of Drinks

Poor

Availability of Drinks

Average

Availability of Drinks

Good

Availability of Drinks

Excellent

Timing of meals

Poor

Timing of meals

Average

Timing of meals

Good

Timing of meals

Excellent

	Poor	Average	Good	Excellent
Caring	Caring Poor	Caring Average	Caring Good	Caring Excellent
Getting things done	Getting things done Poor	Getting things done Average	Getting things done Good	Getting things done 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

Getting things done

Poor

Getting things done

Average

Getting things done

Good

Getting things done

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 your care plan	Quality of your care plan Poor	Quality of your care plan Average	Quality of your care plan Good	Quality of your care plan Excellent
Opportunity to develop independence skills	Opportunity to develop independence skills Poor	Opportunity to develop independence skills Average	Opportunity to develop independence skills Good	Opportunity to develop independence skills Excellent
Opportunity to develop your learning	Opportunity to develop your learning Poor	Opportunity to develop your learning Average	Opportunity to develop your learning Good	Opportunity to develop your learning Excellent
Quality of health care provided	Quality of health care provided Poor	Quality of health care provided Average	Quality of health care provided Good	Quality of health care provided Excellent

Poor

Average

Good

Excellent

Quality of your care plan

Poor

Quality of your care plan

Average

Quality of your care plan

Good

Quality of your care plan

Excellent

Opportunity to develop independence skills

Poor

Opportunity to develop independence skills

Average

Opportunity to develop independence skills

Good

Opportunity to develop independence skills

Excellent

Opportunity to develop your learning

Poor

Opportunity to develop your learning

Average

Opportunity to develop your learning

Good

Opportunity to develop your learning

Excellent

Quality of health care provided

Poor

Quality of health care provided

Average

Quality of health care provided

Good

Quality of health care provided

Excellent

Question Title

* 8. Visitors

	Poor	Average	Good	Excellent
Privacy given to your visitors	Privacy given to your visitors Poor	Privacy given to your visitors Average	Privacy given to your visitors Good	Privacy given to your visitors Excellent
Flexibility of visiting times	Flexibility of visiting times Poor	Flexibility of visiting times Average	Flexibility of visiting times Good	Flexibility of visiting times 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 safe?	Do you feel safe? Yes	Do you feel safe? No	Do you feel safe? 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?	Do you feel respected? Yes	Do you feel respected? No	Do you feel respected? Sometimes
Are you involved with the running of the home?	Are you involved with the running of the home? Yes	Are you involved with the running of the home? No	Are you involved with the running of the home? 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 safe?

Yes

Do you feel safe?

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?

Yes

Do you feel respected?

Sometimes

Are you involved with the running of the home?

Yes

Are you involved with the running of the home?

Sometimes

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

	Poor	Average	Good	Excellent
Overall rating?	Overall rating? Poor	Overall rating? Average	Overall rating? Good	Overall rating? Excellent

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* 1. Which home do you live in?

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* 2. What do you think of your home?

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* 3. Staff

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* 4. Support

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* 5. Food

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* 6. Your Home Manager.

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* 7. Reaching Your Goals and outcomes

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* 8. Visitors

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* 9. General Questions

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* 10. Tell us three things we do well?

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* 11. List three things could we do better?

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

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* 13. General comments and suggestions for improvements?

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* 14. Contact information (optional)