Southampton Living Well Survey

Dear Southampton Resident,
 
Thank you very much for taking the time to participate in our confidential survey!

Social Care in Action and our partners at Age UK Southampton are committed to providing the best Older Persons' activities possible for the residents of Southampton as we emerge from lockdown and look forward to the future. Our mission is to help Older People live well and independently and we would love to hear your opinions on how we can best shape our services to support people to do just that.

Please leave us your contact details at the end of the survey if you would like to learn more about the activities you can get involved in around the city and as a thank you we will be happy to offer you a free trial!

Thanks once again for taking time to answer our questions and we look forward to hearing from you.


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* 1. Please tick your age group:

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* 2. Please tell us your postcode

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* 3. Do you have any carer support?

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* 4. On a scale of 0-5, how would you rate your physical fitness before Covid? 0 being poor and 5 being excellent

By physical fitness we mean state of health and well-being and, more specifically, the ability to perform aspects of sports, occupations and daily activities.

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* 5. On a scale of 0-5, how would you rate your physical fitness now? 0 being poor and 5 being excellent

By physical fitness we mean state of health and well-being and, more specifically, the ability to perform aspects of sports, occupations and daily activities.

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* 6. On a scale of 0-5 how would you rate your emotional health before Covid? 0 being poor and 5 being excellent

By emotional health we mean your ability to cope with both positive and negative emotions.

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* 7. On a scale of 0-5 how would you rate your emotional health now? 0 being poor and 5 being excellent

By emotional health we mean your ability to cope with both positive and negative emotions.

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* 8. On a scale of 0-5 how would you rate your confidence to re-engage with activities and services following the pandemic and being locked down? 0 being poor and 5 being excellent

By re-engage we mean are you confident to take part in or participate again.

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* 9. On a scale of 0-5 how would you rate your independence? 0 being poor and 5 being excellent

By independence we mean are you able to complete your activities of daily living and occupation with (0) or without support (5)

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* 10. On a scale of 0-5 how would you rate your confidence to socialise following the pandemic and lock down? 0 being poor and 5 being excellent

By socialise we mean meeting up with your friends, family and joining in with activities/services

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* 11. Please tell us about any disabilities or medical conditions that you have?

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* 12. Would you say you have any immediate or short term needs you would like support with?

By short term needs we mean can you achieve what you want to be able to achieve in the next month?

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* 13. How do you currently access services such as appointments with a GP or social activities? (tick all that applies)

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* 14. On a scale of 1 star to 5 stars how would you rate your confidence using technology and interacting on social media i.e. Facebook 1 being poor and 5 being excellent

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* 15. On a scale of 1 star - 5 stars how would you rate your confidence in accessing services over the internet? 1 being poor and 5 being excellent

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* 16. If you do use the internet, what do you use it for?

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* 17. Do you currently attend any of the following in your local community?

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* 18. Are you confident in attending local activities in your community?

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* 19. If required, what help and support would you need to access local activities in your community?

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* 20. If you do not currently attend any groups/services/clubs in your community, what kind of activities would you be interested in joining? Tick ALL that apply

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* 21. In what type of environment would you feel comfortable accessing your chosen activities above? (tick all that apply)

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* 22. Are you confident in using public transport to get around?

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* 23. Are you confident in using your own vehicle to get around?

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* 24. If you were to attend any of the activities you specified above, how far would/could you travel independently?

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* 25. If we provided low cost, Covid safe transport to take you and drop you off at our activities, would you take this up?

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* 26. Where would you like the activities you identified above to be held? (please tick all that apply)

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* 27. If you were interested in our programme of activities, how many times a week would you likely attend?

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* 28. What time of day would you like to attend any activities?

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* 29. Do you need assistance to book services/activities?

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* 30. How would you/your carer normally book services/activities?

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* 31. How would you feel comfortable participating in activities/services? (please tick all that apply)

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* 32. Would you welcome support from a volunteer-befriender to attend any of the activities you identified above?

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* 33. Would you need any support or help to learn how to access the internet to book activities/services?

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* 34. Due to the pandemic, do you feel you would need some support with raising your confidence before coming out and accessing services in the community again?

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* 35. Would you like to be able to access some of the activities you are interested in at home via the internet i.e. some of the talks or creative/crafting or wellbeing activities?

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* 36. If you said above that you currently attend social activities in the community, what do you usually pay per session?

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* 37. What do you think is an affordable, good value price for the types of activities you have specified you would like to attend per session?

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* 38. What would your preference be in paying to attend the activities you specified?  (please tick all that apply)

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* 39. Where did you hear about this survey?

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* 40. If you are interested in accessing a free activity session please leave your details below and a member of the team will be in touch.

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