What do you think about this service?
These are questions are about ______
We ask them to find out what you think is good and not good about the service.
Choice
Do you get to choose what you do in your daily life?
This might be:
- Doing the things you like
- Doing things when you want to
- Getting support in the way you choose
- Choosing who supports you
Please tick one box:
Is there anything else you would like to say about this?
Can you choose what time you get up and go to bed?
Is there anything else you would like to say about this?
Can you choose whether to have a bath, a shower or a wash?
Is there anything else you would like to say about this?
Can you choose what clothes you wear?
Can you choose what you eat and drink?
Is there anything else you would like to say about the choices you can make?
This might something that you like or something you do not like.
Medication
If you take medication, can you choose who helps you take it?
Can you choose where you take it?
Is there anything else you would like to say about your medication?
This might something that you like or something you do not like.
Safety
How safe do you feel in general?
Do you feel safe when you are inside______?
Do you feel safe when you are outside?
Does anything worry you about where you live?
Have you ever fallen over in______?
Is there anything else you would like to say about your safety? This might be things you like or things you don’t like.
Do you know who the manager of______is?
Do you know where you could find them to speak about something?
How often do you see the manager?
If you were not happy about something to do with the service, how would you make a complaint?
Food and drink
Do you get enough to eat and drink?
Do you like the food and drinks on offer?
How do you know what the choices are?
Do you help planning what is on the menu?
Can you have snacks and drinks between meals?
Do you ever feel rushed at meals times?
Are you able to get support with eating?
Is there anything else you would like to say about the eating and drinking at ______?
This might be things you like or things you don’t like.
How you spend your time and who you see
Can you have people come to visit you?
Can you go out to visit other people?
Do you regularly go to a:
- Club
- Group
- Church
- Library
- Other type of group?
If so, please say which ones:
Do you have a job?
If you do not have a job, would you like one?
Do you go to school or college?
If you do not go to school or college, would you like to?
Are you able to access a computer if you want to?
Do you choose how you spend your day?
What activities are offered at the service?
Are there any activities you would like to do that are not currently being offered?
Do you spend time with the staff?
Is there anything else you would like to say about how you spend your time?
This might be things you like or things you don’t like.
Your room
Are you happy with how clean your room is?
Are you happy with how comfortable your room is?
Do you have your own belongings?
Do you have your own furniture?
Do you have somewhere you can lock away your belongings if you want to?
Is there anything else you would like to say about your room? This might be things you like or things you don’t like.
They way you are supported
How does the support you get make you feel about yourself?
If you need support to wash or dress does do you get to choose who supports you?
If you need support to wash or dress do the staff know how you like it to be done?
Do staff always knock on your door before they come in to your room?
Is there anything else about they was you are supported? This might be things you like or things you don’t like.
Do you feel supported to keep yourself clean and presentable?
Do staff support you to do things for yourself?
Closing questions
What’s the best thing about living here?
If you could change one thing about the service, what would it be?
Please rate how much you like living here from 1 to 10 (1 being not at all, 10 being you think it is perfect for you).
1 2 3 4 5 6 7 8 9 10
Thank you for answering these questions