F–84

Briarcare Limited

Briarcare House, Harp Lane, Cavendish Road, Clare, Suffolk C010 8PH

Tel: 01787 279000 / Fax: 01787 279007

SERVICE USER SATISFACTION SURVEY

We at Briarcare Ltd are anxious to make every effort to provide a satisfactory service. We would be most grateful if you would take the time to answer the next few questions. These will be used to make sure we have a clear understanding about how YOU feel about our service and where, if possible, we can make improvements.

1 How many hours of Home Care do you usually receive each week?

(Please write in this box)

2 Do you receive any practical help from any friends, neighbours or family members

(Please write in this box)

3Do your Carers arrive at times that suit you?

(Please tick one box)

Always

Usually

Sometimes

Never

4Do your Carers arrive on time?

(Please tick one box)

Always

Usually

Sometimes

Never

5If, at times, you require an earlier or later visit, are your needs

accommodated?

(Please tick one box )

Always

Usually

Sometimes

Never

6Do your Carers work for the allocated time?

(Please tick one box )

Always

Usually

Sometimes

Never

7Are all tasks completed before your Carers leave you?

(please tick one box)

Always

Usually

Sometimes

Never

8Are you happy with the way in which you are cared for?

(Please tick one box)

Always

Usually

Sometimes

Never

9. If you could change anything about the Service you receive what would it be ?

(Please write in this box)

Please feel free to add any further comments

(Please write in this box)

Thank you for taking the time to complete our questionnaire. Your opinions are important and we will be pleased to ensure that any staff concerned are informed about the comments we have received.

We will also ensure that any concerns/problems you may have highlighted will be addressed.

Should you wish to contact us directly you will find our telephone number at the top of this questionnaire.

A stamped addressed envelope has been enclosed for your convenience.

Yours sincerely

Karen J. Stokeld

Group Director

Issue No 1 Rev: No 0 Issue Date 01.03.2005 Authorised By KS Page 1 of 3