In order to ensure that we are continuing to provide a good quality of Domiciliary Care to meet your needs we would be obliged if you would assist us by completing the following questionnaire. It is by asking about our Care Service, and whether you feel that it meets your needs as you perceive it, that we are able to look at ways of improving and maintaining the standard of care we provide. Please note that there is no provision for you in your name. this is to ensure privacy and confidentiality and to enable you to able you to be totally honest with your answers. For each OBSERVATION listed please tick the appropriate SCORE box according to how you thing we rate and when completed please put the questionnaire into the envelope provided, seal it and pass it to our Domiciliary Care Worker. Thank you for your help.
Are you kept adequately informed /consulted about your care state of health?
Do you feel that you had sufficient say in your Care Assessment and the development of your Care Plan?
Are you consulted with respect to changes to your Care Plan?
Do you find the Care Staff looking after you to be friendly, approachable and efficient?
Do you feel that you are able to discuss personal matters with our Care Staff?
Are you satisfied with the personal care given to you?
Are you satisfied with the help given to you regarding taking medication?
Are you satisfied with the dietary care,.i.e. meals and snacks, given to you?
Are you satisfied with the standard of cleaning and other household services given to you?
Are you confident with the standard of other personal services given to you?
Are you confident that your personal affairs are kept Confidential by our Care Staff?
How well do you feel that your dignity and privacy is being respected?
How well do you feel that your democratic rights are being respected?
How well do you feel that your needs (cultural, spiritual, language etc) are respected and catered for?
Do you feel that you are sufficiently involved in reviews of your care needs?
How do you rate the accuracy and quality of information shared with during these reviews?
How well do you feel that your views are listened to and taken into account?
How you ever felt uneasy or intimidated wen our Care Staff are with you, and if so why?
How do you rate our level and quality of response when you telephone our Organisation to speak to us?
Do you feel confident that you can contact us at any time day or night?
What do you feel about the level of information given to you regarding or complaints procedure?
Do you know how to make complaint?
If you have had cause to make a complaint, what do you feel about the manner in which it was handled?
Do you feel that you could talk to us in confidence?
What are your overall impressions of our Organisation?
Would you recommend us to other potential service users for Domiciliary Care?