Adult Short Break (Respite) Services in Essex

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Questionnaire on respite services in
your area

We are
currently collecting data for independent research on local short break respite
services in south and mid Essex for adults with learning disabilities and
complex care needs. We would really appreciate input from parents and carers so
that we have a better understanding of the requirement for more respite facilities
in the area.

This data
will be used to determine if the services that are already provided are meeting
the needs of the service users. If the data shows that carers are struggling to
find suitable respite facilities then this information will be presented to
local councils to promote awareness of the issue and persuade them to allocate
money towards the creation of a new short break centre.

The
statistics we collect from this questionnaire may also be shared with other
establishments that could support our case, however all information is
completely confidential and no personal details are included in our data
collection.

We encourage
you to express as much information as you like in regards to this matter, using
a separate sheet of paper if required, your views and feelings on the matter
are very helpful to us.

1. Your son/daughter/service user's age bracket

16-18
19-24
25-40
40+

2. Your Local authority *

3. Are you entitled to respite care? Do you know how many hours you are entitled to per month?

Yes (Please Specify Below)
No
Not Sure

Comments:

4. Do you currently use a short breaks provider?

Yes
No, we are on a waiting list
No, we are currently not seeking a short breaks service

5. What are your main reasons for using/not using respite services?

6. Do you think there is need for another short breaks provider in the local area? *

7. What length of time would be best suited to you and your son/daughter/service user if they were to go on a short break?

8. What hours would you consider to be an appropriate time for drop off and pick up for overnight respite?

	HH	MM
Drop Off
Pick Up

Adult Short Break (Respite) Services in Essex

1. Page 1

1. Your son/daughter/service user's age bracket

2. Your Local authority *

3. Are you entitled to respite care? Do you know how many hours you are entitled to per month?

4. Do you currently use a short breaks provider?

5. What are your main reasons for using/not using respite services?

6. Do you think there is need for another short breaks provider in the local area? *

7. What length of time would be best suited to you and your son/daughter/service user if they were to go on a short break?

8. What hours would you consider to be an appropriate time for drop off and pick up for overnight respite?

9. What services and facilities would you expect to see in a short breaks facility?
*

10. What services and facilities do you think a short breaks provider could deliver that would make their experience In respite more enjoyable? *

Adult Short Break (Respite) Services in Essex

1. Page 1

1. Your son/daughter/service user's age bracket

2. Your Local authority *

3. Are you entitled to respite care? Do you know how many hours you are entitled to per month?

4. Do you currently use a short breaks provider?

5. What are your main reasons for using/not using respite services?

6. Do you think there is need for another short breaks provider in the local area? *

7. What length of time would be best suited to you and your son/daughter/service user if they were to go on a short break?

8. What hours would you consider to be an appropriate time for drop off and pick up for overnight respite?

9. What services and facilities would you expect to see in a short breaks facility? *

10. What services and facilities do you think a short breaks provider could deliver that would make their experience In respite more enjoyable? *

9. What services and facilities would you expect to see in a short breaks facility?
*