Questionnaire for People Receiving Home Care

Questionnaire for People Receiving Home Care

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Who provides your care?

Cymorth Llaw
Abercare
Carelink
Plas Garnedd

Anheddau
Môn Care
Crossroads

What types of things do you get help with?

Does the care provided allow you to do things when you want e.g. get up in the morning, go to bed?

Yes
No

If no, why not?

Do you believe you have as much control as you would like about decisions around your care?

Yes
No

If no, why not?

Do all home carers treat you with dignity, courtesy and respect?

Yes
No

Comments:

Do the home carers turn up on time?

Never
Sometimes
Always

If ‘Never’ or ‘Sometimes’ do the home carers inform you that they will be late?

Yes
No

Are you able to receive the service in the language of your choice?

Yes
No

This question requires an answer

Please rank the following six aspects of care in order of importance to you (6 = most important and 1 = least important).

Being listened to about important things
Home carers having the right skills, knowledge and training
Having enough time to do all that is needed
Receiving visits from as few different workers as possible
Receiving the best quality care possible
Being signposted effectively to other relevant sources of information

What, if anything, could improve the home care you receive?

Any other comments: