Staff Care and Nursing Home Coronavirus Survey


1. All your personal information is treated confidentially and anonymous in reports, in line with data protection laws. What this means is we keep it under lock and key, we won’t share your personal details with anyone else, and we get rid of them when we’re done. Are you happy for the information you give us to be stored and used this way? *


2. What is the name of the care/nursing home you work at?


3. What type of home is this:


4. Did you have an outbreak of Coronavirus?


5. If yes, did you receive any help from:


6. What, in your opinion, were the main reasons for having an outbreak or being able to avoid this?


7. The NHS have recently been providing some interventions to help care and nursing homes. Are you aware of these?


8. What support would you need to help your home deal with an outbreak/a second outbreak?


9. What support would you want from the Local Authority and/or the Clinical Commissioning Group/Hospitals/GPs etc. in future, to ensure you are properly supported in the longer term?


10. Do you have any other comments?


11. Would you like to sign up to our newsletter to hear more about the work we do?


12. Please help us learn a little bit more about you.

Do you consider yourself:


13. How old are you?


14. What is your ethnic origin?

  • Asian/Asian British
  • Black/Black British
  • Mixed/Multiple ethnic groups
  • White
  • Other ethnic group

15. Do you identify as:


16. Do you consider yourself disabled?


17. Are you a carer?


18. Which religion, if any, do you follow:


19. Would you like to sign up to our newsletter to keep up to date about this project and the other work we do?


20. What are the first three letters of your postcode? (e.g. EN4)