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(Questionnaire for Carers of People who use Social Services)
February 2011
How do you feel about Social Services in Caerphilly County Borough?
Help us to find out
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What is the questionnaire about?
We want to know what you think about the services we provide for you and the person you are caring for.
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Why is this questionnaire important?
This questionnaire helps to improve Social Services for you and other people by providing valuable feedback on the services we provide.
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Who should fill it in?
The responses to questions should be given from the point of view of the person whose name was on the envelope.
We would prefer you to fill this in yourself but if you like, you can ask someone you trust to help you fill it in. (Perhaps somebody in your family, a friend or your advocate if you have one but it's your views we want, not theirs).
You don't have to give your name and information provided will be treated in accordance with the Data Protection Act. Information provided will only be used by authorised employees. If you provide information that raises worries about your or someone else's safety or well-being we have an obligation to act on it.
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How do I fill it in?
All you need to do is tick the box that best fits with your views for each question. Some questions ask you to write additional comments, only fill these in if you wish.
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How should I return the completed questionnaire?
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Please submit your completed questionnaire before 28 February 2011.
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Your Data
You are entitled to a copy of the information we hold about you for a fee of £10.00. If you wish to make a request to see your data or if you wish to object to the way in which it is being used, please e-mail foi@caerphilly.gov.uk, or write to the Information Officer, Caerphilly County Borough Council, Ty Penallta, Parc Tredomen, Ystrad Mynach, Hengoed, CF82 7PG or you can contact 01443 864320.
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The person I support/care for is my :
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The age of the person I support/care for is :
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The amount of caring hours I provide per week is :
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I have received an offer to have my needs assessed as a carer
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I get help with my supporting/caring role.
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The help I receive as a carer :
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I have found it easy to get information about the services I might need for myself as a carer.
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I have found it easy to get information about social services I might need for the person I care for.
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I am aware of the written assessment of the needs of the person I support/care for.
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I have been involved in deciding what help or services the person I support/care for should receive.
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Making use of Social Services
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There is a care plan that describes the services the person I support/care for will receive.
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The social worker or care manager responds quickly when there is an important change in the situation of the person I support/care for.
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At least once a year, there is a review to discuss the services received.
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The range of services available are :
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The person I support/care for has been given choices about the type of care they receive.
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How far do you agree or disagree with the following statements :
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How far do you agree or disagree with the following statements :
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Please give examples and if possible, why they were helpful.
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Would you like to see any improvements?
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Please give examples, where possible.
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WE WOULD BE GRATEFUL IF YOU COULD COMPLETE THE FOLLOWING
PLEASE NOTE, THESE ARE OPTIONAL QUESTIONS ONLY
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Do you have a disability?
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WHAT IS YOUR ETHNIC GROUP?
Please select ONE of the appropriate boxes to indicate your cultural background.
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Chinese or other ethnic group
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Thank you for taking the time to complete this questionnaire.
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