Feedback
Who is completing this form?
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Who is completing this form?
How long have you been involved with our service?
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How long have you been involved with our service?
How satisfied are you with the domiciliary support service overall?
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How satisfied are you with the domiciliary support service overall?
Would you recommend our service to others?
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Would you recommend our service to others?
Please rate the professionalism of the support staff
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Please rate the professionalism of the support staff
Do you feel the support provided meets your (or the service user’s) individual needs?
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Do you feel the support provided meets your (or the service user’s) individual needs?
How well do staff communicate with you/about the person receiving care?
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How well do staff communicate with you/about the person receiving care?
Do staff treat you (or the service user) with dignity and respect?
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Do staff treat you (or the service user) with dignity and respect?
Do you feel the support staff are well-trained and competent?
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Do you feel the support staff are well-trained and competent?
Are tasks and care activities completed as agreed in the care plan?
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Are tasks and care activities completed as agreed in the care plan?
Do you feel safe (or feel the person receiving care is safe) with the support workers?
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Do you feel safe (or feel the person receiving care is safe) with the support workers?
Do staff promote the service user’s independence and wellbeing?
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Do staff promote the service user’s independence and wellbeing?
What do you value most about the service?
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Is there anything we could improve?
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Do you have any concerns or complaints you’d like to raise?
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Would you like to be contacted to discuss your feedback?
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Would you like to be contacted to discuss your feedback?