Service User's Questionnaire

What is the survey about?

This survey is about your views and opinions of the service you receive from Northern Case Management Limited.

Who should complete the questionnaire?

The questions should be answered by the person named. If that person needs help to complete the questionnaire, the answers should be given from their point of view - not the point of view of the person helping

Completing the Questionnaire

Please tick the appropriate box. Please do not write your name or address anywhere on the questionnaire unless you wish to be identified.

Questions or help?

If you have any queries about the questionnaire, please call the office.

Your participation in this survey is voluntary.

The questionnaire should take no longer than 15 minutes to complete. Your answers will be treated in confidence.

Section 1 - Involvement and Information
1.1 Do you have a copy of your support plan?

1.1 Do you have a copy of your support plan? Yes No Don't know
1.2 Do you feel able to speak to your case manager about changes to your support plan?

1.2 Do you feel able to speak to your case manager about changes to your support plan? Yes No Don't know
1.3 Do you feel able to speak to your support team about changes to your support plan?

1.3 Do you feel able to speak to your support team about changes to your support plan? Yes No Don't know
1.4 Are you consulted by your support team regarding alternative activities?

1.4 Are you consulted by your support team regarding alternative activities? Yes No Don't know
Section 2 - Personalised Care, Treatment, and Support
2.1 Do you feel that your support team help maintain your independence?

2.1 Do you feel that your support team help maintain your independence? Yes No Don't know
2.2 Are you addressed by your preferred name/title?

2.2 Are you addressed by your preferred name/title? Yes No Don't know
2.3 Are you happy for records to be kept in your home?

2.3 Are you happy for records to be kept in your home? Yes No Don't know
2.4 Are your ethnic and cultural needs being understood and met?

2.4 Are your ethnic and cultural needs being understood and met? Yes No Don't know
2.5 Are you treated with dignity and support by your support team?

2.5 Are you treated with dignity and support by your support team? Yes No Don't know
2.6 Are you treated with dignity and support by NCM representatives?

2.6 Are you treated with dignity and support by NCM representatives? Yes No Don't know
2.7 Do you feel you have enough privacy when you need it?

2.7 Do you feel you have enough privacy when you need it? Yes No Don't know
2.8 Do you have enough say in your care and treatment?

2.8 Do you have enough say in your care and treatment? Yes No Don't know
Section 3 - Safeguarding and Safety
3.1 Do you feel safe with your support team?

3.1 Do you feel safe with your support team? Yes No Don't know
3.2 Do you feel your home is a safe environment for you and your support team?

3.2 Do you feel your home is a safe environment for you and your support team? Yes No Don't know
3.3 Do your support team operate a petty cash account?

3.3 Do your support team operate a petty cash account? Yes No N/A
3.4 If so, is your petty cash managed in a satisfactory manner?

3.4 If so, is your petty cash managed in a satisfactory manner? Yes No N/A
Section 4 - Suitability of staffing
4.1 Do you feel your support team are trained to meet your requirements?

4.1 Do you feel your support team are trained to meet your requirements? Yes No Don't know
4.2 Do you feel that your Case Management team offer enough support and supervision to your support team?

4.2 Do you feel that your Case Management team offer enough support and supervision to your support team? Yes No Don't know
Section 5 - Quality and Management
5.1 Do you know how to raise any concerns?

5.1 Do you know how to raise any concerns? Yes No Don't know
5.2 Do you feel that your concerns are listened to and understood by your case manager?

5.2 Do you feel that your concerns are listened to and understood by your case manager? Yes No Don't know
5.3 Do you feel informed if there are changes to your nominated case manager?

5.3 Do you feel informed if there are changes to your nominated case manager? Yes No Don't know
5.4 Are you confident that the quality of NCM's service is consistent?

5.4 Are you confident that the quality of NCM's service is consistent? Yes No Don't know
5.5 Can you contact your NCM case manager easily?

5.5 Can you contact your NCM case manager easily? Yes No Don't know
5.6 Does your NCM case manager visit you often enough?

5.6 Does your NCM case manager visit you often enough? Yes No Don't know
Any additional comments you may wish to make -
This questionnaire is intended to be anonymous. However if there are any specific issues this questionnaire has raised that you would like to discuss with your case manager, you may enter your name below or phone your case manager in confidence

Service User's Questionnaire

Service User's Questionnaire

Section 1 - Involvement and Information

Section 2 - Personalised Care, Treatment, and Support

Section 3 - Safeguarding and Safety

Section 4 - Suitability of staffing

Section 5 - Quality and Management