(RESIDENTS)

 

Name:

Address:

Contact No.:

 

  1. Are your needs being met?

 

YES

 

NO

 

 

  1. Does the staff let you make choices? (e.g. About what you wear or eat)

 

Always

 

Nearly always

 

Sometimes

 

Never

 

Didn’t answer

 

 

  1. Does the staff treat you with respect?

 

Always

 

Nearly always

 

Sometimes

 

Never

 

Didn’t answer

 

 

  1. “The quality of the service I receive is….”

 

Excellent

 

Good

 

Average

 

Poor

 

 

  1. Does the support you receive from Joseph’s Care home allow you to be independent?                 

 

Strongly agree

 

Agree

 

Disagree

 

Strongly disagree

 

 

  1. Do you feel that staff understands your needs?

YES

 

NO

 

Didn’t answer

 

 

 

 

 

 

 

 

  1. Does the facility clean and well organized?

 

YES

 

NO

 

 

  1. Do you find with communication either with phone service or individual that it is clear?

 

YES

 

NO

 

Didn’t answer

 

 

  1. Overall how satisfied are you with the support you receive from Joseph’s Care Facility?

 

Very satisfied

 

Quite satisfied

 

Neither satisfied or dissatisfied

 

Quite dissatisfied

 

Very dissatisfied

 

Didn’t answer

 

 

  1. Is there any way in which you see our service could be improved? If yes please comment in the space below.

 

YES

 

NO

 

Didn’t answer

 

 

Comment: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

 

The outcomes we wish to achieve through our service are:

Personal Centred Care ♦ To Improve quality of life ♦ To make a positive contribution ♦

To give you the choice & control of your life ♦ Improve your health & well-being ♦

Freedom from discrimination ♦ To maintain your personal dignity

 



(FOR FAMILY)

 

Name:

Address:

Contact No.:

 

  1. Are your needs being met?

 

YES

 

NO

 

 

  1. Does the staff treat you with respect?

 

Always

 

Nearly always

 

Sometimes

 

Never

 

Didn’t answer

 

 

  1. “The quality of the service I receive is….”

 

Excellent

 

Good

 

Average

 

Poor

 

 

6.  Do you feel that staff understands your needs?

 

YES

 

NO

 

Didn’t answer

 

 

     7.  Does the facility clean and organized?

YES

 

NO

 

 

  1. Do you find the answer phone service clear? If no how this could

 

YES

 

NO

 

Didn’t answer

 

 

 

  1. Overall how satisfied are you with the support you receive from Joseph’s Care Facility?

 

Very satisfied

 

Quite satisfied

 

Neither satisfied or dissatisfied

 

Quite dissatisfied

 

Very dissatisfied

 

Didn’t answer

 

 

 

  1. Is there any way in which you see our service could be improved? If yes please comment in the space below.

 

YES

 

NO

 

Didn’t answer

 

 

 

Comment: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

The outcomes we wish to achieve through our service are:

Personal Centred Care ♦ To Improve quality of life ♦ To make a positive contribution ♦ To give you the choice & control of your life ♦ Improve your health & well-being ♦ Freedom from discrimination ♦ To maintain your personal dignity