Title Page

  • Conducted on

  • Conducted by

  • Location

First impressions

  • Do you feel welcome?

  • Is the environment odourless/pleasant smelling?

  • Was the reception area inviting?

  • Does the lounge appear calm and well organised?

  • Are staff interacting with residents?

  • Are staff dressed appropriately? Name badges on?

Resident Feedback

Diet

  • Do you have access to the menu?

  • Do you have input into the meal choices?

  • Are the meals offered to your taste?

  • Is the food offered to you of a good standard?

Staff attitudes and engagement

  • Are staff nice to you?

  • Do staff treat you with respect?

  • Do you feel staff spend enough time with you?

  • Does the home offer enough activities?

  • What activities would you like the home to offer?

General

  • Does the resident look well-kept (clean, well-fitting clothes, shaved?)

  • Do you feel safe here?

  • Do you have access to an advocacy service?

  • Do you know who to contact, or how to raise any concerns, ie safeguards or complaints?

  • Are you happy here?

  • Is there anything else you wish to discuss, or any other feedback to add?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.