Information

  • Document No.

  • Conducted on

  • Service user

  • Staff member

  • Are you happy with the care you are receiving?

  • Comments

  • Do you care staff arrive on time

  • Comments

  • Are you informed if a member of staff is running late

  • Comments

  • Would you contact the office to inform us if a carer is or was late to a call

  • Comments

  • Do your staff wear uniform or are they appropriately dressed

  • Comments

  • If you receive personal care does the member of staff wear PPE (gloves and aprons)

  • Comments

  • Do you feel that you are treated with dignity and respect

  • Comments

  • Do you feel you can contact the office if you have a concern? And do you feel confident that it gets dealt with?

  • Comments

  • Are there any extra services or assistance we could provide for you

  • Additional comments/information

  • Add signature

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