Client Questionnaire

The service provided by Complete is continually being reviewed to find ways in which we may improve and enhance the things we do well. Your feedback is vital in this process and to provide you with the opportunity to do this we hope that you can take a few minutes to complete this questionnaire or get someone to help you.

Your responses will be treated with confidence and at all times data will be presented in such a way that your identity cannot be connected with specific data.

 

SECTION ONE: About You
Name
Disability Spinal Cord   Acquired Brain Injury
   
Other (Specify if you wish)
SECTION TWO: Your Contacts
 
How did you find out about CPA?
 
Recommended Internet Social Services Spinal Injury Unit
Other (please specify)
 
Who is your Complex Care Manager / Senior Care Manager / Care Manager?
Name
Don't know
When did you last meet with them?

 

   
Who is your Care Co-ordinator / Team Leader (if applicable)?
Name
Don't know
When did you last meet with them?  
   
Who is your Named Nurse or Link Nurse?
Name
Don't know
When did you last meet with them?  
 
   Y    N Sometimes Comments
Are you happy with the level of contact you receive?
 
Does your Care Manager visit/telephone you regularly?
 
Can you easily contact your Care Manager?
 
Do you generally find your Care Manager helpful and supportive?
 
Does your Named Nurse or Link Nurse visit/telephone you regularly?
 
 
Very Satisfied Fairly Satisfied Neither Fairly
dissatisfied
Overall opinion of Care Manager
   
SECTION THREE: The Personal Assistants
   
How did you receive information about your current PAs before they began work with you?
Manager
  
PA Profile
  
Rotas  
Other (Please specify)
 
 
   Y    N Sometimes Comments
Do you meet your PAs before they begin working with you?
 
If no, would you like this to happen?
     
Do your PAs contact you in advance to arrange convenient change over times?
 
Have you ever consulted our Personnel Department about the conduct of your PA?
 
   
Please list the 5 most important attributes in a PA to you?
1.
2.
3.
4.
5.
   
 
   Y    N Sometimes Comments
Do your PAs generally meet your expectations?
 
 
Very Satisfied Fairly Satisfied Neither Fairly dissatisfied
Overall Opinion of PAs
 
   
SECTION FOUR: Organisation Considerations
   
General
 
   Y    N Sometimes Comments
Do you have occasions when you ring Central Head Office?
 
Can you easily make contact with the office staff you require?
 
If unavailable, do office staff ring back promptly?
 
Do you find reception staff helpful and approachable?
 
   
Rotas
 
   Y    N Sometimes Comments
Have you ever used the out of hours service?
 
If you left a message was your call returned promptly?
 
Are you satisfied with the frequency that you receive rotas?
 
Are you satisfied with the accuracy of rotas that are sent to you?
 
Are queries about rotas handled efficiently?
 
Do you find rota staff helpful and approachable?
 
   
Training
   
Are you happy with the training your PAs receive from Complete in the following areas:
   
 
   Y    N Sometimes Comments
Personal Care
 
Moving and Handling
 
Health and Safety
 
First Aid
 
   
Is there any training you feel would be suitable for your PAs to undertake?
     
If yes, please specify  
   
Invoices
 
   Y    N Sometimes Comments
Are invoices sent to you on a regular basis?
 
Do you find invoices easy to understand?
 
Are the invoices generally accurate?
 
Are invoice staff friendly and approachable?
 
Are queries about invoices handled efficiently?
 
(If relevant) would having the facility of paying your bills by Direct Debit help you?
 
   
 
Very Satisfied Fairly Satisfied Neither Fairly dissatisfied
Overall opinion of Office Staff
 
   
Overall Satisfaction of Complete Personal Assistance
 
   
Overall opinion of how complaints (if any) have been dealt with
 
   
Any further Comments:  

 

  
 

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