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Carer Survey
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Carer Survey
If you have used our Carer Liaison Officer Support Service, please take a moment to complete this survey to help us improve our service for carers.
How was the patient admitted?
*
Required
** None
Admissions Ward
Emergency Department
Other (please specify below)
Other (please specify)
Pre Admission/Assessment
I was involved in the assessment of the patient’s needs
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
I was informed of what would happen to the person I care for
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
I feel I was recognised as a Carer
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
How did your experience of pre admission/assessment make you feel as a Carer?
What could have been done to make your experience as a Carer better?
Inpatient Stay (if applicable, otherwise please go to the next question)
I was invited to be involved in the patient’s care
None
Strongly agree
Agree
Neutral
Disagree
Strongly Disagree
I was informed of visiting times and given options of different times
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
I was informed about the patient's treatment during their stay
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
I was informed of changes to their needs or treatment during their stay
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
I was informed about support with the costs of visiting e.g. transport, parking
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
I feel I was recognised as a Carer
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
How did your experience during the patient’s inpatient stay make you feel as a Carer?
What could have been done to make your experience as a Carer better?
Which ward was the patient in?
If the patient passed away before discharge please tick this box
Yes, the patient passed away before being discharged
Discharge Planning
I was involved in the discharge planning
None
Strongly agree
Agree
Neutral
Disagree
Strongly agree
I feel my own health and capacity to care was taken into account during the discharge process
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
I was given information about the support the patient would need after discharge
None
Strongly agree
Agree
Neutral
Disagree
Strongly Disagree
I feel I was recognised as a Carer
None
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
How did your experience during the patient’s discharge planning make you feel as a Carer?
What could have been done to make your experience as a Carer better?
OPTIONAL: Patient’s Health Conditions. Please tick those applicable
Alzheimer’s / Dementia
Mental Health Condition
Child under 18
Physical Disability
Old Age/Frailty
Learning Disability
Stroke
Visually impaired
Hearing impaired
Other (please specify)
Other (please specify)
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