Carer Questionnaire

People who provide unpaid care and support to those using our mental health, learning disability and autism services are often known as carers. Carers can be family members, friends and neighbours.

We are really keen to hear about your experience whilst the person that you care for has been accessing care and treatment. We would therefore be grateful if you could complete this questionnaire.
Q1What is your relationship to the person that you care for?
 
 
 
 
 
Q2How long has the person that you care for used our services?
 
 
 
 
 
 
 
 
Q3In which area did the person that you care for access their care and treatment?
 
 
 
 
Q4
 
Q4b
Q4c
Q4d
Q4e
Q4f
Q4g
 
Q5Did you feel that staff recognised you and the role you played in providing care and support to the person that you care for?
 
 
 
 
Q6How soon did you feel that staff recognised you in this role?
 
 
 
 
 
 
Q7Did you feel that staff welcomed your views, knowledge and any concerns you had about the person that you care for?
 
 
 
 
Q8Did you feel that staff were happy to listen to you?
 
 
 
Q9Did you feel that staff involved you in decisions about the care and treatment planning for the person that you care for?
 
 
 
 
Q10If medication or treatment for the person that you care for was introduced or changed, was this explained to you ?
 
 
 
 
Q11Did staff explain confidentiality (what information could and couldn't be shared) to you?
 
 
 
Q12Did the person that you care for ever stop you receiving information from staff about their care and treatment?
 
 
Q12aWere you offered support and general information if the person that you care for wished not to disclose information to you?
 
 
Q13Were you aware of any particular staff who had a role in supporting you as a carer?
 
Q14Were you provided with any of the following information ? (please select all that apply)
 
 
 
 
 
Q15How was the above information provided to you? (please select all that apply)?
 
 
 
 
 
Q16Was the format of this information appropriate for you?
 
 
Q17Were you provided with information on what to do if you have concerns about the person that you care for?
 
Q18Did staff make you aware of dedicated services that are available to support you as a carer?
 
Q19Did staff make you aware of your possible rights to a carers assessment?
 
Q20Overall, how satisfied were you with the support you as a carer received from Pennine Care?
 
 
 
 
Q21
Q22
 
Q23
Q24
 
Q25Do you consider yourself to have a physical or mental health condition or disability?
 
 
Thank you for taking the time to share your experience.
Making the patient and carer voice loud and unmissable in Pennine Care
 
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