Service User Survey Date(Required) DD slash MM slash YYYY Name Post Code How do you rate your overall experience of this service?ExcellentPretty goodNeutralNot so greatTerrible1. Do the carers approach you politely? Yes No 2. Do the carers communicate with you properly? Yes No 3. Do the carers ask for your choice? Yes No 4. Are carers wearing full PPE? Yes No 5. Do the carers respect your privacy and dignity? Yes No 6. Are carers wearing full uniform and I.D? Yes No 7. Do the carers support you with all the tasks? Yes No 8. Are carers following correct handling procedures? Yes No 9. Do the carers prompt and support you with medication? Yes No 10. Do you need any extra support (accompany, hospital appointments, shopping calls etc.) Yes No 11. Are you happy with the overall service? Yes No 12. Do you have any concerns to discuss? Yes No Comments(Required)13. What does the service do well? 14. What could the service do better? 15. Would you like to add anything to your comments?