Carers' Survey

Carers' Survey

INFORMATION - This section should be completed with the carer.








IDENTIFY & ASSESS NEEDS OF THE CARER - To be completed by carers and staff/volunteer together. Discuss each question, even if no needs or concerns are identified.


THE CURRENT CARING SITUATION - To be completed with the carer. Please indicate the level of support (Low, Medium, High) you require with the following.















THE CARERS HEALTH & WELL-BEING - Please indicate the level of support (Low, Medium, High) you require with the following.
















MAKE A PLAN TOGETHER - Use this section to briefly note the details of alerts requiring action now, any actions taken today, and any next steps which have been agreed.
NEXT REVIEW - Agree a review date with the carer and the person responsible for follow-up. All questions should be revisited during a review to monitor the support provided and any change in the alerts. It is recommended that review dates be more frequent for carers which indicated more 'Medium' or 'High' responses in the survey.

We’ll only use your phone number or email address to contact you about this request. However, from time-to-time we’d also like to keep you updated about our work. Please tick your contact preference if you’d like us to keep in touch. Read our privacy policy here.