s
Please tell us your full name
(Your answers will not be linked to your name)
Maximum 255 characters
0/255
Please tell us your carer's full name
Are you happy with your shared lives arrangement?
No
Ok
Yes
Comments:
Maximum 20,000 characters
0/20,000
What do you think about the food you are given?
Not good
Excellent
Do you get to choose what you like to eat?
Never
Sometimes
Always
Can you choose when you have your short breaks?
Do you have all you need in the local area?
(for example: public transport / shops)
Nothing
Everything
Are you happy with the amount of time
your carer joins you for activities?
Is there a TV in your room?
Are your friends and family welcome to visit you?
Have you been given a house key?
Do you feel that your carer
understands and respects you?
Do you feel ok to talk openly with your
carers about any problems you may be having?
Are you happy with your bedroom?
(for example - is it big enough or decorated to your liking?)
Are you happy with how clean the
house is, including the bathroom?
Are there any other concerns or comments
you would like to tell us about?
Thank you for taking the time to tell us about your home life
