Customer Association Feedback Questionnaire - Tell us what you think?
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Customer Association - (Parent, Family Member, Friend, Unpaid Carer, etc)
As a whole, do you feel Darwin is run efficiently and effectively
Yes
No
If No, please explain why?
Are there any areas of service provision that we do particularly well?
Are there any areas of service provision what we need to improve in?
Do you feel that Darwin is an understanding, approachable and friendly company?
Yes
No
If No, please explain why?
How do you rate Darwin Communication with you?
Excelent
Good
Average
Poor
Very Poor
Unacceptable
Any additional comments?
Do you feel you can communicate with the following staff members.
Senior Management
Yes
No
Senior Support Workers
Yes
No
Support Workers
Yes
No
If you have answered No to any section above, please explain why?
Staff working for Darwin have the necessary skills, knowledge and training to fulfil their duties?
Yes
No
If NO, please can you explain why?
Do you feel that the support we give to our Customers is?
Person Centred:
1
2
3
4
5
Outcome Focused
1
2
3
4
5
Promotes Independence and Life Skills
1
2
3
4
5
Value for Money
1
2
3
4
5
Our Staff are well matched to Customers
1
2
3
4
5
Inclusive
1
2
3
4
5
Please rate the quality of accommodation provided
Welcoming
1
2
3
4
5
Presentable
1
2
3
4
5
Tidy & Clean
1
2
3
4
5
General Facilities
1
2
3
4
5
Size of Rooms
1
2
3
4
5
Size of Communal areas
1
2
3
4
5
Value for Money
1
2
3
4
5
Staff Professionalism
1
2
3
4
5
What would you like to see from Darwin in the Future?
How can we improve our engagement events?
If no, please explain why?/ Any additional comments
Suggestions or comments
Submit
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