High Peak Consultation Questionnaire

High Peak Consultation Questionnaire

Derbyshire Carers Association is running a Consultation Project across the High Peak until the end of 2023. The High Peak Consultation Project has two main aims: firstly to listen to and record the experiences of carers in High Peak, and secondly to make ‘best practice’ recommendations for future service provision, based on carers’ feedback. The questions below have been informed and inspired by interviews with carers. It would be very much appreciated if you could take a few moments to answer the survey, as the more carers who respond, the more accurately Derbyshire Carers Association can respond to any concerns or feedback that you have. Answers may be quoted in the Consultation Project’s final report, but any identifying features will be removed, and all answers are anonymous. If you would like to get more involved with the Consultation Project, then please ring Emma Beestone on 07816 283550 or email emma.beestone@derbyshirecarers.co.uk Thank you.
Who do you care for (please tick all that apply)?

SpouseParentChildOther family memberFriendNeighbourOther
If other, please specify
Why does the person (or people) you care for, need your support?

Physical health conditionMental health conditionSensory impairmentLearning disabilityAutismDependence on alcohol or drugsOther
If other, please specify
How many years have you been caring for?
How many hours a week do you provide care/support?

0-9 hours10-19 hours20-34 hours35-49 hours50-100 hoursMore than 100 hours
How well do you feel that you are coping well with your caring responsibilities?

Very wellFairly wellCoping some of the timeNot very wellNot at all
Do you feel that caring has had impact on your own mental health?

Significantly improved my mental healthSlightly improved my mental healthNeither negatively nor positively affected on my mental healthSlightly worsened my mental healthSignificantly worsened my mental health
Do you feel that caring has had impact on your own physical health?

Significantly improved my physical healthSlightly improved my physical healthNeither negatively nor positively affected my physical healthSlightly worsened my physical healthSignificantly worsened my physical health
Do you have a disability?

YesNoPrefer not to say
Are you happy to continue caring in the future?

YesYes, with the right support in placeNoMaybeSometimes
Do you worry about your ability to continue caring in the future (please tick all that apply)?

Yes, because of my own mental healthYes, because of my own physical healthYes, because of a deterioration in the mental health of the person I supportYes, because of a deterioration in the physical health of the person I supportNo
Do you have a plan in place for what happens to the person you look after if you become unable to support them? (e.g. Emergency plan/ agreement with another relative etc.)

YesNo, I do not worry about becoming unable to support themNo, but I do worry about what would happen if I became unable to support themNo, but I would like to put a plan in place
Have you had any respite in the last 12 months?

Yes, daytime onlyYes, overnightNo, I haven’t wanted anyNo, I haven’t been able to access any
If yes, how was this respite organised?

Through Adult Social CareThrough the NHSPrivately, through an agencyThrough a charity (such as Carefree)Another friend or family member took overOther
If other, please specify
If respite was organised through Adult Social Care or the NHS, were you given enough notice of when the respite would be available?

Yes, plenty of noticeYes, some noticeNo, not enough noticeNo notice
Do you feel that the respite offered catered to the needs of your cared for?

YesNo
If no, please specify why
Do you feel well supported in your caring role?

YesNoSometimes
Who do you think offers you the most support as a carer (please tick all that apply)?

Peer SupportFriends, family and neighboursDerbyshire Carers AssociationGPAdult Social CareHospital TeamCommunity teams (including Community Mental Health Team)District NursesAdmiral NursesPalliative care/hospice supportWebsitesHelplinesOtherI do not get any support as a carer
If other, please specify who
Do you feel let down by the support offered by any of the following (please tick all that apply)?

Peer SupportFriends, family and neighboursDerbyshire Carers AssociationGPAdult Social CareHospital TeamCommunity teams (including Community Mental Health Team)District NursesAdmiral NursesPalliative care/hospice supportWebsitesHelplinesOtherI do not get any support as a carer
If other, please specify who
Do you feel adequately consulted, and that your opinion is respected, when professionals are making decisions about your friend/family-member’s care?

YesNoSometimesDepends on the service
Do you feel that there is good communication between all professionals involved in your friend or family member’s care?

YesNoSometimes
Do you feel well informed about what support is available to you?

YesNo
Do you feel well informed about what support is available to your friend or family member?

YesNo
How would you like information about support services to be communicated?

Over the phoneVia Text messageVia WhatsAppVia emailOn the webIn personVia postOther
If other, please specify
What is most likely to stop you accessing a support service?

DistanceCostAppropriateness of supportResistance of friend/family member that I am caring forLack of timeInability to leave friend/family-member unattendedLack of interestOther
If other, please specify
Do you worry about money?

YesNoSometimesPrefer not to answer
If you have completed any benefit forms on behalf of yourself, or the person you care for, did you find them easy to understand and complete? (e.g. Carers’ Allowance, PIP, Attendance Allowance)

YesNo
If no, please say why
Has being a carer had a positive impact on your own life?

YesSometimesIn some waysNo
If you answered a), b) or c) to the above question, what is the greatest positive about being a carer?
What do you find most challenging about being a carer?
What single change would make the biggest difference to your ability to care in the future?
If you require any support as a carer, please don't hesitate to contact Derbyshire Carers Association on 01773 833833.
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