East London Care and Support Feedback Form

Name

First NameLast Name
Email
example@example.com
1. Do you consider the service provided by East London Care and Support to be 'Safe’? where I am/my family member is protected from mistreatment and avoidable harm.

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5

1 is Strongly Disagree, 5 is Strongly Agree
2. Do you consider the service provided by East London Care and Support to be 'Effective'?, where the care and support I receive/my family member receives has positive outcomes. Staff promote a good quality of life using knowledge and experience.

1

2

3

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5

1 is Strongly Disagree, 5 is Strongly Agree
3. Do you consider the service provided by East London Care and Support to be 'Caring'? where staff are involved in my/ my family member’s care needs, treating me/ my family member with compassion, kindness, dignity and respect.

1

2

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5

1 is Strongly Disagree, 5 is Strongly Agree
4. Do you consider the service provided by East London Care and Support to be 'Responsive'? where the staff team are organised to meet my/my family member’s needs.

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5

1 is Strongly Disagree, 5 is Strongly Agree
5. Do you consider the service provided East London Care and Support to be 'Well-led'? where management of the team assures the delivery of high quality person-centred care, supports learning and innovation, and promotes an open and fair environment.

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5

1 is Strongly Disagree, 5 is Strongly Agree
6. Did the staff at East London Care and Support achieve the level of care we promised to you/your family member?

YesNo
7. Would you recommend East London Care and Support to a family member or friend?

YesNo
8. In your experience, how would you score the overall performance of East London Care and Support staff?

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5

1 is Poor, 5 is Outstanding
9. Do you think you can help with improving the care?

YesNo
10. What aspects of the care could we improve?
11. What else would you like to see added to your services?
East London Care and Support Feedback Form
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