PCS - Client Satisfaction Survey

Client Satisfaction Survey

This Form can be anonymous should you prefer. It is not obligatory to input your Name should you wish for your review to remain anonymous.
We hope you will always feel able to raise any concerns you have about the services we provide to you. In order to be sure that we are giving you our best service we would be grateful if you would fill in this questionnaire so that we can identify any area for development in our overall service to you as a valued Service User.

We would appreciate it if you answered the questions openly and honestly. We assure you that your answers will be treated with strictest confidence by the management.

The summary of this survey will be made available to all Service Users, families, and employees, and will be given to the Care Quality Commission at their inspection, and will also be given to all those making enquiries relating to the service.

If any of the questions do not apply to the service you are receiving, please state 'NA' in the comments column.
When you first started with PCS, were you contacted by ourselves for an initial assessment?*

YesNoN/A
If No, please provide comments below and what actions you would like to be taken.
Do your Care Staff behave professionally within your home and are they presentable?*

YesNoSometimesN/A
If No or Sometimes, please provide comments below and what actions you would like to be taken.
Are your Care Staff respectful of your home and possessions?*

YesNoSometimesN/A
If No or Sometimes, please provide comments below and what actions you would like to be taken.
Do you feel comfortable and safe with your Care Staff?*

YesNoSometimesN/A
If No or Sometimes, please provide comments below and what actions you would like to be taken.
Do you feel you are treated with dignity and do staff respect your privacy?*

YesNoSometimesN/A
If No or Sometimes, please provide comments below and what actions you would like to be taken.
Are you happy with the Care Staff that visit you?*

YesNoSometimesN/A
If No or Sometimes, please provide comments below and what actions you would like to be taken.
Are the Office Team/Management helpful when you contact them and Do you feel able to request any changes to your care package?*

YesNoSometimesN/A
If No or Sometimes, please provide comments below and what actions you would like to be taken.
Do you feel the care you receive helps you maintain your independence and improve the Quality of your life?*

YesNoSometimesN/A
If No or Sometimes, please provide comments below and what actions you would like to be taken.
How would you rate care staff?*

(1 = Poor and 5 = Excellent)
How would you rate office staff/management?*

(1 = Poor and 5 = Excellent)
Would you recommend this service to your friends and family ?*

(1 = Poor and 5 = Excellent)
How would you rate the overall experience with PCS? *

(1 = Poor and 5 = Excellent)
Any other comments or feedback
Name

First NameLast Name
Thank you for your help with this survey. Your views and comments are helpful to us to help us identify those things we do well, but more particularly those things that we can improve for you. Your compliments are very much appreciated, as are your suggestions and observations about how we can do things better.
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