Client Survey Client Survey Date Survey Completed:(Required) DD dash MM dash YYYY Clients Name:(Required) First Last Client Area:(Required)NewcastleCastlewellanSeaforde/Loughinsland/BallykinlarDrumanessBallynahinchBelfastDownpatrickCrossgarKillyleaghSaintfieldBallygowanComberDundonaldSurvey Completed With: Client as listed above NOK Other Please list the Name of NOK or other person completing survey on behalf of client: 1. Do you feel satisfied/happy with the quality of care you are receiving from our carers and Lydian Care at this time?(Required) Yes No 2. On a scale of 1 being excellent, 2 being good, 3 being fair and 4 being poor how would you rate the quality of the care you receive?(Required) 1. Excellent 2. Good 3. Fair 4. Poor 3. Are your carers wearing their PPE/Protective equipment(for example apron, gloves and or mask when required) when they attend your calls?(Required) Yes No 4. Do you feel the carers attending your calls, treat you with dignity and respect?(Required) Yes No 5. On a scale of 1 being excellent, 2 being good, 3 being fair and 4 being poor how would you rate the dignity and respect shown?(Required) 1. Excellent 2. Good 3. Fair 4. Poor 6. Have you ever had a late or missed call?(Required) Yes No 6.2 – Was this reported to the office?(Required) Yes No 6.3 Please detail if it was a late or missed call and how it was reported.(Required)7. Do you know who to contact if you have a concern regarding your package of care?(Required) Yes No 8. Any Additional Comments(Required)
