New Life Aged and Disability Care Participant Feedback We value your feedback. This survey is designed to be simple, respectful, and easy to complete on phone, tablet, or computer. Estimated time 3–5 minutes Format Multi-page survey Step 1 of 6 Participant Details Name of participant * Form filled in on participant’s behalf by a parent/carer? * Yes No Can the participant speak? * Yes No Rights If you have a problem at New Life Aged and Disability Care programs or work do you speak up? * Yes No If someone hurt you would you tell someone at New Life Aged and Disability Care? * Yes No Since the last survey has anyone from New Life Aged and Disability Care hurt you? * Yes No Since the last survey has anyone from New Life Aged and Disability Care spoken to you in a way that made you feel bad? * Yes No If yes, please let us know what happened Participation and Inclusion Are you happy with the activities you do at New Life Aged and Disability Care? * Yes No Do you get to choose which activities you want to do? * Yes No Would you like to learn new skills? * Yes No Individual Outcomes Did you talk about your Support Plan with New Life Aged and Disability Care staff? * Yes No Are you happy with your Support Plan? * Yes No Feedback and Complaints Do you know about New Life Aged and Disability Care’s Advocates? * Yes No Do people at New Life Aged and Disability Care try to help if you have a problem? * Yes No Service Access Are you new to any of New Life Aged and Disability Care’s programs or services? * Yes No If you are new, did you find New Life Aged and Disability Care staff helpful in explaining to you what you can do? * Yes No Service Management Do you feel New Life Aged and Disability Care staff understand your needs? * Yes No Do New Life Aged and Disability Care staff treat you with respect? * Yes No Would you feel comfortable bringing up any issues/ideas with Managers or the CEO? * Yes No What (if anything) do you like about New Life Aged and Disability Care? Has New Life Aged and Disability Care provided you with a handbook, including offering to get through it? Do you feel safe when being supported by New Life Aged and Disability Care, and whether staff act professionally at all times when providing support? Does New Life Aged and Disability Care and its staff respect your cultural and religious beliefs? Have you been told about the Service User Representative group and its purpose / functions? For Families & Carers In what way can New Life Aged and Disability Care improve support for you, or your son/daughter? Has New Life Aged and Disability Care provided information on the types of services we offer? Has New Life Aged and Disability Care provided you with information on the services you receive and how often you receive them? Any further Comments: Independent Advocate Do you need to speak to an independent advocate about any concerns you have right now? * Yes No If yes, please write your name Contact phone number Previous Next Submit Survey
