Creating Spiritually Enriching Opportunities for Lesbian, Gay and Bisexual Students on Campus
consultations.kent.gov.uk · Web viewHeterosexual Gay/Lesbian Bisexual I prefer not to say...
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Your Life, your well-being easy read questionnaire Hello, we would like to know what you think of ‘Your life, your well- being’. You can tell us on the internet at: www.kent.gov.uk/adultsstrategy or fill in this form. You can do this from the 30 September to 4 November 2016. 1. About you (please place a X) a) User of social care services ☐ b) Carer ☐ c) Family member of a service user ☐ d) A Social Care or Health professional ☐ e) Responding on behalf of an organization What is its name? Click here to enter text. ☐ KCC Social Care, Health and Wellbeing
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Transcript of consultations.kent.gov.uk · Web viewHeterosexual Gay/Lesbian Bisexual I prefer not to say...
Your Life, your well-being easy read questionnaire
Hello, we would like to know what you think of ‘Your life, your well-being’.
You can tell us on the internet at:www.kent.gov.uk/adultsstrategy
or fill in this form.
You can do this from the 30 September to 4 November 2016.
1. About you (please place a X)
a) User of social care services ☐
b) Carer ☐
c) Family member of a service user ☐
d) A Social Care or Health professional ☐
e) Responding on behalf of an organization
What is its name?
Click here to enter text.
☐
f ) Other (please tell us)Click here to enter text.
KCC Social Care, Health and Wellbeing
2. Did you understand the document?(please place an X)
Yes I understood it all☐
I understood some of it☐
I understood a bit☐
I did not understand any of it. ☐
Don’t know /not sure☐
3. Do you agree with our values and principles, as explained on page 13 of the document?
Person centered care and support
AgreeNeither agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐Supporting people to be safe
AgreeNeither agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐Promoting independence
KCC Social Care, Health and Wellbeing
Agree Neither agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐
PreventionAgree Neither
agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐Quality of careAgree Neither
agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐IntegrationAgree Neither
agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐Answering for what we doAgree Neither
agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐Best use of resourcesAgree Neither
agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐Please tell us what, if anything, you don’t agree with in the values and principles:Click here to enter text.
KCC Social Care, Health and Wellbeing
4. Do you agree with the proposed approach to care and support that we have set out in the three themes below?
promoting well-being promoting independence supporting independence.
Promoting well-beingAgree Neither
agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐Promoting independenceAgree Neither
agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐Supporting independenceAgree Neither
agree or disagree
Disagree Do not know
☐ ☐ ☐ ☐5. Please tell us what, if anything, you don’t agree with in the three themes:
Click here to enter text.
6. General commentsIf you have any other comments on the draft strategy, please providethem here:Click here to enter text.
9. Equality Impact AssessmentWe have completed an Equality Impact Assessment on the strategy. You can view it on the internet at: www.kent.gov.uk/adultsstrategyYou can tell us what you think here.Click here to enter text.
KCC Social Care, Health and Wellbeing
These questions are about you.You do not have to fill them in if you do not want to. We want to make sure that everyone is treated fairly and equally, and that no one gets left out.
That’s why we are asking you these questions.
We won’t share the information you give us with anyone else. We’ll use it only to help us make decisions, and improve our services. Please place an X in the box.
10. Are you…?Male ☐Female ☐Prefer not to say ☐
11. How old are you?
Click here to enter text.
I prefer not to say ☐12. What ethnic groups do you belong to? (Your ethnic group is about lots of things, such as where your family comes from and the language you speak).
Click here to enter text.
13. Do you have a disability? (A disability is if you have a problem or an illness to do with your mind or body, and it makes it hard for you to do everyday things).Yes ☐No ☐Prefer not to say ☐
KCC Social Care, Health and Wellbeing
13(a). If you have answered Yes to the question above, please tell us the disability or the impairment you have. You can tick more than one box.
Learning disability ☐Mental health condition ☐Physical impairment ☐Sensory impairment ☐Long-standing illness/health condition ☐I prefer not to say ☐14. Do you belong to a religion or belief?Yes ☐No ☐I prefer not to say
14(a). If you have answered Yes, which religion or belief do you follow?
Click here to enter text.
15. Are you?Heterosexual Gay/Lesbian Bisexual ☐I prefer not to say ☐Heterosexual Gay/Lesbian Bisexual ☐I prefer not to say ☐Thank you for filling in this form.Kent County Council (KCC) collects and processes personal information in order to provide a range of public services. KCC respects the privacy of individuals and endeavors to ensure personal information is collected fairly, lawfully, and in compliance with the Data Protection Act 1998.What do I do with this form?Save it and email it to us at: [email protected]
Alternative formatsIf you would like this document in anyother format or language, please email:[email protected] or call 03000421553. Text 18001 03000 421553.
KCC Social Care, Health and Wellbeing
