Your Experience in Milford Care Centre

Please rate your experience of the time you spent in Milford Care Centre.

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* 1. Please tick the service(s) you were involved with.

Hospice

Hospice at Home (Community)

Nursing Home

Day Care (Older Person)

Day Care (Palliative Care)

Bereavement Support Service

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* 2. Are you currently or have you been a?

Patient / Resident / Client

Spouse / Partner

Family

Visitor

Other (please specify)

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* 3. Please tick the box which best describes your experience in Milford Care Centre.
The information you provide will be used to improve the quality of our service.

	Excellent	Good	Reasonable	Poor	Very Poor	Not Applicable
Your welcome and admission was:	Your welcome and admission was: Excellent	Your welcome and admission was: Good	Your welcome and admission was: Reasonable	Your welcome and admission was: Poor	Your welcome and admission was: Very Poor	Your welcome and admission was: Not Applicable
The care you received in Milford Care Centre was:	The care you received in Milford Care Centre was: Excellent	The care you received in Milford Care Centre was: Good	The care you received in Milford Care Centre was: Reasonable	The care you received in Milford Care Centre was: Poor	The care you received in Milford Care Centre was: Very Poor	The care you received in Milford Care Centre was: Not Applicable
Explanations about your treatment and care were:	Explanations about your treatment and care were: Excellent	Explanations about your treatment and care were: Good	Explanations about your treatment and care were: Reasonable	Explanations about your treatment and care were: Poor	Explanations about your treatment and care were: Very Poor	Explanations about your treatment and care were: Not Applicable
Staff listened respectfully to your concerns and opinions:	Staff listened respectfully to your concerns and opinions: Excellent	Staff listened respectfully to your concerns and opinions: Good	Staff listened respectfully to your concerns and opinions: Reasonable	Staff listened respectfully to your concerns and opinions: Poor	Staff listened respectfully to your concerns and opinions: Very Poor	Staff listened respectfully to your concerns and opinions: Not Applicable
Provision of information was:	Provision of information was: Excellent	Provision of information was: Good	Provision of information was: Reasonable	Provision of information was: Poor	Provision of information was: Very Poor	Provision of information was: Not Applicable
Respect for privacy and dignity was:	Respect for privacy and dignity was: Excellent	Respect for privacy and dignity was: Good	Respect for privacy and dignity was: Reasonable	Respect for privacy and dignity was: Poor	Respect for privacy and dignity was: Very Poor	Respect for privacy and dignity was: Not Applicable
The standard of catering was:	The standard of catering was: Excellent	The standard of catering was: Good	The standard of catering was: Reasonable	The standard of catering was: Poor	The standard of catering was: Very Poor	The standard of catering was: Not Applicable
The environment in which the care was provided was:	The environment in which the care was provided was: Excellent	The environment in which the care was provided was: Good	The environment in which the care was provided was: Reasonable	The environment in which the care was provided was: Poor	The environment in which the care was provided was: Very Poor	The environment in which the care was provided was: Not Applicable

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* 4. Do you have any suggestions you feel may improve our service?

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* 5. Do you have any general feedback or comments for us?