CHC Feedback

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* 1. Are you a carer or person with CF?

I have CF

I am a carer

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* 2. What is the age of the person receiving CFWA Home Care services?

0-5

6-12

13-18

19-25

25+

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* 3. In the last six months, who has been your Home Care Worker (HCW)?

Frances Kwiatkowski

Sharon Alaga

Kate Tindall

Sophie Maffey

Heather Riley

Ishbel Macqueen

Hayley Fullarton

Natasha Cobb

Josephine Palladino

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* 4. Please rate the HCW service according to the following criteria:

	Poor	Average	Good	Excellent
How reliable is your HCW service? (always punctual and rarely cancels)	How reliable is your HCW service? (always punctual and rarely cancels) Poor	How reliable is your HCW service? (always punctual and rarely cancels) Average	How reliable is your HCW service? (always punctual and rarely cancels) Good	How reliable is your HCW service? (always punctual and rarely cancels) Excellent
How friendly and approachable is your HCW?	How friendly and approachable is your HCW? Poor	How friendly and approachable is your HCW? Average	How friendly and approachable is your HCW? Good	How friendly and approachable is your HCW? Excellent
Does your HCW act in a professional manner? (for example, shows respect, empathy and integrity)	Does your HCW act in a professional manner? (for example, shows respect, empathy and integrity) Poor	Does your HCW act in a professional manner? (for example, shows respect, empathy and integrity) Average	Does your HCW act in a professional manner? (for example, shows respect, empathy and integrity) Good	Does your HCW act in a professional manner? (for example, shows respect, empathy and integrity) Excellent
How competent is your HCW service? (Understands individual’s treatment routine)	How competent is your HCW service? (Understands individual’s treatment routine) Poor	How competent is your HCW service? (Understands individual’s treatment routine) Average	How competent is your HCW service? (Understands individual’s treatment routine) Good	How competent is your HCW service? (Understands individual’s treatment routine) Excellent
Does your HCW practice good infection control procedures in your home? (wears gown and performs hand hygiene appropriately)	Does your HCW practice good infection control procedures in your home? (wears gown and performs hand hygiene appropriately) Poor	Does your HCW practice good infection control procedures in your home? (wears gown and performs hand hygiene appropriately) Average	Does your HCW practice good infection control procedures in your home? (wears gown and performs hand hygiene appropriately) Good	Does your HCW practice good infection control procedures in your home? (wears gown and performs hand hygiene appropriately) Excellent
Is your HCW able to be flexible with their service delivery?	Is your HCW able to be flexible with their service delivery? Poor	Is your HCW able to be flexible with their service delivery? Average	Is your HCW able to be flexible with their service delivery? Good	Is your HCW able to be flexible with their service delivery? Excellent

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* 5. Please answer the following questions about your home care service:

	Not at all	Somewhat	Unsure	Quite a bit	Greatly
Has the HCW service helped to increase your knowledge of your CF health regimes?	Has the HCW service helped to increase your knowledge of your CF health regimes? Not at all	Has the HCW service helped to increase your knowledge of your CF health regimes? Somewhat	Has the HCW service helped to increase your knowledge of your CF health regimes? Unsure	Has the HCW service helped to increase your knowledge of your CF health regimes? Quite a bit	Has the HCW service helped to increase your knowledge of your CF health regimes? Greatly
Does the HCW service help to maintain or improve compliance with your care routine?	Does the HCW service help to maintain or improve compliance with your care routine? Not at all	Does the HCW service help to maintain or improve compliance with your care routine? Somewhat	Does the HCW service help to maintain or improve compliance with your care routine? Unsure	Does the HCW service help to maintain or improve compliance with your care routine? Quite a bit	Does the HCW service help to maintain or improve compliance with your care routine? Greatly
Does the HCW service help to improve quality of life for your family?	Does the HCW service help to improve quality of life for your family? Not at all	Does the HCW service help to improve quality of life for your family? Somewhat	Does the HCW service help to improve quality of life for your family? Unsure	Does the HCW service help to improve quality of life for your family? Quite a bit	Does the HCW service help to improve quality of life for your family? Greatly
Does the HCW service help you feel better supported?	Does the HCW service help you feel better supported? Not at all	Does the HCW service help you feel better supported? Somewhat	Does the HCW service help you feel better supported? Unsure	Does the HCW service help you feel better supported? Quite a bit	Does the HCW service help you feel better supported? Greatly
Do you think the HCW service enables you to better fulfill your day to day activities?	Do you think the HCW service enables you to better fulfill your day to day activities? Not at all	Do you think the HCW service enables you to better fulfill your day to day activities? Somewhat	Do you think the HCW service enables you to better fulfill your day to day activities? Unsure	Do you think the HCW service enables you to better fulfill your day to day activities? Quite a bit	Do you think the HCW service enables you to better fulfill your day to day activities? Greatly

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* 6. Please provide any additional comments/suggestions for this service.