Out of Hours Care Survey 1. Default Section Question Title * 1. Where in NSW do you live? Central and Eastern Sydney Northern Sydney Western Sydney South Western Sydney Southern Sydney North Coast of NSW The Hunter Central Coast Blue Mountains Illawarra South Coast New England North West Central NSW Capital Country (area surrounding the ACT) Snowy Mountains Far West Riverina/ Wagga Wagga The Murray/ Albury Question Title * 2. How many hours of personal assistance do you receive per week from an outside service provider? 0- 5 hours 6- 10 hours 11- 15 hours 16- 20 hours 21- 25 hours 26- 30 hours 31- 35 hours 36- 40 hours In excess of 40 hours Question Title * 3. What are your living arrangements, are you living? Alone With partner With family members Sharing with others Group home Other (please specify) Question Title * 4. What outside service provider provides the majority of your personal assistance? Not applicable Home Care of NSW Commercial agency Question Title * 5. Approximately how many times in the last 12 months have you not been serviced for personal assistance by your service provider? 0- 5 occasions 6- 10 occasions 11- 15 occasions More than 16 occasions Question Title * 6. At what days of the week and at what times are you most likely to experience problems with receiving personal assistance Monday Tuesday Wednesday Thursday Friday Saturday Sunday Question Title * 7. What time of the day are you most likely to experience problems? Before working hours Early evening from say 5.00 pm to 8.00 pm From 8.00 pm to midnight Question Title * 8. In an emergency, do you have access to a service provider that will cover an unattended personal assistance service, and if so what type of service provides this? Unable to access service provider Out of Hours Access to an Out of Hours coordinator through the commercial service provider Access to the Out of Hours Emergency Respite Service operating in the Botany/ Randwick local government areas Question Title * 9. Under what circumstances have you not been serviced? (tick as many as applicable) Incorrect roster Support worker delayed Support worker unable to attend and vacancy not filled Out of Hours facilities not available Out of Hours coordinator unable to fill vacancy Not sure Other (please specify) Question Title * 10. When you have not received personal assistance service, under what circumstances has this left you? Question Title * 11. For anyone with access to the Out of Hours Emergency Respite Service please comment on how this service has this benefitted you? Done