Emergency Social Work Team (ESWT) Out of Hours ServiceFeedback Form Survey

This short feedback form is designed to capture your feedback after using the services of Shropshire Council's Emergency Social Work Team. These questions shouldn't take long to complete but they will help us learn what is working well and how we can improve our services in the future. Please share your views and feel free to skip any questions you would rather not answer.

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* 1. When did you last contact us?

Date

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* 2. If you can't remember the date, please provide an approximate timescale.

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* 3. In which capacity did you contact us?

As a member of the public or someone open to social services

As a professional

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* 4. Did you contact us for....

Yourself

For someone you help or are concerned about (e.g. family, friend, neighbour, service user)

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* 5. Did you contact us in relation to....

An adult

A child

A mental health concern

Other (please specify)

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* 6. What type of support did you contact ESWT for?

Information or advice

A notification

Referral into a council service

Mental Health Act Assessment

Other assessment

Carers support

Signposting to another organisation/service

If you have selected other asessment, please explain which type below

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* 7. If you were signposted to another organisation, which did you need to contact?

NHS

Police

Housing

Voluntary sector service

Other, please describe

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* 8. Overall, how satisfied were you with the service from the Emergency Social Work Team (ESWT)?

Very satisfied

Satisfied

Neither satisfied or dissatisfied

Dissatsified

Very dissatisfied

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* 9. Please select the response that best fits your view below....

	Strongly agree	Agree	Neither agree or disagree	Disagree	Strongly disagree
My enquiry was dealt with my someone with the appropriate knowledge	My enquiry was dealt with my someone with the appropriate knowledge Strongly agree	My enquiry was dealt with my someone with the appropriate knowledge Agree	My enquiry was dealt with my someone with the appropriate knowledge Neither agree or disagree	My enquiry was dealt with my someone with the appropriate knowledge Disagree	My enquiry was dealt with my someone with the appropriate knowledge Strongly disagree
My enquiry was dealt with politely and professionally	My enquiry was dealt with politely and professionally Strongly agree	My enquiry was dealt with politely and professionally Agree	My enquiry was dealt with politely and professionally Neither agree or disagree	My enquiry was dealt with politely and professionally Disagree	My enquiry was dealt with politely and professionally Strongly disagree
The response was clear and easy to understand	The response was clear and easy to understand Strongly agree	The response was clear and easy to understand Agree	The response was clear and easy to understand Neither agree or disagree	The response was clear and easy to understand Disagree	The response was clear and easy to understand Strongly disagree
The response was efficient and without delay	The response was efficient and without delay Strongly agree	The response was efficient and without delay Agree	The response was efficient and without delay Neither agree or disagree	The response was efficient and without delay Disagree	The response was efficient and without delay Strongly disagree

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* 10. What was the result of the service you recieved? (Select all that apply)

I was able to access the service I needed

I obtained the information I needed

I made progress with an issue or referral

I had support in an emergency/ difficult situation

I received reassurance and felt better after speaking to someone

Other (please specify)

Emergency Social Work Team (ESWT) Out of Hours Service
Feedback Form

Question Title

* 1. When did you last contact us?

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* 2. If you can't remember the date, please provide an approximate timescale.

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* 3. In which capacity did you contact us?

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* 4. Did you contact us for....

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* 5. Did you contact us in relation to....

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* 6. What type of support did you contact ESWT for?

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* 7. If you were signposted to another organisation, which did you need to contact?

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* 8. Overall, how satisfied were you with the service from the Emergency Social Work Team (ESWT)?

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* 9. Please select the response that best fits your view below....

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* 10. What was the result of the service you recieved? (Select all that apply)

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* 11. Did anything not go so well, and do you have any suggestions for improvement?

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* 12. Please add any other comments you wish to make, including anything that did go well.