GoCo Home Care Package Client Survey
1.
Your age:
Under 65 years old
66-75 years old
76-85 years old
86-95 years old
Over 96 years old
2.
Is English your first language?
Yes
No
If no, please tell us your first language:
3.
Do you identify as an ABORIGINAL &/OR TORRES STRAIT ISLANDER?
Yes
No
4.
In which LOCAL GOVERNMENT AREA do you live?
Gunnedah Shire
Liverpool Plains
Moree Plains
Narrabri Shire
Tamworth Regional
5.
Please tick how you rank our support:
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
I am given the care and services that I need. (18)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
I understand my support choices, service agreement, support plan and the fees I have to pay.
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
I understand other information GoCo has provided (eg about how to complain and what my rights are).
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
I believe I am given choice in care and service provision. (22)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
The services provided to me are planned and reliable (eg assistance is provided on the days/times agreed). (19)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
I feel confident with the way the staff provide care and services to me. (17)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
Staff/volunteers support me to be independent and able to participate in my local community. (27)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
The staff know what is important to me and respect my needs and preferences (lifestyle, customs, culture, language and my religious and spiritual preferences). (24)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
Staff listen to me and respond quickly and sensitively to my needs. (25)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
I feel comfortable about making a complaint if I need to. (30)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
I am generally happy with the care and services I receive. (8)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
My quality of life has improved since the service started. (34)
Strongly agree
Agree
Unsure or neutral
Disagree
Strongly disagree
6.
Could we provide A BETTER SERVICE to you?
Yes
No
If Yes, how?
7.
If you would like GoCo to see your individual response please write your name here: