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As someone whose relative/friend is currently under the care of Cygnet Health Care we would be most grateful to take a few moments to complete this satisfaction questionnaire. The information you provide will enable us ensure that the services we provide are of a high standard.

This form can be completed anonymously if you prefer.

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1. Name (optional)

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2. Service user's initials (optional)

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3. Please state the name of the hospital and ward where your friend or family member is being cared for:

  Hospital Ward
Hospital / Ward

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4. How satisfied are you that you were identified as a relevant person with an important caring role early in your friend or family member's admission?

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5. How satisfied are you that you received appropriate information about Cygnet when your friend or family member was admitted, or shortly afterwards?

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6. How satisfied are you that staff at the hospital have catered to any specific needs you may have as a carer? These may include cultural, religious or various practical needs.

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7. How satisfied are you that you know who to contact to express any concerns you may have about your friend or family member? This could include the ward manager, the named nurse, the social worker, etc.

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8. How satisfied are you that you had the opportunity to tell the care team about how your friend or family member used to be before they became unwell (or how they are when they seem to be coping well)?

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9. How satisfied are you that you that you have been able to tell the care team about your hopes and expectations for a positive outcome for your friend or family member?

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10. How satisfied are you that the care plans and medication management plans of your friend or family member have been explained to you?

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11. Are you aware of how to make a complaint if you needed to?

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12. How satisfied are you that staff are polite and approachable when you phone or visit?

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13. How likely are you to recommend the hospital to others who need this type of care?

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14. Cygnet want to support the families and friends of our service users. If you have any ideas how we can improve the support that we provide to you please comment below.

Thank you for taking the time to complete the Family and Friends Satisfaction Questionnaire.

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