About Personalisation in Enfield...

1.	How would you prefer to get information, advice or guidance about social care services? PLEASE SELECT ONE RESPONSE ONLY
	Visit the Council website
	Contact us by telephone
	At a library
	At a GP surgery / clinic
	Speak to someone in person
	Other

If 'other', please state

2.	Preventative services can help maintain a person's health, well-being and independence before reaching a stage where they need social care support. Which of the following would help you? PLEASE SELECT THE THREE OPTIONS YOU THINK ARE MOST IMPORTANT
	Health advice (e.g. information about living with specific conditions, healthy living, weight management, exercise classes)
	Equipment and minor adaptations (e.g. handrails, bath seat, walking stick)
	Assistive technology (e.g. fall detector, gas monitor, personal alarms)
	Financial advice (e.g. benefits advice, paying bills)
	Social activities (e.g. luncheon clubs, befriending clubs, peer support groups)
	Advice on keeping safe (e.g. personal safety, home safety and security, crime prevention)
	Advice on keeping your home warm
	Support to get out and about (e.g. community transport, someone to accompany you on shopping trips or when you go out)
	Volunteering
	Skills training (e.g. cooking classes, managing your finances, computer skills)
	Education and employment training (e.g. applying for courses and jobs, completing job applications)
	Practical help with things at home (e.g. minor repairs, gardening, paying your rent, managing bills)
	Other

If 'other', please state

The Council wants to encourage people to assess their own needs. In order to do this,

3.a	Would you prefer to: PLEASE SELECT ONE RESPONSE ONLY
	Complete an online self-assessment on the Council website
	Complete a self-assessment over the telephone
	Complete a written self-assessment form
	Complete a self-assessment with help from someone in person

3.b	If you think that you may need help to complete a self-assessment, who would you prefer to help you? PLEASE SELECT ONE RESPONSE ONLY
	I would prefer to complete this myself
	A family member or friend
	My unpaid carer
	My paid carer / personal assistant
	My social worker / care manager / health worker / key worker
	Someone from a community / voluntary group
	Someone from a support group
	An independent person acting on my behalf (e.g. advocate, solicitor)
	Other

If 'other', please state

4.	Who would you like to help you manage your Personal Budget? PLEASE SELECT ONE RESPONSE ONLY
	I would prefer to do this by myself
	A family member or friend
	My unpaid carer
	My paid carer / personal assistant
	My social worker / care manager / health worker / key worker
	Someone from a community / voluntary group
	An independent person acting on my behalf (e.g. advocate, solicitor)
	Other

If 'other', please state

5.	Advocacy is about helping people say what they want, secure their rights, represent their interests and obtain the services they need. If you needed advocacy, who would you want to support you? PLEASE SELECT ONE RESPONSE ONLY
	A family member or friend
	My unpaid carer
	My paid carer / personal assistant
	My social worker / care manager / health worker / key worker
	Someone from a community / voluntary group
	Someone from a support group
	An independent person acting on my behalf (e.g. advocate, solicitor)
	Other

If 'other', please state

6.	One of the ways in which the Council is planning to increase choice is by encouraging the development of services.  PLEASE SELECT THE THREE OPTIONS THAT YOU FEEL ARE THE MOST IMPORTANT TO YOU
	Personal care services (e.g. helping you wash, get dressed, get into and out of bed)
	Home services (e.g. helping you keep your home clean and with odd jobs around the house)
	Personal assistants to support you with a variety of things (e.g. doing your shopping, taking you out and providing personal care)
	Short breaks for unpaid carers
	Meals (e.g. preparation, shopping, home meals service)
	Alternative therapies (e.g. massage, reflexology, reiki)
	Leisure activities (e.g. swimming, tai chi, walking clubs, gym)
	Social activities (e.g. luncheon clubs, befriending clubs, peer support groups)
	Education and learning
	Computer training (e.g. how to use a computer, internet and email)
	Training for future employment
	Other

If 'other', please state

7.	What is the most important way to help people stay safe? PLEASE SELECT THE THREE OPTIONS THAT YOU FEEL ARE THE MOST IMPORTANT
	Information about paid carers / personal assistants (e.g. Criminal Records Bureau checks, training, qualifications)
	General information about providers (e.g. services they offer, size of organisation, costs, ratings and charter marks)
	Knowing how to report abuse
	Training for carers and personal assistants (e.g. how to lift and move people, giving medication, preventing accidents in the home)
	Support to manage a Personal Budget (e.g. recruiting a care worker / personal assistant, responsibilities as an employer, managing finances)
	Other

If 'other', please state

8.	Please use the space below to give us any other comments, concerns and suggestions that you may have about personalisation

About you...

9.	Please select the option which best suits your ethnicity
	White		Mixed
	Asian		Do not wish to state
	Black		Other

If 'other', please state

10.	Are you:
	Male		Female		Do not wish to state

11.	Do you consider yourself to have a disability or long-term illness?
	Yes		No		Do not wish to state

12.	Your age:
	16-19		60-69
	20-29		70-79
	30-39		80-89
	40-49		90 and over
	50-59		Do not wish to state

13.	Please select the postcode area you live in:
	EN1		N13
	EN2		N14
	EN3		N18
	EN4		N21
	EN8		N22
	N9		Other
	N11

If 'other', please state

14.	Do you: PLEASE SELECT ALL THOSE THAT APPLY
	Have access to the internet		Have a mobile phone
	Use email

15.	Do you: PLEASE SELECT ALL THOSE THAT APPLY
	Currently receive a social care or support service		Work in social or health care
	Provide care for someone as their unpaid carer (as a member of the family or a friend)		None of the above
	Live in Enfield

16.	How did you find out about this questionnaire? PLEASE SELECT ONE RESPONSE ONLY
	From the Enfield Council website		From a poster
	From another website		GP surgery / clinic
	Through my social worker / care manager		Library
	Voluntary / community group		Other
	An advert in the local paper

If 'other', please state

Thank you for taking the time to complete this questionnaire. The closing date for questionnaires is Friday 17 September 2010.

The results of this consultation will be available on the Enfield Council website in December 2010.

If you would like information about Adult Social Care services, please visit www.enfield.gov.uk or call the Customer Services Contact Centre on  020 8379 1000.

Prize Draw If you want to take part in the prize draw, please let us have your contact details below. Please be assured that the details you give us will only be used to contact you if you win a prize and will not be used for any other purpose. If you have won a prize you will be notified by Monday 1 November 2010.

17.	Name

18.	Address (and postcode)

19.	Phone number

20.	Email