Survey of your individual experience of Saint Francis Hospice services

1. Your experiences at Saint Francis Hospice

 

1. Please indicate if you are the following (please tick those that apply):

 

2. Please tick one box only next to the statements below, to indicate if you strongly disagree, disagree, agree or strongly agree.

Strongly DisagreeDisagreeAgreeStrongly Agree
Overall my experience of using hospice services was good
Whilst using hospice services adequate written information was available
Telephone calls were dealt with adequately and I was satisfied with the response
Staff and volunteers were polite, friendly and at all times professional
Privacy was respected at all times
Dignity was respected at all times
I felt I was appropriately assessed and offered the services I needed at the time
I was given time to ask questions or raise concerns
Physical needs were met at all times by hospice services
Cultural needs were respected and met at all times by the hospice.
 

3. Where did you or the person you cared for receive the care and services of Saint Francis Hospice?

 

4. Was this the place of their choice?

 

5. I used the following services during the DAY and found them useful (please score only those services you used)

Strongly DisagreeDisagreeAgreeStrongly Agree
Inpatient Unit / the Ward
Day services at Pemberton Place / outpatient clinics / group sessions
Visit from the Specialist Community and Crisis Support Team
Advice on the telephone from the Specialist Community and Crisis Support Team
Hospice at Home from 9am to 5pm
Physiotherapy
Complementary Therapy
Occupational Therapy
Pastoral Care Team
Family Support Services Bereavement Service
Several of the above services
 

6. I used the following services during the EVENING and found them useful (please score only those services you used)

Strongly DisagreeDisagreeAgreeStrongly Agree
Hospice at Home from 5pm to 9pm
Support from the Specialist Community and Crisis Support Team
 

7. I used the following services during the NIGHT and found them useful (please score only those services you used)

Strongly DisagreeDisagreeAgreeStrongly Agree
Hospice at Home from 10pm to 7am
The Inpatient Unit for advice on the telephone
Support from the Specialist Community and Crisis Support Team
 

8. Please tick one box only next to the statements below, to indicate if you strongly disagree, disagree, agree or strongly agree.

Strongly DisagreeDisagreeAgreeStrongly Agree
I was satisfied with the practical nursing care offered by hospice services
I was satisfied with the emotional support offered by hospice services
I was satisfied with the equipment offered by the hospice
If applicable: I was satisfied with the information provided to me at the time of the death of my loved one
Thinking back on my overall experience of hospice services, I was satisfied with the care and support offered
I would recommend your services to friends and family if they need similar care
 

9. Do you have any comments or suggestions to help us in the further development of our services?

 

10. If there are any parts of our service that you were unhappy with (i.e. a score of 1 or 2) we would be grateful if you would provide us with details. If you would like to discuss these, please provide us with your name and contact details.

 

11. Do you have any comments on the content or style of this survey?

 

12. Would you like us to contact you to discuss further any comments you have made to the above questions? If yes, please provide us with an email address to contact you on.

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