Adult Carer Survey
Which GP Practice are you registered with?
Which neighbourhood do you live in?
3. Is your GP practice aware of your caring responsibilities?
Please tell us who you care for :
How many hours a week do you spend caring for this person?
What type of support do you provide?
Have you received a carer's assessment?
If your answer is "No" or "Unsure" please speak to a contact officer at Manchester City Council on 0161 234 5001 to ask for an assessment
Please tell us your employment status
Please tell us how many hours a week you spend on doing something that is only for you:
If you use any community resources please tell which ones you use and the type of activity you do there (for example lunch groups, community centre, knit and natter, exercise classes, massage, befriending service, local walking group etc):
Please tell us about other activities or groups you would like to use that would support your health and wellbeing?
Please tell us what prevents you going to or using the above activities in question 11
Please tell us if you live with a long term condition?
Please tell us what the NHS and Social Care could do to support you in your caring role?
Are you aware of the existing support groups in the city that can support you in your role as a carer?
If you have answered “No” or “Unsure”, you can visit the Manchester Carers Network website at https://www.manchestercarersnetwork.org.uk/ or you can share your contact details if support is required. By sharing your contact details with us, you are giving consent for us to pass them to the Manchester Carers Network to contact you.
Are you aware that as a carer you are entitled to a short break?
Please tell us what training or development opportunities you would like to support you in your role as a carer.
Are you aware that as an unpaid carer you are entitled to a free flu vaccination?
Are you aware of the Emergency Carers Card in Manchester?
Do you feel as though you have enough information about the medication that the cared for person is currently taking?
If you have responded “No” or “Unsure” you can visit your local Pharmacy and ask for a medicine use review. The Pharmacist will be able to respond to any questions or queries.
Do you know who to contact should you require any aids, adaptations or equipment to support you in your role as a carer?
If you have answered “No” or “Unsure”, please contact Social Services on 0161 255 8250
As a carer do you feel that the cared for persons confidentiality is used as a barrier to you supporting the cared for person?
As a carer please tell us how often do you feel vulnerable?
If you are feeling vulnerable, you can contact {insert contact details of Carers UK/Samaritans/NHS 111
What is making you feel vulnerable?
Do you feel you are treated with dignity and respect by healthcare professionals?
if you answered "No" or "unsure" to the last question, please tell us about your experience
If the person you care for has had hospital treatment in the last year please tell us what worked well:
If the person you care for has had hospital treatment within the last year please tell us what you feel could be improved:
Please tell us the best way we can keep in touch with you:
Does the person you care for live with you?
Please tell us what health condition/s the person you care for lives with:
Has the person you care for had an assessment of their needs within the last year?
If you have answered “No” or “Unsure” please contact Manchester City Council on 0161 234 5001 to ask for an assessment.
Please tell us what support you feel the NHS and or Social Care can provide to help the person you care for manage their health and well-being.
5. Please tell us what support the looked after person would benefit from in their local community to support their health and wellbeing.