All Age Carers Support Service Questionnaire Who do you provide care for? Family member Friend Other If other please tell us more What is the gender of the person you care for? Male Female Other If other please tell us more Is the person you care for an adult or child? Adult Child What is the age of the person you care for? 0-17 18-25 26-39 40-49 50-59 60-69 70-79 80-89 90-99 100+ Have you received support from any local organisation(s) or received support from anywhere else? Yes No Not aware of a local support organisation If yes, where was the support received from, and did you receive the right support at the right time? How valued do you feel by professionals, as a carer? Extremely valued Somewhat valued Neither valued or unvalued Somewhat unvalued Extremely unvalued Do your loved ones know you are caring for a family member, friend or neighbour? Yes No If yes, do they understand what a caring role involves? A young carer is someone under 18 who cares for a family member or friend. If you are a young carer, do you feel you are recognised as a young carer and your school, college and any other organisation or services will support you by providing support? Yes No As a carer do you feel there are barriers in reaching your potential at school, work, training? Yes No If yes, please explain the barriers you face. As a carer do you have time to enjoy things that you like doing, outside of your caring role, do you have the chance to have a break, have some time to yourself and to relax? Yes No If no, what would you like to be doing if you could? Do you feel mentally well to continue with your caring role? Yes No Do you feel physically well to continue with your caring role? Yes No Do you feel that there is information, advice and guidance available to help you in your caring role? Yes No If yes, do you think this information is the right information for you, is it readily available and you know where to go to find it? Yes No If yes, where do you find the information to help you? Do you feel that you can access breaks from your caring role, so you can rest and concentrate on your own wellbeing? Yes No What does good support look like to you? Please tick all of the support options you know about... Community Lounges Micro providers Day Opportunities Shared Lives Direct Payments Domiciliary care Other If other, please specify... Do you know how to access financial support, if needed? Yes No Do you know how to access employment support, if needed? Yes No Do you feel listened to by professionals, and have someone to go to, to be heard? Yes No If yes, who is it you go to? Do you feel in control to choose what is best for you and the person you care for? Yes No Are you aware of carer’s assessments which identify needs, personal outcomes, and the impact of a caring role on your wellbeing? Yes No If yes, do you know where to go for a carer’s assessment?