We are committed to helping people live safe and fulfilling lives in their own homes.
This Self-Help Questionnaire is for anyone aged 18 or over who may find it increasingly difficult to look after themselves. For example, you or someone you know may be having difficulty getting in and out of the bath, managing stairs or with some aspects of personal care.
You can complete the questions for yourself or on behalf of someone else as we believe that you and those closest to you can best assess your needs. On completing the questionnaire you will be directed to relevant information that can support independent living,
Based on your answers, additional prompts will appear to fully understand personal circumstances. The questions are split into categories; if you don’t think a category is relevant, just move onto the next question. The amount of time to complete will depend on the answers given. You don’t have to complete the questionnaire in one go, you can save your partly completed questionnaire and return at a later point.
To allow you to do this we need your email address and we can send you a link to your questionnaire. Once completed, you will be provided with a summary of the information and advice available to support independent living based on the personal circumstances. Partly completed questionnaires and the summary of information and advice will be available for 30 days.