CAH Adult Social Care Charging Policy Review - ExtraCare Housing

South Gloucestershire Council is consulting on proposed changes to how we charge for ExtraCare Housing. Please refer to the Consultation Paper before answering the following questions; available via https://consultations.southglos.gov.uk/consult.ti/Extracarehousing/consultationHome

The closing date for this survey is 30 March 2016.

Q1	Please tell us if you are responding as one of the following?
	A service user		A resident of South Gloucestershire or other stakeholder (please go to Question 4)
	A family member/friend of a service user		A possible future user of these services (please go to Question 4)

Q2	Please tell us the ExtraCare housing scheme that you/your relative or friend lives in?
	Badminton Gardens, Downend		Nutfield House, Filton
	Cambrian Green Court, Yate		Springfields, Filton
	Falcon Court, Kingswood

	Other, please specify

Q3	How satisfied are you with the service you currently receive?
	Very satisfied		Dissatisfied
	Satisfied		Very dissatisfied
	Neither satisfied or dissatisfied		Don't know

Q4	How strongly do you agree or disagree with the proposal to change the charging bands to more closely reflect the level of service provided?
	Strongly agree		Tend to disagree
	Tend to agree		Strongly disagree
	Neither agree or disagree		Don't know

Q5	Please tell us how these proposals may impact on you?

Q6	Please leave any comments or thoughts you may have about the proposal to change the ExtraCare housing charging bands?

About You

Q7	Are you female or male?
	Female		Prefer not to say
	Male

Q8	What is your age?
	Under 60		75 to 79
	60 to 64		80 to 84
	65 to 69		85 +
	70 to 74		Prefer not to say

Q9	Do you consider yourself to be disabled?
	Yes		Prefer not to say
	No

Q10	Please tell us your ethnic origin
	Arab		Mixed/multiple ethnic group - Other
	Asian/Asian British - Bangladeshi		Mixed/multiple ethnic group - White & Asian
	Asian/Asian British - Chinese		Mixed/multiple ethnic group - White & Black African
	Asian/Asian British - Indian		Mixed/multiple ethnic group - White & Black Caribbean
	Asian/Asian British - Other		White - English / Welsh / Scottish / Northern Irish / British
	Asian/Asian British - Pakistani		White - Other
	Black/African/Caribbean/Black British - African		White Irish
	Black/African/Caribbean/Black British - Caribbean		Other
	Black/African/Caribbean/Black British - Other		Prefer not to say
	Gypsy or Traveller

Any personal information that you have supplied will be held by South Gloucestershire Council in accordance with the Data Protection Act. This information will only be used as part of this exercise and personal information will not be published or passed onto any other organisation.

Many thanks for completing the survey. Just click the SUBMIT button to send us your response.