Care Service Feedback Form Care Service name * Your name * First Name Last Name Why did you choose to participate in the Adopt a Grandparent programme? * It is a good initiative to support recipients of care It shows innovation It supports people who are lonely and isolated I hope it will help us to achieve Good or Outstanding CQC inspections It is a good addition to our activity programme Other Have you seen value in being a part of the programme? * Yes No Please provide detail: Have you had a CQC inspection since starting AAG? * Yes No If yes, was Adopt a Grandparent mentioned in the report and what did the report say about the programme? Did you find the programme easy to set up? * Yes No Please provide detail: Have you seen a positive change in participating residents’ cognition? * Yes No If yes, please specify Have you seen a positive change in participating residents’ mood? * Yes No If yes, please specify Have you seen a positive change in participating residents’ interaction with activities and daily life? * Yes No If yes, please specify Have you seen a positive change in participating residents’ physical abilities? * Yes No If yes, please specify Would you say you've had a positive experience with the Adopt a Grandparent programme? * Strongly Disagree Disagree Neutral Agree Strongly Agree Is there any other feedback that you would like to give us that hasn't been covered in the questions above? Thank you!
