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Last updated 18/08/10

ADVOCACY SERVICE - Questionnaire

We are committed to providing clients with the highest standard of service in terms of care support services. We also recognise the best practice recommendations of the National Care Standards. To this end the following questionnaire has been designed to establish if you are aware of the issues involved and if necessary to provide any assistance which may be required.

On Behalf Of:.

Home ...........: Manager/Matron:

Contact Name

e-mail.............. Telephone..........

Address..........

		Yes	No	Don't Know or N/A
1	Has a Social Services assessment been undertaken?
2	Is any nursing care required at present?
3	Has an application for Attendance Allowance been made?
4	If yes, is an entitlement to the higher rate allowance expected?
5	Has an entitlement to Pension Credit been established?
6	Is the value of assets excluding property less than the local authority support threshold?
7	Is a property owned?
8	If yes, has local authority support under the 12 week disregard rule been considered?
9	Has longer term funding from the local authority been investigated?
10	If local authority funding is to be provided, will this and other income meet the current fees payable?
11	Has a will been established?
12	Are any funeral arrangements in place?
13	Has a Power of Attorney been appointed or in the process of being appointed?
14	Do you have details of specialist support groups which may be appropriate? (ie Stroke Assn/Alz. Society etc)

CareAware which is a public information and advisory service specialising in issues relating to long term care for the older people. Its objectives are to improve public understanding and knowledge about the care system, to reinforce the rights and choices of the individual and to assist the public on the complex issues associated with care provision. CareAware will contact you in order to address the issues raised by the answers above.