MARKET RESEARCH – Project In Home Care

We are looking for people who receive care in their home due to a long term condition to take part in an in home interview for 1 hour about care services.

Please answer the questions below.

Name:

Telephone number:

Home Postcode:

Age:

Occupation:

Job Title:

Industry:

Working status i.e. full time, part time, etc

Occupation and job title of chief income earner in the household:

Who do you live with at home?

If you have children, please tell us their ages.

Do you receive care from someone in order to remain living independently? Yes/No?

Is care provided for you due to a long term condition? Yes/No. Please specify the long term condition that you receive care for.

Which of the following tasks/activities do you require help with on a regular basis?

• Cooking
• Preparing food
• Eating
• Drinking
• Household chores and housework
• Personal hygiene
• Mobility

Have you undergone means testing with your local authority – in other words have they told you whether the local authority will pay for all or some of your care costs?

• Yes – the local authority will be paying for all my costs
• Yes-I will be paying some of these costs myself
• Yes-I will be paying all these costs myself
• No-I have not undertaken means testing because I will be paying these costs myself
• No – I have not yet undertaken means testing/I am awaiting confirmation

Please forward this on to anyone you know who may be interested.
 

Unfortunately, it is impossible to reply to all emails or phone messages.   We receive lots of responses to researches that are emailed out. You will be contacted by phone if your application is successful. However, we apologise if you do not hear from us, but please keep trying for future projects that are sent out.

We look forward to hearing from you.
 
Kind regards,
 
 
Daliah Salem
trend MARKET RESEARCH LTD