Your experiences and ideas are important to us at Inclusion Gloucestershire
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Why are we asking?
Inclusion Gloucestershire will be writing a new strategy (a big plan) to guide our work for the next three years.

We want to know what is important or worrying to you so we can think about this when we write our strategy.

We are asking a lot of people to tell us their views, this includes people with lived experience of disability or mental health conditions, family carers, people who work in health and social care and other organisations and our staff and trustees.
The sections of the survey
This survey has 4 sections.

Section 1 asks you about worries you may have in various parts of your life and the support you may get.  We would like everybody to answer these questions please.

Section 2 has some questions about you and who you are and where you live etc and we are asking about this so we can see if different people are concerned about different things. We would like everybody to answer these questions please.

Section 3 has some more detailed questions about the different areas we have asked about. If you have time, we would really like to understand your experiences more but if you are short of time, you can skip all or some of these questions - it really is up to you.

Section 4 asks about your contact details but you do not have to give us these if you don't want to. If you do give us your contact details, we can stay in touch with you.
Consent
Before we get started, we want to check that you agree to take part. Taking part is voluntary and you can stop at any time.

All of the information we collect will be kept securely by Inclusion Gloucestershire and Google Forms who are helping with the research.
We will not use any of your personal details (if you give them to us) in any reports we write.

If there are questions you do not want to answer, you can leave them blank.

Are you willing to take part in the survey? *
If you are supporting someone else to fill in this survey, please tell us.
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Filling out the survey
If you feel whilst answering the questions, that you may need help or advice on any of the topics, please look at these websites where you might find information to help.

https://www.yourcircle.org.uk

https://www.bewellglos.org.uk

If you can not get the information you are looking for then you can contact Dawn on dawnc@inclusion-glos.org  or 07525 847382 and she will try to help you or let you know about other organisations who may be able to help.

If you do not have lived experience yourself, please answer the questions on behalf of people you know who have lived experience of disability or mental health conditions.

If you would like this survey translated into another language please email Dawn on dawnc@inclusion-glos.org or call her on 07525 847382.

If you would like an paper copy of  an easy read survey,or a paper copy of this survey, please email info@inclusion-glos.org or call our office on 01452 234 003.

If you would like someone to call you to talk with you about the survey  and fill it on your behalf please email dawnc@inlcusion-glos.org or phone  07525 847382.

The survey will close at 5.00 p.m.on Tuesday 20th July 2021.
What will we do with the information you give us?
We will write a report about what you and other people  have told us in this survey but the report will not have any personal details in it like your name or contact information.

We will put the report on our website and share it on social media so people know what we have been told is causing concern or worries to people in Gloucestershire.

We will use the information to help us write our next big plan.
Section 1 - Are you worried about parts of your life and support?
We would like everybody to fill out this section.

This section will ask you if you are worried about parts of your life and support. It will help us to understand what things are most important to disabled people and people with mental health conditions.

1. Are you worried about accessing the health care you need? This might include your GP, hospital or treatment and therapy sessions?
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2. Are you worried about accessing support and help for your mental health and well-being?                                      
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3. Are you worried about Long Covid? Long Covid is a name to describe symptoms that people may have a long time after they have had Covid.  
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4. If you need help from the social care team, are you worried about being able to have a social care assessment or a review of your support?    
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5. Are you worried  about getting access to advocacy support if you feel you need it? Advocacy is speaking up for yourself or asking other people to speak up for you.
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6. Are you worried  about your finances? This might include the money you have coming in or bills you have to pay or debts you might have.
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7. Are you worried about your housing? This might be worries now or for the future.
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8. Are you worried about getting support to find and maintain paid work or unpaid voluntary roles?  
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9. Are you worried about getting  support to find ways to learn new things? This may be a course at a college or joining a group to learn a new skill or hobby.  
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10. If you are at school or college now, are you worried about the support you are getting?  
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11. Are you worried about your access to leisure and social activities?  
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12. Are you worried about being able to have regular contact with friends, family and other people who are important to you?
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13. If you are an unpaid or family carer, are you worried about the support you receive in this role? This might include breaks from your caring role.  
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14. If you are an unpaid carer, are you worried about being able to get a social care assessment or a review of your needs as a carer?  
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15. Are you worried about sharing concerns, complaints or compliments with any of the organisations who you are supported by?  
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16. Are you worried about the services you receive, being able to provide you with the support you need and  recognising your individual cultural needs?  
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17. Are you worried that you have been discriminated against in the last year?  Discrimination is if you are treated differently because of who you are. This may be because you are disabled or because of your sexuality or because of your culture or religion. It may also be because of your age or your gender or because you are pregnant. It may also be because you are married or in a civil partnership.
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18. Are you worried about about getting accessible information to meet your needs? This could be information from any organisations or services that you use e.g. councils, GP's, banks, leisure centres, buses etc.  
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19. Are you worried about difficulties you may have in accessing services and facilities? This could be difficulties in getting into buildings, understanding the signs in buildings, lighting being too bright, no hearing loops etc. This could be any organisations or services that you use e.g. councils, GP's, banks, leisure centres, buses etc.
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20. Are you worried about your access to technology? This may be equipment like laptops, tablets and smart phones or it may be technology to help you be more independent like heating controls that you can talk to.
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21. Are you worried about how safe you feel when you are not in your home?
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22. Are you worried about how much exercise you are taking? Exercise may be taking a walk or going to a class or sporting activity.
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23. What is the one thing that is causing you most concern at this time? Please tell us more about this and share your ideas about how Inclusion Gloucestershire might be able to help with this.
Thank you. Please fill out Section 2
Section 2 - Questions about you
We would like everybody to fill out this section.

This section will ask you information about you, things like your age, ethnicity, which area you live in etc.

It will help us to understand which things are causing worry to different people.
What is your gender identity?
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Do you identify as trans/transgender?
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What is your sexual orientation?
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How old are you ?
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Is English your first language?
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Please tell us your ethnicity
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Please tell us if you have lived experience of any of these? If you have lived experience in more than one area, please list them all in the "other" section.
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Which area of Gloucestershire do you live in?
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Are you a member of Inclusion Gloucestershire?
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Have you been using any of Inclusion Gloucestershire's services in the last 6 months? This might be the Inclusion hubs, drama group, advocacy support, speak up groups or MHELO (Mental Health Experience Led Opportunities).
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Thank you. If you do not have time to tell us any more information at this time, please scroll down to Section 4 to tell us your personal details if you want to. Or you can scroll down now to the bottom of the form and press submit.
Section 3 - More detailed information
You only need to fill out this section if you want to tell us more and you have time.

This section will ask you more detailed questions about aspects of your life including your care and support, your home and money, work, volunteering , learning, leisure and choice and control.

You can tell us about good things or not so good things and we really would really like to have this detailed information if you have time.

This information will help us to understand your experiences in more detail.

If you do not want to fill out this section please move to section 4 and tell us about your contact details if you want to.

If you don't want to tell us your contact details, then please scroll down to the bottom of the form and press submit.
Your health, care and support
23. Please tell us if you have experienced any difficulties in accessing the health care you need.
24. Please tell us if you have  experienced any difficulties in accessing support and help for your mental health and well being.
25. How easy is it for you to get health screening appointments (things like smear tests, cholesterol tests)  and health checks?
Not easy at all
Very easy
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26. Please tell us of any difficulties you have had getting health screening or health checks. This can include difficulties when you were having the checks as well as organising them.
27. If you are concerned about getting a social care assessment or review, what are your concerns?
28. If you have support from social care, has the amount of planned support that you have changed in the last year?
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29. Please tell us about any changes that have happened in your social care support and how you feel about them.
30. If you have support from social care, please tell us what you think about how much you pay towards this and how this is worked out.
31. If you have wanted advocacy support and not been able to get it, please tell us more.
32. If you have had advocacy support, can you tell us what support you had and how it worked for you.
Your home and your money
33. If you are concerned about your finances, can you tell us what your concerns are? This might be to do with how to claim benefits, worries about debts, or other things like you have lost your job.
34. If you have worries about housing, please tell us more.
35. Please tell us about where you live now. When we talk about formal support, we mean from paid carers who may work for you as a Personal Assistant or may work for a care agency.
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Work, volunteering, learning and leisure
36. Please tell us about whether you are working or volunteering at the moment
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37. If you have had support to find and maintain paid work or unpaid voluntary roles, how good was it?
Not at all good
Very good
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38. Please tell us about your experiences in getting support to find paid work or unpaid voluntary roles.
39. If you have had support to find ways to learn new things (like a new skill or hobby) to learn about, how good was it?
Not at all good
Very good
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40. Please tell us about your experiences in getting support to find ways to learn new things.
41. If you go to school or college, please tell us more about the support you get in school or college.
42. How happy are you with your access to leisure and social activities?
Not at all happy
Very happy
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43. Please tell us about your experiences of accessing leisure and social activities. This might be good or bad experiences.
Friends and family
44. How happy are you with your current contact with friends, family and other people who are important to you?
Not at all happy
Very happy
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45. Please tell us of anything that gets in the way of you having have regular contact with friends, family and other people who are important to you.
Family/Unpaid carers
46. If you are a family/unpaid carer, please tell us more about the support you receive in your caring role. This can be good or bad things.
47. If you are a family/unpaid carer, please tell us your experiences of the carers assessment or review if you have had one or asked for one.
Choice, control and other important things
48. Please tell us about any of your experiences in sharing concerns, complaints or compliments with organisations who support you. These can be good or bad things.
49. Please tell us more about how services meet your individual cultural needs or not.
50. If you have been discriminated against, please tell us more about this.
51. If you experience difficulties in accessing information from services and organisations, please tell us more.
52. If you experience difficulties in accessing services and facilities, please tell us more.
53. How much do you feel you are able to have choice and control in your life?
Very poor choice and control
Excellent choice and control
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54. Please tell us more about your views on choice and control.
55. If there is anything you would like to tell us about that you haven't already, please tell us here.
Section 4 - Your contact details
We would like to be able to contact you  but you don't have to give your contact details  to us if you don't want to.

If you do give us your details, we will use them for only three reasons:

1) to talk to you to find out more about your answers to this survey
2) to ask you to help us with other surveys or research and
3) to write to you about how you can become a member of Inclusion Gloucestershire.

We will keep your personal contact details safely for 4 years from the date the survey closes, so this will be until 20th July 2025.

To find out more about our data protection policies or to withdraw your consent please email info@inclusion-glos.org

We will not share your personal details with other people or organisations.

If you give us your contact details you are agreeing to the above.

Please tell us your full name.
Please tell us your address.
Please tell us your phone number.
Please tell us your email address
Thank you
Thank you very much for completing our survey.

Please keep an eye on our website and social media as we will share information about what you have told us on these

https://www.inclusiongloucestershire.co.uk/research-strategy-and-partnerships/

https://www.facebook.com/inclusionglos/

https://www.instagram.com/inclusiongloucestershire/

If you want to post your survey back to us....
Please post your survey by  5pm on 20th July 2021 to us at:
Inclusion Gloucestershire
2 St Michael's Court
St Michael's Square
Gloucester
GL1 1JB
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