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Adult social care self-help tool

  1. Self-help form

Are you having challenges or problems living safely and well at home?

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Do you face challenges with aspects of your everyday life or are you looking after someone who does? For example, with getting washed and dressed or cooking and preparing meals?

If so, we are here to help and support ‘you’. ‘You’ refers to the person with care and support needs, not a carer, family member or friend.

If you care for another adult, find out about an assessment for yourself by phoning Devon Carers on 03456 434 435 or by visiting the Devon Carers website for information and advice.

We want to support people to access great information and advice, to support their care and support needs.

By answering 14 questions, you can be given information about support, equipment and local services that could help you with your care and support needs. This is not an exhaustive list, but it covers most of the areas where care and support could be needed in your life.

You can then send the results to your email address or print them off.

To get the best results:

  • choose ‘No’ if you cannot do any part of the activity described in the question, even if you can do some of the things described
  • respond to the questions based on how you feel on the days you cannot achieve as much as you would like

Completing this will give you more information about services that could help you.

All you need to do is click in the circle next to the ‘Yes‘ or ‘No‘ to select your response to the question.

Questions
1
Do you have a disability, physical or mental illness or challenge or problem, which stops you from living life the way you would like to?
Do you have a disability, physical or mental illness or challenge or problem, which stops you from living life the way you would like to?
2
Can you shop for food, prepare meals, eat a healthy diet and drink plenty of fluids?
Can you shop for food, prepare meals, eat a healthy diet and drink plenty of fluids?
3
Can you keep yourself clean? For example; brushing your teeth and washing your hair, body and other personal care.
Can you keep yourself clean? For example; brushing your teeth and washing your hair, body and other personal care.
4
Can you go to the toilet without help or assistance? For example; with no help or equipment to help you get on or off the toilet.
Can you go to the toilet without help or assistance? For example; with no help or equipment to help you get on or off the toilet.
5
Can you get dressed and undressed on your own, and keep your clothes clean, without help and support?
Can you get dressed and undressed on your own, and keep your clothes clean, without help and support?
6
Can you move around your home and neighbourhood without a walking aid or equipment? For example; a walking frame, wheelchair or person to help.
Can you move around your home and neighbourhood without a walking aid or equipment? For example; a walking frame, wheelchair or person to help.
7
Can you keep your home clean and tidy? For example; hoover, dust, clean the toilet or sink.
Can you keep your home clean and tidy? For example; hoover, dust, clean the toilet or sink.
8
Do you feel safe in your home? For example; your home is secure and you feel safe from crime, violence, abuse or pressure such as telephone selling.
Do you feel safe in your home? For example; your home is secure and you feel safe from crime, violence, abuse or pressure such as telephone selling.
9
Do you feel safe from abuse and no one is hurting you? For example; you are not being hurt physically, emotionally, sexually, or financially, by another person.
Do you feel safe from abuse and no one is hurting you? For example; you are not being hurt physically, emotionally, sexually, or financially, by another person.
10
Can you stay in contact with your friends and family? For example: you can maintain relationships through mobile phone calls, visits from others, social networks or video call tools, such as Zoom or FaceTime.
Can you stay in contact with your friends and family? For example: you can maintain relationships through mobile phone calls, visits from others, social networks or video call tools, such as Zoom or FaceTime.
11
Can you work in a job, learn or study at college or school or volunteer to help others if you need or want to? For example; work in a shop, a café, or an office. You can learn new things.
Can you work in a job, learn or study at college or school or volunteer to help others if you need or want to? For example; work in a shop, a café, or an office. You can learn new things.
12
Can you take part in social activities with friends and can use local facilities, such as going to a library, using a leisure or sports centre, visiting a place of worship, going to a social club or visiting a cafe?
Can you take part in social activities with friends and can use local facilities, such as going to a library, using a leisure or sports centre, visiting a place of worship, going to a social club or visiting a cafe?
13
Can you look after a family member who needs you for care and support? For example; you look after an older relative or a child, you cook meals for them or help them at home.
Can you look after a family member who needs you for care and support? For example; you look after an older relative or a child, you cook meals for them or help them at home.
14
Can you manage your alcohol intake and do not need to use recreational drugs or other substances not prescribed (drugs not from a doctor) to help you cope with life through the day?
Can you manage your alcohol intake and do not need to use recreational drugs or other substances not prescribed (drugs not from a doctor) to help you cope with life through the day?