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Adult Services

My Needs: Self-Assessment

Press 'Start' to begin the self-assessment

  1. 1. Practical Aspects of Daily Living

    • How are you managing your day to day life? Shopping, cleaning, cooking, doing laundry, managing money, paying bills?


      Please click on one option below and then click next.

    1. I can manage my day to day life on my own
    2. I rarely need support
    3. I sometimes need support up to once a week
    4. I need support several times a week
    5. I need support every day
  2. 2. Personal Care

    • hands

      How are you looking after yourself? Washing, dressing, using the toilet, etc.


      Please click on one option below and then click next.

    1. I can manage my personal care on my own
    2. I need support several times a day
    3. I need support every day
    4. I need support several times a week
    5. I need support up to once a week
    6. I rarely need support
  3. 3. Meals and Nutrition

    • bowl of salad

      What help do you need to eat and drink? Do you need help preparing meals or eating them?


      Please click on one option below and then click next.

    1. I cannot eat and drink without support
    2. I cannot prepare any food for myself
    3. I need support to prepare hot food
    4. I can manage to prepare all my food without support
  4. 4. Time Spent With Others

    • library

      How are you making and keeping friends? This is about all the people you know, not just your family.


      Please click on one option below and then click next.

    1. I need support to meet more people
    2. I need support to keep in touch with other people
    3. I can keep in touch with the people I want to see
    4. I find it difficult/challenging to be with other people and need support
  5. 5. Outside Your Home

    • find support suppliers and equipment

      Outside your home, what are the things you like or need to do? Eg, using the library, cinema, clubs, community centre, place of worship. It is about being involved in the community and local organisations.


      Please click on one option below and then click next.

    1. I need support to be part of my community several times a week
    2. I need support to be part of my community at least once a week
    3. I am able to participate in my community as much as I want to
  6. 6. Staying Safe in and out of the home

    • elderly gardener

      Can you keep safe - both in your home and when you go out? Think about your safety when using a cooker, going downstairs, going on a bus. Reasons could be due to physical problems, memory problems, or difficulty learning some tasks.


      Please click on one option below and then click next.

    1. I can manage to keep myself safe
    2. I am aware that I have to be cautious
    3. I need weekly support
    4. I need support every day
    5. I need support 24 hours a day
  7. 7. Time Spent With Support

    • anxious lady

      How much support do you need from someone else (either paid or relative/friend) to:
      A) help you with tasks
      B) To keep you safe and stop you hurting yourself


      Please click on one option below and then click next.

    1. I need support 24 hours a day
    2. I need support all day
    3. I need support twice a day
    4. I need support once a day
    5. I can manage on my own/ I do not need support
    6. I need support up to once a week
  8. 8. Safeguarding

    • couple sitting on bench

      How safe do you feel with other people? Are people taking advantage of you, or hurting you physically, emotionally or financially? Can you say 'no' to things you don't want, or phone and report concerns?


      Please click on one option below and then click next.

    1. I do not need any help to keep myself safe from other people
    2. I am vulnerable in some situations and need help to keep myself safe from other people
    3. It is highly likely that other people might harm me
    4. I believe that I have been harmed

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