survey questions for Meals on Wheels service users

Name of household member(s):

Address: *

Postcode:

Age(s) and gender(s):

For example, if there are three women in the house aged 77, 79 and 86, and two men aged 81 and 92, you could list these concisely as: F77, F79, F86, M81, M92

What is your reason for needing help with getting a meal?: *

unable to prepare a hot meal for yourself

unable to shop

unable to go out

other (please state)

More than one of these reasons may apply. Please select as many boxes as you wish.

Other reason for using the Meals on Wheels service:

Are you able to heat up a ready-cooked meal?: *

yes

no

How many times a week do you receive help with getting a meal?: *

If you do not have help every day, what arrangements are made in between for you to have a meal?:

Do you like the meals you are helped with? Are they: *

What would you say about the size of the meals?:

too much

too little

about right

How could they be improved?:

Please use this space to write anything you think might be helpful in improving the quality of the meals and the delivery service (even if you are already satisfied with it, there is always room to improve).

How would you prefer to receive your meal?: *

delivered ready to eat

a ready-cooked or frozen meal for you to heat up

prepared for you in your home

in a café or pub

at a luncheon club

from a takeaway

other – please say which

Please choose as many as you like out of the list above.

Other:

If you have selected more than one delivery method above, which one
would you prefer ahead of the others?:

delivered ready to eat

a ready-cooked or frozen meal for you to heat up

prepared for you in your home

in a café or pub

at a luncheon club

from a takeaway

other (as specified above)

How much do you pay (each week) for the meal and the help you need to get it?: *

How would you rate that cost?: *

too much for you

very expensive

affordable

a reasonable price

How would you prefer to pay for your meal?: *

in cash when it is delivered

by weekly or monthly cheque or postal order

by direct debit from your bank account

other (please specify)

Other preferred method to pay for your meal:

What is most important to you about the meals on wheels service?: *

Please choose one or two from the list above.

Other reasons why the meals on wheels service is important to you:

What other help do you receive at home?: *

Other help you receive at home:

Do you have friends and/or family visiting regularly?: *

yes

no

If yes, what help are they able to offer you?:

Do you go to a day centre?: *

yes

no

If yes, how often?:

Can you think of any help or support which would make a difference to you? For example:

Please note: This question is not related directly to the Meals on Wheels provision, but it may help to make clearer what might be done to make a long-term sustainable and cost-effective service. Any information you can provide here will be of great help to us. You can provide as much additional information as you wish in the box below ('other').

Other help or support which would make a difference to you:

Would you be willing for someone to come and see you to talk about the
service and how it might be improved?:

yes

no

They would of course contact you first and agree a convenient time.

Rebuilding Society Network

survey questions for Meals on Wheels service users