SUPPORTING PEOPLE OUTCOMES QUESTIONNAIRE 2017

To be completed for all service users starting support, at review of support and/or at end of support

Scheme Information

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Service User Information

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8. Please indicate if you are completing Outcomes information for a service user who:
 
 
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OUTCOMES

Promoting Personal and Community Safety

12. Outcome 1: Feeling safe
 
 
 
 
 
13. Have any of the following prevented progression for the service user
 
 
 
 
14. Outcome 2: Contributing to the safety and well-being of themselves and of others
 
 
 
 
 
15. Have any of the following prevented progression for the service user
 
 
 
 

Promoting Independence and Control

16. Outcome 3: Managing accommodation
 
 
 
 
 
17. Have any of the following prevented progression for the service user
 
 
 
 
18. Outcome 4: Managing relationships
 
 
 
 
 
19. Have any of the following prevented progression for the service user
 
 
 
 
20. Outcome 5: Feeling part of the community
 
 
 
 
 
21. Have any of the following prevented progression for the service user
 
 
 
 

Promoting Economic Progress and Financial Control

22. Outcome 6: Managing money
 
 
 
 
 
23. Have any of the following prevented progression for the service user
 
 
 
 
24. Outcome 7: Engaging in education/learning
 
 
 
 
 
25. Have any of the following prevented progression for the service user
 
 
 
 
26. Outcome 8: Engaged in employment/voluntary work
 
 
 
 
 
27. Have any of the following prevented progression for the service user
 
 
 
 

Promoting Health and Wellbeing

28. Outcome 9: Physically healthy
 
 
 
 
 
29. Have any of the following prevented progression for the service user
 
 
 
 
30. Outcome 10: Mentally healthy
 
 
 
 
 
31. Have any of the following prevented progression for the service user
 
 
 
 
32. Outcome 11: Leading a healthy and active lifestyle
 
 
 
 
 
33. Have any of the following prevented progression for the service user
 
 
 
 

End of Support Information

34. Was support ending planned?
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Homelessness Status

36. Homelessness status at start of support
37. Homelessness status at end of support

Completion Details

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