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* 1. Are you a Carer for someone that you live with?

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* 2. How did you find out that you are a Carer?

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* 3. If it was yourself, was it easy to find out where to get support?

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* 4. In your role as a Carer where does the most important help you receive come from?

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* 5. What type of help do you currently receive or would like to receive that would improve things for you?

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* 6. As a Carer what is the biggest challenge or problem you have?

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* 7. After talking to your Support Worker did this help you in your caring role?

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* 8. Where you and your support worker have made a plan (please tick all that apply)

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* 9. Put the list below in order from most important (1) to least important (8) to you:

  1. Physical Health – You are physically healthy with adequate: sleep, personal hygiene, diet and access to universal health services including registration with a GP and dentist.
  2. Living environment – Your living environment is positive. You feel settled, accepted and respect with your own space to play and study.
  3. Being safe – You are protected from harm by the adults that look after you. You are aware of the risks and are not taking part in activities related to alcohol, drugs and sex in the community and internet.
  4. Parental relationships – You have a positive relationship with your parents or other adults (when not living at home). This is recognised by your sense of being loved, supported, comforted, and praised.
  5. Feelings and Behaviour – You manage strong feelings in a positive manner. You are able to tell others what you feel and think in a way that helps you and makes you feel better.
  6. Friends – You make and keep positive friendships with people of a similar age. You know who to ask for help if you are bullied.
  7. Confidence and Self-esteem – You in general and in relation to your caring role, feel at ease and know you matter. When caring you don’t need to do anything that makes you feel uncomfortable.
  8. Education and Learning – You are doing your best at school including attendance (except when ill). And you take part in extracurricular activities that interest you in and outside school.

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* 10. Is there anything missing from the list that you think is important?

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