Skip to content

Adult Social Care self-help tool

  1. Self-help form

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

(If it’s helpful, you can read about how to enlarge a webpage and read aloud a webpage).

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 statements 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’ (‘X‘) if you cannot do any part of the activity described in the statement, even if you can do some of the things described
  • answer the statements 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 on the button next to the ‘Yes‘ or ‘No‘ to select your answers to the statements.

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

Top