Mapping Exercise of Activities and Services to Reduce Poverty
This questionnaire has been developed as a way to build a picture of the extent and type of activities and services provided in Carmarthenshire to reduce the effects of poverty. The information gathered will be used to support residents of Carmarthenshire, by providing up to date advice on services and will help us to plan future services. The results will be available on the Children and Young Peoples Partnership page www.thecarmarthenshirepartnership.org.uk
 
Please complete a separate questionnaire for each project/service delivered by your organisation.
 
If you would like to complete a paper copy of this form please return it to us at the address given at the bottom of this survey. If you have difficulty in printing out the form please contact our team and we will post them to you, the contact details are at the end of the form. Thank you in advance for your time in helping us and please forward to any other organisation involved in providing support, advice and services to address poverty.
1. Background - Please provide the name and contact details of your organisation below

Q1. Organisation name

Q2. Organisation address

Q3. Organisation post code

Q4. Is this address confidential?
Yes
No

Q5. Telephone number

Q6. Helpline number (please include opening times)

Q7. E-mail address

Q8. Website address

Q9. Contact name

Q10. Contact title

Q11. Alternative contact name

Q12. Would you be willing for us to show your organisations/groups details on any resources developed to support this work?
Yes
No

Q13. Partner(s) - Please list any partners and detail the support they provide

2. Description of your project/service - Please describe below the work your organisation undertakes to reduce the effects of poverty. If there are several separate pieces of work please complete separate questionnaires for each one as individual projects eg. Anti poverty programmes, funding schemes, food banks, family support, specific advice.

Q14. Please state the name of your project/service

Q15. Please summarise your project (including any financial support you can offer people)

Q16. How many offices does your project have?

Q17. Where are the offices located?

Q18. What geographical areas does your project cover?

Q19. Funding (Please list all funders of this initiative or note how you fund it)

Q20. Is the funding...
On going
Time limited

Q21. Will the project end when the funding ends?
Yes
No

Q22. If the project is time limited, when does it end?

Q23. What type of service do you provide?
Information (on available services e.g. leaflets)
Advice (discussion of problems and possible solutions)
Advocacy/Representation (acting on behalf of people in negotiation with others e.g. landlords, court)
Campaign and Publicity (campaigning to change policy to improve services)
Training/Education/Courses
Sign-posting to other agencies
Time limited interventions
Specific support of identified needs (e.g. equipment loan)
Other

Q24. In what ways can your service be accessed?
Face-to-face (in office/venue)
Face-to-face (in clients home)
Face-to-face (in differing community venues e.g. community halls, surgeries)
Telephone
Website
E-mail
Other

Q25. How are clients/participants referred to this service?
Self referral
Partner agencies referral
Your service targets areas or groups
Other

Q26. When are your services available?

Face-to-face Telephone
Q26.1. Opening hours (e.g. 9.00 to 5.00)
Q26.2. Days of the week (Monday to Friday)

Q27. Are your services available at any other times? If so, please specify

Q28. Do you have an out-of-hours service?
Yes
No

Q29. If so, please provide further detail

Q30. Do you have an outreach service?
Yes
No

Q31. If so, please provide further detail

Q32. Which of the following issues does your service/project address?
Participation
Inclusion
Access to services
Education
Training
Financial literacy
Money management
Debt advice
Benefits advice
Employment
Mental/emotional health
Substance misuse (alcohol/drug/solvent abuse)
Health and wellbeing
Healthy eating/cooking on a budget
Transport
Houisng issues
Fuel poverty
Physical activity
Play
Accident prevention
Consumer Contract Law
Home security
Other

Q33. Which of the following age groups does your work target?
Ante-natal period
Infancy (0-3 years)
Early childhood (4-7 years)
Late childhood (8-10 years)
Pre-teen and/or adolescence (11-18)
Early adulthood (19-25 years)
Adults (26-49 years)
Adults (50-59 female)
Adults (50-59 male)
Adults (50-64 male)
Adults (60 plus)
Other

Q34. Who are the target population for your organisation's work? (please tick all that apply)
Children in families
Parents
The elderly vulnerable
Children and young people in need/care
Those living in poverty
Those experiencing bereavement
Those affected by divorce
Those not in education, employment or training
Those in debt
Those with low income
Young carers
Those that are homeless
New entrants - non English speaking
Those recently discharged from hospital
Those with chronic conditions (e.g. diabetes)
Those with physical disabilities
Those with learning disabilities
Those with diagnosed mental health problems
Those with alcohol problems
Those with drug problems
Those who have experienced abuse of any kind
Those who hev experienced domestic violence
Those who are unemployed
Specific geographic targetted areas
Specific minority ethnic groups
No specific target group
Other

Q35. Please use this box to add any detailed information with regards to the above (e.g. specific conditions, ethnicities etc)

Q36. Please describe any gaps/unmet needs in the services you provide and your evidence base (this could be as a result of a funding shortfall, time limited services or staffing, expansion of customer base, waiting lists, rural population etc)

Q37. Please describe the arrangement you have in place to gather feedback from your customers?
(e.g. satisfaction surveys, exit questionnaires etc)

Q38. What is the current staff commitment?

Q38.1. Full time staff (WTE)
Q38.2. Part-time staff (hours)
Q38.3. Volunteers (hours)

Q39. How many people did your project/service support...

Q39.1. Between 1st April 2008 and 31st March 2009?
Q39.2. Between 1st April 2009 and 30th September 2009?

3. Future Direction

Q40. What is the next step in the development of this project?

Q41. Which areas will your organisation focus on over the coming year?

Q42. What will be your main challenge?

Q43. What can you evidence as areas of need for the County in relation to reducing the effects of poverty?

Q44. Please add any other comments

Q45. What does your project save other services? Can you evidence savings on your project results for other organisations?

Thank you for taking the time to complete this questionnaire
If completed electronically the questionnaires will automatically be returned for collation when you click submit. If you would like to complete a hard copy and are having difficulty printing off a copy please contact us 01267 224659. Completed hard copies should be returned to :
 
Lesley Rees
Partnership Development Officer
County Hall
Carmarthen
SA31 1JP


This survey was created by KeyPoint.