Q1	Your age?
		18-29		50-64
		30-39		65-74
		40-49		75+

Q2	Gender?
		Male		Female

Q3	Ethnicity?
		White British		Caribbean
		White Irish		African
		Any other White background		Any other Black background
		White & Black Caribbean		Indian
		White & Black African		Pakistani
		White & Asian		Bangladeshi
		Any other Mixed background		Any other Asian background
		Chinese		Other ethnic group

	Please state

Q4	What is your current status?
		I work full time
		I work part time
		I am not currently in employment

Q5	Do you work as a volunteer for any organisation?
		Yes
		No

Q6	Do you receive any support services yourself?
		Yes
		No

Q7	Are you a main carer, a partner or a friend of someone who receives support services?
		Yes
		No

Q8	Who provides the services. Please state the name of the service provider and the service they provide, e.g. ABC Voluntary Organisation, Meals Services?

Q9	Which of the following services do you receive? Please select all that apply
		Meal Preparation		Delivered Meals
		Volunteering Opportunities		Employment Support
		Practical Support: pension collection, shopping, paying bills		Activities
		Health Promotion		Advocacy
		Befriending and Home Visiting		Support in recovering  from crisis
		Assistance in the Home		Falls Prevention
		Transport		Advice
		Day Support		Support for Substance Misuse
		Support in accessing  community facilities		I do not receive any services
		Training and Skills		Other Please specify

	Please specify

Q10	What do you feel the service(s) enables you to achieve?
	Helps me feel less isolated at home or in the community.	--Click Here--Yes definitelyYes a littleNo benefit
	Improves my physical and/or mental health well-being.	--Click Here--Yes definitelyYes a littleNo benefit
	Prevents dependence and increases my Independence.	--Click Here--Yes definitelyYes a littleNo benefit
	Assisted me to adopt a healthy lifestyle.	--Click Here--Yes definitelyYes a littleNo benefit
	Enabled me to feel safe and secure.	--Click Here--Yes definitelyYes a littleNo benefit
	Enables me to participate and manage every day problems.	--Click Here--Yes definitelyYes a littleNo benefit
	Is supporting me to recover from a crisis in my life.	--Click Here--Yes definitelyYes a littleNo benefit
	Offers me support in seeking volunteering opportunities.	--Click Here--Yes definitelyYes a littleNo benefit
	Provides support, training and opportunities to seek employment.	--Click Here--Yes definitelyYes a littleNo benefit
	Enables me to remain engaged in my local community.	--Click Here--Yes definitelyYes a littleNo benefit

Q11	We have outlined seven strategic priorities for Manchester City Council. Which do you consider to be important?
	Tackling Unemployment	--Click Here--Very importantImportantNo opinionNot importantNot at all important
	Promoting Independence	--Click Here--Very importantImportantNo opinionNot importantNot at all important
	Helping to prevent people reaching a crisis	--Click Here--Very importantImportantNo opinionNot importantNot at all important
	Providing Personalised services	--Click Here--Very importantImportantNo opinionNot importantNot at all important
	Supporting Adults and Families who have a range of needs	--Click Here--Very importantImportantNo opinionNot importantNot at all important
	Promoting Equality	--Click Here--Very importantImportantNo opinionNot importantNot at all important
	Supporting Recovery from Crisis	--Click Here--Very importantImportantNo opinionNot importantNot at all important

Q12	Please record any comments you would like to make about why you answered the above question in the way you did

Q13	Thinking about the way we have decided to prioritise our future investment, do you agree with our proposals?
		Yes
		No
		Not sure

	Please say why

Q14	Specifically, do you agree that cost and quality should be considered equally in making decisions about funding priorities?
		Both cost and quality should be of equal importance
		Cost should be more important than quality
		Quality should be more important than cost
		Not sure

	Please say why

Q15	Do you agree that services should have to reach minimum standards of quality in order to quality as a funding priority?
		Yes
		No
		Not sure

	Please say why

Q16	Do you think that this approach for investing in services is fair across all groups?
		Yes
		No
		Not sure

	Please say why

Q17	Do you have any other comments?