Welcome to Unity Dorset: Approved Dorset Council Framework Provider & ISF Provider
Kempston Road,Dorset, DT4 8XB
09:00 - 17:00 Main Office Mon - Fri
Home Start Your Journey
Name Of Service User: (Required)
Capacity: Are you assessed as having capacity or do you lack capacity in some aspects of your life :
Disabilities and Injuries:
Illnesses or Diseases:
Who is in your circle of support?
Who is completing this form? (If you are completing this form on behalf of someone else please state your name and relationship)
What Is The Best Contact Email Address?
What daily living tasks do you need help with? (For example help with cooking, cleaning, shopping, prompting hygiene, medication)
What are your daily living outcomes? (what do you want to achieve independence with or maintain)
What are you current hobbies, interests or routine? (For example help with cooking, cleaning, shopping, prompting hygiene, medication)
What are your short term/long term goals? (Any goals/outcomes you may have for daily living tasks, short term/long term goals)
How many hours of support do you think you need each day/week and what days of the week? (please specify per day/per week)
Do you have any behaviours that challenge?
Do you require personal care? (Please note that Unity Dorset does not provide personal care or any other regulated activity such as managing finances, however if you are unsure we can answer your questions)
What training or skills would you require your support worker to have?
What personality traits you look for in your support worker?
Would you be interested in taking part of the selection or recruitment of your support worker(s)?
What do we need to do to maintain your well-being?
Is there any Risk of Harm to Self?
Is there any Risk of Harm to Others?
Is there any Risk of Harm from Others?
Is there any Risk of Accidents?
Is there any Physical Health Related Risks?
Is there any Other Risks?
Are there any outcomes you would like to achieve with your risks?