Commissioned Short Breaks survey


1. Does your child have an allocated Short Break?


2. Is your child;


3. How old is your child? *


4. What is your child's religion/belief/faith?


5. Please describe your child's disability? *


6. What is your child's ethnicity?

  • White
  • Asian or Asian British
  • Mixed
  • Black or Black British
  • Other Ethnic Group

7. Which of the commissioned short breaks provision has your child attended in the last 12 months?


8. How strongly do you agree or disagree about the range of commissioned provision for Short Breaks in relation to the statements below;

If your child has attended more than one provision please answer for the one attended most recently.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
My child enjoys their short break
The short break has impacted positively on my child's confidence
The short break has enabled my child to socialise with peers
The range of provision means the short break suits my child's needs/interests
The provider understands the needs of my child
It is important to me that I have a relationship with the provider
Our family life is made easier due to the short break we receive for our child
The short break gives me sufficiency time to recharge and relax
The short break allows me time to spend with my other children
The short break allows me to manage and complete household tasks
The short break allows me to undertake education, training and/or leisure activities

9. What would you like to see from the commissioned short break provision in the future?


10. We are looking for parents/carers of children and young people who have recently attended commissioned short breaks provision to take part in a consultation session to support our procurement activity. If you would like to be involved in this group please include your contact details below. Please note the session will be delivered virtually so to allow for productive discussion numbers will be limited to 2 representatives per provision, 8 in total. The session is scheduled for 30th September, time to be agreed when attendees are confirmed.