Visual Assessment for Young Carers for young carers aged 12-17 years old Visual Assessment - Secondary School "*" indicates required fields Young Carers come in all shapes and sizes. They can be any young person between the ages of 5 – 17 who do lots to help a loved one with an illness, disability, mental health condition or dependent on drugs/alcohol. Barnet Young Carers is here to help you with the care you provide for your loved one by offering you someone to talk to; helping you keep up with school work; supporting your family and best of all - giving you a chance to have some fun with lots of activities. Name:* The Person I Care For Is:* Email:* The email address will be used to email a PDF copy of this assessment Please select the tasks and frequency you help the person who care for with: Helping the person get dressed:* Helping the person get washed:* Helping the person use the toilet:* Helping the person get around:* Helping the person with eating/drinking:* Helping the person with medication:* Is there anything else you would like to tell us about your caring role Please select the tasks and frequency you help the person who care for with: Helping the person with the washing up:* Helping the person with the hoovering:* Helping the person with the cooking:* Helping the person with the food shopping:* Helping the person with the laundry:* Helping the person with the ironing:* Helping the person with the sweeping/mopping:* Helping the person with the gardening:* Is there anything else you would like to tell us about your caring role Please select the tasks and frequency you help the person who care for with: Talking to the person about their day:* Comforting the person when they are upset:* Dealing with the person when they are angry:* Offering hugs to cheer the person up:* Keeping the person company:* Offering a nice gesture (e.g. making a cup of tea):* Is there anything else you would like to tell us about your caring role Please select the tasks and frequency you help the person who care for with: Organising medical appointments:* Looking after siblings on your own:* Collecting prescriptions:* Signing/interpreting for someone:* Is there anything else you would like to tell us about your caring role Please select the tasks and frequency you help the person who care for with: Dealing with bills/finances:* Working part-time to earn an income:* Organising benefits:* Budgeting for family:* Is there anything else you would like to tell us about your caring rolePlease tell us if there is someone who helps you with these things* How does caring for the person make you feel? Select the appropriate emoji* If you were granted a wish that would help you at home with your caring role, what would it be?* I am currently in year:* If I am worried about anything, the member of staff I can talk to at school/college is:* My favourite subject at school/college is* The best thing about school is:* The most difficult thing about school/college is* When I leave education, I hope to one day:* Are you ever late for school/college?* Never Sometimes A lot Do you ever miss school/college?* Never Sometimes A lot How I feel about school. Select the appropriate emoji* My favourite thing to do during the weekend is:* One activity I would like to try is:* A hobby that I’m interested in is:* If I could go on a day trip, I would like to go:*How often do you see friends outside of school/college?* I never see them I sometimes see them I see them a lot How I feel about my social life. Select the appropriate emoji* Are you part of any teams/clubs?* Yes No If yes, tell us what you do* Social activities and clubs (through Barnet Young Carers and local organisations)* Help in school (having someone to understand my caring role/school groups)* Outings* Help with school work (tuition; homework clubs)* Having someone to talk to about my caring role (a referral to be made to receive 1:1 mentoring/counselling)* Someone to train me with things that might make my caring role more manageable (e.g. cooking; life skills workshops)* Someone to help me look after the person I can for* Support online (Barnet Young Carers website/social media)* Is there anything else you would like support with? Let us knowNameThis field is for validation purposes and should be left unchanged.
