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Register your interest in other topics

Register your interest in other topics

Please use this form to tell us which adult social care topics interest you and how you would like to be involved. We will then invite you to join us as relevant activities come up.

Where possible we would like to contact you by email, but we can also contact you by phone or post if you prefer. You can tell us your preferences as you complete the form.

If you have any problems completing the registration form please email our Engagement Team at getinvolved@solihull.gov.uk

Please select the areas of adult social care which interest you

* required*

Autism

Carers

Dementia

Learning disabilities

Mental health

Older people

Physical disabilities

Preparing for adulthood (moving from Children's Services to Adult Social Care)

Any other area of adult social care (please specify)

Please select all the adult social care topics which interest you

* required*

Adapting your home/staying independent at home

Care at home

Care homes (residential and nursing)

Day opportunities

Helping people with care and support needs to find jobs

Housing options

Information and advice services

Partnership board* - autism

Partnership board* - learning disabilities

Partnership board* - carers

Personal budgets / direct payments

Support for carers

Technology enabled care

Any other adult social care topic (please specify)

*Our partnership boards are made up of people with lived experience, voluntary and community sector colleagues and Council officers. Board members provide direction and oversight of strategies and project work, to make sure they reflect the right priorities for people who receive our services, the Council and our partners.

How would you like to be involved in adult social care projects? You can select as many options as you like.

* required*

Attend face to face events such as focus groups or discussion groups

Join online events (using Microsoft Teams or Zoom via your computer or mobile phone)

Take part in discussions or conversations by phone or email

Take part in long term projects

Take part in online surveys

Other (please specify)

Please tell us your first name and surname

* required*

Maximum 255 characters

0/255

Please tell us a bit more about you

* required*

I receive care services arranged and paid for by Solihull Council

I arrange and pay for my own care

I receive a direct payment from Solihull Council

I am a carer

I have an interest in adult social care

Other (please specify eg if you are a personal assistant to someone receiving care)

Please tell us your postcode

* required*

Maximum 255 characters

0/255

Some projects may be specific to areas of Solihull so it is helpful if we know which part of Solihull you live in.

How do you want us to contact you? Please select all that apply.

* required*

By email (please provide your email address in the box below)

By phone (please provide your mobile phone number or landline in the box below)

By post (please provide your full postal address and postcode in the box below)

Please provide your preferred contact details (email, phone or postal address)

* required*

How we store and use your information

We will not share any personal details or information without your express permission. Please read the privacy notice below or contact us at getinvolved@solihull.gov.uk if you have any specific questions.

Privacy Notice - Adult Care and Support (solihull.gov.uk)

Equalities monitoring questions

We are asking the following questions because we want to make sure we involve lots of different people from the borough. You do not have to answer these questions but doing so will help us to:

better understand the communities we serve
identify and resolve any issues that would otherwise prevent us involving different groups of people
ensure our services are suitable for and reach as wide an audience as possible
meet our obligations under the Equality Act 2010

If you have any questions in relation to this data collection, please contact us at: getinvolved@solihull.gov.uk

How old are you?

Under 18

18-24

25-39

40-49

50-59

60-64

65+

Prefer not to say

10.

Do you have caring responsibilities?

Yes

Prefer not to say

11.

Do you consider yourself to have a disability, long term health condition or learning difference? (tick all that apply). Under the Equality Act 2010, a person is considered to have a disability 'if they have a physical or mental impairment, and the impairment has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities’.

No known impairment, health condition or learning difference

A long-standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy

A mental health difficulty, such as depression, schizophrenia or anxiety disorder

A physical impairment or mobility issues, such as difficulty using your arms or using a wheelchair or crutches

A social/communication impairment such as a speech and language impairment or Asperger’s syndrome/other autistic spectrum disorder

A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D

Blind or have a visual impairment uncorrected by glasses

Deaf or have a hearing impairment

Prefer not to say

An impairment, health condition or learning difference that is not listed above (specify if you wish)

12.

How do you describe your gender?

Female (including trans female)

Male (including trans male)

Non-binary / agender / gender fluid

Prefer not to say

Prefer to self-describe

13.

Which of the following best describes your sexual orientation

Asexual

Bi/bisexual

Gay man

Gay woman / lesbian

Heterosexual / straight

Pansexual

Prefer not to say

Other (please state)

14.

How do you describe your ethnic background?

Arab

Asian or Asian British - Bangladeshi

Asian or Asian British - Indian

Asian or Asian British - Pakistani

Asian or Asian British - Chinese

Other Asian background

Black or Black British – African

Black or Black British - Caribbean

Other Black background

Mixed – Asian and White

Mixed – Black African and White

Mixed – Black Caribbean and White

Other mixed background

White British

White Irish

Gypsy or Traveller

Other White background

Prefer not to say

Prefer to self-describe (please state)

15.

How do you describe your religion/belief?

Buddhism

Christianity

Hinduism

Islam

Judaism

Sikhism

Spiritualism

No religion or belief

Prefer not to say

Any other religion or belief (please state)