ROSCAs 2008 - NOMINATION FORM
 

Category 3 - The Carer and Service User Involvement Award (Individual or Team)

Please note fields marked * are compulsory.

I am the proposer and my contact details are:


Name and Job Title *
Department and Work Address *
Telephone Number
Email Address

I wish to nominate the following individual or team for this award:


Name and Job Title*
Department and Work address *
Telephone number
Email Address
Have you informed them of your nomination? * Yes No

 

3. The carer and service user involvement award (Individual or Team)

This award recognises a genuine commitment to putting the needs of service users and the carers that we serve at the heart of what we do. Nominees will have clearly shown that they have engaged with service users and the carers and listened to their view allowing them to make truly informed contributions to discussions. Nominees will be able to demonstrate that involvement has resulted in plans that were jointly conceived and developed and have support of the carers and service users in implementing the plans.

When you nominate a person or a team please:

  1. Describe how involvement has been achieved and the area that this has been applied to.
  2. Describe how your nominee (individual or team) has attempted to ensure that relevant members of our community could contribute in a way that is sensitive to their needs.
  3. Give an example of a careror service user view that has changed the wayservices are provided to better reflect local need.
  4. Give a quote from you as the proposer as to why you believe this (individual or team) should be recognised.
Give a supporting quote from a carer or service user involved stating how well they felt they had been involved and why they thought this was successful.


My Reasons for Nominating this Individual or Team

In this section please summarise why you feel your nominee deserves the award. Please focus on how they make a real difference and how they meet the criteria for this award.  It is really helpful if you could give as much information as possible about your nominee and why you think they are different and special.

The judging panel want to know about your nominee and will use your information to assess the merit of each nomination. You can use an additional sheet if you need more space, giving specific examples/evidence to support your nomination to help the judging panel.

How has involvement been achieved and in which area/s has this been applied?


How has your nominee (individual or team) attempted to ensure that relevant members of our community could contribute in a way that is sensitive to their needs?


Give an example of a careror service user view that has changed the wayservices are provided to better reflect local need


Please give a quote from you as the proposer as to why you believe this individual or team should be recognised





Please give a supporting quote from a carer or service user who has been involved to show how well they felt they had been involved and why they thought this was successful


Any other information which you want to share with the panel in support of your nominee



Please read the following section carefully:

The information I have given is correct to the best of my knowledge. I understand that I may be asked for further information. The decision of the judges will be final and no correspondence will be entered into relating to the decision/s of the judging panel. All nominations and winners will be publicised to help promote the overall work of the Trust and its staff and to promote positive images of mental health, learning disability and substance misuse services.

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