Schedule 3 Communal Establishment Questionnaires

Selecting one of the following:

• Medical or Care

• Education

• Detention

• Travel or temporary accommodation

• Armed Forces

• Religious establishment

• Staff/worker accommodation only

• Other establishment

If Medical or Care is chosen a follow up question is asked

1_B What type of Medical or Care establishment?

Selecting one of the following:

• Care home with nursing

• Care home without nursing

• Mental health hospital/unit (including secure units)

• Children’s home (including secure units)

• General hospital

• Other hospital

• Other medical or care establishment

If Education is chosen a follow up question is asked

1_C What type of Education establishment?

Selecting one of the following:

• University (for example halls of residence)

• School

• Other education establishment

If Detention is chosen a follow up question is asked

1_D What type of Detention establishment?

Selecting one of the following:

• Prison service establishment

• Approved premises (probation / bail hostel)

• Detention centre

• Other detention establishment

If Travel or temporary accommodation is chosen a follow up question is asked

1_E What type of Travel or temporary accommodation establishment?

Selecting one of the following:

• Hostel/temporary shelter for the homeless

• Hotel, guest house, B&B, youth hostel

• Holiday accommodation (for example holiday parks)

• Other travel or temporary accommodation

Select all that apply:

• Aged 0 - 17

• Aged 18 – 24

• Aged 25 – 64

• Aged 65 and above

Select all that apply:

• Older people

• Physical disability

• Respite care

• Mental illness

• Learning disability

• End of life care

• Chronic illness care

• Acute illness care

• Intermediate care

• Substance misuse

• Nurses/doctors

• University and/or college students

• Schoolchildren

• Armed forces personnel

• Prisoners/offenders

• Homeless people

• Staff

• Asylum seekers

• Seasonal/temporary workers

• Paying guests

• Other

Selecting one of the following:

• Health and Social Care body or group

• District Council

• Government department/agency

• Housing Association

• Charity/voluntary organisation

• Private owner/company

• Other

[Information about all the individual residents at establishment address]

6 Please complete the following details for each person who lives here

Entering response in the format:

• First name(s)

• Last name

Entering response in the format:

Day-Month-Year

Selecting one of the following:

• Female

• Male

[Visitor question at communal establishment]