BGS Social & Environment Questionnaires

British Geriatrics Society
Date Published:
08 February 2019
Last updated: 
08 February 2019

Most healthcare consultations are done outside of the patient’s home and without the next of kin or informal carers present. It is vitally important that healthcare professionals are aware of a patient’s social situation and support structures in order to best tailor their advice and support.

Social assessment has historically been the domain of social workers. Healthcare professionals have tended to ask a few perfunctory questions and move on. Patients’ social circumstances affect their mental and physical wellbeing, compliance with advice and frequency of contact with the health services.

Social assessments can easily be done by the patient themselves, a well-informed carer, a nurse or healthcare assistant or indeed a social worker working as part of the multidisciplinary team. 

There are a huge number of different ‘social assessments’ quoted in the literature but they are difficult to access and some are copyrighted. They all ask essentially the same questions, which have been collated in the BGS Social Questionnaire and Environment Questionnaire found below. Please feel free to adopt and adapt these to your own requirements.

Does the patient live alone? If no, who do they live with?                                                                              

  • Lives alone
  • Lives with_____________


What informal support is available?

  • Family
  • Friends
  • Neighbours
  • Clubs/societies
  • Faith group
  • Community group
  • Voluntary e.g. befrienders


How often is support available?

  • Several times a day
  • Daily
  • Approximately weekly
  • When needed
  • Very occasionally
  • Other______________


What formal/professional support is available and involved?

  • Lives in a care home
  • Domiciliary care agency [include number of visits a day]
  • District nurse
  • social worker
  • Voluntary sector
  • Hospice CNS etc.
  • Housing Association [is there a warden?]
  • Age UK befriender
  • Meals on Wheels


Does the patient get out and about?


  • Yes – independently
  • Yes – with some difficulty
  • Yes – but with great difficulty
  • No – completely housebound

If yes has access to own vehicle [e.g. car, mobility scooter]?



If a driver have any concerns been expressed about their ability to drive? If yes, by whom?



If no but able to get out – specify mode of transport – one or more may apply


  • Relies on family
  • Public transport
  • Taxis
  • Voluntary drivers
  • Ambulance transport only

Is the patient a carer?


If so have they been seen by Carers Support worker?


Have they had a formal carer’s assessment by Social Care?


Do they receive a Carers Allowance?



Are there any Pets?


If yes – do they pose any risk to patient or others?





Has the patient has a social services needs based assessment?



Are they eligible for care funding?



Do they have a personal Budget?



Has Continuing Healthcare screening been completed? Urgent/Non Urgent



Are they eligible for CHC funding?



Are they in receipt of:

  • Attendance allowance
  • Mobility allowance
  • Disability living allowance
  • Income support
  • Housing benefit
  • Pension credit

Are there any concerns about Capacity?




Are there any safeguarding issues – including DOLs?




Is there anyone with Power of Attorney?

If so which sort?

If so please record their names

Is there an IMCA?


Enduring Power of Attorney

Lasting POA – Health &Welfare

Lasting POA – Property & Affairs



Has a will been made?

Is there a funeral plan?






What is the nature of the home circumstances?


  • Owner
  • Rented private
  • Rented housing association
  • Nursing home
  • Residential home
  • Other (please specify)

Are there any unusual circumstances of which visiting professionals need to be aware (e.g. high rise block of flats with buzzer access, very rural and isolated?)


Does the accommodation have stairs?


  • No stairs
  • Stairs without difficulty
  • Stairs relying on banister rails (ascending left/right/both) in situ
  • Stairs with chair lift
  • Not safe on the stairs

Availability of toilet facilities



  • Toilet upstairs only
  • Toilet downstairs only
  • Toilet upstairs and down
  • Commode available upstairs/downstairs


  • Upstairs/downstairs
  • Bath/shower cubicle/shower over bath/walk in shower
  • Able to get in and out of bath/shower?

Equipment in situ [drop down menu to be created, e.g. stair lift, commode, hoist, pressure mattress, pressure cushion, syringe driver etc]

  • Commode
  • Hoist
  • Pressure mattress
  • Pressure cushion
  • Hospital bed


Any need for bariatric equipment?


  • Yes/no

Access to the home is via:

  • Front door/back door/side entrance
  • Patient able to give access
  • Key safe [if yes, provide code__________]
  • Door entry system
  • Neighbour
  • Next of kin

Is the patient able to hear you to allow access if the property is locked?

  • Yes
  • No – access using________


Any additional comments about the property/access (e.g. three steps to back door/very dark side access)?



Is there a telephone?


  • No
  • Landline with cable
  • Landline with hand held receiver
  • Mobile

Cooking facilities

  • Gas cooker
  • Electric cooker
  • Microwave

Other comments about kitchen/fridge, etc

(e.g. neat and tidy/somewhat clutter/dirty and unhygienic?)


Any concerns about damp?

  • Yes/No


  • Gas fire/electric fire/central heating
  • Heating generally adequate/inadequate
  • Lighting generally adequate/inadequate

Any risks for patient/carers or staff in terms of

  • Access to accommodation
  • Flooring
  • Clutter
  • Slipping or tripping
  • Cleanliness
  • Adequate electrical equipment
  • Gas fire/heater with adequate ventilation?
  • Lighting
  • Pets
  • Other







Is there a working smoke detector?


Does the patient have a pendant alarm?

If no – would this be appropriate?


Is there current use or potential scope for use of telecare/telehealth?





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