Health & Safety IN-HOUSE / PEER AUDITS EXPLAINED (Including Toolkit)
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1 Health & Safety IN-HOUSE / PEER AUDITS EXPLAINED (Including Toolkit) Document No: G027:07-15/1 Page 1
2 A Sensible Risk Management approach The Corporate Health Safety & Wellbeing Service is striving to improve the health, safety & wellbeing culture across the organisation. The Service is a diverse professional team with a wealth of experience and knowledge. Its purpose is to provide competent advice, guidance, training and support to the authority to meet its health safety & wellbeing needs and statutory obligations. It is a fully integrated service provider that prides itself on its flexible, consistent, common sense based approach to improve the safety & wellbeing culture of the organisation. What we believe in A Sensible Risk Management approach It is therefore the goal of the Corporate Health, Safety and Wellbeing Service to provide you with the help you need to help yourself. The Corporate Health Safety and Wellbeing Service (CHSWS) a fully integrated service provider consisting of: The Health and Safety Team based at the Guildhall. The Health and Safety Training Team based at Jubilee Court The Occupational Health and Wellbeing Unit based also at the Guildhall Stress Management & Counselling (SMAC) Document No: G027:07-15/1 Page 2
3 You can contact the Corporate Health, Safety and Wellbeing Service via the following: Telephone: Webpage: What are Audits? The auditing of Health & Safety performance consists of: Day to day monitoring and checks Peer auditing Corporate Health, Safety and Wellbeing Service auditing. Basically an audit is the process of formally checking that what is being done is being done as procedure states it should, that the necessary paperwork is kept as is required by legislation, things are being done in accordance with the Corporate Health and Safety Policy, best practice etc What are Peer Audits they are a formal means by which service areas can self-audit against the operational health and safety management system. Peer Audits as the name suggests is where operational colleagues from another part of your service area carry out a thorough examination of Health and Safety documents for your particular workplace or premises. The Peer Audit is designed to identify areas of strength and weakness in the day to day management of Health and Safety. Peer audits are carried out by Service staff, using checklists based on Corporate Health and Safety Policy, procedures, protocols and legislation The Audit needs to be carried out as recommended and at least on a six monthly basis by members of staff who have been suitably trained to do so. This can then be used as a benchmark upon which subsequent auditing can be assessed. It is also a useful tool with regards to Succession Management and the gauging continuous improvement and slippage in standards. Formal Peer Auditing has already been successfully adopted in some service areas and it is the corporate aim of the Executive Board for them to be carried out across all Directorates. Document No: G027:07-15/1 Page 3
4 The manner in which the peer audit should be carried out The auditing team should communicate with those being audited, by talking to staff and involving them in the process providing positive feedback on good performance and will encourage commitment to further improvement The purpose of the process is to avoid out and out criticism by being factual and helpful. Where possible, ways should be identified in which problems can be corrected, rather than merely noting they exist. If possible, those being audited should be encouraged to come up with the solutions themselves. We all work for the same organisation and it is the ideal opportunity to communicate and share good practice. Included within the Peer Audit Toolkit is an example of a Checklist and an annual schedule. The reason behind the yearly planner is to enable you to carry out your inhouse audit/monitoring in manageable bite sized chunks across a period of twelve months. The Peer Audits can then focus on the whole six month cycle when carried out (hence twice a year In-house / Peer Audit Responsibilities (As detailed in the roles and responsibilities in the Corporate Health and Safety Policy) Senior Manager: Responsible for ensuring Peer Audit/ teams are appointed and the designated staff are suitably trained A programme schedule of peer audits is established Peer Audits are conducted with the required frequency and monitored Where the need for corrective actions are identified, that the actions are tracked through to completion. Co-ordinating peer audit programme(s), and in particular for: Establishing the peer audit timetable(s) Producing checklists Providing standardised peer audits and inspections Producing peer audit and inspection feedback reports Following up the results of peer audits to track that required actions have been taken through to completion Document No: G027:07-15/1 Page 4
5 Line managers and Supervisors Responsible for ensuring Day-to-day monitoring of health and safety Participating in audits and inspections as defined in procedure agreement Ensuring that identified problems are dealt with in a timely manner Members of Staff involved in the internal audit and inspection teams Responsible for ensuring They attend training to enable them to conduct effectively the Peer audit process Carry out their Peer auditing duties as defined in the process protocol Document No: G027:07-15/1 Page 5
6 Health & Safety In-house / Peer Audit Toolkit Directorate: Peer Audit/ Service Area or Site: Auditor Name(s): Date of Peer Audit: Date of Next Peer Audit: NB - The frequency of in-house and peer audit programmes does not absolve line management of the responsibility to supervise and monitor operations on a day to day basis. Document No: G027:07-15/1 Page 6
7 In-house / Peer Audit Checklist Note: The following is not a definitive checklist. Service areas should prepare their own checklist based on their own health and safety arrangements as described in the Corporate Health and Safety Policy, procedures, guidance and protocols. This checklist is a basic peer/internal audit checklist to which Service Areas and schools would adapt as necessary, making reference to specialised subjects such as COSHH etc, depending on their own activities carried out. Checklist Training YES NO Have new staff members received induction training? (Evidence) Have training needs for staff been identified? (Evidence) Are training records available? (Evidence) Accidents Have all accidents been investigated, recorded and reported? (Evidence) Health and Safety Policy Is the current policy available and communicated to all staff? (Evidence) Is there a source of information for visitors? (Evidence) Is there a Health and Safety Law information poster displayed in the building? Are employees aware of their H&S committee representatives? Condition of premises Have building defects with health and safety implications been reported to Facilities Management section and followed up if appropriate? (Evidence) Is a current copy of the site Asbestos survey available, emergency procedures in-place with evidence of communication to contractors and employees as appropriate? Fire Precautions Is the Fire Safety File including risk assessment readily available and up to date? (Evidence) Are EAPs NOPs and PEEPs readily available for scrutiny and up to date? (Evidence) Are there procedures for what to do in the event of a fire are they posted? (Evidence) Are evacuation routes kept clear, adequately signed and illuminated? (Evidence) Are fire escape routes kept clear doors in good condition and kept closed? Can they be easily opened to effect escape? (Evidence) Document No: G027:07-15/1 Page 7
8 Have fire extinguishers been serviced within the last 12 months? (Evidence) Have a fire drills been held as defined in the Management of Fire Safety Policy (Evidence) First Aid Are there adequate arrangements for first aid? (Evidence) Are employees aware of the first aiders/arrangements? Is there a fully stocked first aid box with evidence of contents checks? Electrical Safety Has Portable Appliance Testing (PAT) being carried out? (Evidence) Are tests/inspection records in date and readily available? (Evidence) Is there a hazard spotting/visual inspection regime in-place? Housekeeping/Welfare Is the workplace in a clean and orderly manner Are there sufficient COSHH storage arrangements(evidence) Is waste removed regularly? Is there access to clean drinking water? Is there a suitable kitchen/rest area for employees to prepare and eat meals away from the workstation? Manual Handling Have situations where staff might be injured lifting or carrying been identified? (Evidence) Has a risk assessment and action been taken to remove or reduce the risk of injury? (This includes training) (Evidence) Relevant Training Records available (Evidence) Computer Workstations Have users been identified and trained (DSE awareness)? (Evidence) Have workstation assessments been carried out, including reviews for any pregnant employee? (Evidence) Have there been any ill health or injuries reported with reference to computer workstation use? (Evidence) Access to/working at Heights Has the foreseeable need for working at height been identified and assessed? Is there safe access to any storage above head height? Are ladders, stepladders and kick stools regularly inspected? YES NO Document No: G027:07-15/1 Page 8
9 Machinery/Equipment YES NO (Photocopiers, communal printers, trucks and trolleys, TVs, Video/DVD players, etc.) Are there safe systems of work for the operation of machinery/equipment in the department (Evidence) Are safe systems of work being followed? (Evidence) Are safety devices on machinery maintained? (Service records) Off Site Activities/V&A/Lone Working (Seminar or conference attendance/placement Officers Visits/Outreach Home Visits) Are risk assessments written (to a suitable and sufficient standard) (Evidence) Are contact (booking out/in) arrangements in place(evidence) Are the Safety Guidance documents available for staff to consult (Evidence) Are Violence and Aggression incidents (HS3) reporting records available (Evidence) Is feedback obtained and evaluated for improvement of safety systems (Evidence) In-house or PEER Audits-Recommendations Document No: G027:07-15/1 Page 9
10 Directorate: Service Area: Year: The Corporate Health Safety and Wellbeing Service Annual PEER Audit Schedule for (Date) Month/Activity Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Training Fire Safety Safety Policy Inspection(s) Electricity At Work Waste HAVs COSHH PPE Lone Working First Aid Manual Handling Noise Asbestos Add or delete as necessary Note: This is an example only of the structure and composition of a schedule. It should be based on the nature of the activities carried out in your particular service area/premises. Advice on how to build your specific structure can be obtained from the CHSWS Document No: G027:07-15/1 Page 10
11 PEER AUDIT FINDINGS (FINAL PAGE) RECOMMENDATIONS AGREED ACTION / COMMENTS RESPONSIBILITY FOR IMPLEMENTATION IMPLEMENTATION DATE PRINT SIGN Name & Signature of Auditor PRINT SIGN Name & Signature of Person responsible for completion of actions Document No: G027:07-15/1 Page 11
12 Possible additional Topic areas: These should be considered for inclusion to the In-house / Peer Audit checklist dependent on the site specific and operational need: NB As detailed in the Premises Managers Toolkit. TOPIC AREAS 1. Policy awareness/ access to and communicated 2. Risk Assessments 3. Induction & Training details 4. COSSH R/As - Storage 5. Asbestos/ Survey etc 6. Fire File etc 7. Electricity PAT Cert 8. L.E.V. 9. Water Systems Legionella 10. Lifts / Lifting Equipment LOLER R/As 11. Manual Handling R/As etc 12. First Aid Arrangements etc 13. Instruction and Training details e.g. induction 14. Boilers/Pressure Vessels Service details etc 15. Kitchens Risk Ass/ Certs etc 16. Management of Contractors signing in book etc 17. Management of Accidents - Records etc Document No: G027:07-15/1 Page 12
13 Further additional topic areas that could be added to the Peer Audit Accident Reporting Documentation and records HS1 HS2 HS3 Asbestos Asbestos Register Information Asbestos Survey Asbestos management plan Annual records of Asbestos Checking COSHH Information COSHH Assessments and implemented actions (Management controls) Data Sheets CONTRACTORS (New Works & Maintenance) Documentation - Records of; Who When on site Work carried out Work completion and satisfactory standards sign-off by Facilities Management Section. Electrical Records of: PAT Testing Fixed Wire testing Emergency Lighting (also under Fire related info) Records Fire Safety Management related Information Fire Risk Assessment/ Alarms/drills/signage-sprinklers-smoke-detectors-escapes to include/emergency lighting site plan Document No: G027:07-15/1 Page 13
14 FIRE EVACUATION PROCEDURES for site PEEPS, NOPs & EAPs etc FIRE INFORMATION; FIRE MARSHALS-WARDENS OFFICE SAFETY / FIRE RELATED TRAINING/ Contractor(s) and in-house tests and inspections documentation First Aid Related Information Risk Assessments First Aiders Names Telephone Nos Training Records kept in training specific file? Location of first aid Boxes. Records of use kept in a register. Gas Safety Certificates Maintenance documentation Hazard spotting Checklist records Record/Evidence of task being carried out Evidence of internal and external (the grounds and car park(s) within the curtilage of the premises) Health and Safety Meetings Minutes Agenda(s) - etc Health and Safety Staff Site induction Aide Memoire to be drawn up by individual sites Health and Safety Staff Training Mandatory Courses Records of courses attended Document No: G027:07-15/1 Page 14
15 Health Surveillance Staff details (Occupational Health) Relevant risk assessments Monitoring Records Legionella Records documentation Lifts/Lifting Equipment All kinds of: Passenger lifts Lifting gear Hoists (People carrying or others) Certification for equipment Insurance Co or as per FM directive Lone Working Risk Assessments - Staff Details Telephone Nos Guidance - Logging System etc Maintenance to building Records of Building consent/ works carried out /asbestos management Risk assessments if applicable FRA Template 5 Steps Operational Pregnancy New and Expectant Mothers DSE Traffic Management COSHH and supporting detail (storage etc) First Aid and supporting detail (storage etc) Signage - in all its forms Ensure suitability and maintenance Document No: G027:07-15/1 Page 15
16 Traffic Management Traffic Management (car parking etc pedestrian routes, signage) Site Map of system Utilities Information Cut off positions, Meter locations, shared supplies etc Violence and Aggression Risk Assessments Management systems - Information Reporting protocols, records Red- Flag system or similar. Inclement Weather related tasks and duties The provision and evidence of a suitable management system in place - stating what to do in the event of - this should include protocols on weather related problems such as Snow -Gritting etc Welfare Facilities Records of maintenance faults etc. The title headings can be added to the In-house / Peer Audit Checklist if required. NB: These lists are not exhaustive Document No: G027:07-15/1 Page 16
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