Incident Details
-
Brief description of incident
-
Date and time of when the incident began
Emergency Action
-
Was an evacuation required?
-
At what time was the evacuation completed?
-
Did the Fire Service attend the incident?
-
At what time did the fire service arrive on site?
-
Did the Police attend the incident?
-
At what time did the police arrive on site?
-
Did the Ambulance Service attend the incident?
-
At what time did the ambulance service arrive on site?
-
At approx what time were the Critical Incident team notified of the incident?
Staff Roles
-
Are first aiders required?
-
Record the names of nominated first aiders. Ensure first aiders are qualified and have first aid equipment.
First Aider
-
Is an area required for family members of injured or deceased persons?
-
State the area reserved for family members and nominate a staff member to liaise with families - it would be most appropriate for a member of the CIM team to fulfil this role.
-
Are there displaced and unsupervised (by a parent or guardian) under 16's on site? .
-
nominate at least 1 female and 1 male member of staff to be solely responsible for supervising the group. Those nominated to supervise should begin compiling a register of names and contact numbers
supervising staff member
-
Is a staff member available to take a record of all staff working at the site at the time of the incident?
-
Nominate 1 or more people to take a register. Please include tenants and contractors e.g. catering staff, NHS etc.
staff register
-
Is a staff member available to take a record of all customers present at the time of the incident?
-
Nominate 1 or more persons to take a customer register. It would be advantageous to begin taking witness statements at this point however this should not interfere with any police investigation.
customer register
CIM Response
-
Record the names and times that members of the CIM team arrived on site
CIM Team Member
-
Select date
CIM Tasks
-
Is it necessary to contact Quality Leisure Management (01451861084)?
-
If yes take a record of who contacted QLM, who they spoke with and at what time. You may add several entries
QLM Contact
-
Select date
-
Is it necessary to contact the Health and Safety Executive?
-
If yes take a record of who contacted The HSE, who they spoke with and at what time. You may add several entries. Go to the HSE website for more guidance on what is a RIDDOR reportable incident.
HSE Contact
-
Select date
-
Is it necessary to contact Stirling Council?
-
If yes take a record of who contacted the Council, who they spoke with, from what department and at what time. You may add several entries
Stirling Council Contact
-
Select date
-
Is it necessary to contact SEPA?
-
If yes take a record of who contacted SEPA, who they spoke with and at what time. You may add several entries
SEPA Contact
-
Select date
-
Is it necessary to contact the Active Stirling board?
-
If yes take a record of who contacted the board member, who they spoke with and at what time. You may add several entries
Board Member Contact
-
Select date
-
Is it necessary to contact Active Stirlings Insurers?
-
If yes take a record of who contacted the insurers, who they spoke with and at what time. You may add several entries
Insurer Contact
-
Select date
-
Are media statements required?
-
Any statements should be prepared in conjunction with police and Stirling Council. State the person(s) writing any media statements. Any statement drafts should be confidential and should not be released until approved by the Chief Executive or in his absence a Senior Manager.
media team member
-
Have staff been briefed not to discuss the incident with others?
-
Is an incident response area required?
-
Where is the designated incident response area?
-
Is there access to at least 2 phones?
-
Is there access to email?
-
Is there access to the Internet?
-
Is there access to a photocopier?
-
Are additional members of the team from outside the CIM team required to assist in managing the incident?
-
If yes take a record of who is required. For example consider IT, HR or bookings team support.
additional team members
-
Do any imminent bookings or services need to be cancelled?
-
Give details of any services to be cancelled and who is overseeing this task
-
Is transport required to move staff or customers to another venue?
-
Give details of what transport is arranged and who is overseeing this task
-
Is any catering required for staff and/or customers?
-
Give details of any catering arranged and who is overseeing this task
Timeline
-
Take a record of the full timeline of events from when the incident began until the incident was closed and the scene was secured. Where possible give approximate times for each event within the timeline.
event
-
Select date
-
Record the time of the de-brief session for all of the team involved.
-
When complete and published forward this record to the Chief Executive Officer or in his absence the Senior Management Team. This record will form part of Active Stirlings investigation of the incident in addition to any witness statements, risk assessments, operating procedures, training records, maintenance records and more.
