FOR3026 Site Safety Inspection V16.0

• Document No.

• Project Number

• Discipline/s

  Select Civils Signalling Telecomms E&P Other

  • Civils
  • Signalling
  • Telecomms
  • E&P
  • Other

• Title of audit & Description of works

• Examples: Civils - cable route installation. Signalling - testing

• Client

• Conducted on

  Date

• Prepared by

• Location
  Address

• Type of site control

  Select LSL staff only Contractor - Contractor provides own supervision of work Contractor - LSL representative on site Subcontractor - Linbrooke supervised Subcontractor - subcontracted package of works Other -specify in section further detail

  • LSL staff only
  • Contractor - Contractor provides own supervision of work
  • Contractor - LSL representative on site
  • Subcontractor - Linbrooke supervised
  • Subcontractor - subcontracted package of works
  • Other -specify in section further detail

• Name of contractor / subcontractor/s and any other further detail (if required)

• Personnel

1.0 Documents

Have the following been checked: 1.1 Safe Work Pack. Validation sheet, operational risk documents, task risk documents & permits? 1.2 Risk assessments. Point of work assessments? 1.3 Work package plan? Detailed design? 1.4 Other documents?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Task risk assessment not suitable / sufficient Insufficient instruction Insufficient info Incorrectly complete (office) Insufficient methodology Out of date documents Not specific to works Not authorised Non BMS document Good practice No observations raised Insufficient documents Other: specify in 'further detail'

  • Task risk assessment not suitable / sufficient
  • Insufficient instruction
  • Insufficient info
  • Incorrectly complete (office)
  • Insufficient methodology
  • Out of date documents
  • Not specific to works
  • Not authorised
  • Non BMS document
  • Good practice
  • No observations raised
  • Insufficient documents
  • Other: specify in 'further detail'

• Further detail

• Provide further detail on each point raised above. Example:
  Task risk assessment not suitable / sufficient - does not identify risks observed on site
  insufficient instruction - risk controls within TBS were not task specific.
  Good practice: all risk controls are specific to task. Not task specific - the methodology does not fit with the work being carried out.

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

2.0 Competence

2.1 Have the following been checked: 2.2 Inductions? Do competencies match task, location and operational risks? 2.3 Is mentoring or monitoring in place as necessary? 2.4 Are personal folios in place and up to date? Is there evidence of management reviews of the folios? 2.5 Is the right person in charge of the site/task?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Insufficient induction Unsuitable to task Insufficient mentoring Supervision unsuitable No evidence of competence Out of date competency Insufficient training Insufficient knowledge and skills Insufficient experience Good practice No observation raised Other : specify in section 'further detail'

  • Insufficient induction
  • Unsuitable to task
  • Insufficient mentoring
  • Supervision unsuitable
  • No evidence of competence
  • Out of date competency
  • Insufficient training
  • Insufficient knowledge and skills
  • Insufficient experience
  • Good practice
  • No observation raised
  • Other : specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Example:
  Insufficient induction: induction does not highlight key risks within the CPP.
  Unsuitable supervision - Stihl saw use not supervised
  Good practice - all competence match the task and are in date No evidence of competence on site - auditor to verify

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

• Yes

  No

  N/A

3.0 Fleet & Vehicles

Have the following been checked: 3.1 Clean, tidy and mileage recorded? (Correctly loaded & within weight capacity limits)? 3.2 Serviceable (tyres, oil levels, washer fluid, lights, mirrors. Signs of unreported damage)? 3.3 Parked sensibly without causing risk? 3.4 Do all fuel cards (where allocated) match with the vehicle on site and the nominated driver?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Unreported damage Incorrectly loaded Unserviceable Poor parking Poor driving Dirty Unauthorised driver ALO controls insufficient Unsuitable for task or terrain No user checks Service or maintenance OOD Good practice No observation raised Other: specify in section 'further detail'

  • Unreported damage
  • Incorrectly loaded
  • Unserviceable
  • Poor parking
  • Poor driving
  • Dirty
  • Unauthorised driver
  • ALO controls insufficient
  • Unsuitable for task or terrain
  • No user checks
  • Service or maintenance OOD
  • Good practice
  • No observation raised
  • Other: specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Example:
  Good practice - all vans parked without causing risk, clean & tidy.
  Unreported damage - front light damaged not reported.
  Incorrectly loaded - items within trailer not secured.

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

4.0 Equipment

Have the following been checked? 4.1 Tools & equipment: condition, maintenance & calibration? (Obtain photos of bar-codes for tracking purposes). 4.2 Is the equipment suitable for the task and complete? 4.3 Is the equipment being used as intended for purpose? 4.4 First aid, firefighting, PPE & equipment for emergency measures? (Includes vehicles).

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Out of date calibration Out of date for service or maintenance Unserviceable Unsuitable for the task Incorrectly used No pre start check Dirty or neglected No evidence of PAT Good practice No observation raised Maintenance required Other: specify in section 'further detail'

  • Out of date calibration
  • Out of date for service or maintenance
  • Unserviceable
  • Unsuitable for the task
  • Incorrectly used
  • No pre start check
  • Dirty or neglected
  • No evidence of PAT
  • Good practice
  • No observation raised
  • Maintenance required
  • Other: specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Example: Good practice - Stihl saw used as per manufacturers instructions, pre-start up checks conducted.
  Equipment not used correctly - wrong drill bit used for task when drilling.

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

5.0 Materials

Have the following been checked? 5.1 Sufficient, correct type & quality? 5.2 Suitable delivery & storage arrangements? 5.3 Being used & handled correctly?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Incorrect storage of materials Incorrectly used Incorrect type Unsuitable delivery arrangements Insufficient amount Order or delivery planning issue Supplier issue Good practice Non disposal of surplus No observations raised Other: specify in section 'further detail'

  • Incorrect storage of materials
  • Incorrectly used
  • Incorrect type
  • Unsuitable delivery arrangements
  • Insufficient amount
  • Order or delivery planning issue
  • Supplier issue
  • Good practice
  • Non disposal of surplus
  • No observations raised
  • Other: specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Example:
  insufficient - cable the incorrect length for the task. Supplier issue - Supplier failed to deliver materials

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

6.0 Housekeeping

Have the following been checked? 6.1 Is the site, its access/egress routes and work areas free from hazards & risks? 6.2 Is the site tidy and free from rubbish/unrequired materials? 6.3 Has all the waste been correctly segregated and placed in appropriate labelled skips?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Untidy worksite Untidy working practices Access & routes obstructed Incorrect waste management Poor storage Poor site layout Good practice No observations raised Other: specify in section 'further detail'

  • Untidy worksite
  • Untidy working practices
  • Access & routes obstructed
  • Incorrect waste management
  • Poor storage
  • Poor site layout
  • Good practice
  • No observations raised
  • Other: specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Examples:
  Untidy work site - walkways full of obstacles Good practice - clean tidy work site, waste segregated on site, materials secured and banded

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

7.0 Occupational Health & Wellbeing

Have the following been checked? 7.1 Are noise, vibration, hazards and uncontrolled air borne risks (asbestos, silica, dust, exhaust fumes...) being effectively controlled? 7.2 Are fatigue mitigation plans & measures sufficient?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Noise not adequately controlled Vibration not adequately controlled Fatigue not adequately controlled Dust - silica not adequately controlled Dust - asbestos not adequately controlled Exposed to harmful substances (COSHH) Exhaust emissions not adequately controlled Insufficient breaks Good practice Adverse Weather conditions No observations raised Other: specify in section 'further detail'

  • Noise not adequately controlled
  • Vibration not adequately controlled
  • Fatigue not adequately controlled
  • Dust - silica not adequately controlled
  • Dust - asbestos not adequately controlled
  • Exposed to harmful substances (COSHH)
  • Exhaust emissions not adequately controlled
  • Insufficient breaks
  • Good practice
  • Adverse Weather conditions
  • No observations raised
  • Other: specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Examples: Noise: staff not wearing hearing protection when using Stihl saw
  HAV: -HAV not monitored on site Good practice - dust suppression kits used

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

8.0 Welfare

Have the following been checked? 8.1 Are there welfare facilities compliant with the project’s welfare requirements (including meeting CDM and client standards)? 8.2 Are the facilities clean, tidy, serviceable and emptied on a regular basis?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Insufficient expendables Dirty Insufficient provisions for # of staff Unserviceable No access to provided facilities Facilities too far from work group No welfare assessment Good practice No observation raised Maintenance Not adequate Other: specify in section 'further detail'

  • Insufficient expendables
  • Dirty
  • Insufficient provisions for # of staff
  • Unserviceable
  • No access to provided facilities
  • Facilities too far from work group
  • No welfare assessment
  • Good practice
  • No observation raised
  • Maintenance
  • Not adequate
  • Other: specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Examples:
  Not adequate - not enough toilets for number of staff on site (welfare assessment), no drying room. Good practice - enough toilets for number of staff on site, welfare cabin clean & tidy

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

9.0 Security

Have the following been checked? 9.1 Does the site have appropriate control measures to prevent theft, vandalism or arson? 9.2 Do the teams know what to do when spotting a trespasser? Has trespass been an issue?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Vehicles unlocked Unsecure storage Insufficient barriers / fencing Access points unlocked Plants or materials not secured Good practice Insufficient knowledge No observation raised Other: specify in section 'further detail'

  • Vehicles unlocked
  • Unsecure storage
  • Insufficient barriers / fencing
  • Access points unlocked
  • Plants or materials not secured
  • Good practice
  • Insufficient knowledge
  • No observation raised
  • Other: specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Examples:
  Unsecure storage:/ materials - equipment volt unlocked when checked, work group at different location.
  Good practice - gates locked, materials secure & banded

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

10.0 Hazardous Substances

Have the following been checked? 10.1 Are COSHH items & hazards being adequately controlled?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Unsuitable control measures Inappropriate equipment for controls Controls not briefed Controls not applied Products not secured or stored correctly No emergency measures Product labels or signage incorrect Good practice Invalid documents No observation raised Other: specify in section 'further detail'

  • Unsuitable control measures
  • Inappropriate equipment for controls
  • Controls not briefed
  • Controls not applied
  • Products not secured or stored correctly
  • No emergency measures
  • Product labels or signage incorrect
  • Good practice
  • Invalid documents
  • No observation raised
  • Other: specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Examples:
  controls not briefed - risk controls for use of aerosol not briefed. controls not applied - staff did not use FFP3 mask when using aerosol

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

11.0 Environmental

Have the following been checked? 11.1 Are the team aware of their environmental control measures & emergency measures? 11.2 Where there are any hazardous substances in use, have they been stored and labelled appropriately?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Insufficient environment controls Insufficient spill control Insufficient knowledge of risks & controls Controls not applied as per plans Good practice No observation raised Other: specify in section 'further detail' ESMP not on site

  • Insufficient environment controls
  • Insufficient spill control
  • Insufficient knowledge of risks & controls
  • Controls not applied as per plans
  • Good practice
  • No observation raised
  • Other: specify in section 'further detail'
  • ESMP not on site

• Further detail

• Provide further detail on each point raised above. Examples:
  insufficient environment controls - breeding bird checklist not done as per instruction in TBS.
  Good practice - 7M exclusion zone set around Japanese knotweed, boot wash used

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

12.0 Control Measures

Have the following been checked? 12.1 Adherence to task & location controls: for height, confined spaces, electricity, ALO, deliveries, plant etc? 12.2 Work environment risk controls? 12.3 Operational risk controls? 12.4 Emergency preparedness (as suits risk e.g. fire, types of injury or damage)?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Task control measures insufficient Operational controls insufficient Controls not briefed Controls not applied Controls not understood Risks not identified Good practice No observation raised Other: specify in section 'further detail'

  • Task control measures insufficient
  • Operational controls insufficient
  • Controls not briefed
  • Controls not applied
  • Controls not understood
  • Risks not identified
  • Good practice
  • No observation raised
  • Other: specify in section 'further detail'

• Which hazards were not adequately controlled

  Select Not Applicable Silica dust Lifting operations Work at height Electricity Manual handling Hazardous substances Confined spaces Fatigue Buried services ALO Temp works HAV Operational Fire Lighting Noise Trespass security Biological hazard Asbestos Other: specify in the 'further detail' section

  • Not Applicable
  • Silica dust
  • Lifting operations
  • Work at height
  • Electricity
  • Manual handling
  • Hazardous substances
  • Confined spaces
  • Fatigue
  • Buried services
  • ALO
  • Temp works
  • HAV
  • Operational
  • Fire
  • Lighting
  • Noise
  • Trespass
  • security
  • Biological hazard
  • Asbestos
  • Other: specify in the 'further detail' section

• Further detail

• Provide further detail on each point raised above. Examples: Task control measures insufficient - 'no test before touch' applied - electricity,
  controls not applied - staff did not barrier off the manhole before setting up the mobile scaffold - WAH
  Good practice - staff set up mobile scaffold as per manufacturers instructions, pre-use checks conducted.

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

13.0 Quality

Have the following been checked? 13.1 Is the design being followed? 13.2 Are there any signs of poor quality workmanship? 13.3 Are there signs of activities or situations that are inefficient or may cause financial/time loss?

• Points raised (select all appropriate) - provide further detail on each selection where applicable

  Select Design not followed Client requirements not followed Unecassary snagging left No photo evidence of pre / post work site Poor workmanship Processes not followed No evidence of quality checks Good practice No observation raised Loss of time No QMP on site Other: specify in section 'further detail'

  • Design not followed
  • Client requirements not followed
  • Unecassary snagging left
  • No photo evidence of pre / post work site
  • Poor workmanship
  • Processes not followed
  • No evidence of quality checks
  • Good practice
  • No observation raised
  • Loss of time
  • No QMP on site
  • Other: specify in section 'further detail'

• Further detail

• Provide further detail on each point raised above. Examples:
  Design not followed - installation appears to be different to the design
  unnecessary snagging left - labels not applied. Good practice - installation check sheet completed, equipment installed as per manufacturers instructions

Actions

• Action/s required?

  Yes

  No

  N/A

• Mandatory - Click the "Action" button above - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day. Multiple actions can be raised.

14.0 Behaviours. % Safe Questions.

The inspector is to decide answers to the following 10 questions. The questions are then to be used to fuel a safety conversation. Subsequent findings are to be recorded in section 15.

• 1. Can workers explain details of their operational, task and location risk controls?

  Yes

  No

• 2. Are methodologies, control measures and safe practices being followed?

  Yes

  No

• 3. Can the workers explain details of their emergency control measures?

  Yes

  No

• 4. Do the workers know the lifesaving rules?

  Yes

  No

• 5. Do the workers know the work-safe procedure?

  Yes

  No

• 6. Can the workers give details of the last safety brief (tool box talk)?

  Yes

  No

• 7. Have all noticeable close calls been reported by the team? (Answer yes even if none reported, team are still to demonstrate reporting procedure).

  Yes

  No

• 8. Has the team recently received a debrief from their supervisor and was the debrief sent to HSEQ?

  Yes

  No

• 9. Did the workers engage in open, honest discussion regarding performance & HSEQ matters?

  Yes

  No

• 10. Have all changes been properly dealt with, recorded and authorised? (Answer yes if no changes, team are still to demonstrate change procedure).

  Yes

  No

15.0 Further notes (if required), any further actions required, any non-conformances (NCR) raised, advice given, outcomes of safety conversations and de-briefing comments provided to the team. State how any NCRs were closed on site.

16.0 Safety conversation

• Did you have a safety conversation?

  Yes

  No

  N/A

• Topics covered (select all appropriate) - Provide further detail (below) on each selected

  Select No safety conversation held 1.0 Documents 2.0 Competence 3.0 fleet & vehicles 4.0 equipment 5.0 materials 6.0 housekeeping 7.0 occupational health and well being 8.0 Welfare 9.0 security 10.0 Hazardous substances 11.0 environment 12.0 control measures 13.0 quality Other: specify in section 'further detail'

  • No safety conversation held
  • 1.0 Documents
  • 2.0 Competence
  • 3.0 fleet & vehicles
  • 4.0 equipment
  • 5.0 materials
  • 6.0 housekeeping
  • 7.0 occupational health and well being
  • 8.0 Welfare
  • 9.0 security
  • 10.0 Hazardous substances
  • 11.0 environment
  • 12.0 control measures
  • 13.0 quality
  • Other: specify in section 'further detail'

• Further detail

• Click the "Action" button above ONLY if an action can be agreed with the project team - determine 'who' & 'date to be closed by' - agree with project team. Click 'Mark as complete' if the action is closed out on site / on the day.

• Provide further detail on the topic/s of conversation above. Examples: 2.0 Competence - staff requested further training on the Cat scan & Generator 4.0 Equipment - staff spoke about alternative types of gloves for the work activity.

• Auditor:

  Sign

• PIC / Supervisor acknowledgement of findings

  Sign

• Information & Guidance
  Completing your inspection
  1. Inspect all areas in sesctions 1 to 13 (questions within 1 to 13 are for guidance).
  2. Complete the percent safe questions.
  3. Conduct a safety conversation and inspection debrief with the team.
  4. Return the completed form to HSEQ.
  Completing the checklists. When working through the checklists on pages 1 & 2, as applicable, satisfy yourself that each item is:
  1. Present. 2. In date. 3. Completed correctly. 4. Within calibration or inspection timelines. 5. Serviceable. 6. Relevant/specific to the work. 7. Sufficient to cover hazards & mitigate risks. 8. Briefed to all personnel. 9. Being adhered to. 10. With sufficient evidence & records in place. Look for & record good practices too.
  Percent safe questions. The percent safe questions will give a good starting point for sparking a safety conversation. You will know why you concluded your score, ask the team to score themselves too and discuss/agree all reasoning.
  Your answers allow a means of measuring behavioral performance and are important in trend analysis. There are 10 questions, each earns 10 points. All questions are applicable to any site and must be asked. Each question must be answered with a ‘yes’ or ‘no’. A ‘yes’ answer earns points, ‘no’ answers do not.
  Safety Conversation. Watch & listen during your inspection, then lead a safety conversation with the team as part of your debrief to them. In the discussion, you should ask questions which lead the team to explain & acknowledge their own strengths & weaknesses without you having to tell them. Use anything you saw at the site to help fuel the conversation. Your questions should be aimed at:
  • Gaining assurance of the workers’ level of competence, quality of work & safe practices.
  • Educating & motivating by providing information, briefs, updates.
  • Delving in to general project performance and gaining opportunities for feedback or consultation regarding: occupational health, safety, wellbeing, sustainability & the environment. Also consider: programme time or finance constraints, the plan, personnel, materials, plant, equipment, designs, client & third party interactions etc.
  Ensure you record your safety conversation in section 15 and add notes on any lessons learnt.
  Site Debrief of Findings - The team must be debriefed on your findings, this must include positives, negatives and any advice you may provide (there may be comments the inspector may wish to raise which are suitable for sending via the debriefing QR application too – take the opportunity to lead by example in debriefing).
  Returning your completed inspection report. The auditor is to ensure that their site safety inspection report is returned to HSEQ for recording & analysis (hard copy or scans/photos via hseq@linbrooke@co.uk.
  Operational leaders’ meeting (OLM). The OLM is held each Friday at 09:00. Join by dialing: 020 3137 2688 & entering conference ID: 89 21 66 86.
  Confidential reporting
  1. In both QR codes, for close calls and debriefing, it is possible to raise your concerns without disclosing your identity.
  2. Alternatively, you can confidentially discuss your concerns with the HSEQ Manager via 07788 393598.
  Close calls & debriefs. Following your site inspections, any close calls and debriefs should be shared.