GLOBE GROUP - Induction & Health Surveillance

Title Page

Employee name
Date of Induction
Inducted by
Trade
Your Address
Your Contact Number
Date of Birth
Sex (Male/female/Other)
Nationality
Emergency contact name & number
Relationship
I confirm that i have submitted any known Medical conditions to the HR Manager prior to works commencing
I confirm that i have submitted Evidence of rights to work in the UK to the HR Manager prior to works commencing Evidence of rights to work in the UK

Personal Details

Hand arm Vibration Questionnaire

Date of previous HAVS screening (if completed)
Have you been using hand held vibrating tools, machines, or hand fed processes in your job, (IF NO, OR MORE THAN 2 YEARS SINCE LAST EXPOSURE - NO NEED TO ANSWER FURTHER IN THIS SECTION.
Do you have any numbness or tingling of the fingers lasting more than 20 minutes after using vibrating equipment?
Do you have any numbness or tingling of the fingers at any other time?
Do you wake at night with pain, numbness, or tingling in your hands or wrists?
Have any of your fingers gone white with cold exposure? (Whiteness means a clear discolouration of the fingers with a sharp edge, usually followed by a red flush).
Have you noticed any change in your response to your tolerance of working outdoors in the cold?
Are you experience any other problems in your hands or arms?
Do you have difficulty picking up very small objects, eg screws or buttons or opening tight jars?
Has anything changed about your health since the last assessment?
I certify that all the answers given are true to the best of my knowledge and belief.

Medical Questionnaire

Do you have any injuries or orthopedic problems (hernia, back, knees, shoulders, etc)?
Do you suffer from impaired vision (long or short sighted)?
Do you have any difficulty in hearing in normal conditions?
Do you have any known cardiovascular problems (abnormal ECG, previous heart attack, etc)?
Do you suffer from any respiratory illness (COPD, etc) or have problems with breathing when completing work activities?
Do you suffer from any stomach, bowel, or bladder issues?
Do you suffer with any skin issues (dermatitis)?
Do you suffer with Vertigo?
Do you suffer with Anxiety / Stress?
Do you suffer with Drug or Alcohol dependency?
Do you suffer with Rheumatism, arthritis, tensons, ligament, joint issues?
Have you ever been advised by a doctor, physician or specialist not to perform any type of exercise/activity?
Do you have any other medical condition, injury, or anything else we should be aware of?
I certify that all the answers given are true to the best of my knowledge and belief.

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I have read and understood the H&S Policy that was issued during my HR induction.
I have read and understood the Environmental Policy that was issued during my HR induction.
I have read and understood the Environmental Policy that was issued during my HR induction.
I have read and understood the Drug & Alcohol Policy that was issued during my HR induction.
I have read and understood the Training Policy that was issued during my HR induction.
I have read and understood the Anti Bribery & Corruption Policy that was issued during my HR induction.
I have read and understood the Anti slavery & Human Traficking Policy that was issued during my HR induction.
I have read and understood the Personal Protective Equipment Policy that was issued during my HR induction.

To be completed by operative

I am able to communicate in English and understand health and safety signs or warning indicators (If the answer is No, then a further risk assessment and additional control measures will be required).
I am aware that i must wear Hard hats, high visibility jackets, safety footwear and gloves, along with any other necessary task specific PPE / RPE / FPE as identified by way of Risk Assessment.
I am aware that i am responsible for the maintenance, use, and safe keep of any PPE issued to me, and will be liable to reimburse Globe Group for any lost, damaged, or neglected personal protective equipment assigned to me.
I confirm that i must complete daily pre use PPE / FPE / Equipment checks (visual) prior to works commencing, In addition, a recorded check must also be completed on a weekly basis.
I agree that i must attend a site specific induction, and read and comply with the controls that are set out within the Method Statements, Risk / COSHH Assessments.
I am aware that I need to report Immediately to the Globe Group Management team ALL accidents, incidents, near miss incidents, and any hazards that i feel may cause harm or damage.
I have been advised of the location of the First Aid facilities, welfare facilities, and the fire assembly point.
I agree that i must have a CSCS / CISRS /CPCS / NPORS Card or equivalent to be able to work on a construction site / operate plant, and must not carry out any works that i have not been assessed as competent to complete.
I am aware that good housekeeping is mandatory and Globe Group operate a 'sweep as you go' policy. All rubbish and waste materials to be deposited in skips provided, and any materials must be stored in agreed locations and in an approved manner. <br>
I confirm that i will not put myself or others at risk of harm as a result of my acts.
I am aware that company provided uniform must be worn. <br><br>
I am aware that Smoking or vaping is only permitted in designated areas.<br>
I agree that Mobile phones must not be used in work hours unless required for the nature of the business, or if Health and Safety is compromised.
I am over the age of 18 and have no medical conditions which will affect the safety of myself, or others whilst working.
Note 1: If under 18 – a separate risk assessment is needed
Note 2: Medical conditions - details must be submitted to HR.
Inductee Name and Signature

Manual Handling

Nearly all tasks involve manual handling. This can mean lifting and carrying, pushing or pulling a range of objects.
Some manual handling injuries may develop over a period of time rather than being the result of a single accident.
Other injuries from manual handling include bruises, cuts, hernias, wrenched shoulders and crushed limbs.
Back injuries, are a major concern for manual handling operations and can be caused by bad handling techniques.
If a load is lifted with the back in the wrong position, the lower back will take a lot of pressure. It is not designed to take this strain and may be damaged as a result.
It is not just lifting that causes strain. Over reaching and twisting when moving objects can also lead to injury.
Before lifting assess the weight of a load. Can manual handling of the object be avoided, and lifting machinery or aids be used instead? If not, do you need help in moving the load? If more than one person will be involved, you must work as a team with one person supervising the lift.
Assess the need for protective clothing. Should you be wearing gloves to protect your hands, or steel capped boots on your feet, or any other protective clothing?
Stop and think- PLAN THE LIFT. Where is the load to be placed? Use appropriate handling aids if possible. Do you need help with the load? Remove obstructions such as discarded wrapping materials. For a long lift, such as floor to shoulder height, consider resting the load mid-way on a table or bench to change grip. Position the feet
Feet apart, giving a balanced and stable base for lifting (tight clothing and unsuitable footwear make this difficult).
Leading leg as far forward as is comfortable and if possible, pointing in the direction you intend to go.
Adopt a good posture
When lifting from a low level, bend the knees. But do not kneel or overflex the knees. Keep the back upright,
maintaining its natural curve (tucking in the chin helps). Lean forward a little over the load if necessary to get a
good grip. Keep the shoulders level and facing in the same direction as the hips.
Get a firm grip - Try to keep the arms within the boundary formed by the legs. The best position and type of grip depends on the
circumstances and individual preference; but must be secure. A hook grip is less tiring than keeping the fingers
straight. If you need to vary the grip as the lift proceeds, do it as smoothly as possible.
Keep close to the load - Keep the load close to the trunk for as long as possible. Keep heaviest side of the load next to the trunk. If a close
approach to the load is not possible, slide it towards you before trying to lift.
Don’t jerk - Lift smoothly, raising the chin as the lift begins, keeping control of the load.
Move the feet - Don’t twist the trunk when turning to the side.
Put down first, then adjust
If precise positioning of the load is necessary, put it down first, then slide it into the desired position.
If in doubt, get help.
NEVER put your health at risk - if you’re unsure, always ask for assistance.
GLOBE GROUP carry out on-site manual handling training assessments, records of which will be held on file. Below is a list of
general products that are used by GLOBE GROUP that will be lifted as part of routine works, The Manual handling hierarchy as
set out above will be followed at all times. GLOBE GROUP provide lifting and moving equipment to enable materials to be
moved from place to place, always ensure that lifting / moving equipment is NEVER overloaded – if you are unsure – ASK YOUR SUPERVISOR!!

Steel Scaffold Tube KGs Per Item No. Per Tonne
21' Length 28.57 35
20 Length 27.21 37
19' Length 25.85 39
18' Length 24.49 41
17' Length 23.12 43
16' Length 21.77 46
15' Length 20.41 49
14' Length 19.04 53
13' Length 17.69 57
12' Length 16.33 61
11' Length 14.97 67
10' Length 13.6 74
9' Length 12.24 82
8' Length 10.89 92
7' Length 9.52 105
6' Length 8.16 123
5' Length 6.8 147

Timber Boards KGs Per Item No. Per Tonne
13' Length 23.81 42
12' Length 21.97 46
10' Length 18.31 55
8' Length 14.65 68
6' Length 10.99 91
5' Length 9.16 109

Fittings KGs Per Item No. Per Tonne
Drop Forged Double 1.31 763
Pressed Double 0.93 1075
Drop Forged Swivels 1.25 800
Pressed Swivels 1.09 917
Pressed Singles 0.68 1471
Sleeves 1.15 869
Spigots 0.9 1111
Base Plates 0.4 2500
As a general guide, the following amounts of materials will be the maximum to be lifted or lowered by rope and wheel:
• Two boards up to 4m (13 feet) long (47.6kg);
• One tube up to 6.4m (21 feet) long (28kg);
• Two tubes up to 3.0m (10 feet) long (27.2kg);
• Three tubes up to 3.0m (10 feet) long (40.8kg).
The maximum mass that can be hoisted on a Gin Wheel is 50kg, but please note that this also includes the
weight of the rope. It is therefore critical that the weight of the rope is taken into consideration when hoisting tube/boards at very high levels.
I have read the above Manual Handling training guidance, and understand that i must assess all loads prior to moving, pushing, or pulling any item, and use mechanical means (where possible) safely and within the Safe Working Limitations.

Competency / Qualifications

Please tick and provide photos (FRONT AND REAR) of relevant Training:
CSCS
CISRS
SSSTS/SMSTS
First Aid
CPCS / NPORS (Plant Operators)
Telescopic Handler
Asbestos Awareness
Abrasive Wheel
CCDO
Working At Height and Harness
Confined Spaces
Traffic Banksman
Fire Marshall
Slinger Signaller
Transporting Loads
Mobile Boom
Scissor Lift
Static Boom
Driving licence
If you hold any other qualification ensure that the office is aware and holds a copy for office records.