Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Hazardous Substances

  • Are all hazardous substances stored in locked areas?

  • Are patient rooms free from cleaning chemicals?

  • Are all substances recorded on the COSHH Register and have they been risk assessed?

  • Are all COSHH Risk Assessments accessible to staff?

Fire & Evacuation

  • Are day shift staff on the Inpatient Unit aware of the evacuation procedures? (Ask minimum of 3 staff)

  • Are day therapies staff aware of the evacuation procedures? (Ask minimum of 2 staff)

  • Are staff in the complementary therapies area aware of the evacuation procedures?

  • Are night shift staff on the Inpatient Unit aware of the evacuation procedures? (Ask all staff)

  • What is the condition of the fire doors?

  • Are all fire doors free from obstructions and not wedged open?

  • Are all self closing devices in working order?

  • Is there evidence that AFD has been serviced within the last 6 months?

  • Is there evidence that the fire alarm test is being carried every week?

  • Is there evidence that all emergency lighting has been serviced in the last year?

  • Is there evidence that emergency lighting flick testing is being carried out monthly?

  • Is the fire alarm panel free from faults?

  • Is there adequate fire exit signage in place?

  • Are refuge areas clearly signed?

  • Is there adequate fire alarm instruction and information for visitors?

  • Are oxygen cylinders stored internally secured to the walls?

  • Is there a limited amount of internally stored oxygen?

  • Are housekeeping employees aware of the procedures for safely using a tumble dryer?

  • Are additional oxygen cylinders stored externally in a designated location?

  • Are flammable materials kept to a minimum and stored away from ignition sources?

Patient Rooms

  • Are all patient rooms free from trip hazards?

  • Are oxygen concentrators and cylinders in use correctly secured and in a safe location?

  • Is there procedures in place for checking oxygen concentrators and cylinders when in use? (Ask 2 employees)

  • Is electrical equipment in good condition?

  • Is there adequate storage available?

  • Has all equipment and furniture in the patient rooms been serviced?

  • Is all equipment and furniture in patient rooms in good, safe condition?

  • Is there evidence that the shower heads and hoses have been replaced within the last 4 weeks?

  • Is there any equipment or furniture which may cause entrapment of a patient?

  • Is there evidence that flushing of outlets has been carried out?

  • Are patient rooms free from sharps containers and sharp instruments?

  • Are patient bed rails in safe working condition?

  • What is the overall risk of harm to patients from hazards in the rooms?

Patient Lifting Equipment

  • Has all lifting equipment been serviced within the last 6 months?

  • Can certification be provided to prove this has taken place?

Sharps

  • Is there an adequate amount of sharps containers?

  • Are in use containers not overfilled?

  • Are filled sharps containers correctly labelled and dated?

  • Do the sharps in use/in stores have a mechanical safety cover?

  • Is there adequate and visible signage/guidance for dealing with sharps injuries?

  • Are clinical staff aware of sharps injuries procedures? (Including reporting and first aid etc)

  • Are sharps containers stored in a safe location?

  • Are employees aware of when a sharps injury is RIDDOR reportable? (Ask 1-2 employees)

Risk Management & Reporting

  • Do all employees know where to access risk assessments and safe systems of work? (Ask 2 employees)

  • Are employees aware of reporting procedures? (Ask 2 employees)

  • Do employees know when to report serious and imminent dangers? And who to? (Ask 2 employees)

  • Do employees know where to access health and safety policies? (Ask 2 employees)

  • Are employees aware of health and safety procedures associated with new and expectant mothers and women of child bearing age?

Training

  • Is there evidence that all clinical staff who assist patients have carried out clinical manual handling training within the last year?

  • Have all housekeeping staff been sufficiently trained in the safe use of hazardous substances?

Equipment & PPE

  • Has all electrical equipment been PAT tested in the last 12 months?

  • Is all equipment clean and in good condition? (Including wiring and plugs etc)

  • Is all equipment stored in a safe location?

  • Is there evidence that all cleaning equipment has been checked in the past week?

  • Are employees wearing the correct PPE when carrying out cleaning tasks? (Ask 1 employee)

  • Are employees wearing the correct PPE when mixing and using hazardous cleaning chemicals?

  • Is there evidence that PPE is being checked weekly to ensure it is still safe and suitable for the task it is meant for?

  • Is PPE stored in a designated, safe location?

Walkways & Flooring

  • Are all walkways free from trip hazards?

  • Are all walkways free from obstructions? (Ensuring safe movement of patients)

  • Is all flooring in good condition?

  • Is the lighting on all walkways suitable and sufficient?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.