Incident Investigation

• Investigation Conducted On

  Date

• Investigator

• Location of Investigation
  Address

• Report Reference Number

• Date & Time of Incident

  Date

• Venue

• Location within Venue

• Injured or Affected Person

• Witnesses

• RIDDOR Reference Number (if applicable)

• Description of Incident

Introduction

• The aim of the incident investigation is not to determine blame or liability, so far as is necessary to achieve its objective, but to identify factors that may have contributed to the incident occurring and to subsequently implement further control measures internally to prevent a recurrence.

Investigation Format

• The investigation report will follow the standard incident investigation format, which incorporates the following steps.

• The Immediate Reponse

• Information Gathering

• Analysing the Information

• Identifying Potential Causes/Contributory Factors

• Recommendations

• Take Effective Actions

• Listed below are factors that will be considered as part of the investigation.

• The immediate response should be to first check that the area is safe, and no one else can be harmed. The immediate responders should then tend to the injured, if there are any. Depending on the severity of the incident, the immediate responder may have to call for additional help, either first aid or an Ambulance.

• Review of the Immediate Response to the Incident

• Incident Report Form

  Yes

  No

  N/A

• RIDDOR Report Form

  Yes

  No

  N/A

• Photographs

  Yes

  No

  N/A

• Witness Interviews

  Yes

  No

  N/A

• Written Statements

  Yes

  No

  N/A

• Physical Objects, Equipment and/or Areas Inspected

  Yes

  No

  N/A

• Training Records

  Yes

  No

  N/A

• Risk Assessments

  Yes

  No

  N/A

• NOP/EAP and/or other Site Procedures

  Yes

  No

  N/A

• Other Information

  Yes

  No

  N/A

• This section of the report will look at all the information gathered and aim create an accurate record of what has occurred. Combining witness statements, notes, photographs and other information will provide a detailed timeline of events leading up to and during the incident. Where written procedures and risk assessments have been gathered, these will be reviewed to determine whether or not they were adequate and had they been followed, as well as determining if the people involved in the incident had been appropriately trained and were they competent to follow the guidance or procedure.

• Data Analysis Summary

Immediate Cause and Contributory Factors

• Detailed in this section are the immediate causes and contributory factors of the incident. These are normally fairly quick to determine and can often be determined at the time the incident occurred or through the gathering of witness statements.

• Summary of Immediate Causes and Contributory Factors

Prevailing Contributory Factors

• Detailed in this section are any prevailing contributory factors. These are factors that have contributed to the immediate cause of the incident, and are normally identified during the data analysis stage of the investigation.

• Were any prevailing contributory factors identified?

  Yes

  No

  N/A

• Summary of Prevailing Contributory Factors

• This section of the report details recommendations to ensure that similar incidents are not repeated.

Hierarchy of Control

• Recommendations follow the hierarchy of control.

  

• Are there recommendations?

  Yes

  No

  N/A

• Recommendations are detailed below.

• Summary

• Investigator

  Sign