NEM workplace risk assessment Third Space

• Third Space new and expectant mother workplace risk assessment

• Third Space

• Conducted on

  Date

Information

• This risk assessment should be completed jointly by the new and expectant mother and a supervisor/manager. The assessment should be reviewed throughout the pregnancy tied in with GP information and at the request of the new and expectant mother.
  The information gathered is used to compile a general risk assessment to ensure that the level of risk is acceptable and any follow up actions managed.

• Select date

  Date

• NEM name

• Carried out by

Movement and posture

• Do work activities involve awkward twisting or stretching that pose a risk?

  yes

  no

• Do you need to stand for long periods of time without a break?

  yes

  no

• Do you need to sit for long periods of time without a break?

  yes

  no

• Is there sufficient space within the workplace without restrictions?

  Yes

  No

Manual handling

• Do work activities involve manual handling task that could be considered a risk?

  yes

  no

• Do work activities involve repetitive lifting of objects?

  yes

  no

• Do work do work activities involve lifting objects that are difficult or cumbersome to grasp or hold?

  yes

  no

PPE and uniform

• Are adequate/suitable sizes of PPE/uniforms available?

  Yes

  No

  N/A

Hazardous substances/cross contamination

• Are hazardous substances used at work known to be of risk to yourself?

  yes

  no

• Are there any infectious risks in the workplace undertaken by yourself?

  yes

  no

Working time

• Are you expected to work long hours or overtime that could be considered a risk?

  yes

  no

• Do you have some flexibility and choice over your working hours?

  Yes

  No

• Do work activities involve very early starts or late finishes ?

  yes

  no

• Does your work involve overnight shifts?

  yes

  no

Work related stress

• Are you aware of what to do if you believes you are being bullied harassed or victimised?

  Yes

  No

• Do you have any concerns about your pregnancy such as medical condition that you need to inform us of?

  yes

  no

• Are there work activities which are known to be particularly stressful, for example dealing with irate customers?

  yes

  no

• Are colleagues and supervisors supportive toward the pregnant worker?

  Yes

  No

Environmental conditions

• Do work activities involve exposure to uncomfortably cold/hot temperatures (below 16c above 27c) ?

  yes

  no

• Is there sufficient lighting around the workspace?

  Yes

  No

Welfare

• Is there somewhere suitable in the workplace to rest?

  Yes

  No

• Are you provided with easy access to toilets and allowed sufficient breaks when needed?

  Yes

  No

• Is there suitable welfare facilities to comfortably sit and have breaks for food and drink?

  Yes

  No

• Any other notes?

• undefined

• NEM sign

  Sign

• Risk assessor sign

  Sign