New Star

• Induction Form

  Induction Form

• Full Name

• Start Date

  Date

• Prepared by

• Home Address
  Address

• Full Name: -

• Mobile Number: -

• Email Address: -

• Have you been previously employed by Mattison Scaffolding LTD?

  Yes

  N/A

• NI Number: -

• Date of Birth: -

  Date

• Nationality: -

• Do you understand and speak English? -

  Yes

  N/A

• Marital Status: -

• No. of Dependents: -

• Next of Kin Details: -

• Full Name: -

• Relationship: -

• Address: -

• Tel: -

CISRS Details: -

• Position Applied For: - (State Grade)

• Current CISRS (or affiliated, i.e. CSCS) Number: - (To confirm the above)

• Picture of CISRS/CSCS Card

  Media

• Remember! Incorrect or incomplete details or the late submission of this form will result in delayed payment for which Mattison Scaffolding cannot be held responsible

• Alertness and reasonable physical fitness are essential for construction duties. It is therefore important to be accurate with your answers to these questions, although trivial matters should be ignored. When you answer NO you are accepting a degree of responsibility for your own safety

• You are reminded that should you be informed by a medical practitioner that you are unfit for work in anyway, you must notify Mattison Scaffolding Ltd immediately

Please study this list and sign the declaration at the bottom: -

• Do you have Diabetes needing insulin?

  Yes

  N/A

• Do you suffer from Epilepsy or fits?

  Yes

  N/A

• Have you ever had blackouts, recurrent dizziness or any condition which may cause sudden collapse or incapacity?

  Yes

  N/A

• Do you smoke?

  Yes

  N/A

• Do you get discomfort or pain in the chest or shortness of breath on exercise e.g. climbing a single flight of stairs?

  Yes

  N/A

• Do you have difficulty in moving rapidly over short distances including on slopes, steps or rough ground?

  Yes

  N/A

• Do you suffer with a bad back? If so, please give details

  Yes

  N/A

• Would you have difficulty in looking over either shoulder?

  Yes

  N/A

• Do you have any difficulty with your eyesight (simple problems needing glasses need not be included)?

  Yes

  N/A

• Do you wear glasses / contact lenses/both? *

  Yes

  N/A

• Do you have any difficulty hearing normal conversations?

  Yes

  N/A

• Are you taking any medication that is giving you dizziness or drowsiness?

  Yes

  N/A

• If so, please specify

• Are you taking medication that has not already been specified?

  Yes

  N/A

• Have you used drugs of abuse within the last 12 months?

  Yes

  N/A

• Have you had any alcohol related illness during the last 12 months?

  Yes

  N/A

• Have you at any time during the last 12 months been subject to any form of health screening?

  Yes

  N/A

• Have you had to give up any previous job for medical reasons? If so, please give details

  Yes

  N/A

Have you knowingly been exposed during your working life to any of the below?

• Lead,

  Yes

  N/A

• Asbestos,

  Yes

  N/A

• Radiation,

  Yes

  N/A

• Loud noise,

  Yes

  N/A

• Dust,

  Yes

  N/A

• Fumes,

  Yes

  N/A

• Chemicals,

  Yes

  N/A

• Harmful substances or associated environments,

  Yes

  N/A

• HAVS

  Yes

  N/A

• Other? Please specify

  Yes

  N/A

• If you have been exposed to any of the above, has this led to any illness or industrial injury? If yes, has industrial compensation been sought? Please give details

• I declare that to the best of my knowledge I have answered the above questions honestly and accurately

  Yes

  N/A

• Signed by Operative:

  Sign

• Signed on behalf of Mattison Scaffolding Ltd:

  Sign

• Date: -

  Date

Areas of responsibility

• Department:

  Select Operational Scaffolding of Mattison Scaffolding Ltd Transport Division of Mattison Scaffolding LTD Yard Division of Mattison Scaffolding LTD

  • Operational Scaffolding of Mattison Scaffolding Ltd
  • Transport Division of Mattison Scaffolding LTD
  • Yard Division of Mattison Scaffolding LTD

• Drug and Alcohol policy explained explain and understood: -

  Sign

• Position:

• Date:

  Date

• Erecting, altering and dismantling scaffolding and all associated duties in accordance with current legalisation, best practice health & safety guidance, and compliance with the CISRS training scheme

• Carrying driving duties and delivers for Mattison Scaffolding LTD all associated duties in accordance with current legalisation, best practice health & safety guidance, and compliance.

• Duties above explained?

  Yes

  N/A

Skills and abilities required:

• Being agile and physically fit, Being responsible and respectful, Thinking quickly and implementing safety practices, Being organised, diligent and methodical, Understanding Design drawings and plans, Using good co-ordination and working as part of a team, Using good communication in written and verbal form, Using the tools and instruments of the trade correctly

Training required:

• Must have completed or working towards the apprenticeship for scaffolding or the CISRS training scheme for Scaffolders

• CISRS Card No

• CISRS Grade

• Expires end

  Date

• Picture of Relevant Cards: -

  Media

I confirm that the above person has received instructions, various assessments and training as detailed above

• Signature:

  Sign

• Position:

Induction Training Checklist: -

• Prior to the induction of any operative the particular department head shall explain to the operative the items listed below

• Pre-Employment, Application form completed and returned, Competency questionnaire completed, Interviewed and acceptable, CISRS Registration checked,

Induction

• Advise employee that, as employers, we have a legal and moral responsibility to ensure that all new employees receive adequate and sufficient information, instruction and training to perform the duties for which they are being employed. In addition, we must ensure, as far as is reasonably practicable, their health, ty and welfare at work. The following ty induction must therefore be completed prior to commencing work

• General Safety Policy Statement – Equality and Diversity Policy Statement - Environmental Policy Statement - Quality Policy Statement - Accident Reporting – Requirement to report all accidents, incidents and near misses - Personal Protective Equipment (PPE) - H & S guidance (NASC) – Issue copy and outline – compliance is mandatory - Compliance with legislation, company standards, rules and assessments - No bombing of equipment rule (treated as gross misconduct) - Company arrangements for consultation/training/meetings.

  Issued & Understood

• Issue Safety Handbook and outline contents – instruct operative to read it and comply with it - First aid and welfare arrangements

  Issued & Understood

• Explain legal requirement for employees to ensure the safety of themselves and their colleagues by reporting safety system problems or serious/imminent dangers

  Issued & Understood

Terms & Conditions

• Hours of Work – Basic/Overtime

• Punctuality & Flexibility - Holidays – entitlement (details issued) - How to book holidays – with supervisor and office - Holiday pay – basic - Termination – notice by the company - Termination – notice by the employee - Responsibility to get to work.

• Sickness – notification

• Sickness – Self certification and doctor’s notes

• Responsibility to get to work

Grievance & Disciplinary procedure

• Verbal/Written/Final warnings - Gross Misconduct - Appeals

Administration/Paperwork

• Completed Personal Details form - Signatures for all Policies - Signature for Contract of Employment - Signature for Induction pack

• Where applicable – Driving licence examined - original & copy taken (certify as true copy)

  Media

• P45 submitted or P46 completed (If Applicable)

• Copy of passport taken for right to work within the UK checked (certify as true copy)

  Media

GENERAL RULES

• The Mattison Scaffolding Ltd Health and Safety Policy details the rules and the standards, which relate to all operatives at work. It is the responsibility of all to comply with these rules and to behave in a safe manner whilst at work

• Any operative found in breach of procedures or failing to comply with the requirements set out in the safe systems of work will have any future offer of work withdrawn. (Examples of which included below)

• Any contravention of the Health and Safety legislation is a criminal offence and a prosecution can be taken against any operative by the enforcing authority (HSE) (EHO)

• - Willfully breaching the safety rules or safety policy,

• - Willfully working in an unsafe manner, ignoring the written safe system of work,

• - Removing any guard or protective device without permission,

• - Operating any machine plant or equipment without authority,

• - Misusing items provided for the first aid and firefighting,

• - Recklessly interfering with or misusing anything provided in the interest of Health, Safety or Welfare at work,

• - Defacing or removing notices, signs, labels or any warning device,

• - Misusing any chemical, flammable substance, toxic material, etc.,

• - Smoking in designated ‘no smoking’ areas or whilst using flammable substances,

• - Taking part in horseplay or practical jokes,

• - Making false declarations or interfering with evidence following an accident or dangerous occurrence,

• - Misusing compressed air, electric or pneumatic equipment,

• - Overloading lifting equipment

INDUCTION NOTES

SCOPE

• All operatives are required to provide details and personal information for the company insurance and in the event of an accident having the essential information available

PROCEDURE

• It is the responsibility of each head of department to carry out induction for any new starters providing services to Mattison Scaffolding Ltd

• All departments shall complete the following documentation:

• Personal/training details,

• Start register,

• Personal protection/equipment issue form (if applicable),

• Scaffolder reminder card (if applicable),

• Health questionnaire form (if applicable),

• Induction checklist form to cover induction/employment related items,

DECLARATION BY NEW EMPLOYEE

• I confirm that I have received induction training in the areas as detailed above and that I have received and understood all documentation as detailed: -

  Sign

• Date: -

  Date

DECLARATION BY PERSON CARRYING OUT INDUCTION

• I confirm that I have carried out the induction training as detailed above and have issued all relevant documents: -

  Sign

• Date: -

  Date