Information
Before starting any new document ensure to refer to previous visits/interactions to identify any outstanding actions that may need to be carried forward. Any progress should be recognised and praised.
-
Employee ID (payroll number)
-
Employee Name
-
Prepared by
-
Conducted on
-
Visit Type
- HomeSafe
- RTW
- Quality & Compliance Visit
- Damage Claim
- Investigation
- Coaching
- Equipment Inspection
- 121
- IDD
- Probation Discussion
TM RISK ASSESSMENT
TM RISK ASSESSMENT
-
Are there any hazards?
-
Hazard type
- Traffic
- Ground
- Third Party
- Weather
- Pets
- Non carpeted flooring
-
Are hazards controllable?
-
Details
-
Visit type
- HomeSafe
- RTW
- Quality & Compliance Visit
- Damage Claim
- Investigation
- Coaching
- Equipment Inspection
- 121
- IDD
- Probation Discussion
HOMESAFE
-
Job No
-
Job type
- Service
- Install
- Install (multi-screen)
- MHO
- MHO (multi-screen)
- Other
-
Observation
-
Is the Engineer working safely on arrival?
-
Risk Assessment
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Manual Handling
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
PPE
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Damage Awareness
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Working at Height
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Ladder type
- No Ladder
- Combi Ladder
- Single Section
- Double Section
- Triple Section
- CAT
- DAT
- SAT (inc rope access)
- Access Ladder (inc flat roof working)
- 10 Rung
- Rope Assisted 15 Rung
- Rope Assisted 19 Rung
-
How was Combi- ladder used?
-
Additional record of findings (Equipment set up and description of job as was carried out. Highlight positive aspects of work witnessed)
-
Add pictures to support observation (inc RAMS forms if applicable)
-
Additional HomeSafe on this visit
-
Job No
-
Job type
- Service
- Install
- Install (multi-screen)
- MHO
- MHO (multi-screen)
- Other
-
Risk Assessment
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Manual Handling
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
PPE
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Damage Awareness
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Working at Height
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Ladder type
- No Ladder
- Combi Ladder
- Single Section
- Double Section
- Triple Section
- CAT
- DAT
- SAT (inc rope access)
- Access Ladder (inc flat roof working)
- 10 Rung
- Rope Assisted 15 Rung
- Rope Assisted 19 Rung
-
How was Combi- ladder used?
-
Additional record of findings (Equipment set up and description of job as was carried out. Highlight positive aspects of work witnessed)
-
Add pictures to support observation (inc RAMS forms if applicable)
-
Additional HomeSafe on this visit
-
Job No
-
Job type
- Service
- Install
- Install (multi-screen)
- MHO
- MHO (multi-screen)
- Other
-
Risk Assessment
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Manual Handling
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
PPE
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Damage Awareness
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Working at Height
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Ladder type
- No Ladder
- Combi Ladder
- Single Section
- Double Section
- Triple Section
- CAT
- DAT
- SAT (inc rope access)
- Access Ladder (inc flat roof working)
- 10 Rung
- Rope Assisted 15 Rung
- Rope Assisted 19 Rung
-
How was Combi- ladder used?
-
Additional record of findings (Equipment set up and description of job as was carried out. Highlight positive aspects of work witnessed)
-
Add pictures to support observation (inc RAMS forms if applicable)
-
Additional HomeSafe on this visit
-
Job No
-
Job type
- Service
- Install
- Install (multi-screen)
- MHO
- MHO (multi-screen)
- Other
-
Risk Assessment
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Manual Handling
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
PPE
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Damage Awareness
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Working at Height
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Ladder type
- No Ladder
- Combi Ladder
- Single Section
- Double Section
- Triple Section
- CAT
- DAT
- SAT (inc rope access)
- Access Ladder (inc flat roof working)
- 10 Rung
- Rope Assisted 15 Rung
- Rope Assisted 19 Rung
-
How was Combi- ladder used?
-
Additional record of findings (Equipment set up and description of job as was carried out. Highlight positive aspects of work witnessed)
-
Add pictures to support observation (inc RAMS forms if applicable)
-
Additional HomeSafe on this visit
-
Job No
-
Job type
- Service
- Install
- Install (multi-screen)
- MHO
- MHO (multi-screen)
- Other
-
Risk Assessment
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Manual Handling
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
PPE
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Damage Awareness
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Working at Height
-
WHAT? (what was Safe/ Unsafe?)
-
WHY? (why did the Engineer do it this way?)
-
HOW? (how was this recognised/ refined/ rectified?)
-
Ladder type
- No Ladder
- Combi Ladder
- Single Section
- Double Section
- Triple Section
- CAT
- DAT
- SAT (inc rope access)
- Access Ladder (inc flat roof working)
- 10 Rung
- Rope Assisted 15 Rung
- Rope Assisted 19 Rung
-
How was Combi- ladder used?
-
Additional record of findings (Equipment set up and description of job as was carried out. Highlight positive aspects of work witnessed)
-
Add pictures to support observation (inc RAMS forms if applicable)
Please ensure to upload a copy of this HomeSafe document to the relevant team folder on the designated Office365 site.
RTW
-
Type of absence
-
First day of absence
-
Last day of absence
-
Absence reason
- Alcohol/ Drug addition
- Allergy
- Asthma (excl work related)
- Blood disorder
- Breast problems
- Cancer/ Tumors
- Chest/ Respiratory problems
- Cold/ Cough/ Flu/ Influenza
- Dental
- Diabetes/ Thyroid/ Endocrine
- Disease of nervous system
- Ear/ Nose/ Throat condition
- Epilepsy or Neurological
- Eye problem
- Gastrointestinal problems
- Gynae including period pains
- Headache/ Migraine
- Heart/ BP/ Cirulatory
- Infectious disease
- Kidney/ Bladder problem
- Non work Injury/ Burn/ Fracture/ RTA
- Non work Musculoskeletal problem
- Non work Back/ Disc problem
- Occupational Asthma
- Occupational Dermatitis
- Pregnancy related
- Scheduall Sickness code
- Stess/ Anxiety/ Depression (non work)
- Stess/ Anxiety/ Depression (work related)
- Swine flu
- Unknown cause
- Vertigo/ Dizziness/ Insomnia
- Virus
- Work Injury/ Burn/ Fracture/ RTA
- Work related Musculoskeletal problem
- Work related Back/ Disc problem
- Other
-
Please state reasons
-
Is the absence work related?
-
Details
-
Was this a linked absence?
-
Details
-
Did Engineer visit a GP during their absence?
-
Is this absence over 7 days?
-
In line with the company absence policy if the absence is over 7 days the employee must provide a 'Fit to Work' certificate in order for a full return to work.
-
Has a 'Fit to Work' note been provided?
-
Add any pictures of 'Fit To Work' certificates
-
Is this absence over 7 days?
-
In line with the company absence policy if the absence is over 7 days the employee must provide a 'Fit to Work' certificate in order for a full return to work.
-
Is the Engineer currently on any medication?
-
Details of medication
-
Number of absences in rolling 12 months?
- 0 (first absence)
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10+
-
How many?
-
Percentage absence in rolling 12 months?
-
Has this absence triggered further action?
-
Process Triggered?
-
Absence Ref Guide
-
Occupational Heath referral required?
-
Date of referral/ planned referral
-
Additional information
-
If the returning Engineer has been off 28 days or more please refer to the RTWL in the first instance before a full return to work
-
Reason for Absence
-
Any follow up considerations?
-
Add any pictures of doctors notes
Please ensure to email a copy of this document to: admin.laserfiche@bskyb.com
Reopen Visit Type and include 'IDD' if required
QUALITY & COMPLIANCE VISIT
-
Job Number
-
Type of Quality & Compliance Visit
-
-
Is the Engineer working safely upon your arrival?
-
What areas of safety have you observed during this visit?
- Risk Assessment
- Manual Handling
- PPE
- Drilling
- Damage Awareness
- Combi Ladder Work
- Standard Ladder Work
- Flat Roof Work
- Pitched Roof Work
- Other
-
Capture any highlights/ adjustments/ coaching
-
Add media to support
-
Was the engineer able to demonstrate a full understanding of the Safe working practices that you witnessed during your observation?
-
Please provide detail of what was unsafe and what action is required?
CONNECTIONS & SET UP
-
Check all relevant boxes indicating compliance
-
Dish
-
Cable
-
F-Connections
-
Data Logger
-
HDMI Leads
-
Power Leads
-
STB Software (Check using Model Lookup Tool on iKnow2)
-
Mesh
-
Additional information
-
Add media to support
CUSTOMER EXPERIENCE
-
Your assessment of Engineer’s interaction and customer experience
-
Is there evidence of a safe visit?
CONNECTIONS & SET UP
-
Check all relevant boxes indicating compliance
-
Dish
-
Cable
-
F-Connections
-
Data Loggers
-
HDMI Leads
-
Power Leads
-
STB Software (Check using Model Lookup Tool on iKnow2)
-
Mesh
-
Additional information
-
Add media to support
CUSTOMER EXPERIENCE
-
Talk through the customers experience of their visit as a whole, cover ETA, appearance, attitude, workmanship etc. Capture highlights of conversation
-
ACE COMPLIANCE
-
Did the engineer recommend a product/service that suited you after discussing your current package?
-
If you completed a sale/upgrade with the engineer, did they leave you a sales information booklet confirming what you had bought?
-
If you completed an upgrade/sale with the engineer, did they run through Key Information with you before leaving?
CUSTOMER EXPERIENCE
-
Talk through the customers experience of their visit as a whole, cover ETA, appearance, attitude, workmanship etc. Capture highlights of conversation
ACE COMPLIANCE
-
Did the engineer recommend a product/service that suited you after discussing your current package?
-
If you completed a sale/upgrade with the engineer, did they leave you a sales information booklet confirming what you had bought?
-
If you completed an upgrade/sale with the engineer, did they run through Key Information with you before leaving?
DAMAGE CLAIM
THIS IS A STAND ALONE FORM AND SHOULD NOT BE USED ALONG SIDE ANY OTHER SECTION OF THIS DOCUMENT
Job Details
-
Incident Number
-
Date of Incident
-
Location of Incident
-
Add signature
-
Customer Details
Engineer Details
-
Engineer
-
Tech Number
-
Team Number
Person completing report
-
Prepared by
-
Date of TM site visit
Liability
-
In my opinion was this caused by a Sky visit or install?
-
Record Of Findings Full details giving reason for denying or accepting liability with photographic evidence including report and clearly stating liability accepted/ denied
-
Were there any witnesses?
-
Witness details if not the person reporting the incident (only required if not the customer)
Photographs & Drawings
-
Add pictures to support findings
-
Add drawing to support findings (if required)
-
Add drawing to support findings (if required)
Corrective Actions
-
Has the person reported been made aware of the incident?
-
H&S Dept notified?
-
Is further investigation required?
-
Who will carry out further investigation?
-
Has incident report been completed on SOLARS?
-
What corrective action has been taken to prevent a recurrence?
Customer
-
What action has been agreed with customer?
-
Customer Signature
Email completed document to claimshandling@bskyb.com
INVESTIGATION
-
Explanation of investigation (Reasons and findings)
-
Add pictures to support investigation
-
Is the Engineer present?
I certify that I attended an investigation meeting and will not disclose to any third party the information discussed at this meeting (other than for the purposes of seeking legal advice). Please note that any breach of this agreement may result in action under the company's disciplinary procedure.
-
Engineer
-
Firstly, thank you for meeting me. Before we go any further you've signed the confidentiality agreement which I remind you means that you cannot discuss the content of this meeting with anyone. Do you understand?
I am currently conducting an investigation and I would like to ask you some questions.
Please be as open and honest as you can because it's important to me that I am able to gather all the facts.
You should be aware that the notes from this discussion we have today may be used going forward in any formal process. This means that these notes may be provided to other employees who have been involved in the situation, if necessary to do so. -
Tick box to open dialogue
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Tick for more text boxes
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
TM
-
Engineer
-
Is there anything else regarding the incident that I have not asked which you feel may be relevant or that I need to look into?
-
Engineer
-
I have no further questions at this time however I may need to speak to you again.
I will finish my investigation as quickly as possible and let you know where we go from here. -
Has this investigation resulted in a suspension from duty?
-
For the reasons discussed today you are now suspended from the work place on full pay until these matters can be fully investigated. In the first instance you will be suspended until -
-
This matter will be kept confidential. If necessary your colleagues will be informed that your absence is for personal reasons.
In the meantime we may need to talk to you about this issue during your suspension so you should be available for contact and to attend meetings if necessary during your normal working hours. You will be advised of the outcome of the investigation as soon as possible.
Should you for any reason need to speak to one of your work colleagues or to come into your place of work you should contact me in the first instance for prior authorisation.
If you would like any advice or guidance in relation to company polices or processes during your period of suspension please contact ER.
Reopen Visit Type and include 'IDD' if required substituting 'Engineer' with customer, witness etc.
COACHING
-
Reason for coaching
- Revisit
- Quality
- Connectivity
- SM3 Use
- Technical
- Safety
- Customer Service
- Completions
- ACE
-
Coach on site observations/ comments
-
Engineer comments - What will you take away from today's session?
-
Follow up details (if required)
-
Review date
-
Add pictures to support
-
What areas of safety have you observed during this visit?
- Risk Assessment
- Manual Handling
- PPE
- Drilling
- Damage Awareness
- Combi Ladder Work
- Standard Ladder Work
- Flat Roof Work
- Pitched Roof Work
- Other
-
Capture any highlights/ adjustments/ coaching
-
Add pictures to support
-
Was the engineer able to demonstrate a full understanding of the Safe Working practices that you witnessed during your observation?
-
Please provide detail of what was unsafe and what action is required?
PROBATION DISCUSSION DOCUMENT
-
Week of Probation
-
Type Of Meeting
-
Welcome & Specific Team Information
-
Add media to support
-
Expectations for Performance, Attendance & Conduct
-
Add media to support
-
Targets/ Objectives
-
Add media to support
-
Support Measures or Adjustments
-
Add media to support
-
Dates & Times of Weekly 121's & Interim Review
-
Add media to support
-
Additional Comments
-
Add media to support
-
What's gone well? - Encourage & praise good performance/ behaviours
-
Add media to support
-
Progress against targets/ objectives set in Introductory Meeting
-
Add media to support
-
Any concerns around Attendance, Performance or Conduct?
-
Add media to support
-
Expectations moving forward
-
Add media to support
-
Support Measures or Adjustments
-
Add media to support
-
Additional Comments
-
Add media to support
-
What's gone well? - Encourage & praise good performance/ behaviours
-
Add media to support
-
Progress against Targets/ Objectives set in Introductory Meeting & 121's
-
Add media to support
-
Any concerns around Attendance, Performance or Conduct?
-
Add media to support
-
Expectations moving forward - Set expectations if improvement(s) not met
-
Add media to support
-
Support Measures or Adjustments
-
Add media to support
-
Date of Final Probation Review Meeting
-
Additional Comments
-
Add media to support
-
Discuss overall Attendance, Performance & Behaviours
-
Outcome
-
Congratulate on successfully completing probation period & celebrate success!
-
Set expectations moving forward
-
Add media to support
-
Explain reason for extension
-
Expected End Date -Duration of extension (no less than 4 weeks & no longer than 13)
-
Agreed improvements expected
-
Add media to support
-
Agreed support required if appropriate
-
Add media to support
-
Set expectation that if improvement not made this could result in non-confirmation of probation.
-
Additional Comments
-
Add media to support
-
TM
-
Engineer