Review of the Environment

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• Home Code

• Conducted on & Arrival Time

  Date

• Prepared by

• Location
  Address

1. People Present

• Name:

• Company:

• Position:

2. Distribution

• Name:

• Company:

• Position:

• 3. Purpose of Visit - Review of Environment

4. Budget Summary

• PM Estimate £?

• Total > £

• HOP to Confirm £?

• Approved £?

• Not Approved £?

5. Budget Summary by Code

• 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)

• 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)

• 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)

• 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)

• 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

Key Areas to Review

• 1. Do all opening windows above the ground floor or excessive drops have approved window restrictors?

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 2. Are all glazing panels toughened/laminated or covered with protective film? (Review if required with home manager.)

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 3. Do all final exit doors above the ground floor contain energised keeps or overhead magnets hard wired to fire panel?

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 4. Are all crucial doors fire doors in serviceable condition?

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 5. Are all locks to bedroom doors escape locks; if not do staff carry keys in the event of fire?

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 6. Are there any "Dorgard" devices on cross fire doors or crucial doors?

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 7. Are all fire escapes in serviceable order?

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 8. Do all external escape routes contain emergency lighting? (borrowed Light is acceptable in certain circumstances)

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 9. Review all internal emergency lighting and smoke head active controls - are all areas covered?

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 10. Are the outside waste bins secured within an enclosure? Are they on show to public or visitors?

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• 11. External decoration review condition insert year 1-5 for works.

  Select 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP) 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP) 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP) 4. Cat 4 - Fire Risk Assessment remedial works (auto approve) 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

  • 1. Cat 1 - Health & Safety issues and outstanding CQC issues from the last visit (HOP)
  • 2. Cat 2 - Works that will have an adverse impact on CQC inspection (HOP)
  • 3. Cat 3 - Works the PM has identified that will have an adverse impact on the environment (HOP)
  • 4. Cat 4 - Fire Risk Assessment remedial works (auto approve)
  • 5. Cat 5 - Legionella Risk Assessment remedial works (auto approve)

• Notes: Transfer all estimated costs to budget summary below and action any compliance or HS issues.

7. Budget Summary

Budget Summary -

• Number -

• Location -
  Address

• Description -

• Code -

• Action -

  Pass

  Fail

  N/A
• MO Mins -
  Address
• PM Estimate -
  Address

• Photo -

  Media

• Authorisation?

8 & 9 - Any other Business and Attachments

• Any other Business

• Attachments

  Media

• Auditor Name & Signature

  Sign