Title Page
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Self Assessment - Element 9, 10 -17
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Conducted on
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Prepared by
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Location
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Personnel involved
Critical Element 9 - workplace observation
1. The auditor is able to observe some selected audit standard requirements in practice.
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1. Hazard registers
2. Evidence of assessment of hazards to determine their significance.
3. Current safety information on display.
4. Incident and injury (accident) registers available in the workplace (hard copy or electronic).
5. Forms completed (where applicable).
6. Evidence of personal protective equipment in use according to what is appropriate for the area visited.
7. Restricted areas of work are clearly marked.
8. Escorting and signing requirements are in place for restricted areas of work.
9. Emergency evacuation procedures are clearly outlined (e.g. signs, posters, designated listed employees trained to take control in an emergency e.g. wardens, first-aiders).
10. Emergency exits are clearly marked.
11.Emergency equipment is clearly marked and current.
12.Security logbooks, visitor registers (or similar) are provided.
13. Personal protective equipment is available for site visitors (where applicable). -
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Critical Element 10 - 17 - Injury Management
10. There is employee training or similar awareness programme that ensures all employees are informed of the claims lodgement procedures.
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1. Standard training or training programme examples.
2. All employees have some means of informing service providers of their employer’s ACC Partnership Programme status (e.g.. Identification cards, brochures, introductory letters).
3. Evidence that information is provided at least annually to all employees.
4. Evidence that information is readily available to all employees (e.g.. notifications, publications, posters or similar staff communications). -
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11. There is a procedure to ensure injured employees are aware of their entitlements and of the process for applying for those entitlements.
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1. Notification procedure. Yes No action required
2. Evidence that information on entitlements is readily available to all employees (e.g.. Intranet, fact sheets, brochures).
3. Evidence that information on entitlements that may be applicable, is provided with acceptance of claims for cover. -
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12. Claims contain confirmation of early contact and initial consideration of rehabilitation needs. (Not applicable for "medical-fees only" claims.)
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1. Procedure requiring early contact and an initial needs assessment with injured employees within five working days of injury notification.
Yes No action required
2. Evidence that contact is made and an initial needs assessment carried out within two working days of injury notification. -
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13. A written rehabilitation policy that: – Is included in staff orientation training – Includes objectives and responsibilities – Includes consultation with union* and other nominated employee representatives*. – Is current, dated and signed by a senior manager – Is widely accessible in the workplace
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1. Policy document. Yes
2. Records of staff induction, provided in staff handbooks, Intranet (or similar).
3. Evidence that the policy recognises the employees’ need for support, advice and representation from the employees’ union* or other nominated employee representative* (e.g.. colleague, friend, family). -
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14. The employer has documented procedures for early intervention strategies, including managing the recovery of employees following injury, and intervention as soon as a potential gradual process injury is identified.
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1. Rehabilitation and return to work procedure, including monitoring and follow-up.
Yes No action required
2. Rehabilitation resourcing responsibilities are designated at senior management level.
Yes No action required
3. Designated management responsibilities for rehabilitation for each work site.
4. Documented rehabilitation support responsibilities for union* and other nominated employee representatives*.
Yes No action required
5. The policies and procedures are developed and implemented in consultation with union* and other nominated employee representatives*.
Yes No action required
6. Evidence that rehabilitation and return to work processes have been implemented (where applicable). -
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15. Line managers and union* and other nominated employee representatives* actively involved in rehabilitation management understand the process of maintaining employees in the workplace and supporting safe and early return to work.
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1. Information available. Yes No action required
2. Evidence of training programme (or similar) within 12 months of programme entry (not applicable for initial audit).
3. Evidence that training has been carried out within the last two years. -
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16. Injured employees are informed and understand the process and responsibilities for rehabilitation, including the need for early intervention.
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1. Processes covering staff and management responsibilities, early return to work expectations, selected work options, support available and the right to union and other nominated employee representation*.
employees.
2. Evidence that information is provided at least annually to all employees.
3. Evidence that process information is readily available to all employees (e.g.. notifications, publications, posters or similar staff communications). -
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17. The rehabilitation policy includes provision of rehabilitation opportunities for non-work injuries
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1. A statement in the policy (e.g.. opportunities for alternative duties when available, access to preferred providers).
2. Evidence that employers have been involved in the rehabilitation or return to work programme of employees who have sustained non-work injuries (where applicable). -
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18. Rehabilitation plans are monitored and reviewed at agreed timeframes for the duration of rehabilitation
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1. The responsibility for monitoring and timeframes for reviews are specified in the rehabilitation plan.
Yes No action required
2. Monitoring of rehabilitation progress occurs at least weekly for the duration of rehabilitation. -
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19. The employer ensures that any previously unidentified health and safety or injury prevention issues arising out of the rehabilitation process are fed back into hazard management
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1. Evidence of feedback from rehabilitation planning into hazard management (eg. forums, hazard register, staff communications, training plans) (where applicable).
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