WHSMS Auditor Tool - DE - SafetyCulture

Information

Document No.
Audit Title
Client / Site
Conducted on
Prepared by
Location
Personnel

Element 1 Health and Safety Policy

1.1 POLICY

1.1.1
Senior Management in consultation with workers and/or their representatives shall define and document its policy for, and commitment to work health and safety. The policy shall be endorsed and supported by the most senior person within the organisation such as the Chief Executive Officer. The policy will also be endorsed by the site manager to verify their commitment to the content of the policy. The health and safety policy shall include a commitment to:
a) The risk management process and ensure consistency with the nature of workplace activities and scale of health and safety risks;
b) Comply with relevant health and safety legislation and other requirements placed upon the organisation or to which the organisation subscribes;
c) Establish measurable objectives and targets for health and safety to ensure continuous improvement aimed at elimination of work-related illness and injury;
d) Provision of appropriate health and safety training to all workers;
e) The consultation process to ensure all workers are included in the decision making processes impacting on workplace health and safety;
f) The dissemination of health and safety information to all workers and visitors to the workplace;
g) Effective implementation of the health and safety policy.
Information: A meaningful health and safety program depends on commitment from management. The health and safety policy is the primary document in the health and safety management system. It must clearly set out the intentions of the organisation with respect to continuous improvement of health and safety.
Examples:
• An authorised copy of the policy document that clearly states health and safety objectives and an organisational commitment to both legislative compliance and improving health and safety.

• Can senior management explain the objectives of the health and safety policy?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
1.1.2
The health and safety policy is available to all parties, including regulatory authorities, suppliers, contractors, and those visiting the workplace.
Information:
The BaptistCare health and safety policy communicates its commitment to health and safety and is freely available to all other parties with which it deals. This demonstrates to suppliers and contractors the level of support they can expect. The policy would normally be displayed in a prominent position in the organisation as a constant reminder of the company direction.
Examples:
• An electronic copy of the policy on the BaptistCare intranet
• Policy contained in the BaptistCare Annual Report
• Policy is included in induction material
• Policy included in tender documentation
• How are contractors advised about the health and safety policy?
• Policy on display in reception / visitor areas.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 2: Planning: Legal Requirements and Practical Guidance

2.1 LEGAL REQUIREMENTS AND PRACTICAL GUIDANCE

2.1.1
The facility / site's procedures, work instructions and work practices reflect the requirements of current health and safety legislation, standards, codes of practice, agreements and guidelines.
Information:
The organisation has an obligation to ensure compliance with current legal requirements and to be aware of other technical or industry standards and codes of practice which may influence the way work is planned and performed.
Examples:
• A procedure for creating and reviewing procedures and work instructions that checks applicable legislative and other requirements.
• Procedures and work instructions that reference current requirements.
• Can the relevant manager(s) explain how BaptistCare ensures that procedures meet relevant requirements
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
2.1.2
Relevant personnel in the organisation / site are advised of, and have ready access to, current relevant health and safety legislation, standards, codes of practice, agreements and guidelines.
Information:
Individuals should be aware of how to access the information relevant to the work they are undertaking.
The organisation also needs to actively notify affected persons and workplace parties, so that the
necessary activities or actions can be taken to ensure continued compliance or make appropriate
changes to procedures.
Examples:
• Distribution lists for particular information, topics or issues.
• Copies of advisory memoranda.
• Minutes of meetings that record discussion of new requirements.
• Can workers nominate the location or contact person for reference information.
• Current information maintained at an accessible location such as at a library, on microfiche, in the health and safety department, electronically, etc.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
2.1.3
The organisation and/or individual satisfies legal requirements to undertake specific activities, perform work or operate equipment including any:
a) licence;
b) certificate of competency;
c) notification;
d) registration;
e) approval, exemption and/or
f) other relevant requirements.
Information:
The organisation needs to identify and meet current legal requirements for the operations that it undertakes or equipment that is held or operated, e.g:
• Dangerous goods / Hazardous Chemical storage, manufacture and transport;
• Registrations of high risk plant such as pressure vessels, cooling towers, cranes and lifts;
• Licences or approvals for certain processes such as asbestos removal, use of carcinogens, radioactive sources and lead;
• Electrical work;
• Operation of particular types of industrial equipment, such as fork lift trucks;
• Rigging operations;
• Licensing and registration of vehicles; and/or
• Relevant driver’s licences.
These and others may be applicable depending on the extent of the business and the jurisdiction in which it operates.
Examples:
• A list of the applicable site licensing or registration requirements with matching records.
• A register or record of licence holders.
• A list of plant requiring registration and copies of current registrations.
• Copies of licences.
• Correspondence from legislative authorities.
• Can the relevant manager(s) explain how licences etc are kept current?
• Can relevant workers nominate the legal requirements for specific work or equipment?
• Licences / certificates carried by users of mobile plant.
• Registration certificates displayed on plant.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
2.1.4
Changes to health and safety legislation, standards, codes of practice, agreements and guidelines generate a review of existing local procedures.
Information:
The organisation should conduct a systematic check of legislative changes and updated standards or codes to identify whether any alterations are needed to the current methods of work.
Examples: • An information management procedure which requires reviews of procedures and work instructions in response to new information.
• Copies of procedures and work instructions which reference current legislation, standards and codes.
• Minutes of meetings where BaptistCare’s current work practices are reviewed against the latest industry or legislative requirements.
• How can you demonstrate that you do this?
• Can you give some examples?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 2: Planning: Objectives and Targets

2.2 OBJECTIVES AND TARGETS

2.2.1
Health and safety objectives and targets consistent with the organisation’s health and safety policy are documented, are appropriate to the site's activities and consider:
a) legal requirements;
b) standards, codes and guidelines;
c) health and safety hazards and risks;
d) leadership and employee participation and
e) technological developments.
Information:
Any objectives need to consider all the issues that can impact on the setting of health and safety objectives and the achievement of targets. A risk assessment approach can be used to prioritize action. The involvement of workers in the setting of goals and objectives is encouraged. The objectives and targets must also be tailored to the organisation’s risk exposure and give consideration to workers, the working environment and locations, technology and any current information about the risks. The organisation may also consider safety culture and the external business environment.
Examples:
• Minutes of meetings that record discussions about the selection of suitable health and safety objectives and targets.
• Health and safety objectives and targets reference the standard to be met, e.g legal requirement, technical requirement.
• Safety culture survey results influence the development of objectives and targets
• Objectives and targets reflect senior management involvement.
• Who was involved in the setting of the objectives and targets?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
2.2.2
Specific health and safety objectives and measurable targets have been established for all relevant functions and levels within the organisation / site.
Information:
The organisation should determine its objectives and develop measurable targets which meet these objectives. Commitment to achieving these outcomes would be expected to be incorporated in the company’s health and safety policy. The targets must be achievable, measurable and integral to the organisation’s everyday work. Targets need to be set across all functions of the organisation (including operations, administration, sales, etc.) so that safety is viewed as a part of routine activities.
Examples:
• Minutes of meetings which record discussion of health and safety objectives and targets.
• Health and safety plan which lists objectives and targets to be met by particular departments for given timeframes, for example:
* Objective: Eliminate injuries associated with lifters. Target: Zero injuries in financial year.
* Objective: Provide emergency training to all new workers. Target: Training to be provided in first week of employment.
• Business and individual performance plans which detail specific targets for health and safety and how they will be measured.
• How are objectives and targets measured?
• Do you record the measurement?
• Which functions have been determined as relevant for the development of objectives and targets?
• Can line managers explain how objectives and targets cascade through the organisation and demonstrate how it is achieving the WHS plans?
• Can line managers explain how they contribute to the development of objectives and targets?
• Noticeboards displaying objectives and targets and information on progress to achieving the objectives and targets.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
2.2.3
The organisation sets health and safety performance indicators that are consistent with its objectives and targets.
Information:
Measurement of health and safety performance should extend beyond statistics relating to injury numbers or injury rates, i.e. ‘negative indicators’. Whilst these are vital, they provide information after the event. ‘Positive’ or lead indicators are measures of actions taken to prevent injury and disease such as number of inspections conducted, training provided, risk assessments conducted, etc. which demonstrate progress on preventive actions.
Examples:
• Suitable performance indicators are included in performance appraisals.
• Both positive and negative indicators are used when measuring progress against the health and safety program.
• Health and safety plan which lists health and safety performance indicators to be met by particular
departments, for example:
(i) Percentage of injuries associated with client aggression and
(ii) Percentage of new workers given WHS induction training in first week.

• What performance indicators have been set?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 2: Planning: Health and Safety Management Plans

2.3 HEALTH AND SAFETY MANAGEMENT PLANS

2.3.1
There is a health and safety management plan(s) that defines the means by which the organisation will achieve its objectives and targets. The plan(s):
a) responds to legal requirements;
b) is based on an analysis of information relevant to the nature of the organisation’s activities, processes, products
or services;
c) takes account of identified hazards and health and safety management systems failures;
d) aims to eliminate or reduce workplace illness and injury;
e) defines the organisation’s priorities;
f) sets timeframes;
g) allocates responsibility for achieving objectives and targets to relevant functional levels and
h) states how the plan will be monitored.
Information:
In order to achieve systematic, and sustainable improvements in health and safety, the organisation needs to plan and organize the activities. Sometimes the complexity of an operation or organisational change requires specific detailed plans to be developed to augment the general health and safety plan. All relevant available information should be evaluated prior to the development or review of health and safety plans. Information gained through hazard identification and risk assessment will provide a firm foundation for a strategic plan. Accident and incident records will highlight problems which need to be addressed in such plans. For example, if records indicate that manual handling type injuries are the most likely to occur, then improvements may be indicated in the way manual handling is addressed at the workplace. Other information, such as the results of worker surveys or the planned introduction of new
technology, may need to be considered in health and safety plans. Information from external sources also provides vital input. Such information may range from the specific requirements of health and safety legislation, standards and codes, to industry knowledge and experience with the processes or products involved. Some tasks within the plan will be more important than others, some tasks will be easier to achieve and some will require additional personnel or other resources. The plan needs to identify all these factors, including the persons who are allocated prime responsibility for ensuring that each task is completed, and what measurements will be acceptable as an indication that the task is complete.
Examples:
• Hazard, incident or other health and safety data/records which match the issues covered in the health and safety plan.
• A documented health and safety plan which references particular legislation, Australian or industry standards or codes.
• Minutes of meetings which record the sources of information used in the development or review of the health and safety plan.
• A documented health and safety plan which includes objectives and the means by which those objectives will be achieved through the allocation of resources, completion dates, and responsibilities.
• A series of documented plans or projects developed to address a particular activity.
• Are workers aware of the health and safety plan and their part in it?
• Health and safety plans are available in the workplace.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
2.3.2
The organisation /site documents its methodology to reduce health and safety risks through hazard identification, risk assessment and development of risk control measures in accordance with the hierarchy of controls and legal requirements.
Information:
Uncontrolled hazards have the potential to cause injury or illness to workers and members of the public. The uncontrolled hazards must be identified before action can be taken to reduce the associated health and safety risks. Risk assessment means establishing whether there is a risk associated with the identified hazards. Having identified the hazards and assessed the risks, the organisation needs to establish effective control measures. Any process for controlling hazards should demonstrate consideration of the hierarchy of control.
The organisation needs to establish what risk assessment models may be useful in qualifying and quantifying their risk exposures. Legislative requirements also need to be incorporated into the methodology, e.g. some jurisdictions mandate factors to be considered in risk assessment processes and prohibit certain control options. The organisation should integrate this formal, systematic process into their daily operations, such as tendering to supply services.
Examples:
• Documented procedures for reduction of risk across the organisation and its operations using the process of hazard identification, risk assessment and risk control, e.g. to review plant, equipment and standard operating procedures.
• Documented procedures for hazard identification, risk assessment and risk control across the various business activities in the organisation.
• A documented procedure which requires the use of the hierarchy of controls in the determination of control measures.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
2.3.3
The organisation / site monitors its progress towards meeting the objectives and targets set in the health and safety plan and takes corrective actions to ensure progress is maintained.
Information:
Monitoring of the progress of the health and safety plan provides an opportunity to:
• Confirm that realistic targets have been set;
• Revise priorities; and
• Reallocate resources to areas that need help.
Examples:
• Minutes of meetings that record discussions about progress toward health and safety targets.
• Regular reports from individual departments about progress towards the set objectives and corrective action undertaken.

• How does the organisation monitor progress?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
2.3.4
Health and safety plans are reviewed on a regular basis, to ensure they are kept up-to-date, and when there are changes to the organisation’s activities, processes, products or services.
Information:
Changes are inevitable, whether generated by new technology, internal restructures or imposed through different or difficult operating conditions. The organisation needs to make sure that the planning process anticipates, considers and incorporates changes where necessary so that objectives can still be met.
Examples:
• Reviews should be conducted regularly at appropriate intervals to ensure continuing suitability and effectiveness of the system to satisfy the organisation’s health and safety needs in all areas of business activity.

• Dates of reviews found in minutes, memos or other documents.
• Reports of findings of reviews..
• What circumstances generate a review of the health and safety plan?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Structure and Responsibility - Resources

3.1 STRUCTURE AND RESPONSIBILITY - RESOURCES

3.1.1
Financial and physical resources have been identified, allocated and are periodically reviewed, to enable the effective implementation of the organisation’s health and safety management system.
Information:
To achieve the objectives of the health and safety management system, it needs to be adequately resourced and those resources should be directed towards the reduction of the organisation’s health and safety risks. The level of resources also needs to be reviewed at regular intervals. Physical resources can include the reference library, monitoring equipment, suitable facilities for health and safety training, etc.
Examples:
• Resources are identified and allocated in system documentation.
• Reports, minutes of meetings etc. that confirm resources have been reviewed.
• Physical evidence of the allocation of resources, e.g. new equipment, modifications to plant and training facilities.
• Budget information that demonstrates allocation of resources to implement the system.
• Are financial resources directed towards higher order controls which will reduce risk, e.g. engineering?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.1.2
There are sufficient qualified and competent people to implement the organisation’s health and safety management system.
Information:
A successful health and safety management system requires access to specialist advice and guidance.
Employing specialised staff within the organisation should provide advantages, such as having an understanding of the operations and personnel, and being able to keep and use the knowledge gained from working with health and safety issues at the workplace. Advice and guidance can also be obtained from a variety of sources such as health and safety consultants, occupational physicians, ergonomists, engineers, chemists and hygienists.
Examples:
• Documentation for health and safety personnel that shows their qualifications and experience.
• Reports of health and safety advice received from external providers, e.g. noise and plant assessments.
• Contracts with health and safety professionals to provide specific services, e.g. health surveillance and medicals.
• How did the organisation determine it had access to sufficient qualified and competent people?
• What are the qualifications and the competencies of the people?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.1.3
Those who represent workers on health and safety matters are provided with time and resources to effectively undertake this role.
Information:
Workers provide valuable input to the health and safety program. Management needs to demonstrate their support of worker representatives by providing them with opportunities to confer with their workgroups and attend training, and provide access to information and other facilities such as telephone, photocopier, filing cabinet, etc. as needed.
Examples:
• Evidence of worker representative’s participation in:
* Risk assessments;
* Health and safety training;
* Workplace inspection;
* Committee meetings; and
* Accident/incident investigations, etc.
• Do worker representatives confirm that adequate support is provided?
• Do worker representatives confirm that they have time to adequately handle individual work health and safety concerns raised with them?

• Suitable facilities available for use by worker representatives.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation - Structure and Responsibility-Responsibility & Accountability

3.2 STRUCTURE AND RESPONSIBILITY - RESPONSIBILITY AND ACCOUNTABILITY

3.2.1
Officers can demonstrate an understanding of the organisation’s legal obligations for health and safety.
Information:
It is essential that senior management are aware of their legal obligations for health and safety in relevant jurisdictions and have an understanding of how to go about meeting those obligations.
Examples:
• Letters and memoranda from senior managers concerning legal requirements.
• Records of attendance and course details for relevant health and safety training attended by senior management.
• Documentation provided to senior management explaining the legal obligations they have.
• Can senior management explain BAPTISTCARE’s health and safety legislative obligations?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.2.2
The specific health and safety responsibilities [including legislative obligations], authority to act and reporting relationships of all levels in the organisation have been defined, documented and communicated.
Information:
The organisation needs to implement arrangements to meet its general and specific health and safety legislative responsibilities, e.g. nomination of management health and safety representatives, registration and maintenance of plant, training, supervision, health monitoring and reporting, record keeping, notification of incidents or participation in consultative arrangements. People also need to understand their role within the health and safety management system. This requires the organisation to provide detail to their personnel about actions required to meet the allocated responsibilities.
Examples:
• Responsibility and authority for health and safety should be defined in position descriptions or aggregated in a format that is readily accessible by the position holder. The authority to implement these responsibilities should also be defined and documented.

Detailed or specific responsibilities and reporting relationships defined and allocated in:
* The health and safety policy;
* Health and safety agreement;
* Health and safety manual or work instructions;
* Contract/tender documents;
* Position descriptions; and
* Organisation structure or chart.
• Can people demonstrate knowledge of their health and safety responsibilities?
• Do people know the health and safety responsibilities that have been assigned to other people?
Response
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.2.3
Where contractors are utilised in the organisation, the health and safety responsibilities and accountabilities of the organisation and the contractor(s) have been clearly defined, allocated and communicated within the organisation and to the contractor(s) and their workers.
Information:
Many organisations use contractors to provide services. Although the employment conditions of contractors may vary considerably from those of other workers, the organisation still owes a duty of care to contractors and their workers. The contractors also have obligations. To avoid confusion and prevent erroneous assumptions, the responsibilities and accountabilities for work health and safety should be sorted out between the parties. For instance, the contractor and the organisation should define which party will take responsibility for control of the working area, systems of work, plant and equipment, hazardous substances use, storage and disposal, induction training, supervision, resolution of issues, first aid facilities, etc. Having done that, the organisation should make sure that all relevant parties are informed of the health and safety arrangements.
Examples:
• The responsibility, authority and accountability of contractors, and labour hire workers to carry out health and safety management system requirements, should be defined. Appropriate training should be provided to ensure they are competent to meet the system requirements.
• The organisation should define a process for consultation, communication and cooperation with contractors to ensure that responsibilities are performed effectively.

• Position description for ‘contract manager / designated Contact Person’ which describes responsibilities for sorting out the various health and safety responsibilities and communicating that information.
• Signed contracts which define the persons responsible for each of the health and safety actions and activities to be undertaken and facilities to be provided.
• Information on responsibilities provided to all workers.
• Induction program for contractors covering responsibilities and accountabilities.
• Contractor review procedures incorporate health and safety performance review.
• Can workers explain their responsibilities to contractors?
• Can contractors or contractor workers explain their health and safety responsibilities to BaptistCare workers?.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.2.4
Personnel are held accountable for health and safety performance in accordance with their defined responsibilities.
Information:
There needs to be some measurement of whether managers, supervisors, workers and others in the workplace are meeting their allocated health and safety responsibilities. A formal review of performance should include measurements of health and safety achievements against the assigned responsibilities.
Examples:
• The roles and responsibilities are reviewed during the audit process..
• The organisation should define an accountability process to ensure that responsibilities are performed effectively.
• Documented individual health and safety performance appraisals or reviews for personnel with health and safety responsibilities.
• Group performance schemes which evaluate health and safety performance.
• Notes or records of interviews where health and safety performance has been discussed.
• Has there been an assessment of health and safety performance of individuals in line with their allocated responsibilities?
• Can personnel explain how they are held accountable for their allocated health and safety responsibilities?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Structure and Responsibility - Training and Competency

3.3 STRUCTURE AND RESPONSIBILITY - TRAINING AND COMPETENCY

3.3.1
The specific requirements of tasks are identified and applied to the recruitment and placement of personnel.
Information:
The safe performance of some tasks may require the worker to have particular skills and competencies. For example, a plant operator’s certificate of competency or demonstrated knowledge or qualification in a particular subject. There are also some tasks where there can be medical requirements relevant to the safe and satisfactory performance of the task. For example, one would not assign a person who was colour blind to a task where colour perception was essential to safety.
Examples:
• Job task analysis/workplace assessments or similar process undertaken which identifies the specific requirements, including medical constraints, of tasks undertaken in the organisation.
• Job descriptions or similar which identify the specific requirements relevant to health and safety of tasks to be performed.
• Records of the staff selection process that demonstrate the selection of candidates/job applicants who meet relevant health and safety requirements.•

• What tasks have been identified as having specific requirements impacting on health and safety?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.2
The organisation / site has established and implemented procedures for identifying and defining the health and safety training needs (including any prescribed by legislation) for all workers or visitors, where relevant. A written training plan(s) based on the outcomes of the training needs shall be developed and implemented.
Information:
An organisation needs to determine the competencies or qualifications, training and experience required by their workers and others for the safe performance of the various tasks at the workplace. This includes ‘volunteers’ where these people work on a regular basis with the organisation. Even contractors who are engaged to perform specialised work may require additional in-house training to participate in certain tasks, e.g. maintenance. In situations where a contractor has developed such a training plan for its workers, the host organisation needs to have access to a copy of this plan.
It also follows that there must be a process for matching individuals against the competencies, and providing extra training where needed.
Competency based training focuses on training individuals to perform actual jobs in the workplace. The training program should:
• identify what people need to do in their jobs;
• identify what people need to know to do their jobs;
• identify the standard of performance required in the job; and
• identify how, when, where and by whom assessment will occur.
The training should include all aspects of work performance and not just narrow task skills. Employees should be able to transfer and apply skills, knowledge and attitudes to new situations and environments as a result of the training.
Examples:
• Health and safety competencies (skills, knowledge, experience and qualifications) for all levels of the organisation should be identified and documented as a competency profile for all employees or positions including senior management, line managers/supervisors, operations personnel, those with specific responsibilities such as first aiders, fire wardens and safety representatives. The identified competencies should take into account the work activities of the organisation and any risk associated with the conduct of such activities. Training requirements should be at a minimum, the gap between the training need for the position and the establish competency of the individual to safety perform the position.

• Job descriptions detailing skills/competencies required.
• Training needs analysis.
• Task skills matrix showing individual competencies and further training needs.
• Organisational training plan.
• Personal development plans for individuals.
• Results of assessment of workers for specific tasks.
• How were training needs determined?
• How are workers assessed?
• Do personnel have the competencies identified as required?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.3
The organisation / site has an induction / orientation program for all personnel including management, which is based on their likely risk exposure, and provides relevant instruction in the organisation’s health and safety policy and procedures.
Information:
All new and transferred personnel, regardless of level, need induction in health and safety policy and procedures, emergency procedures, accident reporting, hazard reporting, consultative arrangements, etc. The extent of training should be determined by the level of risk associated with the undertaking. An assessment is also needed to determine the briefing requirements for visitors and contractors. This ensures that they are informed of the health and safety requirements at the work-site. The induction requirements will vary according to the site visited and the activities undertaken by the visitors and contractors, e.g. a RACF would be expected to have very different procedures to an office.
Examples:
• Documentation that outlines the content of the induction training.
• Induction records for all employees, including managers.
• Contractor induction program.
• Records of visitor briefings and contractor inductions.
• Have top management, been inducted into the organisation?
• Can workers (including casuals and volunteers) confirm their attendance at orientation training?
• “Briefing” procedure for visitors which, depending on requirements, vary from full site induction to “sign-in books” and visitor pamphlet or cards.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.4
The organisation / site consults with workers to identify their training needs in relation to performing their work activities safely.
Information:
Working with workers to clarify training needs will not only identify training gaps but provide information about opportunities for further improvement or enhancement of job performance.
Examples:
• Consultative mechanisms include WHS training requirements and these are reported at HS meetings or other appropriate forums.
• Consultation regarding training requirements can be discussed at toolbox talks and recorded in minutes.
• Can workers confirm that their supervisors talk to them about extra training requirements?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.5
The organisation / site trains personnel to perform their work safely and verifies their understanding of that training.
Information:
The organisation needs to ensure that workers undertaking tasks have the competency to perform them safely. This applies to new workers and to those transferring from another site or department. Training must be understood, and applied to actually benefit the organisation and the individual. The training must ensure that those with language, literacy or learning difficulties are able to understand the information. The organisation needs to develop methods by which it can measure the individual’s understanding of the learning outcomes and also the ability to apply that new understanding in the workplace. Records of all training should be maintained, including on the job or ‘buddy’ training.
Examples:
• The competency of workers including any contractors, or labour hire workers should be assessed prior to their being expected to carry out the tasks associated with their position responsibilities.

• Documentation concerning the content of the training and how it is delivered.
• Training program materials that demonstrate attention to differing levels of ability and literacy.
• Training evaluations which match the documented requirements, e.g. completed tests and supervisor evaluations.
• Job specific health and safety training records for all workers.
• How does BaptistCare confirm that workers understand the written and spoken components of their training?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.6
Training and assessment is delivered by persons with appropriate knowledge, skills and experience.
Information:
To deliver effective training, trainers need the skills and knowledge of the task combined with an ability to
impart that knowledge and information. The mix of these may differ depending on the type of training and
the types of skills and knowledge to be imparted.
Examples:
• Training and assessment responsibilities should be designated to competent persons and statements of responsibility, authority and accountability established. Responsibilities should include training delivery, supervision, assessment and/or verification tasks..

• Train the trainer records or equivalent.
• Skills knowledge and experience of the trainer have been defined and documented.
• How do you determine what the appropriate knowledge, skills and experience of the trainer needs to be?
• How do you check the skills and competencies of those providing training?
• How do you check the trainer is appropriate to the task?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.7
Tasks are allocated according to the capability and level of training of personnel.
Information:
An organisation should only allocate tasks to workers who are capable of undertaking the tasks safely.
The skill and training of the worker must be matched to the requirements of the task.
Examples:
• A task analysis that identifies the competencies, including the specific health and safety competencies of the task.
• A recruitment procedure that ensures persons chosen to undertake tasks have the necessary competencies.
• Records that identify the training undertaken by personnel to enable them to undertake their job safely.
• A ‘return to work’ process that matches workers to tasks that they can perform safely whilst recuperating from injury, illness or other trauma.
• Skills/competency matrix of personnel is developed and used to assign individuals to appropriate tasks.
• Can the organisation explain on what basis people are allocated to particular tasks?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.8
Management has received training in health and safety management principles and practices appropriate to their role and responsibilities within the organisation, and the relevant health and safety legislation.
Information:
Managers and supervisors should know their legal health and safety obligations. They also need to participate in such things as development of health and safety management plans, the risk management process, check that hazard control measures function correctly, etc. and have sufficient knowledge to ensure that workers under their direction perform the work safely.
Examples:
• Training program outline which covers relevant content.
• Training attendance records for managers and supervisors in accordance with identified needs.

• Have you received health and safety training, when was this and what was covered by that training?
• Can managers confirm they have received health and safety training?
• Can managers explain what was included in their health and safety training?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.9
Those representing the PCBU and the workers on health and safety matters, including representatives on consultative committee(s), receive appropriate training to enable them to undertake their duties effectively.
Information:
To be effective, PCBU and worker representatives need training that covers health and safety management principles, health and safety legislation, and the consultation process.
Examples:
• Suitable training course outline.
• Records of attendance for PCBU and worker representatives.
• Can PCBU and worker representatives confirm that they have attended the relevant training?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.10
Refresher training (as required) is provided to all personnel to enable them to perform their tasks safely.
Information:
Over time there is a tendency for people to forget aspects of tasks, especially when tasks are not performed regularly. An assessment should be made to determine when refresher training for particular competencies and tasks is needed, and at what intervals.
Examples:
• Training plan which contains time frames for refresher training as appropriate.
• Training records that show refresher training has been conducted in line with the
assessment/training plan.
• Identification of processes/plant requiring refresher training.
• Can workers confirm that adequate refresher training is provided?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.3.11
The training program is reviewed on a regular basis, and when there are changes to plant or processes in the workplace, to ensure that the skills and competencies of personnel remain relevant.
Information:
Training courses need to be regularly reviewed to determine whether they are still up to date and are achieving the desired outcomes. Courses should also be reviewed when equipment or work practices are changed.
Examples:
• Procedures for the review of training and assessment should be implemented to ensure the effectiveness of programs to meet skills and knowledge requirements of the workplace. Review outcomes should be used to update competency profiles, program requirements, resources and strategies to maintain relevance, currency and continuous improvement.
• Records of training reviews.
• Examples of changes in training following changes in plant or processes.
• When was the last time that the training program was reviewed?
• Can workers confirm that when there are changes to plant or processes that they have received appropriate training?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Consultation, Communication and Reporting- Consultation

3.4 CONSULTATION,COMMUNICATION AND REPORTING - CONSULTATION

3.4.1
There are documented procedures, agreed to by workers, for worker involvement and consultation on health and safety matters, including a procedure for dealing with health and safety issues, and resolving disputes if they arise.
Information:
To ensure consistency and gain worker commitment, arrangements for worker health and safety representatives and consultative processes should be documented and communicated to workers. This enables workers to participate in improving health and safety within the organisation. The documented procedures should also define what constitutes a health and safety issue, how issues are to be reported, to whom, and the methods for resolving such issues. An issue resolution procedure reduces the possibility of a health and safety issue escalating into an industrial dispute. The procedure should set out the involvement of the various parties in the workplace such as workers, worker health and
safety representatives, supervisors, managers and also the involvement of any external body when an issue cannot be resolved within the work place.
Examples:
• Documented consultation procedure.
• Terms of reference for a health and safety committee.
• A documented and agreed health and safety issue resolution procedure which is relevant for all parties in the workplace, identifies the various types of health and safety issues that may arise in a workplace and the way of handling those health and safety issues.
• Have worker representatives agreed to the formal consultation arrangements?
• Procedures or flowcharts displayed in the workplace.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.4.2
The organisation, in consultation with workers, has determined the number of representatives required to effectively represent all defined work groups.
Information:
Effective consultation is achieved when all workers have an opportunity to hear about and raise health and safety issues and concerns. This will be simple in a small workplace, but more complex in an organisation where there are a range of worker skill levels, multiple sites, differing operations and hazards. The number of worker representatives will depend on factors such as:
a) The overall number of workers;
b) Overtime and shift arrangements;
c) The number and grouping of workers who perform similar types of work;
d) The separation of work areas;
e) The variety of work; and
f) The nature of the hazards at the workplace.
Examples:
• Minutes of meetings that record discussion or representation arrangements
• Agreed list of workgroups or areas having worker representatives.
• Are workers satisfied with the number and representation of worker representatives for health and safety?
• How was the number of worker representatives determined?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.4.3
The consultative arrangements allow the workers to select those who will represent them on health and safety matters.
Information:
For consultation to be effective, workers need to have confidence in those who will represent them.
Therefore workers need to be involved in the selection process.
Examples:
• Documented consultative arrangements that provide for workers to elect a representative.
• Meetings which record elections of worker representatives.
• A list of worker representatives.
• Did workers select their current health and safety representative?
• Election information posted on noticeboards.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.4.4
Details of the consultative arrangements, including the names of representatives for health and safety matters, are communicated to workers.
Information:
Communication must ensure all workers are aware of those persons who can help them to resolve health and safety issues and how the process works. Arrangements for worker health and safety representatives and consultative committees should be documented and widely known.
Examples:
• Information about consultation and issue resolution arrangements are included in induction or other training
• Names of worker and PCBU representatives communicated, e.g. electronically or included in team briefings.
• Can workers name their representatives?
• Names/pictures of representatives posted on noticeboards
• Information about consultation posted on noticeboards.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.4.5
Workers or their representatives are involved in the development, implementation and review of procedures for the identification of hazards and the assessment and control of risks.
Information:
When procedures are developed or reviewed, workers should be consulted and involved in the process. In this way valuable information on hazard identification and control can be gained. The procedures developed from this process are more likely to be accepted by workers due to their involvement.
Examples:
• Terms of reference for a health and safety committee.
• Minutes of meetings that record discussion relating to the formulation of relevant policies and procedures.
• Examples of working papers that show the employee involvement in development of a relevant policy or procedure.

• Can workers or their representatives recall being involved in the development or review of health and safety policies and procedures?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.4.6
Workers or their representatives are consulted regarding proposed changes to the work environment, processes or practices and purchasing decisions that could affect their health and safety.
Information:
Workers often have a wealth of practical experience that can be valuable in ensuring that workplace changes are implemented effectively. It is appropriate to consult with the relevant workers when changes are proposed, so that potential health and safety issues can be identified and resolved.
Examples:
• Project documentation that mandates consultation with workers as part of the process.
• Minutes of team briefings/meetings recording discussion on proposed workplace changes.
• Minutes of health and safety committee meetings recording discussion on proposed workplace changes.
• Can workers/representatives confirm that they receive information about proposed changes and have an opportunity to contribute or comment prior to the changes being implemented?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.4.7
Worker representatives and management meet regularly about health and safety issues and minutes of their meetings are available to all personnel.
Information:
Effective health and safety consultative arrangements require the participants to meet at regular intervals and keep a record of what is discussed. Copies of the minutes should be available to all personnel. In some organisations these arrangements may take the form of one or more health and safety committees.
Examples:
• Worker and management representatives confirm that meetings are held regularly and according to schedules.
• Minutes of consultative meetings are distributed electronically or by other means.
• Minutes of meetings demonstrate attendance by worker representatives across all shifts.
• Health and safety committee terms of reference which refer to meeting schedules.
• Committee meeting calendar.
• Minutes of committee meetings which match schedules.
• Do workers know where to find copies of current consultative meeting minutes?
• Meeting schedules and minutes of previous meetings posted on noticeboards.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Consultation, Communication and Reporting - Communication

3.5 CONSULTATION,COMMUNICATION AND REPORTING - COMMUNICATION

3.5.1
The organisation’s health and safety policy and other relevant information on health and safety are communicated to all workers, and consider language and standards of literacy.
Information:
An effective method for the systematic distribution of information should be developed. Workers need accurate health and safety information to perform their work safely, and the organisation must fulfil its obligations to keep workers informed about health and safety activities and issues. Where there are multiple committees or where organisations have different locations with similar operations, an exchange of health and safety information can be invaluable. Where workers may have difficulty understanding or reading English, the information needs to be translated or directly explained to individuals.
Examples:
• A documented procedure for information distribution.
• Minutes of regular ‘tool box’ meetings incorporating a health and safety focus.
• An organisational publication which includes regular articles on health and safety.
• A computer network which provides relevant health and safety information to all workers.
• Designated workplace translators.
• Information presented in languages other than English.
• Can workers give the location of, or explain the content of the organisation’s health and safety policy?
• Do workers receive other relevant health and safety information?
• Health and safety policy displayed on noticeboards.
• Copies of health and safety publications/alerts posted on noticeboards/ in staff rooms.
• Health and safety information posted in pictorials or in language other than English.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.5.2
The organisation regularly communicates to workers the progress towards the resolution of health and safety disputes.
Information:
The dispute resolution procedures need to explain how feedback is provided to workers. The requirement to report progress will tend to encourage action by the responsible parties to resolve matters in a timely fashion. Similarly, where matters are complex and difficult to resolve, workers are more likely to understand the reasons for delays. Relying on health and safety committee meeting minutes to communicate information may not always be appropriate. Sometimes, information needs to be conveyed more regularly than the frequency of meetings.
Examples:
• Internal memos, team meetings or health and safety committee minutes which detail progress on health and safety matters raised by workers.
• Can workers explain what progress has been made on relevant outstanding health and safety disputes?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.5.3
There are procedures for exchange of relevant health and safety information with external parties, including customers, suppliers, contractors and relevant public authorities.
Information:
To address legal requirements and to maintain good business practice, an organisation needs to ensure that there is an ongoing exchange of information with customers, suppliers and other relevant parties. The organisation needs to identify the parties involved and set up lines of communication and systems which ensure the desired exchange of information.
Examples:
• A strategic assessment of the external parties and what information is required to be exchanged.
• Such information may include but are not limited to:
* The latest information on product safety, including hazard alerts, Safety Data Sheets; or other information on chemicals;
* Product recalls;
* Instructions for the safe installation, commissioning, operation and maintenance of plant;
* Emergency planning information supplied to the relevant authorities; and
* A listing of key contacts for exchange of information.
• Communication responsibilities for the acquisition or provision of health and safety information included in position descriptions.
• Purchasing arrangements which require the provision of relevant information and confirmation that it is received.
• Information about chemicals, or Safety Data Sheets sought and received from suppliers, or provided to distributors and other customers.
• Minutes of meetings with contractor, customers or suppliers which record the health and safety information being discussed or exchanged.
• Correspondence or other records of communication between the organisation and relevant authorities.
• Does the organisation / site receive health and safety information from external parties?
• Does the organisation / site know which authorities require them to submit health and safety information, and the scope and frequency of that information?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.5.4
There is a documented complaints procedure that encompasses health and safety issues for dealing with formal and informal complaints received from external parties.
Information:
Complaints about health and safety issues can originate from external as well as internal sources. Complainants may include customers, members of the public, regulatory authorities, contractors or suppliers. Complaints can be an early warning to the organisation of serious situations, e.g. product batches which don’t meet safety requirements, workers or customers acting in an unsafe manner, unsafe deterioration of buildings and poorly designed or unhygienic facilities. Formal complaints may be received via telephone, letter, fax or e-mail. Informal complaints may be obtained via a third party, through published works, via meetings, etc. There should be a procedure to collect the details of the complaint and take relevant action. This procedure may be incorporated into other procedures which collect client feedback.
Examples:
• Copy of procedure for collecting, recording and dealing with external complaints.
• Examples of correspondence regarding external complaints.
• Have you received any complaints from external parties, including from health and safety inspectors?
• How do you track and deal with complaints from external parties?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Consultation, Communication and Reporting- Reporting

3.6 CONSULTATION,COMMUNICATION AND REPORTING - REPORTING

3.6.1
Workplace injuries and illnesses, incidents and health and safety hazards, dangerous occurrences and systems failures, are reported and recorded in accordance with documented procedures.
Information:
Workers in the workplace are often the first to become aware of a health and safety hazard either by direct observation or as a result of things going wrong. There needs to be an effective process for capturing that information. Details need to be recorded so that risk assessment and appropriate corrective action can be taken. This will help to prevent a recurrence or more serious consequences. Records will also provide information about trends which may occur. All personnel need to be aware of their role and responsibilities in the reporting and recording process.
Examples:
• A documented procedure for reporting injuries, incidents, hazards and systems failures.
• A shift logbook for recording hazards and failures.
• Completed injury/incident forms.
• Register of injuries.
• Copies of hazard and failure records.
• Can workers explain when, how and what type of incidents and hazards are reported and recorded?
• Report forms available in the workplace.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.6.2
Where there is a legislative requirement, injuries, illnesses, incidents and dangerous occurrences are notified to the appropriate authorities.
Information:
Local legislative requirements may require certain matters to be formally notified to appropriate authorities. These may include specified incidents involving dangerous goods, plant and certain personal injuries and illnesses. The appropriate authorities may include the health and safety regulatory authority and emergency services authorities.
Examples:
• A documented procedure for injury, illness and incident notification, including the need to notify appropriate authorities.
• Appropriate notification forms.
• Completed notification forms.
• Can the organisation explain what events need to be notified?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.6.3
Reports on health and safety inspections, testing & monitoring, including recommendations for corrective action, are produced and forwarded to senior management and worker representative(s) as appropriate.
Information:
All workplace inspection programs need a mechanism for fixing the identified problems. Those undertaking the inspections (with specialist input if required) need to provide recommendations on how the adverse condition may be rectified. Senior management and worker representatives need to monitor the inspection process, and be aware of any specific issues or trends which occur at the workplace.
Examples:
• Inspection reports which record the recommendations for corrective action.
• Distribution listing for inspection reports which includes senior management and the consultative committee(s).
• Minutes of consultative meetings which record the inspection reports as an item on the agenda.
• Minutes of senior management meetings which record discussion on inspection reports.
• ‘Hazard registers’ or inspection summaries that are sent to senior management and the consultative committee.
• Who forwards the reports and how often?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.6.4
Regular, timely reports on health and safety performance are produced and distributed within the organisation / site.
Information:
All personnel in the organisation can benefit from regular information about health and safety performance. It reminds them of the importance attached to the health and safety program, provides positive reinforcement to those who are taking an active part in the process and assists with the timely notification of trends, both positive and negative.
Examples:
• Health and safety performance reports.
• Can worker representatives confirm that the organisation’s health and safety performance is regularly discussed or reported?
• Health and safety performance data displayed in the workplace.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.6.5
Reports of audits and reviews of the health and safety management system are produced and distributed within the organisation / site.
Information:
Everyone in the organisation has a stake in the success or failure of the health and safety management system. Where comprehensive formal system monitoring takes place, it is only reasonable to provide reports of those activities to those who have been actively involved with the program's implementation, e.g. management, health and safety officers, worker health and safety representatives and the health and safety committee. The outcomes also need to be communicated and records kept so that progress can be monitored until the next review is held.
Examples:
• Audit reports.
• Management system review reports.
• Health and safety committee minutes which record discussion of results of audits and reviews.
• Can managers and worker representatives confirm that reports are distributed?
• Reports displayed in the workplace.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Documentation

3.7 DOCUMENTATION

3.7.1
The organisation / site’s health and safety plans, local procedures and other safety related documents are documented in a planned and organized manner.
Information:
The key health and safety documents must be prepared and maintained so that they can be easily recognized and accessible to the users. It is not always practical to document everything in a single manual. Some information may overlap or be incorporated into other manuals, and some information may be presented in other formats such as:
• Electronic data;
• Chemical manifests;
• Charts, plans; and
• Process information.
Recording and documenting the health and safety management system requires that it’s planning arrangements, procedures and instruments (tools and forms) should be documented and stored in a suitable print and/or electronic form.
If some of the health and safety documents are dependent on particular data or information in other manuals, etc., the links and location of the references should be clear.
Examples:
• Health and safety incorporated into quality, corporate or other similar manuals.
• Health and safety information with links to other manuals.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.7.2
Specific instructions and safe work procedures associated with particular products, processes, projects or sites have been developed where appropriate.
Information:
Sometimes specific instructions and safe work procedures are needed to address complex or detailed processes, products and projects, e.g. hazardous substances management or a particular production line. In other situations the corporate manual may need to be tailored to meet the local requirements of a particular site or facility.
Examples:
• Specific instructions and safe work procedures should exist where:
* there are activities carrying a health and safety risk (including those stated in legislative requirements). These may include hazardous work premises and processes, working environments, use of hazardous substances and construction work;
* the absence of such instruction would adversely affect health and safety performance; or
* there are requirements for specific emergency procedures; the approval of processes and equipment; or the certification of personnel to work on certain equipment or be involved in the conduct of certain processes.
• Safe work procedures should be documented in a manner that ensures those involved or exposed to a hazardous process are equipped to conduct work activities in a safe and healthy manner.
• Safe work procedures may include but are not limited to:
* a description of the activity or process;
* the person or position that has supervisory responsibility for the activity or process;
* a clear explanation in sequential order of the steps or stages comprising the procedure or process potential hazards safety controls to minimise potential risk for any identified hazard
* health and safety precautions to be exercised in the course of carrying out the work activities.
• Specific manuals developed where the nature of the operation requires detailed plans, policies, procedures, work instructions etc.?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Document and Data Control

3.8 DOCUMENT AND DATA CONTROL

3.8.1
The organisation / site has a system for creating, modifying and approving health and safety documents and data, and notifying relevant persons of any changes. Obsolete documents and data are identified and retained (where required) for legal and/or knowledge preservation purposes and are removed from all points to prevent unintended use.
Information:
Documentation is prepared to assist and guide workers to put health and safety into practice at the workplace. There needs to be a process which ensures that the relevant personnel have input into the creation and approval of documents and data, before they become part of the operating system. Policies, safe work procedures and instructions are typical documents used for this purpose.
To ensure their integrity, any modifications to the documents or the data need to be similarly approved. The next step is to let all the relevant parties know about the new documents or the changes.
Obsolete documents kept for historical or legal purposes should be clearly identified and removed from use so that they are not confused with current versions.
Examples:
• Procedures to control system documentation including policy, system planning arrangements, procedures and instruments (tools and forms) should be established and maintained. Such procedures ensure:
* the creation, modification and approving health and safety documents and data, and notifying relevant persons of any changes;
* documents are legible, dated (with dates of revision), readily identifiable and maintained in an orderly manner for a specified period.
• Responsibility and authority for the creation and modification of documents within the system should be designated to person(s) in authority or those charged with responsibility for particular work activities, operations or work areas. Such responsibilities should be documented in position
descriptions, system planning arrangements, procedures and instruments (tools and forms).
• A written document control procedure.
• Procedures which have been signed off by relevant persons.
• Minutes of meetings which record discussion about modified procedures or data.
• Electronic or paper distribution lists which confirm that relevant persons/areas have been notified of, or received modified procedures.
• Documents stamped or otherwise identified as ‘obsolete’.
• Can managers/worker representatives confirm that they are informed about changes to documented standards?
• What does the organisation do with obsolete documents?
• How does the organisation determine what documents need to be retained?
• The only documents in the user area are the current versions.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.8.2
Documents and data critical to health and safety shall be clearly identifiable, duly authorized prior to issue, kept legible and include their issue status.
Information:
Because documents and relevant data are subject to change, it is vital that only current versions are known and used. The information must be complete and legible, e.g. pages numbered. A draft procedure or new version should be easy to identify in comparison with the current authorised version.
Examples:
• Changes to documented procedures are recorded and communicated to workers. A master list (document control register) or equivalent control procedure should be established and maintained to identify the current revision of documents.
• A document control procedure which defines the type of document covered by the procedure and the required format.
• Documents which are legible, identified, authorised and dated in accordance with the organisation’s document control procedure.
• Numbered versions of documents.
• Draft documents appropriately identified.
• Documents which contain references to information such as the organisation’s operating requirements for:
* Maximum levels of exposure to noise or hazardous substances in particular areas;
* Maximum or minimum temperatures required for chemical storage;
* Pressure levels; and
* Weight limits for racking.
• Can line managers/worker representatives explain how they ensure that they are working with the latest versions?
• Current copies of relevant documents in user area.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.8.3
The organisation/site provides personnel with ready access to relevant health and safety documents and data and advises them of its availability.
Information:
In the course of doing their work, personnel will need to refer to the content of the organisation’s health and safety documentation. The placement of that information must suit their needs, whether it is in hard copy or electronic format. Responsibility should be assigned for the provision and maintenance of this documentation to ensure that it is current and complete.
Examples:
• A document control procedure that describes the storage and method of updating health and safety documents.
• Do workers know where the relevant health and safety documents are located?
• Have supervisors/employees been notified about relevant data and documents?
• Current copies of relevant documents in user areas.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.8.4
Documents and data are regularly reviewed by competent persons to ensure the adequacy and currency of the information.
Information:
Changes to legislation, equipment, processes and technology will all impact on the information contained in the organisation’s policies, procedures and work instructions. All of these documents need review on a regular basis to ensure they remain relevant and reflect the current working methods. Reviewers should not only understand the document and its contents, but also be aware of any pertinent background information.
Examples:
• System documentation including policy, planning arrangements, procedures and instruments (tools and forms) should be regularly reviewed for their compliance to document control requirements.
• Corrective action should be undertaken to address nonconforming documentation. The procedures implemented to control documents should be reviewed and the efficiency with which the system is maintained should be evaluated.
• Relevant position descriptions should contain responsibilities for the review of system documentation requirements.
• A document control procedure which describes the review process.
• Minutes of meetings which record reviews of documents or data.
• Circulation of draft documents which demonstrates input from competent persons.
• Documents reviewed in accordance with a predetermined schedule.
• How do you ensure that persons involved in health and safety document reviews are competent?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Health and Safety Risk Management Program

3.9 HEALTH AND SAFETY RISK MANAGEMENT PROGRAM

3.9.1
The organisation / site has identified the hazards, including public safety hazards that are associated with its activities, processes, products or services; assessed the risks involved; and implemented suitable control measures. The risks shall be eliminated, or otherwise controlled and monitored, in accordance with hierarchy of controls and legal requirements.
Information:
To identify hazards, the organisation should look at where and how it does business and who could be affected. All foreseeable health and safety hazards should be identified. For example, the organisation needs to evaluate the place where the work takes place, the related equipment, raw materials and how they are used in the production process. Hazardous manual handling tasks must be identified.
Hazards are not limited to the physical environment in which people work and may include psychosocial hazards. Hazards can be introduced through the actual type of work or working arrangements at an organisation. For instance, an organisation needs to examine whether there are sufficient people allocated to perform a task safely under all circumstances including tight time frames and emergency situations. Some monotonous tasks may increase worker frustration and anxiety.
For many workplace hazards, there is very comprehensive information readily available to assist organisations. Regulations, codes of practice, industry and technical standards will provide guidance.
Records of the risk assessment should be maintained to demonstrate how decisions are made on the suitability of risk controls [with reference to the hierarchy of controls]. Particular engineering controls should be selected on the basis that they will eliminate or substantially lower the risk to workers. Where an effective hazard control is achieved through a specific work method, safe work practices should be documented in the form of procedures and/or work instructions. The training, supervision, qualifications and equipment needed for the job should be included in the procedure.
This isn’t a one-off exercise. Once an organisation is up and running, the hazard identification, risk assessment and risk control process needs to be integrated into function
Examples:
• Procedures for the identification of hazards arising from the conduct of work activities, processes, products or services are implemented.
• Procedures for assessing risk associated with identified hazards are implemented.
• Risk controls are assigned, recorded and implemented.
• Risk controls for all identified hazards are commensurate with the assessed level of risk.
• Can workers confirm their involvement in the process?
• Has information from the organisation’s injury/incident records been used to identify hazards?
• Has the organisation sought industry specific knowledge on hazards and causes of injuries and illness?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.9.2
The hazard identification, risk assessment and risk control process is undertaken by personnel competent in the use of the organisation’s methodology.
Information:
There are many risk management methodologies available, e.g. qualitative risk assessment (using risk chart), risk calculation using a nomogram, process safety review, fault tree analysis, event tree analysis, cause-consequence analysis, ‘what-if?’, failure modes and effects analysis, hazard and operability study (HAZOP), energy models, human reliability analysis, etc. Whatever the methodology used, staff or consultants working with the organisation’s methodology must understand how it is used and should have undertaken some instruction or training in the process. Different methodologies are useful for different purposes and the staff or consultants should be aware of the strengths and weaknesses of the methodologies used.
Examples:
• Copy of internal training records confirming training in risk management.
• Instructions to contracted health and safety professional(s) indicating the type of risk management process(es) used by the organisation.
• Documentation confirming the knowledge of the risk management methodology being used by contracted health and safety professional(s).

• Can the relevant person(s) explain the application of the chosen methodology?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.9.3
The organisation / site documents all identified hazards, risk assessments and risk control plans.
Information:
In addition to compliance with legal requirements, the recording of risk management activities allows for easy referral, follow up and review. It would be almost impossible to ensure that hazard identification, risk assessments and risk control plans were comprehensive and complete, i.e. involved the relevant persons and looked at all relevant factors, without keeping some record of that process.
Examples:
• A Health and Safety Risk Register/s should be kept that lists all identified risks in the workplace.
• Records should be kept of identified hazards and the measures implemented to control such hazards commensurate with the assessed risk. Documents produced as a requirement of this element should be controlled and maintained in accordance with health and safety management system requirements.
• Hazard/Risk register.
• Job safety analyses, Safe Work Method Statements.
• Risk assessments and risk control plans.
• ‘Safety Case’ documentation.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.9.4
Risks of identified hazards are assessed in consultation with workers having regard to the likelihood and consequence of injury, illness or incident occurring, based upon the:
a) legal requirements;
b) evaluation of available information;
c) records of incidents, illness and disease and
d) the potential for emergency situations.
Information:
Risk assessment involves deciding whether it is likely that someone could be hurt by being exposed to the hazards, and how serious the injury or illness might be. Risk assessment should also address the likelihood and severity of incidents associated with the potential for property damage. All the contributing factors need to be identified and examined. Usually, there is extensive information available to assist with this assessment from within the organisation and from external sources such as other similar workplaces, industry groups, legislators and technical journals, i.e. safety, medical and scientific. Any known instance where loss of control of the hazard has resulted in injury, illness or other serious outcomes needs review.
Examples:
• Risk assessments that record or reference the current state of knowledge about the hazard and its potential effects.
• Risk assessments that refer to information in SDS.
• Risk assessments that follow Code of Practice and/or advisory standard models.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.9.5
Identified control measures shall be implemented in accordance with the assigned risk control priorities.
Information:
The purpose of risk assessment is to determine the organisation’s and the worker’s level of risk exposure. Clearly, the higher the level of risk exposure, the more urgent the action to be taken. Priority needs to be given to those risks at the more serious end of the scale, but the organisation needs, also, to discuss and determine how and when all the risks will be reduced to an acceptable level.
Examples:
• A risk control plan based on the determined level of risk of each hazard.
• Minutes of meetings that record discussion about priorities.
• Can worker representatives confirm that discussions have been held about the order in which hazards are to be actioned?
• Risk controls implemented according to a predetermined schedule.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.9.6
Risk management procedures shall be reviewed and revised where necessary to ensure relevance, currency and compliance to health and safety management system requirements.
Information:
Continuous improvement in risk management will only occur when questions are asked about the integrity, validity and effectiveness of the mechanisms and processes which are used to manage risk. The organisation needs to schedule regular opportunities to revisit the entire hazard identification, risk assessment and risk control process. When control measures fail to work as expected or incidents occur, there must be a check to determine whether the process was followed.
Examples:
• Review and evaluation of procedures, process and outcomes should include:
* hazard identification, risk assessment and risk control process
* effectiveness of implemented control measures.
• Control measures should be reviewed to ensure outcomes of the risk management process are effective, do not introduce additional hazards and are implemented to in accordance with legislative and health and safety management system requirements.
• Health and safety plans that schedule a review of the hazard identification, risk assessment and risk control process.
• Minutes of meetings that record discussion about the process used for a particular issue.
• Review documents that report on the effectiveness of the process.
• Can management explain what circumstances prompt the review of the hazard identification, risk assessment and risk control process/methodology?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.9.7
The organisation/site has a process for identifying and managing change that may impact on health and safety.
Information:
An organisation is more exposed to risk during times of change in the workplace. A number of factors may influence this risk, e.g. unexpected situations, poorly considered changes to systems of work (either temporary or permanent), movement of personnel to new or different tasks, training that lags behind the development of new processes/equipment, introduction of new or different materials and equipment, increased use of contractors during an installation or overhaul, additional pressure on supervisors to maintain outputs and time delays in preparing revised documents, work procedures, work instructions, etc.
Examples:
• Change management procedure which requires health and safety implications to be identified and strategies to be prepared.
• Project plans which identify interim arrangements to manage the health and safety risks associated with the introduction of changes.
• Training or workshop/meeting records that record discussions about managing change safely.
• Risk assessments.
• Contingency plans.
• What is the organisation’s definition of ‘change’?
• Can managers explain how change is identified and managed?
• Can workers/representatives confirm that changes are managed safely?
• Additional staffing to cover peak workloads.
• Interim engineering controls or administrative controls, e.g. fencing, signs, access controls, etc.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Hazard Identification, Risk Assessment and Control of risks.

3.10 HAZARD IDENTIFICATION, RISK ASSESSMENT AND CONTROL OF RISKS

3.10.1
The organisation / site determines those areas where access controls are required and ensures effective controls are implemented and maintained.
Information:
Some areas of the workplace environment require restricted entry. Deciding which parts of the workplace need restrictions on access is part of the hazard identification, risk assessment and risk control process conducted at criterion 3.9.1. Restricted access may be required to control the level of exposure to such things as mobile plant, electrical hazards, hazardous chemicals, hazardous machinery and electromagnetic radiation. If an organisation has designated certain areas as restricted, it follows that procedures should be in place to ensure that conditions for entry are defined and access restrictions are enforced.
Examples:
• Hazard identification, risk assessment and control documentation identifying restricted access areas.
• Site map showing restricted access areas.
• Records of checks done, e.g. inspection checklist, minutes of health and safety committee meetings, security guard reports, etc.
• Can workers indicate the areas which have restricted access?
• Can workers/representatives confirm that access controls are maintained?
• An access control procedure, e.g. sign-in book, security guards, authorised card access, key register, etc.
• Signs or systems which designate restricted access areas, e.g. pedestrian walkways and bollards to restrict vehicle access.
• Engineering controls, e.g. presence sensing devices, barriers and fences, conventional and time delay locks, etc.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.2
Health and safety requirements are identified, evaluated and incorporated into all purchasing specifications for services.
Information:
When an organisation engages the services of contractors to perform work on its behalf, it must give special consideration to the health and safety issues involved in the provision of those services. For example, a contract may include reference to the people, processes and equipment to be used, the standard of work to be achieved, the legislative obligations to be met, the responsibilities of the various parties, and specify how the contractor is expected to comply with organisational procedures.
Examples:
• The organisation’s purchasing documentation should clearly define the required health and safety specifications for the services being procured. Where contractors or labour hire workers are to be admitted to site, documentation should include but is not limited to:
* elements of the health and safety management system to be implemented;
* reference to site specific health and safety risk;
* provisions for health and safety induction;
* inspection, test or audit records;
* reports indicating a review of health and safety performance.
• A documented purchasing procedure that outlines how health and safety is considered prior to the decision to purchase services (which may be incorporated into a quality procedure).
• A preferred supplier listing, with information to demonstrate that all contractors on the list have been informed about the organisation’s specific health and safety requirements.
• Contract documents that specify the health and safety requirements of the contractor’s service delivery.
• A tender process which requires information to be provided about the potential service provider’s management of health and safety.
• Can the relevant contract manager/purchasing officer describe how the purchasing specifications are determined?
• Contractors adhering to organisational requirements, e.g. wearing high visibility vests in designated areas.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.3
The ability to meet health and safety requirements is assessed in the selection of contractors and labour hire workers.
Information:
The organisation should have a process for the selection of contractors and labour hire workers which requires them to provide information about how health and safety is managed. The supplier’s management system should address all health and safety issues relevant to the performance of the service required. Ideally the suppliers should provide evidence through audits or inspections that demonstrates an effective health and safety management system is in place.
In some cases it may be necessary to visit the supplier’s premises or work sites to assess the effectiveness of the health and safety management systems prior to engaging them to work for the organisation.
Examples:
• Processes used to select suppliers of services and human resources may include but are not limited to:
* the identification of applicable health and safety requirements in tender documentation;
* evaluation of submitted tenders for health and safety requirement compliance;
* ensuring health and safety requirements are clearly stated in contractual documentation;
* evaluation of health and safety documentation submitted by the successful tenderer prior to commencement of service delivery.
• Personnel responsible for establishing health and safety specifications for services, and reviewing purchasing documentation, should be appropriately skilled and experienced and where required carry the necessary qualifications. Such skills, experience and/or qualifications should be defined.
• The competency of contractors and suppliers of labour hire workers to meet health and safety specifications should be assessed by management. Such responsibilities should be documented in position descriptions, system planning arrangements, procedures and instruments (tools and forms).
• A contractor / labour hire selection procedure which requires the provision of health and safety management systems information.
• Tender documents for the supply of services which include requirements for the supplier to maintain effective health and safety management systems.
• Documents relevant to management of health and safety obtained from contractors or suppliers of labour hire workers.
• Records of contractor assessments conducted by the organisation.
• Minutes of meetings that record discussion of contractor health and safety management.
• Recommendations or referrals regarding contractors or suppliers of labour hire workers.
• Can the contract manager explain the process for selection of contractors?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.4
Contractor health and safety performance is monitored and reviewed to ensure continued adherence to organisation’s health and safety requirements or specifications.
Information:
Having documented the health and safety requirements with respect to the provision of services, it remains for the organisation to ensure that the contractor provides what is stipulated. This makes good sense from a health and safety point of view and also from a financial viewpoint. Checks should be undertaken before the commencement of work and at defined intervals throughout the term of the contract or service period.
Examples:
• The type and extent of health and safety control exercised by management should be dependent upon health and safety risk factors and evidence of the supplier’s previously demonstrated capacity and performance.
• Records of contracted services health and safety conformance should be maintained.
• A purchasing or contract procedure which describes the methods by which services are to be evaluated for conformance with specifications, e.g. performance indicators.
• Minutes of contract review meetings that record discussion of health and safety issues.
• Audit reports of contractor safety performance.
• Correspondence with contractors about health and safety matters/noncompliance.
• Recommendations regarding change of preferred suppliers.
• Can workers confirm that the safety performance of contractors is checked?
• Contractors observed to be operating safely.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.5
The organisation / site determines their health and safety requirements prior to the purchase of goods, and communicates those specifications to the supplier.
Information:
Health and safety issues should be considered prior to any purchase of equipment, materials or substances. The organisation needs to consider:
its legal requirements; relevant standards; the potential impact on affected personnel; training requirements; changes to work procedures; personal protective equipment; and any other relevant technical data or information.
This helps to anticipate hazards and avoid or minimise the risks connected with the use of the new equipment or materials. Those involved in the selection of new products should check the relevant available health and safety information before making the purchase. The purchase can also generate other health and safety needs at the workplace. For example, an item of plant may require operator training, new procedures and work instructions and perhaps extra supervision for a time. Similarly, a substance at the workplace may require training for users, specific personal protective equipment, modified storage areas, extra monitoring and sampling equipment and documented procedures. Identifying these additional issues will reduce the likelihood of injury and illness and provide more
accurate costing and ensure that resources are available to satisfy those needs.
After the organisation determines the health and safety component of the purchase, the next step is to communicate those requirements to the supplier of the goods.
Examples:
• Procedures should be developed and implemented for measuring the capacity of suppliers of goods to comply with health and safety specifications and requirements as required by the organisation’s health and safety management system and health and safety legislation, standards or codes of practice.
• Processes used to select suppliers of goods may include but are not limited to:
* the identification of applicable health and safety requirements in tender documentation;
* submitted tenderer evaluation for health and safety requirement compliance;
* evaluation of health and safety documentation submitted by the successful tenderer prior to supply of the goods.
• Organisation of purchasing documents & records should clearly define the required health and safety specifications for the goods being procured.
• Where goods such as materials, plant and equipment are procured, the procedures for compiling detailed health and safety specifications should be implemented and should include any compliance requirements such as those required by standards, legislation or organisational health and safety requirements.
• A documented purchasing procedure that outlines how health and safety is to be considered prior to the decision to purchase.
• A system or listing of relevant health and safety and related information that can be accessed by those recommending a purchase.
• Examples of where health and safety has been examined prior to the decision to purchase, including risk assessments, completed pre-purchase checklists which prompt users to identify additional needs, records of meetings with suppliers and user trials of equipment.
• Copies of purchase orders that specify health and safety requirements.
• Purchase orders placed with ‘approved suppliers’, providing that approved suppliers have been selected on the basis of their ability to supply the selected products to the required standard.
• Can workers recall any situations where equipment, goods or chemicals were introduced, and if the necessary changes were made at the same time, e.g. new instructions, training, changes to maintenance/cleaning routines?
• Products that comply with purchase specifications.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.6
Procedures shall be established and implemented for verifying that purchased goods conform to health and safety requirements, and any non-conformances shall be addressed before the goods are put into operational use.
Information:
It is important to let the supplier know what the organisation wants, i.e. communicate the health and safety specifications at the time of purchase. However, it is equally important to check that the supplier meets those specifications and also sends the right article. Once they are delivered, all goods need to be checked against the purchasing specifications. That check may sometimes need to be done by the person who originated the purchase. The check should be completed before the new goods are accepted for use.
Examples:
• The type and extent of health and safety control exercised by management should be dependent upon health and safety risk factors and evidence of the supplier’s previously demonstrated capacity and performance. Verification procedures should be implemented to ensure purchased goods conform to specified requirements.
• Procedures should be reviewed regularly. Review procedures should ensure relevance and currency of health and safety specifications, health and safety management system requirements and procedures for identifying the conformance of goods to predetermined health and safety
specifications. Corrective actions should be implemented where identified.
• Personnel responsible for establishing health and safety specifications for goods and reviewing purchasing documentation should be appropriately skilled and experienced and, where required, hold the necessary qualifications. Such skills, experience and/or qualifications should be defined.
• A purchasing procedure which includes a checking requirement to ensure that goods received match purchasing specifications.
• Records of checks of received goods against health and safety specifications.
• Can workers explain how the health and safety specifications are verified?
• Central inward goods/receiving and holding area.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.7
Hazard identification, risk assessment and the development of control measures are undertaken during the design stage of products, buildings or processes, or when the design is modified.
Information:
Hazard identification and risk assessments should be undertaken whenever the organisation designs new or modified equipment, processes, products, buildings or work areas. Doing this at the design stage should not only ensure maximum safety, but should also reduce the number of modifications or alterations required during the manufacture, installation or commissioning phase.
Examples:
• The control measures should incorporate any legal requirements in relation to the organisation’s products, e.g:
* To classify dangerous goods and hazardous substances and develop and supply Safety Data Sheets; and
* Provide information relating to the safe use of products, and safe operation and maintenance of plant
• Procedures should be established and implemented to ensure hazard identification, risk assessment and the development of control measures are undertaken during the product or process design stage, or when the process is modified. Design procedures are implemented to ensure:
a) adequate definition of health and safety requirements in design documentation
b) designs and modifications meet specified health and safety requirements and verification obtained where applicable
c) reviewing the design process.
• Design personnel should be responsible (with authority and accountability established), for ensuring that health and safety requirements are incorporated in design processes. This includes ensuring that any products such as plant or facilities comply to legislative requirements and health and safety specifications. Verifiers should be appropriately skilled and/or qualified to identify risk associated with the design process. Their training, qualification, certification and/or experience should be defined in position descriptions, system planning arrangements and procedures.
• Where the design process involves the design of a facility, item of plant or equipment, the design process should be managed through implemented procedures that identify any risks associated with:
* construction methods -including processes and materials;
* use and maintenance - especially risk arising out of the nature of the design itself;
* removal, demolition or decommissioning activities – especially where there is risk arising from the materials or processes used in the design.

• Project reports that record hazard identification, risk assessment and risk control activities at the design stage.
• Minutes of design review meetings that record discussion of health and safety issues associated with the proposed new work.
• Safe operating procedures and/or manuals for materials/equipment designed, produced and used inhouse or sold by the organisation.
• Safety data sheets for substances produced and sold by the organisation.
• Can workers confirm that health and safety issues are examined prior to installation or commissioning of new equipment or other changes?
• Can the maintenance department confirm that new equipment is able to be safely maintained?
• Can plant operators confirm that equipment is designed safely and operates within safe operating parameters?
• Direct observation of newly designed equipment or new processes.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.8
Competent personnel verify that designs and modifications meet specified health and safety requirements.
Information:
Responsibility should be assigned to competent persons to ensure that all hazards are identified and risks assessed during design or redesign activities. The final design needs to match the health and safety requirements which have been specified in the project documents.
Examples:
• Competent personnel verify that designs and modifications meet specified health and safety requirements.
• Records such as design registration and design verification in meeting health and safety requirements should be maintained. Any health and safety risk introduced to the workplace as a consequence of the design process should be recorded and records maintained for review purposes.
• The design process should be reviewed regularly to ensure the process employed safeguards the health and safety of personnel and meets health and safety management system requirements.
• Review procedures should identify any risk introduced by way of the design process and improvement.
• A design procedure which requires competent persons to ‘sign off’ the project.
• Project documentation demonstrating input of competent persons.
• Minutes of project review meetings.
• What has the organisation determined as the necessary academic qualifications, design experience, skills, technical and health and safety knowledge for ‘competent’ persons?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.9
There are procedures to ensure that materials and substances are disposed of in a manner that minimizes risk of personal injury and illness.
Information:
The safety of persons and their environment must be considered whenever there is a requirement to dispose of materials or substances, e.g. demolition or dismantling of plant and equipment, asbestos, radioactive waste, by-products of manufacturing, cleaning processes and pathology services, including blood, specimens, sharps and other biohazards. In addition, disposal of chemicals creates potential for personal exposure and environmental contamination.
Examples:
• Risk assessments.
• A procedure that details specific requirements for disposal of identified materials.
• Contracts with licensed asbestos removalists.
• Contracts with waste disposal companies.
• Records of disposal in accordance with procedures.
• Can relevant workers explain the safe methods for disposal?
• Sharps’ containers.
• Waste treatment plants.
• Spill kits.
• Bund valves and triple interceptor valves in default ‘closed’ position.
• Appropriate storage methods and areas for surplus/damaged stock awaiting disposal.
• Observation of demolition work or dismantling of equipment which is consistent with safety requirements.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.10
Facilities and amenities in the workplace conform, as a minimum, to relevant legislation, standards and codes of practice.
Information:
An organisation must ensure that its facilities are of an acceptable standard and appropriate to the work undertaken. Facilities refer to washrooms, showers, lockers, dining areas, drinking water, etc. There may be specific legislative requirements and details in building regulations and codes.
Examples:
• Assessment of facilities and amenities required at the workplace.
• Reports that demonstrate assessment of facilities against requirements.
• Completed workplace inspection documents that include a check of the suitability of facilities provided.
• Can workers/representatives confirm that facilities are acceptable and appropriate?
• Observation of acceptable and appropriate facilities and amenities.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.11
The organisation / site documents procedures or work instructions for the safe handling, transfer and transport of hazardous substances and dangerous goods.
Information:
The risks associated with hazardous substances and dangerous goods will usually increase when there is a need to move or handle them in some way. The way that substances are handled can dramatically influence the risk of illness, injury or damage. For instance, the work practices, processes, maintenance requirements and workplace conditions are some of the factors which have the potential to alter the risk of exposure and to cause property damage. The safest methods must be determined after thorough assessment, and documented to ensure that all relevant workers can employ them. Procedures can form the basis for the training of workers. The transfer of chemicals increases the risks of, e.g. ignition, spillage, personal exposure or injury resulting from lifting or manually handling containers, cylinders and packages. Similarly the actual transport of chemicals from one place to another creates potential risks of temperature change, impact and damage to packaging causing spillage, fire, explosion, contamination of other products, etc. For these reasons, the handling, transfer and transport of substances is often regulated by government authorities. An organisation should have documented procedures which not only describe best practice management of these activities but which also meet legal requirements.
Examples:
• Copies of relevant legislation.
• Relevant documented procedures, e.g. procedures or work instructions for decanting, spraying, mixing, transfer, etc.
• Can workers/others explain the procedures for transfer/transport of particular substances?
• Can workers point to the location of the written instructions, and explain the correct methods for handling particular substances?
• Pictorial instructions at point of use.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.12
Comprehensive health and safety information on all hazardous substances and dangerous goods is readily accessible.
Information:
Comprehensive information needs to be available to all staff that use hazardous substances and dangerous goods. It should be easy to refer to when needed, so the actual location of the information is crucial. Any Safety Data Sheet which forms part of this information must be less than 5 years old and contain the relevant safety information, e.g. refer to the Code of Practice for the Preparation of Safety Data Sheets for Hazardous Chemicals Dec 2011. The organisation needs to consider the most effective way of providing the information to the workers and others, e.g. in hard copy, electronic format and when required translated into other languages.
Examples:
• Minutes of meetings which record discussion about suitable content and placement of information.
• Responsibility assigned for maintaining currency of information.
• Can the relevant workers point to where the information is kept and retrieve the information?
• Can relevant workers explain or refer to the relevant safety requirements for handling, spillage and disposal, first aid and emergency, etc.?
• Current SDS and other relevant information are readily accessible.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.13
The organisation ensures that hazardous substances and dangerous goods are safely stored.
Information:
Once the hazards have been identified and the risks assessed, the organisation uses this information to ensure that hazardous substances and dangerous goods are stored in a manner that reduces the risks posed by these chemicals. For example, this will require that:
• Each substance is stored under environmental conditions that will ensure its integrity, i.e. within the manufacturer’s recommendations on the SDS or information on the label, e.g. storage of gas cylinders out of direct sunlight;
• Sources of ignition, e.g. non-flame proof electrical equipment and installations, vehicles, smoking areas and hot work are sufficiently separated from flammable substances;
• Any storage or spills of substances can be contained and isolated from other incompatible substances, materials or structures;
• Substances are not kept beyond their stability limit, e.g. self reacting monomers are stabilized and kept at the appropriate temperature and pressure;
• Any expiration dates are identified and procedures introduced to ensure that out-of-date substances are not distributed or used;
• Bulk containers and ancillary equipment is fit for the purpose and maintained in accordance with technical standards and manufacturer’s guidelines;
• Any specific legal requirements are met;
• Storages of substances are separated from buildings and public areas in accordance with published technical standards and protected from damage or impact; and
• Persons are prevented from falling into or being engulfed by liquid or solid substances.
Examples:
• Manual or procedures that identify specific storage requirements for each class/type of chemical.
• ‘Hazard alerts’ which identify issues associated with the storage of specific chemicals.
• Copies of legislation and associated standards relating to the storage of hazardous substances and dangerous goods.
• Packaged goods inspection records.
• Engineers reports of tanks and spill containment/bunded areas.
• List of identified materials subject to deterioration and/or ‘use by’ dates.
• Classification of ‘hazardous areas’ report (refer AS/NZS 2430).
• Do workers know which substances are to be kept separate?
• Can workers explain the safe storage requirements?
• Impact protection.
• Designated areas designed to segregate incompatible classes of hazardous substances and dangerous goods.
• Evidence of spillage control systems in storage areas.
• Flammable liquid cupboards or rooms.
• Adequate ventilation.
• Flameproof and/or intrinsically safe electrical equipment.
• Containers/packages in good condition.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.14
There are ‘Permit to Work’ procedures for high-risk tasks.
Information:
A ‘Permit to Work’ procedure is an administrative control used to reduce the risk of illness or injury arising from particular work situations. These are usually associated with construction, maintenance or cleaning operations. A Permit is a formal written authority given to appropriately trained personnel, to carry out work in areas where particular hazards or adverse conditions may be present. The permit, issued by an authorised person (not the person doing the work), confirms that the job in question has been assessed and clearly defines the safety precautions to be taken. The procedure must be rigorously enforced. The success of these procedures relies on effective training, supervision and
maintenance of any necessary personal protective equipment, access and testing equipment. Permits are typically issued for entry to confined spaces, hot work activities such as welding, grinding, introduction of ignition sources in areas where flammable vapours may be present, use of radioactive sources, roof access, working at heights, high voltage installations and digging or trenching operations.
Examples:
• ‘Permit’ procedures that describe the range of permits, and provide detailed instructions for each type of work, including the responsible persons.
• List of people authorised to issue and cancel permits.
• Completed permits.
• Standard operating procedures that reference the permit procedures.
• Can maintenance personnel explain the permit procedures?
• Can the authorising officers explain the permit process?
• Access/work in operation which demonstrate conformance to permit procedures.
• Signs that designate areas subject to access permit.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.15
Where personal protective equipment is required, it is appropriate for the task, its provision is accompanied by suitable training, and it is used correctly and maintained in a serviceable condition.
Information:
Personal protective equipment (PPE) is sometimes chosen as a permanent or temporary control measure to reduce personal risk exposure to certain hazards in the workplace. It is often used in conjunction with higher order risk controls, e.g. engineering. The use of PPE should be supported by instruction, training, supervision of use, regular maintenance and replacement procedures. The effectiveness of PPE as a risk control relies on ongoing administrative processes. It is therefore a lower order, less desirable risk control option.
Examples:
• Risk assessments.
• Work procedures that specify the type of PPE required for tasks.
• A record of supply and replacement of PPE.
• Records of PPE training and instruction provided to employees.
• PPE maintenance procedures and records, e.g. for self-contained breathing apparatus.
• Documented medical, physical or other requirements which apply to workers who are required to wear PPE.
• PPE replacement procedure, e.g. hard hats, goggles, glovers, RCDs etc.
• Can the organisation explain the choice of PPE as a control measure?
• Can relevant employees explain the PPE procedures for use (including fit), storage, maintenance and replacement?
• Identification of areas, e.g. signs where PPE is required.
• Observation of PPE storage practices.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.16
Plant and equipment is maintained and a record is kept which includes relevant details of inspections, maintenance, repair and alteration of plant.
Information:
An organisation should be confident that plant and equipment will operate safely under all foreseeable operating conditions. A scheduled inspection and maintenance program will contribute to that aim, and also assist in the prevention of breakdowns and repairs. Schedules may be based on the manufacturer’s recommendations, legislative requirements, technical standards, and industry or local experience with the plant and equipment. Keeping detailed records of all maintenance demonstrates compliance, and provides hard evidence about equipment performance.
Examples:
• Maintenance schedules that match manufacturers guidelines and legislative requirements.
• Detailed inspection procedures for all relevant items of plant and equipment including timetables, checklists, etc.
• A plant register or record for all relevant items of plant and equipment. [The record(s) should include, as a minimum, inspection details, maintenance history, alterations and registration details where appropriate. The format could be hard copy such as files, logbooks or card index or it may be a computerised maintenance record system, depending on the needs of the organisation.]
• How does the organisation satisfy itself that plant and equipment are safe?
• Plant and equipment free of physical signs that would indicate lack of maintenance, e.g. corrosion, oil leaks, mechanical stress and excessive wear or other damage.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.17
There is a process for unsafe plant and equipment to be identified and quarantined or withdrawn from service.
Information:
The process should include a procedure to be developed to ensure that workers and others can report plant or equipment that appears unsafe and which may be in need of maintenance or replacement. Once the plant is confirmed as unsafe, the procedure should enable the identification and timely removal of the item of plant or equipment from service. Methods of isolation may include using a quarantine area, tagging the equipment, attaching a locking device, removing the energy source, etc.
Examples:
• A procedure that includes a reporting mechanism and tagging of unsafe plant for removal from service.
• Can workers explain how equipment is identified as being ‘unsafe’?
• Tagging or quarantine procedures in use.
• Appropriate and current tags available/in use.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.18
Appropriate controls are used to ensure the safety of persons working on or near plant and equipment that is in the process of being cleaned, serviced, repaired or altered.
Information:
Where there is the possibility of an inadvertent start-up of plant there must be a system to control access to the starting mechanisms or power sources. Other hazards may include the presence of toxic gases or lack of sufficient oxygen in the surrounding atmosphere, the need to energise the plant to check settings, or working on or around plant that is in operation. These situations need to be controlled to protect the safety of persons, such as cleaners, operators and maintenance workers.
Procedures for de-energising the plant, or a section of the plant, are necessary to prevent those persons coming into contact with dangerous or moving parts. For instance, a ‘lock out’ system involves the use of locking devices to isolate and prevent machinery becoming operational. Other engineering controls may be used to prevent plant operation or to ensure that the plant will only operate with limited, time delayed movements.
Examples:
• Isolation and lockout procedures for maintenance activities.
• Maintenance of an access permit system.
• Records, e.g. logbook of lock out/tag out activities.•
• Can maintenance/operations employees describe the isolation and lock out procedures?
• Can employees explain what situations require atmospheric testing prior to entering for
cleaning/maintenance purposes?
• What controls are used to protect people from plant and equipment that have stored energy?
• Engineering controls such as ‘teach mode’ on robot installations, time delay limited movement or inching controls, captive key systems, etc.
• Lock out stations.
• Lock out procedures displayed on individual items of plant.
• Locks in use.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.19
Competent personnel verify that plant and equipment is safe before being returned to service after repair or alteration.
Information:
Repairs or alterations should be completed as specified and normal operating conditions and safety features checked before plant is returned to service. A competent person should be authorised and delegated with the responsibility for ensuring that the above conditions are met.
Examples:
• Documents which describe the procedure for signing off repairs.
• Lock out procedures which describe the checks to be made before re-start, including the persons responsible for those checks.
• Service records that confirm checks of plant made by designated persons after repair/alteration.
• Can the relevant personnel explain what checks are required before plant/equipment is returned to operation?
• Can workers/representatives confirm that plant/equipment is checked for safety before it is returned to operation?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.20
Safety signs, (including regulatory, hazard, emergency information and fire signs), meet relevant standards and codes of practice, and are displayed in accordance with legal and organisational requirements.
Information:
Signs are used to assist with the communication of information about hazards at the workplace and to provide advice about responding in emergency situations. Certain warning signs are required to assist emergency personnel and authorities to effectively respond at an incident. An organisation needs to establish which safety signs are required to meet legislative requirements, industry and internal standards. To ensure a consistent approach and standard of presentation for all safety related signs, organisations should comply with the relevant legislative requirements and/or published standards, e.g. Australian Standard 1319 Safety Signs for the Occupational Environment.
Examples:
• Workplace assessments that report on the standard and type of signs required in the workplace, e.g. exit signs, pictorial signs, dangerous goods class labels and placards.
• Purchasing procedures that ensure that signs comply with the relevant standard.
• A procedure for review of sign requirements in response to changes (of legislation and/or workplace arrangements).
• A report indicating that standards of workplace signs are maintained.
• Workplace inspections which include a check of signs.
• Well maintained signs that meet organisational requirements and well located in the appropriate areas.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.21
There are procedures to ensure that materials are transported, handled and stored in a safe manner.
Information:
Inappropriate transport, handling or storage of materials can increase the risk of injuries and illnesses. Inadequate systems may result in overloading of storage facilities, excessive reaching or lifting, restricted aisles and passageways, overcrowding or traffic congestion. The hazards associated with mobile plant are well documented. The organisation should aim for systems to manage mobile plant which are consistent with legal requirements, industry best practice and latest technology. (Note: This criterion does not refer to hazardous substances or dangerous goods).
Examples:
• Risk assessments (refer to AS/NZS 4084 – Steel Storage Racking).
• A warehousing procedure that identifies safe stacking heights, storage areas, speed limits, lift truck operations, etc.
• Safe mechanical and manual handling procedures for movement of materials.
• Records of inspection and maintenance of racking, pallets, pallet trucks, trolleys and other mechanical aids.
• Records of checks that materials are stored in designated storage areas.
• A procedure for traffic management.
• Can the relevant workers explain the procedures for safely moving and storing materials?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.22
Individuals are supervised according to their capabilities and the degree of risk of the task.
Information:
Workers require differing levels of supervision depending upon the complexity of the assigned tasks, the risks associated with those tasks and the capability of the individual. Workers who have experience performing the task are likely to be more capable than those just starting out. All these factors should be considered when determining the degree of supervision required.
Examples:
• Risk assessments/task analyses that identify the level of supervision required for tasks.
• Evaluations of worker competency to perform assigned tasks.
• Supervision/team rosters which demonstrate resources in appropriate areas at appropriate times, e.g.for new workers or for higher risk tasks.
• Logbooks.
• ‘On the job’ training procedures (and records) that identify the level of supervision required (and provided).
• Can supervisors explain what situations/personnel require extra supervision?
• Can worker representatives confirm that individuals/tasks get the necessary supervision?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.23
There are supervisory arrangements that ensure that tasks are performed safely and work instructions and procedures are followed.
Information:
Supervision will provide some confidence that tasks are performed in accordance with work instructions or procedures. The organisation should determine the resources, the arrangements and individual competencies required to deliver the necessary level of supervision.
Examples:
• Organisation chart that identifies line managers.
• Rosters that record allocation of supervisor/team leader position.
• Job descriptions include the requirement for supervisors to ensure tasks are performed safely.
• Procedural compliance audits.
• Manager and supervisor health and safety performance appraisals.
• Can the managers/supervisors explain how the supervisory arrangements have been determined?
• Can employees/representatives confirm that supervisory arrangements are suitable across all shifts and for all types of work?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.24
There is a documented process which requires the organisation to identify potential health and safety hazards, (including public safety hazards), assess the potential risks and determine appropriate risk control strategies when providing its goods and/or services to others whether under contract or otherwise.
Information:
Organisations that tender to supply goods or services to external parties, and enter into formal contracts, need to consider the health and safety implications of the proposed work. This reduces the possibility of injury and illness resulting from equipment failure, defective products or poor work practices. Public safety issues need to be included in these considerations, as do the suitability of plant and equipment, training of workers, site-specific hazards, and legislative requirements.
The organisation needs to protect the health and safety of its workers whether or not the workplace is owned by and under the control of the PCBU. For example, community care workers, sales representatives and service technicians. The organisation may need to liaise with the customer to determine the necessary health and safety arrangements and to assess the environment in which the workers will be expected to work. For example, information may be gathered on environmental or other local hazards, what site induction and specific training will be provided, permit to work systems, status of equipment to be used, what supervision will be provided, the name of the management representative for health and safety, the restricted areas and emergency and first aid response.
Examples:
• Completed risk assessments or checklist-type documents that identify health and safety requirements at customer workplaces. For example, a site safety plan.
• Supporting instructions for workers, such as technicians, about actions to be taken if a customer workplace fails to meet safety standards defined in checklists.
• Records of training for relevant workers in how to identify health and safety hazards at customer workplaces, and action to be taken.
• Contracts or agreements with customers that include requirements for health and safety.
• Incident/hazard reports, correspondence, records of meetings that deal with customer safety issues.
• Health and safety audits/inspections of customer workplaces, e.g. checks of host PCBU’s for apprenticeship training schemes.

• Can workers/representatives explain how their health and safety is considered when they are providing services to their customers off site?
• Can the contract managers explain how health and safety is included in the contract review process?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.25
Customer-supplied goods and services used in the organisation’s work processes are subject to hazard identification, risk assessment and control prior to use.
Information:
Customer-supplied goods and services are those which are supplied to the organisation by a customer. The organisation then performs work on that product or uses that service as part of another task. Examples are raw materials or components supplied by a customer who requires the organisation to mix or process the materials into a product. Repair type industries routinely perform work on customer supplied product. Testing laboratories provide services involving customer samples, including infectious and hazardous substances.
When customer-supplied goods or services are received they need to be assessed for safety in the same way as any other goods or services used by the organisation. This may involve undertaking a hazard identification and risk assessment prior to use. If necessary, customer-supplied product should be quarantined from other products until suitably assessed. Systems are needed which would identify any damage, deterioration, or changes in composition which could impact on health and safety at the workplace.
Examples:
• A documented procedure which requires that customer-supplied goods and services undergo hazard identification and risk assessment.
• Records of hazard identification and risk assessment for customer-supplied products.
• Procedures and work instructions for safe handling of customer-supplied product.
• How does the organisation verify that customer-supplied goods or services always meet the agreed specifications?
• Can the employees/representatives describe the health and safety specifications of the customer supplied goods or services, e.g. labelling, packaging, test results, material?
• Can employees/representatives explain what happens with customer-supplied products or services that don’t conform to health and safety requirements?
• Quarantine areas for customer-supplied goods.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.10.26
All substances in containers and transfer systems are identified and clearly labelled to avoid inadvertent or inappropriate use.
Information:
It is important that raw materials and other products can be easily identified to avoid incorrect use and subsequently any potential harm to people or damage to plant or property. Where this is likely, the packages, containers, tanks and pipelines should carry appropriate labels or other markings to meet the relevant standards and ensure the contents can be identified. In particular, hazardous substances and dangerous goods must be clearly and durably labelled to ensure the safety of persons required to handle those substances.
Where appropriate, non-hazardous substances should be clearly labelled to distinguish them from those that are hazardous. Where substances are decanted into smaller containers, the container must be suitable for the contents and clearly labelled. Labelling must include the relevant safety information.
The organisation should also ensure that any substances which are stored on site are known and labelled appropriately, e.g. cleaning materials, gardening chemicals, etc. which might be stored for use by contractors.
Examples:
• A purchasing procedure which incorporates checks of all incoming substances to ensure correct supply and clear, durable labelling.
• A procedure to ensure that all substances are appropriately identified and, where necessary, labelled throughout the production process.
• Labels are produced to comply with legislative requirements.
• Records of hazard/quality inspections which check suitability and integrity of labels.
• Can workers correctly identify the contents of all containers, receptacles, etc.?
• Clear identification, labelling and marking on all packages, containers, tanks and pipelines.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 3: Implementation: Emergency Preparedness and Response

3.11 EMERGENCY PREPAREDNESS AND RESPONSE

3.11.1
Potential emergency situations have been identified and emergency procedures are documented and regularly reviewed.
Information:
Emergency situations, which could originate both on and off-site, need to be identified prior to the development of suitable emergency procedures. On-site emergency situations may include:
• a hazardous chemical leak on the premises;
• a fire;
• a bomb threat or other threatening situation; or
• a medical emergency.
Off-site emergency situations could include:
• a building or a grass fire on an adjoining property;
• a chemical leak from a nearby chemical complex; or
• a company vehicle involved in a road accident.
Documented arrangements must at least cover evacuation procedures and should be developed where possible with the help of expert advice. A regular review process will ensure that the procedures remain appropriate to the likely emergencies. It is logical to review procedures when alterations are made to the site, or in response to changes in the business environment, e.g. security alerts. The frequency of reviews may also depend on the complexity of the procedures.
Examples:
• Risk assessments.
• Emergency procedures manual.
• Schedule of reviews of emergency procedures.
• Emergency procedures which record dates of review.
• Minutes of meetings which record discussion about the suitability of emergency procedures.
• Correspondence/records of meetings with industry experts in emergency management.
• Emergency procedures are available in the workplace.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.11.2
The organisation has allocated overall responsibility for control of emergency situations to specified individuals and communicated this information to all personnel.
Information:
When emergency situations arise, there should be persons appointed and ready to manage the situation. The organisation should consider which persons are best suited to take on these responsibilities and let all workers know who they are.
Examples:
• Responsibility, authority and accountability should be defined for persons performing health and safety activities such as safety officers, first aid officers or fire emergency wardens. These responsibilities may reside outside of position descriptions.
• An emergency plan showing the names of wardens or emergency controllers.
• Induction process that includes introducing workers to local fire wardens.
• Are workers able to recognise the fire wardens and first aiders in their work areas?
• Identification apparel for responsible persons, e.g. helmets, armbands, etc.
• Notices posted of the names of persons with emergency control responsibilities.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.11.3
Workers receive training and practice in emergency procedures appropriate to their allocated emergency response responsibilities and the degree of risk.
Information:
To ensure an effective response to emergency situations, all workers need to be trained in the relevant emergency procedures. For instance, rescue and first aid procedures need to be rehearsed by workers who are required to work in confined spaces. Persons who are appointed to manage an emergency should receive training that will enable them to discharge those responsibilities confidently and competently. Workers also need to have the knowledge and confidence to take immediate action. Practices and rehearsals should cover all emergency situations, e.g. mock fire situations, medical emergencies, bomb threats, etc.
Examples:
• Attendance records for general emergency training, e.g. included in induction.
• Outline of warden training program.
• Attendance records at warden training.
• Schedule of tests, drills or other rehearsals of emergency procedures.
• Records of emergency tests or drills.
• Records of attendance at mock emergency practice drills.
• Can workers/representatives explain what to do in the event of a specific emergency?
• Can worker/representatives confirm that emergency procedures are practised?
• Emergency plan posted.
• Emergency instructions posted.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.11.4
Competent persons have assessed the suitability, location and accessibility of emergency equipment.
Information:
Appropriate emergency equipment needs to be readily accessible in the event of an emergency. Advice about the type and location of equipment should be sought from competent professionals, e.g. organisations such as the fire brigade. These persons can advise about the performance of particular equipment and which type will best cope with the range of potential situations, whether for fighting fires, dealing with chemical spills or alerting others where there are threats to personal security.
Examples:
• Emergency equipment assessment reports prepared by competent professionals or organisations.
• Can the organisation demonstrate that the emergency equipment assessment is still current, i.e. have any changes been introduced that would affect the location and type of emergency equipment needed?
• Specified emergency equipment located in accordance with assessment.
• Spill kits provided with instructions, suitable absorbent material, appropriate personal protective equipment, etc.
• Emergency showers and/or eyewash stations operating and maintained.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.11.5
Emergency and fire protection equipment, exit signs and alarm systems are inspected, tested and maintained at regular intervals.
Information:
Emergency systems need to be regularly inspected and tested to verify that they are working effectively or will activate as required. Emergency equipment may include smoke detectors, fire extinguishers, sprinklers, fire hoses, emergency lighting, evacuation warning devices, spillage containment materials and duress alarms.
Examples:
• Contracts for inspection and maintenance of emergency equipment, systems and exit signs.
• Records of inspection and maintenance in accordance with contracts.
• Test results or logbook of alarm tests.
• Emergency lighting test logbook.
• Records of workplace inspections which check operation of smoke detectors.
• Plan that shows location and type of all emergency equipment provided.
• Can the organisation explain the schedule for inspection and test of all emergency equipment that ensures it remains in operational condition?
• Service tags on extinguishers and hose reels.
• Illuminated emergency exit signs.
• Records of tests in sprinkler main control rooms.
• Clearance maintained to emergency equipment, including sprinkler heads.
• Spill kits complete.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.11.6
A dangerous goods and/or hazardous substances manifest or inventory system is in place and in accordance with legal requirements.
Information:
An organisation needs to keep track of the range and quantity of dangerous goods and hazardous substances that are stored on its premises. This helps to manage storage areas, ensure that all Safety Data Sheets are obtained and, where required, manage notification requirements to the relevant authorities.
The inventory or manifest should list all dangerous goods and hazardous substances, and the quantities used or produced at the workplace. The inventory needs to be updated when new dangerous goods / hazardous substances are introduced or old ones are discontinued.
The inventory/manifest should be readily available and accessible to emergency authorities.
Examples:
• A dangerous goods/hazardous substances inventory database
• Correspondence with emergency authorities regarding the quantity and classes of dangerous goods/hazardous substances on site.
• Regular reviews of inventory are conducted.
• Can relevant workers explain how the inventory is managed?
• A copy of the current dangerous goods manifest in an emergency information box at the vehicle entry to the site.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.11.7
The organisation / site has assessed its first aid requirements, and the first aid system in place is appropriate to the organisational risks.
Information:
Prompt first aid will minimise the effects of an injury or illness and promote quicker recovery. Trained first aiders, first aid equipment and facilities appropriate to the nature of the likely risks should be available.
Examples:
• A current documented assessment of workplace first aid requirements, e.g. number of first aiders, level of first aider training, number of first aid kits, first aid equipment, special requirements such as antidotes, etc
• Records of inspections that check first aid facilities.
• Records of first aid treatment.
• Records of first aider training.
• Can the organisation demonstrate the factors taken into account in the first aid assessment, e.g. previous injuries or illnesses at the workplace?
• First aid kits.
• First aid room.
• Eye wash facilities.
• Emergency showers.
• Resuscitation equipment.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
3.11.8
The organisation / site has systems in place to assist workers who are exposed to critical incidents at work.
Information:
A critical incident is any incident which directly or indirectly causes significant distress to a person, either at the time it occurs or later. Critical incident stress management is required in many industries, e.g. banking, emergency services, health care, etc. As part of the hazard identification and risk assessment process, an organisation should identify the
tasks or areas where workers may be exposed to critical incidents as a result of their work. There should be procedures in place to support and assist workers. Effective system components will include policy, procedures, staff training and the provision for defusing, debriefing and counselling services by appropriately trained personnel.
Examples:
• Risk assessment documentation showing persons or areas where there is a likelihood of work related critical incidents.
• Critical incident stress management policies and procedures.
• Contract with debriefing and counselling services.
• Training program for ‘at risk’ personnel and records of training.
• Statistics or records of critical incident debriefing and counselling services provided.
• What is the organisation’s definition of a ‘critical incident’?
• How does the organisation become aware of a critical incident?
• Can employees/representatives confirm that the organisation provides support to employees after critical incidents?
• Posters that advertise critical incident services for worker assistance/peer support.
• On-site facilities for counselling/peer support.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 4: Measurement and Evaluation- Monitoring and Measurement General

4.1 MONITORING AND MEASUREMENT GENERAL

4.1.1
There is a documented health and safety inspection, testing & monitoring programs that:
a) meets legal requirements;
b) defines intervals based on identified risk;
c) incorporates a reporting and corrective action process;
d) uses workplace specific checklist(s);
e) monitor conformance to the organisation’s safe working procedures and
f) monitor the effectiveness of control measures.
Information:
Regular inspections will identify uncontrolled hazards and unplanned changes occurring in the workplace including plant. Once identified, they must be reported. An assessment will then determine the appropriate corrective action. Responsibilities must be assigned to ensure that corrective actions are implemented and monitored. Checklists, developed as part of the initial risk assessment activity, provide a useful prompt and promote consistency of approach to the inspections. A checklist needs to be tailored to the particular workplace or site. ‘Generic’ documents often contain irrelevant items and can overlook vital issues specific to particular areas or operations. For this reason it is a good idea to consult about the development of the checklist with those workers who work in the areas exposed to the hazards.
Inspections should check more than physical hazards in the workplace. The inspection program should:
• Focus on how worker behaviour matches their expected safety performance, and whether the standard operating procedures need to be reviewed;
• Check whether the workplace meets legislative obligations, e.g. appropriate worker facilities, licensed drivers, etc.;
• Check all control measures for effectiveness, particularly those that have been recently introduced as a result of corrective actions for incident investigations or workplace inspections.
Examples:
• The test and inspection system planning arrangements, procedures, instruments (tools and forms) should be reviewed regularly to ensure ongoing relevance and maintenance in accordance with health and safety management system requirements. Corrective actions should be implemented where identified.
• The inspection, testing & monitoring program may use statistical measures of health and safety management system performance. The cause of adverse trends should be analysed and health and safety program priorities revised to ensure adequate resources and processes to reverse such trends.
• Procedures for the review of testing and inspection records should be implemented to ensure conformance verification and identify corrective actions where non-conformance is recorded.
• Inspection, testing and monitoring procedures should be planned and implemented at key times in the operational cycle and according to procedural requirements. For example, materials procurement, routine maintenance, plant installation and commissioning, standard operating procedures.
• Documented procedures for inspection that include schedules and checklist(s) covering all locations (including mobile and temporary) and hazards, and which requires that persons are assigned responsibility for ensuring that corrective actions are implemented.
• Records of inspections undertaken at regular intervals.
• Inspection reports which include details of corrective actions to be taken and by whom.
• Inspection documents which cover checks of safe operating procedures and relevant legislative requirements.
• Minutes of meetings that record discussion on the evaluation of corrective actions arising from inspections.
• Can the organisation explain the rationale for the inspection frequency/inspection schedule?
• Can worker/representatives confirm that an inspection, testing and monitoring program is in place and undertaken?
• Workplace standards appear to be maintained.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
4.1.2
Inspections seek input and involvement from the personnel who are required to undertake the tasks being inspected.
Information:
Workers have valuable on-the-job experience and can provide useful information on the hazards associated with particular tasks. This information is easily obtained if those workers are involved in the inspection process or have the opportunity to provide information to the inspection team.
Examples:
• A workplace inspection procedure which includes a requirement to consult with workers performing the work.
• Records of worker input during inspections, e.g. minutes of meetings, notes on inspection checklists.
• Can workers confirm that they are involved in the inspection process?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
4.1.3
Engineering controls, including safety devices, are regularly inspected and tested to ensure their integrity.
Information:
Where engineering controls are used to reduce risk, they should be regularly checked to ensure that they continue to maintain the expected level of safety. For example, fixed guards and barriers may be damaged or missing a fixing screw or bolt, interlocked guards may be worn or disconnected, presence sensing systems may require adjustment, and emergency stop buttons, trip wires and duress alarms may malfunction, and automatic shutdown or pressure relief devices may fail to operate at critical levels. Ventilation systems may fail to provide the recommended level of performance.
Examples:
• Maintenance contracts to inspect and test specific engineering controls.
• Procedure that includes a checklist and schedules for inspection of engineering controls.
• Completed checklists of plant guarding status.
• Records or log of tests undertaken on safety devices.
• Service records of presence sensing systems.
• Can workers/representatives confirm that there are regular checks of engineering controls, including safety devices, e.g. guards, exhaust systems, etc.?
• Well-maintained machine guarding in place.
• Other engineering controls appear to be functioning.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
4.1.4
Monitoring of the workplace environment (general and personal) is conducted where appropriate and records of the results are maintained.
Information:
The need for workplace monitoring of hazards such as noise, fumes, gases, vapours, dusts, radiation, cold, heat, etc. should be identified during the hazard identification and risk assessment process. Such monitoring may include personal dosimeters as well as static area monitors. The monitoring should be conducted by competent personnel and records maintained. Additional monitoring requirements may exist where contaminated air, insufficient oxygen, or flammable vapours may be present in a confined space.
Examples:
• Records of health and safety inspection, testing and monitoring should be maintained and made available to personnel. Persons responsible for the keeping of testing and inspection records should be identified and their responsibilities defined.
• Procedures for workplace environmental monitoring, including confined space entry.
• Records of workplace environmental monitoring.
• Can the organisation explain the reasons for the monitoring and how acceptable exposure levels have been determined?
• Can the organisation explain the reasons why particular types of monitoring equipment have been selected for use?
• Does the organisation’s procedure cover the frequency of monitoring and what happens when a deviation from the required level is detected?

• Static monitors in appropriate locations.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
4.1.5
Inspection, measuring and test equipment related to health and safety monitoring is appropriately identified, calibrated, maintained and stored.
Information:
Where specialised equipment is used for health and safety related inspection, measuring or testing, e.g. sound level meters, there needs to be a documented process to ensure that the equipment will function as designed and provide accurate and relevant readouts. The equipment needs to meet relevant standards and be calibrated and adjusted accordingly. Storage environments can also affect the integrity of the equipment and its calibration. If the equipment is supplied and used by external consultants, there should be confirmation that the equipment has been correctly calibrated and maintained.
Examples:
• Documented procedures for the management of health and safety related inspection, measuring and test equipment.
• Records of calibration of equipment performed by competent persons in accordance with manufacturer’s specifications.
• Records of scheduled maintenance in accordance with the manufacturer’s specifications.
• Storage facilities designed to prevent damage and maintain equipment accuracy.
• Can workers/representatives confirm that measuring equipment is checked regularly?
• Current calibration stickers on equipment.
• Current calibration certification is available.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 4: Measurement and Evaluation- Monitoring and Measurement - Health Surveillance

4.2 HEALTH SURVEILLANCE

4.2.1
The organisation / site has identified those situations where employee health surveillance should occur and has implemented systems to conduct this surveillance. The health of employees exposed to specific hazards is monitored, recorded, reported and action is taken to address any adverse effects.
Information:
Legislation may prescribe health surveillance for workers exposed to specified hazards. Health surveillance, which includes biological monitoring, can assist in evaluating the risk to health from hazardous substances and other hazards (e.g. noise) for which there are known and acceptable health surveillance procedures by:
• determining the dose of hazardous substances absorbed; and
• detecting the early signs of adverse health effects that may occur due to exposure.
Legislation may require the monitoring of workers who have been identified as having exposure to a ‘scheduled’ hazardous substance and where the exposure to the hazardous substance is such that it is likely that an adverse effect on the worker’s health may occur under the particular conditions of use.
It is important that biological monitoring is not used as an alternative to the implementation of control measures. However, monitoring needs to be considered in situations where:
• the risks to health are largely controlled through the lower order controls, e.g. PPE or administrative controls;
• symptoms have been reported which are likely to be related to the use of a workplace substance;
• incidents or near misses have occurred; or
• control measures have deteriorated significantly as a result of poor maintenance.
Results are used as a baseline against which any changes in worker health can be readily identified and appropriate action taken. Legal requirements may also apply to the maintenance and retention of the test results. Individual results must be treated as confidential medical records.
Examples:
• There may be situations where health surveillance should occur beyond any locally prescribed requirements, e.g. drug and alcohol testing, hepatitis, eyesight, fitness levels, lung function tests, etc

• Risk assessments which identify the need for health surveillance.
• Documented policy or procedure for health monitoring / health surveillance program.
• Schedule for screening and testing.
• Records of health monitoring / health surveillance which match scheduled arrangements.
• Records that health monitoring is conducted by competent, and where applicable, approved persons.
• Records that include details such as name and position of worker, type of monitoring conducted, testing procedure, test provider, and requirements specified in the relevant legislation.
• Records that demonstrate that workers are informed of the need for the monitoring and of the results.
• Contracts with providers of health monitoring services.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 4: Measurement and Evaluation- Incident Investigation, Corrective and Preventative Action

4.3 INCIDENT INVESTIGATION, CORRECTIVE AND PREVENTATIVE ACTION

4.3.1
There is a procedure, which includes involvement of operational line management, for the investigation of injuries, illnesses, incidents and other systems failures impacting on health and safety.
Information:
Injuries, illnesses, and incidents, including those which are notified to authorities, should be investigated. This is to determine the contributing factors so that similar occurrences can be prevented. Incident investigations should focus on corrective actions, not the allocation of blame. The investigation should involve management representatives, such as supervisors, who have direct knowledge of the relevant work area and work processes.
Examples:
• The investigation and corrective action procedures may include but are not limited to:
* hazard reporting;
* reporting of accidents and incidents and their subsequent investigation;
* analysing all health and safety management system processes, work operations, records, service reports and complaints to detect and eliminate potential causes of nonconforming system;
* implementing corrective action procedures to deal with prioritised health and safety management system failures;
* applying controls to ensure that corrective actions are undertaken;
* establishing procedures for assessing the s and the effectiveness of implemented control measures;
* implementing a procedure for recording changes in health and safety management system resulting from corrective actions.
• Investigation procedure.
• Fully completed investigation documents which show the involvement of line managers in the process.
• Can the organisation explain who is involved in investigations?
• Can line managers confirm their involvement in investigations?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
4.3.2
Investigations shall:
a) be undertaken by a competent person(s) in accordance with the organisation’s procedure;
b) identify the factor(s) that led to the injury, illness, incident or other system failure;
c) review the identified hazards, assessed risks and effectiveness of the control measures and
d) recommend appropriate control measures and corrective actions.
Information:
When an incident or more serious situation occurs, there needs to be a re-examination of the system which is implemented to manage the hazard, and whether it is suitable. To do this, the organisation needs to review the situation from first principles, i.e. recheck that all the hazards were initially identified, and whether the risks were correctly assessed before the control measures were selected. Investigations too often seek someone to blame when things go wrong, instead of trying to find out what really caused or contributed to the unexpected outcome. The choice of risk controls, system of work, standard of training, supervision and reporting of previous incidents are some of the factors that might need to be considered.
The incident investigation reports should specify what remedial action is needed to prevent similar incidents occurring in the future. As some recommended actions may take time to implement (e.g. training), each recommendation should have an allocated time frame to allow those responsible to schedule their tasks. It would be expected that recommendations would, where possible, concentrate on systems and processes rather than on the deficiencies of individual workers.
Examples:
• List of competent persons/positions who do investigations.
• Investigation procedures/documents that require examination of root causes.
• Investigation reports that focus on systems rather than personal failure, contain recommendations and refer to checks of existing control measures.
• Review of existing hazard identification and risk assessment documentation.
• Investigation procedures and/or the incident form include provision for recording recommended actions.
• Minutes of meetings that record reviews of control measures and discussions about recommendations arising from investigations.
• Can workers/representatives confirm that investigations try to find out why things have gone wrong rather than blame someone?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
4.3.3
Responsibility is assigned to identified personnel for implementing and reviewing the effectiveness of corrective actions arising from investigations.
Information:
The investigation process will only be effective if prompt corrective action is taken to rectify the identified deficiencies. This is more likely to occur if particular individuals are given the responsibility of making sure recommended action is taken. The control measures also need to be followed up to ensure that they achieve the desired result.
Examples:
• Corrective action responsibilities should be designated to competent persons and statements of responsibility, authority and accountability established. Responsibilities should include development and implementation of corrective action, review of processes and follow through on identified non-conformances. Management should ensure through implemented processes of review that corrective action responsibilities are
met and that procedural outcomes are properly actioned and followed through.
• Investigation procedures and/or the incident form include provision for assigning individuals to implement corrective actions.
• Records of corrective actions assigned to individuals.
• Records of implementation of corrective actions, e.g. minutes of meetings.
• Records of review on the effectiveness of implemented control measures.
• Can worker representatives confirm that corrective actions are checked to see if they work?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
4.3.4
Corrective actions are discussed with personnel affected prior to implementation.
Information:
To ensure corrective actions arising from an incident investigation are appropriate and realistic, it is important to get the input of personnel who will be directly affected by those actions. The people closest to the situation may raise issues which had not been considered by the parties recommending the corrective action.
Examples:
• Investigation procedures which include a requirement that consultation take place with affected personnel prior to implementation of corrective action(s).
• Evidence that affected personnel are consulted prior to implementation of corrective actions, e.g. minutes of meetings.
• Are workers/representatives asked for their opinion on proposed changes after incidents have occurred in their work area?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 4: Measurement and Evaluation- Records and Record Management

4.4 RECORDS AND RECORD MANAGEMENT

4.4.1
There are effective systems for management of health and safety records including their:
a) identification and traceability;
b) collection, indexing, filing;
c) access and confidentiality;
d) retention and maintenance;
e) protection against damage, deterioration or loss;
f) retrieval and g) disposal.
Information:
An organisation needs to identify what health and safety records it requires to be kept and to determine how they will be collected and stored. The safe and organized storage of records will ensure that they are readily available when required to those who are authorised to look at them. The disposal of the records will depend on the organisation’s needs and any specific legislative requirements for their retention, e.g. health surveillance and risk assessment documentation.
Examples:
• Some examples of records that should be kept by an organisation are listed below:
* qualifications, skills, knowledge, competency and certifications;
* induction and training;
* inspection and test reports;
* audit reports;
* internal management system review reports;
* minutes of management review meetings;
* incident reports/accident reports and investigations;
* minutes of health and safety meetings, including health and safety executive meetings relating to health and safety
* statistical analysis of health and safety data;
* health and safety action plans;
* safety equipment records;
* hazardous substances and dangerous goods inventories;
* design reviews and approvals;
* risk management documentation;
* records pertaining to the engagement of contractors and their compliance with health and safety requirements;
* records associated with supplier compliance including suppliers of goods, services and labour hire.
• The privacy of individuals and confidentiality of records should be accounted for in the procedures implemented for the indexing, filing, storage and retrieval of records. Procedures should be developed for obtaining access and/or releasing an individual’s confidential records.
• Responsibility for the identification of record keeping compliance requirements and record keeping provisions should be documented in position descriptions, system planning arrangements, procedures or instruments (tools and forms).
• Procedures for the identification, collection, indexing, filing, storage, maintenance and disposal of health and safety records should be reviewed at appropriate intervals.
• Relevant documented procedure for record keeping.
• Automatic computer backup facilities for electronic records.
• What health and safety records does the organisation keep?
• Where are the health and safety records for (e.g. audiometric testing) kept?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 4: Measurement and Evaluation- Health and Safety Management System Audits

4.5 HEALTH AND SAFETY MANAGEMENT SYSTEM AUDITS

4.5.1
Scheduled audits are conducted to verify whether the health and safety management systems:
a) comply with planned arrangements;
b) have been properly implemented and maintained and
c) are effectively implemented across the organisation.
The audit program takes into consideration the significance of health and safety risks and the results of previous audits.
Information:
An organisation should have an internal mechanism to verify that all aspects of the health and safety management system are effectively operating as planned. This verification could be achieved by conducting a complete system audit or audits of parts of the system at more frequent intervals.
Audits should focus more regularly on those areas which carry the greatest risk exposure, the highest level of administrative controls and where problems have been identified in the past. The audit schedule should also take into account the complexity of the systems and the organisational structure.
Examples:
• The audits should provide assessment and evaluation of health and safety management systems, importance of activities audited and health and safety performance outcomes.
• Management should ensure that there is a comprehensive system of planned and documented health and safety audits to verify the established health and safety management system:
* effectively meets organisational health and safety policy as well as objectives and targets for injury/illness prevention and continuous improvement;
* conforms to any legislative and/or industry codes of practice or standards;
* has been properly implemented and maintained.
• Audit schedules.
• Audit reports.
• Audit schedules based on risk level and results of previous audits.
• Follow up audits for problem areas.
• How often does the organisation conduct audits of the health and safety management system?
• How does the organisation’s audit program take into account health and safety risks?
• How often does the organisation audit higher risk areas?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
4.5.2
Deficiencies highlighted by the audits are prioritised and progress monitored to ensure corrective action is implemented.
Information:
A follow-up or surveillance audit should be used to monitor the implementation of corrective actions resulting from the findings of an audit.
Examples:
• Audit results should be documented and communicated to personnel, including employees in the area where the audit was undertaken.

• Records or minutes which include a priority list for corrective actions.
• Surveillance audits which verify implementation of corrective actions.
• Records of corrective actions taken.
• Can the organisation explain how health and safety deficiencies are prioritised and the implementation of corrective actions monitored?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 5: Management Review

5.1 MANAGEMENT REVIEW

5.1.1
Recommendations arising from health and safety management systems reviews generate actions to improve performance.
Information:
Areas identified as deficient need to be actioned. The process of management review must ensure that recommendations are documented for corrective action.
Examples:
• Records should be used to review and evaluate the effectiveness of the health and safety management system to prevent injury and illness in the workplace.
• The outcomes of the review process should be used to modify and amend system’s criteria such as policy, objectives, responsibilities, planning arrangements procedures and instruments (tools and forms) to ensure relevance, currency and continuous improvement.
• Review outcomes should be used to implement performance improvement strategies and ensure continuous improvement.
• Reports of health and safety management system reviews which include recommendations for action.
• Minutes of health and safety management system review meetings which record the discussion of health and safety issues raised by audit results, business, industry or supplier/customer requirements, legal issues and the overall health and safety performance of the organisation.
• Health and safety plans which schedule activities/actions arising from recommendations
• Evidence of changes made as a result of management reviews, e.g. organisation restructure, changes to assignment of responsibilities, changes to policy, reallocation of resources, etc.
• What factors were considered in the last review of the health and safety management system?
• What actions have been planned or implemented, by the organisation, as a result of the last management review of the health and safety management system?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

Element 6: Injury Management

6.1 INJURY MANAGEMENT

6.1.1
You have nominated your return to work coordinator. Your return to work coordinator is given the level of responsibility and authority necessary to fulfil the duties of their role under the legislation.
Information:
The functions the return to work co-ordinator is required to undertake have been comprehensively documented and all workers have been made aware of these arrangements and know how to access them. The organisation conducts reviews to ensure these duties are undertaken.
Examples:
• your nomination of a return to work coordinator, and the verification from the coordinator that they have been given the authority and responsibility to fulfil the functions of the role
• a position description and key performance indicators for the return to work coordinator
• your occupational rehabilitation program naming the return to work co-ordinator
• the minutes from your safety committee show you have dealt with return to work issues
• The nominated RTW Co-ordinator has received training to perform the role?
• Name of RTW coordinator is displayed.
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
6.1.2
You have systems in place for identifying, collecting, filing, maintaining, retaining, and ensuring the confidentiality of injury management records.
Information:
You must ensure:
• injury management records are kept for the required time period*;
• confidential medical information is kept separate from payroll and other personnel information, either through
having separate injury management files or separating the information within a file;
• injured worker’s files are securely stored; and
• access to files is restricted to persons with a legitimate right of access.
These procedures should be closely linked with your document control procedure.
Examples:
• a document that specifies records should be kept, the form in which the records should be kept, the location of the records, who is authorised to keep them, who is authorised to access them, and for how long each record should be kept.
• your written file management procedures
• your workplace’s storage/disposal policy
• Injury Management files are maintained in a secure area
• Injury management files are maintained separate to HR files
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments
6.1.3
You have a process in place that identifies relevant return to work staff, introduces them to treating
practitioners and enables them to liaise with these professionals.
Information:
The BaptistCare Injury Management and Return to Work policy requires your return to work coordinator to liaise with any parties involved in the occupational rehabilitation of an injured worker, or the provision of medical or hospital services to an injured worker. The Guidelines for the preparation and revisions of return to work plans issued by the WorkCover Authority in September 2010, require that return to work plans are developed and revised in consultation with your injured worker, their treating practitioner and where one is involved, the approved occupational rehabilitation provider.
To ensure that your return to work coordinator can fulfil this task, contact needs to be arranged with the relevant injury management service providers (e.g. the workers chosen treating practitioner(s)). These providers will then be aware of your commitment to the occupational rehabilitation and return to work of injured workers, and they will know who to speak to about the return to work process in the workplace.
Contact with injury management providers can be made by letter, telephone or in person.
Examples:
• a document (this could be a letter) that expresses the employer’s commitment to return to work, including occupational rehabilitation, that introduces the return to work coordinator to treating practitioners and describes the role of the return to work coordinator
• injured worker’s file notes – records of phone conversations with treating practitioners
• your staff handbook detailing the functions of the return to work coordinator
• Who attends the doctor with the injured worker?
• Can injured workers confirm that RTW coordinators attend the treating doctor with them?
Rating
Evidence:
Key Contacts
Name
Title / Position
Documents Submitted
Title
Version / Date
Location
Observations
Comments

WHSMS Auditor Tool - DE

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1.1 POLICY

2.1 LEGAL REQUIREMENTS AND PRACTICAL GUIDANCE

2.2 OBJECTIVES AND TARGETS

2.3 HEALTH AND SAFETY MANAGEMENT PLANS

3.1 STRUCTURE AND RESPONSIBILITY - RESOURCES

3.2 STRUCTURE AND RESPONSIBILITY - RESPONSIBILITY AND ACCOUNTABILITY

3.3 STRUCTURE AND RESPONSIBILITY - TRAINING AND COMPETENCY

3.4 CONSULTATION,COMMUNICATION AND REPORTING - CONSULTATION

3.5 CONSULTATION,COMMUNICATION AND REPORTING - COMMUNICATION

3.6 CONSULTATION,COMMUNICATION AND REPORTING - REPORTING

3.7 DOCUMENTATION

3.8 DOCUMENT AND DATA CONTROL

3.9 HEALTH AND SAFETY RISK MANAGEMENT PROGRAM

3.10 HAZARD IDENTIFICATION, RISK ASSESSMENT AND CONTROL OF RISKS

3.11 EMERGENCY PREPAREDNESS AND RESPONSE

4.1 MONITORING AND MEASUREMENT GENERAL

4.2 HEALTH SURVEILLANCE

4.3 INCIDENT INVESTIGATION, CORRECTIVE AND PREVENTATIVE ACTION

4.4 RECORDS AND RECORD MANAGEMENT

4.5 HEALTH AND SAFETY MANAGEMENT SYSTEM AUDITS

5.1 MANAGEMENT REVIEW

6.1 INJURY MANAGEMENT

Related checklists

WHSMS Auditor Tool - DE

Free WHSMS Auditor Tool - DE Checklist

Go digital today!

Convert your paper checklists into digital forms

1.1 POLICY

2.1 LEGAL REQUIREMENTS AND PRACTICAL GUIDANCE

2.2 OBJECTIVES AND TARGETS

2.3 HEALTH AND SAFETY MANAGEMENT PLANS

3.1 STRUCTURE AND RESPONSIBILITY - RESOURCES

3.2 STRUCTURE AND RESPONSIBILITY - RESPONSIBILITY AND ACCOUNTABILITY

3.3 STRUCTURE AND RESPONSIBILITY - TRAINING AND COMPETENCY

3.4 CONSULTATION,COMMUNICATION AND REPORTING - CONSULTATION

3.5 CONSULTATION,COMMUNICATION AND REPORTING - COMMUNICATION

3.6 CONSULTATION,COMMUNICATION AND REPORTING - REPORTING

3.7 DOCUMENTATION

3.8 DOCUMENT AND DATA CONTROL

3.9 HEALTH AND SAFETY RISK MANAGEMENT PROGRAM

3.10 HAZARD IDENTIFICATION, RISK ASSESSMENT AND CONTROL OF RISKS

3.11 EMERGENCY PREPAREDNESS AND RESPONSE

4.1 MONITORING AND MEASUREMENT GENERAL

4.2 HEALTH SURVEILLANCE

4.3 INCIDENT INVESTIGATION, CORRECTIVE AND PREVENTATIVE ACTION

4.4 RECORDS AND RECORD MANAGEMENT

4.5 HEALTH AND SAFETY MANAGEMENT SYSTEM AUDITS

5.1 MANAGEMENT REVIEW

6.1 INJURY MANAGEMENT

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