Performance Standard for the administration of Incident Reporting & Investigation

HEALTH AND SAFETY MANAGEMENT SYSTEM Performance Standard for the administration of Incident Reporting & Investigation Performance Standard for Incident Reporting & Investigation 28.10.08 HSMS CPS Doc 03, Version 2 April 2012 Page 1 of 12

HEALTH AND SAFETY MANAGEMENT SYSTEM Performance Standard for Incident Reporting and Investigation 1. Purpose and Scope 1.1 Leeds City Council (LCC) believes that the completion, collation and analysis of incident report forms (CF50 and CF50A) and associated investigations is a crucial means of monitoring health and safety performance, enabling LCC to learn from events and improve its health and safety management system. 1.2 This document explains the administrative arrangements in place for reporting and investigating incidents involving any employees of Leeds City Council contractors appointed to carry out work or supply goods and services service users (including learners) visitors to Leeds City Council premises volunteers working on behalf of Leeds City Council 1.3 An incident is defined as any event which results in, or has the potential to cause injury, ill health or damage to any person, property or equipment. This includes, incidents that result in an injury; non-injury incidents; near misses; dangerous occurrences and environmental incidents 2. Process 2.1 Incident reporting All incidents are recorded on either the LCC Incident Report Form (the CF50) or the LCC Report of Aggression or Violence Report Form (the CF50A). Part A of these forms fulfils the requirement for completing the Accident Book BI510 Part A of the forms should preferably be completed by the person involved in the incident, as this is not always possible their line manager or a colleague on behalf of the person involved can complete them. Part B of the forms is completed by the line manager of the person involved in the incident. In the case of incidents to non-employees, Part B is completed by a service manager at the location involved. All reports are sent to the Business Support Centre (BSC) Where an incident, which requires immediate reporting, occurs outside office hours the local emergency reporting arrangements are followed. These arrangements are detailed in local arrangements at Service level 2.2 Reporting Timescales All incidents are reported as soon as possible after the incident and as a minimum Fatalities and Major incidents immediately by telephone to the BSC followed by the report form as soon as possible (see Appendix 1 of this document for guidance on Major incidents) All other incidents to the BSC by report form within 10 days of the incident Performance Standard for Incident Reporting & Investigation 28.10.08 HSMS CPS Doc 03, Version 1 Page 2 of 12

HEALTH AND SAFETY MANAGEMENT SYSTEM 2.3 Incident investigation All incidents are subject to a brief investigation which is recorded in Part B of the CF50 or CF50A. These investigations are conducted by the manager completing the form Investigation must take place as soon as practicable after the incident occurs in order to obtain all the facts. In addition, a further investigation is completed by the line manager using the LCC Incident Investigation Form (in accordance with the Performance Standard for Incident Management) when the incident has been reported under RIDDOR when the incident has resulted in any lost time (Lost time is defined as any absence from work as a result of the incident other than on the day of the incident.) when the incident had the potential for serious injury or when the manager feels a further investigation is necessary. The completed investigation form is sent by the manager to the BSC 2.4 The Business Support Centre. reports incidents to the HSE in line with the requirements of the Reporting of Injuries, Diseases and Dangerous Occurrence Regulations 2012 (RIDDOR) records all incidents on the LCC incident reporting database records the actions taken following investigations on the incident reporting database informs the relevant H&S Team for the Service involved of all incidents which are reportable under RIDDOR and serious cases of violence and aggression (e.g. where police have become involved) sends a copy of any reports of Violence and Aggression upon request by Legal Services sends a copy of all environmental incidents to Environment City produces reports quarterly for the Safety, Well-being and Attendance Performance Report and as required by Services and H&S Committees 2.5 Legal Services For incidents involving violence and aggression, Legal Services will run regular reports from the data base to identify reported incidents which appear to require further action to be taken. They will request a copy of the CF50A and supporting documentation submitted from the BSC. This documentation will be reviewed and as required, further investigations will be carried out. Following this, advise and agreement will be made with the client service of an appropriate course of action to be taken which will implemented. Performance Standard for Incident Reporting & Investigation 28.10.08 HSMS CPS Doc 03, Version 2 April 2012 Page 3 of 12

HEALTH AND SAFETY MANAGEMENT SYSTEM 2.6 Monitoring and Review Incident data are regularly monitored by managers, the HR Service and H&S committees to identify risk areas and underlying trends 3 Records 3.1 Records are kept by the BSC on the LCC incident reporting database and in hard copy Hard copies of incident forms, RIDDOR reports and investigation reports are kept Indefinitely for incidents involving asbestos For 40 years for incidents involving other hazardous materials Where a child is involved, until the child reaches the age of 21 For 3 1 /2 years for all other incidents Database records are kept indefinitely for statistical purposes. Information containing personal data will be dealt with as per our current procedures on Data Protection Laws. 4 Roles and Responsibilities in addition to those referred to in the LCC Health and Safety Policy 4.1 Employees are responsible for Reporting incidents immediately to their line manager in order that the incident is recorded on the CF50 or CF50A Cooperating fully in any investigation of an incident in which they have been involved or which they have witnessed 4.2 Heads of Service are responsible for ensuring there are adequate resources for incident investigation 4.3 Line Managers/Supervisors are responsible for ensuring that all incidents occurring to their employee/s or within their premises, area or work activities are:- Recorded on a CF50 or CF50A and; Reported to the BSC within the specified timescale Informing their local H&S Teams as soon as possible of serious incidents resulting in major injury to members of staff or serious incidents of violence or aggression. To seek advice from their local Safety Teams where there is uncertainty as to whether an incident should be reported. Suitably investigated and that the findings are sent to BSC Monitored and reviewed to identify risk areas and underlying trends 4.4 The LCC Business Support Centre is responsible for Reporting incidents to the HSE under the Reporting of Injuries, Diseases Performance Standard for Incident Reporting & Investigation 28.10.08 HSMS CPS Doc 03, Version 2 April 2012 Page 4 of 12

and Dangerous Occurrence Regulations HEALTH AND SAFETY MANAGEMENT SYSTEM Recording all incident forms accurately on the LCC database Ensuring the database is kept up to date Informing the local HR contact for the Service involved of all RIDDOR reportable incidents as soon as possible Informing the local HR contact for the Service involved of serious incidents of violence or aggression as soon as possible Asking advice from local HR where there is uncertainty as to whether an incident should be reported Notifying the HR Service of any problems in the reporting and recording process Sending forms relating to violence and aggression upon request from Legal Services Sending copies of forms reporting environmental incidents to Environment City Providing reports as required by Services and H&S Committees Storing incident reports, RIDDOR reports and investigation forms for the required time. Communicating effectively and regularly with the HR Service on the performance of the reporting and recording process 4.6 The HR Service are responsible for Reviewing the effectiveness of the incident reporting and recording system Sharing with Services information on serious incidents and serious cases violence and aggression which could have immediate implications for others Reviewing incident reporting data to identify risk areas and underlying trends Monitoring incident investigations to identify risk areas and underlying trends Providing LCC senior managers with information on incidents as part of the SWA Performance Report on a quarterly basis. Providing Safety Committees and Union Safety Representatives with information on incidents Communicating effectively and regularly with the Business Support Centre on the performance of the reporting and recording process Providing information to union appointed safety representatives 4.7 Legal Services, are responsible for advising upon and agreeing with client services the appropriate level of action following an incident involving violence and aggression and recording any resulting actions taken on the database 4.8 H&S committees regularly monitor incident reporting. Performance Standard for Incident Reporting & Investigation 28.10.08 HSMS CPS Doc 03, Version 2 April 2012 Page 5 of 12

HEALTH AND SAFETY MANAGEMENT SYSTEM Appendix 1 Major Incidents include for further information contact HR Safety, Well-being and Attendance Death Major injury: Fracture, other than to fingers, thumbs and toes; amputation; dislocation of the shoulder, hip, knee or spine; loss of sight including temporary; injury to the eye; electric shock or burn; hypothermia, heat-induced illness; unconsciousness; requiring resuscitation; hospital admittance for more than 24 hours; member of the public taken directly to hospital for treatment Reportable disease: Some poisonings; some skin diseases; skin cancer; lung diseases; infections; other conditions such as occupational cancer; certain musculoskeletal disorders; hand-arm vibration syndrome, etc. Reportable dangerous occurrences: Fire; explosion; collapse of buildings, scaffold, or equipment; contact with overhead power lines; accidental release of biological agent or hazardous substances; failure of radiography or irradiation equipment; uncontrolled release of flammable liquid. Reportable gas incidents: Accidental leakage; inadequate combustion; inadequate removal of products of the combustion process. Performance Standard for Incident Reporting & Investigation 28.10.08 HSMS CPS Doc 03, Version 2 April 2012 Page 6 of 12

Incident Log No: Logged (delete as appropriate) Y N Date: CF50 Report of an Incident Part A 1. About the person filling out this form 2. About the incident What is your full name? When did the incident happen? Date Time What is your job title? Address of where the incident happened What is your telephone number? What Service do you work for? Post code Describe the location, e.g. area, room, office What is your work address? Post code 3. Describe what happened Give as much detail as you can, including: What you were doing at the time Who else was there Weather conditions (if appropriate) The name of any substance involved The name of plant or work equipment involved 5. About the person injured or involved What is their full name? What is their home address? Post Code What is their telephone number? Are they? Male Female What is their date of birth? What is their job title and pay number? What is their Directorate and Service 6. About the injury or damage What was the injury / damage sustained and what part & side of body affected? (e.g. left, right, fracture, cut, etc) 4. Names of any witnesses 7. For the injured employee only I sign to agree that the above is a true record of the events as described. I do / do not* give consent for my employer (or Leeds City Council) to disclose my personal information to appointed safety representatives, for them to carry out the health and safety functions given to them by law *delete as appropriate Signed: Date: CF50 April 2012 Page 7 of 12

PART B (to be completed by line manager responsible for location or injured person) 8. Was the person injured or involved Employee? Volunteer worker? Service user? Pupil / student? Member of the public / visitor? Contractor? Give company name below 9. Was the incident A fatality? A major injury? e.g. fracture 11. Initial findings / immediate action which may help to prevent recurrence An injury to an employee or contractor which is likely to prevent them doing their normal work for more than 7 days? An injury to an employee, member of the public, service user or pupil which meant they had to be taken from the scene of the incident to a hospital? A dangerous occurrence? e.g. fire Photos / sketch taken? Yes No Was there a risk assessment? Yes No Further investigation required? Yes No 12. Witnesses contact details (see 4 over) Another type of injury incident? An environmental / pollution incident? Non injury incident? 10. If the incident results in time off work (LCC employees only) When did the employee stop work? Date Time What are their normal working hours? From To Send the completed form to: Business Support Centre Leeds City Council Belgrave House Leeds email: BSC HR CF50/LCC 13. Your details (if different to 1 over) What is your full name? What is your job title? What is your telephone number? What Service do you work for? What is your work address? Post code Signed: Date: For official use only Which authority(s) was the incident reported to: NA HSE EA YW EH Date reported to above authority/s, if applicable: RIDDOR reference: LCC incident database reference: Time off work due to injury? Yes No No. of days Page 8 of 12

Incident Log No: Logged (delete as appropriate) Y N Date: CF50A Report of Aggression or Violence Part A 1. About the person filling out this form 2. About the incident What is your full name? When did the incident happen? Date Time What is your job title? Address of where the incident happened What is your telephone number? What Service do you work for? Post code Describe the location, e.g. area, room, office What is your work address? Post code 3. Describe what happened Give as much detail as you can, including: What you were doing at the time Any relevant details of the assailant The badge no of any police officer involved or any crime number 5. About the person injured or involved What is their full name? What is their home address? Post Code What is their telephone number? Are they? Male Female What is their date of birth? What is their job title and pay number? What is their Directorate and Service 6. About the abuse or violence What was the injury / damage sustained and what part & side of body affected? (e.g. left, right, fracture, cut, distress etc) Name of alleged perpetrator, if known Address of alleged perpetrator, if known Post Code 4. Names of any witnesses CF50A APRIL 2012 Page 9 of 12 7. For the injured/abused employee only I sign to agree that the above is a true record of the events as described. I do / do not* give consent for my employer (or Leeds City Council) to disclose my personal information and details of the incident to appointed safety representatives, for them to carry out the health and safety functions given to them by law *delete as appropriate Signed: Date:

PART B (to be completed by line manager responsible for location) 8. Was the person injured or involved Employee? Volunteer worker? Service user? Pupil / student? Member of the public / visitor? Contractor? Give company name below 9. Was the incident A fatality? A major injury? e.g. fracture An injury to an employee or contractor which is likely to prevent them doing their normal work for more than 7 days? 11. Initial findings / immediate action which may help to prevent recurrence An injury to an employee, member of the public, service user or pupil which meant they had to be taken from the scene of the incident to a hospital? Another type of injury incident? Verbal abuse? e.g. swearing, racist Note: A hate incident form (RH1) may also be required for racism or sexism. Non injury incident? Photos / sketch taken? Yes No Was there a risk assessment? Yes No Further investigation required? Yes No 12. Witnesses contact details (see 4 over) 13. Your details (if different to 1 over) What is your full name? 10. If the incident results in time off work (LCC employees only) When did the employee stop work? Date Time What are their normal working hours? From To Send the completed form to: Business Support Centre Leeds City Council Belgrave House, Leeds email: BSC HR CF50/LCC What is your job title? What is your telephone number? What Service do you work for? What is your work address? Post code Signed: Date: For official use only Which authority(s) was the incident reported to: NA HSE Police Date reported to above authority(s), if applicable: RIDDOR reference: LCC incident database reference: Time off work due to injury? Yes No No. of days Forwarded to Civil Litigation Section: Yes No Date Page 10 of 12

Managers Incident Investigation Form Name of Person Involved: Date of Incident: Pay No. of Person Involved: Time of Incident: Location of Incident: Person in Charge of Location: Reason for investigation Incident reportable to the HSE under RIDDOR Lost time incident Incident with the potential for serious injury or ill health Other (please state) Tick Full description of circumstances: include details of loss (injury damage) and consider weather, machinery and equipment, personal protective equipment etc What control measures were being used? Immediate cause of incident: Possible underlying cause(s) of incident: Immediate management action taken: Further management action taken to prevent re-occurrence: Is there a written record of a risk assessment for the activity Any changes required to the risk assessment, safe system of work etc: Has the risk assessment been revised since the incident Physical Evidence Collected: Type Location and Relevance Plant and equipment Page 11 of 12 Yes Yes Yes No No No

Managers Incident Investigation Form Materials and Substances PPE Photographs/ CCTV Sketches Audio recordings Other documentation Witnesses Name Contact Details Investigation carried out by: Name: Signature: Location of the records of the interview Position: Date: Date forwarded to Business Support Centre Guidance on Completion of Investigation Form Location of Incident Be precise, give an address if necessary and state where in the premises the incident occurred. Full Description of Circumstances State exactly what activity was being undertaken at the time of the incident, state what equipment was being used and what loss/damage to equipment and injuries to personnel were sustained. If it is relevant, state what the weather conditions were like at the time of the incident. Control Measures The risk assessment for the task will specify the control measures that should have been in place at the time of the accident. State whether the control measures were being observed. Was he/she in possession of all the specified documentation and PPE? Had he/she received all of the specified training? If not - make certain your investigation records this. Immediate Cause of Incident This is the factor that led directly to the incident. For example, if someone slips on a wet floor the Immediate Cause is the liquid on the floor. Possible Underlying Cause(s) of Incident (Using the same example as above) Establish why the floor was wet. Was there a spillage, had the floor just been cleaned.. Were the controls in place and were they being followed Management Action Your role as an investigator is to establish why the incident happened and where appropriate to put in place measures to prevent a similar incident occurring in the future. Can you change the way the job is done? Would refresher training help? Just telling the injured person to take more care is NOT sufficient. You might take some action immediately and other action, which will require retraining or re-equipping, over a period of time - document all your immediate and future actions (stating timescales) on the investigation form. Performance Standard for Incident Reporting & Investigation 28.10.08 HSMS CPS Doc 03, Version 2 April 2012 Page 12 of 12