Health and Safety Self-Assessment Form

Solent Safety

Health and Safety Consultancy for Hampshire and the South Coast

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Health and Safety Self-Assessment

This self-assessment aims to help establish where you are now in relation to health and safety management. Use the form below to help you think throgh where you may have gaos. Be honest, you can only improve when you recognise an opportunity. Use the send button below and I can then more readily help you improve. There is no obligation and any information will be treated with the strictest confidentiality.

Item	Details	Yes	No

Policy	Do you have an up to date health and safety policy statement?	1	2
Policy	Can directors/managers demonstrate their commitment to the policy?	3	4

Responsibilities	Are responsibilities for health and safety assigned?	5	6

Arrangements	Do you have any procedures for managing health and safety?	7	8
If yes, which of the following are covered:		Yes	No
	Competant person to advise on health and safety	9	10
	Workplace Equipment	11	12
	Substances hazardous to health	13	14
	Manual Handling	15	16
	Personal Protective Equipment	17	18
	Driving for, and at, work	19	20
	Workplace Transport	19	20
	First Aid	21	22
	Noise	23	24
	Work at Height	25	26
	Excavation	27	28
	Contractors and sub-contractors	29	30
	Signs and signals	31	32
	Fire precautions and fire risk assessment	33	34
	Employers liability insurance	35	36
	Accident reporting and investigation	37	38
	Civil claims	39	40
	Enforcement Action	41	42
	Do you provide health and safety information to employees?	43	44
	Do you have a health and safety committee?	45	46
	Do you provide safety training for employees?	47	48
	Do you set health and safety objectives on an organisational level?	49	50
	Do you set health and safety objectives on an individual level?	51	52
	Do you have emergency response plans?	53	54

Risk Assessments		Yes	No
	Have you carried out workplace risk assessments?	55	56
	Have you carried out driving at work risk assessments?	55	56
	Do you have systems in place to ensure risk assessments are reviewed and revised when appropriate?	57	58

Monitoring	Do you carry out safety inspections?	59	60
	Do you have a system for analysing accident causation?	61	62
	Do you have an audit system in place?	63	64
	If so was an audit carried out within the last two years?	65	66
	Are health and safety metrics reported to director level?	67	68

Review	Do you review your health and safety performance?	69	70

Name: name	Job title: job title
Organisation: organisation	Telephone: telephone
Email: email	Post Code: postcode