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r/16/12/20812

Health and Safety Management Plan

Southern Rural Fire Authority Health and Safety Management Plan i r/16/12/2081212

Contents

HEALTH AND SAFETY ARRANGEMENTS .................................................................................................. 1

Health and Safety Policy Statement ............................................................................................................. 1

Roles and Responsibilities .......................................................................................................................... 2

PCBU ................................................................................................................................................ 2

Officer ............................................................................................................................................. 2

Worker ............................................................................................................................................ 2

Other person at workplace ............................................................................................................. 3

Board of Directors ........................................................................................................................... 3

Management ................................................................................................................................... 4

Safety Officers at the Fire Ground .................................................................................................. 4

Review Policy ...................................................................................................................................... 6

Policy ............................................................................................................................................... 6

Review Procedure ........................................................................................................................... 6

Annual External Review .................................................................................................................. 6

Management Review ...................................................................................................................... 7

Post Critical Event Review ............................................................................................................... 7

Hazard and Risk Review .................................................................................................................. 7

Governance Review ........................................................................................................................ 8

Monthly Health and Safety Checklist .............................................................................................. 8

HEALTH AND SAFETY FORMS .................................................................................................................. 9

Management Checklist for Governance No. 1 ............................................................................................... 9

Health and Safety Governance Agenda No. 2 ............................................................................................. 10

Monthly Health and Safety Checklist No. 3 ................................................................................................. 11

Incident and Injury Reporting and Recording ................................................................................... 12

Policy ............................................................................................................................................. 12

Definitions ............................................................................................................................................. 14

Near Miss (Incident) Report No. 4 .............................................................................................................. 18

Accident Report No. 5 .............................................................................................................................. 19

Level 1 Investigation No. 6 ........................................................................................................................ 20

Level 2 Investigation No. 7 ........................................................................................................................ 21

Emergency Procedures (fixed building sites only) ................................................................................ 40

Policy ............................................................................................................................................. 40

Possible Emergencies .................................................................................................................... 40

Southern Rural Fire Authority Health and Safety Management Plan ii r/16/12/2081212

1. Fire ........................................................................................................................................ 41

2. Earthquake ............................................................................................................................ 42

3. Serious Injury ........................................................................................................................ 43

4. Extreme Weather Conditions ................................................................................................ 43

5. Tsunami ............................................................................................................................. 44

EMERGENCY ......................................................................................................................................... 45

FIRE POLICE AMBULANCE ................................................................................................................ 45

Information and Training Policy ................................................................................................................. 46

New Employees ............................................................................................................................. 46

Record of Employee Skills ............................................................................................................. 46

SRFA Fire Plan Standing Instructions ........................................................................................................ 47

SRFA Code of Safe Conduct ........................................................................................................... 47

Worker Participation, Engagement and Communication ............................................................................... 48

Other People at the Place of Work ............................................................................................................. 49

Definition ...................................................................................................................................... 49

Policy ............................................................................................................................................. 49

Contractor Engagement ................................................................................................................ 50

Contractor Agreement No. 10 .................................................................................................................... 55

Engaging Clients/Customers ..................................................................................................................... 57

Policy ............................................................................................................................................. 57

Procedure for Engaging Clients ..................................................................................................... 57

On Site Issues Procedure .............................................................................................................. 57

Contractor Engagement No. 11 ................................................................................................................. 58

Hazardous Substances Management ......................................................................................................... 59

Policy ............................................................................................................................................. 59

Definitions ..................................................................................................................................... 59

Monitoring Employee Work Fitness ............................................................................................................ 61

Return to Work ........................................................................................................................................ 62

Working Alone and Remotely .................................................................................................................... 63

Smoke-free Working Environment ............................................................................................................. 64

Smoke-free buildings: ................................................................................................................... 64

Passive smoking: ........................................................................................................................... 64

Complaints: ................................................................................................................................... 64

Appendix ................................................................................................................................................. 65

Southern Rural Fire Authority Health and Safety Management Plan 1 r/16/12/2081212

HEALTH AND SAFETY ARRANGEMENTS

Health and Safety Policy Statement

Southern Rural Fire Authority (SRFA) is committed to maintaining a safe and healthy working environment for all employees, managers, contractors, volunteers and people in the vicinity of where we are working. Health and safety is everyone’s responsibility, and everyone is expected to share in our commitment to avoid all accidents and incidents, which may cause personal injury, property damage, illness or loss of any kind. Every worker is expected to act safely at all times to ensure their own welfare and that of their fellow workers and others in the workplace.

We will ensure the safety of workers by: Providing and maintaining a safe working environment.

Providing facilities for health and safety.

Ensuring all plant and equipment is safe.

Ensuring all workers and other people at (or in the vicinity) of the place of work are not exposed to unmanaged or uncontrolled hazards.

Developing and implementing emergency and evacuation procedures.

Setting health and safety objectives and performance criteria for management.

Encouraging accurate and timely reporting and recording of all incidents and injuries.

Investigating all reported incidents and injuries to identify all contributing factors and, where appropriate, formulating plans for corrective action.

Actively encouraging the early reporting of any pain or discomfort.

Ensuring that all workers are made aware of the hazards and associated risks in their work areas and are adequately trained so they can carry out their duties in a safe manner.

Encouraging worker consultation and participation in all health and safety matters.

Promoting a system of continuous improvement, including annual reviews of policies and procedures.

To achieve this we will:

1. Systematically identify all hazards, and control the associated risks in our workplace. Where there are significant risks we will take all reasonably practicable steps to control the risks to prevent any injury, adverse health effects or damage.

2. Inform all workers of these hazards, the associated risks and the controls.

3. Ensure all employees are properly trained and supervised until they are assessed as being competent, including an induction process for new employees.

4. Inform all workers of emergency and evacuation procedures.

5. Record all incidents (near misses), illness and accidents in our workplace, and take all reasonably practicable steps to prevent these events from happening.

6. Carry out planned self-inspections to monitor health and safety issues.

7. Measure our improvements through setting measurable objectives and targets aimed at the reduction of risk and the elimination of work related injuries and illnesses.

8. Ensure all workers are given reasonable opportunities to participate effectively in ongoing processes for the improvement of health and safety in our workplace.

Signed: 9/12/2016 9/12/2016

Chairperson Southern Rural Authority

Date: Chief Executive/ Principal Rural Fire Officer

Date:


Roles and Responsibilities

PCBU

Definition

Person Conducting a Business or Undertaking (PCBU). This is the legal entity or in the case of a sole trader, it could be a person. In our Organisation the PCBU is Southern Rural Fire Authority (SRFA) Responsibilities

As a PCBU we must ensure, so far as is reasonably practicable, the health and safety of all of our workers and other persons in our workplace are not put at risk by our work. This is called the primary duty of care.

Officer

Definition

An officer is a person who occupies a position that allows them to exercise significant influence over the management of the Organisation or undertaking. In our PCBU the officers are the Southern Rural Fire Committee and the Chief Executive Officer. Responsibilities

Officers will exercise due diligence to:

Acquire (and keep up-to-date) knowledge of work health and safety matters;

Understand the nature of SRFA operations and the general hazards and risks associated with them;

Provide appropriate resources and processes to eliminate or minimise the health and safety risks associated with the SRFA's operations;

Make sure the SRFA has appropriate processes for receiving information on hazards, risks, and incidents, evaluate that information, and respond in a timely way;

Make sure there are processes in place so that the SRFA complies with its legal obligations; and

Verify that appropriate resources and processes have been provided and are being used.

Worker

Definition

A worker is an individual who carries out work in any capacity for a PCBU. A worker may be a rural firefighter, volunteer, contractor, sub-contractor or a visitor. Volunteer Workers are individuals who carry out work in any capacity for a PCBU with the knowledge or consent of the PCBU and on an ongoing and regular basis and the work is an integral part of our business. Employees, Volunteers and Contractors

“Stand in the Gap” If anyone sees an unsafe act / plant or equipment, do not just do nothing, it is your legal and moral responsibility to do something about - stand in the gap. If you can not immediately address the issue, then report the issue.


All employees and contractors are inducted into SRFA and their role. They are provided with information on hazards, their controls and what to do in the event of an incident or emergency. They are responsible for taking reasonable care of their own health and safety and the health and safety of others who could be affected by their acts. To do this they are expected to:

Practice safe working methods including wearing suitable protective clothing or using safety equipment and ensuring tasks are not carried out without the proper controls in place;

Working in a safe manner to protect themselves, their fellow workers and all plant, property and equipment;

Only operating equipment for which they have been trained and instructed in and hold appropriate certificates for or with their Manager or Supervisor’s authorisation or specific supervision;

Abiding by all displayed rules, safety regulations, policies and procedures;

Keeping their work area or equipment clean and tidy and maintaining a high level of housekeeping;

Protect themselves, their fellow workers and any other party, from unsafe situations by carrying out their duties in a safe and responsible manner;

Actively encourage safe behaviour in the workplace;

Participate in the risk identification, assessment and control program;

Ensure they understand the risks that affect their jobs and the control measures in place;

Report any new hazards / risks, accidents, incidents or work related illness;

Being familiar with all emergency equipment in the work area and all emergency site procedures; and

Not willingly interfering with or misusing items or facilities provided, in the interest of safety.

Other person at workplace

Examples of other persons at workplaces include workplace visitors, customers, suppliers, sales coordinators, delivery people. Responsibilities - Other persons i.e. media, landowners, have their own health and safety duty to take reasonable care to keep themselves and others safe at a workplace.

Board of Directors

SRFA is committed to providing a healthy and safe workplace. This requires wide commitment and the assignment of responsibilities at all levels of our organisation. The Board of Directors is ultimately accountable and has overall responsibility for ensuring that the organisation complies with the Health and Safety at Work Act 2015 and associated regulations and codes of practice. The Board also has responsibility for ensuring that our annual strategic planning, including resource allocation, encompasses and promotes workplace health, safety and wellbeing. The Board are aware of SRFA critical safety risks and will review our health and safety performance, ensuring that valid health and safety objectives are set, measured and achieved. We understand individual Directors are officers with specific due diligence obligations under the Act, as set out below. We will discuss health and safety matters at each board meeting and will monitor and review health and safety with a view to continuous improvement.


As Directors we are responsible for providing quality advice and guidance on health and safety standards and assisting management to promote a positive health and safety culture. We will do this by:

Keeping up to date knowledge of work health and safety matters;

Assisting with development and implementation of policies;

Auditing the implementation of policies and procedures within the Organisation;

Setting health and safety Key Performance Indicators (KPI’s);

Monitoring health and safety performance;

Overseeing accident reporting and investigations; and

Verifying policies and procedures are being implemented and followed in the workplace.

Management

Management will ensure policies and procedures are adhered to and that people who don’t adhere to polices or procedures are held to account. Management will be responsible for day-to-day health and safety management as outlined in our Health & Safety Management Plan, including:

Ensuring employees and contractors are inducted and trained in our health and safety policies and procedures;

Implementing policies and procedures;

Ensuring effective mechanisms are in place for employees to raise health and safety issues and that these are addressed;

Ensuring all accidents/incidents/near misses are accurately reported, recorded and investigated;

Participating in the hazard identification, assessment and control program including regularly reviewing hazards and their controls and updating the risk register;

Ensuring the proper hazard controls are provided and being used;

Documenting all hazard identification, assessment and control;

Completing the Hazardous Substances Register and procedure;

Ensuring maintenance checks are completed in accordance with policy;

Ensuring emergency procedures and practice evacuations are implemented;

Monitoring performance and compliance;

Assessing competency and ensuring necessary training is completed and recorded; and

Ensuring Contractors are engaged and receive Contractor inductions.

Safety Officers at the Fire Ground

A Safety Officer will be appointed by the Incident Controller at a rural fire or emergency incident in the following circumstances:

More than one Volunteer Rural Fire Force (VRFF) in attendance at the scene.

More than 15 personnel involved in fire / emergency scene operations including other emergency service personnel.

Where the incident controller deems there to be specific need to appoint a Safety Officer


When selecting personnel to fulfil the role of Safety Officer, the Incident Controller must:

Select personnel that have minimum qualifications / positions of Crew Leader/ Rural Fire Officer or a person that holds the required skills and experience to manage the principal hazard present.

Provide appropriate briefing on the role required. A Safety Officer reports directly to the Incident Controller of the incident and will typically be a dedicated role depending on the type / size/ scale of the incident.


Review Policy

Policy

SRFA will review and maintain this Health and Safety Management Plan (HSMP) as a quality living document. As an organisation, we are dedicated to continuous improvement in health and safety. The Health and Safety Management Plan (HSMP) will be systematically reviewed and evaluated in accordance with the following procedures.

Review Procedure

The review process will include:

Annual external review;

Monthly checklists;

Review of internal practices;

Review of employee meetings;

Post critical event reviews;

Hazard and risk management review. 1. The review processes will be carried out in consultation with employees, managers and the Directors.

2. The result of any reviews will to be discussed and reported to all employees, including management and the Directors.

3. At SRFA’s request, a qualified provider will update and review the Health and Safety Management Plan in accordance with this procedure.

4. Officers, Management and any Health and Safety Co-ordinator will be required to attend regular training and keep up to date with both the legislative requirements and relevant industry guidelines. To do this we will attend health and safety training, discussions and forums.

5. Following any formal review and changes to the document, it will be re-signed and dated as appropriate.

Annual External Review

An external review will be undertaken on an annual basis by a qualified provider. The review will ensure the HSMP:

Complies with current legislation including the relevant regulations;

Complies with relevant codes of practice, industry guidelines and WorkSafe NZ guidance;

Is understood and implemented effectively within the Organisation;

Is practical and appropriate for the work environment;

Adequately assists in progressing health and safety objectives and targets. Where practical, SRFA must attend to any identified deficiencies as soon as possible and within one month of receiving the report.


Management Review

On an annual basis or as documented in individual policies, all policies and procedures in the health and safety system, including this Review Policy, must be reviewed by the Management to ensure that they remain effective and suit the needs of our Organisation. The purpose of the review is to ensure its continuing suitability, adequacy and effectiveness.

Suitability - fitness of the management system for its defined purpose - policy, processes, procedures, controls;

Adequacy - is the integrated management system sufficient to meet requirements - legislative, regulatory, organisational, contractual;

Effectiveness - extent to accomplishing planned activities and achieving planned results.

We will ensure all relevant documentation and information has been circulated prior to any management review meeting. Any changes or amendments need to be discussed and communicated to all affected workers.

Post Critical Event Review

Health and safety management will be reviewed after any event which may have a bearing on Health and Safety practices. This will be initiated by SRFA, or their appointed coordinator(s). This includes, but is not limited to:

A notifiable injury or illness;

A major incident involving property damage;

A notifiable incident;

A potentially serious near miss incident;

Any change in major work procedures;

Any change in operations; and

The introduction of new or altered machinery/equipment. The process of review will consider:

The main contributing factors to any injury, incident or injury;

Whether current policies and/or procedures are sufficient to prevent or minimise a recurrence of an injury, incident or injury;

Any new hazards or risk;

Whether employees have an adequate understanding of their responsibilities; and

Whether additional employee training or information is required.

Hazard and Risk Review

SRFA will maintain a risk register. Hazards and risks identified must be updated on the risk register as soon as possible, adequate controls put in place and employees and other relevant persons, including contractors must be informed.


Management must also review all currently identified hazards and their associated risks, listed in the risk register as well, any risks identified at the time (of the hazard). The review must confirm the status of current hazards and risks. In addition, management must inspect the workplace on a regular basis to identify any additional hazards that have not already been identified during the regular hazard review. As part of this review, accident, incident and near miss data will be analysed. Analysis will include the following: Number and cost of injuries, accidents, absences and near misses: Types of injuries that have occurred;

Types of illness’ that have occurred;

Hazards and risks involved in the injuries;

Work areas or tasks that have a high number of injuries, accidents or incidents; and

Pattern of injury in terms of time of day or weekends.

Governance Review

The Directors will meet on a regular basis. As part of this regular discussion, health and safety will form part of the agenda. Prior to the Directors meeting, the Senior Manager team must provide the completed Management Checklist (Form No. 1) and provide the required details to the Directors. The Health and Safety Governance Agenda (Form No. 2) will be used as a basis of health and safety matters to be discussed.

Monthly Health and Safety Checklist

The Senior Manager team must complete the Monthly Health and Safety Checklist (Form No. 3) on a monthly basis. Any actions that arise from the Checklist will be rectified as soon as possible and discussed in the monthly Safety Meeting where necessary.


HEALTH AND SAFETY FORMS

Management Checklist for Governance No. 1

CHECKLIST Y/N ATTACH

Monthly meeting carried out? Meeting Minutes

Monthly checklist completed? Monthly Checklist

Any incidents/near miss? Incident Register

Investigation Form

Any Accidents? Accident Form

Investigation Form

Notification Form (if applicable)

Any reports of discomfort or occupation illness? Early Reporting Form

Investigation Form

Anybody off sick or Injured? Absentee Data

Any new hazards identified? Updated Risk Register

Risk assessment carried out for new hazards? Updated Risk Register

Any controls changed? Updated Risk Register

Any new employees? Acknowledgement Form

Capabilities Analysis

Assessment Forms

Any training undertaken? Training Records

Vehicle maintenance up to date? Maintenance Records

Any contractors engaged? Contractor Agreement

Contractor Induction Form

Monitoring Documentation

Assess Objectives/Targets and KPI’s Assessment Documentation

Any qualified assessors been onsite? Assessment Reports

Any audits carried out? Audit Documentation

Any other relevant matter? Relevant documentation

MANAGER’S SIGNATURE: DATE:


Health and Safety Governance Agenda No. 2

Health and Safety topics for discussion during the Bi-Monthly Governance Meeting. Discuss and review Directors Health and Safety Charter.

Review monthly safety meeting minutes.

Discuss monthly health and safety checklist.

Ensure all notifiable events have been reported by Management and the Director/s

Discuss any incidents that occurred.

Discuss all accident reports.

Discuss any work related illness.

Review and discuss all accident investigations.

Review and discuss data on absence rates due to sickness.

Review new hazards, risk assessments and discuss the controls.

Discuss and review any Health and Safety Management Plan amendments.

Discuss one relevant Industry Guideline.

Report and discuss any Director/Trustee health and safety training recently completed.

Discuss any recent policy reviews or audits.

Discuss management health and safety KPI results.

Discuss health and safety targets and objectives.

Any other matters arising.

Southern Rural Fire Authority Health And Safety Management Plan 11 r/16/12/2081212

Monthly Health and Safety Checklist No. 3

Checklist Completed Actions Required Person(s) Responsible Action closed (date)

Any new hazards identified? Updated risk and HSNO register Risks assessed Updated controls Communicated new hazards and risks to relevant

employees JSA’s completed as required

Any new accidents, incidents, illnesses, discomfort All relevant forms completed and filed All incidents, injuries, illness investigated If notifiable event occurred - correct procedure followed

and WorkSafe NZ notified.

New Employees Health and Safety training completed Induction checklist completed and filed

Employee training and capability Employee training record updated Capability analysis updated New JSA completed and appropriate employees

trained

Contractors and Clients Acknowledgements and Agreements up to date for any

new contractors and clients JSA completed as required Contractors checklist completed

Vehicles and Machinery Pre-operational checklists completed Maintenance up to date

Other Health and safety meeting held Emergency response information current PPE in safe condition and issued where required First Aid Kit checked and stocked Fire Extinguishers current

Checklist completed by Site:

Date completed Signed by:


Incident and Injury Reporting and Recording

Policy

Southern Rural Fire Authority is committed to reporting and investigating accidents, incidents and events in the workplace. Our policies and procedures aim to ensure:

All incidents, injuries, illness, and discomfort are be notified to the Manager immediately or as soon as practical.

All employees with an injury, illness and/or signs of discomfort accurately complete the accident/early reporting form and return this to the Manager immediately.

All incidents and injuries are investigated by the Manager; not to place blame or fault, but to identify new hazards and controls and therefore avoid future injuries.

All employees are informed of the injury, illness, incident, discomfort investigation, i.e. new hazard identified and the hazard controls.

All notifiable events, involving any person (employee, contractor and other person/s, are reported to WorkSafe NZ as soon as possible.

All accident, incident, illness, discomfort data is maintained, collated and reviewed regularly to identify patterns or particularly dangerous work.


Event – Incident / Accident / Illness

Is This A Worksafe NZ Notifiable Event(definition of notifiable event found on next page]

Accident / Illness / Incident

Minor accident incident

(near miss)

Immediate medical assistance

provided

Phone Emergency Services

Ensure that no others can be

hurt by the event

Under different circumstances

could this have a more serious

outcome

Fill in accident form –

Form # 5

Fill in accident report level 1

Form # 6

Secure the scene

Fill in accident form

Form # 5

Fill in Event Form (near miss)

Form # 4

Notify the CEO

YES

CEO Notifies Worksafe NZ

CEO Notifies Board

Worksafe NZ Investigator attending scene

Worksafe NZ request Duty Holder review

YESNO

Worksafe NZ advise that no further actin will

be taken

NO

PRFO notifies Insurance

Company

Scene can only be released by

Worksafe NZ or the PRFO

Report goes to Management

Team to review risk register to

ensure controls are still relevant

or need updated

Report goes to Board.

Board reviews and signs off on any

recommendations

Control measures

implemented to prevent

future occurrence

Give completed form to

H & S Co-ordinator

Management Team to

review risk register to

ensure controls are still relevant

Summary of event goes to Board

Board advises employees/other

affected PCBU of outcome from

investigation

YES NO

YES

YES

NO

Internal Investigation -

Investigation Form # 7

Report and changes goes to the Board


Definitions

Accident

An event that causes any person to be harmed. Incident

In different circumstances, might have caused any person to be harmed. Injury/Harm

An illness, injury, or both and includes physical or mental harm caused by work-related stress. Notifiable Event

A notifiable event means any of the following events that arise from work:

(a) the death of a person; or

(b) a notifiable injury or illness; or

(c) a notifiable incident. Notifiable Incident

An unplanned or uncontrolled incident in relation to a workplace that exposes a worker or any other person to a serious risk to that person’s health or safety arising from an immediate or imminent exposure to:

an escape, a spillage, or a leakage of a substance; or

an implosion, explosion, or fire; or

an escape of gas or steam; or

an escape of a pressurised substance; or

an electric shock; or

the fall or release from a height of any plant, substance, or thing; or

the collapse, overturning, failure, or malfunction of, or damage to, any plant that is required to be authorised for use in accordance with regulations; or

the collapse or partial collapse of a structure; or

the collapse or failure of an excavation or any shoring supporting an excavation; or

the inrush of water, mud, or gas in workings in an underground excavation or tunnel; or

the interruption of the main system of ventilation in an underground excavation or tunnel; or

a collision between 2 vessels, a vessel capsize, or the inrush of water into a vessel; or

any other incident declared by regulations to be a notifiable incident for the purposes of this section.


Notifiable Injury or Illness

1. Any of the following injury or illnesses that requires the person to have immediate treatment (other than first aid):

The amputation of any body part

A serious head injury

A serious eye injury

A serious burn

The separation of skin from underlying tissue (such as degloving or scalping)

A spinal injury

Loss of bodily function

Serious lacerations. 2. An injury or illness that requires, or would usually require, the person to be admitted to a hospital for

immediate treatment.

3. An injury or illness that requires, or would usually require, the person to be have medical treatment within 48 hours of exposure to a substance.

4. Any serious infection (including occupational zoonoses) to which the carrying out of work is a significant contributing factor, including any infection that is attributable to caring out work:

With micro-organisms; or

That involves providing treatment or care to a person; or

That involves contact with human blood or bodily substances; or

That involves handling or contact with animals, animal hides, animal skins, animal wool or hair, animal carcasses, or animal waste products; or

That involves handling or contact with fish or marine mammals.

5. Any other injury or illness declared by regulations to be a notifiable injury of illness for the purposes of this section.


Incident Procedure

1. In the event of an incident the Manager must be notified as soon as possible. Note: If the incident amounts to a notifiable event, follow the Notifiable Event Procedure. This requirement applies to all employees, working family members, visitors, and contractors.

2. The incident must be investigated.

The Level 1 Investigation Form (Form No. 6) should be used in the event of any minor incident that is not regularly occurring and does not have the potential to result in a notifiable event.

The Level 2 Investigation Form (Form No. 7) should be used in the event of an incident that is occurring regularly or has the potential to result in a notifiable event.

3. The result of the investigation must be communicated to all affected workers including any action taken

to control or prevent the incident from reoccurring. Accident Procedure

1. In the event of an accident resulting in an injury the Manager must be notified immediately. Note: If the accident amounts to a notifiable event, follow the Notifiable Event Procedure. This requirement applies to all employees, working family members, visitors, and contractors.

2. The employee must complete the Accident Report (Form No. 4) and give this to the Manager.

3. The accident must be investigated and appropriate Investigation Form completed:

A Level 1 Investigation Form No. 6 should be used in the event of any minor accident that is not regularly occurring and does not have the potential to result in a notifiable event.

A Level 2 Investigation Form No. 7 should be used in the event of an accident that is occurring regularly or has the potential to result in a notifiable event.

4. The result of the Investigation must be communicated to all affected workers including any actions taken to control or prevent the accident from reoccurring.

Work Related Early Discomfort Procedure

1. In the event of an employee experiencing signs of early discomfort potentially caused by a factor in the workplace the Manager must be notified as soon as possible.

2. The workplace discomfort must be investigated to determine the root cause. This investigation may include sending the employee to a specialist to seek their professional medical opinion.

3. The result of the investigation must be communicated to all affected workers including any action taken to control or prevent the risk of harm reoccurring.

Two incident reporting forms are required to be filled in, these are:

1. SRFA Fire Ground Incident - Crew Leaders HSWA Incident Report Card;

2. WorkSafe NZ Notifiable Events for either Incidents or Notifiable Accidents /Illness.


Work Related Illness Procedure

1. In the event of an employee suffering an illness which has the potential to relate to factors in the workplace, the Manager must be notified immediately. Note: If the incident amounts to a notifiable event, follow the Notifiable Event Procedure.

2. The cause of any workplace illnesses must be investigated to determine the root cause. This investigation phase may include sending the employee to a specialist to seek their professional medical opinion.

3. The result of the Investigation must be communicated to all affected workers including any action taken to control or prevent the risk of harm reoccurring.

Notifiable Event Procedure

1. In the event of a notifiable event (death or notifiable injury, illness or incident WorkSafe NZ needs to be notified immediately. If unsure whether the event amounts to a notifiable event, contact them anyway.

Notification must be given by the fastest possible means in the circumstances:

Phone: 0800 030 040

Email: [email protected]

Electronic Notification: www.forms.worksafe.govt.nz/notifiable-event-notification

Post: The Registrar, WorkSafe New Zealand, PO Box 105-146, Auckland 1143. 2. Take all reasonable steps to ensure the site is not disturbed until authorised by an inspector. Except:

To assist an injured person; or To remove a deceased person; or That is essential to make the site safe; or To minimise the rise of a further notifiable event; or If under the direction of the Police.

3. An investigation into the event must occur, sometimes in consultation with the WorkSafe NZ Inspector.

4. WorkSafe NZ may require us to give written notice. Written notice will be in the Notifiable Event Form (Forms No. 8 and No. 9). WorkSafe NZ provides 48 hours notice for this form to be submitted following the PCBU being informed of the requirement to do so.

5. The event and any outcome of the investigation must be reported to employees.

6. Records of all notifiable events must be maintained for a minimum of five years.

http://www.forms.worksafe.govt.nz/notifiable-event-notification


Near Miss (Incident) Report No. 4 Location

Time Date

Tick appropriate box

RED

Stop Work And Report

YELLOW Use Caution and

Report

GREEN Continue and

Report

Unsafe Act

Unsafe Condition

Unsafe Equipment

Unsafe use of Equipment

Description of Near Miss / incident

Reported by

Name:

Signature:


Accident Report No. 5

Personal Details

Name: Phone Number:

Address: Date of Birth:

Sex: Male Female

SRFA: Job Title:

Permanent Casual Contractor Visitor

Accident Details

Date: Time:

Date Reported: Hours at Work:

Notifiable Event: Yes No Notification to WorkSafe NZ: Yes No

Treatment Near Miss No Treatment First Aid Doctor Hospital

Injury Type Strain/Sprain Cut Head Injury Fracture/Break Burns

Gradual Process Bruising Poison/Chemical Multiple Injuries No injury

Action Taken to Prevent Recurrence Action?

By Whom?

When?

Initial needs Assessment (Only Complete If a Doctors Visit Was Required) Able to continue full duties Able to do light duties Unable to work

Help available from home Assistance required at home Transport assistance needed

Form Completed by: Position:

Where did the accident happen? Location of Injury (circle location)

How did the accident happen?

What type of vehicle was involved (if at all)?

Was the person trained for the task? Yes No

Was a significant hazard involved? Yes No

If yes, what was the hazard?

Is the hazard on the Risk Register? Yes No

How serious could the accident have been?


Level 1 Investigation No. 6

PARTICULARS OF EVENT Date of event M T W T F S S

Time Location Date reported

THE PERSON Name Address

Age Phone number

Date of event Length of employment at plant on job

DAMAGED PROPERTY Property/material damaged Nature of any damage

Object/substance inflicting damage

THE INCIDENT Description

Describe what happened (space overleaf for diagram - essential for all vehicle event)

Analysis

What were the causes of the event?

HOW BAD COULD IT HAVE BEEN? WHAT IS THE CHANCE OF IT HAPPENING AGAIN?

Critical Serious Minor Minor Occasional Often

Prevention

What action has or will be taken to prevent a recurrence? Tick items already actioned

By whom When

Use space overleaf if required

INVESTIGATION OF INCIDENT Investigated by Signed Date


Level 2 Investigation No. 7

Section 1: The Organisation

Your Organisation:

Registered business name (include trading name) and postal address:

Number of employees: Number of sites:

Directors:

Phone: Email:

Are you employed by a Principal or have you engaged a Contractor?

Principal ☐ Contractor ☐ N/A ☐

Principal (company who engaged your services) if relevant:



Directors:

Contact name: Their role/title:

Phone: Email:

Contractors (people you have engaged) - those on site at the time of the incident:



Directors:

Contact name: Their role/title:

Phone: Email:


Section 2: The People

Who is investigating:

Lead investigator:

Name:

Role/title:

Phone: Email:

Others involved in investigation ie, H&S Committee, HSR, Department manager etc.

Was injured person involved in the investigation? Yes ☐ No ☐

People at the scene:

Injured party:

Name:

Role/title:

Address:

Start time: Statement obtained: Yes ☐ No ☐ (please provide copy)

Witnesses (those present at scene; the first aider; first on scene etc.)

Were there any witnesses: Yes ☐ No ☐

Statement/s obtained: Yes ☐ No ☐ (please provide copy)

Type of injury: Mark location of injuries:

☐ Bruising ☐ Dislocation ☐ Strain/sprain

☐ Scratch/abrasion ☐ Internal ☐ Fracture

☐ Amputation ☐ Foreign body ☐ Laceration/cut

☐ Burn/scald ☐ Chemical reaction

☐ Other (specify)

Comments:

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

----------------------------------------------------------------------------------------------------


Section 3: Describe The Incident Scene

Provide detailed relevant information

Date of incident: Time of incident: am ☐ pm ☐

Address and exact location of incident (i.e. 123 First St, Auckland. South east corner of warehouse 2):

Working conditions at the location and time of the incident (e.g. poor lighting, extreme temperature, time pressures, confined working space etc.):

Weather conditions at the time of the incident (if applicable):

Create a timeline. Describe the details in the order of what happened immediately before, during, and after the incident:

Before (i.e. Worker started at 0700 and attended a toolbox meeting at…):

During (i.e. The incident description):

After (i.e. John was first on scene and provided first aid to the injured party while Peter called an ambulance…):


Section 3 continued - complete if appropriate:

DIAGRAM OF LOCATION OF INCIDENT


Section 3 continued – complete if appropriate:

PHOTO(S) TAKEN

Provide photo taken immediately after incident and/or items directly related to the incident.


Section 4: Identify Direct Cause(s): Immediate factors that influence human decisions

A direct cause is anything that is at the location that has had an immediate influence on actions or decisions made by workers leading to the incident occurring (the actions or inactions of people, obstacles, poorly maintained equipment etc).

People: List all those who were present in the area and describe the actions or inactions of: the injured party; supervisors (who was in charge?); others (witnesses etc.). Have these actions or inactions contributed or failed to stop the incident?

Plant (building, machinery etc.) and Equipment (bench saw, gas bottles, pallets etc.): What plant and/or equipment was at the location that had an influence on the incident? What was this influence?

Substances: What substances were at the location that had an influence on the incident? What was this influence?

Environment: Describe the environment and how it influenced the incident (confined working space etc.).


Section 5: Your Health and Safety Management System

IDENTIFY CAUSATIVE FACTOR(S)

Given that people make mistakes and/or take short-cuts, what could have been in place to mitigate the consequences of their actions?

Training: What training or instruction have the parties been provided (induction, task specific, hazard identification etc.)? Please provide supporting documents (company records, certificates etc.).

Competence: What qualifications and/or experience do the parties have to undertake the task being performed? How do you know workers are performing as per training provided and remain competent?

Procedures: What procedures do you have that cover the task being performed at the time of the incident? Consider the following: standard operating procedures (SOPs), job safety analysis (JSA), emergency plans, contractor management etc. Please provide a copy of these where applicable. Have the procedures been followed?

Supervision: Who was the supervisor? What level of supervision was required for the task? Has the supervisor or other workers noticed any actions that are out of line with procedures, and if so what actions were taken?

Hazard Identification: When was the hazard identified? Please provide a copy of your hazard identification.

Hazard Control: If the hazard was previously identified, what controls were put in place? How has the incident come to occur with these controls in place?

Hazard Management: What other controls were considered? How do you assess hazards and consider controls?


Monitor and Review: What do you have in place to: Assess effectiveness of hazard/risk controls that are in place? Ensure workers and visitors are doing what they should in relation to the procedures and SOPs? Compare existing controls with new control opportunities?

Governance: How are senior management made aware of hazards and risks within the workplace? When were senior management first aware of the hazards and risks associated with this incident? What factors were assessed when deciding on the existing controls?

Health and Safety Standards: What standards, codes of practice, guidelines do you refer to in relation to the task being performed (you may reference manufacturers manuals or similar)?

Other Causes: If applicable, advise what other causes contributed to the incident (fatigue, complacency etc.)

Section 6: Immediate Factors That Influence Human Decisions

DIRECT CAUSE(S)

Direct causes: Summary of identified key points from Section 4


Section 7: Your Broader Health And Safety System

ROOT CAUSE

Root Cause: Reviewing key points identified in Section 5, can you now identify what, if added or removed from the situation, would have prevented the incident from occurring?


Section 8: Corrective Actions Taken

Corrective Actions Taken: Corrective actions taken to address the direct and root causes as listed above (Section 6 and 7)

Action: Control Type: Eliminate, Minimise

Expected completion date:

By whom:

Guidance on the Hierarchy of Controls: .

Elimination: Completely remove the hazard or hazardous work practice.

Minimisation: Incorporates the following categories.

Substitution: Change a work practice, substance or piece of equipment to provide a safer environment

Isolation: Separate the substance or piece of equipment from people, either by distance or physical barrier

Engineering: Modify the design of the workplace of plant and/or environmental conditions

Administrative: Develop procedures and systems to control the interaction between people and hazards

PPE: Implement PPE to prevent physical contact between a person and a hazard Note : Whenever introducing these controls, you MUST always re-assess to ensure you haven’t introduced a new hazard/risk.


Section 9: Supporting Documentation (add others as necessary)

Statements (injured party, witnesses etc.) Procedures

Standard operating procedures Hazard identification and control docs

Toolbox minutes Training records

Skills assessment documentation Certification (forklifts, cranes etc.)

Section 10: Sign-Off

Person responsible for report

Name:

Title:

Signature:

Date:

Health and Safety Representative (if applicable)

Name:

Title:

Signature:

Date:

Chief Executive or Senior Decision Maker

Declaration: I confirm that improvements identified in this report have been implemented or are planned to be implemented by the dates specified.

Name:

Title:

Signature:

Date:


Emergency Procedures (fixed building sites

only)

Policy

Emergencies are any unplanned events that can have a significant effect on your Organisation. They may involve physical or environmental damage, or injury, harm or death to employees, visitors, contractors, or members of the public. All employees are to be familiar with the emergency procedures included in this health and safety management plan. Employees have emergency responsibilities assigned to them and are trained how to carry them out in the case of an emergency:

Emergency contact details will be displayed at every emergency exit and in the main office area:

An emergency drill for all employees is to be conducted every six months. These drills are recorded and a note made of any further improvements or training needed.

All emergency equipment including first aid kits and fire extinguishers are checked and replenished as necessary by the Manager.

Possible Emergencies

Natural: Earthquake, earth movement/slip, flood, heavy snowfall, tsunami, volcanic eruption. Man-made: Injury, chemical spill, fire, gas leak, missing person, power failure, and vehicle accident.

Whilst every event is unique, there are some basic steps to follow when responding to any emergency, which are outlined below:


1. Fire

Response actions (as appropriate)

Discovery of a fire

Activate the fire alarm

Call 111

Warn anyone in immediate danger

If no personal danger and safe to do so extinguish the fire

On hearing the fire alarm

Evacuate the building using the nearest fire exit

If indoors, time permits, and there is no danger, close all doors and windows

If outdoors ensure that you and any others are removed from the scene and are at no risk

Fire Wardens should direct colleagues, clients and visitors in their area to the designated assembly point(s)

Ensure workers and clients with disabilities are assisted by a responsible person

Walk calmly and quickly and avoid panic

Fire Wardens to check rest areas, bathrooms and common rooms en route to the designated exit point

Returning to the building Ensure all employees remain at the evacuation point until clearance to leave is given. Do not return to the building(s) until given the all clear by the Fire Service.

The continuing operation of work will be determined by the nature of the fire and the availability of resources such as building, employees and other resources. The responsibility of whether or not to continue work rests with the manager.

In the event that a designated Fire Warden is not available, the most senior person present will act as Fire Warden.


2. Earthquake


During an earthquake

If indoors:

• Drop to the floor, take cover under a desk or table and hold onto the legs until the shaking stops.

Keep away from shelves containing heavy objects and other large items of furniture.

Keep away from windows.

Stay indoors until the shaking stops and it is safe to go outside.

If outside:

Move away from buildings, trees, streetlights and power lines, then.

Drop, cover and hold.

When the shaking stops Keep calm and ensure your personal safety first

Check on those around you and offer assistance if necessary

If anyone requires medical assistance, call 111 and/or administer first aid

If the area is unsafe evacuate to the site disaster assembly areas:

Keep staff and clients away from dangerous areas

Ensure electrical sources and gas taps are turned off

If the office is located near the coast be aware of the possible risk of tsunami

Listen to the radio for instructions from Civil Defense.

Ongoing operations following an earthquake

The continuing operation of the organisation will be determined by the severity of the earthquake and the availability of resources such as buildings, services, equipment, staff and other resources.

The responsibility of whether or not to continue work rests with the Chief Executive Officer.


3. Serious Injury


Serious Injury

Keep calm.

Ensure your own safety and the safety of others.

Assess area for danger e.g., live wires, poisonous substances

Raise the alarm and get a person to contact Emergency Services on 111

First aid treatment as required. Do not assume death has occurred - give immediate first aid.

Notify the Chief Executive Officer: isolate and contain the area.

If notifiable, preserve the scene and notify WorkSafe NZ for scene clearance.

Complete appropriate forms.

4. Extreme Weather Conditions


Prior to coming into work If any adverse weather conditions (heavy snow fall, gale force winds, and

heavy rain warnings i.e. flooding) that could risk your health and safety in the workplace transpires before you are due to commence work, make contact with your manager.

If any adverse weather conditions that could risk your health and safety in the workplace transpire during work hours, make contact with your manager.

Each situation will be assessed at the time and a decision made as to whether work will commence, continue or cease for the day in question.

Storm conditions /flooding reported or sighted in the workplace

Ensure all windows and doors are closed.

Pick up any debris around the outside of your workplace that could become airborne.

If you have to move outdoors be aware of flying debris.

During heavy rain be mindful of surface flooding caused by overloaded stormwater systems or blocked drains.

Check the source of the flood and that no employees, clients or visitors are in danger.

Switch off any electrical equipment that could be affected by floodwaters, and move any valuable documents or equipment to a safe area.

If flood is due to burst pipes turn off water at the mains if possible.

If safe to do so, move equipment onto higher areas.


5. Tsunami

Response actions (as appropriate):

Don’t wait, just evacuate Listen to your radio or TV for advice and information.

Don’t wait to be told to evacuate if a strong earthquake occurs and your worksite is located in an area at risk of a Tsunami. Evacuate if instructed by Civil Defence.

Evacuate everyone to high ground

Evacuate at least 1 km inland or 35 meters above sea level (which ever one is highest), by vehicle if possible

All employees and visitors will be accounted for.


EMERGENCY

FIRE POLICE AMBULANCE

111 WORKPLACE LOCATION

151 Tay Street, Invercargill Emergency Assembly Point:

grass section in front of building

IMPORTANT PHONE NUMBERS

Mike Grant 027 4716 095 Kew Hospital 03 218 1949

Elton Smith Invercargill Police 03 211 0400

Electricity Supplier

National Poison Centre 0800 764 766 Electrical Faults (PowerNet) 0800 808 587

WorkSafe NZ 0800 030 040 Plumber

FIRST AIDERS

Employee Name (Job/Area) Employee Name (Job/Area)




Information and Training Policy

The safe induction and training of SRFA employees is the first step in keeping everyone safe. IIt gives us the chance to explain in detail the hazardous situations firefighters will encounter as well as the specific health and safety requirements of our roles. New Employees

New employees will be under the direct supervision of a qualified and experienced person until they complete the required training standards. Training can be formal (i.e. unit standards), task specific (i.e. MVA training), refresher training (i.e. use of equipment and procedures) or informal and as required. All training must be documented. All training must be delivered in such a way that it is clearly understood and competency must be assessed at the completion of each training session or block of training. Explain: • The activity or process • How it works • Hazards and how to avoid them • How and when to use safety equipment • How to stop and start machines and equipment • How to check and adjust before starting or using equipment • Location and operation of other controls • Purpose of guards and safety devices • Correct work methods to be used • Emergency Procedures. Get the trainee to repeat or demonstrate back to you. Supervise until you are satisfied that they can do the work in a safe manner. Follow up and re-test from time to time. Make sure the trainee knows that if in doubt they should ask and not try to work things out on their own. Refer to Fire Response Plan for current competencies.

Record of Employee Skills

Qualifications, assessments and/or relevant training will be recorded for each employee. This can be found in the SRFA training database and Fire Response Plan. The level of skill, competency and independence to complete a certain tasks must also be included.

The SRFA Induction checklist will be used to introduce new personnel to the Southern Rural Fire Authority. This includes fire management staff, volunteers, contractors and stakeholder organisations (where they will be involved in rural fire operations). Completed copies of the checklist are to be kept by the originator and a copy sent to the SRFA.


SRFA Fire Plan Standing Instructions

Only firefighters who are safely clad are permitted on the fire ground. Clothing must protect personnel from physical injury, exposure to radiant heat and build-up of metabolic heat

SRFA Code of Safe Conduct

SRFA adheres to the following values: Understand the values that underpin High Reliability Organisations.(HRO)

1. Preoccupation with Failure HROs do not ignore any failure, no matter how small, because any deviation from the expected

result can snowball into tragedy. It is necessary, therefore for HROs to address any level of technical, human or process failure immediately and completely. It's also important to be somewhat fixated on how things could fail, even if they have not.

2. Reluctance to Simplify HRO’s are complex by definition and they accept and embrace that complexity. HROs do not

explain away problems, instead they conduct root cause analysis and reject simple diagnoses. 3. Sensitivity to Operations HROs understand that the best picture of the current situation, especially an unexpected one,

comes from the front line. Because front line employees are closer to the work than executive leadership, they are better positioned to recognize failure and identify opportunities for improvement

4. Commitment to Resilience Resilience in HROs means the ability to anticipate trouble spots and improvise when the

unexpected occurs. The organization must be able to identify errors for correction while at the same time innovating solutions within a dynamic environment.

5. Deference to Expertise Expertise, rather than authority, takes precedence in an HRO. When conditions are high-risk

and circumstances change rapidly, on-the-ground subject matter experts are essential for urgent situational assessment and response.

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Worker Participation, Engagement and Communication

SRFA provides all reasonable opportunities for any employees and contractors to participate in ongoing processes for improving health and safety. Good communication and an effective team is our approach to health and safety. Open communication is critical for identifying, assessing and controlling hazards and risks in the workplace. All workers are required to report any new hazards and their associated risks as well as engage in the regular hazard review process. All workers are required to report any injuries, incidents, illness or discomfort as per our Incident and Injury Reporting and Recording Procedures. Every worker must take reasonably practicable steps to ensure: Their own safety while at work; That no action or inaction of the worker while at work, causes harm to any other person(s); They follow all policies and procedures set by SRFA; That all personal protective clothing and equipment is worn and used.

Regular Employee Meetings

Health and safety is a component of our regular monthly staff meetings. Relevant information about legal or other health and safety requirements must be advised and discussed during these regular meetings. The Health and Safety forum (made up of Volunteers and agencies) meet every three months. These meetings are intended: To raise awareness of health and safety issues; For education on health and safety matters; and To set and agree standards regarding health and safety.

These forums must also be used for employees to: Be involved in the development of policies and procedures to manage risks; Be consulted where there are any changes that affect workplace health and safety; Put forward ideas to improve health and safety; Be advised of the outcome of any accident investigation, or significant hazard reported since the previous

meeting; Be advised of any relevant accidents or incidents that have occurred elsewhere in the industry that the

Directors/Manager and other workers have been made aware of. Notes of each forum discussion must be recorded. Notes will be followed up as soon as possible by the appropriate persons.


Other People at the Place of Work

When we employ contractors or subcontractors to carry out work in our workplace we are what is known as the ‘Principal’ (definition below).

It is therefore important that we ensure all our contractors are aware of our safety rules and procedures.

Failure to do this and in the unfortunate scenario where a contractor is injured (even if they are at fault) may expose us as the Principal to a prosecution.

Definition

“Principal”- Principal means a person who or that engages any person (otherwise than as an employee) to do any work for gain or reward.

Policy

As a principal, we are required to take all practicable steps for a contractor’s safety and the safety of their employees. To achieve this:

We will undertake a pre-qualification appropriate for the type of job we are contracting out.

We as the Principal will advise all “regular/approved” contractors in writing of standards to be met. Refer to “Contractor Agreement” (Form No. 10 ) or an on-site meeting to sign off on workplace hazards, their associated risks, risk controls and relevant policies and procedures.

We will notify contractors of all hazards and associated risks (and the controls) they may be exposed to whilst the contractor is undertaking work in our workplace. Providing them with a detailed copy of the workplace map will assist us in doing this.

Contractors are expected to:

Provide us (the Principal) with documentation to confirm they have met and comply with their own responsibilities under the Health and Safety at Work Act 2015.

Inform us of what hazard they are bringing with them, into our workplace.

Provide us with health and safety records including accident and incident data.

Advise us (the Principal) of all incidents or injuries, any new hazards found or concerns while they are working in our workplace.


Contractor Engagement

The level of detail required for pre-qualification will be appropriate for the type of work being undertaken, its complexity, risk and duration. For the purposes of our contractor engagement and management procedure, contractors will be classified into three levels. The purpose of the pre-qualifying process is to ensure that we only engage contractors who have safe systems and processes in place to ensure all workers go home safe from our workplace at the end of the day. After qualifying a contractor we will continue to communicate and collaborate about all work activities to ensure that risks associated with their work do not cause harm to others working in the same area and that other work being carried out by us or other contractors does not harm any workers. Level 1 - High risk Level 1 Contractors who: Undertake jobs that would be project like in nature; and/or Are undertaking activities considered moderate to high risk as per risk table. Emergency Incident Response. All Level 1 contractors must be formally assessed and approved prior to and in emergency situations. Other than for emergency incident response: We will determine what work needs to be contracted out, and consider the broad health and safety implications. We will carry out an initial appraisal of the significant hazards and their associated risks relating to the work of the specific project or task. We will provide any significant health and safety information to our potential contractors which will include our workplace map (buildings only), our risk register, emergency procedures, relevant policies and reporting requirements. The contractor will be required to submit supporting documentation prior to assessment. We will complete the following checks under our due diligence obligations:

Check any references from the contractor’s past jobs that are the same or similar in nature;

Verify that the contractor is qualified, licensed and authorised to carry out the type of work we are engaging them to do;

Review evidence that the tools and/or equipment the contractor uses are well maintained and meet relevant safety standards (example electrical tagging, maintenance policy, recent codes of compliance);

Review risk assessments and site safety plans;

Review the contractor’s processes for safety induction, supervision, monitoring and risk assessment;

Review the contractor’s safety management system;

Obtain evidence from the contractor regarding their history of:

- notifiable injuries or events;

- lost time injuries, i.e. injuries that have resulted in a worker being unable to report to their next shift;

- medical treatment injuries;

- operational safety, e.g. details of prohibition or improvement notices;

- notifiable illness data;

Verify the contractor’s willingness to agree to regular monitoring and supervision;


Consult with the contractor to ensure risks and controls are communicated and understood by both parties;

Review the contractor’s drug and alcohol policy.

It will be the responsibility of the Manager engaging the contractor to ensure the audit of the contractor is completed prior to any work being carried out by the contractor.

For Emergency Incident Response Unless the contractor has been prior inducted, a full induction appropriate to the situation will be undertaken prior to tasking Awarding the Contract The health and safety responsibilities of the scope of work must be written into a contract and agreed with the contractor. After the contract has been signed and approved, the contractor must be recorded on the approved/preferred contractors list. The Manager must ensure all contractors undergo a Health and Safety Induction, prior to commencing any work on site. This includes making sure all contractors, sub-contractors and their workers are aware of our: Hazard / Risk Register. Emergency procedures. Incident and accident reporting requirements. Requirement for personal protective equipment. Health and Safety Management Plan. Workplace layout/map. “No Go” zones. Nearest evacuation assembly area. First Aid Kits. Induction Forms must be signed by all Contractors. For emergency incidents this will be noted on a T Card and filed. Any new employee to the site working for an already inducted contractor or subcontractor must be presented with the Health and Safety documents listed above and sign the relevant induction form kept in the completed inductions file. Contractors are expected to familiarise themselves and their employees and subcontractors with the above documentation. Each time a contractor comes onto site they will be required to sign in and out. For emergency incident, this is the Incident Control Point. All inductions are valid for two years. Annual updates will be emailed to contractors if new risks arise during the two year period.


Level 2 - Low Risk Level 2 Contractors are persons/Organisations who: Could be engaged at short notice; Perform the same job for us on a frequent basis; and/or Are undertaking activities considered low risk using the Risk Matrix. It is be the responsibility of the team member engaging the contractor to ensure that the Contractor Health and Safety Agreement and the contractors documentation has been verified prior to the contractor commencing work for us. Contractors are required to provide the following applicable documentation and information: Provide a copy of their health and safety policy; Risk register and/or a JSA for specific work activity being completed; Verification of competency (adequately trained personnel); Any required certificates and permits; Accident reporting procedures; Emergency procedures; Verification of machinery; Plant and equipment maintenance. The Manager must ensure all contractors undergo a Health and Safety Contractor Induction, prior to commencing any work on site. This includes making sure all contractors, sub-contractors and their workers are aware of our: Risk Register; Emergency procedures; Incident and accident reporting requirements; Requirement for personal protective equipment; Health and Safety Management Plan; Workplace layout/map; “No Go” zones; Nearest evacuation assembly area; First Aid Kits / fire extinguishers. Contractor Induction must be signed by all Contractors and the Manager and filed with the Completed Inductions File. Any new staff to the site working for an already inducted contractor or subcontractor must be presented with the Health and Safety documents listed above and sign the relevant contractors’ induction form kept in the completed inductions file. Contractors are expected to familiarise themselves and their employees and subcontractors with the above documentation. Each time a contractor comes onto a building site they will be required to sign in and out at the Main Reception/Office. Level 3 - If level 1 and 2 are not applicable Level 3 one off situations Level 3 pre-qualification phase is to only be used if a Contractor needs to be engaged immediately and there is no time for document exchange. This should only be cases of emergency other than emergency incident response


We still require the Contractor to undergo a site induction process. This includes making sure all contractors, subcontractors and their workers are aware of our: Risk Register and the hazards and risks they may be exposed too; Emergency procedures; Incident and accident reporting requirements; Requirement for any personal protective equipment; Health and Safety Management Plan; Workplace map/layout; Any “No Go” areas; First Aid Kits / fire extinguishers. The Contractor Induction must be signed by all Contractors and the Manager, or their chosen Co-ordinator, and filed with the Completed Inductions File in the office.

Each time a contractor comes onto site they will be required to sign in and out at the Main Reception/Office.

Contractor Monitoring Contractors engaged on site will be: Regularly monitored for following health and safety practices agreed in the contract; Investigated following any incident or injuries; Notified of any breaches or concerns; Evaluated post agreement. We as the Principal will review the JSA or standard operating procedures provided to ensure the job was completed in line with these documents. SRFA will keep and maintain an approved/preferred contractors list for aircraft to ensure contractors engaged by SRFA are committed to Health and Safety. This is to be reviewed at least annually, following the completion of a job and updated as necessary. Should a contractor breach any SRFA policy or procedure, the Health and Safety Co-ordinator will notify the person or SRFA immediately and require the matter to be rectified. Continued breaches, a serious breach or failure to rectify could result in the Contractor being stood down and not being engaged to complete future work at SRFA and they would be removed from the preferred contractor list.

Multiple PCBU’s in a Workplace

We recognise the potential for multiple Organisations and workers to be working together in our workplace. We will ensure workers are aware of others in the immediate area. SRFA will consult, cooperate and coordinate with other third parties workers who are performing work on our property as appropriate, regarding health and safety. It is our expectation that our contractors will similarly interact, consult, cooperate and coordinate activities as well as exchange relevant health and safety information. At a minimum this will involve an exchange of overlapping JSA’s and hazard and risk management. We also expect workers to be engaging in workplace meetings together. As part of our contractor monitoring and management we will ensure consultation, cooperation and coordination is occurring.

Visitors to the Workplace SRFA is committed to the health and safety of visitors to our workplace. We seek to ensure all visitors are not harmed while in our workplace. Visitors will be required to adhere to our workplace policies and procedures in respect of health and safety.


To ensure the health and safety of visitors to workplace:

Visitors will be regularly monitored whilst in the workplace.

If an incident or accident were to occur involving a visitor in our workplace, a SRFA employee will obtain the relevant information and complete the appropriate notification forms.

SRFA will maintain clear signage including emergency procedures, emergency exits and emergency assembly points.

SRFA will have the appropriate hazard and risk controls in place in our workplace by implementing the hierarchy of controls. If a visitor is performing a task that exposes them to risk or requires an administrative control and/or PPE, there will be consultation and discussion prior to completing the task.

The visitor is responsible for:

Signing in and out at the Office or Incident Control Point upon arrival and departure.

Acting on the instruction of all employees in the residence in the case of an emergency.

Reporting any accident or incident to a SRFA employee.

Advise a SRFA employee of any special assistance that may be required in case of an emergency requiring evacuation. Where visitors are not complying with SRFA health and safety requirements, the employee responsible for the visitor will first discuss the concerns with them including the potential risks they are posing. If the behaviour or conduct continues, the visitor person will be asked to leave the workplace.


Contractor Agreement No. 10

Date ___________________ Dear

Re: Contract For Southern Rural Fire Authority

To comply with the Health and Safety at Work Act 2015, we require all contractors who wish to tender for contracts or maintain a service agreement/remain a preferred contractor/supplier to provide the following information:

1. Health and Safety Management Plan that includes:

Hazard / Risk Register; Emergency procedures; Incident and accident reporting requirements; Requirement for personal protective equipment; Health and Safety Management Policy Statement; First Aid Kits/Fire extinguishers locations; Policies and procedures specific to the work being carried out; Accident and incident data; and Assurance of suitably trained employees.

2. Contractors are reminded that all work is subject to the provisions of the Health and Safety at Work Act 2015.

Contractors must consult, co-operate with and co-ordinate activities with all other PCBUs working in the workplace at the time.

Contractors are to comply with all regulations, enactments, codes of practice (approved or voluntary) applying to the trade or profession within which they operate.

SRFA, are to be advised of any and all hazardous plant, equipment, machinery or substances which are brought into our workplace.

All people utilised are fully trained in the work to be undertaken or are closely supervised by someone who is.

In the “event” of a death of a person, notifiable injury or illness, or a notifiable incident that occurs in our workplace, in addition to being recorded and notified under the Health and Safety at Work Act 2015 to WorkSafe NZ, it must be reported to us, as the Principal.

All safety clothing/equipment required to minimise the risk of injury is to be provided by the Contractor, accessible to and used by any person engaged in the workplace.

3. Before commencing work for us, all contractors must ensure that any workers of the contractor, subcontractors on our premises, or if an individual, they are conversant with:

Risk Register; Emergency procedures; Incident and accident reporting requirements; Requirement for personal protective equipment; Health and Safety Management Policy Statement; Workplace layout/map; “No Go” zones; Nearest evacuation assembly area; First Aid Kits/Fire extinguishers locations; Policies and procedures specific to the work being carried out; Safety rules and procedures as outlined on our risk register and as per relevant industry

guidelines on the WorkSafe NZ website (http://www.Organisation.govt.nz/worksafe/ information-guidance/guidance-by-industry) and/or the NZ safety standards website.

http://www.business.govt.nz/worksafe/


4. We as the Principal to the contract retain the right to inspect the contract operation at any time, to ensure all safety procedures and rules are being followed. Failure to follow such rules and procedures may result in the contract being terminated immediately.

5. Where any policy and/or procedure of ours contradicts any policy and/or procedure of the contractor’s, our policies and procedures will prevail whilst work is being conducted in our workplace unless both parties mutually agree to something different.

I agree to abide by all the above conditions, on behalf of:

Contractor’s Name:

Contractor’s Signature:

Date:

Contact Phone:

Sign the attached copy and return with your Health and Safety Management Plan/Manual


Engaging Clients/Customers

Policy

Southern Rural Fire Authority is committed to providing a safe working environment in all locations workers work, which obviously includes our client’s/customers workplace/s. We will attempt to engage all of our clients/customers so they play their part in providing a safe and healthy workplace. Southern Rural Fire Authority has created an Off Site Issue Form for employees to provide feedback on any health and safety concerns and issues that arise whilst in a client’s/customers workplace. When a health and safety issue arises or is identified in a client’s/customers workplace, the form needs to be filled out as soon as possible and returned to the Health and Safety Co-ordinator

Procedure for Engaging Clients

Management will advise all clients/customers in writing of the health and safety standards that Southern Rural Fire Authority expects before they are willing to complete work. Clients/customer will be sent the “Customer/Client Engagement” letter. Southern Rural Fire Authority will request all relevant client/customer health and safety details (e.g. their master risk register, health and safety policy, emergency procedure process and accident reporting information) and ensure employees are aware of these before completing work for that business.

On Site Issues Procedure

The completed forms are to be scanned and emailed, posted or hand delivered to the Health and Safety Co-ordinator as soon as possible. The Health and Safety Co-ordinator will follow up the concern with the customer/client. If no action is taken to correct the concern then they will follow up with the customer/client and will not complete any work until the hazard, risk or concern is addressed. Any hazards identified during this process and not on the risk register should be filled in as soon as possible. If any employee has concerns about how the issue or concern has been resolved please contact the Health and Safety Co-ordinator or complete a new On Site Issue form.


Contractor Engagement No. 11 Date: ___________________ Dear: SRFA is committed to providing all of their employees with a safe and healthy work environment. We are committed to communicating and collaborating with our clients to ensure our employees are not exposed to uncontrolled hazards whilst carrying out work at your site /location we also want to ensure we do not expose any of your employees or anyone else to any uncontrolled risk. Before we begin to provide services to you, we require an assurance that you are committed to a safe and healthy workplace for all contractors coming on to your workplace. More specifically we request that you: 1. Provide us with a copy of your site /location map highlighting “no go” areas and with relevant risks

identified (i.e, slippery areas, risky areas, chemical cupboards, etc.). 2. Provide us with a Master Risk Register for your site /location. 3. Ensure any necessary induction is completed before our employees begin work in your site /location,

including emergency procedures.

4. Provide a Health and Safety Policy Statement for your site /location. We appreciate your cooperation and commitment to the safety of our employees. Yours faithfully

Mike Grant CHIEF EXECUTIVE SOUTHERN RURAL FIRE AUTHORITY


Hazardous Substances Management

Policy

Our policy is to ensure safe storage, safe use and safe disposal of all hazardous substances that come into our workplace. Compliance with relevant legislative, regulatory and Council requirements is essential. www.hazardoussubstances.govt.nz contains vital information on each hazardous substance and product and is our reference to safely storing, using and disposing of hazardous substances in our workplace.

Definitions

Hazardous Substance (a) Any substance with one or more of the following intrinsic properties: Explosiveness, flammability, a

capacity to oxidise, corrosives, toxicity (including chronic toxicity), ecotoxicity, with or without bioaccumulation.

(b) A substance that, when in contact with air or water (other than air or water where the temperature or

pressure had been artificially increased or decreased) generates a substance with any one or more of the properties specified.

Material Safety Data Sheet (MSDS) A document that describes properties and use of a chemical product or formulations - identified chemical and physical properties: health hazard information, precautions for use, safe handling, first aid and disposal information. This must have a New Zealand emergency contact phone number and address and should be no older than five years. It should also have 16 points or sections to it. This must be available to employees within 10 minutes. Safe Storage We will store chemicals on shelving that is made of non-combustible materials. We will ensure we have appropriate equipment available to ensure that any leaks or spills are adequately contained. We will ensure the storage location remains locked. We will ensure we do not store incompatible chemicals together by referencing MSDS sheets upon delivery to our site. Using the HSNO calculator we will ensure we have an adequate number and appropriate types of fire extinguishing equipment available. We will ensure our employees are trained and competent in the use of fire extinguishers. We will ensure:

All chemicals and fuels will be kept in their original packaging and only the smallest amount possible will be stored, in the correct upright position away from heat/flames;

If packaging becomes damaged or the substance needs to be transferred to smaller containers, clean containers that will not react with the chemical will be used, and must be labelled clearly;

Material Safety Data Sheets (MSDS) will be displayed with all the chemicals;

Containers will be checked regularly to make sure they are in good condition.

The chemical store/location will have the correct safety signage displayed.

Display signs in all storage area entrances, including vehicle access points, and these will be at eye level.

http://www.hazardoussubstances.govt.nz/


If storage is in a room inside a building, display signs at the building entrance and at the entrance of the room.

Signs will be big enough so they can be read from 10 metres away. We will replace any faded or worn signage.

Safe Use Check the product on www.hazardoussubstances.govt.nz and comply with all recommendations and information as well as the product label and MSDS. Those handling the products must be familiar and trained to do so, this includes being familiar with the emergency response should something go wrong while using the product. Any contractor using hazardous substances must have the correct approved handler certificate for the type of work and product they are using. Personal hygiene is important when working with chemicals always wash your hands, arms and face, especially before eating, drinking, and smoking. It is recommended that you always shower or bath at the end of the day using soap and washing hair. Clothes that were worn during chemical handling should be washed separately from other washing. Safe Disposal

If disposal is necessary follow the disposal instructions on the product label, HSNO website and any requirements on the MSDS. Do not mix the hazardous waste with normal rubbish or pour it down the sink, stormwater drain or onto the ground. Spill Kit

A spill kit is readily available. The Manager will regularly review the hazardous substance register, the product label, the corresponding MSDS and information on the hazardous substances website to ensure the kit remains appropriate for the substances stored. All employees to be trained on how to safely use the spill kit and an induction process for all contractors.


Monitoring Employee Work Fitness

All employees must be fit for work. Unfit employees can be unsafe. Refer Rural Fire Health and Fitness Programme Policy - October 2014

“Fit for work” means a person can physically and mentally perform assigned tasks competently and safely. Fitness for work can be affected by: Fatigue; Dehydration; Psychological and emotional issues; Environmental factors; Alcohol and drugs; Prolonged noise; Repetitive movements and manual handling. Pre-Employment We will incorporate a self disclosure question into our recruitment processes when selecting new employees. The onus is on the job seeker to be open and honest in disclosing any condition that may prevent them from carrying out any aspect of the position. Ongoing Monitoring SRFA is committed to resourcing health monitoring where appropriate. The purpose of ongoing health monitoring is to enable the proactive management of health for workers. In particular, SRFA tests as per our policy. Post Event Testing In the event of an accident, incident or illness where an individual’s health may have been harmed, health testing or monitoring may be required to assess or treat any injury. General Any concerns in regard to health or fitness for work should be reported to the Manager. Consent will always be obtained from the individual for all types of testing detailed above and for the release of the results. Any health records will be kept confidential. Alcohol and drugs

Refer Policy - Drug and Alcohol - October 2016.


Return to Work

SRFA is committed to helping employees get back to work safely. We provide a proactive return to work (RTW) process to help employees who have suffered work related injuries or illnesses return to their previous role. This includes liaison with the ACC case manager in the development and implementation of a personalised return to work programme. Effective communication following an injury is critical. If the employee sees a doctor they must inform their supervisor how they got on and provide the following information: The diagnosis of the injury or condition, The type of treatment prescribed (e.g., physiotherapy, medication), Advice on work tasks and hours, graded return to work and a worksite assessment.

When an employee has been prescribed time off work, the Manager will keep in regular contact, at least weekly, to discuss: Any concerns about job security and demands on the employee’s return to work, Workplace issues and changes, Different methods of returning to work, Issues regarding transport to and from work. All discussions will be documented in employees file. Similarly all employees are required to keep SRFA up to date with any information regarding their injury treatment, assessment and management.

It is our policy, that where appropriate work is available we will provide light duties and/or reduced hours.


Working Alone and Remotely

Working alone is work carried out in an area where normal means of contact (e.g. verbal, sight) with other staff are not available, so that the potential risk of existing hazards is increased to the extent that extra precautions are needed. This may include working in isolated areas on-site or off-site, either during or outside normal working hours. All employees must carry a cell phone with them whilst working alone or in remote locations. The phone must be kept within reach at all times so you can access it quickly if something goes wrong. If there is no cell phone coverage, a satellite based communication system should be used e.g. Spot. If an employee is working in a particularly isolated or remote area, they will be expected to check-in with management/office on an hourly basis, where possible, using text messages. Check with the Manager prior to departing around the check in time expectations. All employees are required to communicate regarding expected time of return as well as communicating when they have arrived home safe if they have been working remotely. In high risk scenarios we will implement the buddy system. Employees are aware that they may request a second person be made available at their reasonable request. Do not enter any situation or location where you feel threatened or unsafe.


Smoke-free Working Environment

SRFA recognise that the use of tobacco and smoking presents a health hazard that can have serious implications for both the smoker and the non-smoker and that smoking habits may have life-long adverse consequences. We support a safe and healthy environment free from smoking in accordance with the Smoke-free Environments Act 1990. This policy was developed based on the following principles: 1. Everyone is entitled to a smoke-free environment in all the areas normally used for work. 2. Everyone who does not smoke, or who does not wish to smoke in their place of work, must, as far as is

reasonably practicable, be protected from tobacco smoke in their place of work. 3. The implementation of this policy depends on everyone responding courteously to the desire for a smoke-

free environment. We will maintain smoke-free signage.

Smoke-free buildings:

Smoking in buildings is prohibited as it endangers the safety of others, creates an unhealthy environment and causes damage to property. In the event that an employee chooses to smoke, a designated area, such as outside of the premises, should be used.

Passive smoking:

Smoking is permitted in outside designated areas, provided others are protected from smoke drift and passive smoking by the smoker keeping their distance from people, open windows and open doors within their close proximity. Complaints:

Complaints regarding smoking and suggestions or complaints regarding a smoke-free environment should be brought to the attention of the Manager.


Appendix

Reference Southern Rural Fire Policy Document

r/14/9/14031 Emergency Vehicle Response

r/14/9/13982 SRFA Policy Code of Conduct - October 2014

r/16/9/15576 SRFA Policy Drug and Alcohol - December 2016

r/15/10/18132 SRFA Induction Policy - October 2015

r/16/1/113 SRFA Induction Package - April 2016

r/14/9/13941 SRFA Rural Fire Health and Fitness Programme - October 2014

r/14/9/14001 SFRA Policy Fire Equipment Servicing

r/16/9/15423 SRFA Fire Response Plan - October 2016

r/16/2/1503 SFRA Policy Use of “SPOT” GPS devices

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