Example RA Falls from Height General Risk Assessment Form

NorthumbriaUniversity

Appendix 3General Risk Assessment Form

DATE:ASSESSOR:LOCATION:ASSESSMENT

AREA/ACTIVITY GENERIC WORKING AT HEIGHT RISK ASSESSMENT

Item no. / Activity/equipment/materials, etc. / Hazard / Persons at risk / Severity / Likelihood / Priority
H 48-100
M 20-40
L 0-16 / protective measures required /

Result*

1 / Falls and falling materials in connection with Roof Work / Staff
Contractors personnel
Users of premises
Students / Falls from height resulting in death, serious injury
Struck by falling materials
Accessing scaffold systems / a) Only approved contractors to be used following receipt of method statement and risk assessment.
b) Contractor to be advised by person commissioning work of any specific risks inherent to the premises, (e.g. fragile structures, roof lights) when quoting for work.
c) Contractor to prepare job specific risk assessments detailing how he will control risks associated with work at height, including access, egress, storage and movement of materials, segregation and control of work area. These to be agreed with the Estates Department representative
d) Where work is to be carried out and protection is not afforded by the structure of the building, physical guardrails and edge protection must be installed, prior to commencement of work at height where a person may fall through any distance.
e) In all circumstances, fragile roof lights must be physically protected to prevent people falling through them
f) Fragile roof structures identified and signed. Contractor to determine safe system of work to these areas on an individual basis
g) Work area to be protected by secure fencing to prevent access by students.
2. / Use of ladders and step ladders / All users / Falls, breaks, fatality / Only industrial class 1&2 step ladders and ladders to be used. Ladders will be stored in clean dry easily accessible areas and not subject to excessive heat or dampness
Employees should carry out a visual inspection prior to use
…………………. will ensure that all stepladders and ladders are inspected for wear and damage by a competent trained person on a monthly basis. The details should be entered onto a ladder register. The competent trained person is…………………………….. and the ladder register is held by ……………………………..
If the ladder shows signs of excessive wear or damage, it will be taken out of use immediately and labelled UNSAFE DO NOT USE.

Northumbria University – Risk Assessment Form

To be completed by the manager undertaking the risk assessment
Name: Job Title:
Signature: Date:
To be completed by the Senior Manager
I consider this risk assessment to be suitable and sufficient to control the risks to the health & safety of both employees undertaking the tasks and any other person who may be affected by the activities.
Name: Job Title:
Signature: Date:
NB – if senior managers do not agree that the risk assessment is suitable and sufficient then the assessment must be reviewed.

Generic RA Falls from Height