Five Star Health and Safety Management System Audit Report

Five Star Health and Safety Management
System Audit Report

York College
Sim Balk Lane
York
YO23 2BB

Audit by: Will Wilkinson
Date of audit: 24 27 June 2013
Reference number: FSA/209272

Version 1.1

Private and Confidential
Content

Introduction
Disclaimer
Background
Scope
Audit scoring
Grading system
Action planning

Audit outcomes
Executive summary
Five Star Audit result

Audit findings
Section 1 Policy and Organisation
1.01 Safety policy statement
1.02 SMS scope, nature and scale (control arrangements)
1.03 Leadership and commitment
1.04 Roles and responsibilities
1.05 Document management
1.06 Consultation and communication
1.07 Competence and capability
1.08 Occupational health and wellbeing
1.09 Change management

Section 2 Strategy and Planning
2.01 Occupational health and safety objectives
2.02 Occupational health and safety plan
2.03 Benchmarking and initial review
2.04 Provision of resources
2.08 Risk management and control
2.09 Risk profiling
2.11 Legislative compliance
2.12 Emergency incident planning
2.13 Procurement and design (including contractor approval)
2.15 Sustainable health and safety attitudes and behaviour

Section 3 Implementation and Operation
3.01 Risk management and assessment
3.02 SMS controls (general)
3.03 Work equipment
3.04 Personal protective equipment
3.05 Manual handling
3.06 Workstation (DSE) ergonomics
3.07 Housekeeping, storage and welfare facilities
3.08 Traffic management
3.09 SMS controls (specific)
3.10 Permit to work systems
3.11 Safe isolation
3.12 Working at height
3.13 Lifting equipment
3.14 Pressure systems
3.15 Hazardous substances
3.16 Electrical safety
3.17 Management of noise
3.18 Management of vibration
3.19 Safe working/operating procedures
3.21 Sustaining occupational health and safety attitudes and behaviours
3.22 Emergency incident management
3.23 Fire safety management
3.24 Management of other potential emergency occurrences/Incidents

Section 4 Performance Measurement
4.01 Occupational health and safety plan (monitoring)
4.02 Occupational health and safety objectives (monitoring)
4.03 Active measurement
4.04 Inspections and audits
4.05 Risk assessment review
4.06 Legal and other requirements compliance monitoring
4.07 Health surveillance
4.08 Contractor and supplier monitoring
4.09 Documentation management
4.10 Reactive measurement
4.11 Accident, incident, near miss reporting and investigation systems
4.12 Ill Health and absenteeism monitoring
4.13 Loss/damage analysis

Section 5 Evaluation and Review
5.01 Management review and reporting
5.03 Continual improvement
5.04 Legislative compliance and other requirements
5.05 Occupational health and safety programmes and planning

Verification

Introduction
This audit was arranged by York College and conducted on behalf of the British Safety Council by
Will Wilkinson.

The auditor would like to take the opportunity to thank all management and staff for their assistance,
contribution and hospitality throughout the audit process.

The audit was conducted using the following process of objective evidence gathering:

The audit was conducted by reviewing key areas of the organisations health and safety documentation
and systems in relation to the requirements of the British Safety Councils Five Star Audit 2013
specification and was followed by an inspection of the sites and associated buildings.

The inspection process is used to determine the effectiveness of the implementation of the
organisations health and safety arrangements.

This subsequent report has been prepared to identify the strengths and areas for improvement within
the organisation's health and safety management systems and also to provide recommendations,
together with action planning, for consideration.

The Five Star Audit process involves an in-depth examination of an organisations entire health and
safety management system(s) and associated arrangements, focusing on the key aspects of their
approach to managing occupational health and safety in the workplace and offers a structured path for
continuous improvement towards best practice.

It is emphasised that the audit report will only comment on the conditions observed and impressions
formulated during the audit visit.
Disclaimer
Every effort has been made to ensure that all statements and information offered in this report are
provided in good faith and are related to observations made during the audit, together with information
supplied by the organisation. The auditor assumes that the aforementioned information supplied and
representations made by the organisation during the audit, on which the report is based, were current,
valid, accurate and complete. The organisation must notify the British Safety Council of any factual
inaccuracies, or misinterpretation of information provided by the organisation, as reflected within the
report.

The issues commented on in this report are limited to areas reviewed during the audit process, and
should not be taken as identifying all areas of possible unsafe conditions and/or contravention of
statutory requirements. Due to the dynamic nature of ongoing operational activity, the report may cease
to be entirely accurate immediately after being provided to the organisation.

All relevant information contained in this report may need to be disclosed to the organisations insurers.
The contents of the report alone may not be sufficient for their requirements and further information
may therefore be required. British Safety Council accept no responsibility to the organisation or their
(potential) insurers as a result of inaccuracies in the report arising for whatever reason, if the report is
disclosed for the purposes of obtaining insurance.

Background
York College is the largest provider of A Level and vocational programmes for 16 - 19 year olds in the
region, offering over 40 A Level subjects and 80 vocational programmes. The college also offers a
range of Higher Education courses for full and part-time study as well as many Adult Learning classes.
York College has a 60 million building and has state of the art facilities including a Theatre, Ashfields
restaurant, Hair and Beauty salon, Spa and Nail Bar, a 3G sports pitch and multi-use games area,
engineering and construction workshops, art and design studios and a Learning Centre on three floors
equipped with the latest technology. York College employs over 600 full time staff and employees in
teaching, management, administration, soft and hard facilities management, catering, cleaning and
security services. Its Senior Management Team (SMT) comprises of the Principal, two Deputy
Principals, four Assistant Principals and the Director of Finance. The College has a Construction Centre
in Osbaldwick, which provides training in apprenticeship skills within two separate facilities. In addition
there is a joint venture in the York Railway Academy with the College utilising the facilities and
providing learning environments for students.

The College is currently involved in assisting in an investigation by the enforcing authorities.

Scope
The scope of this audit has been agreed between York College and the British Safety Council and
includes the occupational health and safety management systems of the company and the sites visited,
which were agreed prior to the auditor attending the locations.

As requested by the client, this audit did not cover the past operations of the Nursery which is now
closed.

It should be noted that the findings and subsequent recommendations made within this audit report are
applicable to the aforementioned areas and activities only.

Audit scoring
The five sections of the audit are divided into sixty six (66) elements which attract a maximum
numerical value of 5000 points. Wherever an element of the audit is not applicable to the organisation,
it is subsequently withdrawn from the audit. Scores are expressed as a percentage of the total available
mark for each element, section and the audit as a whole. The total available mark is that which is
applicable to the organization and will discount areas of the audit that are agreed not applicable.

Throughout the audit, two safety management indicators (SMIs; sub-sections of leadership and
continual improvement) are evaluated either as elements within their own right in certain sections, or
alternatively as scoring areas within other elements.

The cumulative scoring for these two sub-sections are then converted into a percentage figure which
can provide an additional 0.5% - 2% to the overall audit grading when measured against the threshold
criteria shown below.

SMI 1 and 2 cumulative scoring
85% - 88% Add an additional 0.5% to overall grade

This aspect of the audit process is designed to encourage organisations to focus upon continually
developing their safety management systems and culture through demonstration of commitment and
robust leadership at all levels.

The verification process allows the auditor to record
Specific areas inspected
Personnel interviewed
Documentation reviewed

Grading system
The audit was conducted using the British Safety Councils numerical safety grading system.
Details of the scoring, together with recommendations for each element where the element fails to
score the maximum available is set out later in the report.

Action planning
The recommendations against the marked requirements of the Five Star Audit have been
presented in tabulated colour coded format as per the key below:

The red coded differential indicates where significant marks (over 40%) have been lost in respect of the
five star audit scoring criteria and the amber coded differential indicates where marks have been lost (1-
40%).

Wherever this is identified by the auditor, a recommendation will be provided that, if followed and
implemented, would assist the organisation in working toward best practice standards.

The green coded area indicates wherever full marks have been awarded in respect of the five star audit
scoring criteria. The organisation must monitor these elements in order to maintain best practice and
demonstrate continuous improvement.

The action planning tables are also designed to allow the organisation to plan for implementation of the
recommendations by populating the relevant columns as appropriate.

If any elements of the audit are not applicable to the audited organisation then this will be left blank
within the relevant table and indicated as N/A.

As with any time-bound audit, observations and recommendations made are based upon the scope and
depth of information reviewed during the process.

Audit Outcomes

Executive summary
The primary aim of this audit was to provide an external, independent assessment of the occupational
health and safety management systems and arrangements developed by the organisation and the
effectiveness of their implementation.

Five Star Audit result
The organisation was awarded an overall audited score of 93.14% and also achieved a cumulative
score of 93.22% within the Safety Management Indicator areas.

These outcomes equate to an overall star grading of: 5 Stars

A summary of organisational performance is provided in graphical format below:

Policy and Organisation
The College has established pertinent and applicable policies and arrangements and a strong
organisational focus for OHS&W. The College has ensured that they have understood the risks
faced by the Organisation and established and implemented a SMS applicable to those risks.

Strategy and Planning
The College has established an overriding strategy to for OHS&W and produced formal OH&S
objectives which are monitored through the management review process. The HS&W team ensure
that plans are produced to implement improvements in the SMS and continually report on
performance.

Implementation and Operation
The HS&W team have evolved and implemented the safety management systems in such a way
that it could be described as subtle which is refreshing to the auditor. The practical application of
the systems allows the staff to deliver and learners to receive practical training in trades such as:
Masonry, Welding, Electronics, Electrical and Mechanical Engineering etc. using well managed
facilities.

Performance Measurement
The College has established good performance measurement processes and this includes
OHS&W within the reviews and improvement strategies.
92.57%
93.87%
87.00%
86.04%
96.90%
97.33%
85.60%
SMI and section scores as a percentage of marks available.
Section 1 - Policy and Organisation
Section 2 - Strategy and Planning
Section 3 - Implementation and Operation
Section 4 - Performance Measurement
Section 5 - Evaluation and Review
Leadership SMI
Continuous Improvement SMI
The College has an opportunity for improvement by including positive indicators within the monthly
OHS&W reporting. These indicators give the organisation a view of the active performance within
each area therefore providing information not only of, deficiencies and areas where improvements
can be made but shows where safety excellence is being applied.

Evaluation and Review
The College ensures that all elements of the SMS are evaluated and periodically reviewed to
monitor performance, which feeds into the Governors report. The College would benefit from
ensuring that all legal and other requirements are evaluated and reviewed against the SMS and its
implementation.

Leadership
The Organisation has established clear roles and responsibilities, which are defined and
accountabilities set. Leadership principals are demonstrable through arrangements of the SMS and
the behavior of staff. OHS&W is prominently lead from the Senior Executive and effectively
communicated through good leadership at departmental level.

Continuous Improvement
Through the formal reviews of the SMS the College has established robust systems to monitor and
measure their improvement in safety which has had a positive effect on the reduction of injuries
and loss events.

93.22%
0.5% Bonus mark
1.0% Bonus mark
1.5% Bonus mark
2.0% Bonus mark
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Average SMI mark showing percentages required for bonus marks
Audit Findings

Section 1 Policy and Organisation

Overall Section Score: 85.60%

1.01 Safety policy statement
York College has produced a formal statement of intent which is signed by the Principal and Chief
Executive Officer, Alison Birkinshaw and in addition is co-signed by the Chair of the Corporation, J.
Short and is dated 18 April 2013.
The statement contains a commitment to comply with all legal and other standards that apply to York
College, and to prevent ill health and injury. The statement contains an explicit commitment to provide
training, information and instruction and to conduct periodic reviews, although it does not contain a
commitment to provide adequate resources, a commitment to continuous improvement, nor does it
outline the framework for setting OH&S objectives.
The Policy Statement and health & safety handbook are available on the College website and the
Policy posted in strategic locations around all premises and communicated to employees during the
induction process and through personal reviews.

1.02 SMS Scope, nature and scale (control arrangements)
The Safety Management System is described within the procedure Health and Safety Management
System dated May 2013, which follows the current model from HSG 65 Successful Health and Safety
Management, Plan, Do, Check, Act (PDCA). The procedure details the mechanisms used to continually
improve, although there are no formal control arrangements described such as procedures, schedules
of inspections and audits and specific schedules of reviews etc. That said Section 4 of the HSW Policy
describes the arrangements for health and safety and includes:
Information, instruction & training
Supervision
Competency
Accidents and work related ill health
First aid
Health surveillance
Monitoring
Emergency procedures
38.46%
100.00%
100.00%
100.00%
10.00%
92.86%
100.00%
100.00%
80.00%
1.01 Safety Policy Statement
1.02 SMS scope, nature and scale (control
arrangements)
Fire and evacuation
HSW manual.

Management reviews have been undertaken with senior management, key members of staff and the
Health and Safety team, which were described as the main process for determining the nature and
scale of the needs for the Occupational Health Safety Management System (OHSMS) and has assisted
in establishing suitable control arrangements.
The OH&S Manual describes the responsibilities of the organisation within section 3 and cover:
The Corporation
The Principal
Health and Safety Advisory Manager
College Managers
All Staff
Students
Contractors
Visitors (members of the public)

Within the Health Safety & Welfare Policy (HSWP) appendix 1 is how the Organisation will manage risk
within Risk Assessment, which shows each area and its activities and issues responsibility to managers
to ensure that risk assessments are undertaken and the risk controls employed and monitored.

The ultimate responsibility for Occupational Health and Safety is the Principal, Allison Birkinshaw who
has formally appointed David Jackson designated as the responsible person to manage health safety
and welfare on the Colleges behalf. David has a team of two HSW Advisers and an HSW Administrator
to assist in discharging the duties of the College regarding OHS&W.
Through involvement in the many reviews and active monitoring processes it is evident that leadership
in OH&S is at the forefront of the culture in the College. It was clear through discussions with Head of
Division and the Senior Management Team (SMT) that they are intrinsically involved in the SMS at all
levels including safety committees and carrying out safety walks and performance reviews showing
commitment from the top.

As previously reported the Organisation has detailed roles and responsibilities for OH&S and these
responsibilities and accountabilities are communicated to each member of staff through their Job
Description upon appointment, which are included within their respective performance reviews
(appraisals).
Records were provided for the Principal, Deputy Principal (Resources) and the HAS Manager and
these show OH&S accountabilities.
As stipulated within the roles and responsibilities the HAS Manager, David Jacksons, duties include
ensuring that reports on the OH&S performance of the College and associated activities are presented
to the Senior Management Review.

Through initial discussions it was revealed that a process for the approval and control of documents
had been established, the policy /procedure approval and review cycle 2013 shows the College OH&S
Procedures, their review cycles, the reviewer and target dates for completion. That said, there is no
clear audit trail of document history and version control. The review cycle has assigned references for
the SMS documentation but stops short of assigning references to forms. There seems that there is no
provision within this system to prevent unintended use of documents or use of obsolete documentation.

Within the Safety Management System document section 3.15 is the arrangements The College has
many processes in place for consultation and communication with employees, students and other
stakeholders such as:
Joint Consultation and negotiation committee
Inductions
Management Reviews
Health & Safety Committees
Communications meetings
Newsletters
Toolbox Talks
Web Site
Intranet

The Joint Consultative Committee is described as the prime means of communication and consultation
between the Organisation and the Unions, management, student and staff representatives which
provides an open forum where OH&S can be discussed and through joint input improvements in the
SMS can be not only achieved but embraced.
The roles and responsibilities of the employee representatives for health and safety have been
described within the HSW Committee terms of reference and constitution dated 15 May 2013.
The ongoing safety committee meeting is a forum whereby operational controls and consequences of
non conformance are communicated.

The documented roles and responsibilities clearly define management and supervisory levels and tie
into each employees job description including competence requirements which are included within the
individual performance reviews.
York College has prepared a matrix of staff training which details the general and specific training
requirements for each employee and in addition the compliance with the plan is monitored on a
percentage complete basis.

The College has established a documented Health and Wellbeing Policy which defines and documents
the responsibilities and describes the arrangements for managing occupational health and wellbeing
throughout the organisation.
The Policy contains descriptions of the arrangements of:
Health Surveillance and assessment
First Aid
Occupational Stress
Healthy Lifestyle initiatives
Absence & Attendance analysis
Post job offer health screening
Fitness for work standards

The provision of health surveillance is based on the job profiles and risks associated with specific
legislation.

Through discussions it became clear that the College do not have a single documented procedure
which describes the management of change within the business, although there are many mechanisms
which are in place to manage the process of change. An example of which was presented for the
changes to the management information system which included assessment of risk and potential,
setting of key milestones and monitoring progress and project planning also recognition of change to
training and competencies. The Organisation would benefit from establishing a formal procedure which
describes the change management processes and how these interact with the safety management
systems and arrangements.
Section 1 Policy and Organisation Recommendation Priority
Person
responsible
Completion
date
1.01 Safety policy statement The Organisation should consider making an explicit
commitment within the Policy to Continuous improvement. The
Organisation should consider making an explicit commitment
within the Policy to provide adequate resources. The
Organisation should consider being more explicit within the
statement regarding their commitment to consult &
communicate with other Stakeholders. The Organisation should
consider including an outline of the framework to objective
setting.
80.0%
1.02 SMS scope, nature and scale (control
arrangements)
100.0%
1.03 Leadership and commitment 100.0%
1.04 Roles and responsibilities 92.9%
1.05 Documentation management The Organisation should consider establishing a formal
document management system to ensure that all elements of
the SMS are up to date and the correct versions of documents,
policies and procedures are being used. The Policy should
clearly assign responsibility and authority for document
approval. The Policy should include the arrangements for the
identification of OH&S documentation and data. The Policy
should describe the methods of how to prevent the unintended
use of obsolete documentation. The Policy should outline how
the use of external documentation is controlled within the SMS.
The Policy should reflect the requirements of the Data
Protection Act 1998 in respect of security, loss, confidentiality
etc.
10.0%
1.06 Consultation and communication 100.0%
1.07 Competence and capability 100.0%
1.08 Occupational health and wellbeing 100.0%
1.09 Change management Although there are various mechanisms within the
management systems for managing change the Organisation
should consider establishing a formal and documented change
management procedure, describing the arrangements for all
change within the College business. Ensure that the Change
Management Policy includes the description of assessment of
potential risk resulting from change. Include within the Change
Management Policy change in operational control. The
Organisation should consider including defined roles and
responsibilities within the change management procedure.
The Policy should include the arrangements for the
communication of change and subsequent SMS controls. The
Policy should include competency / training requirements
arising from change.
38.5%
Section 2 Strategy and Planning


2.01 Occupational health and safety objectives
The Management review and self assessment reports are the key processes for objective setting and
development and following this a quality improvement plan is developed with section 4.6 relating to
OH&S. Objectives are set at functional levels through key performance indicators and strengths and
weaknesses are identified through the individual performance reviews. The process of objective setting
is established through the management review which includes; relevant legal requirements, findings of
risk assessments and results of active and reactive monitoring and SMART targets are set and
measured through the Individual performance review.

As mentioned previously, the Quality Improvement Report contains OHS&W planning for improvement
which is within the overall College strategic plan for 2012 2015. The self assessment contains the
specific functional objectives and includes; organisational risk requirements, emergency arrangements
and describes the responsibilities and defines timescales for achievement.

The Management review process ensures that all of the SMS and associated arrangements are
reviewed for their current status and then ensures that the objectives set and the implementation plans
are based on improving OHS&W. The initial review included; suitability of current arrangements,
organisational and OH&S risk and performance and has identified that benchmarking is to take place
using information from other colleges.

Through discussions held with the finance Director and Heads of Department it was clear that budgets
are set for each department including the OHS&W and evidence of this is included within the overall
business plans, which include provision for: personnel, infrastructure, systems, finance, training and
development and contingency planning.

The College has a specific OHS&W plan which has been developed separate from the main elements
of the SMS and reflects the commitment to prevent ill health and injury within the Organisation. Health
100.00%
100.00%
100.00%
100.00%
50.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
2.01 Occupational health and safety
objectives
2.09 Risk profiling
2.13 Procurement and design (Including
contractor approval)
2.15 Sustainable health and safety attitudes
and behaviour
surveillance is in place and determined through the risk assessment section of the Work Health
Assessment, which identifies the risks faced by the employee in their duties and reflects the
requirements of current legislation and Department of Health guidance. The provision of occupational
health support includes counselling and assistance programmes and lifestyle campaigns which are all
included within the resource planning.

York College has engaged in a great deal of time and resource to identify the needs of its target
audience regarding consultation and communication of the OHS&W processes. The consultation and
communication of health and safety has been addressed according to the nature and scale of the
business and associated risk. The College has both a Web site and Intranet for stakeholders and
employees to access OH&S information. There is a formal Health and Safety Committee which meets
with union and non union representatives five times per academic year as per the constitution and
minutes are produced and available. Methods of communication include: poster campaigns,
newsletters, toolbox talks, meetings etc. and evidence was seen and verified during the audit.

Each Head of Department ensures that the functional OH&S objectives are considered when assigning
SMART targets and are actively involved in strategic planning process. Clearly defined Management
responsibilities are assigned in the self assessment and within the overall business plan. It was
explained that health and safety is a standard agenda item in all meetings.

The College has established HSP 15 which is the procedure for assessing and managing all OHS&W
risks in addition the Risk Management Policy produced by finance reflects the Corporate Governance.
Within HSP 15 section 2.4 & 2.5 is the defined methodology for identification of hazards and evaluation
of risk and risk control measures are required to be hierarchical in nature. Risk assessment control
measures reflect the risk evaluation and routine checks by the HS&W team and Heads of Department
ensure they remain applicable. The Risk Management Policy section 12(b) states the annual planning
and budget processes are used to set objectives, agree action plans and allocate resources which was
discussed with the Director of Finance, Trevor Armer.

2.09 Risk profiling
The overall risk strategy is in place to identify strengths and weaknesses and where potential impacts
affect other areas of the business, both internal and external, and is integral to the development of the
OH&S policies and programmes implemented by the HS&W team. The College has identified routine
and non routine activities, capabilities and behavior, workplace and equipment hazards and applied
controls through the risk assessment process which is hierarchical and appropriate to the risk. The
College has risk assessments covering all student and other employer activities. Activities are
outsourced to Contractors through the Estates department and risk assessments are required for any
work.

The College has established many processes to manage change, although it was not clear how these
processes interact and that they specifically follow the requirements of current legal or industry
standards. It was revealed through the discussions with staff that change within the College happens on
a daily basis from small classroom upgrades to introducing MS Exchange from Lotus Notes throughout
the IT network. Impact assessments are undertaken to ensure that any outcomes are to the expected
project plan. The College would benefit from establishing a formal, documented change management
procedure or management instruction.

York College has established robust management systems which are compliant with industry standards
and demonstrate their legal understanding.
York College currently does not have a documented procedure within the SMS which outlines the
responsibilities, describes the formal arrangements for identifying, the applicable legal and sector
requirements, the continuous monitoring and measurement of how the Organisation is complying
compliance. The procedure should also describe how the OHS&W annual objectives are chosen using
the information contained in the legal register.

York College has developed an Incident and Business Continuity Plan which was under review at the
time of the audit, although the current arrangements will remain until the revised procedure is
implemented. All potential threats have been recognised and applicable to the College, controls have
been established and are in place and adequate resources have been made available.
Arrangements are in place for:
Fire emergency
Industrial action
Pollution
Food Poisoning
Transport
Bomb threat
Supplier failure
Off site activity
Inclement Weather
Flood
Power Failure
Terrorism
Loss of IT
Contagious illness

Command and control arrangements are also in place to ensure that any event is managed, which
detail the Departments and outlines the responsibilities for managing emergency events. The BCP has
been reviewed in conjunction with the College and the North Yorkshire Police Counter Terrorism Squad
and it was revealed the procedure was deemed satisfactory.

2.13 Procurement and design (Including contractor approval)
York College has established a formal process for the approval of contractors and suppliers, which was
explained by Carole Rutter, Procurement Co-ordinator. All selection and procurement of contractors is
carried out as per the procurement process with pre selection heavily weighted to health and safety.
Contractor evaluation is undertaken by the Estates department dependant on the risk and scale of the
work to be undertaken. Applications to tender are through the electronic portal called Intend which is
used in the public sector and contractors use to place proposals for the tendered works. The College
has an approved supplier list which is periodically reviewed.

Formal plans have been produced for training and development of staff which commences at the
employment stage through interview and following this through the individual performance reviews,
which identifies the training requirements and training needs of the individual by the line manager.
Training compliance measurement is undertaken by the H.R. department ensuring that any statutory
and refresher training is undertaken within the required timescales. Individual capabilities, behavior,
resources, legal & other compliance requirements, monitoring and supervision are all considered within
the process.

2.15 Sustainable health and safety attitudes and behaviour
The Organisation has established a broad range of management procedures and arrangements to
establish a positive health and safety culture, which are to known standards and routinely internally
audited. The current OH&S programmes have been designed to encourage employee involvement and
work continues to improve the systems to address ownership of OH&S throughout all departments. The
York College Way was described as the core behaviors required from all patrons of the premises
including staff, students and visitors and is in prominent locations throughout the buildings.
Section 2 Strategy and Planning Recommendation Priority
Person
responsible
Completion
date
objectives
100.0%
2.02 Occupational health and safety plan 100.0%
2.03 Benchmarking and initial review 100.0%
2.04 Provision of resources 100.0%
2.05 Occupational health and wellbeing 100.0%
2.06 Consultation and communication 100.0%
2.07 Leadership and commitment 100.0%
2.08 Risk management and control 100.0%
2.09 Risk profiling 100.0%

100.0%

2.11 Legislative compliance The College should establish a formal procedure for the
identification of all applicable legislation and industry/sector
standards the College has a duty to comply with.
Ensure that the procedure outlines the responsibilities and
describes the arrangements for the College legal register and
its upkeep. The process to ensure that management and
others are updated on legislative changes should be included
within the legal compliance procedure.
50.0%
2.12 Emergency incident planning 100.0%
2.13 Procurement and design (including
contractor approval)
100.0%
2.14 Competence and capability 100.0%
2.15 Sustainable health and safety
attitudes and behaviour

100.0%

Section 3 Implementation and Operation


The Organisation has established a formal management procedure for hazard identification and
risk assessment, HSP 15, which can be seen as being implemented throughout the College and
associated activities as a principal tool to identify and manage risk. All work activities, work areas
and specific processes have been risk assessed including where regulations call for specific
assessments. Evidence was seen of area and activity assessments.
Evidence of the application of risk assessments was seen throughout all locations visited during
the tours and examples seen in the Osbaldwick Construction Centre for: Operation of Table
Routers dated 18 June 2013 and Operation of hand held Rip Saws dated 19 June 2013. Each risk
assessment has been through a rigorous approval process and are placed adjacent to the working
areas with briefings given to both staff and students.

York College has established a robust system of SMS controls which have evolved through the
Companies experience and applied to the nature and scale of the hazards and risk.
Prior to work commencing the risk assessment process and risk management strategies ensure that
the controls to be applied adequately protect employees, contractors and members of the public and
cover any hazards that non employees create.
The hierarchy of risk controls are included within the procedures and can be demonstrated through the
use of workspace, enclosures etc.
The risk assessments detail not only the workplace precautions but also the risk controls to be applied.
The Risk assessment process also ensures that the appropriate skill levels and competencies are
applied to each work activity.
Hard controls are in place such as guards and emergency stops on machines and soft controls such as
safe working procedures. During the tour many examples of work equipment were checked and in all
cases the controls were in good condition and fit for purpose

3.03 Work equipment
All work equipment is entered onto the PPM scheme managed by the Estates Department, which
ensures that all work equipment is serviced, inspected and tested on a routine or cyclic basis.
There are formal records for statutory maintenance and these were made available for such as
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
90.00%
100.00%
100.00%
100.00%
80.00%
85.71%
100.00%
100.00%
100.00%
100.00%
72.73%
100.00%
100.00%
100.00%
100.00%
3.03 Work equipment
3.11 Safe isolation
3.21 Sustaining occupational health and safety attitudes and
behaviours
3.24 Management of other potential emergency
occurrences/Incidents

lifting equipment and pressure systems with written scheme of examination in place from RSA.
Signs were in place each of which were applicable to the risk and compliant with the road traffic act
and signs and signals regulations.
Hand tools were seen during the tour and in each case were seen on shadow boards or within
cupboards.
Defect maintenance is carried out on the site and appropriate trained maintenance personnel are
deployed to conduct the work.

The College has established a formal procedure ref: HSP14 PPE & Clothing which ensures that any
PPE required is suitable and sufficient to the residual risk following the risk assessment process using
the hierarchy of risk controls. Where PPE is to be used then the risk survey table HSP 14 appendix (a)
must be filled in by the area competent person in consultation with the user. All PPE seen during the
audit was in good condition and provided free of charge. Ian Murray has an approved PPE register
which details the correct BS EN references. PPE is inspected as part of the routine inspections and
audits in addition to PPE warning signs.

The College has established a formal procedure ref: HSP 09 Manual Handling Policy and Guidance
which describes the arrangements and outlines responsibilities for correct application.
Manual handling is currently included within the normal risk assessment process and in some instances
has identified mechanical means to prevent work related injuries such as Fork Lift Trucks, Pallet
Trucks, and Trolleys etc. Within the Construction Centre assessments have been undertaken on
manual handling tasks, although the College has not established a register of manual handling tasks
nor is there specific manual handling risk assessment in place. Safe handling techniques are given to
students upon starting their courses dependant on risk and staff have received the CIEH level 2 in
Manual Handling and further staff identified to receive level 3 training.

The College has established a formal procedure ref: HSP 06 DSE Policy which outlines the
responsibilities and describes the arrangements for managing risk from the use of DSE. DSE
assessments have been conducted for all identified users and workstations are set up to the individual
and applicable to their needs. No issues were identified during the tours.

The cleaning staff ensure that all areas of the College including communal areas, classrooms,
workrooms, offices, sports and public areas. During the tour all areas were seen to be of a high
standard of cleanliness and good housekeeping is seen by all to be of high importance.
York College has provided excellent welfare facilities in all areas visited i.e. lavatories, washrooms and
designated kitchen/eating areas, including DDA compliance. All the areas inspected were extremely
clean and fresh with a good supply of towels and soap. The College demonstrates good practice in
regard to the safe handling, storage, segregation and disposal of waste, although storage within some
offices is limited and requires reviewing in relation to the adequate provision of these facilities.

During the construction of the College in 2007, the roads, pedestrian walkways, signage and traffic
routes were put in place and seen to be compliant with the road traffic regulations. Risk assessments
have been undertaken in relation to the movement of vehicles and occupational road risk which were
presented during the audit. Appropriate segregation has been established between pedestrians and
vehicles and a one way system is in place in the car park also a separate road & bus park for students.

Specific risk controls have been applied for all of the workplaces and activities. Engineering controls
have been applied such as guarding of machinery and interlocks in place and further controls including
local exhaust ventilation within the welding shop compartments and masonry shop. There are
procedural controls in place for the work equipment in the shops in the form of training manuals and
work instructions and pre use checks. Emergency stops are in place on workshop machines and clear
signs indicating the controls. Training is in place for staff and students operating machinery and a
defect reporting procedure in place through Estates.

York College has established a permit to work scheme which is described within document ref: HSG 06
dated May 2013 and covers:
Hot Work
Work at Height
Confined Space Work
Asbestos
General

The Estates department has responsibility for the application of the permit to work scheme which was
demonstrated, though through discussions it was revealed that no training had been given to staff with
responsibilities under the scheme. In addition there are no formal authorisations of issuers or acceptors
described within the scheme.

3.11 Safe isolation
All isolation points throughout the College and associated areas have been identified and are able to be
locked to isolate the energy source and where isolations have been applied, the keys for the locks are
kept personally held. Through discussions and checking it was revealed that isolations are detailed on
the PTW although there is no one person in control of the isolation and restoration of energy. Training
in the safe isolation procedure has not been established at the time of the audit.

The College has established a formal procedure ref: HSP 20 Work at Height, which details the
responsibilities and outlines the arrangements for work at height. The Estates department ensures
that all work at height is managed through the risk assessment process and any work to be
undertaken by contractors has to be done through the College procedures. Training in WAH is
carried out for all staff expected to undertake this work and collective protection is used in each
case. All access equipment is maintained by the Estates department and statutory maintenance
and inspections are undertaken as per the maintenance plan.

The Estates department ensure that there is a written scheme of examination which is provided by
Royal Sun Alliance (RSA) and covers all lifting equipment including passenger lifts and certificates of
thorough examination were made available and within date. Any recommendations raised during the
inspections will be entered onto the action tracker to ensure prompt action is carried out.

As with 3.13 above the College has employed RSA, who have produced the written scheme of
examination for all the pressure systems in the school and certificates of thorough examination were
made available and verified.

York College has established a procedure ref: HSP 05 COSHH, which details the responsibilities
and describes the arrangements for transporting, storing, handling and disposal of hazardous
substances and follows the COSHH principals of good practice. Each Department has its own list
of substances but there is no central COSHH substance register. COSHH assessments were seen
and verified in many locations and were applicable to the risk, although in the Maintenance and
YRA this was not the case. In the Maintenance Shop COSHH assessments were seen dated 2006
& 2007, which is against the review period stated as annually. I the YRA MSDS were presented for
substances but there were no COSHH assessments. Whilst checking the COSHH procedure there
was no mention of the changes to the CLP (CHIP) and difference between the new symbols to the
old ones. During the tour of the catering department it was noted that 5 litre containers of corrosive
and harmful substances stored together on shelves in the cleaning store with no segregation or
spill trays in place or spill kits available. The L8 document was completed by Reef Water Solutions
in 2011 which covers the Colleges water systems and potential risk areas and records of analysis
were seen and verified. The College ensures that monthly temperature checks and chlorination of
shower heads is undertaken and Western Environmental carry out three monthly checks of the
water tanks. An asbestos survey has been undertaken and has identified only one gasket which
may have potential asbestos in the Construction Centre, which is a gasket on the main gas
incomer, which is in a locked cage and included within the PTW scheme.

Through discussions it was revealed that a condition survey has just been undertaken by Circuit
Electrical and the electrical installation condition report dated 8
th
June 2013 was presented and
complete. The electrical staff are all qualified and these are checked through the contractor approval
process and are a NIC EIC approved contractor. All C1 and C2 actions raised within the report have
been addressed and a new report issued and resources have been released to complete the C3
actions. PAT testing is undertaken on an annual basis and therefore not based on the risk profile of the
equipment. Labels were seen on all equipment checked.

York College has ensured that noise surveys have been undertaken in each area, which have identified
where noise induced hearing loss could be risk to staff and students. Noise zones have been identified
with the appropriate signage. Noise enclosures and a low noise purchasing policy are in place
demonstrating that the College is addressing noise a source and not just applying PPE.

The College has conducted a risk assessment regarding vibration risk and this has concluded that
Stone Masonry had inherent risks through the use of air chisels, which have been checked and the
vibration magnitude identified. Control measures have been applied such as limits on use, risk
assessment and staff exposed are included within the occupational health screening.

Safe working procedures have been developed for each item of work equipment or machine to be used
by staff or students and examples were displayed adjacent to the individual machines, which was seen
during the tours of the College and associated areas. The work instructions are included within the
training schedules and only level 3 students are permitted to use certain machines. Regular toolbox
talks are given and workshop briefings on the safe operation.

The College has ensured the competence of staff through the job descriptions, training needs
analysis, specific and job related training programmes and also individuals can request further
training in order to improve their skills. The supplier and contractor selection process ensures that
competence is verified prior to work being permitted. The Company induction adequately covers
the relevant occupations and their relevant health risks such as WRULDS for office workers and
manual handling activities and the health risks from the use of hazardous substances.

3.21 Sustaining occupational health and safety attitudes and behaviours
Employee training has been identified and selected taking into consideration the occupational health
and safety risks of the activities or processes the employee will be expected to work with, such as
harness training for working at height, DSE for users etc.
The Organisation has ensured that support services are in place for the staff beyond work related injury
and ill health. Through discussions it was revealed that there have been initiatives to promote and
encourage good health outside the workplace. Return to work interviews are conducted in each case
and an individual risk assessment undertaken to ensure that the individual returns to work in a phased
approach if necessary and records of these are maintained within the H.R. department.

The College has ensured that the emergency incident procedures and assessments have been
communicated to staff through the inductions, committee meetings, visitor briefings and a campus
guide has been produced detailing the emergency arrangements and assembly points. Specific
roles and responsibilities have been established and have been included within the arrangements
including adequate resources provided for the application of the plans. Those with management
responsibilities have undertaken training in the business continuity plan under Operation Argus and
involved in the Project Griffin group.

Adequate fire risk assessments have been undertaken and these have been reviewed by North
Yorkshire Fire and Rescue Service and further recommendations addressed and auctioned. The
content of the fire risk assessments has been communicated to all relevant staff and is available in hard
copy and on the College shared drive. Suitable control arrangements have been established such as
fire detection and warning systems which are routinely tested and checked and any defects reported
and auctioned through the Estates department. All escape routes have been identified and adequate

emergency lighting in place to assist escape, which are also inspected ant tested as part of the
monitoring arrangements. Suitable firefighting equipment has been provided and located according the
findings of the FRA and CHUBB are the approved contractor providing the testing and checking. Fire
wardens have been appointed from the findings of the FRA and through discussions it was revealed at
the Construction Centre that Fire Wardens will sweep alone and are expected to communicate using
their mobile phones. The College should review this practice and complete a lone worker risk
assessment and review the strategy form communication in the event of an incident. PEEPS have been
developed which ensures that those recognised have escorts to refuge points in the event of
evacuation.

3.24 Management of other potential emergency occurrences/Incidents
As previously reported, York College are currently reviewing their business continuity plan and that
further controls are being identified and resourced. The current emergency arrangements are effectively
implemented and it was explained that testing has been undertaken. Staff are trained in incident
management including accidents, incidents, fire risk etc. Sufficient first aid trained personnel are
appointed and adequate first aid arrangements in place applicable to the risks. All emergency events
are recorded including first aid treatment and any actions are addressed to completion.

Section 3 Implementation and Operation Recommendation Priority
Person
responsible
Completion
date

100.0%


100.0%

3.03 Work equipment

100.0%


100.0%

3.05 Manual handling The College should identify which manual handling tasks
require a specific assessment.

General risk assessments have been undertaken on manual
handling tasks although specific assessments should be
undertaken.

The risk assessments should be reviewed to adequately cover
the task, load, individual capability and environmental factors.

72.7%


100.0%

3.07 Housekeeping, storage and welfare
facilities

100.0%


100.0%


100.0%

3.10 Permit to work systems The PTW process describes the details regarding the issuer of
the permit but should also include authorisation of receivers.
The College should consider establishing a formal training
regime for permit issuers and acceptors.

85.7%

3.11 Safe isolation The College should consider establishing formal training for
personnel involved in activities involving safe isolation.

80.0%


100.0%


100.0%


100.0%

3.15 Hazardous substances The College should review their provision of COSHH
assessments to ensure that they are in place and within current
review periods.

Regarding the recent changes to the law on the chemical
classification and labelling, the College should include within
the COSHH Policy the changes to warning pictograms and
advise employees on the changes.

The storage of chemicals within Catering should be improved
with appropriate segregation and spill prevention.

90.0%


100.0%


100.0%


100.0%


100.0%


100.0%

3.21 Sustaining occupational health and
safety attitudes and behaviours

100.0%


100.0%


100.0%

3.24 Management of other potential
emergency occurrences/Incidents

100.0%

Section 4 Performance Measurement


4.01 Occupational health and safety plan (monitoring)
Formal procedures are in place to ensure that performance is measured and discussed with senior
management and processes to establish overall objectives covering all areas including OHS&W to
improve the College. The self assessment and performance review are the vehicles whereby those
objectives are communicated into targets for teams and individuals and those targets measured.

4.02 Occupational health and safety objectives (monitoring)
The health and safety objectives are monitored through the self assessment and Management
Review process which includes mainly reactive performance statistics from the SMS and reported
to senior management as part of the performance review. The H&S committee meetings are
representative of the workforce and the performance included in the meetings.

The HSAM Manager David Jackson carries out monitoring of the health and safety performance on
OHS&W and reports through management meetings, although the majority of the reporting is of the
reactive type. Through discussions it was revealed that there is currently no formal procedure
which describes the process relating to proactive monitoring and measurement of the health and
safety performance of the Organisation. There is input from senior management and Heads of
Department through the routine audits and inspections of the workplace.

4.04 Inspections and audits
There is a process for carrying out audits and inspections in all areas of the College and peripheral
areas such as the Construction Center, although consideration should be given to ensuring that the
SMS is audited against the Legal Register when established.

Risk Assessments are required to be reviewed on an annual basis under normal operating
circumstances, further reviews will be undertaken following any change such as: incident, accident,
process organisational change or change to, or requirement of the law.

4.06 Legal and other requirements compliance monitoring
The College does not currently hold any external certification or accreditation of its SMS such as;
BS OHSAS 18001, although a key step forward has been made by requesting this audit. As
44.44%
100.00%
100.00%
100.00%
16.67%
100.00%
100.00%
50.00%
90.00%
98.57%
66.67%
100.00%
100.00%
4.01 Occupational Health & Safety Plan
(monitoring)
objectives (monitoring)
4.04 Inspection and audits
4.06 Legal and other requirements
compliance monitoring
4.08 Contractor and supplier management
4.11 Accident, incident, near miss reporting
and investigation systems
4.12 Ill health and absenteeism monitoring

reported there is no formal legal register established and therefore the monitoring of compliance
with the Colleges obligations cannot be visibly demonstrated within the SMS.

Health monitoring is carried out and surveillance for staff identified within the risk assessment as
being at risk from exposure to specific hazards such as lead, hazardous substances, noise,
vibration, dust etc. The monitoring programs are to the individual and appropriate to the task being
undertaken.

4.08 Contractor and supplier monitoring
As reported in 2.13, York College has established a formal process for the approval of contractors
and suppliers, which is managed through Procurement. The monitoring of the performance of the
contractor or supplier is undertaken both by the Estates team and Procurement. Where
performance is unsatisfactory, a vendor can be removed from the approved list.

The bulk of SMS documentation was subject to control through the HS&W team in the absence of a
formal managed document control process as previously commented on in section 1.05.

The HSAM carries out reactive statistical analysis on accidents and incidents including underlying
causes and human factors. The Estates team carry out monitoring of the reactive maintenance
statistics and each of the departments report findings to the SMT.

4.11 Accident, incident, near miss reporting and investigation systems
The HSA Manager carries out the collation of accident and incident data and conducts analysis of
the results to identify any trends and opportunities for improvement. It could not be demonstrated
that the statistics on incident frequency rates are analysed in relation to other recognised industry
sector figures. Producing Accident Frequency Rates (AFR) as a percentage against the number of
hours exposed gives the opportunity to include reduction of these rates within the overall objective
setting process.

4.12 Ill health and absenteeism monitoring
Ill health absence data is tracked through the HR Department and trigger points applied for fuller
investigation in terms of total absence time or multiple absences within a given period. OHS&W
Department track types and location and RIDDOR reporting in regard to ill health. Analysis is
undertaken for root causes and contributing factors and also reported through to senior
management.

The Estates team ensures that defects and damage is recorded and an analysis is undertaken on
the response times and close out rates and performance of the active and reactive maintenance
which is included in the Governors report. Through discussions with the Director of Finance it was
revealed that there is currently no specific cost analysis carried out on the H&S loss or potential
loss events.

Section 4 Performance Measurement Recommendation Priority
Person
responsible
Completion
date
(monitoring)
100.0%
objectives (monitoring)
100.0%
4.03 Active measurement Although the College has many mechanisms in place for both
active and reactive reporting and monitoring, it would benefit
from a detailed procedure describing the input streams and
analysis of the data. The Organisation should assess the types
of active monitoring that is undertaken, identify further positive
indicators, set targets and measure performance and ensure
that this information is used in the periodic management review
as an indicator of continuous improvement.

66.7%
4.04 Inspections and audits Racking and shelving inspections should be undertaken by a
suitably competent person.

98.6%
4.05 Risk assessment review Not all risk assessments checked were within the current
review period. Carry out a formal review of each departments
risk assessments to ensure that they are within review periods
set down by the College.

90.0%
4.06 Legal and other requirements
compliance monitoring
The College should establish a process or procedure for the
monitoring of compliance with relevant legislation and other
sector standards or requirements. The College could consider
external accreditation of its OHSMS such as BS OHSAS
18001. Senior Management should be included in the reporting
on the evaluation of compliance monitoring. Please record the
answers to these questions in the main body of the report.

50.0%
4.07 Health surveillance 100.0%
4.08 Contractor and supplier monitoring 100.0%

4.09 Documentation management The College should include the document management system
(when implemented ) within the internal and external auditing
schedules. Any Identified non conformances should be
addressed in a timely manner. Ensure that results of non
conformances are included within reports to senior
management. Ensure that legislative requirements relating to
the control and retention of SMS documents are included within
the document management systems. The document register
(when implemented) should be included within reviews.

16.7%
4.10 Reactive measurement 100.0%
4.11 Accident, incident, near miss
reporting and investigation systems
100.0%
4.12 Ill Health and absenteeism monitoring 100.0%
4.13 Loss/damage analysis The Organisation should consider calculating the costs of
actual and potential incidents in order to aid analysis.
Monitoring of the information can show how safety initiatives
and improvement of the safety culture reduce costs to the
business. The Organisation should consider calculating the
costs of actual and potential litigation costs in order to aid
analysis.

44.4%

Section 5 Evaluation and Review


The Management review agenda has been established and is circulated to all relevant staff prior to the
meeting to ensure that all relevant information and analyses is brought to the meeting for discussion in
order to monitor performance.
The Management review process covers the results of internal audits, internal and statutory
inspections, accident and incident statistics, reviews of risk assessments including actions arising from
previous reviews

The provision of resources for OHS&W is evident throughout the implementation of the hard and soft
risk controls and their maintenance. Resources and budgets for departments are discussed with the
Senior Management in the overall review and the implementation and planning of those resources is
the responsibility of the HODs.

The College has established an ongoing review of the safety management system through active and
reactive monitoring which includes information from inspections, audits, meetings and also accident and
incident learning points. Improvements can be demonstrated through the continual reduction in accident
incidence over the past three years.

5.04 Legislative compliance and other requirements
As previously reported no formal monitoring of legal compliance is described within the SMS, although
Heads of Departments maintain continuous professional development which ensures that all legal or
educational or other standards are known and addressed through application of their duties.

5.05 Occupational health and safety programmes and planning
As described throughout this audit report, York College has established formal review procedures
covering the OHS&W systems and its implementation with monitoring of performance being undertaken
by the HODs through management review. Through analysis of the performance data the College
recognise where improvements can be made and these are included within the consideration of the
HS&W objectives.
100.00%
7.14%
100.00%
100.00%
100.00%
5.04 Legislative compliance and other
requirements
programmes and planning

Section 5 Evaluation and Review Recommendation Priority
Person
responsible
Completion
date
5.01 Management review and reporting 100.0%
5.02 Provision of resources 100.0%
5.03 Continual improvement 100.0%
5.04 Legislative compliance and other
requirements
The process for active and reactive performance
measurements should include an evaluation of how effectively
the organisation is complying with relevant legislative or other
applicable standards. The College should establish
documented records of the legislative performance reviews.
The process should stipulate the requirement for legislative
compliance and how it shall be effectively fulfilled. Records
should be maintained of potential impact through changes to
relevant legislation.

7.1%
programmes and planning
100.0%

Verification
Verification of this audit was conducted using the following processes:
Interviews with key personnel and employees
Tours and inspections of workplace(s)
Identification and review of relevant documentation

Interviews
Interviews, both formal and informal, were held with a wide range of personnel during the audit
process including those listed below:

Dr. Alison Birkinshaw Principal & Chief Executive
Louise Lawrence-Crockford Deputy Principal, Resources
Trevor Armer Director of Finance
Graeme Murdoch Deputy Principal, QA & Support
Bob Sarnor Assistant Principal, LL & HE
Denise Morrison Assistant Principal, Employer Engagement
Mark Doyle Assistant Principal, Vocational
David Jackson Health & Safety Advisory Manager
Geoff Wroe Estates & Facilities Manager
Carole Rutter Procurement Co-ordinator
Chris Leng HR Manager
Kevin Clancy Head of Division (Construction)
Lennon Chappell Technician & H&S Co-ordinator (Construction)
Harpal Sambi Brickwork Tutor (Construction)
Ken Brown Facility Supervisor (Osbaldwick)
Tony Mulligan Learning Assistant & Risk Assessor (Construction)
Allan Bates Learning Assistant & Risk Assessor (Construction)
George Palmer Learning Assistant & Risk Assessor (Construction)
Paul Hill Stonemasonry Tutor
Lisa Rowntree Head of Division (Engineering)
Tony Simons Team Leader (Engineering)
Jim McMahon Team Leader (Motor Vehicle)
Jim Laycock Learning Assistant & Risk Assessor (Engineering)
Nigel Cocks Health & Safety Co-ordinator (Engineering)
Peter Kidd Assistant Health & Safety Adviser
Alwyn Davies Assistant Health & Safety Adviser
Ian Murray Administrator Health Safety & Welfare
Clive Hibbert Assistant Estates Manager
Sandra Hirst Estates Administrator
Azhar Iqbal IT Systems & Services Manager
Chris Greenfield IT Service Team Leader
Lee Armstrong Head of Division (Sports & Public Services)
Angela Haw YRA Co-ordinator

Workplace inspection
The tour of the premises included:

At York College:

Offices
Welfare facilities
Toilets
Catering
Carpentry Workshops
Electrical Workshops
Stonemasonry Workshops
Welding Workshops
Electronics Workshops
Art and crafts Workshops
Motor Vehicle Workshops
Storage Areas

Gym

At The Osbaldwick Construction Centre:

Offices
Welfare facilities
Toilets
Plastering Workshops
Carpentry Workshops

At The York Rail Academy:

Offices
Welfare Facilities
Class Rooms
Electronics Workshop

Documentation reviewed
A range of documentation, including those listed below, was reviewed and authenticated during the
audit process:

The York College Way
Safeguarding Procedures
The Health Safety and Welfare Policy
OHSMS Objectives & Targets
The Statement of Intent
Management Review Minutes
Safety Committee Minutes
Self Assessment Report David Jackson
Job Descriptions
Purchase Requests
Contractor Evaluations
New Starter Guide
COSHH Assessments:
EES 04 - WD40 Dated
EES 06 Brake Cleaner
EES 06 Unleaded Petrol each were dated 26 June 2013

Infrastructure condition survey by Gleeds 29 September 2009
Estates statutory maintenance planner
Certificate of thorough examination for Otis Atrium Lift RH dated 28
th
May 2013
Certificate of thorough examination for Electric disabled platform lift dated 14 August 2012
Certificate of thorough examination for Prestige Autoclave dated 1
st
May 2013
Certificate of thorough examination for Casoli Immersion Heated Steam Boiler dated 1 May 2013
Training certificates
Business Continuity Planning
Fire and Emergency Arrangements
First Aid documents & Proof of competency
Occupational Health Policy & Procedures
Temperature Monitoring Records
Housekeeping and Deep clean schedules

Five Star Health and Safety Management System Audit Report

Uploaded by

Copyright:

Available Formats

Five Star Health and Safety Management System Audit Report

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Five Star Health and Safety Management System Audit Report

Uploaded by

Copyright:

Available Formats

What was the audit reviewing?

What sections did the audit cover?

Five Star Health and Safety Management

System Audit Report

You might also like