OTHM Assignment Submission: Unit 3 Risk & Incident Management 1

Student Name: Marina Fanaru

Unit Ref: Y/617/7540

Risk & Incident Management
Task 1 of 4 Essay
Task 2 of 4 Report
Task 3 of 4 Essay
Task 4 of 4 Report

OTHM Assignment
Occupational Health & Safety
Diploma & Certificate
OTHM Assignment Submission: Unit 3 Risk & Incident Management 2

Authentication Cover Sheet

Learner Name Marina Fanaru

Tutor Name Brian Fitzgerald

Learner Registration
No.
Study Centre Name Communication & Management Institute
Qualification Title Occupational Health and Safety Diploma & Certificate

Unit Reference No. Y/617/7540

Unit Title Unit 3 Risk & Incident Management

Word Count

Due Date 02/09/2021

Submission Date 02/09/2021

Declaration of authenticity:
1. I declare that the attached submission is my own original work. No significant part of it has been submitted for
any other assignment and I have acknowledged in my notes and bibliography all written and electronic sources
used.
2. I acknowledge that my assignment will be subject to electronic scrutiny for academic honesty.
3. I understand that failure to meet these guidelines may instigate the centre’s malpractice procedures and risk
failure of the unit and / or qualification.
4. All sources of academic information have been acknowledged by means of proper referencing as per CMI policy
on referencing. Im aware of CMI policy on Plagiarism and I have ensured to avoid plagiarism using paraphrasing
as much as possible.
5. I wish to confirm that I have retained a copy of this project/assignment for my own personal use and in the event
of being requested for an additional copy from my tutor

Marina Fanaru /
_________________
Learner Name/Signature
Date: 02/09/2021
OTHM Assignment Submission: Unit 3 Risk & Incident Management 3

Unit 3 Assignment Tasks

TASK 1 - DETAIL THE PROCESSES AND STRATEGIES USED TO IDENTIFY
AND ANALYSE RISK AND HOW THIS INFLUENCES RISK MANAGEMENT
WITHIN THE ORGANISATION.
Format: Essay

Task 1 of 4 - Essay - Assessment Criteria 1.1, 1.2, 1.3, 1.4, 1.5, 1.6
Detail the processes and strategies used to identify and analyse risk and how
this influences risk management within the organisation.

(Word count: max 1,000 words + 10% leeway)

The following must be included:

1.1 An outline of the sources of information used to identify hazards and

assess risks, within the organisation. (Max 185 words)

When somebody is confronted with a health and safety problem, whether is a health
and safety professional, a manager, a contractor, an external auditor or an
employee, they will need to consult various information sources to understand the
essence of the problem, the scale and what can be done to address the problem
The sources available can be internal to the organisation and/or external.

Internal sources which should be available within any organisation include:

• Accidents and ill-health records and investigation reports;

• Absentee records;
• Inspection and audit reports undertaken by the organisation and by the
external organisations such as : HSA -Ireland , HSE -UK etc
• Maintenance and equipment examination records;
• Near miss and hazard information;
• Risk assessments including hazardous substances;
• Training records;
• Reports of damage which has occurred in the workplace;
• Documents which provide information to workers: Safety Operating
Procedures, Safe System of Work, Method Statements etc
(Hughes, 2016, p114)

External sources available outside the organisation are numerous and include:

• H&S legislation ( http://enterprise.gov.ie/ ; https://healthservice.hse.ie ;

www.hsa.ie )
OTHM Assignment Submission: Unit 3 Risk & Incident Management 4

• HSA –Ireland website for general information and sector specific guidance
and publication (Approved Codes of Practice, guidance documents, forms etc
(www.hsa.ie)
• HSE -UK :publications, journals books, their website: https://www.hse.gov.uk
• European Safety Agency( https://osha.europa.eu/en )
• World Health Organisation ( http://www.who.int/ )
• Irish, European and British Standards
• Information and data from manufactures and suppliers
(Hughes, 2016, p114)

1.2 An explanation of techniques used in the organisation to identify hazards.

(Max 185 words)

The methods and techniques of risk assessment may be well understood but they
will struggle to be effective in reducing incidents and injury unless they are deployed
within an effective management framework ,where the organisation as a whole
understands its roles and responsibilities.(Channing, 2013,p204)
Hazard identification and elimination should be the foundation of any H&S
management system and must be an ongoing process, constantly reviewing all
tasks, routine and non-routine ,observing situations and behaviours that has the
potential to cause harm to people ,equipment and/or environment.(Ron
McKinnon,2020, p78)
The hazard identification techniques are many but they should be appropriate for
the scale and nature of the hazards and might include:
• Safety reviews and studies of the causes of past major accidents and
incidents;
• Failure Mode and Effective Analysis (FMEA);
• Job safety analysis (Task analysis);
• Human error identification methods;
• HAZOP (Hazard and Operability Studies)
• Industry standard checklists for hazard identification.

A walk around the workplace taking notes of what could reasonably be expected to
cause harm, ideally completed by a team formed by staff who perform the task
,somebody independent to the task ,and also safety representatives, is also an
essential part of hazard identification.

There is no right or wrong techniques that can be used in the process of hazard
identification ,everything depends on the scale and nature of the business and the
risk associated with the organisations processes and activities.
In some cases ,hazards can be identified simply by observation, but in more complex
cases ,a combination of more detailed and special techniques and systems may be
needed, such as hazard and operability studies (HAZOP) and hazard-analysis
techniques such as event or fault-tree analysis(ETA,FTA),and a specialist advice
may be needed to choose and apply the most appropriate method.(HSA ,2006, p26)

1.3 An explanation of how risk assessments are implemented and evaluated

within the organisation. (Max 185 words)
OTHM Assignment Submission: Unit 3 Risk & Incident Management 5

In accordance with the clause 6.1 “Actions to Address Risks and Opportunities” in
ISO 45001:2018, worlds international standard for OH&S, risk assessments are
showing how well an organisation achieves its goals of preventing work-related
injuries and ill health to workers. Comprehensive identification of hazards and
associated risks is the cornerstone on which a successful OH&S management
system is built. (M. Dentch, 2018, p32 )
The principles of risk assessment should be straightforward and based on the
following activities:
1. Identify hazardous conditions, processes that could potentially cause harm,
injury or damage;
2. Consider what this harm, injury, or damage might be, who and how serious
the result of exposure might be;
3. Evaluate the likelihood that harm, injury or damage will occur, considering the
control measures that already exist;
4. Evaluate the control measures ,identify gaps in adequate provision and
prioritize actions needed to correct the situation;
5. Monitor, record and re-evaluate at planned intervals and/or when needed:
circumstances/materials/processes etc. change.(J. Jacqueline , 2002, p 13)

The HSA Publication “Health and Safety Management in Healthcare, Information

Sheet” (Nov 2010) gives guidance for small residential care providers and small
healthcare practices on how to identify hazards associated with the type of work in
healthcare settings (physical, chemical, biological and human factor hazards) ,the
risks and the severity of the harm associated with those specific hazards.
There are specific regulations relating to risk assessments for certain types of
hazards at work, including manual and patient handling risk assessments, hazardous
chemicals, biological agents, display screen equipment and carcinogens and risk
assessments for pregnant employees.
The risk assessment will tell whether the control measures that are in place are
sufficient or not, and what needs to be done to reduce the residual risk (remaining
risk) to as low level as reasonably practicable.( Hughes, 2016, p 103)

1.4 An explanation of how the organisation measures, monitor and reports

hazards. (Max 185 words)

The identification of the hazard is the first step in any risk assessment process.
However ,hazard can be reported at any time by the workforce when something
unsafe is observed ,independent of the risk assessment process. This type of
reporting is a great tool to improve H&S awareness among employees and reinforce
a positive safety culture.
The best way to measure hazards is through a Risk Register.(R.R)
R.R is a management tool that records risk, the possible risk outcomes, indicates
control measures, and allocates responsibility for risk reduction actions.

When monitoring hazards reports you can identify trends ,and based on the findings
you can implement further corrective measures to reduce the risk associated with
those unsafe practices or trends.
Open actions from hazard reports should be tracked and a priority should be applied
to all open actions, based on the risks involved and the number of those affected by
the risk, the organisation will have an action plan with priorities for action.
OTHM Assignment Submission: Unit 3 Risk & Incident Management 6

A non- exhaustive list of some of the common hazards and risks in nursing homes
can be found on the HSA website (www.hsa.ie ), but the most common occupational
hazards and risks are related to Manual/Patient Handling /Violence and
aggression/Shift Work : uncooperative resident, preventing resident falling from a
bed/chair, overexertion from lifting/repositioning/transferring patients, improper
technique or incorrect sling used on the hoist to lift a resident, inadequate training,
lack/damaged equipment, time pressure to keep up with the resident timetable of
the personal care plan ,confused/aggressive/vulnerable residents, working nights,
changing shifts etc. that can result in :musculoskeletal disorders;
physical/psychological aggressions ; sleep problems and other health problems)etc.

A hazard report should be detailed and should contain information about who is
reporting the hazard, date, time, location, brief description of the hazard, what action
are required to address the hazard, the level associated with the hazard(low,
medium high).

1.5 An explanation of how the organisation records risk assessments to meet

regulatory and statutory requirements. (Max 185 words)

As per Section 19 of the Safety ,Health and Welfare at Work Act 2005 all employers
have a legal duty to identify the hazards posed by their workplace and work
activities, assess the risks posed by these hazards and prepare written risk
assessments.
Under Section 20 of the 2005 Act ,the employer must also prepare a Safety
Statement ,which is the place to record the significant findings of the Risk
Assessments( under section 19),the protective and preventive measures to be taken,
the necessary resources allocated to implement the changes that are needed.

Other statutory provisions for each and specific field are detailed in General
Application-The Safety ,Health and Welfare at Work regulations 2007:Manual
handling, pregnancy at work ,electricity etc.
All these Regulations require risk assessments to be carried out on the subjects
covered by the Regulations.( HSA,2006, p 42 )
It is also very important to stay vigilant about hazards and risks, as the workplace is
constantly changing ,that’s why the workplace conditions ,hazard records and risk
assessments must be regularly reviewed to conclude if the safety measures that are
in place are adequate or some further actions are needed to keep the workplace
safe.
The written record is important and should include evidence of the Risk Assessment
being communicated to all employees, and can be used as a basis when reviewing
risks and also as evidence in any proceedings arising from an accident involving the
risk.

1.6 An explanation of how calculations and analysis are used within the
organisation to make improvements and identify failure. (Max 185 words)

Safe system of work are needed when hazards cannot physically eliminated and an
element of risk remains.
OTHM Assignment Submission: Unit 3 Risk & Incident Management 7

The potential of something to cause harm at work will vary in severity. Harm may not
arise from exposure to a hazard in every case ,in practice, the likelihood and severity
of harm will be influenced by several factors: how effectively the hazards are
controlled, the extent and the nature of exposure, latent effects of the hazards and
also individual susceptibility and personal experience working with that specific
hazard.
The likelihood of harm may be rated as: high, medium and low
The severity of harm :major, serious, slight
Only one or several employees can be exposed for a short or period of time or
continually.
In this case ,risk can be calculated as the combination of the severity of harm with
the likelihood and the number of people exposed to it :
Risk = Severity x Likelihood x Number of workers
Of harm of occurrence exposed to hazard
(HSA, 2006, p 45)
This simple computation enables the assessor to make a quick comparison of risks,
and if hazards could affect more than one person, the risk assessor should assign
more weighting to evaluate this risk.
In practice, every organisation use risk assessments systems which best suit their
needs, depending on the size and the nature of the work and activities carried out in
the organisation.
For major accident hazards sites usually is used a combination of quantified risk
assessment (QRA), hazard and operability studies (HAZOP) and fault tree analysis
(FTA).
FTA-Fault Tree analysis is an analytical technique that is used to trace the
chronological progression of factors contributing to the accident situation, and is
useful not only for system safety, but also in accident investigation, and the principal
of multi-causality is utilised in this type of analysis.
(J. Channing, 2013, p235)
A fault tree diagram is drawn from the top down. The starting point is the undesired
event, called the “top event”, because is placed at the top of the diagram, and then
you have to work out and draw the immediate contributory fault conditions leading to
that event.
In my example I’ve assigned a probability of 1 for Oxygen being present , as it
always is in the surrounding atmosphere.
Essentially we:
• Add the probabilities which sit below an OR gate (this is a “rare event”
approximation)
OTHM Assignment Submission: Unit 3 Risk & Incident Management 8

• Multiply the probabilities which sit below an AND gate

So, in this example (purely illustrative), combining probabilities upwards to the
next level gives:
Probability of FUEL being present = 0,15+ 0,04+ 0,07 = 0,26
Probability of OXYGEN being present = 1
Probability of IGNITION being present = 0,3+ 0,08+ 0,25 = 0,63
Moving up again we can now calculate the probability of the top event.
These faults are below an AND gate, so we multiply the probabilities, giving:
0,26x 1x 0,63 = 0,1638

Fault Tree Analysis e.g. Fire Triangle

(0,26 x 1 x 0,63) = 0,1638

Fire

&

FUEL OXYGEN (1) IGNITION

(0,26) (0,63)

OR OR
1

0,3 0,08
0,15 0,04 0,07 0,25
OTHM Assignment Submission: Unit 3 Risk & Incident Management 9

Task 2 of 4 - Report - Assessment Criteria 2.1, 2.2, 2.3

Carry out an evaluation of the organisation’s strategies and
techniques for controlling risk.
(Word count: max 1,000 words + 10% leeway)
The following must be included in your report:

TASK 2 – REPORT
CARRY OUT AN EVALUATION OF THE ORGANISATION’S STRATEGIES AND
TECHNIQUES FOR CONTROLLING RISK.

AC 2.1 An evaluation Risk Assessment is a complex stage ,because beyond any statistical and
of the common risk mathematical calculation ,implies a vision and an attempt to predict the
management future, to assess the possible dangers, threats and attacks .
strategies used within This activity is often the most complex of the risk assessment process
the organisation. because of such factors as:
Max 367 Words • Opportunities and threats can interact in ways that cannot be
anticipated ;
• A single risk can have multiple effects: additional costs, delays,
penalties etc.
• Events which are opportunities for a person or organisation(cost
savings) may be threats to other (reducing profits)
• Mathematical techniques used to quantify the risk may provide
time accuracy but safety unfounded.
Laura – Diana Radu (2009, p 643-644)
To estimate the risk ,there are three broad categories of methods :
1. Qualitative
2. Semi-quantitative
3. Quantitative
The most used is the first one (qualitative risk assessment methods ) ,and
is used to identify assets, does not require to determine the likelihood of
data ,but only estimates the potential losses. This assessment is often used
when numerical data are inadequate or unavailable, time and resources
are limited(budget or expertise).
OTHM Assignment Submission: Unit 3 Risk & Incident Management 10

Like any risk assessment ,the quality begins with gathering information on
risk factors, followed by risk classification in terms like:
o Acceptable/Unacceptable or such as:
o Low/ Medium/ High
Once the risk is classified as high risk for the assets ,the mitigation
measures will be decided and deployed, while the remainder risk will be
subject to further examination by semi-quantitative or quantitative
methods.
Semi- quantitative risk assessment are used to describe the relative risk
scale: low, medium, high or very high and the levels of risk can vary from 3
to 10 or more. In a semi-quantitative approach ,different scales are used to
determine the likelihood of adverse events and their consequences.
Analysed probabilities and their consequences do not require accurate
mathematical data, the scope is to develop a hierarchy of risks against a
quantification and the order in which they should be reviewed ,but not the
relationship between them.
Quantitative risk assessment is currently a topic discussed by many
specialists from different fields. Methods are varied and with great value
in terms o audit, but most notably are:
o Value at risk method (Delta Method, Historical Simulation Method,
Monte Carlo Method)
o Bayesian Method
o Belief Function Method

All methods have their advantages and disadvantages ,the key is to find
not the “perfect ” one, but the most appropriate to the activity that is
applied, able to identify and take into consideration as many situation
involving the risk and make and objective assessment of their effects on
the course of normal activity of the organisation.
Laura Diana Radu (2009,p 656)

AC 2.2 A justification The International Standard for OH&S-ISO 45001 : 2018, requires
of the organisation’s organisations to have processes for the elimination and reduction of OH&S
use of risk avoidance, hazards using the following hierarchy:
risk reduction, risk
transfer, risk analysis, • Eliminate the hazard
risk evaluation, and • Substitute whit less hazardous processes, operations, materials or
risk review strategies. equipment
Max 367 Words • Use engineering controls/reorganization of work
• Use administrative controls, Including training
• Use adequate personal protective equipment (PPE)

In practice, it is not really important which hierarchy is used in selecting a

risk control measure or combination of measures. What is more important
is that you recognise that some types of risk control measures are more
effective in the long term than others, and that you take this into account
when deciding which measures to recommend. (Dr Tony Boyle,2019, p38-
40)
There are four main groups of risk control strategies :
OTHM Assignment Submission: Unit 3 Risk & Incident Management 11

1. Risk avoidance (risk elimination)

2. Risk retention (risks that are not insured)
3. Risk transfer (insurance companies)
4. Risk reduction (partial/complete withdrawal from a business with
particular characteristics)
Risk avoidance is the best solution to risk, and comes after the
organisation estimated the risk and the consequences with the possibility
of a serious injury and/or a fatality.
Manual handling is the highest accident trigger reported to the HSA by the
healthcare sector .In 2010 ,35% of the total number of incidents reported
by the healthcare to the HSA were manual handling incidents. The costs
associated with manual handling related claims analysed was over €2
million.
The Safety , Health and Welfare at Work (General Application)Regulation
,Chapter 4 of part 2(S.I.No.299 of 2007), also known as the Manual
Handling of Loads Regulation ,outline the requirements that must be
fulfilled in relation to Manual Handling.
Although the risk can’t be always avoid a lot of measures can be
implemented to avoid and/or reduce the risks from Manual Handling
activities:
• Training in the use of patient hoist or sliding sheet;
• Training in patient handling techniques;
• Widening of door openings to allow hoist to fit through;
• Installation of low gradient ramps and slopes to be used instead of
steps;
• Undertaking of preventive maintenance programmes for
equipment/facilities.(HSA, Guidance on the management of
Manual Handling in Healthcare, 20111)
Risk retention is for the good risk managers and means that every risk that
is not transferred ( to insurance) is retained, a good example will be
broken or deteriorated equipment, if you can buy new items for the price
of the premium it is pointless to insure, take the risk instead.

Risk transfer refers to the legal assignment of the costs of certain potential
losses resulting from the occurrence of an event specified in the insurance
policy (e.g. fire, accident, etc.) ,from one party( organisation) to another
(Insurance company).

Risk reduction involves partial or sometimes complete withdrawal from a

business with particular characteristics ,and always comes with associated
costs and must therefore be considered in the cost/benefit framework
before a final decision is made.
Risk evaluation should ensure that data is collected ,analysed and
evaluated on;
• Losses/incidents
• Conformity/Non-conformity
There are four aspects that should be covered by Risk evaluation :
• Documents (policies, procedures, manuals etc)
• Records (accident records, records of risk and opportunity
assessments, maintenance records ,permits to work etc.)
OTHM Assignment Submission: Unit 3 Risk & Incident Management 12

• Locations (all location for which the organisation is responsible

should be regularly checked to ensure that the conditions are
adequate and the risk control measures are in place and
effective)
• Activities (not just the core production or service activities but
also training activities, maintenance, cleaning etc. should be
checked at agreed intervals , analysed, reviewed and
adjustments should be made based on a prioritized actions
plan)
Risk is a complicated subject, and is possible to become embroiled in the
mathematics of probability or the complexity of perceptions of risk, but
amidst all this complicated elements of the risk equation ,the thing that
always need to me remembered is that the supreme objective is simply to
prevent people from being harmed. (Channing, 2013, p185 )
AC 2.3 An The general duties of the employer( Part 2, section 8) under the Safety,
explanation of Health and Welfare at Work Act 2005 include:
characteristics and “To provide system of work that are planned, organised, performed,
development process maintained and revised as appropriate so as to be safe and risk free”
for safe systems of When developing a safe system of work (SSW) an organisation should
work and safe think about the hazards, risks posed by these hazards and all the
operating procedures hazardous activities that are taking place within the organisation and
used within the formulate an introduce appropriate controls.
organisation. When developing a SSW sources that can be consulted are:
Max 367 Words
o Legislation
o HSA guidance notes
o HSA approved codes of practice
o Manufacturer’s information
o Risk assessments
o Inspection reports
o Accident statistics
o Professional bodies / journals
o Workforce etc.

The Safe System of Work must include the following characteristics:

• Identify and highlight the major hazards;

• Risk assessments & Method Statement;
• Permits-to work;
• Job Safety Analysis;
• Monitoring

In residential care facilities like in any other workplaces, employers have

the duty for the health and safety of the contractors( building/cleaning
/maintenance contactors) and also for the people who do not work for
them but may be affected by their workplace and/or workplace
activities(unsafe premises causing injury/harm to a resident/relatives such
as a trip on an uneven floor surface ,faulty equipment etc.)
The contractors must be made aware of any relevant health and safety
issues which may affect their health and safety while working on the
OTHM Assignment Submission: Unit 3 Risk & Incident Management 13

premises, and they need to provide relevant extracts from their Safety
Statement( Permit -to-Work, Method Statement ,Job safety Analysis)
relating to any hazards and risks associated ,so that the employer and the
employees to be aware of any risks which may affect them.
The employer must ensure that everyone ,starting from managers have
instructions, training and supervision to ensure the job is carried out
safely.
Job analysis and risk assessment should identify were specific training is
required, such as dealing with aggressive people or manual handling
training, and safe pass training involved in maintenance activities.
When training needs are identified ,there should be a planned approach in
addressing those needs, and also refreshed when needed to maintain the
skills of the employees.(HSA, Health and Safety at Work in Residential Care
Facilities, 2012, p 7)
In summary ,a safe system of work includes:
• Safe work equipment
• Safe handling
• Storage/transportation of substances
• Proper information/training/instruction
• A safe place of work
• A safe working environment

Task 3 of 4 - Essay - Assessment Criteria 3.1, 3.2, 3.3, 3.4

Assess the organisations approach to incident investigation.

(Word count: max 1,000 words + 10% leeway)

The following must be included:

3.1An outline of the range of loss causation theories and techniques used
within the organisation. (Max 275 words)
There are many loss causation theories developed and improved over time, and
from each of them we can take something and use it , from the early stages
(planning phase),reviewing and investigating (checking phase) and definitely in the
OTHM Assignment Submission: Unit 3 Risk & Incident Management 14

last phase -performance improvement phase, when we act to improve based on the
lessons we’ve learned.

One of the many accident causation theories is the well - known Heinrich/Bird
Accident Ratio Triangle that is showing a ratio between fatal and/or serious
accidents, minor injuries, damage accidents and near miss accidents often reported
as: 1/ 10/ 30/ 600 and is often referred as “Heinrich Law”.
Although the data when using this method has a number of limitations ,what we all
can learn is that for every fatality or major injury there are multiple minor/damage
accidents and much more near misses that should be used as a accident potential
predictor, therefor every organisation should encourage near miss reporting and
investigating, by doing that we can learn and prevent more serious accidents.
As the 16th century philosopher Desiderius Erasmus would say “prevention is
better than cure” (Brainy Quote,2016,para.1).

Another theory is known as Accident Domino Sequence (Domino effect) when the
accident sequence is interrupted by the elimination of even one of the factors that
comprise it ,then the loss cannot occur and the incident will be prevented.

A modern approach to loss causation are Multi – causality theories – often there is
more than one cause of an accident that happen in sequence ,and at the same time.
Adverse events have many causes(immediate, underlying, root causes), seen as a
chain of failures and errors that lead almost inevitably to the adverse event.
To prevent adverse events you need to provide effective control measures ,which
should address all the causes : immediate, underlying and root causes .
(HSG245;2004,p 6)

3.2 A Justification for the use of quantitative methods in analysing loss data.
(Max 275 words)

Measurement is an accepted part of the “plan- do- check- act” and measuring
performance is as much part of a H&S management system as financial, production
or service delivery .
Internal systems for collecting and analysis incidents/accidents and ill-data should be
developed and also be specific about what the system involves and who is
responsible for each part of the procedure.

The data will seek answer to the following questions:

• Are failure incidents occurring, including injuries, ill-health and other loss
incidents?
• Where and why are they occurring?
• What is the nature of the failures?
• How serious are they?
• What are the potential consequences?
• How much has it cost?
• How do these issues vary with time?
• What improvements in controls and the management system are required?
Most organisation will want to collect data on:

• All injury accidents;

OTHM Assignment Submission: Unit 3 Risk & Incident Management 15

• Cases of ill-health;
• Sickness absence;
• Dangerous occurrences;
• Damage to property;
• Incidents with the potential to cause serious injury, ill-health or damage etc.

All the information from the incidents books or report forms alongside with other
business measures should be analysed every month and annually ,however where
are few accidents/incidents quarterly may be sufficient.
There are a number of ways in which data can be analysed including computer
recording programs when significant numbers are involved.
Different formulas to calculate injury incidence or frequency rate are used to
measure and compare health and safety performance between years and
organisations.
HSE’s formula for calculating an annual injury incidence rate is:

Injury incidence rate = Number of reportable injuries in financial year x1000

Average number employed during year

This formula makes no allowances for variation in part-time employment or overtime.

While HSE an industry calculates injury incidence rates per 100,000 or 1,000
employees ,some parts of industry prefer to calculate injury frequency rate ,usually
per million hours worked, to avoid distortions caused when calculating injury
incidence rate by part—and-full time employees and by overtime working.

Injury frequency rate = Number of injuries in the period x 100,000

Total hours worked during the period

(P.Hughes,MBE,2011, p161)

All the data obtained from different quantitative methods then are used by the
organisation to see how they perform, what are their losses, track their losses,
identify trends, benchmarking and most important to learn and further improve.

3.3 An assessment of the needs for reporting events and the impact on the
organisation. (Max 275 words)

The official recording of an occupational injuries and diseases can be considered as

one of the most important aspects of the safety process, and it is also a legal
requirement. When it comes to reporting and recording ,the severity of the event
should never be the sole criteria, as any injury or other loss events reflects the
existence of a gap or a failure in the safety management system. Therefore, all
occupational injuries and/or diseases, including those of a minor nature, property
damage accidents, near-miss incidents, and dangerous occurrences should be
reported and recorded for a future analysis. This, together with other data from
different loss analysing methods will assist in determining trends and problem areas,
also for audit purposes and for the Authority (HSA) inspections and/or investigations.
OTHM Assignment Submission: Unit 3 Risk & Incident Management 16

(R. Mckinnon,2020, p219)

The need to report and also keep records of it is a legal requirement, accidents
and dangerous occurrences are required to be reported to the Health & Safety
Authority (HSA) in line with the Safety, Health and Welfare at Work (Reporting of
Accidents and Dangerous Occurrences) Regulations 2016 (S.I. No. 370 of 2016).

This guidance document explains why accidents and dangerous occurrences

reporting is required, what is reportable, what is not reportable, who and how the
report should be made and these are just few key points as follow:

• Only fatal and non-fatal injuries are reportable. Diseases, occupational

illnesses or any impairments of mental condition are not reportable.(This
information is available from Central Statistics Office, claims data from the
department of Social Protection, insurance claims data etc)
• Directly caused mental injuries such as shock or fright as the result of an
assault ,continue to be reportable.
• Fatal accidents must be reported immediately to the Authority or Garda either
the fatal accident took place at the usual work place or in any other location
other the normal place of work. Subsequently, the formal report should be
submitted to the Authority within five working days of the death.
• Non-fatal accidents or dangerous occurrences should be reported to the
Authority within ten working days of the event.
• Injuries to any employee as a result of an accident while at work where the
injury results in the employee being unable to carry out their normal work
duties for more than three consecutive days ,excluding the day of the accident
(when calculating you should include also weekend and other non-working
days).
(HSA ,2016,p 3)

At the organisation level the effective reporting of loss events will cover two of
the most important needs :

1. Need for prevention - learn and further improve;

2. Legal requirement - compliance with statutory requirements.

The impact of reporting events is tremendous and can make the difference between
organisations having a “weak, negative culture” or having a “strong, positive culture”,
where everyone works safely, feel safe, behave safe, because all members of staff
appreciate the importance of safety, and this is the type of culture that in time will be
embraced even by those who do not share the same values, and will shape people’s
safety-related behaviour and reinforce positive behaviour.

3.4 An explanation of the importance of incident investigations and the impact

on the organisation. (Max 275 words)
OTHM Assignment Submission: Unit 3 Risk & Incident Management 17

Every organisation should have effective procedures in place for

reporting and investigating accidents, ill-health cases, near-misses,
dangerous occurrences, or any other incidents.
The prime purpose of the investigation procedure is to prevent further
accidents, ill-health and/or any other loss events.
The occurrence of loss events is usually an indication of safety and
health management failures. In order to find out why those loss events
have happened (root causes) ,all shortcomings in the safety and health
management system should be investigated.
(HSA, 2006, p48)

Organisations have many methods for protecting themselves against

loss events, including hardware, procedural, and administrative controls.
Incidents can occur when the safeguards for unacceptable risks are
deficient, fail, or missing at all.

The overall goal of the investigation process is to ensure that the

proper safeguards are in place and functioning to prevent and mitigate
the incidents. If adequate safeguards are provided ,any losses that do
occur will be acceptable or tolerable.
More specific investigation objectives within the organisation are as
follow:
• Protect the safety and health of workers and the public
• Preserve the organisation’s human and capital resources
(moral/economic)
• Improve quality, reliability, and productivity
• Ensure continued service to clients and customers
• Comply with regulatory and insurance requirements (legal)
• Comply with organisational and industry policies
• Respond to legal, regulatory, organisational, community, and/or
employee concerns
• Educate management, staff, and employees
• Demonstrate management concern and promote employee
involvement
• Advise others of unrecognized risks and/or ,more effective risk
management strategies.

All these specific objectives are enveloped by the overall goal of

ensuring that proper safeguards are in place and functioning for the
benefit of everyone.
(ABS Consulting, Root Cause Analysis ,a Guide to Effective Incident
Investigation, 2008, p13,14)
OTHM Assignment Submission: Unit 3 Risk & Incident Management 18

The impact of an accident/incident investigation will always depend on

the product of the investigation which are recommendations.
During the investigation the questions that need to be answered are not
just “ what” and “how” but most important “why” it happened ?
The goal is to find out the causal factors, that are performance gaps
(equipment or personnel) and if eliminated ,would have either prevented
the incident or reduced its severity, and the most important is to find out
the root causes for each causal factor, which are deficiencies of
management system that allow the casual factors to occur and develop
into an accident/incident.
Finally, recommendations are developed and implement to eliminate
the root causes and prevent the causal factors ,that led to the
accident/incident, from happening again.

Task 4 of 4 - Report - Assessment Criteria 4.1, 4.2, 4.3, 4.4

Outline the organisations processes and strategies to manage health and
safety incidents.

(Word count: max 1,000 words + 10% leeway)

The following must be included in a Report format:

TASK 4 – REPORT
OUTLINE THE ORGANISATIONS PROCESSES AND STRATEGIES TO MANAGE
HEALTH AND SAFETY INCIDENTS.

AC 4.1 An outline of For an investigation to be successful ,it is essential that everyone is fully
the critical stages for involved, from the top management and down to the workforce. A joint
managing incidents approach will reinforce the message that the investigation is for the
within the benefit of everyone.
organisations. The following critical stages have been outlined by the HSE (UK) in their
(Max 275 words) guidance document: Investigating Accidents and Incidents, HSG 245
(2004,p12):
§ Emergency response
OTHM Assignment Submission: Unit 3 Risk & Incident Management 19

• take prompt emergency action (e. g. first aid);

• make sure the area is safe for you and everyone else;

§ Initial report
• Preserve the scene;
• Note the names of the people involved and the witnesses,
equipment involved (if that is the case);
• Report the adverse event to the person responsible for the health
and safety (or to your superior), who will decide if any further
action are needed.

§ Initial assessment and investigation response

• Report the adverse event to the regulatory authority if
appropriate.
(HSA, Reporting of Accidents and dangerous occurrences,
Regulation 2016, p3,4)
It is good practice and also common sense to investigate all adverse
events, always bearing in mind the potential consequences ( a near- miss
causes can have a great potential to cause serious injuries or ill-health) and
the likelihood of the adverse event recurring ,that is what should be
considered when determining the level of the investigation (Minimal, Low,
Medium, High) (HSE,UK,HSG 245,2004, p13)

The investigation should be thorough and structured in four consecutive

steps:
1. Information gathering/evidence
(Where, When, Who?)

• Witnesses and the scene

• People, machinery ,equipment, environment
• Documents and procedural controls

2. Analysing the Information and identifying causes

• Immediate causes
• Underlying causes
• Root causes

3. Identifying suitable risk control measures

• Temporary/short term measures

• Permanent/long term measures

4. Implementation of the Risk Control action plan and

Communication of the Lessons learned

• SMART objectives (Specific, Measurable, Agreed, Realistic

and Timely)
• Prioritized depending on the magnitude of the risk
• Progress on the action plan should be regularly reviewed
and monitored
OTHM Assignment Submission: Unit 3 Risk & Incident Management 20

• Employees and their representatives should be kept fully

informed about the investigation findings, incident causes,
the contents of the risk control action plan and the
progress in the implementation of the corrective
measures.

AC 4.2 An Outline of Because T. W. Private Clinic doesn’t seem to have /or I am not aware of
the organisations them having an Incident Reporting Plan outline in their OHS policy
policies used to /Incident Management Policy, I choose Abbeyfield Ferring Society Ltd – a
identify, investigate, not-for-profit society that provides high standards services at home and in
report and record residential care facilities ,for older residents living in the Ferring area.
health and safety The Abbeyfield Ferring Society Ltd. Policy& Procedure /Good Practice
incidents. Guidelines is a very detailed document consisting of 12 pages ,with
(Max 275 words) detailed information on different aspects of health and safety including on
Reporting accidents and incidents, fire and emergency procedures, first aid
training and provision, risk assessments etc
In this Document:
4.3.2 outlines the Abbeyfield Ferring Society arrangements for the
effective management of Fire Safety and Emergency Procedures with all
the details in their Fire safety Policy, First Aid Policy
4.3.3 Reporting Accidents and Incidents ( some key elements)
• All employees are required to immediately report all accidents,
injuries and ill health associated with work activities and as a
required legal duty to notify the Health and safety Executive in
the Reporting of Injuries ,Diseases and Dangerous Occurrences
Regulation 2013 (RIDDOR)
• injuries and ill health involving people not at work( residents
/visitors)
• each house /care home keeps and maintain an accident
reporting book that complies with the data protection
• a record of service users falls will be completed and kept
secure with personal plans and risk assessment records; falls
are monitored and reported every month as part of accident
and incident reporting procedures.
• All accidents, injuries, illnesses and incidents will be recorded
and reported routinely to line managers and every month to
the health and safety teams as part of the routine reporting
procedures.
• Accidents Investigation procedures are to identify the causes
of accidents and incidents and the implementation of suitable
preventative and control measures.
The generic risk assessment form and system is used in this
process for minor events. Significant events require formal
investigation with the identification of root causes to enable
both local and organisational learning as part of the quality
management process for continual improvement.

I would rate Abbeyfield Ferring Society Ltd. Incident Policy :

OTHM Assignment Submission: Unit 3 Risk & Incident Management 21

Demonstrating Best Practice because of their commitment shown in

this Policy to Identify, investigate ,report and record all incidents,
accidents, injuries, ill health and all other adverse events and also
really important they will communicate and share the lessons learned
across all parts of their organisation.
https://www.abbeyfieldferring.org.uk

AC 4.3 An Those who are required to report accidents and dangerous occurrences
explanation of how under the Regulation (Employers, Self-employed, Landlords, Owners and
records are Tenants) ,are also required to keep records for a period of 10 years from
maintained within the the date of the incident. The records can be kept in the same format as the
organisation to report was originally made ,that is a copy of the report submitted to the
ensure compliance Authority , will suffice to meet the obligation.
with regulatory and
statutory HSA (Irl) requires that fatal accidents in a workplace should be reported
requirements. immediately to the authority and Garda ,so that the necessary actions
(Max 275 words) ,including any investigation by the Authority ,can take place. Following the
initial report the initial report and within five working days of the death,
the formal report should me made in the approved form. This applies to
any work-related death, including one that takes place within a year of
previously reportable accident.
A non-fatal accident or dangerous occurrence (list can be found in
Appendix 1, HSA Reporting of Accidents and Dangerous Occurrences,
Regulation 2016) should be formally reported within 10 working days of
the event.
Injuries should be reported using the online reporting system on the
Authority website (www.hsa.ie).
Organisations should cultivate a culture where workers have confidence to
report safety incidents /unsafe actions, or concerns without feeling any
fear or blame.
When it comes to recording injuries, the severity of the injurie should
never be the sole criteria, as any injury reflects the existence of a gap
/failure in the safety management system. Therefore any occupational
injuries, ill-health, accidents, incidents, near misses should be recorded
and analysed ,this will assist in determining trends, prevent recurrences,
learn and further improve.
According to R. McKinnon (2020,p 219) official recording is one of the most
important aspects of the safety process, and also a legal requirement ,that
allows organisations to meet regulatory and statutory requirements ,and
also one of the most important tool used when measuring performance, as
records are the outputs of their policies and procedures.
AC4.4 Evaluate an In this paragraph I am going to use my own experience ,how T. W. Private
organisational Clinic managed an incident when I hurt my back while lifting and
process for managing transferring a resident from the bed to the wheelchair, using a
health and safety mechanical aid (hoist ).
incidents. The incident happened in the morning while performing personal morning
(Max 275 words) care for the resident, helping with the transfer from the room to the
bathroom, using a standing hoist ( this particular type of hoist is used for
patients that are still able to help to a certain extent in the process of
moving), being an old type of mobile hoist , requires two carers, one is
operating the hoist and the other is helping the patient to get to the side
OTHM Assignment Submission: Unit 3 Risk & Incident Management 22

of the bed. That morning I was helping the resident to get to the side of
the bed, while doing that I felt a sharp pain in my lower back, and I
couldn’t move.
Step 1- Immediate action
The emergency bell was pressed by my colleague to get help, I was helped
to get to the nearest chair to sit down, and after to be put in a bed in a
lying position.
The Clinical Nurse Manager and the Assistant Director of Nursing that were
on duty at that time were notified of the incident.

Step two- Plan the investigation

The Assistant Director of Nursing came by to check on me ,to see how
serious the incident was and what further steps are needed.

Step 3- Data collection

The assistant Director of Nursing took our statements, both mine and of
the colleague. She was writing them down as we were speaking.
She asked in detail what happened before, the incident itself (where,
when, how, who was involved and who are the witnesses etc.), and what
exactly we did after just before we notified her about the incident.
Because the incident happened inside a resident room (private area), they
didn’t have CCTVs to analyse, they are located in the corridors and other
public areas (dining room, sitting room, physiotherapy room etc. )
Questions about what exact hoist was used, did we visually inspected it
before use, have we followed the manual handling technique from the
personal care plan for that particular resident?

Step 4- Data analysis

The Assistant Director of Nursing analysed all the data gathered

immediately about the incident, and she decided to call the ambulance for
me to get checked by a physician, to exclude any serious back injuries with
serious immediate consequences and also long term consequences.
I was checked by a physician, a neurological exam was done and also a
spine X -ray.
I was observed for few hours and discharged with the recommendation of
2 days off work and painkillers if needed.
Doctor’s conclusion -pulled( stretched) muscle

Step 5- Corrective action

After I came back to work, we ( me, few other carers, the physiotherapist,
the Assistant Director of Nursing that was investigating the incident) had
to review the risk assessment for manual handling for that particular
resident ,and in conclusion was decided that the Resident’s health has
deteriorated recently and as a result the standing hoist is no longer
appropriate to meet Resident’s needs and no longer safe to use from
carer’s perspective.
The Resident was moved to a room equipped with a ceiling hoist ,with
many advantages( easy to use, no manual handling issues when
manoeuvring manual hoists trough the room with carpets, rugs and other
OTHM Assignment Submission: Unit 3 Risk & Incident Management 23

obstacles),and also can be operate by a single carer if the personal care

plan states so.

Step 6- Reporting
Accidents and dangerous occurrences are required to be reported to the
Authority in line with the Safety Health and Welfare at Work (Reporting of
Accidents and dangerous Occurrences-Regulation 2016-S.I. No.370 of
2016) .This is a guidance document that explains what is reportable ,what
is not reportable, who should make the report and how the report should
be made.
An organisation should complete a critical appraisal of all accidents
reporting and investigation process to ensure its efficiency and reliability.
This can be done as part of a health and safety management system audit
to identify the strengths and the weaknesses and what can be done to
improve organisations health and safety management system.

This step needs some improvement in T.W. Private Clinic, the findings
were not being communicated to all the staff ,so that the lesson can be
learned.

Conclusion:
Strengths: The organisation fallowed all steps of the investigation, from
the immediate actions to the corrective measures ,that weren’t just a quick
fix of the problem, the actual root cause was found ( a risk assessment that
wasn’t valid anymore ,because of the change in Resident’s health) ,and
doing that the organisation took the opportunity and reduced the risk of
recurrence of that particular incident related to that particular case, but
also for other similar incidents that may occur.
Weaknesses: Communication is a very important tool, if the findings are
not communicated so that the lessons can be learned, the risk of
recurrence is really high, and the staff will often make their own decisions,
sometimes those decisions will result in unsafe acts, that combined with
unsafe conditions, flaws in safety knowledge and deficiencies in the safety
management system will definitely lead sooner or later to an accident.
Recommendations : always include the relevant findings of the
investigations in the continuing safety and health review process,
communicate the outcome to all relevant parties so that the lessons can
be shared, and in the end the H&S management system is improved.

Bibliography:

P. Hughes , Introduction to Health & Safety at Work (2016)

John Channing, Safety at Work ,Vol. Eight edition, Routledge (2013)

OTHM Assignment Submission: Unit 3 Risk & Incident Management 24

Ron C. McKinnon , The Design, Implementation and Audit of Occupational Health

and Safety Management Systems, CRC Press (2020)

Milton P. Dentch, The ISO 45001:2018 ,Implementation Handbook ,Quality Press

(2018)
J. Jeynes, Risk Management : 10 principles (2002)

Dr Tony Boyle, Health & Safety Risk management, Routledge, (2019)

Health and Safety Management in Healthcare – Information Sheet (2010)

e Article : Qualitative, Semiquantitative, Quantitative Methods for Risk

Assessment: case of financial audit, Laura Diana Radu (2009)

HSA, Health and Safety at Work in Residential Care Facilities, (2007)

HSE (UK), Investigating Accidents and Incidents, HSG 245 (2004)

Phil Hughes MBE, Ed Ferrett , Introduction to Health and Safety at Work, Fifth
edition, (2011)

S.I. No. 370/2016, Safety, Health and Welfare at Work ( General Application-
Amendment N0.3) Regulations 2016
www.Irishstatutebook.ie

HSA, Guidance on the Safety, Health and Welfare at Work ,Reporting of Accidents
and dangerous Occurrences, Regulations (2016)

Lee N. Vanden Heuvel, Donald K. Lorenzo, Laura O. Jackson, Walter E. Hanson,

James J. Rooney, David A. Walker, Root Causes Analysis Handbook a Guide to
Effective Incident Investigation, Third Edition, ABS Consulting, (2008)