Key learnings from a High Potential Incident
HPI OSH Alert #485
Date of incident: 26 October 2016
Safety Flash issued: 23 November 2016
A contractor was observed working from a fully extended ladder approximately 5 metres in the air with no form of fall prevention. The contractor was working alone and the ladder was in an area where vehicles pass, it was also on loose gravel with nothing to secure it to the structure it was leaning against. He was also wearing a short sleeve shirt whilst performing the works.
Why did this happen?
- The Job Safety Environment Analysis (JSEA) was inadequate:
- Working at heights risks and controls were not adequately identified
- JSEA was generic and not specifically developed for this task
- Lack of prior notification to site and no Clearance to Work (CTW) issued.
- No site induction or Corporate OSH induction performed.
- The contractor did not adequately assess the hazards, risks and controls of the task and used inappropriate equipment for the job – a ladder instead of an Elevated Work Platform (EWP)
What will the business area involved in the incident do to stop this from happening again?
- Complete a toolbox talk on the current procedure/process to grant contractors site access.
- Present at Service Delivery Managers (SDM) Forum on site access protocols for capital and maintenance at depots and offices.
- SDMs to review and nominate CTW authorised persons, update the list and ensure it is located at the front desk with the site access information pack.
What will our organisation do to stop this from happening again?
- Review and resolve the current requirement for 5 days’ notice on Clearance to Work and its incompatibility with reactive repair work.
- Develop a Toolbox to reinforce the protocols for contractor site access i.e. Inductions, PPE and CTW across the whole organisation.
- Conduct briefings on the contractor site access protocols to all depot and office personnel including nominated Clearance to Work personnel.
What key learnings can you discuss with your team to stop this from happening again?
It is essential to follow the correct process for granting contractors access to site.
- What are the main steps of the correct process to grant contractors access to site?
- What do we need to check that contractors have before gaining access to our site?
- Who are the CTW authorised persons for our site and where can we find this information?
How do we ensure Contractors and Sub Contractors understand and adhere to requirements?
- What checks do we perform when we have Contractors onsite?
- How do we make people aware when Contractors will be onsite?
If you would like further information about anything included in this HPI OSH Alert, please contact Charis Neumann, Snr OSH Analyst Incidents, (08) 6330 6629.