Ryde House Group Accident Report Form

Ryde House Group Accident and Injury Report Form
The legal requirements for recording and reporting accidents, diseases and dangerous injuries at work are laid down in the Social Security (Claims and Payments) Regulations, the Social Security Administration Act and the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR).
Recording Accidents at Work

To comply with regulation, a record of injuries that happen to any person (employee, client, visitor) must be retained.

Safety Representatives are legally entitled to be given/receive information from completed accident forms under the Safety Representatives and Safety Committees Regulations and the Health and Safety (Consultation with Employees) Regulations. All accident form submissions are automatically made available to RHG Health & Safety Officers.

If the injured person ticks the box (and authenticates the consent with his/her signature) then the information contained within the record may also be disclosed to other elected Health & Safety representatives and any other third party requiring the information. Where consent is not obtained, the information will be anonymised to enable disclosure.
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR)

RIDDOR states that an employer must notify, report and record some deaths and injuries that arise from accidents at work.

You must produce RIDDOR records when asked by HSE or local authority inspectors.

RIDDOR records will always be disclosed to RHG health and safety officers.

1. ABOUT THE PERSON WHO HAS HAD THE ACCIDENT OR INJURY

The injured person must not complete this form. If you have had an accident or injury please speak to another member of staff (senior or manager) who will report it on your behalf.
Is the injured individual a staff member, service user or visitor*

Staff MemberService UserVisitor/Other
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

TownCounty

Post Code
Location*
For Outreach support please use 'Outreach'
2. ABOUT YOU, THE PERSON COMPLETING THIS FORM
Name*

First NameLast Name
Location/ Department*
Occupation

5. FOR COMPLETION BY THE HEALTH AND SAFETY REPRESENTATIVE ONLY

Please complete this section if this accident/injury is reportable under RIDDOR.
How was the RIDDOR report made?
When was the RIDDOR report made? Please ensure evidence of this is filed.
Name and signature of reporting person
HR
Should be Empty:

Ryde House Group Accident and Injury Report Form