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Working for business

Measuring your capabilities inWorkplace Safety ManagementACC Workplace Safety Management Practices Audit Standards

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ACC workplace safety managementpractices audit standards

These are the audit standards used by ACC approved auditors conductingworkplace audits to evaluate applications to enter the ACC Workplace SafetyManagement Practices programme.

The audit standards: are aligned with the Australia/New Zealand Standard for Occupational

Health and Safety Management Systems (AS:NZS4801:2001) are designed solely to help ACC determine your eligibility to receive a

levy discount under the ACC Workplace Safety Management Practicesprogramme.

Achieving a standard under the ACC Workplace Safety Management Practicesprogramme does not assess your compliance with any other applicablelegislation, including the Health and Safety in Employment Act 1992. You willstill need to ensure compliance with any other legislation which applies to you.

What do the audit standards cover?

The audit standards cover the following critical elements:

1. Employer commitment to safety management systems

2. Planning, review and evaluation

3. Hazard identification, assessment and management

4. Information, training and supervision

5. Incident and injury reporting, recording and investigation

6. Employee participation in health and safety management

7. Emergency planning and readiness

8. Protection of employees from on-site work undertaken by contractorsand sub-contractors

9. Workplace observation

10. Focus group interviews with management and employees.

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What are the three levels of performance?

Within the audit standards there are three measurable levels of performance:

Primary Secondary Tertiary

The standards required for each level are shown using shading indicated below.

Primary(10% discount of Workplace Cover levy)

programme entry level requirements

Secondary(15% discount of Workplace Cover levy)

consolidation of good practice

Tertiary(20% discount of Workplace Cover levy)

continuous improvement,best practice framework

Achieving the standards

To achieve a discount under the ACC Workplace Safety Management Practicesprogramme you must meet all of the Primary level requirements in eachsection of the audit standards.

The audit provides ACC with a snapshot of your safety management practices.

It is your responsibility to monitor and evaluate injury prevention performance

in your workplace and to ensure your workplace health and safetyperformance meets or exceeds the Primary level requirements.

Employers who meet the Primary entry level requirements are encouraged toprogress through to Secondary and Tertiary levels in future audits.

More information?For more information contact:

your Relationship Manager, Workplace; or

the ACC Business Service Centre on0800 222 776 .

You can view and download the ACC Workplace Safety ManagementPractices Audit Standards and Audit Guidelines from the ACC websitewww.acc.co.nz

1. Health and safety documentsthat include a statement of commitment.

2. Information provided tomanagement staff on how tosupport safe and early returnto work.

3. Evidence of managementinvolvement in supporting safeand early return to work (where

applicable).

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1. Employer commitment to safetymanagement practices(AS/NZS 4801:2001 Sections 4.2, 4.4 and 4.6)

Objective

The employer is able to demonstrate an active, consultative commitmentto all areas of health and safety management in the workplace.

Details of requirements

Verified by Achievedyes/no

1. There is a documentedhealth and safetypolicy.

1. Policy document.

2. The policy isauthorised by currentCEO or other seniormanagement*representatives.

1. Appropriate signature, positionand date.

2. Process for senior management toreview policy document at leastevery two years.

3. The policy incorporatesmanagementcommitmentto comply withrelevant legislation,regulations, codesof practice and safeoperating procedures.

1. Policy document includesstatement of commitment tocomply with relevant standards.

4. The policy includesspecific understandingof managementresponsibilities forhealth and safety.

1. Policy document includesmanagement commitment tohealth and safety.

2. Specific health and safetyco-ordination roles are designatedat senior management* level.

3. Management positions arereviewed against the performanceof designated health and safetyresponsibilities.

4. Evidence that individualmanagement performance hasbeen reviewed against health andsafety responsibilities.

Continued

*Please refer to the definitions on page 28 if you require further clarification.

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5. The policy includesan outline of individual employeeresponsibilitiesfor health and safety.

1. Policy document states individualresponsibilities for health andsafety in the workplace.

6. There is commitmentto consultation withunion* and othernominated employeerepresentatives*regarding participationin health and safetymanagement.

1. Policy document includesstatement of support for employeeconsultation and participation.

7. There is specificmanagementcommitment toaccurate reporting andrecording of workplaceincidents and injuries.

1. Health and safety documentsinclude a specific statementrequiring accurate reporting andrecording.

2. Records of this requirementincluded in performance review of management roles.

8. There is commitmentto continuousimprovement in health

and safety.

1. Indicative statement in policydocument.

2. Evidence that a system existsfor the review of health andsafety-related policies by seniormanagement* to ensure theirongoing effectiveness (for examplerecords of reviews or a documentedreview procedure or checklist).

3. Evidence that excellence in healthand safety management andinnovation by staff is formallyrecognised (e.g. recognitionin staff newsletter, reward for

innovative ideas).

Continued

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9. There is specificcommitment toensure managers(including seniormanagement*) havean understandingof health and safetymanagement relativeto their positions.

1. Evidence of this commitmentin policy statement, positiondescriptions (or similar).

2. Evidence that seniormanagement* have beeninvolved in health and safety (e.g.seminars, briefings, conferences,training sessions) within theprevious two years.

10. There is specificcommitment bymanagement tosupport the safeand early return towork of their injuredemployees.

1. Health and safety documentsthat include a statement of commitment.

2. Information provided tomanagement staff on how tosupport safe and early return towork.

3. Evidence of managementinvolvement in supporting safeand early return to work (whereapplicable).


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2. Planning, review and evaluation(AS/NZS 4801:2001 Sections 4.3, 4.4 and 4.5)

Objective

The employer is able to demonstrate a focus on continuous improvementthrough a systematic approach to occupational health and safety thatincludes setting specific objectives, establishing and supporting systemsor programmes to achieve objectives, regular review of progress and evaluation of outcomes.



1. There is a process toensure that health andsafety managementfor the workplace isreviewed.

1. Process to review health andsafety management annually.

2. Process to review health andsafety management that occursafter a critical event and/or if thereis a change in work procedures orhealth and safety policy.

2. Health and safetyobjectives are set thatare appropriate tothe size and type of business, relevant toeach level within thebusiness and relatedto identified hazards(where relevant).(NB:Objectives set shouldbe SMART Specific

Measurable Achievable Realistic

Time-bound.)

1. Documented objectives andmanagement plan to achieveobjectives.

2. Procedure to review objectivesannually.

3. Evidence that health and safetyobjectives have been reviewed.

4. Evidence that senior

management* and union* andother nominated employeerepresentatives* have beenincluded in annual review andsetting of objectives.

3. There is an establishedconsultative processto review and evaluatethe effectiveness of hazard management.

1. Process or planning documents(or similar).

2. Minutes, schedules (or similar)to show there is annual reviewof the effectiveness of hazardmanagement processes.

Continued


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4. The employer isable to demonstrateknowledge of currenthealth and safety-related informationincluding legislation,regulations, currentcodes of practice, andother health and safetystandards relevantto the particularworkplace.

1. Process to identify the health andsafety information specific to theemployers business.

2. Process in place to ensurecompliance or conformance withrelevant requirements.

3. Evidence of regular review toidentify and accommodate anychanges to requirements.

5. A procedure toundertake an annualself-assessment toensure the programmeaudit standards can bemet and maintained.The procedureinvolves management,union* and othernominated employeerepresentatives*.

1. Self-assessment procedure.

2. Evidence that a self-assessment

has been undertaken within theprevious 12 months (may beimmediately prior to initial entryaudit).


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3. Hazard identification, assessmentand management(AS/NZS 4801:2001 Section 4.3 and 4.4)



1. There is a systematicprocedure to identifyand record actual andpotential hazards inthe workplace.

1. A procedure that covers anunderstanding of the range of hazards including (for example)work organisation, job design andhazards facing employees workingoff-site.

2. Review of hazard registers tosupport process in action.

3. Records of regular review ofthe hazard identification andrecording process.

2. There is a processto assess identifiedhazards to determinewhich hazards aresignificant* accordingto the definitionin the health andsafety in employmentlegislation.

1. Documented definition of significance.

2. Process to demonstrate theidentification of significanthazards* and evidence of implementation of this process.

3. The hazard register (or similar)identifies which hazards aresignificant.

Continued

Objective

The employer has an active method that systematically identifies,assesses and manages the actual and potential hazards in the workplace,over which the employer has authority or influence.


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3. There are appropriatecontrols in place foreach significant hazardbased on the hierarchyin the health andsafety in employmentlegislation to:(a) Eliminate the

hazard completely,or

(b) Isolate the hazardto prevent theexposure to thatparticular hazard;or

(c) Minimise the impactof the hazard.

1. Procedure for developingappropriate controls.

2. Details of controls developed forsignificant hazards*.

3. Process for the issue, renewaland maintenance of safetyequipment related to significanthazards* including personalprotective equipment.

4. Evidence that controls developedfor significant hazards* are basedon appropriate documentation oradvice (where applicable).

4. There are appropriatelytrained and/orexperiencedpeople leading theidentification andmanagement of hazards.

1. Records of training, and/or skillsand experience for people leadinghazard management.

2. Evidence of ongoing training orincreased experience for peopleleading hazard management thathas occurred within the previous

two years.5. There is a procedure

for obtaining specialistadvice for managingspecific hazards, wherethis competency isnot available throughinternal staff.

1. Procedure to support theappropriate use of specialistadvice (e.g. the managementof hazardous substances,monitoring of noise levels orassessment of workstations).

2. Accessibility of referenceinformation for all staff (e.g. hardcopy or electronic) that includesrelevant legislation, regulations,codes of practice, safe operatingprocedures, MSDS etc.

3. List or information aboutavailability of internal or externalhealth and safety specialistadvice (where applicable).

Continued


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6. There is a scheduledocumenting theminimum reviewtimetable to monitorsignificant hazards*that have beenisolated or minimised.

1. Hazard review timetableappropriate for particularidentified hazards.

2. Responsibilities assigned forensuring timetable is met andsigned off at each period.

7. There is activemanagement of hazards associatedwith any new ormodified equipment,material, servicesor work processesintroduced into theworkplace.

1. Hazard identification andmanagement documents.

2. A process for consultation withrelevant health and safetypersonnel in the purchase orimplementation of new ormodified equipment, material,services or processes.

3. Evidence of health and safetyissues incorporated intopurchasing and design decisions(where applicable).

8. There is an ongoingopportunity for theactive involvement

of union* and othernominated employeerepresentatives*in identifying andmanaging hazards inthe workplace.

1. Evidence of employee consultationor active involvement in hazardmanagement, or the provision

of ongoing opportunities forinvolvement (process documentaccepted for new applications).

9. There is a processto identify andmanage any areasof the workplacerequiring specifichealth monitoring inrelation to tasks beingundertaken (whereapplicable).

1. Process to identify tasks requiringmonitoring and ongoing regulartesting.

2. Process to undertake baselinemonitoring of health related to

identified tasks and to notifyemployees of results (e.g. hearingtests, lung function tests).

3. Process for post-critical eventtesting and exit testing.

4. Process to manage sub-optimaltest results that includesconsideration of individual medicaland vocational needs.

5. Process to feed back sub-optimalresults into hazard management.

Continued




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10. There is a process toidentify tasks wheresignificant hazards*may make pre-employment healthscreening appropriateto ensure that thepotential for work injuryor work-related illnessthrough exposure tothose particular tasks isminimised.

1. Process documents.

2. Documented rationale andprocess for pre-employmenthealth screening that is linkedto specific significant hazards*(where applicable).

11. Work areas over which

the employer hascontrol or influence areplanned so that theexposure of visitorsand the general publicto workplace hazardsis minimised.

1. Clear marking of designated areas

as appropriate.2. Signage, security log books or

visitors registers available asappropriate to specific areas of theworkplace or escorting restrictionsand induction for site visitors.

3. Evidence that emergency proceduresare covered with site visitors.

4. Provision of appropriate personalprotective equipment for visitors to

the site (e.g. goggles, hi-viz. vests).




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4. Information, training and supervision(AS/NZS 4801:2001 Section 4.4)



1. There is appropriatehealth and safetyinduction training fornew employees andemployees transferringto a new environment,role or task.

1. Evidence of staff health and safetyinduction training that includesconsideration of the followingneeds (where appropriate): Emergency procedures Incident and injury reporting Hazard identification

Employer and employeeresponsibilities The process for employee

health and safetyrepresentation

Information about the healthand safety forum/s

Designated roles for healthand safety and rehabilitation

Work injury claims process Rehabilitation responsibilities

Use and maintenance ofrelevant health and safetyequipment, including personalprotective equipment(e.G. Checklist, traininginformation).

2. Signed employee inductiontraining records (or similarindividual verification).

2. There is identificationof health and safety

training needs inrelation to hazardsassociated withspecific roles, tasks orareas of work.

1. Procedure to identify trainingneeds for specific roles, tasks, or

areas of work (e.g. training needsassessment or training plan linkedto hazard management).

Continued

Objective

The employer will ensure that all employees are informed of their ownresponsibilities and the employers responsibilities for health and safetyin the workplace. The employer will ensure that employees have specificknowledge concerning management of the hazards to which they are exposed through workplace procedures, environment, equipment and materials.

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3. All health and safetyinformation andtraining is delivered sothat the key messagesare clearly understood,taking into accountlanguage, literacy,vision, hearing or othervariables.

1. A process to determine thathealth and safety information andtraining have been understood.

2. Signed employee training records(or similar individual verification).

3. Evidence that task-specifictraining has occurred (e.g.certification, training records orsimilar where applicable).

4. A process for bring-up reminderfacility for recurring trainingor certification requirementsincluding assignment of responsibilities for this process.

5. Evidence to demonstrate thatcompetency has been achievedfollowing specific health andsafety training (e.g. written or oraltests, certifications, practical skilldemonstrations including on-the-job assessments).

4. There is access tointernal staff memberswith the relevantskills, experienceor qualifications toundertake training.

1. Guideline document (or similar)outlining health and safety trainerselection criteria.

2. Records of internal trainers skills,experience or qualifications.

5. There is a process todetermine the relevantskills, experienceor qualifications of external trainers usedfor specific trainingrequirements.

1. Selection criteria or similar foruse of external trainers (whereapplicable).

6. There is a system forcontrolling healthand safety-relateddocuments andinformation includingthe disseminationof applicableinformation to staff and notification of outdated documents.

1. Document control system (paperbased or electronic).

2. Dates on health and safetydocuments at operational sites.

3. Role-specific responsibilitiesto review health and safety

documentation control.

Continued

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7. Health and safetyinformation specificto the workplaceis available to allemployees.

1. Access to further informationis included in health and safetyinformation available in theworkplace (e.g. posters, signs,training, intranet, briefings,meeting schedules or similar).

8. Supervision foremployees undergoingon-the-job trainingis provided byexperienced andskilled staff to ensure

the employeesnewness to the task orrole does not endangerthemselves, others orequipment.

1. A process that requiresassessment of relevant experienceand skills for the supervision of employees undergoing on-the-jobtraining.

2. A process for the clear designationof responsibility for supervision of new employees.



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5. Incident and injury reporting, recordingand investigation(NZS/AS 4801:2001 Section 3, 4.4 and 4.5)



1. There is a system forreporting, recordingand analysingincidents, injuries andwork-related illnesses.

1. Documented procedure.

2. Incident and injury (accident)reporting forms.

3. On-site incident and injury(accident) registers.

4. Procedures requiring early andprompt attention to all reportedincidents and injuries.

5. Collation of all injury and incidentdata into a central record foranalysis.

2. Employees understandtheir specificresponsibilities toreport incidents,

injuries and workplaceillnesses that have ormight have harmedanyone in theworkplace.

1. Reporting systems available inall work areas (e.g. forms in hardcopy or online).

2. Staff communications, teambriefings, health and safetymeeting minutes.

3. Examples of completed incidentand injury reports (whereapplicable).

Continued

Objective

The employer has an active reporting, recording and investigation systemthat ensures incidents and injuries are reported and recorded, and theappropriate investigation and corrective actions are taken. The termsincidents and injuries in this context include all near miss or near hit events, work-related illnesses and injury events that harmed or might haveharmed any employee during the course of their work.

Critical element

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3. When a serious harmoccurs to an employeethe OccupationalSafety and HealthService (OSH) of theDepartment of Labouris notified as soon aspossible and a writtenreport is sent withinseven days. (NB: Thereare other agencies thatthe employer may alsoneed to notify to meetregulatory obligations,

in the event of aserious harm injury).

1. Procedure to notify OSH includingdocumented responsibility fornotification.

2. Example(s) of notification withinrequired timeframe when a seriousharm injury has occurred (whereapplicable).

4. The employer hasa procedure toinvestigate incidentsand injuries thatharmed or might haveharmed an employee.

1. Incident and injury investigationprocedure.

2. Designated incident and injury(accident) investigators.

3. Incident and injury (accident)investigation forms (forms in hardcopy or online).

4. Incident and injury (accident)investigation example reports(where applicable).

5. There is a procedureto ensure correctiveaction is undertakenin relation toany deficienciesidentified during aninvestigation.

1. Procedure for corrective action tobe undertaken when deficienciesare identified in an investigation.

2. Feedback into hazardmanagement included in theprocess.

3. Responsibility for corrective

action is assigned, time-bound,signed and dated as part of anincident and injury investigationand includes training and injuryprevention feedback (whereapplicable).

4. Evidence of senior management*involvement and follow-up(eg. management minutes orcommunications).

Continued



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6. Injury and incidentdata is reviewed toidentify trends andprovide informationto managers andemployees that canbe used in injuryprevention initiatives.

1. Process for at least annual reviewof collated data (e.g. minutes of meetings, distribution of findingsto management and employees).

2. Evidence of at least six monthlyreview of collated data (e.g.minutes of meetings, distributionof findings to management andemployees).

3. Evidence of injury preventioninitiatives implemented whererelevant (e.g. changes in workpractices, specific training).




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Details of

requirements

Verified by Achieved

yes/no1. There is a forum (or

series of forums) toenable communicationbetween the employer,employees andunion and othernominated employeerepresentatives* onissues of interest andconcern related tohealth and safety. (Fora large or multi-siteemployer the numberof forums should beappropriate to the size,type and geographicspread of the business,so that all employeeshave a voice throughto management).

1. Evidence of health and safetyforum(s) that include theparticipation of management andemployee representatives (e.g.minutes of meetings).

2. Evidence of frequency of forum(s)at least quarterly (not applicablefor new applications).

3. Evidence of ongoing opportunityfor joint involvement in injuryprevention initiatives and, whereapplicable, injury managementinitiatives (e.g. planning notes,outcomes of joint initiatives).

4. Evidence of consultativedevelopment, monitoringand review of health andsafety policies, processes andperformance at least annually(e.g. minutes of meetings, actionplans, review documents).

2. There is a processagreed to byemployees, to supportunion* and othernominated employeerepresentative*involvement inhealth and safetydevelopment,monitoring and review.

1. Process for health and safetymanagement that specificallysupports employee involvement.

2. Evidence of agreed process toelect or endorse union* andother nominated employeerepresentatives* to supporthealth and safety.

3. Evidence that information on this

process is readily available andcommunicated to all staff.

Continued

Objective

The employer will ensure thatall employees have ongoing opportunitiesto be involved and to have their interests represented in the development,implementation and evaluation of safe workplace practices.

6. Employee participation in health andsafety management(AS/NZS 4801:2001 Section 4.4)


Critical element

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3. Health and safetytraining is providedto employees activelyinvolved in health andsafety managementto assist in thedevelopment andestablishment of safeworkplace practices.

1. Evidence that health and safetytraining has been undertakenwithin the last two years.

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1. There is a documentedemergency plan thatidentifies potentialemergency situationsand meets relevantemergency servicerequirements.

1. Evidence of identification of therange of potential emergencysituations in the workplace thatconsiders the type and locationof the employer (e.g. chemicalspills, earthquakes, managementof emergency situations foremployees working alone).

2. Evidence of consideration of emergency service requirements.

3. An emergency plan that includesthe response required for therelevant identified emergencysituations.

2. Emergencyprocedures have beenimplemented andcommunicated withall employees andcontract staff.

1. Evidence that the emergencyprocedures have beenimplemented and communicated(e.g. signage, communications,training).

3. Designatedemployee/s orwarden/s for eachwork area trainedto take control in anemergency.

1. List of designated employeesknown to all staff.

2. Training schedules and records.

3. Evidence that review or refresheremergency training has beenundertaken with designatedemployees within the previousyear.

4. Evidence of specific emergencytraining for designated staff

according to identified potentialemergencies in the workplace (eg.civil defence emergency training,advanced first aid certificates).

Continued

Objective

The employer has an effective general emergency plan to manage emergencieslikely to occur within any part of the organisations operation and to complywith legislative requirements.

7. Emergency planning and readiness(AS/NZS 4801:2001 Section 4.4)

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4. There is periodictesting of emergencyevacuation proceduresat regular intervals of no greater than sixmonths apart.

1. Record of emergency evacuation drills.

5. There is a consultativereview of emergencyresponse procedures,after any practice drillsand after any actualemergency event.

1. Minutes of review meetings,particularly post critical event.

2. Evidence of update to proceduresand plans (where applicable).

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8. Protection of employees from on-site workundertaken by contractors and subcontractors(AS/NZS 4801:2001 Section 4.4)



1. Induction toon-site health andsafety proceduresis co-ordinated by adesignated person/sfor all contractedstaff, including one-off maintenancecontractors or similar.

1. Process for the induction of contractors and their staff,according to their level of involvement with employees inthe workplace, and includingsign-off by employer andcontractor or subcontractor.

2. Designated person(s) toco-ordinate health and safetyinduction for contractors.

3. Evidence of completed contractorinduction (where applicable).

2. Criteria to select andmanage contractorsinclude assessmentof health and safety

performance.

1. Documented procedures (e.g.selection checklist or similar).

2. Contractor plans include:

Staff training and competencies Current certification and permits Declaration of the above signed

by contractor.

Continued

Objective

The employer has a systematic approach to ensure that contractors,subcontractors and their employees do not cause harm to the employeesof the principal while undertaking the work required by the contract.(NB: There are other specific duties required of the employer as a result of the health and safety in employment legislation that are not part of this programmes requirements.)

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3. Health and safetyexpectations andresponsibilities arewritten into contracts.

1. Evidence that health and safetyresponsibilities are written intocontracts (e.g. procedures, signedcontracts).

4. There is a process toactively monitor thehealth and safetyperformance of thecontractor at agreedregular intervalsfor the duration of the contract whererelevant. (NB: Only

applies to contractwork undertaken ona site where thereare employees of theprincipal present).

1. Evidence of review of worksitehealth and safety performanceincluding dates and responsibilities.

2. Evidence of feedback fromthe contractor into hazardidentification and incidentand injury reporting (whereapplicable).

5. Post-contractevaluations includehealth and safety aspart of the evaluation.

1. Process for post-contractevaluation.

2. Evidence of completedpost-contract evaluations(where applicable).

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9. Workplace observation confirmation of safe systems in action


The auditor will observethe following:

Achievedyes/no

1. The auditoris able toobserve someselected auditstandardrequirementsin practice.

1. Hazard registers.

2. Evidence of assessment of hazards todetermine their significance.

3. Current safety information on display.

4. Incident and injury (accident) registers

available in the workplace (hard copy orelectronic).

5. Forms completed (where applicable).

6. Evidence of personal protective equipment inuse according to what is appropriate to thearea visited.

7. Restricted areas of work are clearlymarked.

8. Escorting and signing requirements are in

place for restricted areas of work.9. Emergency evacuation procedures are

clearly outlined (e.g. signs, posters,designated listed employees trained totake control in an emergency e.g. wardens,first-aiders).

10. Emergency exits are clearly marked.

11. Emergency equipment is clearly markedand current.

12. Security log books, visitor registers(or similar) are provided.

13. Personal protective equipment is availablefor site visitors (where applicable).

Objective

Under this section, there are a few systems-related requirements that need tobe observed on each selected site that is visited as part of the audit. This will provide some indication of how the documented systems work in practice.(NB: This is NOT a detailed site inspection and should not be relied on tosatisfy legal compliance with other health and safety obligations.)

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10. Focus group interview confirmation of safe systems in action


1. There is an understanding of what constitutes a hazard in the workplace.

2. There is an understanding of the process for hazard identification.

3. There is an awareness of respective responsibilities in the identification of hazards.

4.* There is an understanding of the term significant hazard and the hierarchy of controls in the management of these hazards.

5. There is an understanding of injury and incident reporting and recordingrequirements.

6. There is an understanding of injury or incident investigations includingdesignated responsibilities and the role of the injured employee and themanager concerned.

7. There is an understanding of the responsibilities for corrective action resultingfrom an injury or incident investigation.

8.* There is an understanding of how to initiate rehabilitation support andassistance for any injured employees.

9. There is an understanding of the process for union and other nominatedemployee representation and the way in which to raise health and safetyissues.

10. There is an understanding of the emergency procedures in the workplace.

11.* There is an understanding of how to initiate rehabilitation and of the supportavailable from management for the early return to work of injured employees.

Objective

The employer is able to confirm and validate hazard management systemsthrough management and employee focus groups.

* While these questions may be asked at the management and employee focus groups, primary responsibility forunderstanding rests with the management focus group.

Please refer to the definitions on page 28 if you require further clarification.

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Focus group interviews verify that the systems and processes outlined inthe employers health and safety documentation already viewed, are widelyunderstood and used in day-to-day practice in the workplace.

By undertaking focus group interviews, ACC is seeking to verify characteristics

of a positive safety culture among members and prospective members of theACC Workplace Safety Management Practices programme.

ACC believes that open communication between varying levels of anorganisation, a leadership style that is consultative and co-operative, andappropriate levels of resourcing are indicative of employer commitment to theintegrated management of health and safety in the workplace.

The focus group process:

There will be at least one management and one employee focus groupinterview for each audit completed to confirm safe and active systems.

Where the audit covers more than one site, ACC will request anemployee focus group interview at each site that the auditor will visit.

The management focus group will be made up of senior managementroles involved in workplace health and safety management and willinclude representative line managers or supervisors.

The employee focus group will be made up of employees from theparticular site who are actively involved or interested in workplacehealth and safety management. It is recommended that the groupincludes union representatives and other employee health and safety

representatives. It will often include people from the site health andsafety committee or similar and any employees who have had recentworkplace injuries.

Informed, signed consent will be sought from all participants beforethe focus group begins.

Summary information only will be included in the auditors report.Individuals will not be specifically identified.

If the information from the focus group interviews raises concerns or conflictssharply with other health and safety information submitted during the audit,ACC may request further information. In this event ACC will discuss anyadditional information requirements with the employer concerned.

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Definitions

Consultation

Sharing of information and opinions on a particular issue, or series of issues,between two or more interested parties. The outcome of consultation may notnecessarily be agreement.

Focus groups

By undertaking focus group interviews ACC is seeking to verify keycharacteristics of a positive safety culture in action. There will be at leastone management and one employee focus group interview for each auditcompleted to confirm safe and active systems. Where the audit covers morethan one site, ACC will ask for an employee focus group interview for each site

visited by the auditor. The management focus group will be made up of senior management

roles involved in workplace health and safety management and willinclude representative line managers or supervisors.

The employee focus group will be made up of employees from theparticular site who are actively involved or interested in workplacehealth and safety management. It is recommended that the groupincludes union representatives and other employee health and safetyrepresentatives. It will often include people from the site health and

safety committee or similar, and any employees who have had recentworkplace injuries.

Informed, signed consent will be sought from all participants beforethe focus group begins.

Summary information only will be included in the report. Individualswill not be specifically identified.

Procedure

A process or series of steps that is clearly documented in either hard copy textformat, electronic text format, or a series of hard copy or electronic flowcharts,diagrams, picture-form representations or similar, or any combination of these.

Please note:

The definitions used for the purposes of these audit standards may differ insome respects from similar definitions used in other contexts.

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8

Rehabilitation

A process of active change and support with the goal of restoring aclients health, independence and participation, and comprises treatment,social rehabilitation and vocational rehabilitation. (Refer to the AccidentCompensation Act 2001 for further information).

Self-assessment

An internal assessment carried out by management and union and othernominated employee representatives working together to assess relevantareas of workplace performance against the programme audit standards.From this assessment the representative group should be able to determinewhether they are able to meet and maintain the standards required in an ACCWorkplace Safety Management Practices audit and gain a clear understandingof the performance of health and safety in all areas of the workplace.

Senior management

The management level within a business or organisation that reports directlyto the most senior manager (e.g. CEO or board), and has the authority tomake resources available for health and safety management. This descriptionmay also include the next tier of managers in a large multi-site organisation.

Significant hazard

As defined by the Health and Safety in Employment Act 1992.

Significant hazard means a hazard that is an actual or potential cause orsource of:

a) Serious harm; orb) Harm (being harm that is more than trivial), the severity of whose

effects on any person depend (entirely or among other things) on theextent of the frequency of the persons exposure to the hazard; or

c) Harm that does not usually occur, or usually is not easily detectable,until a significant time after exposure to the hazard.

Union and other nominated employee representative

a) Where there are union members present on a site, it is recommended(but not mandatory under this audit) for union representatives tobe provided with ongoing opportunities to be actively involved inworkplace health and safety management.

b) The term other nominated employee representative can refer

to any non-union employee elected or endorsed by employees torepresent employee interests. A non-union representative should notbe a person selected by management to undertake this role unlessemployees also endorse the person in the role.

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ACC Workplace Safety Management PracticesIf you have any questions about how to fill in this form, please call 0800 222 776If you require another application form, go to www.acc.co.nz/wsmp.Send your application form and supporting documents to:ACC Workplace Safety Management Practices, PO Box 242, Wellington 6140, New Zealand

Name:

Job title/designation:

Phone number:

Email address:

Facsimile number:

Address for correspondence:

Would you also like your levy invoices sent to this address? Yes No

Please provide contact details of the person in your organisation who ACC can contact regarding this application.

Contact persons details

Trading name (eg. Tokoroa Wood Products Limited) :

Legal name (eg. A&P Trading Partnership) :

What name would you like to appear on your ACC Workplace Safety Management Practices certificate?

This application is for a single business entity* or group of companies** (for definitions please see below)

* Asingle business entity is an entity that has one legal name (although it may have several payrolls or ACC numbers).

** Agroup of companies is one where each company is a subsidiary of the same parent company. All subsidiary companies applying on the same applicationmust be owned more than 50% by the parent company and operate a common health and safety system. If your business does not meet this definition, youmust complete a separate application for each company that does not meet these requirements.Please note: Trusts, incorporated societies, partnerships or joint ventures cannot form part of a group of companies ; they must complete separateapplications for each business entity.

Organisation details

Only accounts listed below will receive the Workplace Safety Management Practices discount. ACC account numbers supplied to ACC after an audithas been undertaken may require a separate audit in order to receive a discount.

ACC numbers

Please list all the work site details for all permanent or long-term sites in the blank spaces provided below.Please supply the list on a separate sheet if there is insufficient room here. If you have additional sites that change regularly, please advise us of this below.

Name of site

eg. Tokoroa office

Physical address

eg. Millers Line Tokoroa

Operational duties

eg. 1. Clerical/Administration2. Sawmilling3. Engineering workshop

Number of employees

Full time3

562

Part time200

Worksite details

ACC4028 Application form

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OSH history

In the past 24 months, has your organisation been the subject of a Department of Labour Workplace Safety(OSH) investigation or have you had to notify the Department of Labour (OSH) of any serious harm?

If no, please continue to theSelecting an ACC approved auditor section. If yes, please provide the following:

A full report of your internal investigation into the incident, together with any corrective action recommended and implemented.

A copy of the full OSH report into the incident, together with the recommendations and corrective action implemented (if completed).

Send your supporting documents into ACC with your application form, and advise ACC if any of the documents requested above are unavailable and why.

Please indicate by ticking one of the boxes below who you would like to conduct the Workplace Safety Management Practices audit.

ACC approved staff auditor

ACC approved external auditor. (Please note: by ticking this box and engaging the services of an ACC approved external auditor you are agreeing to payfor the full cost of the Workplace Safety Management Practices audit.)

If you would like to contact an ACC approved external auditor and discuss the possible cost of the audit, please refer to list of auditors on our websitehttp://www.acc.co.nz/approvedauditors

Yes No

Selecting an ACC approved auditor

Annual self-assessment

Declarations

What happens next?

Once you have been accepted into the programme you are required to complete a self-assessment of your workplace each year (refer to criticalelement 2.5 of the ACC WSMP programme audit standards). An annual self-assessment will provide you and ACC with the confidence that the auditstandards can be met and maintained. If this application is for a group of companies , the self-assessment must cover all members of the group.Please present evidence of your annual self-assessment to the auditor in your next renewal audit.

A senior management representative and an employee representative (ie. someone who does not have management responsibilities) musttogether complete a self-assessment of your workplace safety management practices using the ACC Workplace Safety Management Practices AuditStandards. Both representatives must sign the relevant declaration below.

Senior management and employee representatives declarationWe declare that:

We have completed a thorough self-assessment of our organisation and we believe our organisations current workplacesafety management practices will meet at least the Primary level entry requirements for the ACC Workplace SafetyManagement Practices programme.

All worksites listed in this application use a common health and safety system and practise the same standards of workplacesafety and all of the information on this application form is complete and accurate.

Senior management representative(Refer to the ACC Workplace Safety Management Practices AuditStandards for the definition of senior management)

Employee representative(This is someone who does not have management responsibilties eg. the abilityto employ or dismiss staff and can reasonably be taken to represent the views of the workforce)

Name Name

Job title/designation Job title/designation

Signature Signature

Date Date

1. Please send your application form and supporting documents (eg. worksite details listing or information relating to your organisations OSH history) toACCWorkplace Safety Management Practices, PO Box 242, Wellington 6140, New Zealand .

2. Once we have received your application, we will send you a letter advising you how to proceed to audit. For more information onthe audit process, please visit our website www.acc.co.nz for a copy of the Workplace Safety Management Practices Audit Process Fact Sheet.

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Impact assessment

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ACC Workplace Safety Management Practices

PO Box 242, Wellington 6140, New Zealand Telephone 0800 222 776 a s m a n u f a c t u r e d u s i n g E l e m e n t a l C h l o r i n e F r e e ( E C F ) p u l p s o u r c e d f r o m s u s t a i n a b l e

, W e l l M a n a g e d F o r e s t s

ACC Workplace Safety Management Practices

PO Box 242, Wellington 6140, New Zealand Telephone 0800 222 776 a s m a n u f a c t u r e d u s i n g E l e m e n t a l C h l o r i n e F r e e ( E C F ) p u l p s o u r c e d f r o m s u s t a i n a b l e

, W e l l M a n a g e d F o r e s t s

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