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Lone working risk assessment form

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Use this model lone working risk assessment to help identify any risks associated with lone working in the workplace, and implement safe working measures.

Reading time
How long to understand and implement this form?
5 mins
Word count
How many words in this form?
351
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What is a Lone working risk assessment form?

Individuals are alone at work when they are on their own, they cannot be seen or heard by another worker, cannot expect a visit from another worker for some time and/or where assistance is not readily available when needed. Therefore, lone workers are those who work by themselves without close or direct supervision.

Lone working is not against the law, however, the law does require you to carry out a risk assessment.

A separate lone working risk assessment is especially important because lone workers are often more vulnerable than someone who, for example, works in a busy office.

Applicable legal jurisdictions
In which jurisdictions can this form be used?
Great Britain & NI (United Kingdom), Worldwide

Lone working risk assessment

Definition: Lone workers are those who work by themselves without close or direct supervision.

Working alone is not in itself against the law and it will often be safe to do so. However the law (the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999) requires employers to consider carefully and then deal with health and safety risks for people working alone.

Tick as appropriate Yes No
Is there a documented and communicated procedure setting out the means for reporting in?    
Is the work likely to involve any specific hazards associated with it?    
Does the workplace present a specific risk to the lone worker?    
Is there a safe way in and out for one person?    
Does the work involve lifting or handling heavy or awkward loads too large for one person?    
Are chemicals or hazardous substances being used that may pose a particular risk to a lone worker?    
Is there machinery or hazardous equipment involved in the work that one person cannot operate safely?    
Does the staff member have a medical condition that makes them unsuitable to be working alone?    
Working at height?    

 

What arrangements are in place for communication and raising the alarm in an emergency e.g. fire, equipment failure, illness or accident? Details:

 

ADDITIONAL INFORMATION TO BE CONSIDERED IN RISK ASSESSMENT:

(Notes, comments, further details, outline procedures, safe systems of work, standards, drawings, training required etc.)

 

Name of person completing questionnaire:  
Date:  
Risk Assessment Ref:  
Signature:  

Version: [1.0]

Issue date: [date]

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Lone working risk assessment form
lone working risk assessment form