Assessment Task: AWE: WHSSIM Incident Report

Analyse the case study below and discuss the questions 1 – 3 with your group. Then, working on your own,
complete the Incident Report using the template provided.

Student ID 310379 Student Name Shivani

Case Study – Grant’s Kitchen Troubles

Grant Henderson works full-time as the Assistant Accountant in the Finance team at Apex Solutions Head
Office. On the 03rd January 2016 he went to the office kitchen to make a cup of tea. As he was walking to
the fridge to get some milk, he slipped on a puddle of water, falling backwards and hitting his head on the
counter edge. His colleague, Jennifer Brown, from Sales saw him fall. The accident caused Grant a serious
head injury requiring transport to hospital.
On checking, Grant’s Health & Safety Representative discovered that the fridge in the kitchen had been
leaking, producing puddles of water on the floor for some time. When discussing the incident with Grant’s
work colleagues they revealed that a number of workers had almost slipped on the water over a period of
several weeks.

Questions for discussion – record your notes in the spaces provided

1. What appropriate action could have been taken prior to the incident by the (a) organisation and (b)
employees in relation to duty of care?
1. Employees should have reported the fridge to management the first time somebody almost slipped
2. Regular Workplace inspections and risk assessments

2. Was this accident preventable?

Yes

3. How should the findings of the incident investigation be communicated to the other employees?
Face to Face meetings, emails

Injury Definitions
Near Miss An incident that could have resulted in an injury or illness to people, danger
to health, and/or damage to property or the environment.

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Lost Time Injury
Medical Treatment Injury
Disabling Injury or
Restricted Work Injury
Fatal Injury
An injury that results in a minimum of one full shift’s absence.
An injury requiring medical treatment.
Injuries resulting in that person not returning to his/her complete range of
normal duties.
An injury that results in death.

AWE: WHSSIM Incident Report

APEX BUSINESS SOLUTIONS INCIDENT REPORT FORM

General Information
Date: 3rd January 2016 Department: Finance Reported by: Shivani

Injured party details

Name/Surname: Grant Henderson Contact #: 0435656789

Position/Relationship to company (e.g. Employee, visitor, or sub-contractor):

Employee(Assistant Accountant)

You are reporting a

□ Near miss □ Lost Time Injury □ Medical Treatment Injury

□ Disabling Injury □ Restricted Work Injury □ Fatal Injury

Type of Incident
□ Accident □ Security □ Plant/Property damage

□ Environment □ Technology

□ Other (please specify)

Witness/es (if applicable)
Name: Jennifer Brown Contact #: 045678956

Position/Relationship to company: Employee

Incident details
Date of incident: 3rd January 2016 Time: 10:00am
Specific location: Office Kitchen

Date reported: 3rd January 2016 Time reported: 10:10am

Reported to: Management

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 What happened?
Grant Henderson, an assistant accountant at Apex solutions, slipped on a puddle of water on 3rd
January 2016 because of leakage from the fridge in the kitchen and grant got a serious head injury.

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 Immediate action taken

□ First Aid only □ Ambulance called □ Visit to the doctor

□ Other (please specify)

Follow up comments and action (What further action was taken? What is the expected result?)

Key lessons learned (What organisational changes need to be made?)

Injured Person’s Signature: Date:

Manager’s Signature: Date: