Constituency staff Health and Safety
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1. Default Section
1
. What is your job title?
What is your job title?
2
. Please outline your main, regular duties.
Please outline your main, regular duties.
3
. Are there any other tasks you are occasionally asked to perform? If so, please give brief details.
Are there any other tasks you are occasionally asked to perform? If so, please give brief details.
4
. Are you mainly office based, or are you required to work outside the office from time to time?
Are you mainly office based, or are you required to work outside the office from time to time?
Office based
Work outside the office
Part office, part elsewhere
5
. Are you ever required to travel to Westminster for work? If so, please say whether or not you have an office to work in when visiting.
Are you ever required to travel to Westminster for work? If so, please say whether or not you have an office to work in when visiting.
I have a desk in an office for me to work in
Westminster staff let me use their desk when I am there
I use my boss's desk
I use the e-library computer if I need to work
There is no desk space for me when I visit
6
. In your main place of employment, how many other members of staff, both full and part time are working alongside you?
In your main place of employment, how many other members of staff, both full and part time are working alongside you?
1
2
3
4
5
more than 5
7
. How many rooms are provided for the above number of staff? Please count only rooms in which staff sit to work.
How many rooms are provided for the above number of staff? Please count only rooms in which staff sit to work.
1
2
3
4
more than 4
8
. Are there kitchen facilities? If so, please list what is available for staff to use.
Yes
No
fridge
*
Are there kitchen facilities? If so, please list what is available for staff to use. fridge Yes
fridge No
kettle
kettle Yes
kettle No
sink with washing up facilities
sink with washing up facilities Yes
sink with washing up facilities No
microwave
microwave Yes
microwave No
other
other Yes
other No
9
. Are there separate male and female toilets?
Are there separate male and female toilets?
Yes
No
10
. Are the toilet facilities generally of an acceptable standard?
Are the toilet facilities generally of an acceptable standard?
Yes
No
11
. Approximately how many people share the toilet on a regular basis in your place of work? (Not counting constituents and other visitors)
Approximately how many people share the toilet on a regular basis in your place of work? (Not counting constituents and other visitors)
1
2
3
4
5
6
more than 6
12
. Is there a dedicated fire exit from your office (not the main entrance)
Is there a dedicated fire exit from your office (not the main entrance)
Yes
No
13
. Do you have an adequate natural source of light (a window near your workstation) in the room you have to work in?
Do you have an adequate natural source of light (a window near your workstation) in the room you have to work in?
Yes
No
14
. Is the heating and ventilation adequate? Please give details of any problems you may have had.
Is the heating and ventilation adequate? Please give details of any problems you may have had.
15
. Do you have access to your own computer?
Do you have access to your own computer?
Yes
No, I have to share
16
. When you sit at your computer to work, are you able to sit comfortably, with the computer screen straight ahead of you, and good support for your back with both feet flat on the floor?
When you sit at your computer to work, are you able to sit comfortably, with the computer screen straight ahead of you, and good support for your back with both feet flat on the floor?
Yes
No
17
. Have you experienced any work related health problems?
Have you experienced any work related health problems?
RSI
Back pain
headaches
stress
depression
Other work related ailment
18
. If you have suffered from any of the work related problems listed, have you sought medical help?
If you have suffered from any of the work related problems listed, have you sought medical help?
Yes
No
19
. Are you registered disabled?
Are you registered disabled?
Yes
No
Disabled but not registered
20
. Have you received the free eye test which workers on computers are entitled to from your employer?
Have you received the free eye test which workers on computers are entitled to from your employer?
Yes
No
21
. Is your workplace secure against unwelcome intruders?
Is your workplace secure against unwelcome intruders?
Yes
No
22
. What steps have been taken to make sure you are safe in the workplace?
What steps have been taken to make sure you are safe in the workplace?
Video entryphone
panic button
requirement for no-one to work alone
Other
No arrangements made
23
. Are you required to work longer than your contracted hours on a regular basis?
Are you required to work longer than your contracted hours on a regular basis?
Yes
No
24
. Do you know who owns the building you work in?
Do you know who owns the building you work in?
MP
Political party
Trade Union
Commercial business premises company
Other
Don't know
25
. If you have experienced problems with the maintenance of the building,and this has affected your comfort, has it been easy to get these problems sorted out?
If you have experienced problems with the maintenance of the building,and this has affected your comfort, has it been easy to get these problems sorted out?
Yes
No
26
. Is there a fire extinguisher available, and regularly checked and serviced?
Is there a fire extinguisher available, and regularly checked and serviced?
Yes
No
27
. Is there an Employers Liability Insurance certificate displayed?
Is there an Employers Liability Insurance certificate displayed?
Yes
No
28
. Have you, or your employer, been in touch with an Occupational Health expert to assess your work environment?
Have you, or your employer, been in touch with an Occupational Health expert to assess your work environment?
Yes
No
29
. Are there any concerns relating to health and safety, wellbeing or working conditions you would like to mention, which have not been covered above?
Are there any concerns relating to health and safety, wellbeing or working conditions you would like to mention, which have not been covered above?
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