Stress risk assessment Template

MENTAL HEALTH Stress Risk Assessment
Project Name Project Number Project Address
RA Reference Number To be Referenced Who or what is being assessed? Name of Individual
Activity / Description of
works
Office work only, Construction work on site, Office work with occasional site visits, etc.
Associated
Documents
Action Plan To be Referenced
Documented
Conversation
To be Referenced Other
Prescribed medicine List, DSE Risk Assessment,
Workplace Risk Assessment.
Pepared by
Name of OSH
Advisor
Date DD/MM/YY Communicated to
Name of Line
Manager
Date DD/MM/YY Review Date DD/MM/YY
Ref: Stress Risk Assessment Issue No: 1 / Revision No: 1 Issue Date: January 2020 Page 1 of 9
UNCONTROLLED IF COPIED OR PRINTED
Potentia
l Cause
of stress
Ite
m
No.
Questions
Frequency Rating reflecting
work in the last 6 months
Severity
of the
Stress
impact
(L, M or H)
Initial Risk Rating
Control Measures that might help in reponse to the Initial Risk Rating
Residual Risk
Rating
Never
or
Seldom
(L)
Some-
times
(M)
Often
or
Always
(H)
L M H L M H
D
E
M
A
N
D
S
1. Do different
people at work
demand things of
you that are hard
to take forward?
2. Do you have
unachievable
deadlines?
3. Do you have to
work very
intensively most
of the time?
4. Do you have to
neglect some
tasks because
you have too
much to do?

works
Associated
Documents
Documented
Conversation
Pepared by
Name of OSH
Advisor
Name of Line
Manager
Potentia
l Cause
of stress
Ite
m
No.
Questions
Severity
of the
Stress
impact
(L, M or H)
Initial Risk Rating
Residual Risk
Rating
Never
or
Seldom
(L)
Some-
times
(M)
Often
or
Always
(H)
L M H L M H
5. Are you unable
to take sufficient
breaks?
6. Do you feel
pressurised to
work long hours?
7. Do you have
unrealistic time
pressures?
8. Do you feel you
have to work
very fast?
C
O
N
T
R
O
L
9. Are you reliant
on others
advising when to
take a break?
10. Do you feel you
have little say in
your work
speed?
11. Do you feel you
have no choice in
deciding what
you do at work?

works
Associated
Documents
Documented
Conversation
Pepared by
Name of OSH
Advisor
Name of Line
Manager
Potentia
l Cause
of stress
Ite
m
No.
Questions
Severity
of the
Stress
impact
(L, M or H)
Initial Risk Rating
Residual Risk
Rating
Never
or
Seldom
(L)
Some-
times
(M)
Often
or
Always
(H)
L M H L M H
12. Do you feel you
have no say over
the way you do
your work?
13. Do you feel your
work time is
inflexible?
S
U
P
P
O
R
T
(Mana
ger)
14. Does your
manager give
you insufficient
feedback on the
work you do?
15. Do you feel you
can’t rely on your
line manager to
help you with a
work problem?
manager doesn’t
support you
through
emotionally
demanding

works
Associated
Documents
Documented
Conversation
Pepared by
Name of OSH
Advisor
Name of Line
Manager
Potentia
l Cause
of stress
Ite
m
No.
Questions
Severity
of the
Stress
impact
(L, M or H)
Initial Risk Rating
Residual Risk
Rating
Never
or
Seldom
(L)
Some-
times
(M)
Often
or
Always
(H)
L M H L M H
situations at
work?
17. Do you feel
discouraged by
your manager at
work?
S
U
P
P
O
R
T
(Peers
)
colleagues would
not help you if
work became
difficult?
colleagues will
not provide
support if
required?
20. Do you feel a lack
of respect at
work from your
colleagues?
21. Are your
colleagues
unwilling to

works
Associated
Documents
Documented
Conversation
Pepared by
Name of OSH
Advisor
Name of Line
Manager
Potentia
l Cause
of stress
Ite
m
No.
Questions
Severity
of the
Stress
impact
(L, M or H)
Initial Risk Rating
Residual Risk
Rating
Never
or
Seldom
(L)
Some-
times
(M)
Often
or
Always
(H)
L M H L M H
listen to your
work-related
Lproblems?
RELA
TION
SHIP
S
22. Are relationships
strained or is
there friction or
anger between
colleagues?
23. Are you subject
to unkind words
or behaviour at
work? If so, do
you feel ‘bullied’
at work?
R
O
L
E
24. Are you unclear
about what is
expected of you
at work?
25. Are you confused
about how to
carry out your
role?

works
Associated
Documents
Documented
Conversation
Pepared by
Name of OSH
Advisor
Name of Line
Manager
Potentia
l Cause
of stress
Ite
m
No.
Questions
Severity
of the
Stress
impact
(L, M or H)
Initial Risk Rating
Residual Risk
Rating
Never
or
Seldom
(L)
Some-
times
(M)
Often
or
Always
(H)
L M H L M H
26. Are you unclear
about what your
duties and
responsibilities
are (job
description or
alteration of it)?
27. Are you unclear
about the goals
and objectives
for your team /
department /
organisation?
28. Do you have
issues
understanding
how your work
fits into the
overall aim of the
organisation?
29. Do you lack
opportunity to
question

works
Associated
Documents
Documented
Conversation
Pepared by
Name of OSH
Advisor
Name of Line
Manager
Potentia
l Cause
of stress
Ite
m
No.
Questions
Severity
of the
Stress
impact
(L, M or H)
Initial Risk Rating
Residual Risk
Rating
Never
or
Seldom
(L)
Some-
times
(M)
Often
or
Always
(H)
L M H L M H
C
H
A
N
G
E
managers about
change?
30. Do you feel
unconsulted
about change at
work?
31. When changes
are made at
work, are you
unclear about
how they will
work out in
practice?
other
I
S
S
U
E
S
32. Is there anything
else that is a
source of stress
for you at work?

works
Associated
Documents
Documented
Conversation
Pepared by
Name of OSH
Advisor
Name of Line
Manager
Potentia
l Cause
of stress
Ite
m
No.
Questions
Severity
of the
Stress
impact
(L, M or H)
Initial Risk Rating
Residual Risk
Rating
Never
or
Seldom
(L)
Some-
times
(M)
Often
or
Always
(H)
L M H L M H
F
A
C
T
O
R
S
O
U
T
S
I
D
E
Of
W
O
R
K
33. Do you feel some
personal
circumstances or
any other factors
outside of work
contributes to
your ability to
meet the
demands placed
on you?

works
Associated
Documents
Documented
Conversation
Pepared by
Name of OSH
Advisor
Name of Line
Manager
Stage 1: Self-assessment by individual assessed Stage 2: Initial Risk Rating by SHEQ Advisor Stage 5: Residual risk rating by individual assessed Stage 7: Other assessments / Documents
Frequency Rating reflecting last 6 months
High
Likely to Very likely to occur
(Often or Always)
Medium
May occasionally occur
(sometimes)
Low
Unlikely to occur
(Never or Seldom)
Severity of stress impact based on last 6 months at work:
High
time off work was taken or the individual
perceives he/she would have needed some
Medium
Workplace adjustments have been made or
the individual perceives they should have
Low
The individual has felt comfortable coping
with the situation
Initial / Residual Risk Rating
Severity
High H H H
Medium M M H
Low L M H
Low Medium High
Frequency
The individual assessed will reconsider each of his/her initial
ratings taking into account the additional measures he/she
identified in stage 3 (with support of OSH Advisor) using the
process used in stage 1 and the risk matrix used in stage 2.
If the individual assessed is under prescribed
medication, the medicine list should be
securely kept by OSH Advisor (GDPR). A
workplace risk assessment including
considerations such as driving, medication
risk should be conducted if deemed relevant.
Possible other health conditions should be
identified and, if any, their influence on stress
levels determined e.g. Fibromyalgia causes
stress and requires DSE and workplace risk
assessments covering manual handling.
Stage 3: Stress Management techniques Stage 6: Design of an Action Plan Stage 8: Documented Conversation
In order to achieve best outcomes, the individual
assessed contributes actively to the identification of
control measures that suits him/her particular needs.
He/she should be given access to relevant documents
and sufficient time to read them and enhance his/her
knowledge in stress management techniques e.g.
Stress Management Policy, NHS Health Scotland
booklet ‘Steps to deal with stress’, The UK National
Work-stress Network ‘Work Stress’ handbook, HSE
website, etc.
An Action Plan must then be drawn-up based on the findings
of this stress risk assessment and considering the residual risk
rating implications as stipulated in the table below.
Interpretation of Residual Risk Rating
High
Stop work, inform Line Manager and
seek advice from Occupational Health
Medium
Contact Line Manager for advice
Low
Self regulate your activity e.g. pacing
oneself when feeling overwhelmed
OSH Advisor shall organise a meeting with
individual assessed and his / her Line
Manager to review the findings and
implement the Action Plan.
OSH Advisor present takes notes in order to
produce minutes of meeting i.e. a
‘Documented Conversation’.
Stage 4: Identification of Control Measures Stage 9: Define a Review Date
On the initiative of the individual assessed with
support of Occupational Safety and Health Advisor. Stage 10: Implementation of Action Plan

Stress risk assessment Template

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