Incident review form
What this template is for: Incident review layout for management sign-off and learning — example scenario shown.
Incident summary (sample)
| Field | Record |
|---|---|
| What happened | Person slipped transferring to chair; staff assisted, no injury. |
| Immediate action | Comfort checked; GP informed as precaution; environment tidied. |
| Injury / impact | No treatment required; bruise check completed — none observed. |
| Safeguarding link | Not safeguarding; recorded as accident with learning. |
| PBS / support plan review | Mobility plan reviewed — extra stand-by assist documented. |
| Lessons learned | Clutter near chair removed; staff brief on transfer positioning. |
| Manager sign-off | RM review completed — actions assigned to team lead. |
What the full template includes
Blank incident review form with grading, duty of candour prompts, safeguarding crossover, PBS review, and manager sign-off fields.