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WFH risk assessment and DSE template

WFH risk assessment and DSE template

In partnership with Omny Group

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This resource was created in partnership with health and safety experts at Omny Group. It is intended as a basic general template only and designed for low-risk small to medium sized businesses. For tailored legal advice and support, you can get in touch with the Omny Health & Safety team here. 

If your employees work from home, even occasionally, you still have a duty to protect their health, safety and wellbeing.

This template helps you carry out a combined home working and display screen equipment (DSE) assessment in line with Great Britain’s health and safety legislation, including:

 

It covers:

    • The general home working environment

    • Lone working and wellbeing considerations

    • Individual display screen equipment set-up

You are not expected to inspect someone’s home in detail, but you must take reasonable steps to identify and manage risks associated with the work being carried out there.

How to use this template

This assessment can be:

    • Completed by the employee as a self-assessment

    • Reviewed by their line manager

    • Discussed during a check in

Where issues are identified, practical steps should be agreed and recorded in the action plan.

Employee and working from home details – to be completed by the employee

Your name:  
Job title:  
Department:  
Line manager:  
List of all working locations: e.g. Home, London office  
Typical number of days worked from home per week:  
Date of assessment:  
Next review date:  

 

 

Working from home environment risk assessment – to be completed by employee

Please complete the following tables by indicating Yes or No in the right hand columns.  

 

Suitable workspace

When working from home, do you have:  Yes / No / N/A
A stable desk or table to work at?   
A chair that feels supportive?   
Enough lighting to work comfortably?   
Comfortable temperature and ventilation?   
Noise levels that feel manageable for work?   
Window coverings, such as blinds or curtains, to help reduce glare where needed?   
 Sufficient space to move safely in your work area?   

 

 

Fire, physical and electrical safety

When working at home:  Yes / No / N/A
Is your work area free from trip hazards, such as trailing cables, bags or clutter?   
Are your cables safe and in good working condition?   
Are your plugs and sockets being used safely? E.g. No overloaded extension leads, no daisy-chaining adaptors and no signs of overheating.   
Is your employer-provided equipment in good working order?   
Do you know how to report faulty equipment?   
Do you have a working smoke alarm on every floor of your home?   

Do you have clear access to exit routes from your work area? 

  
Do you know what to do and who to contact in an emergency situation?    
Do you have access to basic first aid supplies?   
Do you know what counts as and how to report a work-related accident or incident?   

 

 

Staying connected and well

While working from home, do you:  Yes / No / N/A
Have regular contact with your manager or team?   
Know how to raise concerns or report issues?   

Feel clear about your expected working hours?

  
Take regular breaks from working?  
Feel confident managing your workload?  
Know when you are and are not expected to respond to messages?  

 

 

Working from home DSE assessment - to be completed by employee

If you regularly use display screen equipment when working from home, please also complete the following section.

 

Your chair and posture

When working from home:  Yes / No / N/A
Can you adjust the backrest on your chair?  
Does the chair's backrest support your back?  
Can you sit with your feet flat on the floor or on a footrest?  
Is your seat height adjustable so that your elbows are level with (or slightly above) your desk while typing?  
If your chair is adjustable, do you know how to adjust it?  
Are you free from work-related aches, pains, numbness, tingling and pins & needles? This includes neck pain, back pain and shoulder or wrist discomfort.  

 

 

Your screen

When working from home:  Yes / No / N/A
Is your laptop and/or separate screen directly in front of you?  
Is the top of your laptop and/or separate screen roughly at eye level?  
Is your laptop and/or separate screen at a comfortable viewing distance?  
Is your laptop and/or separate screen free from glare or reflections?  
Can you adjust the brightness and contrast of your laptop and/or separate screen if needed?  
Is your laptop and/or separate screen clear, legible and free of flickering?  
If you are using a separate screen, does it tilt and swivel?   
If using multiple screens, are they positioned so that you can avoid twisting?   

 

 

Keyboard and mouse

When working from home:  Yes / No / N/A
Are your keyboard and mouse positioned so your arms feel relaxed?   
Do you have space to rest your wrists and forearms?   
Is there enough space for all the equipment you need, without feeling cramped?   
If you mainly use a laptop, do you use a separate keyboard and mouse?   

 

 

Other devices and ways of working

When working from home:  Yes / No / N/A
Do you use a landline or mobile phone to make or receive work calls?   
If you regularly take phone calls at work, do you have a headset?   
If you work with hard copy documents, do you have a document holder and a sloped surface?   
If you hand write or hand draw, do you take regular breaks from doing so?   
If you regularly use a smartphone or tablet for your work, do you take regular breaks from using it?    
If you have a handset for your telephone, are you able to avoid cradling the handset to your shoulder?   

 

 

Breaks from screen work

When working from home:  Yes / No / N/A
Do you take regular short breaks away from your screen?   
Does your work allow you to change tasks where possible?   
Are you able to change your posture and move around during the day?   

 

 

Eyes and eyesight

Have you: Yes / No / N/A

Had your eyes tested in the last two years?

  
Been informed that you may be entitled to a free eye test if you regularly use display screen equipment?   
Been experiencing any eye strain, headaches or discomfort linked to screen use?   

 

 

Other

Do you:  Yes / No / N/A

Have a disability or medical condition and feel you are lacking the adjustments to your set-up that you need to work safely and comfortably while at home?

  
Feel you need more training on setting up your workstation safely?   

 

 

Manager review – to be completed by the employee’s line manager

This section helps you review the employee’s responses, identify any risks and agree on practical next steps. Your role is to check that risks have been identified, that appropriate action is taken where needed, and that legal duties are being met.

Start by reviewing all the employee’s responses carefully and making sure they have completed all sections relevant to them. Then:

    • Clarify any issues with the employee if needed

    • Decide whether adjustments, equipment or guidance are needed

    • Record agreed actions and timescales in the table below

This free working from home checklist for employers and managers includes guidance on your legal obligations where you are unsure.

And if you want to provide the employee with a checklist that helps them stay safe and compliant while working from home, you can find one here.

 

Action tracker

Fill out the table below with:

    • Any risks identified in the assessment

    • The follow-up actions you have agreed with the employee to control or reduce those risks

    • The deadline by which those actions must be taken

You can add more rows if needed.

When an action has been completed, come back here and record the date on which the action was taken.

Risk Action required Responsible person Deadline (Date) Completed on (Date)
         
         
         
         
         

 

 

Employee confirmation

I confirm that I have completed this self-assessment accurately and to the best of my knowledge.

Where risks have been identified, appropriate actions and deadlines have been agreed and recorded.

Employee name:

Signature:

Date:

 

Assessor confirmation

I confirm that I have reviewed this assessment and considered the employee’s responses.

Where risks have been identified, appropriate actions and deadlines have been agreed and recorded.

Assessor name:

Signature:

Date:

 

Review and update

This assessment should be kept under review and revisited if any working arrangements change or if the employee reports discomfort of concerns.

Use template

A final reminder

Now the employee has completed their working from home risk assessment and DSE assessment, it should be stored somewhere safe, secure and easy to access.

With Breathe, you can upload completed DSE assessments to the employee’s record, keeping them alongside everything else, from contracts to sick leave and booked holiday. So, all the important details live in one place.

You can also manage wider health and safety responsibilities in the same system – creating risk assessments, recording incidents, assigning roles like first aiders and fire wardens, and keeping track of certifications.

It all connects, so you can see the full picture and feel confident nothing’s slipping through the cracks.

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