Incident report or hazard and near miss report
Near Miss Report Example for Aged Care and Home Care
Factual near miss, hazard, and incident report wording for Australian aged care, home care, and disability support settings.
Recommended template
Incident Report Form - Home Care
Adapt every example to the facts and your provider's own documentation process.
View templateWhen to use this scenario
Use this scenario when something caused harm, could have caused harm, or created a safety risk during a home visit or community support.
What to include
- What happened, where, when, and who was involved.
- Immediate response, notifications, evidence, and follow-up required.
- Whether the hazard was removed or further review is needed.
What to avoid
- Guessing the cause before review.
- Assigning blame.
- Waiting to document because the event seemed minor.
Example wording
At approximately 2:15 pm in the client's home, Sam tripped while walking from the lounge room to the kitchen. Worker checked Sam's immediate wellbeing, assisted Sam to sit, and followed provider first aid procedure. Team leader and nominee notified at 2:30 pm. Incident form completed for review.
Common questions
Can I copy this incident report or hazard and near miss report wording directly?
Use it as a starting point only. Check the facts, remove anything that does not apply, add required local details, and follow your provider's documentation process.
What should I do if the situation involved risk or a change in needs?
Record the observable facts and follow your provider's escalation, incident, care management, or reassessment process. A progress note example does not replace local reporting requirements.
Important note
These resources are provided for general operational documentation and educational purposes only. They do not constitute legal, clinical, medical, compliance, or professional advice. Organisations should review and adapt all documents according to their own policies, procedures, registration requirements, funding arrangements, and regulatory obligations.