Success factor 2: Principles in action

East London NHS Foundation Trust, mental health and community trust.

The principle underlying their quality improvement was that the people who know the problem are pivotal to creating the solution. For example, staff developed a project to reduce violence on acute inpatient wards. The trust's board supported this initiative and it led to a massive reduction in violence.

The trust was bold; valuing and supporting frontline staff as they identified problems and made improvements. There is a focus on collective leadership where staff creativity can thrive and co-production is everyday business.

Lorraine Sunduza, Director of Nursing: "Our success is having people talking about equality and human rights in their day to day work while reviewing what they do."

The Christie NHS Foundation Trust, specialist cancer centre.

They significantly improved quality assurance and staff engagement. Champions carried out the commitment principles 'we care, we discover, we teach'. These included:

• treat everyone with compassion, dignity and respect
• promote a fair culture
• listen to our patients and each other
• support staff to develop to their full potential

The trust made specific pledges to staff, for example becoming a disability confident employer.

Jackie Bird, Executive Director of Nursing and Quality: "Our greatest success was early engagement with all staff and using the Christie Commitment Champions to share information and to role model best practice."

Dimensions UK, service supporting people with learning disabilities and those who experience autism.

They appointed an Equality, Diversity and Inclusion manager and their equality and diversity strategy includes:

• the business case for equality and how progress will be monitored
• equality impact assessments, governance and embedding equality within key areas of work

The national strategy has an impact on the workforce at a local level. When we inspected Dimensions Kent we found:

• strong person-centred care that took account of diversity
• good staff awareness of human rights, such as dignity and autonomy.

Lisa Govier, Equality, Diversity and Inclusion Manager: Promote equality and respect of diversity at the core of everything you do. Ensure your vision reflects this, along with the rationale of the business case.

Dimensions UK, service supporting people with learning disabilities and those who experience autism.

• Two 'diversity matters' groups encourage communication and monitor progress
• Equality topics included in staff bulletins, newsletters, communications to families, surveys and complaints monitoring

Dimensions leads the human-rights based campaigns #ImWithSam (disability harassment) and Love Your Vote (removing barriers to voting).

Castlebar Nursing Home, catering for people who need nursing care and for those living with dementia.

Their culture and values promote:

• getting to know people well and discovering their history
• celebrating and recognising diversity - residents are originally from 12 countries, and staff from 27
• maximising people's choice and independence, including people who lack capacity to make some decisions.

Terry O'Connor, registered manager: Investment and culture change took patience and trust over time – but has led to big improvements in care and many areas of outstanding practice.

Frith House, residential care home for 83 older people

Their statement of purpose states, "Our philosophy of care promotes, dignity, privacy, respect for human rights, equal opportunities and the right to enjoy the highest possible quality of life."

The registered manager describes creating a "homely, comfortable atmosphere. A place where people can do what they want, when they want and we work for them."

When we inspected we saw all staff putting this vision into practice. People were supported to be as independent as possible. Sometimes this was achieved by positive staff behaviour, such as staff waiting patiently for people to do things for themselves.

St Paul’s Way Medical Centre, inner-city GP practice, with around 10,000 patients.

The practice provides ‘Time to Change’ training to support staff and patients with mental health needs. This challenges mental health stigma and discrimination. Practice staff are also trained in mental health first aid.

The practice also offers patient Health Champion training to support patients with mental health needs. Once trained, these volunteers support other patients to improve their understanding and control over their healthcare needs.

Patient Health Champions:

• run a weekly stall in the waiting room area
• support the practice to plan and run events
• collect feedback from patients
• signpost patients to local services
• assist patients in the waiting area to use the self-arrival machines
• support a gardening group, a walking group and provide healthy cooking and nutrition workshops to improve people’s mental wellbeing.