Leadership Behaviours Model Culture Leadership Strategy

"the key issues are cultural and not regulatory" Sir Robert Francis QC "if we don't get the culture right we'll never deliver in the ambition" Jeremy Hunt, Secretary of State for Health "there is a culture of denial and failure in our public services" Commons Public Administration Committee "it is about promoting a culture that challenges poor practice and promotes compassionate care" Department of Health Report into Winterbourne View Tracy: The Health and Social care sector has been struggling for some time with how to improve its performance while establishing and maintaining high quality and safe care across current and future service providers.  The most frequent approach is to regulate the practice of providers and where this does not achieve the desired effect, to regulate more.  This approach has not been effective. It has created a culture of blame between regulators and providers while adding to the overall cost of providing Health and Social care services.  The most notable review of service failure is the Francis Report on the Mid Staffordshire Foundation Trust. In his recommendations, Robert Francis notes that performance issues are not a factor of regulation but a factor of organisational culture.

What is Culture Service Performance Strategy Execution Collective Culture Individual Behaviour What is Culture Simply put culture represents “the way we do things around here” Our demonstration of our behaviours defines our culture Our culture supports/detracts from achieving our Strategy How we execute our Strategy determines our collective success or failure. Nigel: Norfolk Independent Care believes that for any process or procedure to be successfully delivered, it requires someone to make the willful decision to act. It requires someone to demonstrate a behaviour that supports the intent of the process. The sum of these collective behaviours is what we call the organisation's culture. If the sum of people's behaviours are not aligned to the intent of policy and procedure, then the organisational culture is the problem and service quality and safety will be affected. The right set of staff behaviours, driven by the right leadership behaviours will see an organisational culture more aligned to quality and safety. Provider organisation that deliver safe and quality care will enable Norfolk to achieve its Health and Social care strategic outcomes. Service Performance

What does success look like?

Prince of Wales - Outstanding CQC Simplify: "fight the tendency to over-engineer and make things unnecessarily complicated when they don’t need to be" Recruitment: "give more weight to human values…looking for the right human values...you can teach them other things" Training: "...practical, that it engages people and that it is at the right level" Culture: "...create a culture where people have confidence to try things, to know that it's OK to take a risk" & "make sure the culture permeates the entire organisation“ Rewards and Recognition: "...little gestures go a long way ... run incentive schemes for staff who go over and above what's expected..." Communication: “...how you truly communicate what your messages are; this is really important" Leadership: "You need a true vision; more than just words on a glossy brochure...it needs to be real with more that lip service paid to it" Nigel: The best way to put this into perspective is to review the findings of an outstanding organisation. In their recent presentation to National Care Homes Congress, the Directors of the Prince of Wales residential home in Ipswich provided a broad outline of the factors that have influenced their success. These success factors are directly related to their leadership behaviours and inlcude: 

Getting to Outstanding CQC Standards Agreed Leadership Culture Outstanding Outcomes Nigel: So the value chain is represented as: National Standards compliance, through an agreed culture focused on Leadership behaviours will deliver success in achieving the required local and national Health and Social care outcomes.

Suggested Leadership Behaviours Effectively communicates purpose and outcome I always take time to explain why we need to do something Makes complex issues simple Being clear about what need to be done. Respects the contribution of all participants I really listen and use what people tell me. Accountable and embraces responsibility I do what I say I will do Working efficiently I am aware of the cost of action and inaction Nigel: We recommend that the Leadership behaviours be worded simply and reflect five key areas of performance: Effective communication Reducing complexity Respect and collaboration Accountability and Integrity Financial Performance The wording of the behaviours should be simple enough to enable the leader to comprehend what is required and for people to recognise when this behaviour is being positively demonstrated.   This slide represents some examples of what these behaviours may look like.  

Questions Service Performance Individual Behaviour Collective Culture Strategy Execution Collective Culture Individual Behaviour Questions Tracy:  In conclusion, the positive demonstration of these leadership behaviours care against the CQC Well Led standard will deliver: an improved leadership culture, success against Norfolk Health and Social care strategic outcomes and improved service performance for the people of Norfolk .  Service Performance

Living Longer, Living Well Information and Advice – Care services located in all communities Loneliness and Isolation – volunteers befriending people using care services. Improving the Experience of Older People Leaving Hospital – Virtual Care Community