Background: Following declining health care practices at one UK health care site the subsequent and much publicized Francis Report made several far-reaching recommendations aimed at recovering optimal levels of care including stringent monitoring of practice. The aftermath of these deliberations have had resounding consequences for quality care both nationally and internationally. Design: A reflective qualitative appreciative qualitative inquiry using a hybrid approach combining case study and thematic analysis outlines the development and analysis of a solution-focused intervention aimed at restoring staff confidence and optimal care levels at one key UK hospital site. Personal diaries were used to collect data. Data analysis: Data were analysed using descriptive thematic analysis. Discussion: The implications of the five emerging themes and the 10-step approach used are discussed in the context of understanding care erosion and ways to effect organisational change. Conclusion: A novel approach to addressing care deficits, which provides a promising bottom-up approach, initiated by health care policy makers is suggested for use in other health care settings when concerns about care arise. It is anticipated this approach will prove useful for nurse managers, particularly in relation to finding positive solutions to addressing problems that surround potential failing standards of care in hospitals.