My purpose is to describe and analyse how care managers experience their position as middle managers in the public sector. I have used a qualitative interview method to answer this question and also to capture my six interview persons opinion and understanding of their own position as middle managers. From my six interviews I noticed some difference in their opinions about how it is being a care manger. The results show that the role as care managers have challenges such as to intertwine their own notion how the caring of the elder should be with strict politic decisions. Other challenges are the limitation of economic recourses and reorganisations. Within the public service care mangers have opportunities to be part of the new changes with interesting comments or directives that the government would like to implement. My result can be understood with the street level bureaucracy and the difference between the concepts leadership and management. Finally I should clarify that my definition between the management and leadership was important to the respondent’s view of themselves and situations in their professional role as care managers. To have and be a manager could be understood with the help of the employment. As care manager you know what you get and can do, and also how the limitations impact them currently in difference situations.

Biståndshandläggning är ett högst aktuellt ämne som diskuteras världen över och som forskas mycket om i Sverige. Syftet med studien var att undersöka hur biståndshandläggare upplever sin egen hälsa av att fatta beslut. Åtta biståndshandläggare intervjuades, varav två var män och sex kvinnor med ett åldersspann på 32–42 år. Sex av dessa hade en socionomexamen och två av de en beteendevetenskaplig kandidatexamen på högskolenivå. I analys av resultatet identifierades fyra grundkategorier: negativa upplevelser, stressupplevelser, positiva upplevelser och förhållningssätt. Resultatet visade att de biståndshandläggare som hade låg arbetserfarenhet upplevde stress genom handläggningsprocessen medan de som hade flera års erfarenhet inte påverkades i lika hög grad. Studien ligger till grund för framtida studier där framtida forskning kan breddas med hjälp av ett större urval för att kunna få en insyn i bredare perspektiv. Undersökningens slutsats var att individens hälsa påverkas genom beslutsprocessen både positivt som negativt.

Syftet med denna uppsats var att genom ett salutogent perspektiv få en ökad förståelse för, inom äldreomsorgen verksamma, biståndshandläggares arbetssituation samt att undersöka vad som kan bidra till att biståndshandläggares arbetssituation upplevs som lättare och mindre påfrestande. Metoden som använts är kvalitativa intervjuer där sex biståndshandläggare verksamma i Värmland har intervjuats. Intervjuerna analyserades genom teman ur KASAM och resulterade i kategorier under varje tema. Under temat begriplighet framkom att biståndshandläggare får stöd från sina kollegor men att de också önskar att det fanns mer resurser för handledning. Biståndshandläggare utför mer än vad som ingår i arbetsbeskrivningen. Under temat hanterbarhet framgår att hög arbetsbelastning hanteras genom att biståndshandläggarna måste planera, strukturera och prioritera. Kollegornas stöd gör arbetet lättare att hantera då de genom att prata med varandra bearbetar känslomässigt påfrestande delar av arbetet. De uttryckte olika behov av att reflektera över sitt arbete. Biståndshandläggare har en stor frihet att planera sin egen arbetsdag och de samverkar med andra professioner. Under temat meningsfullhet framgår att biståndshandläggare finner mening i att göra skillnad för den enskilde. Vårt resultat visar att biståndshandläggarna är utsatta för stress i sitt arbete och att de också har förmåga att möta stressen, men förmågan att möta stressen minskar när arbetsbelastningen blir för hög. / The purpose of this paper was to, by using a salutogenic perspective, achieve a better understanding of eldercare, care managers’ work situation and to explore which factors contribute to the administrator's job situation being experienced as easier and less stressful. The method used were qualitative interviews where six care managers active in Värmland were interviewed. The interviews were analyzed by themes from the Sence Of Coherense and led to categories under each theme. Under the theme comprehensibility was found that care managers receive support from their colleagues but they wish for more resources for professional guidance counselling. Care managers perform more duties than what is included in their job description. Under the theme manageability it shows how administrators have to manage their, high workloads by planning, structurizing and prioritizing. The work is easier to handle when they recieve support from colleagues by talking to each other about strenuous parts of the work. They expressed different needs to reflect on their work. Care managers have a freedom to plan their own and they do collaborate and interact with other professionals. Under the theme meaningfulness the results show that care managers find meaning when they make a difference for their clients. Our results show that care managers are exposed to stress in their work and that they have their own resources cope with. The ability to handle stress is reduced when they feel that the work load is too high.

The health industry in Canada, as well as in other industrial countries, has been in the process of reform for many years. While such reform has been attributed to fiscal necessity due to increased health costs, the underlying causes are far more complex. Demographic changes, new technologies, expanded health care procedures and medications, increased demand and the globalization of health services have all contributed to the change and complexity of the industry. Health reform varies from country to country. In Canada, with a publicly funded health industry, the main reform method has been regionalization. This decentralized reform method arranges health services under a regional corporate management structure. The primary objective of this study was to assess the effects of health reform on the educational development of health-care managers in British Columbia, a western province of Canada. The study had a two-fold approach; to ascertain how health reform had changed the skill needs of health-care managers, and whether e-learning could benefit health management education. The key research questions that guided the study were: How might recent changes in the health industry have affected the learning needs and priorities of health-care managers? What factors might hinder attempts to meet any learning needs and priorities of health-care managers? and What benefits might e-learning provide in overcoming hindrances to effective health management education? / A combination of quantitative (survey closed questions) and qualitative (survey open-ended questions, interviews and stakeholder feedback) methods was employed in this study. Overall, this study is described as productive social theory research, in that it addressed a recognized change in learning needs for health-care managers following a period of health reform, a socially significant phenomenon in the health industry. Relying on such tools as a survey, interviews, and stakeholder discussions, data was collected from over five hundred health-care managers. The data collected in this study provided valuable insight into the paradigm shift occurring in the educational needs of these managers. The study found that health reform had expanded the management responsibilities of healthcare managers and increased the complexity of service delivery. Restructuring of the health industry decreased the number of managers, support systems, and career opportunities for managers and increased the manager’s workload, communication problems and the need for new knowledge and skills. In addressing the learning needs of health-care managers, the study found there were limitations in health management educational opportunities available to health-care managers. The findings also show that current health management education was focused on senior managers leaving the majority of industry leaders with limited learning opportunities to upgrade their knowledge and skills at a time of great organizational change. / In addition, a classroom format dominated the learning delivery options for many managers. A list of fourteen management skills was used in the survey instrument to ascertain what new skills were needed by health-care managers following thirteen years of health reform. The findings show that of the fourteen skills, twenty-nine percent of health-care managers had no training and fifty-seven percent received their training through in-service, workshops and seminars. Irrespective of gender, age, working location and education the data showed that healthcare managers were mainly receiving training in change and complexity and people skills with less training occurring in planning and finances. Using the same fourteen skills, health-care managers priorized their immediate learning needs, listing the top three, as: evidence-based management, change and complexity and financial analysis. While evidence-based management and financial analysis could be attributed to the introduction of a corporate management structure in the health industry, change and complexity was an anomaly as managers were already receiving training in this skill. Health industry stakeholders believed this anomaly was due to continued uncertainties with ongoing health reform and/or a need for increased social interaction during a time of organizational change. In addressing the many learning needs of health-care managers a new health management education strategy was proposed for the province which included the need for an e-learning strategy. / The e-learning approach being proposed in this study is an integration of skill training and knowledge sharing directly blended into the workflow of the managers, using a variety of learning technologies. To support this idea, the study found that the majority of health-care managers were not only familiar with e-learning, they also felt they had the computer and Internet skills for more learning delivered in this manner. While a strong need for face-to-face learning still remained, a blended e-learning strategy was proposed for skill training, one that would accommodate the learning needs of managers in rural and remote areas of the province. Knowledge sharing technologies were also proposed to improve the flow of information and learning in small units to both newcomers and experts in the industry. Since this would be a new strategy for the province, attention to quality and costs were identified as essential in the planning. The study found that after years of health reform a new health management educational strategy was needed for the health industry of British Columbia, one that would incorporate a number of learning technologies. Such a change in educational direction is needed if the health industry wishes to provide their leaders with a responsive learning environment to adapt to ongoing organizational change.

Managers in social care are being relied upon to lead and implement substantial change within the sector. Yet the prevailing view is that the pressure being put on managers by managerialism and the increase in the business aspects of their role is in conflict with social care managers’ values, causing concern and challenging managers’ identity. Additionally, managers in social care are presented as being part of the same homogenous group as social work managers, a potential misrepresentation, which again has consequences for how managers identify with their role. This study aimed to explore and explain how social care managers are experiencing their manager identity and how they categorise themselves from a group perspective. This research was undertaken using a critical realist philosophical approach. The key theoretical framework used is social identity theory. The study findings have achieved the overall aim of the research, establishing that social care managers appear not to be experiencing any conflict in their identities, that managerialism is accepted by managers and seen to be necessary, and that managers’ values, formed in childhood, are a key aspect of how they undertake their managerial role. In addition, social care managers are not the same as social work managers, their social identity is a synthesis of the multiple groups they are members of with the dominant group being social care, because of this they cannot be viewed as being within the same homogenous group. Neither is the social care manager role distinctive from manager roles in other sectors, however how they undertake the role is. The significance of the study is the contribution to both the existing social care literature and the literature on social identity theory.

This essay studies the perceived effects of different communication hindrances on the daily work of care managers. It begins with discussing communication hindrances as a term and moves on to present other researchers findings on how communication hindrances can be bridged and how they affect communication with personnel and care managers. This study is a qualitative study in which five care managers that work with elderly people have been interviewed. The results were analysed using terms such as paternalism, autonomy and power as a theoretical base. The study concluded that care managers perceived communication barriers, such as hearing impairment and dementia among others, as something present in their daily work life and not something out of the ordinary in their profession. It was found that several of the care managers had used communication aids however some felt that they were unnecessary or the elderly’s responsibility to provide in case such measures/methods should be needed. Often it is relatives who stand as a bridge to communication with the elderly and are a great aid in the care application. However they can be a hindrance to the communication if their paternalistic tendencies lead them to take over. This can be a great challenge to the care managers as they try to get the elderly involved in the process in spite of communication hindrances.

As more and more individuals express themselves with tattoos and body piercings and push the envelope on what is deemed appropriate in the workplace, employers have an increased need for creation and enforcement of reasonable dress codes and appearance policies. As with any employment policy or practice, an appearance policy must be implemented and enforced without regard to an individual's race, color, gender, national origin, religion, disability, age, or other protected status. A policy governing dress and appearance based on the business needs of an employer that is applied fairly and consistently and does not have a disproportionate effect on any protected class will generally be upheld if challenged in court. By examining some of the more common legal challenges to dress codes and how courts have resolved the disputes, health care managers can avoid many potential problems. This article, the second part of a 3-part examination of dress codes and appearance policies, focuses on the issue of gender under the Civil Rights Act of 1964. Pertinent court cases that provide guidance for employers are addressed.

Syftet med denna studie är att undersöka hur barnperspektivet beaktas vid handläggning inom LSS, samt att undersöka hur barnets rättigheter, enligt Barnkonventionen, beaktas under processen. Eftersom Barnkonventionen blir lag 2020 ville vi få insikt i hur Barnkonventionen används praktiskt inom LSS. I studien har vi två frågeställningar för att besvara vårt syfte, Vad innebär det att ha ett barnperspektiv i praktiken inom LSS-handläggning? och Hur tillämpas Barnkonventionen i ärenden som berör barn? För att besvara frågeställningarna använde vi oss av en kvalitativ metod med semistrukturerade intervjuer, där vi intervjuade åtta biståndshandläggare som arbetar inom LSS. För att analysera materialet från intervjuerna använde vi kodning och tematisering. Följande teman hittades; miljö, kommunikation och delaktighet, dokumentation, föräldrar till barn med funktionsnedsättning, barn som anhöriga och kunskapsbrist och utbildning. Det empiriska materialet analyserades med hjälp av vårt kunskapsläge och våra utvalda teorier barndomssociologi, Foucaults maktteori och KASAM. Resultatet av vår studie har visat att det saknas kunskap och resurser när det gäller barn med funktionsnedsättning. Biståndshandläggarna vet inte hur olika kommunikationshjälpmedel och Barnkonventionen används i praktiken, vilket resulterar i att barn med funktionsnedsättning berövas sina rättigheter. Vi kan se mycket engagemang och vilja hos biståndshandläggarna eftersom de vill förbättra denna situation, men mer ansträngning krävs för att utveckla metoder som kan främja rättssäkerhet för barn med funktionsnedsättningar. / The purpose of this study is to examine how the child's perspective is taken into account when dealing with LSS, and to understand if the child's rights, according to the Children's rights convention, is taken into account during the process. As the Children’s rights convention becomes a law in 2020 we wanted to gain insight into how the children's rights convention is used practically within LSS. In the study we have two questions to answer about our purpose, What does it mean to have a child perspective in practice within LSS handling? and How is the Children's rights convention applied in cases involving children? To answer the questions, we have chosen to use a qualitative method with semi-structured interviews, where we interviewed eight care managers working with LSS. In order to analyze the material, obtained from the interviews, we used coding and thematization. The following themes were found; environment, communication and participation, documentation, parents of children with disabilities, children as a relative and lack of knowledge and education. The empirical material was analyzed with the help of our state of knowledge and our selected theories childhood sociology, Foucault’s power theory and KASAM. The result of our study has shown that there is a lack of knowledge and resources, regarding children with disabilities. The care managers doesn’t know how different communication aids and the Children’s rights convention, is being used in practice, which result in children with disabilities being deprived of their rights. We can see a great deal of commitment and a willingness in the care managers because they want to improve this situation, but more effort is needed to develop methods that can promote legal security for children with disabilities.

The aim of this study was to highlight care managers view on and experience of the working method Individual need in center (IBIC) and to analyze the consequences of the implementation. IBIC is a method for care managers to identify and adapt the intervention according to the individual’s needs. We performed six individual qualitative interviews with care managers, hence three from Kungsbacka municipality and three from Karlskrona municipality. The results from the interviews indicated that all care managers experienced that their work environment had on some level been affected by the implementation of IBIC. However, there were care managers that recounted that it wasn’t the IBIC method itself that affected their work situation. It was the work system that was used to document the IBIC investigations that was the substantial problem. The analysis showed that care manager’s experiences of IBIC did not accord with Socialstyrelsen’s goal with IBIC. The three core components of IBIC were not distinct enough, which was essential for an implementation to be successful and having positive outcomes. Moreover, care managers experienced that colleague- and manager support was a significant factor in the work environment. Even though they had support from both their colleagues and their managers, the care managers had to use different coping strategies to manage the daily workload. These factors contributed to a stronger sense of coherence (KASAM in Swedish), which is also a contributing factor for the coping process.

Uppsatsen undersöker via fem intervjuer hur biståndshandläggare resonerar kring ett biståndsärende gällande hemtjänstinsatser i äldreomsorgen och hur de motiverar sina bedömningar och beslut. Intervjuerna har företagits på biståndsenheten i Östersund i Jämtlands län. En vinjett som beskriver ett påhittat biståndsärende har stått som utgångspunkt för alla intervjuer och en fenomenologisk hermeneutisk analysmetod har använts vid framtagandet och tolkandet av resultaten. Resultaten som framkommit i studien antyder att biståndshandläggarna i Östersund tenderar att se till både sociala, fysiska, medicinska och psykiska behov hos kunden vid biståndsbedömning. När det kommer till gränssättning av hemtjänstinsatsers omfattning tenderar handläggarna också att vara relativt generösa i sina bedömningar. Hur gränserna sätts verkar emellertid vara något otydligt, delvis eftersom de inte har hjälp av några fastställda riktlinjer och att begreppet skälig levnadsnivå är så pass svårdefinierat. Förslag på framtida forskning, som ges i uppsatsen, är dels att utreda om det stämmer att biståndshandläggarna i Östersund är lika bra på att se helhetsbilden vid biståndsbedömning som studiens resultat föreslår. Att mer noggrant undersöka hur socialtjänstlagens begrepp skälig levnadsnivå tolkas av biståndshandläggarna – och hur det påverkar dem i deras bedömningar – är också ett förslag till vidare forskning. / Through five interviews the essay examines how care managers reason about a case concerning home help services in elderly care and how they motivates their judgments and decisions. The interviews have been undertaken in the city of Östersund in Jämtland. A vignette describing a fictitious case has been the starting point for all interviews and a phenomenological hermeneutical analysis has been used in the producing and interpretation of the results.                       The results emerging from the study suggests that care managers in Östersund tend to look to both the social, physical, medical and psychological needs of the customer when making their decisions. When it comes to setting boundaries of home care interventions the care managers also seem to be quite generous. How to set the boundaries does however appear to be somewhat unclear, partly because they do not have the help of established guidelines and that the concept of decent standard of living (skälig levnadsnivå) is so difficult to define. One suggestion for future research that is proposed in the paper is to investigate whether it is true that care managers in Östersund are as good as it seems to see the big picture of customers needs as the study suggests. Another suggestion is to more closely examine how the concept of decent standard of living is interpreted by care managers and how it affects them when they make their judgments and decisions.