The presented dissertation is concerned with the ethic features of the quality of the social services inspectors professional behaviour in the residental facilities. This dissertation is divided into two main parts. The first part comprises theoretical bases related to given problems with the analysis of the relevant professional literature. The other part comprises with the actual research, the aim of which was finding ethical contexts of the inspection performance, inspector's education in the ethics, ethic code of the inspectors, the inspector profession and the value preferences of the inspectors. The main target is to analyze the ethical connections during the ispection performance in chosen residential facilities of the social services. In the research the quantitative and qualitative methods, the questionnaire survey and structural interviews were used. Based on the synthesis of the acquired knowledge the dissertation presents a view of the ethics application in professional activities of the inspectors. Key words: social services, quailty standards, quality inspections, values, ethics, the ethic code, career of the inspector, residential social services.

Studiens syfte är att beskriva och analysera chefer och medarbetare syn på sina organisatoriska förutsättningar att etablera evidensbaserad praktik (EBP) i socialtjänsten. I uppsatsen läggs ett särskilt fokus på den organisatoriska förutsättningen strategiskt ledarskap och dess betydelse i en EBP-kontext. Frågeställningarna behandlar huruvida det finns en tydlig riktning kring hur verksamheten ska utvecklas, om konkreta förutsättningarna skapas för genomförandet, ifall kontinuerlig uppföljning och återkoppling ges på arbetet samt om det finns uthållighet i utvecklingsarbetet i organisationen. Skillnader i uppfattning mellan chefer och medarbetare undersöks. Empirin har hämtats från två barn- och ungdomsenheter i Stockholms stad i form av en enkätundersökning och fyra fokusgrupper. Materialet har analyserats utifrån tidigare forskning om ledarskap kopplat till implementering av EBP samt Scheins ramverk om organisationskultur och ledarskap. Resultaten från enkätundersökningen visar på statistiskt säkerställda skillnader i uppfattning mellan chefer och medarbetare: cheferna svarar genomgående i en mer positiv riktning än medarbetare. Resultaten från fokusgrupperna visar möjligheter att skapa tydlig riktning, flera likheter i uppfattning om konkreta förutsättningar samt möjligheter att utveckla arbetet med uppföljning och återkoppling. Faktorer som påverkar uthålligheten i organisationen lyfts fram. Sammanfattningsvis visar undersökningen att det strategiska ledarskapet ännu inte finns fullt ut i de undersökta organisationerna men viktiga steg har tagits för att skapa denna organisatoriska förutsättning. Resultat från undersökningen pekar också mot att man framöver bör arbeta mer systematiskt med att inkludera medarbetarna i arbetet med att etablera en evidensbaserad praktik. / The purpose of this study is to describe and analyze social work managers’ and employees’ views of the organizational prerequisites to establish evidence-based practice (EBP) in the social services. The thesis has a particular focus on the organizational preconditions of strategic leadership and its importance in an EBP context. The research questions reflect whether the strategy for development is clear, if conditions are established for implementation, if continuous evaluation is used and feedback given, and whether there is perseverance regarding the developmental work in the organization. Differences in the opinions between managers and employees are examined. The study has a mixed-methods approach. Empirical data were derived from two children and youth units in Stockholm city in the form of a survey and four focus groups. The material was analyzed based on previous research on leadership related to implementation of EBP and Schein's framework of organizational culture and leadership. The results from the survey show statistically significant differences in the opinions between managers and employees: managers consistently respond in a more positive direction compared to the employees. The results from the focus groups show opportunities to provide clear direction, several similarities in opinion about how to create concrete conditions for implementation, as well as possibilities to develop work on evaluation and feedback. These results further highlight factors related to sustainability for strategic leadership. To conclude, the investigations of present study find that the strategic leadership does not yet characterize these organizations, but important steps have been taken in developing this organizational condition. Moreover, the results indicate that future work would benefit from systematically involve employees in the developing efforts to establish an evidence-based practice.

This thesis focuses on service utilisation among children with mild ID and their families, their needs for support and their experiences of support. Aims The overall aim of the thesis was to explore and describe service utilisation patterns among families of children with mild ID from a systems perspective. Methods A cross-sectional, descriptive and comparative quantitative design was used to describe the extent of service utilisation among 84 children with mild ID and their families (paper I and II). The types and number of services utilised were investigated in relation to the child’s age, gender and school setting. Data concerning the services utilised were collected from the organisational records of social services and paediatric habilitation units. In paper III, a descriptive questionnaire design was used to describe the support needs of families of 38 children with mild ID. A confirmatory design was used to examine the relation between family needs for support and (a) parental self-efficacy and (b) parents’ control over services. A confirmatory design was also used to examine the relation between parents’ experiences of the helpfulness of the support and (a) parental self-efficacy and (b) parents’ control over services. In paper IV a longitudinal, comparative and confirmatory design was used to investigate whether social service utilisation patterns differ over time when children with mild ID in self-contained classes are compared with those integrated into mainstream classes (n=405). Results In total, 60% of the families utilised paediatric habilitation services, and 40% of the families used disability-related services provided by social services. The most commonly utilised services were services concerned support outside of the home, such as respite care and services to improve children’s participation in society. Approximately 25% of the families utilised social problems-related services provided by social services. The most commonly utilised services concerned those to support parents in their parenting roles and financial assistance. In contrast to older children, younger children were more likely to utilise paediatric habilitation services. Older children utilised a higher number of disability-related service types provided by social services. Few differences were found between males and females. The majority of families did not utilise such services that are provided by social services. It was rare for families to use both disability-related services and those that address social problems during the same year. Commonly reported family needs concerned information about what services are available for their child, their child's impairment, how to respond to their child's behaviour and how to teach their child skills. Other common needs included access to parent support networks, to find suitable leisure activities for the child, and more alone time for parents. In contrast to families with mothers who did not participate in paid work, families with mothers who were employed expressed a lower requirement for support such as counselling, contact with other parents of children with impairments, more friends and more alone time for parents. Similar results werefound for families with mothers with higher levels of education. Parents with higher levels of perceived self-efficacy reported a lower need for information, as did also parents with higher levels of control over services. Parents with higher levels of control over services experienced the support as being more helpful. Children with mild ID who attended self-contained classes were more likely to utilise paediatric habilitation services than children integrated in mainstream classes. The same pattern was found for utilisation of disability-related services provided by social services. Integrated children who changed school setting to attend self-contained classes were more likely to begin to utilise disability-related services in comparison with those children who continued to be integrated. The former also had a higher likelihood of increasing the number of disability-related service types utilised. Conclusions In addition to disability-related problems, families of children with mild ID may also be at a higher risk of experiencing social problems when compared with the general population. Furthermore, very few families utilised both disability-related services and services addressing social problems. This implies that collaboration flaws exist between those professionals concerned with child welfare services and those concerned with disability-related services. A strong predictor of service utilisation was the type of school setting: children attending self-contained classes had a higher rate of service utilisation than those attending mainstream classes. This indicates that service systems outside of school are designed to collaborate with groups of pupils in special classes rather than individual children in mainstream classes. The strong need for information by families indicates that an ecological framework should be used to identify those factors that affect information availability and effectiveness. To increase parents’ perceived level of control over services, HSO professionals need to work in a capacity building manner with the explicit goal to enhance parental self-efficacy.

Health Studies / (M.P.H. (Health Studies))

This inquiry into informal networks and policy negotiations is set in the theoretical framework of network governance. It builds theory to explain informal networks by examining neighbourhood associations in post-Katrina New Orleans through a variety of qualitative methodologies including interviews, document analysis, surveying and ethnography. In New Orleans, neighbourhood associations do not engage in social-service delivery, they prioritise neighbourhood protection and neighbourhood change. They represent their neighbourhoods through a system of intensive volunteering not elections. That system burns out neighbourhood leaders and leaves associations constantly looking for new volunteers. These associations partner with non-profits, work with politicians, and engage in fierce conflict when excluded from policy negotiations. Finally, they set their agenda based upon the physical characteristics of their neighbourhoods, investing in local institutions. These findings contribute to network governance theory. New Orleans’ democracy of volunteers introduces a new form of democratic anchorage to governance theory. Actors in informal networks have varying priorities. This demonstrates the importance of early involvement by these actors in policy creation and the ways in which policy construction can ignore community. Neighbourhood associations blackmail, bribe and coerce to create their own power, showing how power at the micro-level includes not only resources and decision-making, but also interest. These findings fit into a broader theme. Negotiations with multiple actors improve policy by incorporating complex priorities and neighbourhood context into the policy system. This wider theme of how to address complexity is the policy equivalent of the wisdom of crowds. Policy-makers can either incorporate complexity such as local context and differing priorities or face the conflict and consequences of ignoring it.

The aim of this study was to analyze how social workers in an elder administration in Sweden handle empowerment and needs for people with dementia and what ethical dilemmas the social workers could experience with these clients. The result is based on qualitative interviews where eight social workers had the opportunity to describe their work with elder people with dementia. Five main subjects were identified in the interviews: empowerment, strategies, dilemmas, force and knowledge and understanding in the organization. The analysis of these themes helps us to understand how the social workers in their profession handle different situations and dilemmas which can arise in their daily work. The conclusion from the result and the analysis was that the most frequent dilemmas for the social workers in their work with people with dementia was the clients unwillingness to receive help, relatives’ and other professions’ ignorance about empowerment and also when relatives wanted to make decisions for the clients. The result showed that the social workers used extensive motivational work for the clients with dementia in order to handle their empowerment and needs. The social workers requested that the relatives and the staff who work with elder people should have more knowledge about the empowerment for the clients. / Syftet med studien var att förstå hur biståndshandläggare i en äldreförvaltning i Sverige hanterar äldre demenssjukas självbestämmanderätt och hjälpbehov samt vilka etiska dilemman de kan ha i arbetet med dessa brukare. Empirin bygger på kvalitativa intervjuer där åtta biståndshandläggare haft möjlighet att med egna ord beskriva hur ärendehanteringar med äldre demenssjuka brukare kan se ut. Fem huvudteman identifierades i intervjuerna vilka var: självbestämmande, strategier, dilemman, tvång samt olika kunskaper och förståelse i organisationen. Analysen av dessa teman bidrar till att förstå hur handläggarna i sin yrkesroll hanterar situationer och dilemman som kan uppstå i deras praktiska vardag. Slutsatsen utifrån resultat och analys är att de främsta dilemman som biståndshandläggarna möter i arbetet med demenssjuka brukare är brukarnas ovilja att ta emot hjälp, oförståelse om självbestämmanderätten hos anhöriga och övriga professioner samt när anhöriga vill ta beslut åt brukarna. Utifrån empirin kunde vi se att biståndshandläggarna använde sig av omfattande motiveringsarbete med de demenssjuka brukarna för att hantera deras självbestämmanderätt och hjälpbehov. Något som handläggarna efterfrågade var mer kunskap om självbestämmanderätten bland äldreförvaltningens hemtjänstpersonal och anhöriga till brukarna.

The aim of this study was to understand how a social workers responsible for foster children within the municipal social services, is working with the children’s continuous relationships with family members and other significant related, as well as which knowledge formed the basis for their work practice. The study is based on interviews with eight social workers from three different municipalities. The results showed that the work is based on the law which causing interpretations, in which the individual assessment is in fact to be based on the child's needs- and best, but in practice are decisions made by and involving several parties. The study showed that the guardians and foster cares wills and opinions weigh heavily, often at the expense of the child perspective. As a strategy to assess the child's best, the social workers turn to their own quiet knowledge and colleagues and the organization's traditions to retrieve knowledge that supports the decisions, and to a lesser extent to scientific knowledge and evidence-based practice. The social workers also expressed a wish to work more with scientific underpinnings, but the organization does not work with routine gathering of scientific knowledge.

Syftet med denna studie är att undersöka om socialarbetare tillämpar genusmedvetenhet i arbetet med personer som är utsatta för våld i nära relationer, och hur det i så fall uttrycker sig i mötet med dessa klienter. För att besvara dessa frågeställningar har en kvalitativ ansats tillämpats, med vinjettintervjuer som metod. Den hypotetiske klienten var för tre av informanterna en våldsutsatt man och för tre informanter en våldsutsatt kvinna. Informanternas svar jämfördes sedan och analyserades med hjälp av tidigare forskning på området samt teorier om genus, stereotyper och institutionalisering. De slutsatser vi kunnat dra genom denna studie är att socialarbetare till viss mån påverkas av könsstereotypa föreställningar och att man gör skillnad mellan könen vad gäller insatser, bedömningar och bemötande. Dock har vi även sett att det alltid finns en vilja att hjälpa klienten om behovet finns, i den mån det är möjligt utifrån bland annat det politiska och ekonomiska läget. / The aim of this essay is to examine if social workers apply gender awareness when meeting individuals exposed to domestic violence and how it is expressed in the meeting. To answer these questions, a qualitative approach has been used, with vignette interviews as method. Three of our informants were given a scenario where the client was a man, and three informants were given the exact same scenario but with a female client. The informant’s answers were compared and analyzed through former research and theories such as gender theory, stereotypes and institutionalization. Our conclusions of this study show that social workers, to some extent, are influenced by gender stereotypes and that they distinguish between men and women regarding treatment, assessments and decisions. However, we have also seen that there is always a will to help the client if needed, if it is possible due to the political and economic situation.

<p>The aim of the study was to examine the background and prerequisites for social services responsibility for carers according to the carers’ section in the Social Services Act. How the legislation is perceived and implemented in practice was also studied. The study’s theoretical basis was jurisprudence and the sociology of law. Preparatory work and other sections of importance for the interpretation of the carers’ section in the Social Services Act were also scrutinized. Interviews with four municipal politicians and four local civil servants were conducted. Various factors which affect the prerequisites for the social services duty of care towards carers were identified in the study. By studying the direct effects of legislation various indirect effects were also highlighted. The results showed that legislation is a weak instrument of control in municipalities’ planning and implementation of support for carers. Therefore social services responsibility for carers is unclear and imprecise. For carers themselves it is difficult to know what support they can demand or ask for from social services – municipalities have to offer support for carers but the carers’ section does not give carers any legal right to support.</p>

Syftet med denna studie är att söka svar på i vilken omfattning barn har getts möjlighet att uttrycka sin åsikt inom socialtjänstens förhandsbedömningar som inte har lett till utredning. Detta genom att mäta i vilken omfattning barnets närvaro har dokumenterats inom ramen för en förhandsbedömning som inte har lett till utredning. För att besvara studiens syfte användes utvalda variabler för att ta reda på om det finns eventuella omständigheter som kan ha påverkat om barnet har getts möjlighet att uttrycka sin åsikt. Barnets ställning inom socialtjänsten är stärkt på ett flertal vis och denna studie tar avstamp i vad socialtjänstlagen (SFS 2001:453), FN:s konvention om barnets rättigheter och Stockholms stads riktlinjer för socialtjänsten fastställer om barnets möjlighet till att uttrycka sin åsikt i ärenden som rör dess person.  Studien är en kvantitativ aktstudie och empirin består av 384 förhandsbedömningar som inte lett till utredning. Förhandsbedömningarna är genomförda av samma stadsdel inom Stockholms stad under 2013. Genom att se till dessa dokument gav det oss möjlighet att mäta i vilken omfattning barnets närvaro har dokumenterats i förhandsbedömningarna och på så vis getts möjlighet att uttrycka sin åsikt. Den huvudsakliga teoretiska utgångspunkt vi valt att använda är synen på barn som såväl subjekt som aktör i ärenden som rör dess person. Då studien avser att mäta en företeelse som sker utifrån en socialsekreterares aktiva val i om barnet tillåts att närvara under en förhandsbedömning tolkas resultatet även utifrån ett maktperspektiv.  Studiens resultat visar att barns möjlighet till att uttrycka sin åsikt är begränsad inom förhandsbedömningarna som inte lett till utredning. Då barnets närvaro endast dokumenterats i 20 procent av det undersökta materialet. I resterande förhandsbedömningar har socialtjänsten valt att inte låta barnet närvara och beslut har fattats utan att höra barnets åsikt.