This study is based on a qualitative study with 8 semi-structured interviews. The aim of the study was to describe how social workers in the individual- and family section in social services in two different municipalities in Sweden reason about reporting obligations and to understand what lex Sarah means in the decisions making to report incongruity or not. We interviewed social workers that work in the department of individual- and family section, a municipality worker who works with state governance with all kinds people in the society. We asked the social workers altered questions about how they handle lex Sarah in their work. Three different topics were identified in our study and became the themes: Description, management and conflicting thoughts. Our analysis is based on two different theories, one about the choices a person make being in an organization, the other about how a professional individual have altered pressures to handle in their everyday work. By doing a semi-structured study of the social workers opinions, we found out that the description of incongruity was not the focus just in managing lex Sarah. Results of the study showed that there is several different aspects to take in considerations when social workers in individual- and family section in social services decide whether to report or not. The description is one part and their own individual worries affected them in their decision to report incongruity or not. They all had faith in lex Sarah and thought it could be used as a tool to make their work better.

The aim of this study was to examine the experience, knowledge and attitude to mandatory reports of mistreatments amongst first line managers and assistance nurses in municipal elderly care. The following questions were at the center of the analysis: how do the different professional groups view having to report their own organization? How can various factors affect the mandatory reporting of mistreatments? What knowledge do the different professional groups have of mistreatments and mandatory reporting? A qualitative research method was used to examine these questions in the form of semi structured interviews and a small document study. The interviews were carried out with assistance nurses and first line manages in elder care, we interviewed four respondents from both professional groups. The interviews were then transcribed and coded with help of a content analysis. We have used Berger and Luckmanns theories about institutionalization when analyzing our results. We have also used Lipskys theory about street-level bureaucracy. The analysis is structured around themes and analyzed based on previous research and the above said theories. Our results show that there is a struggle amongst the both first line managers and assistance nurses to fully comprehend the complexity of mandatory reporting of mistreatments and that it’s often hard to draw the line between mandatory reporting of mistreatments and other less severe reporting’s such as deviation reports. Further, we have concluded that there is a fear amongst assistance nurses of reporting. Primarily because of a belief that reprisals, first and foremost from colleagues, will follow. We have also concluded that the workplace often seems to be characterized by a normative system in which loyalty and silence are common elements which may inhibit reporting. Key words: mandatory reporting of mistreatments, knowledge, attitudes, experience, elder care. Nyckelord: lex Sarah, kunskap, inställning, erfarenhet, äldreomsorg.

Syftet var att beskriva innehållet i Lex Sarah- anmälningar och dess påföljder på kommunala äldreboenden i en större kommun i Mellansverige under år 2010. En beskrivande kvalitativ design användes och materialet analyserades med hjälp av manifest innehållsanalys. Bristande omvårdnad var den vanligast förekommande anledningen till att en Lex Sarah- anmälan skrevs. Andra anledningar som bristande kommunikation och felaktigt bemötande förekom, men ofta då i samband med bristande omvårdnad. Verksamhetschefens åtgärder var jämt fördelade mellan insatser riktade mot berörda parter och insatser riktade mot arbetsplatsen. I nästan hälften av anmälningarna ansåg områdeschefen att verksamhetschefens åtgärder var tillräckliga. Områdeschefens vanligaste åtgärder var ytterligare insatser riktade mot berörda parter, medan ytterligare insatser riktade mot avdelningen inte förekom i lika stor utsträckning. Insatser mot kunden och dess anhöriga fanns med, men var näst intill obefintligt. Slutsatsen är att bristande omvårdnad var den vanligaste orsaken till att en anmälan gjordes, och att andra orsaker till att en anmälan gjordes ofta byggde på att brister i omvårdnad förekommit. I de fall kunden nekats hjälp eller blivit felaktigt bemött tog ofta kunden kontakt med anmälaren, i andra fall bevittnade anmälaren händelsen.

This paper aims to find out what lex Sarah is and how the process looks like when it comes to the investigation, from reporting to registration to the IVO, the inspection of health and social care. Who investigates, the objective of the lex Sarah and how many cases of reports that comes to registration from the year between 2010-2014. Which legal consequences it can be for an employee who has been notified is investigated also. Previous research only deals with freedom of speech, criticism and the complaint goes to the asset, and because of that, this paper focuses on individual cases where employees ' perception of a lex Sarah-registration gives a psychosocial approach. The paper is limited to a municipality where statistics are retrieved and a comparison at a national level is performed. Furthermore, two interviews conducted with a socially responsible Coordinator (SAS)who is the responsible lex Sarah-investigators in the municipality and a Union representative person who can provide a possible picture of how people who have been in a lex Sarah-case, feel about that and also persons who have been suspended from their jobs because of the investigation, experienced the situations. It´s clear that people who ends up in situations like this is feeling very sad and gets in chock when they get a message that says they are involved in a lex Sarah-reporting.

Media has reported frequently about elder abuse in Sweden during the year of 2011. The authors have found an interest in elder abuse due to the attention about it and the law about the duty to report elder abuse, which is called lex Sarah. The aim was to investigate, due to quantitative method with surveys, the care givers tolerance to elder abuse, attitude and knowledge about lex Sarah. The result of the thesis was analyzed based on two theories, Lipsky’s street-level bureaucracy as well as Svensson’s, Johnsson’s and Laanemets’ theory about knowledge. The result of the study was that the care givers have knowledge about lex Sarah and believe that lex Sarah helps to improve their work. The respondents’ tolerance to psychological elder abuse were high and their tolerance to physiological abuse were significantly lower. Therefore physiological elder abuse is more often to be reported than psychological elder abuse.

The purpose of this study has been to examine the unit manager’s perspective on making Lex Sarah-notifications. The study has been carries out by six semi structured interviews with persons in leading positions of the elderly from three different municipalities. They were asked about different circumstances that affects the problems with Lex Sarah. The results indicates that the unit manager’s act on elder abuse from the complex mechanisms that exist within the organization. The study results shows that the unit manager’s in the daily tasks are doing their work and solve problems regarding the risk of elder abuse that occur over time, but circumstances will determine if its documented prescribed by a Lex Sarah. The conclusion is that the unit manager’s of the elderly is limited by the circumstances and processes within the organization and that it affects them to lift up and report abuse among the elderly.

Bakgrund Tidigare studier visar att vårdtagare inom äldreomsorgen utsätts för brister och missförhållanden av olika former. Den vanligaste formen av missförhållanden är försummelse av vårdtagaren. En av Socialstyrelsens uppgifter är att värna att god och jämlik vård bedrivs. God vård bedrivs genom att respektera och bevara vårdtagarens integritet. Syfte Syftet var att studera huruvida vårdpersonal uppmärksammat brister och missförhållanden på särskilt boende för äldre samt vilka typer av brister de i så fall uppmärksammat. Syftet var även att under­söka orsaker till eventuella brister och missförhållanden och personalens kunskap om Lex Sarah. Metod Studiespecifik enkätstudie med kvantitativ ansats. Resultat Av respondenterna hade 69 av 80 stycken uppmärksammat någon form av brist och missförhållande under de senaste sex månaderna. Brister i omsorgen gällande vårdtagarens tand- och munhygien samt personliga hygien var de brister som uppmärksammats mest. Respondenterna ansåg bland annat att tidsbrist och kunskapsbrist var troliga orsaker till de brister och missförhållanden som uppmärksammats. Slutsats Studien visar att brister och missförhållanden existerar och uppmärksammas inom äldreomsorgen. Orsaker till de rådande missförhållande är okunskap och tidsbrist hos vårdpersonalen. Det framkom att kunskap om Lex Sarah var hög. / Background Equal and good care is a right for every person in Sweden according to National Board of Sweden. Previous studies show that patients in geriatric care are exposed to abuses of various shapes. The most common form of abuse is neglect of the resident. To give good care the care workers need to respect and maintain the integrity of the resident.   Aim The aim of the study was to investigate if care workers in nursing homes observed any abuse against the elderly and what kind of abuse. The aim was also to find out what possible causes of the abuse could be and investigate the care workers knowledge of Lex Sarah.   Method Study-specific questionnaire with quantitative approach.   Result The result shows that 69 of the 80 respondents had noticed any kind of abuse or neglect in the last six months in their nursing home. The most common abuse or neglect was inadequate care of the teeth and hygiene among the elderly. The respondents think that lack of education and stressful situations may be the cause of the abuse and neglect.   Conclusion The study shows that abuse and neglect does exist in Swedish nursing homes. Causes of the current abuse is ignorance and lack of time among careworkers. The knowledge of Lex Sarah was high among the careworkers.

The purpose of this study was to understand in what ways the law of Lex Sarah contributes to quality within the Swedish social services. The legislation of Lex Sarah aims to ensure quality assurance of social services by eliminating misconduct. Operational developers are keyactors in the investigation process of Lex Sarah. Therefore a central question of this study was: In what ways does operational developers consider that Lex Sarah achieve its purpose? The method of analysis was a qualitative study. The basis of the theoretical framework of the study is social constructivism, in which institutional theory and thoughts describing how ideas are transferred and spread is a part of. The theoretical framework has been helpful to illustrate possible ways of how the idea of quality has been spread from industry to social services. The empirical material has been collected by qualitative semistructured interviews.   Central findings of the empirical material is that there was no coherent definition within the group of operational developers of the quality concept. Emphasis is mainly placed on the quality concept's commitment to legislation and user satisfaction. The term is explained in broad terms and no detailed description is given. Lex Sarah is described as an alarm system and the empirical material also shows oppon it’s controlling functions. Through the empirical material it is also shown that the measures proposed by the operational developers not necessarily lead to improvement or quality of the operations. One explenation highlighted is the gap between investigation and the enforcement. A central discovery is also based on the lack of user influence within the Lex Sarah-process.

I den här c-uppsatsen undersöker vi hur personal inom LSS-boende ser på sin anmälningsskyldighet och vad som inverkar på personalens arbete med att skriva avvikelser och lex Sarah anmälningar. Personal inom LSS-verksamheten måste förhålla sig till de riktlinjer och regler som LSS-lagen säger. Däremot är LSS-lagen komplex och inte tydlig om vad som kan ses som ett missförhållande och detta kan leda till svårigheter för personal i sitt arbete att skriva avvikelser och lex Sarah anmälningar. För att besvara vår studies syfte och frågeställningar har vi använt oss av en kvalitativ forskningsansats med semistrukturerade intervjuer. För att analysera empirin har de teoretiska begreppen handlingsutrymme, kunskap, interaktion mellan individer och Lipskys teoretiska begrepp om gräsrotsbyråkrater använts. Resultatet av studien visar att LSS-personal är införstådda i sin anmälningsskyldighet och att de har kunskap om vad en avvikelse och lex Sarah anmälan är. Däremot fanns det en osäkerhet hos LSS-personalen vart gränsen går mellan en avvikelse och lex Sarah anmälan pga. att det saknas kunskap och att LSS-lagen är komplex. LSS-personalen belyser att det finns både möjligheter och svårigheter med att skriva avvikelser och lex Sarah anmälningar i deras arbete. De möjligheter och svårigheter personalen nämner är kunskap och utbildning, stöd från ledning och arbetskollegor, relationen till chefen och arbetskollegor, personalens normer och värderingar, resurser och kvalitetssäkra verksamheten. / In our bachelor essay we research about how professionals in LSS-residents look at their obligation to give notice on what impact on the professional’s work with writing deviations and lex Sarah reports. Professionals´ who work within LSS-residents must adhere to the guidelines and rules that the LSS-law say. However, the LSS-law is complex and not obvious what can be seen as a bad condition and this can lead to difficulties for staff in their work to write deviations and lex Sarah reports.In order to answer the research questions of and issue we have used qualitative research method with semi structured interviews. To analyze the empirical material, the theoretical concepts acting space, knowledge, interaction between individuals and Lipsky´s theoretical concepts about the street-level bureaucracy have been used. The result of the study shows that professionals´ who work within LSS-residents are aware of their obligation to report and that they have knowledge of what a deviation and lex Sarah report is. However, there was an uncertainty among the professionals´ who work within LSS-residents where the limit goes between a deviation and lex Sarah report due to that there is no knowledge and that the LSS-law is complex. Professionals´ who work within LSS-residents highlights that there are both opportunities and difficulties in writing deviations and lex Sarah reports in their work. The opportunities and difficulties the staff reported on are knowledge and education, support from management and work colleagues, the relationship with the manager and work colleagues, the staff's norms and values, resources and quality assure the work.