The purpose of this study was to understand how the concept of quality as an idea was spread to and translated in municipal elderly care. A central question was: How does literature, policy documents and key people describe the function and meaning of the concept of quality? The method of analysis was a qualitative case study with a critical discourse. The theoretical framework of the study is mainly what is known as institutional theory and a line of thought describing how ideas are transferred and spread. The theoretical focus is on how original ideas are interpreted and why they gain a foothold in new contexts. With the help of empirical material in the form of literature, documents and interviews the study shows how the idea of quality was spread from industry to elderly care.   An essential discovery is that the concept of quality has uncritically been implemented to the municipal care of the elderly, correlating to organizational changes, limited resources and the concept of quality becoming a part of the Social Services Act. The municipal care of the elderly tried to apply a quality control system not designed for a human service organization. In order to succeed it tried to make the idea concrete and intelligible by using various system and manuals. The results show that the process has created conservation rather than a change. There is a paradox between quality as a subjectively created value and quality as a quantitative instrument used to create efficiency.

The group of elderly people in Sweden will increase significantly in the future and science point out that the future elderly people will not accept today’s standards and offers of assistance in today’s public elderly care. Therefore public elderly care stands before a significant challenge in terms of development that has to be sustainable. New research also points out that middle managers can be a great strategic resource, and a founder of success, in the challenge of sustainable development. The aim of the report was to increase the knowledge about what middle managers in public elderly care think sustainable development has to embrace, when it comes to quality and personnel administration, in order to meet the needs of the future elderly people. The aim was also to deepen the knowledge of how formal and informal organizational factors facilitate or limit middle managers possibilities to work with development in general and sustainable development in specific in their units. Interviews, as a qualitative method, were used to gather empirical data and the result was analyzed with theories as Domain theory, New Public Management and Situational leadership. Our findings showed that middle managers have little possibilities to work with sustainable development in their units and that formal factors as budget had a great impact of the middle managers overall possibilities in their work. According to the result it seemed that development and long term planning in this particular organization were tasks mainly for the management and political domain. According to our findings it seemed as if the introduction of New Public Management increased the underlying initial problems of human service organizations. According to Domain theory these problems consists of disjunction, discordance and conflicts due to the differences between the three domains when it comes to principles, success measures, structure and work modes.

<p>The group of elderly people in Sweden will increase significantly in the future and science point out that the future elderly people will not accept today’s standards and offers of assistance in today’s public elderly care. Therefore public elderly care stands before a significant challenge in terms of development that has to be sustainable. New research also points out that middle managers can be a great strategic resource, and a founder of success, in the challenge of sustainable development. The aim of the report was to increase the knowledge about what middle managers in public elderly care think sustainable development has to embrace, when it comes to quality and personnel administration, in order to meet the needs of the future elderly people. The aim was also to deepen the knowledge of how formal and informal organizational factors facilitate or limit middle managers possibilities to work with development in general and sustainable development in specific in their units. Interviews, as a qualitative method, were used to gather empirical data and the result was analyzed with theories as Domain theory, New Public Management and Situational leadership. Our findings showed that middle managers have little possibilities to work with sustainable development in their units and that formal factors as budget had a great impact of the middle managers overall possibilities in their work. According to the result it seemed that development and long term planning in this particular organization were tasks mainly for the management and political domain. According to our findings it seemed as if the introduction of New Public Management increased the underlying initial problems of human service organizations. According to Domain theory these problems consists of disjunction, discordance and conflicts due to the differences between the three domains when it comes to principles, success measures, structure and work modes.</p>