This article explores how three evaluation systems in eldercare governance, two national and one local, operate and interact at the municipal, administrative, and service levels in a Swedish municipality. The case study focuses on the three systems’ contributions to accountability and to improving eldercare quality. It is based on multiple sources, including 28 interviews with local key actors involved in local eldercare governance, and the results derive from a directed content analysis guided by four research questions.

The study demonstrates that the three evaluation systems support accountability and quality improvement in different ways and have different consequences for local actors. The systems create multiple accountability problems and have multiple constitutive effects, for example, creating different notions of what quality in eldercare means. The systems’ contributions to improving eldercare quality differed: the net effect of the two national systems was negative, whereas the local system has helped improve eldercare quality without any identified negative effects so far.

The article broadens our theoretical understanding and knowledge of regulatory mechanisms in eldercare governance. It has significance for eldercare policy by finding that policymakers and service providers must be aware of and manage multiple evaluation systems and accountability problems. Its implication for eldercare practice is that local actors must build evaluation capacity to manage existing evaluation systems in order to improve their own practices.

This article examines the assumptions regarding how Swedish state supervision (SSV) ofeldercare is to achieve its intended effects. It explores how SSV is intended to work toensure and improve eldercare quality, and theoretically and empirically assesses the validityof its guiding assumptions with programme theory methodology. The theoreticalassessment suggests that most intended effects are partly achieved, though the qualityenhancingassumption finds little support in caring research. The assumption that thesupervised parties will improve their compliance with laws and regulations has some validity,but this compliance is temporary and confined to the aspects of eldercare beingsupervised. Twenty-four interviews with the chairs of Social Welfare Committees andcare unit managers provide empirical support for all but two intended effects. SSV hasnot increased ‘awareness of national regulative demands in eldercare’ or contributed to‘general quality improvement in eldercare’. Four unintended effects of SSV were also recognisedin the interviews—for example, unsupervised caring activities were less prioritised.The authors conclude that, although SSV does little to improve eldercare quality, itis needed for transparency and accountability as well as to hold local governments andpublic and private service providers to account for compliance with national statutes.

What is a democratic caring (DC) evaluator and what does it mean to be one, especially in terms of practicing responsibility for the stakeholders one works with in evaluation contexts? This chapter discusses the challenging issue of the responsibilities of evaluators, citing an evaluation of the reception of unaccompanied and separated children (UASC) in Umeå, a northern-Swedish community of over 100,000 residents. DC evaluation does not refer to a new evaluation approach. The notions of DC evaluation and the DC evaluator are used here in discussing what it means to be an evaluator who develops evaluation within a democratic and caring society. The discussion builds on both democratic evaluation and care theory. It is suggested that an enlightened DC evaluator is informed both by democratic evaluation and by research into good care, applying this knowledge reflectively during the evaluation process. This chapter discusses what is involved in developing a DC evaluation with a special focus on the evaluator's respon-sibilities and good care.

The chapter continues with a brief presentation of the case: a democratic evaluation of care for a group of refugee children in Sweden. Subsequently, the theoretical underpinnings of democratic evaluation are presented. The next section discusses what DC awareness means and the responsibilities of a DC evaluator, illustrating this with examples from the case. The chapter concludes by considering what DC evaluation implies for the good care of refugee children.