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.

This article explores how local politicians and care unit managers in Swedish eldercare experience and respond to state supervision. Twelve politicians and 12 managers in 15 previously inspected municipalities were interviewed about their experiences of and reactions to state supervision (SSV) in relation to their views of care quality and routines in eldercare practice. The findings indicate that local managers and political chairs perceived SSV in eldercare positively at a superficial level, but were critical of and disappointed with specific aspects of it: in terms of a) governance—chairs and managers said SSV strengthened implementation of national policies via local actors, but were critical of SSV’s narrow focus on control and flaws in eldercare practice; b) accountability—SSV was seen as limited to accountability for finances and systemic performance; and c) organizational development—SSV was seen as limited to improving routines and compliance with legislation, while local definitions of quality are broader than that. In general, local actors regarded SSV as improving administrative aspects and routines in practice but ignoring the relational content of eldercare quality.

The article reviews the relevance and methodological utility of welfare regime typologies for the study of professional sense-making in social work with families. Focus groups were carried out with social workers in European and Latin American countries representing four different policy regimes. A case vignette was used to elicit social workers’ descriptions of how welfare policy may influence how they understand their work task and the notion of family. The research team identified methodological challenges of general relevance in similar policy-practice studies. There were paradoxes in terms of homogeneity on the regime level vs. heterogeneity within and between national services. Pitfalls appeared in the selection of regime-typical cases, language/cultural barriers, and in deciding organisational level. The article shows that welfare typologies have potentialities in that they may provide a helpful analytical basis for theoretical and practical reasoning in which syntheses between policy and practice can be explored, discussed and challenged.

Evaluating the participatory opportunities for service users within social welfare institutions is a pressing issue. In this article, we explore a group of ethnic minority parents' experiences with child welfare services (CWS) in Norway. A strong narrative theme was deficiency positioning—how lacking a Norwegian normative set of knowledge and skills challenged the parents' opportunities to participate. We analysed how deficiency positioning was perceived, negotiated, and contested in the parents' accounts, and 4 themes emerged: (a) learning to parent, (b) contesting expert knowledge, (c) learning to be a client, and (d) constructing CWS deficiency. Nancy Fraser's concept of “participatory parity” was applied to explore how current institutional structures may enable and limit parents' participation. The analysis provides insight into agencies and informants' sense-making processes as well as the diverse resources and strategies that parents draw upon in the CWS encounter. Furthermore, we argue that an interplay between a strong focus on “parenting skills” and bureaucratic and economic structures positions ethnic minority parents as deficient, thus providing powerful mechanisms for marginalization. Implications for case work and institutional levels are discussed.

This paper elucidates how Swedish child welfare social workers manage complexity co-occuring in the families with which they work and the organisational contexts of practice. Focus groups were held with social workers in three municipalities in Sweden who described work processes generally and in response to a fictitious vignette. The vignette was constructed as a complex family situation to explore how social workers approach complexity when faced with a family with complex needs. Findings showed that social workers are challenged in their everyday work where they are aware of the many needs in a family. They focus on immediate conditions for children while recognising that some problems are less amenable to being solved. However they try to manage complexities related to families as well as the structural conditions of work by sorting, prioritising and oscillating between a child focus and a family service orientation. This paper serves as a necessary reminder of the complexity of social work in the broader area of child welfare and raises further questions about the use of comparative typologies to explain social work practices.

This study examines the conceptualisation of family in key social legislative documents guiding social workers in two European countries, whose welfare systems have previously been labelled as re-familialised (Lithuania) or de-familialised (Sweden). The focus is on the concept of family as delineated on three legislative levels: the constitutional level, the general family policy level, and the child welfare policy level. ‘Family’ is explicit in Lithuanian law, and the regulation of family formation and responsibility is imperative, while this is much less so in Swedish law. The analysis reveals how general welfare systems (regime-types) are linked to legislative frameworks, which, in turn, provide fundamentally different conditions for social work in different contexts.

This chapter consists of two parts. First, two accountability dilemmas are identified, key concepts are defined, and a framework for exploring the interplay among democratic governance, audit systems, and accountability is presented. Second, two different but dominant audit systems used in Swedish eldercare are described and analysed in light of this framework, and consequences of auditing and accountability for key actors involved are discussed, as well as possible ways of resolving the two accountability dilemmas. In relation to the volume, this chapter explores conditions, trends, and challenges in today's audit society and their implications for welfare professions and other key actors. Swedish eldercare is an illustrative case of a phenomenon occurring in most policy sectors.