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.