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- Ahlgren, Thorbjörn, 1959-
(author)
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Institutionalisering på hemmaplan : En idés resa i den sociala barnavården
- 2014
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Doctoral thesis (other academic/artistic)abstract
- This thesis describes and analyses in three substudies how home-based measures for children are expanding and why an open care idea are established as part of the Swedish child welfare. The first substudy describes the national increment of what today can be considered as a treatment policy – non-institutional care in child welfare. The results are analysed with Kingdon's agenda setting theory and shows that the factors of what Kingdon describes as problems-, politics- and policyflow influenced the national increment. Significant mechanisms have primarily been, the profession, the society's concerns for socially disadvantaged children, negative experiences of institutionalisation and a political position to deinstitutionalise all care. The second substudy focuses on how knowledge and research contributes to ideological, professional, and organizational change in child welfare by analysis of Research & Developments reports and articles from the professional journal Socionomen. Based on the neo-institutional concepts of organisational fields and isoformism the study's results shows that a consequence of adaptation strategies and "rationalized myths" are a number of similarities in how home-based measures are organized and which measures that are used. The third substudy, a case study, analyses how we can understand a local development of ideas in social services for children with concepts from neo institutional theory. Interviews and municipal documents are analysed and shows that the local translation of an open care idea is characterized by discretion, personal preferences and action and affects the choice of method and organization. The study also shows a political mistrust of institutional care while there is at the same time political confidence in the individual social worker's ability to find solutions that allow non-institutional measures to be an alternative to institutional care.An overall conclusion of the thesis is that there is now a treatment policy in social services for the children, which involves extensive efforts at home and it has led to that more children receive support from social services. One result of non-institutional care increment is that it led to increased costs for municipalities for intervention for children and young people when out-of-home care has not decreased. Another general conclusion is that translation and adaptation of ideas to local contexts is something that generally fits street-level bureaucrats need for discretion.
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| 2. |
- Larsson, Johan, 1979-
(author)
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Leadership for Quality, Effectiveness and Health
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Leadership, quality, effectiveness and health are important factors in the achievement of organisational success. Three questions are addressed to study these elements: 1. How do leadership values relate to leadership behaviours, quality methodologies and health in organisations? 2. How do leadership behaviours relate to effectiveness and health in organisations? 3. How can leadership tools be designed and used to promote health in organisations? The research is based on five studies from three research projects. This research is reported in five papers. Study I concerned eight organisations in the middle of Sweden; the focus was on leadership values and behaviours. Study II concerned three successful organisations that received the award, ‘Sweden’s number one workplace’. Focus in this study was mainly on leadership behaviours. Study III combined results from Studies I and II with a focus on successful leadership behaviours. Study IV concerned the eight organisations in Study I. A leadership tool in the form of a Plan-Do-Study-Act (PDSA) model was developed and evaluated. Study V was of two organisations in Sweden; the focus in that work was on the use of a leadership tool control chart designed to give managers statistically valid early warning signals about health in their organisations. Theory X and Y together with the three-dimensional leadership behaviour theory were used to assess leadership values and behaviours. The theory surrounding PDSA and control charts were used to develop leadership tools. The dimension of health is defined from a salutogenic humanistic perspective; which emphasizes individual well-being. The dimension of quality is defined as the ability to satisfy or exceed needs and expectations. Effectiveness is defined as the extent to which externally and internally defined objectives are fulfilled. Both qualitative and quantitative research methods were used. Interviews, seminars with employees, collection of human resource and effectiveness figures, and questionnaires completed by managers and subordinates were used to collect data. Managers with more Theory Y-oriented leadership values were rated by subordinates as high concerning quality methodologies and leadership behaviour dimensions. The subordinates of these managers tended to be healthier. Two of the studies identified common groups of leadership behaviours in effective and healthy organisations: strategy and vision, communication and information, authority and responsibility, learning culture, worker conversations, plainness and simplicity, humanity and trust, walking around and reflective personal leadership. These leadership behaviours fit into a leadership profile where all three of the dimensions of structure, relation and change are present. Of the three, the relation dimension is strongest and concluded to be a universal dimension. The developed PDSA model seems to be a leadership tool that influences both leadership values and behaviour, particularly in the area of relation-oriented leadership behaviours. An early warning system built on CUSUM- and Shewhartcharts concerning the health indicators of self-assessed general health and new sickcases per employee was also found to be a powerful and usable leadership tool. For future research, the explorative research findings can be quantitatively tested using representative and preferably cross-national data, with a longitudinal design.
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| 3. |
- Pålsson, David, 1986-
(author)
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The Prerequisites and Practices of Auditing Residential Care : On the Licensing and Inspection of Residential Homes for Children in Sweden
- 2018
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Doctoral thesis (other academic/artistic)abstract
- The aim of this dissertation is to describe and analyse the prerequisites and practices of auditing Swedish residential care for children. Residential care is a complex intervention provided to children in vulnerable life situations. The care is extensively delivered by private providers and shows difficulties in demonstrating clearly positive treatment effects. Licensing and inspections are policy instruments to address alleged quality problems in decentralised and marketised welfare services. However, in research there are mixed opinions on the ability of audits to generate improved service quality.The dissertation consists of four papers exploring central facets of the audit system. The empirical material is based on interviews (n=50) with inspectors and residential staff, documentation (n=286) in terms of guidelines and license/inspection decisions and observations (n=12) at inspection-related events. Each paper includes a unique set of data.Paper I analyses the controls that private residential homes undergo prior to their entry into the market. The results show that a majority of applicants are granted a license and that the controls do not reduce the need for ex post control. There is limited guidance on care content and research evidence is weakly incorporated in the controls. Overall, the state exerts limited influence over the composition and professional development of the care market.Paper II explores the operationalisation process of care quality in inspections. The results show that the standards display a marked variation and there is no differentiation between different residential homes. In general, the standards focus on reducing malpractice and not maximising care quality. In practice, the inspections are often discussion-based and standards relating to work with children are often indistinct.Paper III analyses how inspections are perceived by representatives from residential homes. The results show that inspections induce reflection and to some extent shape the administrative parts of care, but also that it is difficult to discern the actual impact of the inspections on the work. The inspections appear to bring a degree of stability and legitimacy to the work, but there are sometimes tensions between standards and professional judgment.Paper IV studies the influence the inspection process grants children in care. The results suggest that different inspectorial rationales (regulative, supportive and protective) may influence the agency children exert and that it is difficult to allow children’s views to have a substantial impact on the process. Overall, there tends to be a gap between what the children find important and what the audits can address in concrete terms.The theoretical ideas used to analyse the results are derived from institutional organisational theory and the thesis on the audit society. The overall analysis shows that 1) making certain core care aspects auditable and ensuring their impact is difficult (e.g., children-staff relationships, children’s views and use of research knowledge), 2) the system has a restrained character and is in many senses associated with inconclusive formative effects, 3) the use of uniform goals does not necessarily equal a more suitable care provision and 4) the audits signify strong symbolic values. Despite the limitations, the audits may help to discipline care providers, secure a minimum level relative to the audited care aspects and induce reflection among auditees.
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