Professionalized through audit? Care workers and the new audit regime in Sweden

Abstract

The professionalization of social care workers is a policy goal in many welfare states. At the same time, professionalization risks being undermined by enhanced audit. The objective of this article is to analyze whether the audit processes adopted in Swedish eldercare and childcare support or undermine the professionalization of the occupations working there, i.e., nurses, nursing assistants, preschool teachers, and preschool assistants. In particular, we investigate whether the three main forms of audit-standardsetting, inspections, and quality measurements-support or undermine the occupations' ability to achieve professional closure and enhance their external and internal autonomy. The findings suggest that audit processes in eldercare risk undermining professionalization, while in childcare the pattern is reversed: audit appears supportive of professionalization, at least for preschool teachers. This finding suggests that audit processes do not have to be detrimental to professionalization.

Small is beautiful? Explaining resident satisfaction in Swedish nursing home care

“…While marketization reforms have led to an increase in the proportion of privately managed NHs, they remain publicly funded [32]. All NHs, both public and private, are subjected to the same national quality reporting requirements, user safety regulations, and auditing measures [33]. This study includes all NHs in Sweden providing care to individuals over 65 years of age in 2016, excluding facilities offering only short-term care.…”

Beyond auditor and auditee: exploring the governance of performance in eldercare

“…In terms of implications for practice, previous research in social services shows that vague quality and performance standards affect audit practices in several ways (e.g. Munro 2004;Moberg, Blomqvist, and Winblad 2018;Blomqvist and Winbladh 2020).…”

Explaining variations in enforcement strategy: A comparison of the Swedish health care, eldercare, and compulsory school sector

“…Auditing in Swedish social services is a shared responsibility between the national and the regional and local levels of government. Local and regional auditing vary substantially, but at the national level, there has been an increased reliance on state inspections during the last decades (Moberg et al, 2018; Rönnberg, 2012). For the compulsory school sector, the increased reliance on inspection can be attributed to two reforms from 1992: (i) the decentralization of political responsibility from the national to the local governments and (ii) the opportunity for private schools to establish in the local school market (Government Bill, 2008).…”