Samverkan Gävleborg 2022 is a four-year integration project funded by the European Union. The County Administrative Board of Gävleborg is the project owner. The project includes eight municipalities in Gävleborg, RF-Sisu, and the University of Gävle. In each participating organization, there is a sub-project manager responsible for overseeing local work and reporting to the County Administrative Board.

This work report examines the process from the time third-country nationals (TLM) arrive in a municipality until they gain employment or participate in various activities. The work is based on data accessible to the municipalities for a total of 37 individuals from eight Gävleborg municipalities. Additionally, sub-project managers participated in a workshop where they reflected on the process, and these reflections are part of the report's foundation. The compilation shows that TLMs need to register their residence, receive support through the Swedish Public Employment Service's establishment program, enroll in Swedish for Immigrants (SFI), and gain work experience. The most common activities are SFI, followed by some form of internship. Between each activity, there is typically a waiting period. It is easy to view this waiting period as passive time when the individual is not involved in any organized activity. However, the person can engage in certain activities while waiting for decisions from Migrationsverket (the Migration Agency) or other authorities. There can be active waiting times, meaning waiting periods should not always be equated with passive time.

Municipalities often play a critical role in supporting individuals and ensuring waiting times do not become entirely passive. The individuals may need both practical assistance and cognitive and emotional support.

This report was written in collaboration with the University of Gävle and the municipality of Ovanåker.

Samverkan Gävleborg 2022 är ett fyraårigt integrationsprojekt som finansieras av Europeiska unionen. Länsstyrelsen Gävleborg är projektägare.  I projektet ingår åtta kommuner i Gävleborg, RF-Sisu och Högskolan i Gävle. I varje medverkande organisation finns en delprojektledare som håller i det lokala arbetet och som rapporterar till Länsstyrelsen.

I denna arbetsrapport studeras processen från det att tredjelandsmedborgare (TLM) kommer till en kommun och till dess personen får arbete eller blir delaktig i olika aktiviteter. Arbetet bygger på data som kommunerna har tillgång till för totalt 37 individer från åtta Gävleborgskommuner. Delprojektledarna har även i en workshop fått reflektera över processen. Dessa reflektioner utgör också en del av rapportens underlag. Sammanställningen visar att TLM behöver folkbokföras, få stöd genom Arbetsförmedlingens etableringsuppdrag, komma in i svenska för invandrare och pröva på arbetslivet. De vanligaste aktiviteterna är SFI följt av någon typ av praktik. Mellan varje aktivitet uppkommer som regel en väntetid. Det är lätt att se på denna väntetid som passiv tid när individen inte deltar i någon organiserad aktivitet. Emellertid kan personen delta i viss verksamhet även om hen väntar på att få ett beslut från Migrationsverket eller annan myndighet. Det kan finnas aktiva väntetider och det går därför inte jämställa väntetid med passiv tid.

Kommunerna har många gånger en viktig roll för att stödja individerna och för att motverka att väntetider blir just passiv tid. Individerna kan behöva såväl praktisk hjälp som kognitivt och emotionellt stöd. 

Rapporten är skriven genom ett samarbete med Högskolan i Gävle och Ovanåkers kommun.

Bokens abstract

Socionomer och socialvetare har en central roll i utvecklingen av välfärdssamhällets viktiga samhällsinstitutioner, och kunskap är en förutsättning för att effektivt navigera och påverka för social förändring, social sammanhållning och för att ge skydd och stöd för utsatta grupper och individer. Fram till nu har det saknats en lärobok som beskriver de senaste decenniernas förändringar i socialförsäkringen och dess konsekvenser. 

Socialförsäkringar för socionomer redogör för de grundläggande principerna för ersättningar och fördelningssystem, och diskuterar hur dessa system upplevs av dem som befinner sig i situationer där behoven är som störst samt hur olika grupper påverkas av regelförändringar och styrning. Röster från fältet, exempelvis legitimerade hälso- och sjukvårdskuratorer, ger insikt i hur regelverket fungerar i relation till människors behov. Boken för fram argument för hur välutformade socialförsäkringar förebygger sociala problem, jämnar ut skillnader mellan grupper och faseri livsloppet samt motverkar social ojämlikhet.

Socialförsäkringar för socionomer vänder sig till socionomstudenter och yrkesverksamma inom socialt arbete i Sverige, och är en viktig resurs för alla som är involverade eller intresserade av hur socialförsäkringar kan och bör fungera i ett modernt välfärdssamhälle. 

Abstract till kapitel

Alla ska med? Om socialförsäkring och försörjning

Sven Trygged

Det finns en lång rad stödformer för att förbättra människors ekonomi när arbetsinkomster saknas eller inte räcker till. Basen i försörjningssystemet är den allmänna socialförsäkringen som i sin tur består av olika delar. Ersättningen från försäkringen ska göra det möjligt att klara sin försörjning även när man inte arbetar. Systemet är till sin konstruktion könsneutralt och lika för alla, men ersättningarna bygger samtidigt på arbetsinkomster där det finns stora skillnader. Vilken ersättningsnivå är rimlig? Hur ska fördelningen av ekonomiska resurser se ut? I kapitlet belyses frågor om försörjning, arbetslinjen, ersättningars utformning och på vilka grunder ersättningar kan ges. 

BACKGROUND: Marketisation trends have introduced new elements in residential care homes, potentially related to the psychosocial work environment and well-being of care workers. OBJECTIVE: This study examines differences in job demands and resources across public, outsourced, and private residential care home providers and their associations with care workers’ burnout, job satisfaction, and turnover intentions. METHODS: Data from 253 care workers across 19 residential care homes in three municipalities were analysed using a cross-sectional design, with a 45.3% response rate. We applied the Job Demands-Resources theory and the Copenhagen psychosocial questionnaire, conducting analyses of variance to assess differences and multiple regressions using Generalised Estimating Equations, accounting for the nested structure of the data. RESULTS: Our findings were mixed, with job demands and resources differing across provider types. Outsourced care workers reported higher emotional demands than public sector ones, while private providers offered greater autonomy and supervisor support than public ones. Outsourced workers rated higher levels of burnout than those in public settings, although this difference was non-significant after adding other factors to the model. Statistically significant differences in burnout levels were observed between municipalities. Private care workers reported higher job satisfaction than public ones. About 60% of respondents sometimes or more frequently considered leaving their jobs. Public care workers reported higher turnover intentions than those working for for-profit providers. CONCLUSIONS: This study contributes to understanding how provider type, job demands, and resources relate to care workers' well-being. Further comparative research could help clarify the impact of municipal differences versus provider types.

Sweden has long pursued activation policies, particularly towards vulnerable groups in the labour market, with the Swedish Public Employment Service (PES) being the main agent of these policies. Recent cutbacks and organisational changes within the PES have significantly altered the support offered, particularly affecting migrants with low education and little work experience. This study investigates how these migrants experience encounters with the PES after the initial establishment period. A total of 23 refugees, mostly women, participated in semi-structured interviews that were analysed thematically. The interviewees struggled with job applications and requested personal encounters with the PES’s caseworkers, which was often denied. Classification played a role in relation to support from the PES; for example, it seemed that activities offered were based on gendered classifications, limiting some of the women. Furthermore, despite the activation policies, we discerned a risk of becoming inactive, especially because some interviewees believed that they should wait to be contacted by the PES to be offered a job or job-related activity. This calls for a different approach by the PES with more flexibility, practical support and opportunities for in-person meetings.

The exercise of self-determination is a human right; however, for people with dementia (PWD), progressive physical and cognitive impairment negatively affects their decision-making processes. For PWD, it is often relatives who make such decisions. This qualitative study included interviews with sixteen relatives of PWD who live in nursing homes. Research questions are as follows: How do relatives understand the participation of PWD who live in nursing homes? How do co-researchers understand participation and the role of relatives? A co-researcher was consulted when the questions were designed. During the interviews with relatives, photos were used to stimulate discussion. Critical situations in nursing homes were discussed with relatives and later interpreted together with a co-researcher. The findings included an understanding of how relatives played a key role in PWD; however, relatives were concerned that PWD were unable to take part in decisions. In addition, relatives named ways that nursing homes opposed human rights, and the co-researchers also highlighted situations that conflicted with human rights. Classifying dementia as a disability at the policy level could strengthen the rights issues of PWD. The key findings of the study are essential for social workers arranging for placement of PWD in nursing homes. 

People living in nursing homes have the right to self-determination, and difficulty in accommodating this right can create moral distress in staff. This study aimed to explore experiences of situations of moral distress and to identify nursing home staffs’ needs to act with moral agency. Six group interviews were conducted with nursing home staff. Content analysis of the interview responses showed that moral distress can be rooted in both concrete situations with residents and factors related to the work environment and policy requirements. Personnel can address moral distress through both active and passive means. Staff acted to address moral distress mainly in situations with residents and sometimes in relation to co-workers, but they did not try to influence the policy level. 

Authorities and civilians can make a report-of-concern to Social Services if they suspect a child is experiencing or witnessing violence. In 2021, Sweden implemented new legislation that considers children as victims of crime not only when abused but also when witnessing family violence, i.e., Barnfridsbrott. This study aimed to describe and analyze reports-of-concern regarding children witnessing family violence. Are there any changes in number of reports over the years? Who is reporting? And what interventions are most frequent? This is a register-based study of reports-of-concern in Gävle municipality in Sweden for the years 2018–2022. This unique register makes it possible to identify and follow up reported cases as long as they are active by Social Services. Results show there was already a major increase in the number of reports-of-concern in 2020. Most reports are made by Social Services and the police. Of all reports related to family violence, an increasing number lead to further investigations. In most of those cases, the children stay with their families, and Social Services offer counselling. Conclusion: there was a distinct increase in reports related to children witnessing family violence already starting in 2020 in the studied municipality, before the new legislation was implemented.

För många migranter från utomeuropeiska länder tar det lång tid att etablera sig i Sverige. Det gäller i synnerhet personer med låg utbildning, och särskilt kvinnor som saknar erfarenhet av lönearbete i hemlandet. Denna rapport handlar om migranter i Gävleborgs län, som fått asyl i Sverige, avslutat etableringsperioden och stod utanför den reguljära arbetsmarknaden år 2020. Under 2020 genomfördes intervjuer med 23 personer i tre kommuner som gick på SFI. Knappt tre år senare (2023) kontaktade vi deltagarna igen för att ta reda på om de kommit närmare arbetsmarknadsetablering och hur de såg på sin livssituation och framtid. Vi fick kontakt med 13 personer varav 8 medverkade i en ny intervju. För att öka förståelsen för migranternas perspektiv har vi dessutom intervjuat 10 personer från andra kommuner med liknande bakgrund och livssituation som de ursprungliga deltagarna. Resultaten visar att nästan alla respondenter hade kommit närmare arbetsmarknaden och såg ljusare på tillvaron än under 2020. Samtliga hade kommit ut på arbetsplatser genom praktik och anställningar, och många hade gått eller gick på yrkesutbildningar. Att behärska svenska språket upplevdes centralt. Det betraktades som nyckeln till att kunna få ett arbete, samtidigt som arbetet sågs som det bästa sättet att utveckla språket. Det förefaller vara ganska stora skillnader mellan vilket stöd migranter i olika kommuner får. Migranterna uttryckte också stora variationer avseende behov av stöd, vilka hinder de mötte, och i vilken utsträckning de kunde styra sin tillvaro och bestämma en väg framåt. Alla var motiverade till att arbeta och skapa en bättre framtid för sig och sina barn, men det var tydligt att myndigheterna behöver anpassa sina insatser till varje persons individuella förutsättningar för att kunna realisera detta. 

In the wake of welfare sector reforms and the increasing marketisation of eldercare services, nursing home first-line managers (FLMs) are confronted with escalating work demands within streamlined organisations. Given this background, the aim was to investigate FLMs’ perceptions of their psychosocial work environment and of differences between nursing home ownership types. Nineteen managers from three Swedish municipalities from municipal, outsourced, and private nursing homes participated in semi-structured interviews focused on job demands, job resources, and ownership differences. The FLMs’ perceptions were interpreted as forming two themes. Navigating challenges: striving to cope with demands highlighted various challenges, including recruitment, workload, and lack of organisational support. Key stressors encompassed personnel struggles, time constraints, and complex interactions. Influence of ownership dynamics on the work environment explored variation across ownership types. Private nursing home managers enjoyed more decision-making autonomy but faced more scrutiny than did municipal ones. FLMs in outsourced homes described unique stressors, notably uncertainty and increased workload due to the procurement process. These findings underscore the potential need for tailored systemic changes across different ownership types. The policy implications include enhancing communication and support in municipal homes, reducing the span of control in private homes, and revising the procurement process in outsourced homes. These insights suggest that further research outlining differences between ownership types, particularly private and outsourced nursing homes, is warranted. Such research could aid in formulating specific strategies tailored to each ownership type in order to enhance the psychosocial work environment for FLMs in nursing homes.