Sheltered accommodation and the definition of quality in the interface between social services, the non-profit sector and the business sector

Although the provision of sheltered accommodation is perhaps one of the most important interventions for people who have been exposed to violence in a close relationship, it is an area that is relatively unexplored in Sweden. Nowadays, sheltered accommodation is run by municipalities as well as non-profit and private actors, and placements are purchased within the framework of the municipal social services.

Previously, non-profit actors have been very prominent in this area, not least in the form of the women's shelter movement, but there has been a shift towards more and more private actors. A key aspect of competitive tendering and procurement is quality, meaning the quality of the welfare services that are provided. The aim of the current project is to investigate how the actors involved in public administration, commercial companies or non-profit organisations, but also victims of violence, define quality in the provision of sheltered accommodation. Based on an overall qualitative case study design, five municipalities are being examined where documents and experiences from both municipal officials and politicians, as well as non-profit organisations, private actors and victims of violence, are analysed. The results of the study will be used to develop the work of public, private and non-profit actors in the support of victims of violence and, in particular, the specific form of support that sheltered accommodation provides for people who have been exposed to violence in close relationships.

The researchers responsible for the project are Veronica Ekström and Johan Hvenmark. The project is a collaboration between the Centre for Civil Society Research (CCF) and the Department of Social Sciences (ISV) at Marie Cederschiöld University. This means that it is connected to the research networks within CCF and the civil society research that has been conducted there since the mid-1990s, and to the network of researchers on violence currently at ISV. The project intends to set up a reference group that follows and provides feedback on what is being done within the project.

PROBLEM AREA AND THEORETICAL STARTING POINT

Sheltered accommodation is a crucial intervention in the work of social services in the support of victims of violence (Ekström 2018); it is primarily non-profit associations with links to the women's shelter movement that have operated the accommodation in Sweden (e.g., Enander et al. 2013; Lundström & Svedberg 2003), while public actors and commercial companies have together run about 25% (Swedish National Board of Health and Welfare 2013, 2015). At the same time, a number of changes have been highlighted in this area, some of which have been attributed to the changes in the Swedish welfare state described above. Enander et al. (2013) describe, for example, how many women's shelters, and thereby also much of the sheltered accommodation, have gradually left their non-profit roots to become more and more like the professional providers of social services, in part due to requirements set in public procurement and the Social Services Act (SFS 2001: 453). At the same time, some women’s shelters providing accommodation have chosen to withdraw from the tender procedures in public municipal procurement processes for similar reasons. Jenny Westerstrand, chair of the National Organization for Women's Shelters and Girls' Shelters in Sweden, put it this way in a press release from 5 March 2019 under the heading "Women's shelters are being pushed aside by venture capitalists”:

“We are forced to /… / leave the field we have worked in for more than forty years. /… / The tender procedure reflects a completely different logic. The municipalities' demands exclude our women's shelters, which are non-profit associations. ” (www.mynewsdesk.com/se/roks/pressreleases/)

The Swedish model for the provision and consumption of welfare services, where the public sector is responsible for both financing and operation based on ideas of solidarity and equality, has changed sharply in recent decades (Blomqvist 2016; Blomqvist & Rothstein 2000).This has taken place not least through the continuous deregulation and competitive tendering of much of the welfare sector. This has meant, among other things, that the previous dominance of public contractors has been changed in favour of primarily actors from the business community, but also from civil society (e.g. Hartman 2011; Winblad et al. 2015). In order to buy the best care at the lowest cost, most municipalities devote a lot of time and resources to extensive effort in the procurement of individual and family care (Sallnäs & Wiklund 2018). Part of this change relates to the Swedish Public Procurement Act (LOU), which was introduced in the early 1990s, and the associated public procurement system, which has an almost SEK 700 billion annual turnover (www.upphandlingsmyndigheten.se) and whose consequences have been presented as both ambiguous (Hartman 2011) and threatening (Dahlgren 2008; Riksrevisionen 2014). At the same time, it has been found that many municipalities have not been that good at negotiating and managing the contracts they have entered into (Forkby & Höjer 2008; SKL, 2010; Konkurrensverket 2015).

There are currently several examples of both municipalities as procurers and women's shelters as providers of sheltered accommodation that bypass LOU to instead enter into long-term so-called voluntary sector organisation public partnerships (IOPs). Such an example can be found in Eskilstuna, where the Women's Shelter MOA and Eskilstuna municipality have created an IOP and which the chairman of the social committee commented on as follows:

"This is our second IOP in a short time /… /. The contract with the Women’s shelter MOA opens up opportunities to better reach and help people in vulnerable situations. ” (www.upphandling24.se/partnerskap-ger-skydd-i-eskilstuna)

A central aspect of the welfare system within which these changes take place is the quality, meaning the quality of the welfare service that is produced. The Swedish Public Procurement Act (SFS 2016: 1145) states, for example, that a basis for evaluating tenders is finding the “best relationship between price and quality”. Another example is found in the Swedish Social Services Act (SFS 2001: 453) where it is stated that interventions used within the social services must be of "good quality" (Chapter 3, Section 3) regardless of whether they are performed by a public, private or non-profit actor. Although attempts have been made to describe quality and what quality means (e.g. the Swedish National Board of Health and Welfare 2015), in particular in health and social care, it seems to be a relatively unexplored area (see Forkby and Höjer 2008; Hartman 2011). This could be due to the fact that an unambiguous definition does not exist because quality can have both objective and subjective elements (see Garvin 1984).

OVERALL AIM AND SPECIFIC RESEARCH QUESTIONS

Based on the above, the aim of the current project is to investigate how the actors in public administration, commercial companies and non-profit organisations, as well as victims of violence, interpret quality in relation to sheltered accommodation. To operationalise this aim, the project focuses on three empirical arenas where these organisations and actors are found, and where thoughts about and definitions of quality in relation to sheltered accommodation are thought to occur and play a role. The first of these arenas consists partly of the public procurement of sheltered accommodation and partly of the processes that lead to the establishment of IOPs around sheltered accommodation. Here the project intends primarily to answer questions that have to do with the motivations and arguments regarding quality and that are cited by the actors involved in these processes and negotiations. The second arena in the project is about the work of social services related to investigating needs, making assessments and taking decisions about various interventions in the form of sheltered accommodation. The key issue here is how the public officials involved assess the meaning of quality in relation to the cases that are handled. The third arena concerns both non-profit organisations and commercial companies that own and operate sheltered accommodation as well as the victims of violence who stay/have stayed in these. Here the project is primarily interested in questions about differences/similarities in what is viewed as quality between non-profit and commercial actors, but also from the perspective of victims of violence who have lived in sheltered accommodation.

RELATIONSHIP TO PREVIOUS RESEARCH

Knowledge concerning sheltered accommodation in a Swedish context is very limited. We have not found any theses in searches for research about sheltered accommodation, shelters or refuges. Searches for peer-reviewed studies yield few hits. In a study by Weinehall and Jonason (2009), women in sheltered accommodation were interviewed about their lives and the impact of living in sheltered accommodation. There is also one study that specifically deals with sheltered accommodation for people who have been exposed to honour-related violence and oppression (Wikström & Ghazinour, 2010).

Ekström (2016) does not study sheltered accommodation per se, but the support by social services given to women exposed to violence. Sheltered accommodation is described as a crucial intervention for women exposed to violence, but the work of the social services is hampered by access to placements. It often takes a lot of time for social workers to look for vacant places, which are especially difficult to find for some groups of women. These include women with multiple children and women who have problems with substance abuse. The very difficult situation in the housing market in some parts of the country also contributes to women staying in sheltered accommodation for longer periods than they actually need to since the social services, or the women themselves, do not find other solutions in the search for a new home.

As mentioned above, it has been seen that the country's municipalities have themselves not been good at negotiating and managing the contracts they have entered into (Forkby & Höjer 2008; SKL, Swedish Association of Local Authorities and Regions, 2010; The Swedish Competition Authority 2015). To our knowledge, there are no studies that specifically examine accommodation for victims of crimes of violence, but there are studies that have examined other, closely related areas of individual and family care. Storbjörk and Samuelsson (2018) have investigated the care of those with problems with substance abuse and addiction. Public procurement and framework agreements tend to limit the users’ ability to influence the kind of care they can receive. Their results also show that social workers are expected to first and foremost choose the municipality’s own facilities. However, the application of framework agreements seems to vary between municipalities in a somewhat unpredictable way. Forkby & Höjer (2018) have examined social services’ placements in the social childcare market. A clear result in their study is that many social workers deviate from the framework agreements when they have to make individual decisions. Both investigations and action plans were so loosely followed that they have limited value for how future care is to be conducted. The risk of incorrect placements will then be high.

METHOD AND MATERIAL

Based on an overall qualitative design with a comparative potential, the participating researchers will work with empirical material derived from five case studies. Some of these municipality-based case studies deal with more traditional procurements where companies have ultimately entered into contracts with the municipal social services to provide sheltered accommodation for victims of violence. Some of the case studies are about IOP collaborations where the municipalities in question have, without a procurement process, instead chosen to conclude contracts with non-profit organisations for the provision of sheltered accommodation. The empirical material that will be collected and analysed consists partly of documents related to municipalities, companies and non-profit organisations which concern everything from the procurement processes, IOP negotiations and contracts to internal investigations, statements and evaluations. It will also include more organisation-specific documents, such as annual reports and strategy formulations. In parallel with this, focus group interviews and interviews with individuals will also be conducted.

The focus group interviews will be held with management groups in the companies and non-profit organisations included in the case studies, but also with social services officers in the four different municipalities. In the same way, individual interviews will be conducted with elected politicians in the municipalities concerned, representatives for the sheltered accommodation, and victims of violence who have previously lived in one of the sheltered housing accommodations covered by the project.