Lex Sarah i individ- och familjeomsorgen

– utredningar av missförhållanden och dess konsekvenser

Authors

  • Inger Kjellberg
  • Karin Berg

DOI:

https://doi.org/10.64098/SVT.2025.32.1.61067

Keywords:

Individ och familjeomsorg, Missförhållanden, Lex Sarah

Abstract

Reporting of mistreatments (colloquially lex Sarah) is regulated in the Social Services Act and mandatory for all staff working in social services and social care. Since 2011 the provision also applies to individual and family care, and research is still lacking. The reports are investigated by Designated Officials (investigators) employed within the municipality. This study examined how the reported incidents of mistreatment concerning children in individual and family care were assessed, focusing on how the consequences for children were described. 57 reports with investigations from one region were first analyzed using content analysis, thereafter Carol Bacchi’s policy analytical framework was used to discern different problem representations of mistreatments in the investigations. The results showed that the consequences for the children were handled in three ways: they were investigated, the consequences described by reporting staff were overlooked in the investigation, and consequences were not investigated. In the analysis, different understandings of mistreatments emerged. Mistreatments were primarily understood as systematic deficiencies where consequences for the children were made invisible but also as the damage or harm the child suffered. Assessments of mistreatments, as well as its degree of seriousness, varied considerably between investigations, which indicated that serious reports to IVO rested on different interpretations of what was considered serious. The results suggest that it is unclear in what way lex Sarah contributes to quality development and learning from mistakes in individual and family care.

References

Bacchi, C.L. (2009). Analysing policy: what’s the problem represented to be? Pearson.

Bacchi, C.L. & Goodwin, S. (2016). Poststructural policy analysis: a guide to practice. Palgrave Pivot. DOI: https://doi.org/10.1057/978-1-137-52546-8

Berg, K. & Kjellberg, I. (2022). Designated officials’ approaches to judging serious incidents: an analysis of incident reports in care for older people, disability services and family services in Sweden. European Journal of Social Work, 26(5), s. 922–934. doi:org/10.1080/13691457.2022.2155801 DOI: https://doi.org/10.1080/13691457.2022.2155801

Benbenishty, R., Davidson-Arad, B., López, M., Devaney, J., Spratt, T., Koopmans, C., Knorth, E.,

Witteman, C., Del Valle, J. & Hayes, D. (2015). Decision making in child protection: an international comparative study on maltreatment substantiation, risk assessment and interventions recommendations, and the role of professionals’ child welfare attitudes. Child Abuse & Neglect, 49, s. 63–75. doi:org/10.1016/j.chiabu.2015.03.015doi:org/10.1016/j.chiabu.2015.03.015 DOI: https://doi.org/10.1016/j.chiabu.2015.03.015

Björne, P., Deveau, R. & Nylander, L. (2021). Passing laws is not enough to change staff practice: The case of legally mandated “incident” reporting in Sweden. Journal of Intellectual and Developmental Disability, 46(2), s. 186–196. doi:org/10.3109/13668250.2021.1873751 DOI: https://doi.org/10.3109/13668250.2021.1873751

Dickens, J., Cook, L., Cossar, J., Okpokiri, C., Taylor, J & Garstang, J. (2023). Re-envisaging professional curiosity and challenge: Messages for child protection practice from reviews of serious cases in England. Children and Youth Services Review, (152)107081, s. 1–9. doi:org/10.1016/j.childyouth.2023.107081 DOI: https://doi.org/10.1016/j.childyouth.2023.107081

Drisko, J., & Maschi, T. (2015). Content analysis. Oxford University Press. DOI: https://doi.org/10.1093/acprof:oso/9780190215491.001.0001

Ebsen, F., Leth Svendsen, I., Pape Thomsen, L. & Jørgensen, S. (2023). Decisions in Child Protection—Heuristics, Law and Organisation. The British Journal of Social Work, 53(5), s. 2940–2957. doi:org/10.1039/bjsw/bcad065 DOI: https://doi.org/10.1093/bjsw/bcad065

Forkby, T., Höjer, S., & Liljegren, A. (2016). Making sense of common sense: examining the decision-making of politically appointed representatives in Swedish child protection. Child & Family Social Work, 21(1), s. 14–25. doi:org/10.1111/cfs.12100 DOI: https://doi.org/10.1111/cfs.12100

Fransson, S. (2013). Yttrandefrihet och whistleblowing. Om gränserna för anställdas kritikrätt. Premiss förlag.

Heimer, M., Näsman, E. & Palme, J. (2018). Vulnerable children’s rights to participation, protection, and provision: The process of defining the problem in Swedish child and family welfare. Child & Family Social Work, 23(2), s. 316–323. doi:org/10.1111/cfs.12424 DOI: https://doi.org/10.1111/cfs.12424

Keddell, E., & Hyslop, I. (2020). Networked decisions: Decision-making thresholds in child protection. The British Journal of Social Work, 50(7), s. 1961–1980. doi:org/10.1093/bjsw/bcz131 DOI: https://doi.org/10.1093/bjsw/bcz131

Kjellberg, I., Berg, K. & Österberg. T. (2023). Exploring mandatory reporting in social care and social services in Sweden. International Journal of Social Welfare, 33(1), s. 29–41. doi:org/10.1111/ijsw.12588 DOI: https://doi.org/10.1111/ijsw.12588

Kjellberg, I. (2012). Klagomålshantering och lex Sarah och lex Sarah-rapportering i äldreomsorgen. En institutionell etnografisk studie. Diss. Göteborgs universitet. Tillgänglig på: http://hdl.handle.net/2077/30633

Lundström, T., Pålsson, D., Sallnäs, M. & Shanks, E. (2021). A Crisis in Swedish Child Welfare? On Risk, Control and Trust, Social Work & Society, 19(1), s. 1–15.

Mattsson, T. (2017). Våld i barnavårdsutredningar: om socialtjänstens ansvar och viljan att veta. Gleerups.

Platt, D. & Turney, D. (2014). Making threshold decisions in child protection: A conceptual analysis. The British Journal of Social Work, 44(6), s. 1472–1490. doi:org/10.1093/bjsw/bct007 DOI: https://doi.org/10.1093/bjsw/bct007

Power, M. (1999). The Audit Society. Rituals of Verification. Oxford University Press. DOI: https://doi.org/10.1093/acprof:oso/9780198296034.001.0001

Preston-Shoot, M. (2018). What is Really Wrong with Serious Case Reviews?, Child Abuse Review, 27(1), s. 11–23. doi:org/10.1002/car.2487 DOI: https://doi.org/10.1002/car.2487

Proposition 2009/10:131 Lex Sarah och socialtjänsten – förslag om vissa förändringar.

Rees, A.M., Fatemi-Dehaghani, R., Slater, T., Swann, R. & Robinson, A.L. (2021). Findings from a Thematic Multidisciplinary Analysis of Child Practice Reviews in Wales. Child Abuse Review 30(2), s. 141–154. doi:org/10.1002/car.2679 DOI: https://doi.org/10.1002/car.2679

Riksrevisionen (2023). Lex Maria och lex Sarah – statens arbete mot vårdskador och missförhållanden inom vård och omsorg av äldre (RiR 2023:4). Tillgänglig på: https://www.riksrevisionen.se/rapporter/granskningsrapporter/2023/lex-maria-och-lex-sarah---statens-arbete-mot-vardskador-och-missforhallanden-inom-vard-och-omsorg-av-aldre.html

SFS (1993:387). Lag om stöd och service till vissa funktionshindrade

SFS (2025:400). Socialtjänstlag.

Socialstyrelsen (2014). Lex Sarah. Handbok för tillämpningen av bestämmelserna om lex Sarah. Socialstyrelsen.

SOSFS 2011:5 Socialstyrelsens föreskrifter och allmänna råd om lex Sarah.

Taylor, B. (2017). Heuristics in professional judgement: A psycho-social rationality model. The British Journal of Social Work, 47(4), s.1043–1060. doi:org/10.1093/bjsw/bcw084 DOI: https://doi.org/10.1093/bjsw/bcw084

Östberg, F. (2010). Bedömningar och beslut: från anmälan till insats i den sociala barnavården. Diss. Institutionen för socialt arbete, Stockholms universitet.

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Published

2025-11-26

How to Cite

Kjellberg, I., & Berg, K. (2025). Lex Sarah i individ- och familjeomsorgen: – utredningar av missförhållanden och dess konsekvenser. Socialvetenskaplig Tidskrift, 32(1). https://doi.org/10.64098/SVT.2025.32.1.61067

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