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Syftet med denna processutvärdering har varit att kartlägga och analysera arbetet med lägesrapportering och medborgarlöften i Fagersta och Ludvika kommun. I linje med utvärderingssyftet ovan har frågeställningar som undersökts i processutvärderingen för respektive insats i båda kommunerna varit följande: Den första har handlat om vilka framgångsfaktorer, risker och hinder var som funnits utifrån de uppsatta målen och den andra om vilka förbättringsförslagen har varit för respektive insats.

Det empiriska materialet består av intervjumaterial och dokumentation av insatserna i Fagersta och Ludvika. Utvärderargruppen närvarade vid möten i EST-gruppen och lokala Brå i Fagersta, samt FAS-gruppen och lokala Brå Ludvika. Vid dessa tillfällen presenterades utvärderingens upplägg och planeringen för intervjuer. Därefter planerades intervjuerna. Åtta fokusgruppsintervjuer (med sammanlagt 34 deltagare) och tre individuella intervjuer genomfördes. Samtliga intervjuer genomfördes via Teams på grund av rådande omständigheter med Covid-19. Intervjuerna utfördes utifrån en anpassad intervjuguide bestående av semistrukturerade frågor.

Resultaten från processutvärderingen visar att likheterna mellan kommunerna överväger, men det finns också skillnader. I såväl Fagersta som Ludvika kommun utförs ett målinriktat brottsförebyggande arbete och det finns goda förutsättningar att stärka detta arbete. Utifrån resultat och analys av intervjuer kan ett antal slutsatser dras om framgångsfaktorer, risker och hinder, liksom möjliga förbättringsförslag identifierats avseende arbetet med lägesrapporter och medborgarlöften i berörda kommuner. De centrala slutsatserna för det pågående brottsförebyggande arbetet utifrån analysen av intervjumaterialet är följande:

* Arbetet med lägesrapportering har stärkt kommunernas kunskap om sina respektive lokala utmaningar* Kommunernas brottsförebyggande arbete skulle stärkas ytterligare av en mer tydlig och sammanhållen process* Återkopplingen till lägesrapporteringsgrupp och rapportörer behöver utvecklas* Kommunernas kan ytterligare stärka sitt förebyggande arbete genom att tydligare kommunicera de åtgärder som genomförs

In a group home with several apartments along a corridor we noticed that atmidday many of the residents’ doors were open, meaning that everybody whowalks along the corridor of the group home could see into the apartments and see what the resident did. We noticed that there are many scheduled supportservices during this time and asked the staff members why the doors are open.It is because it is easier to provide support

Background: Adults with profound intellectual (and multiple) disabilities need society’s support to live under “as normal circumstances” as possible. Support should be carried out in accordance with the Swedish disability policy vision of full participation in community and equality in living conditions.

Aim: To highlight and problematise the conceptualisation of participation, and how participation is achieved in implementation plans and in everyday life for adults with profound intellectual (and multiple) disabilities living in a group home or in their own home with support from personal assistants.

Method: Quantitative and qualitative methods were used to gain a deeper understanding of participation. In study I, 17 implementation plans were analysed. In study II, 27 social care managers and staff members were interviewed. In study III, 4 adults with profound intellectual (and multiple) disabilities living in a group home and their 13 staff members were observed.

Results: Documentation of participation focused on self-care and community, social, and civic life. In interviews with staff members and managers, the results showed that participation is abstract and hard to handle. Participation for the adults was about doing or being present in general daily activities. The conditions needed for facilitating participation were the adults’ capabilities, staff members’ knowledge, and resources in the social division. Moreover, the adults were listened to, supported in expressing their views, and their views were taken into account. However, they were not involved in decision-making processes nor did they share the power and responsibility for decision-making.

Conclusions: Participation for the adults is conditional, seldom involves decision-making processes, and is hardly ever connected to social contacts and leisure activities. In addition, attitudes about the adults’ capability present a barrier to participation. The social care division need to better enable and facilitate participation by changing the conditions as well as educating the staff around changing their attitudes about the adults’ capabilities. Managers and staff members need to have a shared understanding of what participation entails so that they all work in the same direction. Furthermore, the International Classification of Functioning, Disability and Health (ICF) can be used as a tool when drawing up individual plans so that the adults’ wishes and preferences are considered. Shier’s ladder of participation can be an instrument to increase participation in daily life for adults with PI(M)D.

Keywords: everyday life, participation, profound intellectual and multiple disability, social care

The aim of this project was to evaluate the staff’s experiences of using the Tovertafel for Adults in a care facility for people with Autism and intellectual disability, and whether the use of the Tovertafel for Adults, according to the staff, elicited any developments in the users with a focus on social interaction.

Syftet med projektet var att utvärdera personals erfarenheter av Tovertafel Vuxens inverkan på den sociala interaktionen på en daglig verksamhet för personer som har autism och intellektuell funktionsnedsättning.

The purpose of the project was to evaluate the staff’s experience of using Tovertafel UP at a daily activities centre and determine whether, according to the staff, the use of Tovertafel UP results in any development for people with intellectual disabilities with focus on physical activities and social interaction.

Syftet med projektet var att utvärdera personals erfarenheter av att använda Tovertafel UP på en daglig verksamhet för personer med intellektuell funktionsnedsättning och om användandet av Tovertafel UP enligt personalen innebar någon utveckling för användarna med fokus på fysiska aktiviteter och social interaktion.

Purpose: This study investigated what areas of International Classification of Functioning, Disability and Health were documented in implementation plans for adults with profound intellectual disability or profound intellectual and multiple disabilities with focus on participation.

Methods: A document analysis of 17 implementation plans was performed and International Classification of Functioning, Disability and Health was used as an analytic tool.

Results: One hundred and sixty-three different codes were identified, especially in the components Activities and participation and Environmental factors. Participation was most frequently coded in the chapters Community, social and civic life and Self-care. Overall, the results showed that focus in the implementation plans concerned Self-care and Community, social and civic life. The other life areas in Activities and participation were seldom, or not at all, documented.

Conclusions: A deeper focus on participation in the implementation plans and all life areas in the component Activities and participation is needed. It is important that the documentation clearly shows what the adult wants, wishes, and likes in everyday life. It is also important to ensure that the job description for staff contains both life areas and individual preferences so that staff have the possibility to work to fulfill social and individual participation for the target group.

• Implications for rehabilitation

• There is a need for functioning working models to increase participation significantly for adults with profound intellectual disability or profound intellectual and multiple disabilities.

• For these adults, participation is achieved through the assistance of others and support and services carried out must be documented in an implementation plan.

• The International Classification of Functioning, Disability and Health can be used to support staff and ensure that information about the most important factors in an individual’s functioning in their environment is not omitted in documentation.

Participation is the goal of Swedish disability policy, but it is difficult to achieve for adults with profound intellectual (and multiple) disabilities (PI(M)D). Since these adults are dependent on others in every aspect of their lives, others control their ability to participate in everyday life decisions. This study used observations, analyzed with Shier’s ladder of participation, to elucidate and describe participation in daily life for adults with PI(M)D living in a group home. The results showed that the adults often reached the first three levels of Shier’s ladder, one adult reached the fourth level once, and no one reached the fifth level. Participation on a higher level, therefore, seems hard to reach for adults. Staff members’ attitudes toward the adults’ capability can also be a barrier to participation. Applying Shier’s ladder of participation can provide valuable information that might lead to increased participation in daily life for adults with PI(M)D.

Background

Participation is a central aspect of quality of life, and it is indicative of high‐quality outcomes for people with intellectual disabilities. However, participation is difficult to achieve for adults with profound intellectual and multiple disabilities.

Aim

To describe staff members’ perceptions of what participation means for adults with profound intellectual and multiple disabilities.

Method

Using a phenomenographic approach, 27 interviews were analysed resulting in variations in the conditions for participation.

Results

The interviews revealed conditions for participation at individual, staff and organisational levels.

Conclusion

Participation appears to be an un‐reflected phenomenon, and several conditions must be met to achieve it. The conditions are experienced being fundamental for adults within the target group to achieve any kind of participation. The staff members and managers’ perceptions of participation as conditional can make it more difficult for adults within the target group to achieve the Swedish disability policy goal of participation.