When interpretation becomes unconscious action : A qualitative study on how unit managers evaluate staff competence based on quality care goals in the elderly care

As people live longer the elderly care faces a challenge to ensure caring for everyone, which contributes to an increased demand on recruitment. At the same time the amount of graduating assistant nurses over the last couple of years has been stagnant. Meanwhile, on a political level, there is an assumption that a higher education of employees leads to better quality of care. The purpose of this study is to investigate how unit managers within the elderly care industry assess employees educational and personal competence to gain knowledge of how competencies are valued and attributed in relation to quality. A qualitative study has been performed, where six individual interviews and one focus group interview was conducted. The thesis theoretical starting point for this study is new institutional organizational theory. The result presents how unit managers continuously are put under external pressure from individuals and organisations outside their field of expertise. Middle managers have a broad responsibility and need to assess each situation with industry expertise as well as common sense. This contributes to different interpretations of the concept’s competence and quality. The study shows that assistant nurse education lacks legitimacy among unit managers, which means that the skills in demand are valued low. The conclusion drawn from this study is that both educational and personal competencies are needed to meet the complex needs of the users in relation to the legitimacy of the business. The elderly care industry should be reorganized to capitalise on different types of skills to ensure meeting the demand and establishing a higher status for the professionals within the industry